In the previous chapter, you understood the state of AOD in Australia by establishing the context of AOD in the country. AOD context refers to the larger social, political, historical, economic and legal factors influencing AOD use and treatment. It involves understanding the larger systemic issues and environmental factors that contribute to the prevalence and impact of substance use in society.
You have learnt in Chapter 1 that factors can influence a person’s access to resources, the prevalence of certain substances, the cultural attitudes towards substance use and the policies and laws that shape treatment options. Understanding these contexts can help an AOD support worker better understand clients and apply this understanding in the work practice to provide more effective support.To reiterate, AOD practice refers to the worker’s field of work that involves preventing, treating and managing the use of alcohol and other drugs. It includes a range of interventions and services that aim to reduce the harm associated with substance use and support individuals and their families in achieving recovery and wellness. Applying your understanding of AOD context to your work practice involves using the knowledge and skills gained through research, analysis, education and experience to appropriately support individuals and communities affected by AOD use.
In this chapter, you will learn how to:
It has been continuously reiterated that AOD context refers to the larger social, political, historical, economic and legal factors influencing AOD use and treatment. For this learner guide, this subchapter will also describe the AOD context as the broad context of AOD. On the other hand, specific AOD context refers to the different settings and programs in which AOD support workers provide services and support to individuals who use drugs.
AOD support workers are expected to apply their knowledge of these AOD contexts when working with clients who may have different needs based on their circumstances. By applying these contexts to work practice, AOD support workers can provide appropriate and tailored support to clients and help reduce harm related to AOD use. Work practices of AOD support workers will vary depending on the role of the worker and the sector they work in. Below is a table outlining some of the common AOD work roles in Australia and the relevant work practices associated with each role:
AOD Work Role | Relevant Work Practices |
---|---|
Case Manager | 1. Conducts comprehensive assessments 2. Develop and implement care plans 3. Coordinates referrals to other services as needed 4. Provides clients with practical assistance (such as housing or employment support) |
Counsellor and Therapist | 1. Conduct assessments and develop treatment plans 2. Provides individual and group counselling (such as cognitive-behavioural therapy) 3. Coordinates care with other healthcare professionals |
Outreach Worker | 1, Conduct street outreach to engage with individuals who use AOD 2. Provides harm reduction education and resources 3. Refers clients to other services as needed |
Educator and Prevention Worker | 1. Delivers education and prevention programs 2. Conduct community outreach to raise awareness of AOD-related issues 3. Provides resources and support to individuals and families affected by AOD use |
Support Worker | 1. Provides emotional support to AOD clients 2. Assists clients with basic needs (such as food or clothing) 3. Facilitates access to other services (such as healthcare or legal support) |
Peer Worker | 1. Uses personal lived experience of AOD use and recovery to provide support and advocacy to individuals who use AODs 2. Engages in harm reduction outreach and education 3. Advocates for the needs and rights of people with lived AOD experiences |
Nurse | 1. Provides medical care to individuals who use AODs (such as wound care or detox support) 2. Administers medications as needed 3. Conduct health assessments |
To apply knowledge of broad and specific AOD contexts to AOD work practice, AOD support workers must identify and use legal frameworks and maintain knowledge and awareness of the social, political, economic and legal contexts of AOD.
Outreach services
To supplement the discussion on AOD work roles and practices, one common work practice of AOD workers is to provide outreach services to those who are using AOD. Outreach services focus on assisting people who are unable to access traditional treatment programs or those requiring additional support beyond what is offered in clinics.
Here are some types of outreach services that you can provide to help people who are affected by AOD:
Types of Outreach Services | Description |
---|---|
Street-based | Street-based outreach programs help people who are homeless or who have limited access to healthcare services by providing harm reduction supplies and referrals if deemed necessary. The goal of street-based outreach programs is to reduce the harm associated with drug use and promote healthier choices among individuals who are at risk. |
Park visits | Park visits are usually done through mobile vehicles equipped with medical supplies and staffed by healthcare professionals. This aims to provide services to people who may not be able to access treatments needed for their issues related to AOD. |
Home visits | Home visits are done by outreach workers or healthcare professionals to provide AOD treatment services like consultations and education as well as harm reduction supplies. The aim of home visits is to provide support and care to individuals with AOD issues in their own environment. |
Broad AOD Context in Work Practice
Understanding the social determinants of AOD problems
Knowing the prevalence and impact of AOD problems
Understanding the policy and funding landscape
Recognising the diversity of AOD cultures and experiences
Knowing the range of treatment and support options
AOD support workers who understand the broad context of AOD can grasp how social, economic and political factors, along with the other factors mentioned in Chapter 1, can contribute to AOD problems. This knowledge can inform prevention strategies and help workers to address the root causes of AOD problems.
For a more specific example of an AOD support worker’s understanding of the factors affecting the broad context of AOD, you may refer to the scenario below.
John, an AOD support worker, is working with a young person who has been using drugs heavily and is experiencing housing instability. John understands that homelessness is a social determinant of AOD problems and knows that addressing the young person’s housing needs is crucial to supporting the client’s recovery.
John can use his knowledge of the broader AOD context to advocate for the young person and connect them with appropriate housing and support services. He may also work with the young person to address other social determinants of AOD problems, such as poverty, unemployment and lack of access to education and healthcare.
As seen in the scenario, by addressing social determinants, the AOD support worker is helping the young person recover from their AOD problems and supporting their overall health and wellbeing
AOD support workers can better understand the prevalence and impact of AOD problems in communities. This knowledge can inform their outreach and engagement efforts and help them identify the populations most at risk.
AOD support workers can know the policies and funding structures governing AOD treatment and support services. This knowledge can help them to navigate the system and advocate for improved services and resources.
AOD can appreciate the diversity of cultures and experiences that shape AOD problems. This knowledge can inform their cultural competence and help them to provide more effective and respectful services to diverse populations.
AOD support workers can also be aware of the range of treatment and support options that are available to clients. This knowledge can inform their case management and referral practices and help them to ensure that clients receive the most appropriate and effective care. This will be discussed in detail in the next subchapter, which focuses on the specific context of AOD.
Understanding the broad context of AOD can be beneficial for an AOD worker. It can be concluded that specific AOD contexts are part of a broader AOD context which AOD workers should be knowledgeable about.
The following are the specific AOD contexts that AOD workers should know:
Centre-based work | Withdrawal services | Drop-in centres and recreational facilities |
Housing and residential services | Day Program | Impatient Treatment |
home visits and street and park outreaches | Online AOD work | Telephone services |
The list below the general features or aspects that are commonly associated with each type of AOD work:
Centre-based AOD work focuses on the provision of treatment and support services to AOD clients that are typically conducted in a fixed location or outpatient setting. This involves working in a fixed location, such as a clinic or treatment centre, to provide support and treatment services to individuals with AOD issues.
Here are the different types of services in centre-based AOD work and how it help the AOD clients:
Types of Services in Centre-based AOD Work | How the service helps clients |
---|---|
Client Assessment | Comprehensive assessments are performed in AOD centres to identify the nature and extent of the client’s issues related to substance or alcohol use. The information gathered from this assessment helps in developing an individualised treatment plan that meets the client’s needs. |
Treatment planning | Based on the assessment results, professionals working at AOD centres develop individualised treatment plans that may include a combination of medical, psychological and social interventions. The treatment plan is tailored to meet the client’s specific needs and preferences, with the goal of achieving a successful outcome. |
Centre-based AOD work involves family therapy sessions, education and support groups for families and loved ones. This approach recognises the importance of social support in recovery and aims to improve family communication and relationships, reduce family conflict and stress, and increase the likelihood of successful treatment outcomes.
Withdrawal services in the AOD sector are structured to help AOD clients to safely manage the various symptoms of withdrawal when they stop or reduce the use of AOD.
Withdrawal services are often the first step in treating individuals with AOD issues. They typically provide medical and psychological support to help individuals manage withdrawal’s physical and emotional symptoms.
Here are the different types of withdrawal services that you can use:
Types of | Description |
Home-based | This is typically offered for clients who are unlikely to have complicated issues when they undergo withdrawal. It can be provided by a team of professionals accompanied by a support person like a family member or a friend. |
Outpatient | This is typically offered for clients who do not require admission to a residential service. It involves one-on-one consultations with a health professional for a specific period, together with counselling and other support services. |
Residential | This is typically offered for clients who have problems in AOD use that are severe enough to require monitoring by staff. It also implements strict regulations in the withdrawal unit or hospital to ensure that the client will avoid relapse. |
Drop-in centres are community-based facilities that serve as a safe space for AOD clients. They are designed to be accessible and welcoming to people regardless of their background, especially for those who are homeless or at risk of being homeless.
Drop-in centres provide supplies such as naloxone kits that reduce the harm brought by AOD and can refer people to a range of other support services.
On the other hand, recreational facilities are places where people can engage in leisure activities, like sports, games, crafts and arts. Recreational facilities help AOD clients to engage in positive in healthy activities as an alternative to drug use.
Drop-in centres and recreational facilities can share similarities but serve different purposes. A drop-in centre is a place where people can access a range of services and support without needing an appointment or referral. On the other hand, recreational facilities are places where people can engage in leisure and recreational activities, such as sports, fitness, or arts and culture. While these facilities may offer some supportive services, their primary focus is on providing opportunities for leisure and enjoyment.
A drop-in centre is a place where people can access a range of services and support without needing an appointment or referral.
Housing services aim to provide shelter for people with AOD issues who are either homeless or from unstable housing situations and unsafe living environments. Here are the types of housing services that are available for people with AOD issues:
Types of Housing Services | Description |
---|---|
Sober houses | Sober houses provide a supportive environment for people who are recovering from AOD issues. Residents get access to counselling and peer support and must abstain from any drug or alcohol. |
Transitional housing | Transitional housing is temporary housing that provides a stable and supportive living environment for individuals with AOD issues who are homeless or at risk of homelessness. The goal of transitional housing is to provide a safe and structured living space while individuals work towards achieving more permanent housing. |
Meanwhile, residential services refer to treatment programs that offer intensive and structured interventions to clients who have serious issues on AOD dependence. Clients are to remain in the hospital or facility for a certain period and have access to support from staff for a whole day.
