{"id":4453,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/substancemisuse\/"},"modified":"2026-03-19T10:44:18","modified_gmt":"2026-03-19T10:44:18","slug":"alcoholanddruguse","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/alcoholanddruguse\/","title":{"rendered":"Alcohol and Drug Use"},"content":{"rendered":"\n<p>The <a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/pcft\/Pages\/PCFT%20Home%20Page.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Primary Care Facilitator Team<\/a> provides advice, information and support for GP teams managing those with drug dependence or alcohol problems. Their site gives advice on approaches to harm reduction, including for BBVs.<\/p>\n\n\n\n<p><strong><u>Alcohol and Drugs Services in Lothian<\/u>.<\/strong> <\/p>\n\n\n\n<p>NHS Lothian provides a range of services across Lothian and works in close partnership with Social Work and third sector agencies.<\/p>\n\n\n\n<p>Services are organised by locality \u2013<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/alcoholanddruguse\/alcohol-drug-locality-services\/\" target=\"_blank\" rel=\"noreferrer noopener\">West, East, Midlothian and Edinburgh Health and Social Care Partnerships<\/a>. Edinburgh has four localities. Within each area there are drop-in clinics staffed by third sector agencies.<\/p>\n\n\n\n<p>Other services have a Lothian wide remit and come under REAS:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>The Ritson clinic<\/strong>&nbsp;Potential Ritson referrals should be referred to the local hub in the first instance<\/li>\n\n\n\n<li><strong>LEAP<\/strong>&nbsp;For information about LEAP, please see&nbsp;<a href=\"https:\/\/services.nhslothian.scot\/leap\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/services.nhslothian.scot\/leap<\/a><\/li>\n\n\n\n<li><strong>Harm Reduction Team<\/strong>&nbsp;please see:&nbsp;<a rel=\"noreferrer noopener\" href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/harmreductionteam\/Pages\/Default.aspx\" target=\"_blank\">http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/harmreductionteam<\/a><\/li>\n<\/ul>\n\n\n\n<p>&nbsp;<br>Substance Misuse Services are not able to provide emergency assessment.<\/p>\n\n\n\n<p><strong>C.M &amp; J.C. 02-12-24<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients who have been assessed as having problematic alcohol or drug use<\/li>\n\n\n\n<li>Patients already in treatment who have become unstable and would benefit from reassessment by the specialist service<\/li>\n\n\n\n<li>Adults 18 years of age and above who consent to the referral<\/li>\n\n\n\n<li>Patients looking for further help to achieve recovery<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Patients whose drug use is stable and who require specialist mental health assessment&nbsp;<\/strong>are usually more appropriately referred to General Adult Mental Health Services<\/li>\n\n\n\n<li><strong>Patients with acute medical needs<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Please refer to the appropriate acute medical service at the RIE, WGH or St John\u2019s Hospitals. Such medical emergencies include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>acute confusional states<\/li>\n\n\n\n<li>and\/or withdrawal seizure(s),<\/li>\n\n\n\n<li>with or without Wernicke\u2019s encephalopathy,<\/li>\n\n\n\n<li>acute alcoholic hallucinations<\/li>\n\n\n\n<li>or delirium tremens<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Patients with acute psychiatric needs<\/strong><\/li>\n<\/ul>\n\n\n\n<p>Patients with suicidal intent, or other psychiatric emergencies, please refer to: <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/emergenciesmentalhealthadults\/\" target=\"_blank\" rel=\"noreferrer noopener\">Emergencies Mental Health (Adults) \u2013 RefHelp (nhslothian.scot)<\/a>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Patients under 18 years of age<\/strong>:<\/li>\n\n\n\n<li><strong>East Lothian:&nbsp;<\/strong> Under 18s with subtance use&nbsp;can self refer &nbsp;to&nbsp;MYPAS&nbsp;in &nbsp;via 0131 454 0757 or&nbsp; &nbsp;<a href=\"http:\/\/www.mypas.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.mypas.co.uk<\/a><\/li>\n\n\n\n<li><strong>Edinburgh<\/strong>:&nbsp;The Adolescent Substance Use Service (ASUS) offers treatment and support to young people (living in Edinburgh or East Lothian) aged 18 and under experiencing difficulties with drugs, alcohol or new psychoactive substance. Referrals can be made by professionals, family or the young people themselves. There is no criteria on the level of substance use but it must be causing the young person problems. &nbsp;Referrals to Jayne Reed, ASUS, City Chambers level 6, 249 High Street Edinburgh EH1 1YJ 0131 529 6700 or email&nbsp;<a href=\"mailto:ASUS@nhslothian.scot.nhs.uk\" target=\"_blank\" rel=\"noreferrer noopener\">ASUS@nhslothian.scot.nhs.uk<\/a><\/li>\n\n\n\n<li><strong>Midlothian<\/strong>&nbsp;&nbsp;&nbsp; Under 18s with addiction problems can self refer &nbsp;to&nbsp;<strong>MYPAS<\/strong>&nbsp;in Midlothian&nbsp;Contact via 0131 454 0757&nbsp; &nbsp;or&nbsp; &nbsp;<a href=\"http:\/\/www.mypas.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.mypas.co.uk<\/a><\/li>\n\n\n\n<li><strong><\/strong><strong>West Lothian<\/strong>&nbsp;&#8211; awaiting further info &#8211; please seeks advice from local substance misuse service &#8211; see below<\/li>\n<\/ul>\n\n\n\n<p><strong>Primary Stimulant or Cannabis Users<\/strong>&nbsp;should be referred to: CREW 32-32a Cockburn St, Edinburgh, EH1 1PB, 0131 2203404&nbsp;<a href=\"https:\/\/www.crew.scot\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.crew.scot\/<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">Local Drop in Hubs \u2013 please see individual locality services for details.<\/h4>\n\n\n\n<p>Most patients can simply be directed to their local drop-in service, where they will be seen by a member of staff from one of the third sector agencies.<\/p>\n\n\n\n<p><em>Prescriptions will not be provided at triage appointments.<\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">SCI gateway:<\/h4>\n\n\n\n<p>Written referrals via the SCI gateway can still be made and may be helpful in situations where additional information about medical history or social background would be helpful or the referrer has a specific request.