REFERRAL TO SPECIALIST SERVICES
Referral to specialist substance misuse services is indicated in the following circumstances:
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All opiate misusers should be referred to specialist
services for a triage assessment.
It is suggested that a referral is always made in any of the following circumstances:
- The patient requests a referral.
- The patient is physically dependent on a substance (see appendix 3, page 117 for withdrawal syndromes).
- There is evidence of marked problems occurring as a result of substance misuse - these may be of a biological, psychological/ psychiatric or social nature.
- The presentation is complicated by any
of the following:
- Age under 17
- Pregnancy
- Chaotic behaviour
- Poly-substance misuse
- Injecting substance misuse
- Dual diagnosis (concurrent psychiatric and substance misuse disorder)
- Severe risk of suicide, violence or neglect
- There is a possible risk to children posed by the client
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A number of GPs who have received local training in substance misuse and have joined a Shared-Care Scheme, may act as a source of advice as well as providing prescribing services for more stable patients requiring controlled drugs.
Clients with complex needs such a dual diagnosis or poly-substance misuse may be treated on a 'stand-alone' basis by specialist services, or in shared-care with a specialist GP.
Following stabilisation of a client's substance misuse or the achievement of abstinence, the specialist service may close the case by referring back to the GP, or to a specialist GP, and/or to another specialist service, as appropriate.
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The above information is copyright of Dr Bruce Trathen MBBS MRCPsych (2006). ISBN 0-9545164-0-0. The author grants permission for these guidelines to be downloaded, copied and distributed freely, but does not grant permission for their sale.
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