Here are types of residential services:
Types of Residential Services | Description |
---|---|
Residential rehabilitation services | Residential rehabilitation services are a form of treatment that provides clients with a supportive and structured environment to help them recover from substance use disorders. Clients live in a residential facility and receive intensive therapy and support programs that typically last for several months. |
Residential withdrawal services | Residential withdrawal services are designed to provide medical and psychological support to individuals who are experiencing withdrawal symptoms related to substance or alcohol use. These services typically involve a period of medically supervised detoxification, followed by a period of counselling and support. |
Supported accommodation | Supported accommodation is a type of housing service that provides a safe and stable living space for individuals who may be homeless, at risk of homelessness, or facing other challenges such as addiction, mental illness, or disability. |
Day programs in AOD are outpatient programs that offer treatment and services for clients. This involves structured programs and activities that support and treat people with AOD issues, usually during the day.
Day programs can include various activities, such as group therapy, life skills training and recreational activities. They can be a useful way for individuals to access treatment and support while maintaining their daily routines.
Day programs and residential treatment programs are similar but they have differences. The difference is day programs in AOD do not involve overnight stays, unlike residential treatment programs. Instead, clients attend a program for a set number of hours per day or week and then return home after.
This refers to hospital-based programs that provide medical and psychological support to individuals who require intensive care for their AOD issues. The goal of outreach and home visits is to provide people with access to care and support in a comfortable and convenient location, which can increase their likelihood of engaging in treatment and recovery. Clients receive treatment and support while residing at a treatment facility.
Inpatient treatment especially caters to clients who require intensive support and monitoring to resolve their addiction problems, like those who are at high risk of relapsing or experiencing severe withdrawal symptoms.
Here are some characteristics of inpatient treatment:
Characteristics of Inpatient Treatment | Description |
---|---|
24/7 support and care | Inpatient treatment programs typically offer around-the-clock support and care to clients who require intensive and ongoing assistance with their AOD issues. This ensures that clients can receive prompt attention and support whenever they need it. |
Medical supervision | Inpatient treatment programs are medically assisted to safely support the client in managing their withdrawal symptoms or other health complications caused by their addiction. This can include monitoring vital signs, administering medication, and providing emergency medical treatment if necessary. |
This involves providing support and treatment services to individuals with AOD issues in their environment, such as their home, on the street or in public parks.
Online AOD work services refer to programs and interventions that are delivered through various digital platforms. Here are some advantages of online AOD work services:
These involve providing support and treatment services through online platforms such as:
Web-based
Emails
Discussion rooms
Here are activities that can happen in a discussion room for AOD clients:
Group sharing
Meditation
Cognitive-behavioural therapy
Substance abuse education
Discussion rooms have several benefits that help AOD clients from recovery. These are common benefits of discussion rooms:
This involves providing support and treatment services to individuals with AOD issues over the phone, including crisis support and counselling. Telephone services typically serve as the first point of contact for AOD clients, their families and support people.
Telephone support can provide a convenient and accessible way for individuals to access support and counselling. It can be practical for individuals in crisis or who may not have access to other forms of support.
Telehealth has become increasingly popular in AOD work since the COVID-19 pandemic began. Telehealth refers to the use of electronic communication technologies to provide healthcare services remotely. Many AOD treatment services have implemented telehealth as a way to provide ongoing support and treatment to clients who may be unable or hesitant to attend in-person appointments.
Here are some benefits that AOD clients can get from accessing telephone services:
As an AOD worker, you need to identify the name and contact number of the main provider of the different and available AOD telephone services in the state or territory where you are working.
Specific AOD contexts can be seen as more narrow and focused aspects of the broader AOD context, such as the specific types of drugs being used, the patterns of use and the cultural and societal attitudes towards drug use in a particular region or population. For these reasons, specific AOD contexts will focus more on the different settings and programs in which AOD support workers provide services and support to individuals with specific interventions for AOD use.
Application of knowledge of AOD contexts takes on a holistic approach to AOD support. This is because it creates meaningful change in AOD support workers’ interventions in their typical work responsibilities and addresses the root causes of AOD problems. In both broad and specific AOD contexts, you can apply the knowledge you gain from familiarising yourself with the AOD contexts through general considerations and processes.
The following are the considerations for applying knowledge of AOD contexts:
★ Keeping up-to-date with evidence-based practices
★ Advocating for policy change
★ Addressing stigma and discrimination
★ Providing culturally sensitive care
AOD support workers can use their knowledge of the latest research on AOD use and treatment to inform their practice. This can help ensure that they are using evidence-based interventions and approaches that are most likely to be effective.
An AOD support worker who is keeping up-to-date with evidence-based practices might attend conferences or workshops to learn about the latest research on AOD treatment approaches. They might also regularly read academic journals or attend webinars to stay informed about new developments in the field. Based on this knowledge, the worker might modify their treatment approach to incorporate evidence-based practices, such as motivational interviewing, cognitive-behavioural therapy or medication-assisted treatment.
AOD support workers can use their knowledge of the political and social factors that influence AOD use to advocate for policy changes supporting harm reduction and treatment access. This can involve advocating for local, state or national changes.
An AOD support worker might use their knowledge of the broader AOD context to lobby for changes to laws or policies that impact their clients. For example, the worker might work with advocacy groups to push for the decriminalisation of drug use or to increase funding for harm reduction programs. The worker might write letters or call lawmakers to express their support for policy changes that would benefit their clients.
AOD support workers can use their knowledge of the historical and cultural factors that contribute to stigma and discrimination against AOD clients to inform their practice. This can involve addressing stigma and discrimination in the workplace and advocating for changes at a broader societal level.
An AOD worker might use their knowledge of the broader AOD context to educate others about the harms of stigmatising language or discriminatory practices. For example, the worker might lead training for healthcare providers on providing non-judgmental care to people with substance use disorders, or they might work with community groups to challenge harmful stereotypes about people who use drugs. The worker might also advocate for changes to workplace policies that perpetuate stigma and discrimination.
AOD workers can use their knowledge of the cultural factors that influence AOD use to provide culturally sensitive care to their clients. This can involve understanding cultural beliefs and practices related to AOD use and tailoring treatment plans and harm reduction strategies to meet the specific needs of different cultural groups.
They might use their knowledge of the broader AOD context to understand how different cultural beliefs or values might impact their clients’ experiences with substance use. For example, the worker might learn about how different cultures view addiction or how certain cultural practices might influence drug use patterns. Based on this knowledge, the worker might modify their approach to treatment or support to better align with their client’s cultural needs and preferences. They might also work to create a culturally inclusive environment by ensuring that all clients feel welcome and respected, regardless of their cultural background.
Here are the processes for applying knowledge of AOD contexts:
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
2. Lobby for changes to laws or policies that impact clients:
STEP 1 =======> | Familiarise yourself with the laws and policies that impact your clients. |
STEP 2 ======> | Assess your current treatment approach and identify areas where you can incorporate evidence-based practices. |
STEP 3 ======> | Build relationships with policymakers and their staff to advocate for policy changes that benefit your clients. |
STEP 4 ======> | Collaborate with advocacy groups and other stakeholders to amplify your message and build support for policy changes. |
STEP 5 ======> | Track progress and adjust your advocacy efforts as necessary. |
3. Work with community groups to challenge harmful stereotypes about people who use drugs:
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
4. Modify the approach to treatment or support to better align with the client’s cultural needs and preferences:
STEP 1 ➖➖➖➖➖➖▶️ | Familiarise yourself with the cultural beliefs and practices related to addiction and drug use in your clients’ communities |
STEP 2 ➖➖➖➖➖➖▶️ | Assess your current treatment approach and identify areas to better align with your client’s cultural needs and preferences. |
STEP 3 ➖➖➖➖➖➖▶️ | Choose strategies that align with your client’s cultural needs and preferences. |
STEP 4 ➖➖➖➖➖➖▶️ | Modify your treatment plan to incorporate cultural considerations, such as language, traditions or beliefs. |
STEP 5 ➖➖➖➖➖➖▶️ | Monitor your clients’ progress and adjust your approach as necessary. |
5. Create a culturally inclusive environment in practice by ensuring that all clients feel welcome and respected, regardless of their cultural background:
STEP 1
STEP 2
STEP 3
STEP 4
Applying knowledge of AOD contexts takes a holistic approach to AOD support. It is essential to create meaningful change in the interventions AOD support workers do in their typical work responsibilities and address the root causes of AOD problems. By keeping up-to-date with evidence-based practices, advocating for policy change, addressing stigma and discrimination and providing culturally sensitive care, AOD support workers can help their clients achieve better outcomes and live healthier, happier lives. By implementing these considerations and processes, AOD support workers can positively impact the lives of those struggling with substance use disorders and create a more inclusive and supportive environment for all clients.
Checkpoint! Let’s Review
The AOD sector is regulated by various laws, policies and guidelines at the national, state and territory levels. Understanding these legal frameworks is crucial for anyone working in the AOD field to ensure they provide their clients with safe, ethical and compliant support. This subchapter will discuss the key legal frameworks that impact AOD work in Australia and how to identify and use them.
Legal frameworks guide the rights and responsibilities of individuals and organisations and aim to ensure that practices and services are delivered ethically, safely and effectively. Identification of legal frameworks that impacts the AOD sector is important for AOD workers. Identifying may refer to becoming familiar with and recognising the relevant laws, policies and regulations that guide and govern the AOD sector. Some of the reasons why this is important for the overall AOD practice is because AOD workers:
In this subchapter, different legal frameworks relevant to different aspects of an AOD worker’s practice will be discussed. It must be clear that there are different types of legal frameworks that impact AOD work. The following are some of the key legal frameworks that impact AOD in Australia:
Commonwealth legislation
→ Government laws that apply to all states and territories at a national level.
State and territory legislation
→ Territory government laws that apply within their respective jurisdictions.
Professional standards and codes of ethics
→ Guidelines and standards developed by professional organisations.