<\/p>\n\n\n\n<p>If you believe your patient would be unable to attend then we can offer to assess the patient at their GP practice, at another site or in their home. This will not be offered routinely but if this is something which you feel would be required for your patient please let the service know.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">For each referral please:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Move patients who are currently unstable on opiate replacement prescriptions to daily supervised pickup unless there is a compelling reason not to. This is safer practice in this group and is the first intervention in those referred before decisions are made about increasing doses.<\/li>\n\n\n\n<li>Arrange toxicology testing to confirm substance use, and LFTs for both drug and alcohol patients. A drug diary or alcohol diary can also be helpful.<\/li>\n\n\n\n<li>Check contact details including a current mobile phone number where possible: advise patients that they may be contacted by phone and that the number may appear \u2018unlisted\u2019.<\/li>\n\n\n\n<li>Ensure patients have given consent to a referral and understand that the services operate in partnership Local Authorities &amp; Third Sector Organisations.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Move patients who are currently unstable on opiate replacement prescriptions to daily supervised pickup unless there is a compelling reason not to. This is safer practice in this group and is the first intervention in those referred before decisions are made about increasing doses.<\/li>\n\n\n\n<li>Arrange toxicology testing which will help the assessment process; and a drug diary if appropriate.<\/li>\n\n\n\n<li>Check contact details including a current mobile phone number where possible: advise patients that they may be contacted by phone and that the number may appear \u2018unlisted\u2019.<\/li>\n\n\n\n<li>Ensure patients have given consent to a referral and understand that the services operate in partnership Local Authorities &amp; Third Sector Organisations.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Alcohol-Screening.pdf\" data-type=\"URL\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Alcohol-Screening.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Alcohol screening &#8211; CAGE&nbsp;&amp; FAST<\/a><\/p>\n\n\n\n<p>There is also an app (free to download from&nbsp;<a href=\"http:\/\/www.arcapp.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.arcapp.co.uk<\/a>) which has been developed by Edinburgh ADP. It contains details of services, lists of Mutual Aid and other meetings, a diary, a calendar and relaxation<\/p>\n\n\n\n<p>NICE Alcohol Guidance&nbsp;&nbsp;&nbsp;<a href=\"https:\/\/pathways.nice.org.uk\/pathways\/alcohol-use-disorders\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/pathways.nice.org.uk\/pathways\/alcohol-use-disorders<\/a><\/p>\n\n\n\n<p>Orange book Department of Health Drugs misuse&nbsp;<a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/673978\/clinical_guidelines_2017.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/673978\/clinical_guidelines_2017.pdf<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/aa-edinburgh.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Alcoholics Anonymous<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/ecsca.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Cocaine Anonymous<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/ukna.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">Narcotics Anonymous<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/smartrecovery.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">SMART Recovery UK<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.edinburghadp.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Edinburgh RecoveryHubs<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.westlothianhscp.org.uk\/article\/29287\/Drugs-and-or-Alcohol-How-to-get-HELP\" target=\"_blank\" rel=\"noreferrer noopener\">West Lothian Services<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/www.meldap.co.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Mid and East Lothian Services<\/a><\/p>\n\n\n\n<p><strong><a href=\"https:\/\/accesstoindustry.co.uk\/services-for-adults\/encompass\/\" target=\"_blank\" rel=\"noreferrer noopener\">Encompassopens a new window<\/a><\/strong>&nbsp;&nbsp; (Training, education and employability)<\/p>\n\n\n\n<p><strong><a href=\"https:\/\/www.crew.scot\/\" target=\"_blank\" rel=\"noreferrer noopener\">CREWopens a new window<\/a><\/strong>&nbsp;(Stimulant)<\/p>\n\n\n\n<p><a href=\"https:\/\/scottishrecoveryconsortium.org\/index.php?id=591\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Recovery Consortium<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.sfad.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Families Affected by Alcohol and Drugs<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>The Primary Care Facilitator Team provides advice, information and support for GP teams managing those with drug dependence or alcohol problems. Their site gives advice on approaches to harm reduction, including for BBVs. Alcohol and Drugs Services in Lothian. NHS Lothian provides a range of services across Lothian and works in close partnership with Social<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[656],"class_list":["post-4453","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-guidelines-alcoholanddruguse"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/https-apps-nhslothian-scot-refhelp-guidelines-alcoholanddruguse\/\" rel=\"tag\">Alcohol and Drug Use<\/a>","rttpg_excerpt":"The Primary Care Facilitator Team provides advice, information and support for GP teams managing those with drug dependence or alcohol problems. Their site gives advice on approaches to harm reduction, including for BBVs. Alcohol and Drugs Services in Lothian. NHS Lothian provides a range of services across Lothian and works in close partnership with Social","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4453","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4453"}],"version-history":[{"count":23,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4453\/revisions"}],"predecessor-version":[{"id":27299,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4453\/revisions\/27299"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4453"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4453"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}