Substance misuse


Department of Health and Social Care - Also known as the ‘Orange Book’ this is guidance for clinicians treating people with drug problems. It has guidelines on multiple domains, including misuse of prescription and over-the-counter drugs.

NICE Guideline [NG135] Alcohol interventions in secondary and further education - This guideline covers interventions in secondary and further education to prevent and reduce alcohol use among children and young people aged 11 up to and including 18. It also covers people aged 11 to 25 with special educational needs or disabilities in full-time education. It will also be relevant to children aged 11 in year 6 of primary school.

NICE Guideline [CG115] Alcohol-use disorders: diagnosis, assessment and management of harmful drinking -high-risk drinking) and alcohol dependence - This guideline covers identifying, assessing and managing alcohol-use disorders -harmful drinking and alcohol dependence) in adults and young people aged 10–17 years. It aims to reduce harms -such as liver disease, heart problems, depression and anxiety) from alcohol by improving assessment and setting goals for reducing alcohol consumption.

NICE Alcohol-use disorders: diagnosis and management of physical complications - This guideline covers care for adults and young people -aged 10 years and older) with physical health problems that are completely or partly caused by an alcohol-use disorder.

NICE Guideline [CG120] Co-existing severe mental illness -psychosis) and substance misuse: assessment and management in healthcare settings. - This guideline covers assessing and managing people aged 14 years and over with coexisting severe mental illness -psychosis) and substance misuse.

NICE Guideline [CG52] Drug misuse in over 16s: opioid detoxification - This guideline covers helping adults and young people over 16 who are dependent on opioids to stop using drugs.

NICE Guideline [CG51] Drug misuse in over 16s: psychosocial interventions - This guideline covers using psychosocial interventions to treat adults and young people over 16 who have a problem with or are dependent on opioids, stimulants or cannabis.

NICE Public Health guideline [PH24] Alcohol-use disorders: prevention - This guideline covers alcohol problems among people over 10. It aims to prevent and identify such problems as early as possible using a mix of policy and practice.

NICE Quaity Standard [QS188] Coexisting severe mental illness and substance misuse - This quality standard covers the assessment, management and care provided for people aged 14 and over who have coexisting severe mental illness and substance misuse.

NICE Quality Standard [QS83] Alcohol: preventing harmful use in the community. - It includes policy and practice approaches to prevent harmful alcohol use in adults, young people and children.

Useful resources

British National Formulary – Anxiolytics and Hypnotics - This section of the BNF includes information on benzodiazepine dependence and withdrawal guidance.

British National Formulary – Substance Dependence - Information and further links regarding nicotine, alcohol and opioid dependence.

Centre for Addiction and Mental Health – DAST-10 - The DAST-10 is a 10 question drug abuse screening tool. This document provides the screening test and some information on its use.

Hub of Hope - A directory of local services for support with a wide variety of mental health and related issues.

NICE Clinical Knowledge Summary – Benzodiazepine and z-drug withdrawal - This CKS topic covers the assessment of a person who is being prescribed long-term benzodiazepines or z-drugs and offers advice on managing withdrawal of treatment.

Public Health England – Guidance on the 5 alcohol use screening tests - Contains guidance on the use of, and links to downloads for the Alcohol Use Disorders Identification Test -AUDIT), Alcohol Use Disorders Identification Test for Primary Care -AUDIT-PC), Alcohol Use Disorders Identification Test C -AUDIT-C), Fast Alcohol Screening Test -FAST) and Single Question Alcohol Use Test -M SASQ).

Public Health England – People who inject drugs -PWID): infection risks, guidance and data - This guide is about infections that occur in people who inject drugs -PWID).

Specialist Pharmacy Service – Choosing an equivalent dose of benzodiazepine - This provides information and guidance on approximately equivalent doses of oral benzodiazepines to diazepam.

Patient and carer information

Adfam - Support and information for the families of drug and alcohol users. It also lists a variety of other organisations who are able to provide support.

Alcoholics Anonymous - AA is concerned solely with the personal recovery and continued sobriety of individual alcoholics who turn to the Fellowship for help.

Dan - This is a drug and alcohol misuse helpline for people in Wales.

Drinkaware - Drinkaware is an independent charity which aims to reduce alcohol-related harm by helping people make better choices about their drinking. They provide evidence-based information, advice and practical resources; raising awareness of alcohol and its harms.

Frank - Frank provides accessible information about drugs and a directory of support services local to people in England.

Narcotics Anonymous - NA helps members to support each other to stay drug free and to help others achieve and maintain a drug free recovery and lifestyle. Meetings are free and do not need to be booked in advance.

NHS - Support and signposting for drug addiction

Inclusion - Inclusion is a national organisation that works with individuals, families and communities who are affected by addiction, crime, mental health or need treatment for their sexual health.

Royal College of Psychiatrists - Information for patients, carers, family and friends relating to mental health problems and disorders.

Further information and reading

Certificant in the Management of Alcohol Problems in Primary Care - This RCGP accredited course aims to improve participants’ understanding of alcohol-related problems and equips participants with the skills and knowledge necessary to manage their patients and supporting carers. A component can be completed as elearning alone.

Certificate in the Management of Drug Misuse -Part 1) - An RCGP accredited course, ideal for those working as part of a shared care scheme intending to provide treatment to drug users as part of a locally or nationally enhanced service. Can also complete a component as elearning alone.

Certificate in the Management of Drug Misuse Update – Be Revalidation Ready - An RCGP accredited course ideal for those working as part of a shared care scheme intending to provide treatment to drug users as part of a locally or nationally enhanced service.

Office for National Statistics: Drug misuse in England and Wales: year ending 2020 - An overview of the extent and trends of illicit drug use for the year ending March 2020. Data are from the Crime Survey for England and Wales.

RCGP eLearning course – Alcohol: Management in primary care - This course covers the physical and mental health problems associated with problem drinking. It also describes the different ways of helping people to cut down their drinking and important aspects of care during and after detoxification.

RCGP Screencast – Screening for alcohol use disorders - This screencast looks at screening for alcohol use disorders, and highlights particular opportunities that shouldn’t be missed. The assessment of drinking and the use of brief interventions are also discussed, as well as an introduction to the motivational interviewing approach to achieving change.

RCGP Addictions Forum group - Members are invited to participate in discussions pertinent to the group. The Forum aims to facilitate communication and networking of doctors with an interest in addictions, support the professional development of GPs and raise issues to help inform policy debate.