Organisational policies and procedures
→ Guidelines and procedures developed by the AOD organisation or service where the AOD worker is employed.
How each affects AOD workers’ practice is as follows:
Type of Legal Framework | Impact on AOD Practice |
---|---|
Commonwealth Legislation | As an AOD support worker, you may need licences or permits to handle certain drugs and follow strict rules for storing and disposing of them. Breaking these laws can lead to fines or imprisonment. Knowing the rules and ensuring you and your organisation follow them is important to avoid legal problems. |
State and Territory Legislation | Similar to the above, AOD support workers may also need to obtain licenses or permits to conduct services or adhere to strict regulations for enacting activities because failure to comply with these laws can result in legal consequences such as fines or imprisonment. |
Professional Standards and Codes of Ethics | This may include respecting clients’ rights to privacy and confidentiality, obtaining informed consent for treatment and engaging in ongoing professional development. Failure to adhere to these standards can result in disciplinary action by the professional organisation, which may impact an AOD worker’s career. |
Organisational Policies and Procedures | AOD support workers need to adhere to these policies and procedures to ensure that they deliver services that are consistent with the values and mission of their organisation. |
AOD workers will use the legal frameworks described above in several ways. These frameworks guide AOD workers to ensure their practice is ethical, safe and legally compliant.
Here are some examples of how AOD workers might use these legal frameworks:
To inform their practice:
► AOD workers may use Commonwealth and State and Territory Legislation to understand the legal requirements for their work, such as reporting obligations, confidentiality requirements and duty of care. This information can help AOD workers ensure their practice is legal and ethical.
To guide their decision-making
► Professional standards and ethics codes guide AOD workers to make ethical decisions in their practice. For example, the Australian Association of Social Workers has developed a code of ethics that outlines the ethical principles social workers should follow. AOD workers can use these ethical guidelines to inform their decision-making and ensure they provide the best possible care for their clients.
To comply with organisational policies and procedures
► AOD workers must abide by the organisations’ guidelines and practices. These policies and procedures may cover confidentiality, record-keeping and reporting. AOD workers can ensure safe and effective client care by following these policies and procedures.
In summary, AOD workers will use these legal frameworks to inform their practice, guide their decision-making and comply with organisational policies and procedures. By doing so, they can ensure they provide safe, ethical and effective care to their clients while staying legally compliant.
There are laws in Australia that are specific to the AOD sector that is adhered to on a national level and international level—Human Rights.
A right is a legal or moral entitlement to have or do something. Just like anyone, people with AOD issues have rights. Some of their rights include:
Different laws create these rights. And it is imperative that before you support the person in understanding and exercising their rights, you must first understand the key provisions of the laws that promote their rights.
Human rights refer to all fundamental rights that each person is entitled to as a human being. These human rights are universal because they apply to all people regardless of background and beliefs. Human rights are also inalienable because they cannot be taken away. After World War II, the United Nations General Assembly released the Universal Declaration of Human Rights. This document states and describes all fundamental human rights that must be protected. The Universal Declaration of Human Rights has since been used as the basis for other legislation and guidelines protecting the rights of people.
Several federal, state and territory laws aid Australia in fulfilling its human rights obligations, such as the Australian Human Rights Commission Act 1986 at the national level. This outlines the roles and responsibilities of the Australian Human Rights Commission, which protects and promotes human rights across Australia. This also gives Australia’s obligations effect under the following:
This commits members to recognise the right to access high-quality healthcare services, including prevention, treatment and rehabilitation services for substance use disorders. It also prohibits discrimination in access to healthcare services based on AOD use or dependence.
This commits member nations to prohibit cruel, inhuman or degrading treatment or punishment in relation to AOD use or dependence. This includes protections for individuals detained or incarcerated because of drug offences or AOD use.
This commits member nations to protect individuals’ right to hold and express opinions and beliefs about AOD use, including the right to advocate for harm reduction, treatment and other approaches to addressing substance use disorders.
This commits member nations to prohibit discrimination due to AOD use or dependence in employment, education, housing and access to goods and services. This includes protections for individuals who are currently or previously dependent on drugs or alcohol.
You will find links to all the documents mentioned above from the ‘Legislation’ page of the Australian Human Rights Commission.
Victoria, Queensland and the Australian Capital Territory also have their human rights commissions and a set of legislation and guidelines to protect human rights. Here are the different links to certain legislation:
State/Territory | Human Rights Legislation and Guidelines |
---|---|
Australian Capital Territory | Human Rights |
Queensland | Human Rights Act 2019 |
Victoria | Victoria’s human rights laws |
Human rights are both legal and moral. Human rights are meant to apply to all human beings everywhere, regardless of whether they have received legal recognition. You must uphold and protect human rights as you work with the person. You must ensure that your work practices respect the dignity of the persons.
You and your organisation may ensure that you uphold and protect human rights by using the human rights-based approach in your practices. Human rights-based approaches allow support workers and service providers to use human rights in forming and upholding effective policies, practices and practical realities for all.
Some principles can be followed when using the human rights-based approach. These are:
Everyone has the right to participate in decisions that affect their human rights. Participation must be active, accessible and meaningful. It must give attention to issues of accessibility, including access to information in a form and a language that can be understood.
Accountability requires effective monitoring of compliance with human rights standards, achievement of human rights goals and effective remedies for breaches of human rights. For accountability to be effective, there must be appropriate laws, policies, institutions, administrative procedures and redress mechanisms to secure human rights.
Effective compliance monitoring and achievement of human rights goals also require developing and using appropriate indicators.
A human rights-based approach means that all forms of discrimination in realising rights must be prohibited, prevented and eliminated. It also means that priority should be given to people in the most marginalised or vulnerable situations who face the most significant barriers to realising their rights.
Everyone is entitled to claim and exercise their rights and freedoms. Individuals and communities must understand their rights and fully participate in developing policies and practices that affect their lives. Providing feedback, expressing interests, identifying preferences and expressing sexuality are expressions of thought that must be respected.
A human rights-based approach requires that:
Sourced from Human rights based approaches, used under CC BY 4.0. © Australian Human Rights Commission 2017.
A human rights-based approach can be a valuable tool for AOD workers and service providers to uphold and protect the human rights of their clients. By following the principles of participation, accountability, non-discrimination and equality, empowerment and legality, AOD workers can ensure that their practices are respectful, inclusive and responsive to the needs of their clients.
In the AOD context, human rights-based approaches can be particularly relevant when addressing issues such as informed consent, privacy, confidentiality and discrimination. For example, by prioritising the most vulnerable individuals and communities, AOD workers can ensure that their services are accessible to everyone, regardless of their background or circumstances. Similarly, by actively involving clients in decision-making processes, AOD workers can ensure that their rights and preferences are respected and that they are empowered to make informed choices about their treatment and care. AOD workers can help create a more just, equitable and compassionate society by adopting a human rights-based approach.
When working with clients who use alcohol and other drugs, it is important to recognise and respect their human rights. This includes several ethical considerations that must be considered to ensure that these individuals are treated with respect, dignity and fairness. These ethical considerations are designed to promote and protect the human rights of clients who use AOD, including the client’s right to access care, confidentiality, informed consent, non-discrimination, protection from harm and advocacy. By adhering to these ethical principles, healthcare professionals can ensure that clients who use AOD receive the highest standard of care possible while upholding their basic human rights.
Here are the seven ethical considerations for clients who use alcohol and other drugs, arranged in the order they were presented:
Respect for human dignity
Access to care
Confidentiality
Informed consent
Non-discrimination
Protection from harm
Advocacy
Clients who use alcohol and other drugs should be treated with respect and dignity. Recognising and respecting every individual’s inherent worth and value is important, regardless of their characteristics or circumstances.
Clients who use alcohol and other drugs can access appropriate and effective care. It is important to ensure that services are accessible to all clients, regardless of their characteristics or circumstances, and that barriers to care are identified and addressed.
Clients who use alcohol and other drugs have the right to confidentiality. It is important to ensure that client information is kept confidential and only shared with appropriate parties with the client’s informed consent.
Clients who use alcohol and other drugs have the right to be fully informed about their care and make their own treatment decisions. It is important to provide clients with clear and accurate information about their care and obtain informed consent before providing any treatment.
Clients who use alcohol and other drugs have the right to be free from discrimination based on their characteristics. It is important to ensure that policies and procedures promote non-discrimination and that staff are trained to recognise and avoid discriminatory behaviour.
Clients who use alcohol and other drugs have the right to be protected from damage. It is important to ensure that services are provided safely and effectively and that clients are protected from harm or abuse.
Ethical considerations may also include advocating for clients who use alcohol and other drugs by promoting their human rights and supporting their access to care and services.
AOD support workers help individuals who use drugs and promote their health and well-being. In doing so, AOD support workers must adhere to legal and ethical considerations regarding human rights to ensure that clients receive appropriate care and support while preserving their rights and dignity.
Here are some ways that legal and ethical considerations in AOD work regarding human rights can be applied in organisations:
➤ Providing training and education
➤ Developing policies and procedures
➤ Ensuring informed consent
➤ Implementing anti-discrimination measures
➤ Protecting client privacy
➤ Promoting social justice
➤ Conducting regular audits and evaluations
Organisations can provide training and education to AOD workers on laws, regulations, ethical principles and organisational standards related to human rights. This can help workers understand their legal and ethical responsibilities and apply them in their practice.
Organisations can establish policies and procedures that outline the legal and ethical requirements for AOD work regarding human rights. This can provide a framework for workers to follow and ensure consistency and quality in service provision.
Organisations can obtain informed consent from clients before providing treatment or care. This can involve providing clients with information about the risks and benefits of the treatment and ensuring that they understand the information.
Organisations can implement measures to prevent discrimination in their services. This can involve training workers on cultural sensitivity, ensuring diversity in the workforce, and developing policies to prevent discrimination.
Organisations can protect client privacy by complying with privacy laws and developing policies and procedures for handling confidential information.
Organisations can work towards promoting social justice by addressing the social and economic factors contributing to drug use. This can involve working with clients and other professionals to provide access to appropriate healthcare services and support networks.
