NSW Context

Staff who provide services to drug and alcohol clients in NSW are found across both specialist treatment and prevention agencies as well as generalist welfare and health services including those dedicated to homelessness, mental health and aged care facilities.

The specialist workforce in non government organisations (NGOs) is comprised approximately 1100 staff iacross 110 service sites throughout rural, remote and urban NSW.  Services provide a wide range of interventions including prevention, harm reduction, detoxification, residential rehabilitation, outreach support and community based afer care.  Specialist drug diversion programs are funded through the National Illicit Drug Diversion Initiative and comorbidity service provision initiatives through national comorbidity funding. 

In NSW, the CHC40408 Certificate IV in Alcohol and Other Drugs and CHC50208 Diploma of Community Services (Alcohol and other drugs) are considered appropriate vocational qualifications for entry level work in alcohol and other drugs services.

Prevention

Services may develop prevention and health promotion programs for their local and wider communities.  These initiatives vary widely in their target and scope. This includes entire populations to prevent a problem from occurring, subsets of the population at risk or people with existing problems to reduce harm to them and the wider community. Significant evidence suggests that increasing protective factors, reducing risk factors and building resilience can result in positive outcomes across a range of health and social problems including criminality, drug use and mental health disorders. Prevention strategies include targeted resource production, peer education, community development strategies and school based education programs.

Intoxicated Persons Units

A small number of NGOs run Intoxicated Persons Units (IPUs). These services offer a place where men and women affected by alcohol and other drugs can stay overnight. The centres provide immediate, basic needs such as a safe place to stay, food, clothing and showering facilities. Specialised staff assist clients to look for long term solutions to their problems, such as assisting them to find longer term accommodation or to enter into rehabilitative programs.

Detoxification

NGOs may offer detoxification services (or 'detox' for short). When a person who is physically dependent stops using a drug/s , they can experience withdrawal symptoms.  These symptoms can be alleviated with the assistance of prescribed medication under the supervision of medical staff. This is known as a medicated withdrawal. This can occur in a residential withdrawal unit, a hospital or as an outpatient.

Rehabilitation

Rehabilitation services can be provided in a residential setting or in the community. NGOs provide case management, counselling, group work and life skills programs. Evidenced based interventions are utilised by specialist staff such as Cognitive Behaviour Therapy and Dialectical Behaviour Therapy in residential, non residential, day program and after care rehabilitation program settings. 

Services can reflect the needs of specific population groups including women and children, indigenous clients, young people and families or they may provide services to a large and diverse client group. 

Treatment Setting

NGOs treatment settings exhibit differences that can be described in part by their origin, in part by their affiliations and in part by their practice:

Major charities: Major charitable organisations provide alcohol or drug treatment services as part of a larger social welfare commitment. They often have strong religious affiliations and are well known to the community. They are large organisations and tend to maintain high public profiles. Grant funding supplements the main charitable income source for these agencies.

Community-based services: These agencies are mostly independent organisations that have arisen through community effort and successfully sought funding at some time after they were initiated. The most common examples are the therapeutic communities. These services largely emerged in response to the growth in illicit drug use since the 1970s.

Government initiated NGOs: These services are a more recent phenomenon where government has determined a need for a specific type of service and has sought to have it provided by a non-government organisation. These services have emerged in the last 10 to 15 years. A recent example would the Medically Supervised Injecting Centre (MSIC). 

The majority of treatment services are in or near the Sydney metropolitan area.  Over the last decade a number of regional detoxification and rehabilitation services have been established with new funding. 

Diversion

Drug crime diversion programs aim to decrease the drug crime cycle for individuals in contact with the criminal justice system due to their drug use. Objectives of these programs are to reduce recidivism rates, improve individual health and social functioning and improve community safety. Programs of the National Illicit Drug Diversion Initiative include:

• Cannabis Cautioning Scheme
• Magistrates Early Referrals Into Treatment program (MERIT)
• Youth Drug and Alcohol Court
• Young Offenders Scheme

NSW Health also funds an Adult Drug Court program.

These programs target varying defendants/offenders with a range of drug treatment, health and welfare interventions as part of pre-sentencing or post-sentencing. Program participants are closely monitored by both the health and criminal justice systems to ensure progress and program compliance.

Comorbidity

There is increasing awareness in the sector of the link between drug use and mental health problems. People who experience drug-related problems may also have an increased risk of developing mental health issues. People with mental health problems are reported to have a higher rate of problematic drug use.  It is a complex issue depending on the types of drugs, mental illness and the interplay between the two.  The alcohol and other drug sector are currently undertaking and providing specialist training, developing new models of intervention for clients to address comorbidity, providing specialised programs, revising current program delivery and approaches and strengthening links to mental health service providers in response.

Aboriginal Workers in Certificate IV in Alcohol and Other Drugs Work 

This resource was developed by CSH ITAB in consultation with key industry stakeholders and includes:

Orientation to Alcohol  And other Drugs Sector (CHCAOD2C) Set of Training Book 1 & Book 2

Working with clients who are intoxicated (CHCAOD6B) Training Book

Details and order form available at: www.skillsonline.net.au