NHS Addiction detox services :How Quickly Can I Be Seen?

NHS Addiction Detox Services. They exist, right?

Well, for a start, the NHS is not responsible for providing drug and alcohol services.

All local services are provided by your local authority. They are the ones responsible for providing services, are at liberty to commission any provider. A charity, the NHS, third sector provider or even provide it themselves.

Services differ from county to county.

All provide similar services for heroin and cocaine users while the provision for alcohol can differ.

They may, or may not, fund a residential rehab for you but the process can be long and arduous.

NHS Addiction detox services:How Does It Work?

In complicated ways!

It really is a postcode lottery.

Your local authority commission’s services and thus has control over what is provided. Some will provide residential rehab: Most won’t. Some will provide a home alcohol detox, others will not.

You can’t use a service outside of your local area. While you don’t have to pay for treatment you do have to prove your entitlement to it. If you move, while receiving a prescription from your local service, it will soon stop if you don’t link in with the new service provider.

Local free services do the very best they can but their resources are limited as local authority budgets are squeezed.

Sadly, due to the stigma surrounding addiction, there is always pressure on local authorities to prioritise housing, social services, the elderly, etc. Many, quite wrongly, see addiction as self inflicted. It isn’t. It is a very serious and chronic illness.

What Do Local Authority Addiction Services Provide?

That depends on where you live.

The primary aim of local authority addiction services is crime reduction.

Methadone , for those who use heroin, is given to stop people having to commit crime to pay for drugs.

When someone is on a therapeutic dose of methadone they are less likely to want to take drugs and therefore they will commit less, if any, crime. It also reduces the incidence of accident and emergency attendance due to complications from drug injecting.

All local services provide methadone (or buprenorphine) to those who need it.

For those who are dependent on Cocaine and other short acting drugs, keyworkers provide psychosocial support and keywork sessions. There is no detox for these substances.

With regards to alcohol, it depends on how much you are drinking. A community alcohol detox may be available, in certain circumstances.

NHS Addiction detox services: Alcohol Home Detox

There are national recognised clinical guidelines as to the exclusion criteria for alcohol home detox. There is very little wriggle room.

Should you fall within the list below you won’t be able to have a home alcohol detox:

• Drinking more than 30 units a day
• Previous detox within the last six months
• History of alcohol withdrawal related seizures
• Co-occurring addiction
• Prescription for benzodiazepines, gabapentinoids and strong opioids
• Adverse blood results

Procedure for Home Alcohol Detox

While services vary, almost all will require you to start on a Monday. This is because, in the very unlikely event that there is a problem, it is easier to arrange a clinician to see you during the week than at weekends. Nearly all services are weekday, only.

They will usually require blood tests, either done on site or through your GP.

The service will not accept you for treatment without your GP being involved.

A nurse/specialist support worker will visit you on the Monday morning. They will use a breathalyser to ensure you are safe enough to commence treatment. Your blood alcohol level must be under a certain range to start medication. They will measure your withdrawals using a standardised assessment tool and will visit you again in the afternoon and then daily for the next few days.

NHS Addiction detox services :Free Drug and Alcohol Rehab

Just as there is no such thing as a free lunch, there is no such thing as free drug and alcohol rehab. Someone, somewhere is paying for it!

Local authority budgets are tight. They are getting tighter.

If you link in with local services, your keyworker can put you forward for a stay in rehab but it isn’t going to happen straightaway.

You are going to have to commit to every appointment, every support group running at the service you are assigned to. If you disengage they will pause your funding application. If you totally disengage you will be removed from treatment. This is known as a treatment break.

Local authority services are not an emergency response.

If you adhere to your treatment plan an application for funding might be made. That doesn’t, however, mean you are going to get it.

Detox Only

There are some NHS units that provide residential detox staffed by medical staff 24/7. These units, which are commissioned by local authority addiction services, are aimed at those at significant physical and psychological risk.

Patients who are co-dependent, have a history of alcohol related withdrawal seizures and other complications are highly likely to be catered for in such units. The level of care is second to none.

The problem is that these units do not provide therapy, relapse prevention or aftercare. The aim would be for your local authority service to fund a rehab stay and for you to go straight there the minute you finish detox. It rarely happens. This is why people relapse.

A detox, while absolutely essential, makes someone vulnerable. All those uncomfortable thoughts you were suppressing with drugs and alcohol will resurface. You won’t be able to deal with them. If you could, you wouldn’t have needed a detox.

NHS Addiction detox services: Buvidal Injections

Buvidal is a new treatment for heroin and opioid addiction.

No more pills or potions, it is a long acting injection.

Sounds good? Yes but, actually, it isn’t new.

Buvidal is a new way of taking the drug Buprenorphine, also known as Subutex or Espranor.

It isn’t cheap and local authority services are now realising that it isn’t the golden ticket it was once thought to be.

For those who are settled on Methadone or oral Buprenorphine it can be a game changer. You can stay on it (maintenance) or reduce on it or reduce down and swap to oral medication down to zero. After four weekly injections it can be taken monthly. No more trips to the chemist. You can’t loose it and no one can steal it from you.

The problem is that some local authority services have, quite literally, been dishing it out to all and sundry on the theory that the more chaotic the individual the more you should use it. The complete opposite is true.

NHS Addiction detox services: How to Access

Easily.

Your local authority website will tell you who the provider is. You can ask your GP or look it up on the internet.

Most services are open Monday to Friday. Some have walk in services, others are by appointment only.

No one is turned away. You will be made to feel welcome.

The keyworker you speak to may well be in recovery themselves. While everyone reaches addiction through different strands, there are common experiences. They will have an understanding of what is going on.

Free Advice from An Experienced Addictions Clinician

You can speak to an experienced addictions clinician. We have some who have worked in local authority services.

Our advice is free, confidential and impartial.

Should you choose to seek residential treatment we don’t charge for referrals.

Our service is registered with the Information Commissioner’s Office.

We only signpost to legally registered centres.

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