Organisations can conduct regular audits and evaluations of their services to ensure they meet legal and ethical standards. This can involve monitoring client satisfaction, reviewing policies and procedures and identifying areas for improvement.
By implementing these strategies, organisations in Australia can ensure that legal and ethical considerations in AOD work regarding human rights are applied effectively in their services. This can promote the safety and well-being of clients while upholding their rights and dignity.
AOD support workers are critical in supporting individuals who use drugs to achieve better health and well-being. However, they must also ensure they provide legal and ethical care and respect their client’s human rights. Applying legal and ethical considerations in individual practice ensures that AOD workers uphold clients’ rights and dignity while providing appropriate care and support.
There are several ways that AOD workers can apply legal and ethical considerations in their practice regarding human rights. Some of these include:
Adhering to laws and regulations | AOD workers must be aware of relevant laws and regulations related to human rights, such as anti-discrimination laws, privacy laws, and informed consent requirements. By complying with these laws and regulations, AOD workers can protect the rights of their clients while providing appropriate care and support. |
Respecting client autonomy | Respecting client autonomy is a key ethical principle in AOD work. AOD workers must respect their clients’ decisions, choices and preferences, even if they disagree. This can involve involving clients in decision-making and seeking informed consent for any treatment or care. |
Promoting non-maleficence and beneficence | AOD workers must promote the ethical principles of non-maleficence (avoiding harm) and beneficence (promoting good). This can involve providing evidence-based and appropriate interventions to clients, monitoring and managing any potential side effects and advocating for clients’ rights and well-being. |
Being culturally sensitive | AOD workers must know their client’s cultural backgrounds and beliefs. This can involve providing language support, respecting cultural norms and practices, and avoiding any actions that may be seen as discriminatory or insensitive. |
Maintaining confidentiality | OD workers must maintain client confidentiality and privacy by adhering to relevant privacy laws and ethical principles. This can involve seeking clients’ informed consent for disclosing their information, storing and transmitting data securely and sharing information only on a need-to-know basis. |
Reflecting on practice: | AOD workers must regularly reflect on their approach to meet legal and ethical standards. This can involve seeking feedback from clients, supervisors and peers, identifying areas for improvement and continuously learning and developing their skills and knowledge. |
By applying legal and ethical considerations in their practice, AOD workers can ensure they provide high-quality and ethical care to their clients while upholding their rights and dignity.
Children in the Workplace
As an AOD support worker, you may encounter children in your work with people dealing with AOD issues. It is your responsibility to ensure their safety and well-being. Some of these children may have grown up in an environment where AOD use is common or may have directly experienced AOD use themselves. Children have individual rights, and it is important to help them exercise these rights to safety and protection. Trauma-informed care is crucial when working with such children. You may need to work with parents or legal guardians to provide the necessary care and support. By prioritising the safety and well-being of children, you can help create a better future for them and break the cycle of AOD use.
You can minimise the risks to children through some key considerations, such as:
AOD support workers also need to be aware of the age of consent in their state or territory, as it may impact how they work with minors. For example, suppose a child under the age of consent discloses that they have engaged in sexual activity. In that case, AOD support workers may be required to report this to authorities, depending on their legal obligations in their state or territory.
Here is a more detailed overview of the age of consent in each state and territory:
New South Wales, Victoria, Queensland, Western Australia, Australian Capital Territory and Northern Territory | The age of consent is 17 years old |
South Australia and Tasmania | The age of consent is 17 years old |
An AOD support worker may need to involve a minor’s parents or legal guardians in their treatment and care. This is particularly important when working with children under the age of consent, as their parents or guardians may need to provide informed consent on their behalf.
There are multiple legislation that AOD support workers need to consider in relation to children in the workplace, such as:
United Nations Convention on the Rights of the Child
Family Law Act 1975
The UNCRC recognises the right of every child to the highest possible standard of health, including access to health care services for the treatment of illness and rehabilitation. States must ensure that no child is denied access to these services.
A service or organisation can implement the UNCRC by ensuring that services prioritise the well-being and health of children by offering specialized care and treatment options that are tailored to their unique needs. Meanwhile, support workers should support the children’s rights to health care services and support their families in accessing appropriate care. This may involve advocating for changes in health care procedures that better align with the child’s rights.
The Act outlines the obligations of an adviser in relation to the best interests of a child. The best interests of the child should be the primary consideration and any action should prioritise the child’s best interests.
A service or organisation can implement this Act by including information about the best interests of the child in their client assessment and treatment planning processes. This includes identifying and addressing any risks of harm to the child and ensuring that the child’s safety and well-being are prioritised. Workers should prioritise the safety and well-being of children receiving their services. This includes reporting any suspected child abuse or ng collaborative neglect to the relevant authorities, and working with other professionals (e.g. child protection services) to ensure that the child’s needs are met.
It is also important to note that states/territories usually have their own legislation related to children in the workplace. For example, the NSW have the Children Protection (Working with Children) Act 2012 No 51 which outlines the requirements for working with children in NSW.
Duty of Care Towards the Children
As an AOD support worker, you must care for the children you encounter. This means ensuring that they are not exposed to any harm and are provided with appropriate support services. To fulfil this duty of care, it is important to be aware of the child’s safety standards and how they apply within the context of AOD.
The Safe Child standards are a set of nationally consistent principles designed to protect children from harm. They cover a range of areas, including governance, risk management, staff selection and training and child-friendly practices. AOD support workers must follow these standards in their work with children to ensure their safety and well-being.
One of the key aspects of the child safety standards is the importance of creating a safe and supportive environment for children. This is particularly important when working with children exposed to AOD use or who grew up in an environment where AOD use is prevalent. A trauma-informed approach can help create this kind of environment, as it recognises the impact of trauma on children’s development and behaviour.
Another aspect of safe child standards is the importance of involving parents or legal guardians in the care and support of children. AOD support workers must work closely with parents or guardians to provide appropriate care and support and to prioritise the child’s rights and best interests.
In addition to following the child-safe standards, AOD support workers must also be aware of any legal requirements regarding the care and support of children. This may include obtaining informed consent from parents or guardians, ensuring confidentiality and privacy and reporting suspected cases of abuse or neglect.
Overall, fulfilling the duty of care towards children in the context of AOD requires a thorough understanding of the child’s safety standards, a trauma-informed approach and close collaboration with parents or legal guardians. By prioritising the safety and well-being of children, AOD support workers can play a critical role in creating a better future for them and breaking the cycle of AOD use
Duty to Report Child Abuse or Neglect Related to AOD Use
As an AOD support worker, you are responsible for reporting any child abuse or neglect that you suspect or witness, as it may be related to AOD use. This duty to report is mandated by law and is a crucial step in protecting the safety and wellbeing of children.
Child abuse and neglect can take many forms, including physical, emotional and sexual abuse and neglect of a child’s basic needs, such as food, shelter and medical care. Children exposed to AOD use in their homes may be at a higher risk of experiencing abuse or neglect, as AOD use can impair a caregiver’s ability to provide adequate care and supervision.
If you suspect or witness child abuse or neglect, it is important to report it immediately to the relevant authorities, such as Child Protective Services or the police. You can also seek guidance from your supervisor or a designated child protection officer.
Reporting child abuse or neglect can be a difficult and emotional process, but it is essential to protect the safety and wellbeing of children. AOD support workers should receive training on the signs and symptoms of child abuse and neglect and their legal obligations to report it. By being vigilant and proactive in identifying and reporting potential cases of child abuse or neglect related to AOD use, AOD support workers can help ensure the safety and wellbeing of vulnerable children.
You may find international, national, state or territory or local laws and legal instruments that guide individuals when dealing with children in the workplace. Some examples are linked in the previous discussion. At the national level, child protection laws serve as bases for policies related to children in the workplace. To learn more about the existing legislation related to working with children in each state or territory, refer to the following table:
State/Territory | Legislation Related to Working With Children |
---|---|
Australian Capital Territory | Working with Vulnerable People (Background Checking) Act 2011 |
New South Wales | Child Protection (Working with Children) Act 2012 No 51 |
Northern Territory | Care and Protection of Children Act 2007 |
Queensland | Working with Children (Risk Management and Screening) Act 2000 No. 60 |
South Australia | Child Safety (Prohibited Persons) Act 2016 |
Tasmania | Registration to Work with Vulnerable People Act 2013 |
Victoria | Worker Screening Act 2020 |
Western Australia | Working with Children (Criminal Record Checking) Act 2004 |
Based on ‘Pre-employment screening: Working With Children Checks and Police Checks’, Australian Institute of Family Studies (AIFS) on behalf of the Commonwealth of Australia, CC BY 4.0
You also need to consider that there are local legislations when dealing with children in the workplace. You can check your local library and ask the librarian for assistance in accessing relevant local legislation, or you may seek help from a qualified lawyer. You may also check the official website of your local community and look for relevant content.
Similar to the legal framework for requirements related to children in the workplace, the ethical framework is based on the principle of child protection.
As an AOD support worker, you must ensure that children in your workplace are safe and protected. This includes following ethical standards for working with and around children.
State and territory governments have introduced child-safe standards to ensure that organisations that work with children are providing a safe environment for them. These standards are based on National Principles for Child Safe Organisations, prescribed by the Australian Human Rights Commission.
As an AOD support worker, it is important to familiarise yourself with the child’s safety standards and follow them in your work. These standards include ensuring that all staff and volunteers who work with children undergo a rigorous screening process, implementing child-safe policies and procedures, providing ongoing training for staff and volunteers on recognising and responding to child abuse and neglect and creating a culture of openness and transparency around child safety.
By following these ethical standards, AOD support workers can help ensure that children are safe, protected and treated with dignity and respect. It is essential that AOD support workers receive proper training on these standards and that they are integrated into the culture and practices of their organisation.
Further Reading Follow the link below for further information on National Principles for Child Safe Organisations: National Principles |
To comply with the legal and ethical requirements for working with children, you must do the following:
★ Control the access and movement of children by designating spaces where they can stay.
★ Ensure that children are supervised at all times.
Doing these things will ensure that children are always safe and secure.
Legal and ethical considerations are critical in any organisation that deals with children. The responsibility of ensuring children’s safety and welfare falls on organisations such as schools, childcare centres and social service agencies. To meet these obligations, organisations must develop the following that address legal and ethical issues concerning children:
Policies |
---|
Set out the overall approach and direction that an organisation takes in relation to children’s safety |
➤ Child protection policy ➤ Code of conduct ➤ Privacy policy |
Procedures |
---|
Provide step-by-step guidance on how to implement policies and achieve the desired outcomes. |
➤ Reporting procedures ➤ Screening and recruitment procedures ➤ Incident management procedures |
Guidelines |
---|
Provide additional information and support to staff and volunteers when implementing policies and procedures |
➤ Guidelines for working with children with special needs ➤ Guidelines for communicating with children ➤ Guidelines for responding to disclosures of abuse |
Organisations must comply with relevant legal frameworks and ethical standards in handling cases involving children. For instance, organisations that work with children must comply with various legal frameworks, such as the:
Organisations in Australia must also adhere to ethical standards, such as those outlined by:
These standards ensure that organisations provide respectful, non-discriminatory services and focus on promoting children’s best interests. Organisations may also develop policies and procedures to guide their staff in responding to cases involving children. These policies and procedures may include guidelines for identifying signs of abuse or neglect, procedures for reporting suspected cases and protocols for responding to emergencies. In developing these policies and procedures, organisations must ensure that they align with legal and ethical standards to promote the safety and well-being of children.
In individual practice, AOD workers working with children should be aware of the legal and ethical considerations and ensure they implement them. This includes:
Age requirements
AOD support workers should ensure that any child they work with meets the legal age requirements for employment in their area. They should also be aware of any exceptions or special circumstances that may apply to child employment.
Labor laws
AOD support workers should be familiar with their area’s relevant labour laws and regulations and ensure they comply with them. This includes keeping accurate records of the child’s work hours and ensuring they receive the required rest breaks and other conditions.
Health and safety regulations
AOD support workers should ensure the work environment is safe for the child. This includes identifying and eliminating hazards or risks, providing appropriate protective equipment and ensuring the child receives the necessary training or instruction.
Child labor
AOD support workers should ensure that any work involving children is not exploitative or detrimental to their wellbeing. This includes ensuring that the child works only for a short time or performs a job appropriate for their age or developmental level.
Confidentiality
AOD support workers should ensure that they maintain the confidentiality of the children and their families. This includes obtaining informed consent from the child’s parent or guardian and explaining the limits of privacy to the child.
Informed consent
AOD support workers should ensure that the child and their parent or guardian fully understand the nature of the work, its benefits and any potential risks or side effects. This includes providing information in a way that is appropriate for the child’s age and level of understanding.
In summary, AOD support workers working with children should be aware of the legal and ethical considerations and ensure they implement them in their practice. This includes ensuring that the child’s safety and well-being are a priority and that they are providing culturally competent and inclusive services.
Discrimination may negatively affect the person and hinder them from having a productive and fulfilling life. Because of this, you must be aware of the legislation protecting the person against discrimination.
The definition of disability in the Disability Discrimination Act 1992 covers AOD issues. This Act makes discrimination against people with disabilities, including those with substance use disorders, illegal. This means that people who use drugs or have a history of drug addiction are protected under this law. Disability discrimination happens when a person is treated less favourably than others in a similar situation because of their disability, which includes mental illness.
Aside from disability discrimination, it is also illegal to discriminate against other people based on age, race, religion, sex and gender. This is enacted in the following federal legislation:
In addition, individual states and territories also have laws against discrimination. Here are the different anti-discrimination legislation and guidelines for each state or territory:
State/Territory | Anti-Discrimination Legislation and Guidelines |
---|---|
Australian Capital Territory | Discrimination Act 1991 |
New South Wales | Anti-Discrimination Act 1977 No 48 |
Northern Territory | Anti-Discrimination Act 1992 |
Queensland | Anti-Discrimination Act 1991 No. 85 |
South Australia | Equal Opportunity Act 1984 |
Tasmania | Anti-Discrimination Act 1998 |
Victoria | Equal Opportunity Act 2010 |
Western Australia | Equal Opportunity Act 1984 |
Internationally, anti-discrimination laws are based on human rights treaties, to which Australia is a party, including seven core treaties:
Based on the international human rights system, it is used under CC BY 4.0. © Commonwealth of Australia 2023.
As an AOD worker, I know that international human rights treaties are important because they set the standard for protecting human rights and ensuring everyone is treated equally and without discrimination. By understanding these treaties, AOD workers can ensure that their services are accessible and inclusive to everyone, regardless of their background, gender or ability. This helps to promote and protect the rights of individuals affected by substance use disorders.
You and your organisation must adhere to existing legislation when working with the person. To do this, you and your organisation must do the following:
Provide equal access to all who need your support and services.
Regardless of the person’s gender, race, disability and religion, you must offer them access to the support and services they need. You must inform them of all the options they can choose from and assist them in all the steps or procedures they must undergo.
Treat all persons with respect and dignity.
When communicating and working with the person, ensure that your actions and words are respectful and not discriminatory. Let the person feel accepted and welcome.
Protect the person from any form of discrimination.
Report any case of discrimination that the person may have experienced. Moreover, it is also essential to inform the persons about their rights based on the various legislation related to discrimination. This will help them protect themselves from any form of discrimination.
AOD work involves supporting individuals who struggle with addiction and substance abuse issues. Discrimination is a serious concern in this field, as it can lead to unequal access to resources and services and perpetuate stereotypes and stigmas associated with addiction.
As an AOD support worker, you must be aware of ethical considerations relevant to discrimination and take steps to address and prevent discrimination within your practice. Some important considerations include the following:
cultural competence
AOD support workers should strive to understand and respect their clients’ diverse cultural backgrounds and experiences. This includes awareness of potential biases and stereotypes and avoiding assumptions or judgments based on cultural or ethnic backgrounds.
Anti-discrimination policies
AOD support workers should be familiar with anti-discrimination policies and laws in their jurisdiction and adhere to them in their practice. This includes ensuring all clients have equal access to resources and services, regardless of race, gender, sexual orientation or other personal characteristics.
Addressing biases and stereotypes
AOD support workers should be aware of their preferences and stereotypes and take steps to address and challenge them. This may involve seeking training and education on cultural competency and diversity and regularly reflecting on personal attitudes and beliefs.
Advocacy and activism
AOD support workers can also engage in advocacy and activism to address discrimination in the wider community. This may involve working with community organisations, lobbying for policy change or speaking out against discrimination and stigma in public forums
Overall, AOD work requires a commitment to addressing and preventing discrimination in all its forms. By being aware of ethical considerations related to discrimination and taking proactive steps to address these issues, AOD support workers can create a safe and supportive environment for their clients and help promote equal access to resources and services.
Organisations in the AOD sector can comply with legal requirements and promote ethical practices regarding discrimination by doing the following:
Policies, procedures and guidelines
Organisations should have clear policies, procedures and guidelines in place to prevent and address discrimination in the workplace. These policies should be regularly reviewed and updated to ensure their effectiveness in addressing discrimination.
Communication
Policies and procedures regarding discrimination should be communicated clearly to all employees. This may involve providing training or education sessions, distributing handbooks or other written materials or posting policies and procedures in visible locations throughout the workplace.
Training and education
Organisations should provide training and education to staff on discrimination policies and practices. This can include educating employees on different types of discrimination, how to recognise discriminatory behaviour and how to respond appropriately to such behaviour.
Awareness-raising
Organisations can also raise awareness of discrimination by creating a culture of respect and inclusivity. This can involve celebrating diversity, promoting understanding and tolerance, and creating opportunities for staff to learn about different cultures, religions and backgrounds.
Response procedures
When cases of discrimination occur, organisations must have clear procedures for handling such situations. This may involve conducting an investigation, providing support to affected individuals, taking disciplinary action against perpetrators and making changes to policies or practices to prevent future occurrences.
Compliance
Organisations must comply with legal requirements regarding discrimination, including the Australian Human Rights Commission Act 1986 (Cth), the Disability Discrimination Act 1992 (Cth) and the Fair Work Act 2009 (Cth). It is important for organisations to keep up-to-date with changes to legislation and ensure their policies and practices remain compliant.
By implementing these measures, organisations in the AOD context can create a safe and inclusive workplace for all employees and clients and promote a culture of respect, diversity and equality.
Legal and ethical considerations regarding discrimination are critical in the practice of AOD support workers. Here are some more specific ways that you can apply legal and ethical considerations regarding discrimination in your individual practice:
Learning about the cultural backgrounds of their clients and how it may affect their drug use and treatment
Being respectful of their client’s beliefs, values and cultural practices
Avoiding stereotypes and assumptions based on their clients’ cultural background
Providing culturally appropriate care that is sensitive to their client’s needs
Engaging with interpreters or cultural brokers if necessary to ensure effective communication and understanding
Ensuring the client’s personal and health information is kept confidential and only shared with others on a need-to-know basis
Informing their clients about their right to confidentiality and obtaining their consent before sharing their information
Complying with privacy laws and regulations, such as the Privacy Act 1988 (Cth)
Familiarising with the relevant laws and regulations that govern their practice, such as the Australian Human Rights Commission Act 1986 and the Racial Discrimination Act 1975
Avoiding any discriminatory practices that could lead to legal consequences
Reporting any instances of discrimination or harassment to their supervisor or appropriate authorities as required by law
Providing services to all clients regardless of their race, ethnicity, gender, sexual orientation, age, disability or other characteristics
Ensuring that their clients have equal access to services and resources, including those who are from marginalised or disadvantaged backgrounds
Addressing any barriers the clients may face, such as language barriers
Overall, you must be aware of the legal and ethical considerations regarding discrimination and actively work to prevent discriminatory practices. You should strive to provide non-judgmental, culturally appropriate and inclusive care to all your clients.
Specific AOD laws also protect the rights and dignity of people with AOD issues across Australia. Here are the respective AOD Acts for each jurisdiction in Australia:
State/Territory | Mental Health Act |
New South Wales | Drug Offences |
Victoria | Drugs, Poisons and Controlled Substances Act 1981 |
Queensland | Drug offences |
South Australia | Drugs |
Western Australia | Illicit drugs and the law |
Tasmania | Drugs |
Australian Capital Territory | Drugs of Dependence Act 1989 |
Northern Territory | Drugs and the law |
AOD Acts outline the rights and protections of people with AOD background and their carers and families.
One of these AOD Acts is the Drugs, Poisons and Controlled Substance Act 1981. The Act aims to protect public health and safety by ensuring that these substances are used in a safe and appropriate manner while also enabling access to necessary medical treatments.
Some of the specific objectives of the Act include:
The provisions of legislation must be reflected in your organisation’s policies and procedures and be the basis of your work practices. This means that you must do the following:
Further ReadingLearn more about the AOD Client Charter and Resources, which aims to empower individuals seeking AOD treatment and to promote a client-centred and respectful approach to care. Alcohol and other drug client charter and resources |
Aligning organisational policies, procedures, guidelines, practices and operations with specific AOD legislation is critical for ensuring compliance and delivering quality services. Here are some ways organisations can align their policies and procedures with AOD legislation:
The organisation should comprehensively review its policies, procedures, guidelines and practices to identify gaps or areas that need improvement. The review should include an assessment of the organisation’s compliance with specific AOD legislation.
Organisations must obtain the proper licenses and certifications to comply with AOD legislation. The organisation should identify the permits and certifications required by the relevant legislation and ensure they are received and up-to-date.
Organisations should use evidence-based practices to ensure clients receive effective and appropriate care. Evidence-based practices are those that have been proven to be effective through research and clinical experience.
Staff training ensures all employees understand and comply with the AOD legislation. The organisation should provide ongoing staff training to ensure they are aware of any updates or changes to the legislation.
Organisations should have sufficient resources, including staff, equipment and supplies, to comply with the AOD legislation. This may require the organisation to increase its resources to meet the needs of its clients and comply with the legislation.
Organisations should develop and implement quality assurance processes to monitor compliance with AOD legislation. These processes should include regular audits and reviews of policies, procedures and practices to ensure they align with the legislation.
Organisations should seek legal advice from experts in AOD legislation to ensure they are fully compliant. Legal advice can help organisations understand their legal obligations and provide guidance on how to comply with the legislation.
Aside from the different legislation presented in the discussion, here are specific AOD legislations that you can alo consider reviewing:
United Nations Single Convention on Narcotic Drugs 1961
Therapeutic Goods (Poisons Standard – February 2023) Instrument 2023
Drug and Alcohol Treatment Act 2007 No.7
This is an international legislation that states each party to the convention shall take effective measures to establish and maintain a system of control over the cultivation, production, manufacture and distribution of drugs referred to in Article 1 and to ensure their availability for medical and scientific purposes.
In the AOD sector, a service or organisation can implement this approach by ensuring that only authorised personnel prescribe and dispense controlled substances during treatment.
The schedule 8 of this legislation includes substances that have a high potential for abuse, addiction or dependence. These substances are strictly regulated and can only be used for medical or scientific purposes. Possession of these without authority is considered an offense.
To implement this, a service or organisation in the AOD sector can ensure secure storage of Schedule 8 drugs, limiting access to authorized personnel only. In the context of AOD work practice, this can be accomplished by securely storing the drugs and maintaining detailed documentation of their administration by authorized personnel, including information on when and how they were administered.
This outlines the requirements for the provision of drug and alcohol treatment services, including the need for services to be evidence-based, individualised and culturally appropriate.
A service or organisation in the AOD sector can implement this by ensuring that the services provided are of high quality and meet the standards set out in the Act.
This can be applied in AOD work practice by informing the clients about their rights and responsibilities and ensuring that they are fully informed about their treatment options.
Each state or territory may have their own specific AOD legislation. In this example, NSW has Drug and Alcohol Treatment Act 2007 No.7. You may check available and active legislation in your state or territory.
Consequences of Breaches
When laws and regulations are breached or not complied with, they may cause harm to the person or violate their rights. The national and state or territory governing bodies sanction non-compliance with laws. The authority that will address the non-compliance will depend on the type of violation. For example, a national regulatory authority will handle non-compliance with national law.
Non-compliance incidents are monitored and sanctioned by national, state or territory regulatory authorities. Non-compliance may result in penalties such as the following:
Monetary fines
Suspension
Termination
Criminal prosecution
In the case of international frameworks, they set requirements for member countries. For example, an international judicial body may investigate human rights violations. This is because international agreements, treaties and covenants protect human rights. In these cases, the country with jurisdiction over the case must coordinate and cooperate with international courts. This means that if an organisation violates human rights, it may be investigated nationally and internationally.
Privacy, confidentiality, and disclosure are important concepts in the context of Alcohol and Other Drugs (AOD) in Australia. These concepts are particularly relevant in AOD treatment and support services, where clients may disclose sensitive information about their substance use and related issues.
Privacy is an individual’s right to control personal information and who has access to it. In the context of AOD, privacy means that individuals have the right to keep their substance use and related issues confidential. AOD treatment and support services must ensure that the client’s personal information is kept confidential unless disclosure is required by law or is necessary to protect the client or others from harm.
Confidentiality is the practice of protecting individuals’ personal information by limiting access to it. In the AOD context, confidentiality means that treatment and support service providers should only share a client’s personal information with others who need to know. This could include other healthcare professionals involved in the client’s care, such as a general practitioner (GP) or psychiatrist. However, AOD treatment and support services should always obtain the client’s consent before sharing their personal information unless disclosure is required by law or is necessary to protect the client or others from harm.
Disclosure is the act of sharing personal information with others. In the AOD context, disclosure may occur when a client voluntarily shares information about their substance use and related issues with a treatment or support service provider or when personal information is shared with others for legitimate reasons, such as referral to other healthcare professionals or for statistical reporting purposes. However, it is important to note that there are limits to confidentiality and privacy, and treatment and support service providers must be upfront about these limitations with clients.
Laws and regulations such as the Privacy Act 1988 and the Australian Privacy Principles protect individual privacy and confidentiality. AOD treatment and support services must comply with these laws and regulations when handling clients’ personal information. Professional codes of ethics and practice also guide AOD treatment and support service providers in maintaining confidentiality and protecting clients’ privacy.
The Privacy Act 1988 sets principles that govern how an organisation does the following:
Collect and use the personal information of employees and persons
Ensure accountability for misuse of information that they collect
Ensure the accuracy of the information they collect
Provide employees and persons with access to their own information and that of others
Privacy, confidentiality and disclosure are important concepts in the AOD context. AOD treatment and support service providers must ensure that the client’s personal information is kept confidential, only shared with others who have a legitimate need to know and that clients are informed about the limitations of confidentiality and privacy. Compliance with relevant laws and regulations, as well as professional codes of ethics and practice, is essential in maintaining the confidentiality and privacy of AOD clients.
Information you collect and use for operations is subject to privacy, confidentiality and disclosure laws. In relation to these laws, the handling of information in your organisation is governed by ethical principles that guide practice. Privacy, confidentiality and disclosure policies are based on respect for individual privacy and discretion. Each individual has a right to decide what information they share with organisations and know how it is used. Under disclosure, individuals also have the right to decide if their information should be used or shared.
The following guidelines may apply to you and others in your organisation to maintain an ethical practice in relation to privacy, confidentiality and disclosure:
Do not bring up confidential information in conversations you have with others.
Treat colleagues and persons with respect. Do not judge or discriminate against them based on confidential or protected information.
Do not force people to share information if they are not comfortable with it.
ensure that authorised discussions of confidential matters are conducted in a secure environment.
Always obtain consent when you wish to bring up or discuss confidential information.
These guidelines may be instituted in policies and procedures to require strict compliance by all workers.
While privacy, confidentiality and disclosure are important ethical considerations when working with clients who use alcohol and other drugs, there are also limitations to these considerations.
These limitations may include the following:
In some jurisdictions, AOD treatment and support service providers may be legally obligated to report certain information to relevant authorities, such as when a client risks harming themselves or others. Providers should inform clients about these mandatory reporting requirements at the outset of treatment.
In some situations, AOD support workers may have a duty to warn or protect third parties if they believe the client may pose a danger to them.
AOD treatment and support service providers may be required to disclose a client’s personal information if they receive a court order or subpoena. Providers should inform clients about this possibility and discuss its consequences.
A client’s personal information may need to be shared among members of their treatment team to coordinate care. Providers should inform clients about who will have access to their information and why and obtain the client’s consent for sharing information.
Group therapy sessions may involve sharing personal information with others. Providers should inform clients about the limits to confidentiality in group therapy and ensure that all group members understand and agree to the ground rules around sharing personal information.
With the increasing use of electronic communication in AOD treatment and support services, there may be limitations to privacy and confidentiality, such as the potential for intercepted or hacked messages. Providers should inform clients about these risks and discuss alternative communication methods.
AOD treatment and support service providers may have shared spaces, such as waiting areas or group therapy rooms, where other clients or visitors may be present. Providers should ensure their clients’ privacy in these shared spaces by providing separate waiting areas or scheduling group therapy sessions at different times.
AOD treatment and support service providers must be transparent and upfront about the limitations to privacy and confidentiality with clients. By doing so, providers can help clients make informed decisions about their treatment and support and promote trust and confidence in the therapeutic relationship.
Here are some legislation that must be taken into consideration by organisations and AOD workers in relation to privacy, confidentiality and disclosure:
▶︎ Convention for the Protection of Individuals with regard to Automatic Processing of Personal Data
▶︎ The General Data Protection Regulation (GDPR)
▶︎ Australian Privacy Principles
According to this Convention, personal data undergoing automatic processing shall be accurate and, where necessary, kept up to date. A service or organisation in the AOD sector in the AOD sector can implement this legal consideration by ensuring that all client files are kept in a secure location with limited access. This can be implemented in the AOD work practice by taking appropriate measures to protect the privacy of clients during communication, such a using an encrypted mail.
A limitation of this legal consideration is that personal data can only be collected for specified, explicit, and legitimate purposes. Clients have the right to access, correct, and delete their personal data held by the AOD organisation. The AOD organisation must also implement appropriate technical and organisational measures to ensure the security and confidentiality of personal data.
Under this regulation, personal data shall be processed to ensure its appropriate security, including protection against unauthorised or unlawful processing and against accidental loss, destruction or damage, using appropriate technical or organisational measures.
A service or organisation in the AOD sector can ensure compliance with GDPR by developing policies and procedures about data protection, including measures to ensure that client’s personal data are collected, processed, and stored securely. This can be implemented in the AOD work practice by placing the personal information of individuals receiving treatment or support services in secured locations like electronic systems or physical storage solutions.
A limitation of this legal consideration is that explicit consent from the client is required for the use of their data, except when the use of the information is necessary for the protection of vital interests or for compliance with a legal obligation.
Based on these principles, ‘disclosure’ is a separate concept from ‘unauthorised access’. An APP entity is not taken to disclose personal information where a third party intentionally exploits the entity’s security measures and gains unauthorised access to the information. A limitation of this legal consideration is that disclosure of personal data must be necessary and proportionate to the purpose, and the APPs impose strict requirements on the handling of personal information.
Aside from these, states/territories also have their own legislation on privacy, confidentiality and disclosure. For example, the Privacy and Personal Information Protection Act 1998 No 133 is implemented in NSW.
Informed consent is a concept under privacy, confidentiality and disclosure relating to the actions and steps an organisation must perform before using the information provided by individuals. Under informed consent, you may only use personal information after informing and discussing your intent with the people involved and getting their clear and documented consent.
Informed consent is based on frameworks related to data privacy and protection. For example, an international framework related to informed consent is The Convention for the Protection of Individuals with regard to Automatic Processing of Personal Data (CETS No. 108). This ensures the protection of information that was processed using advanced systems. At a national level, informed consent is governed by the Privacy Act 1988 and the Australian Privacy Principles. These principles set out requirements for consent to be valid. Informed consent is also applied in state, territory and local laws through privacy and information laws, regulations, codes and ordinances.
Informed consent is an ethical and legal requirement in healthcare, including within the context of AOD treatment.
For clients who use alcohol and other drugs, providing informed consent may be challenging due to various factors such as impaired decision-making capacity or limited access to information. These clients may have difficulty understanding the nature of the treatment, the potential risks and benefits and the available alternatives. AOD support workers need to consider these factors and ensure that clients have the support they need to make informed decisions.
AOD support workers can assist clients in providing informed consent by taking steps such as:
Providing clear and concise information about the treatment or intervention in a manner that is appropriate for the client’s level of understanding.
Ensuring that the client has the opportunity to ask questions and seek clarification.
Assessing the client’s decision-making capacity and providing additional support or resources as needed.
Ensuring that the client is not coerced or pressured into making a decision.
Documenting the informed consent process and ensuring the client understands their rights and can withdraw their consent anytime.
The legal requirements concerning informed consent dictate your actions when obtaining consent. Legally, consent is only sufficient and valid when it meets the following criteria:
➤ Consent is only valid if the person giving consent is aware of the related consequences.
➤ People must not be forced to give their consent.
➤ Consent is only limited to the specific purpose requested and discussed, and should not be assumed as granted for other purposes.
➤ The person giving consent must be sufficiently capable of giving consent.
Aside from achieving these requirements, your organisation also has corresponding ethical responsibilities such as:
▶︎ Ensuring that the person involved completely understands what they are consenting to and why
▶︎ Practising due diligence in providing the person involved with all the information they need to give consent to
▶︎ Refusing to proceed if there is enough reason to believe that the person involved is incapable of giving informed consent
In the workplace, you may encounter situations where you need to obtain informed consent from persons, such as:
In these cases, always remember to apply your ethical responsibilities in performing work. For an organisational approach, you must require the same ethical standards from all employees by implementing the necessary policies and procedures for informed consent.
To comply with the requirements of informed consent when handling information, you must:
Legal and ethical considerations regarding discrimination are crucial in organisations, especially in the healthcare sector. Discrimination can take many forms, including discrimination based on a person’s race, ethnicity, gender, sexual orientation, age, disability and other personal characteristics. Discrimination can significantly impact the health and well-being of individuals, particularly those who use alcohol and other drugs (AOD).
Legal and ethical considerations regarding discrimination can be applied through policies, procedures, guidelines, training and education for staff. For example:
Organisations can develop policies and procedures that outline their commitment to promoting equality and non-discrimination and guide how to handle cases involving discrimination. These policies should be developed in consultation with clients, staff and other stakeholders to ensure they are relevant and effective.
Organisations can provide guidelines to staff on obtaining informed consent from clients who may face additional barriers to providing informed consent due to their substance use, such as impaired decision-making capacity or difficulty accessing information. These guidelines can provide a framework for staff to follow and ensure that clients are fully informed and can make decisions about their care.
Organisations can provide training and education on legal and ethical considerations regarding discrimination, including the importance of obtaining informed consent and the potential barriers clients may face. This training can also cover strategies for addressing discrimination and promoting equality in the workplace.
In conclusion, legal and ethical considerations regarding discrimination are critical in organisations that provide AOD treatment. These considerations can be applied through policies, procedures, guidelines, training and education for staff to ensure that clients receive appropriate and ethical care and that workplace discrimination is addressed and prevented.
Here are other legal considerations related to informed consent that AOD workers must take note of:
Convention on the Rights of Persons with Disabilities (CRPD)
Australian Privacy Principles
Privacy and Personal Information Act 1998 No 133
The CRPD recognizes the right of persons with disabilities to give their free and informed consent for any treatment or intervention they may undergo, including those related to substance abuse.
A service or organisation in the AOD sector must provide accessible and easy-to-understand information about the treatment or intervention to the person with a disability and allow them to ask questions and make an informed decision about their care. Meanwhile, a worker must ensure that the client understands the information provided to them about their treatment or intervention and that they are given enough time to consider their decision. It is important to obtain their consent before proceeding with any treatment or intervention.
According to this, organisations must obtain an individual’s consent before collecting, using or disclosing their personal information, unless an exception applies. The consent must be voluntary, current and informed, and the individual must have the capacity to understand the consequences of giving their consent.
There are also legal and ethical considerations implemented in the states/territories. For example, there is the Privacy and Personal Information Act 1998 No 133 in NSW which established principles for the collection, use and disclosure of personal information in the state.
Duty of care is a fundamental legal and ethical concept particularly relevant to Australia’s AOD sector. The AOD sector is critical in supporting individuals who use drugs, their families and the wider community. As such, everyone in this sector must understand their duty of care obligations and how to apply them in their daily work.
Duty of care is a legal concept that refers to the responsibility of individuals and organisations to take reasonable care to prevent harm to others. In the AOD sector, the duty of care is paramount to ensure the safety and well-being of people who use drugs, their families and the wider community. Everyone working in the AOD sector must understand their duty of care obligations and how to apply them in their daily work.
The duty of care concept is based on the common law and has been reinforced by legislative frameworks in Australia. In the AOD sector, the duty of care applies to all individuals and organisations who provide services to people who use drugs. This includes AOD treatment services, harm reduction services, mental health services and primary health care providers.
Knowing the duty of care in the AOD sector cannot be overstated. It provides a framework for ensuring that individuals who use drugs receive the best possible care and support while minimising the risks associated with drug use. Duty of care obligations also helps to ensure that staff members in AOD services are protected from legal liability.
In organisational practice, a duty of care requires that AOD service providers take reasonable steps to identify and assess the risks associated with drug use and develop strategies to mitigate those risks. This includes the following:
★ Implementing policies and procedures to promote safe and responsible drug use.
★ Providing education and training to staff and clients
★ Ensuring that appropriate support services are available.
Policies and procedures are important tools for promoting safe and responsible drug use. They provide clear guidelines for staff and clients on handling drugs safely and minimising risks associated with drug use. Some key policies and procedures to consider are the following:
By implementing these policies and procedures, organisations can create a safer environment for staff and clients.
Education and training are essential components of promoting safe and responsible drug use. Staff should be trained on the risks associated with different types of drugs and how to recognise signs of drug misuse or abuse. Clients should also be educated on the risks associated with drug use and how to use medicines safely. Some key topics to cover include:
By providing education and training, organisations can empower staff and clients to make informed decisions about their drug use and minimise the risks associated with drug use.
Support services are essential for promoting safe and responsible drug use. Clients who struggle with drug use may need access to healthcare professionals, counselling services and addiction treatment programs. Some key support services to consider include:
Medical care
Medical attention if clients experience adverse reactions to drugs or develop health problems related to drug use.
Counselling Service
Counselling to help clients address underlying issues that contribute to drug use and develop coping strategies.
Addiction treatment programs
Access to specialised treatment programs to help clients overcome their addiction and build healthier lifestyles.
Individual practice in the AOD sector requires staff members to act in a way that ensures the safety and well-being of clients. This means that staff members must exercise reasonable care and skill when providing services to clients, including assessing the risks associated with drug use, developing appropriate treatment plans, and monitoring clients’ progress.
Duty of care also requires staff members to respect clients’ rights and dignity, maintain confidentiality and privacy and promote cultural safety and inclusivity. Staff members must also be aware of their limitations and seek advice or support from colleagues or supervisors when necessary. A duty of care provides a framework for ensuring that individuals who use drugs receive safe and effective care and support and that staff members are protected from legal liability.
Below are some legal considerations that an AOD worker must consider:
Article 3 of the Universal Declaration of Human Rights
National Disability Insurance Scheme Act 2013
Civil Liability Act 2002 No 22.
This article states that everyone has the right to life, liberty and security. A service or organisation in the AOD sector can implement the legal consideration by conducting risk assessments, providing appropriate supervision and monitoring, and responding promptly and effectively to incidents or emergencies.
Working in accordance with this legal consideration may involve maintaining accurate and up-to-date client records, respecting client confidentiality, seeking consent from clients before providing any treatment or care, and involving clients in the decision-making process about their treatment and care plan.
According to this legislation, service providers have a duty of care to ensure that clients receive safe and high-quality services that meet their needs and preferences.
A service or organisation must develop individualised support plans for clients that are based on their needs, preferences and goals, and regularly review progress to ensure that the support provided is effective and safe. Meanwhile, workers must follow individualised support plans, participate in training and development opportunities, and report any concerns or issues to relevant supervisors or managers.
Different state/territory legislation also emphasises the importance of understanding the duty of care. In NSW, persons who cause harm to another person will have a civil liability under the Civil Liability Act 2002 No 22.
Codes of conduct and codes of practice are closely linked to the duty of care in AOD work. Both the codes of conduct and practices guide how AOD workers can meet their duty of care obligations.
While codes of conduct and codes of practice are often formalised and documented, they also encompass a range of behaviours, attitudes, and practices expected of AOD workers. Both are designed to provide guidance and set standards for AOD workers in their professional practice.
However, there are some key differences between the two. Below is a discussion of each of their key characteristics, their example and how each is applied in organisations and individual practice in the AOD work.
Codes of conduct |
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⇢ Focus on ethical principles and standards of behaviour ⇢ Provide guidance on the expectations and responsibilities of professionals in relation to their clients, colleagues and the broader community ⇢ Often include specific standards or rules that must be followed ⇢ May include provisions for disciplinary action in cases of misconduct or breach of the code |
There are international, national, state or territory and local ethical considerations that you should consider as an AOD worker. For international legislation, you may check International Standards for the Treatment of Drug Use Disorders. The International Standards provide guidelines for the treatment of drug use disorders, including recommendations for assessing client needs, developing treatment plan, providing pharmacological and psychosocial interventions and ensuring the rights of clients.
As for national codes of ethics, you may check the Australian Community Workers Ethics and Good Practice Guide. This is applied in AOD work as a reference guide for ethical decision-making in both individual practice and organisations. A service or organisation in the AOD sector can implement these standards by using them as a basis for developing policies and procedures related to the treatment of clients with AOD issues. A worker can work in accordance to these standards by using the Standards to assess client needs, develop treatment plans, and provide interventions that are evidence-based and tailored to the individual needs of the client.
Ethical considerations may vary from one state or territory to another. Local communities may also have their own ethical considerations. You may check the official website of you state, territory or even the local government. The websites can help you identify the current codes of conduct used in your state, territory or local community. Here is an example, NSW Health of Conduct aims to ensure that everyone acts with integrity, respects human rights, maintains confidentiality and avoids conflicts of interest or other unethical behaviours.
Social workers in AOD settings are expected to adhere to the ethical principles and standards outlined in the code of ethics. This means that they must uphold the dignity and rights of their clients, maintain confidentiality, and avoid conflicts of interest. Additionally, they are expected to deliver services in a culturally sensitive and respectful manner that is responsive to the needs of their clients.
In organisational practice, the AASW Code of Ethics can be used to develop policies and procedures that promote ethical practice in AOD work. The code of ethics can be used to guide decision-making and provide a framework for ethical reflection and practice. By promoting adherence to the AASW Code of Ethics, organisations can help to ensure that their social workers are providing safe and effective services to their clients while also meeting their ethical and legal obligations.
Codes of practice |
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★ Focus on practical guidelines for carrying out specific tasks or activities ★ Provide guidance on best practices, methods, and procedures for delivering services or carrying out work ★ Often include detailed instructions, checklists or templates to help professionals carry out their work effectively ★ Include provisions for quality assurance and monitoring to ensure that services are delivered consistently and to a high standard |
The Code of Practice for Violence and Aggression at Work in Western Australia is not specifically focused on AOD work but is relevant to the AOD sector. This code guides employers, managers and workers on preventing and managing violence and aggression in the workplace. It applies to all workplaces in Western Australia, including those in the AOD sector.
In the AOD sector, workers can sometimes face situations where clients become aggressive or violent due to the nature of the work. This can pose a risk to the safety and well-being of both staff and clients. The Code of Practice for Violence and Aggression at Work guides risk assessment, prevention strategies and incident response, which can be useful for AOD workers in managing these risks.
In individual AOD practices, the Code of Practice can also guide workers in managing their own safety and the safety of their clients. Workers can use the guidance provided to identify risks and take steps to prevent or manage incidents of violence or aggression. Suppose an AOD worker conducts a one-on-one counselling session with a client who becomes agitated and verbally abusive.
The worker can refer to the Code of Practice to take steps such as remaining calm and non-confrontational, maintaining a safe distance and calling for assistance if necessary. They may also review their agency’s policies and procedures for responding to violent incidents and report the incident to their supervisor. By following the guidance provided by the Code of Practice, the worker can help ensure their safety and the safety of their client.
Organisations, on the other hand, may apply this in several ways, such as:
❖ Conducting a risk assessment and identifying potential areas of concern. Based on these, the organisation can develop strategies to minimise the risks and provide a safe work environment for staff.
❖ Helping in developing policies and procedures for preventing and managing incidents of violence and aggression.
❖ Providing guidance on training and education for staff to manage violence and aggression in the workplace.
❖ Developing a clear and consistent approach to reporting and managing incidents.
Below are some examples of codes of practice that support workers must consider:
☞ International Standards for the Treatment of Drug Use Disorders
☞ Australian Community Workers Ethics and Good Practice Guide
☞ Management of Withdrawal from Alcohol and Other Drugs
The International Standards for the Treatment of Drug Use Disorders provides guidance and recommendations for evidence-based treatment approaches to drug use disorders to improve the quality and accessibility of drug treatment services worldwide.
A service or organisation must adopt evidence-based treatment practices that are consistent with the Standards, such as using validated screening tools, developing individualized treatment plans and providing ongoing monitoring and support. Workers must stay up-to-date with evidence-based practices and provide person-centred care that is respectful of the person’s autonomy and culture.
A community work practitioner, in providing services to individuals and communities, should work in accordance with a code of ethics and in agreement with the principles of individual worth and the individual’s right to social inclusion.
A service or organisation in the AOD sector can implement the codes of practice by fostering a culture of ethical practice by regularly discussing ethical issues and promoting ethical decision-making within the workplace. A worker can work in accordance with the codes of conduct by maintaining appropriate professional boundaries with clients. This may include not accepting gifts and not engaging in any activities that could compromise their objectivity towards clients.
States/territories may also have their own codes of practice for different industries. For example, in NSW, the Management of Withdrawal from Alcohol and Other Drugs is used to outline best practice guidelines for their AOD sector.
The dignity of risk is an important concept in the AOD sector that recognises the right of individuals to make their own decisions about their lives, even if those decisions involve some degree of risk. It is based on the belief that everyone has the right to autonomy and self-determination and that taking risks is a normal part of life.
In the AOD sector, knowing about the dignity of risk is important for practitioners because it helps them to support clients in making informed decisions about their drug use. By recognising the client’s right to autonomy and self-determination, practitioners can help empower clients to take control of their own lives and make decisions consistent with their values and goals.
The dignity of risk is applied in organisations and individual practice in several ways. For example:
Organisations can ensure clients are provided with information about the risks and benefits of different treatment options.
AOD workers can promote fostering a non-judgmental and supportive environment where clients feel safe to decide about their drug use without fear of stigma or shame.
AOD workers can use motivational interviewing techniques to help clients explore the pros and cons of their drug use and make informed decisions about changing their behaviour.
However, it is important to note that dignity of risk is not an absolute right. Practitioners are responsible for balancing the client’s right to autonomy with their duty of care. This means that practitioners must ensure that clients are fully informed about the risks and benefits of their choices and that they are not exposed to undue harm.
In conclusion, the concept of dignity of risk is an important principle in the AOD sector that recognises the right of individuals to make decisions about their own lives, even if those decisions involve some degree of risk. Practitioners can promote the dignity of risk by fostering a supportive and non-judgmental environment, using motivational interviewing techniques and balancing the client’s right to autonomy with their duty of care.
There are additional ways in which the concept of dignity of risk is applied in organisations and individual practice in the AOD sector. They are the following:
⌱ Collaborative decision-making
⌱ supporting harm reduction
⌱ Providing education and information
⌱ Balancing risk and safety
The dignity of risk recognises that clients are the experts in their own lives and have the right to decide about their drug use. Practitioners can promote the dignity of trouble by working collaboratively with clients to develop treatment plans consistent with their values and goals. This involves listening to the client’s perspective, providing accurate information about the risks and benefits of different treatment options, and respecting their decisions, even if they differ from what the practitioner would have chosen.
Harm reduction is an approach to drug use that recognises that people will continue to use drugs but aims to minimise the harm associated with drug use. The dignity of risk is closely linked to harm reduction because it recognises that clients have the right to choose their drug use, even if those choices involve some degree of risk. Practitioners can promote the dignity of risk by supporting harm reduction strategies such as safe injection sites, naloxone distribution, and drug-checking services.
The dignity of risk is based on the belief that individuals have the right to make informed decisions about their lives. Practitioners can promote the dignity of risk by providing clients with accurate information about the risks and benefits of different treatment options and encouraging them to make decisions consistent with their values and goals. This involves educating on harm reduction strategies, the risks associated with drug use, and the benefits of treatment.
Practitioners have a duty of care to ensure that clients are not exposed to undue harm. This means that while promoting the dignity of risk, practitioners must also balance the client’s right to autonomy with their duty to provide safe and effective care. AOD support workers can encourage the dignity of risk by using their professional judgment to determine when a client’s choices may pose a risk to their health and safety and by providing appropriate support and interventions to minimise that risk.
In conclusion, the dignity of risk is applied in organisations and individual practice in several ways in the AOD sector. These include collaborative decision-making, supporting harm reduction, providing education and information, and balancing risk and safety. By promoting the dignity of risk. AOD support workers can empower clients to take control of their own lives and make decisions consistent with their values and goals.
There are also multiple legislation related to the dignity of risk that you must consider, such as the following:
Convention on the Rights of Persons with Disabilities
National Disability Insurance Scheme (NDIS) Act 2013
Disability Inclusion Act 2014 No 41
The Convention recognises that all persons with disabilities have the right to respect for their inherent dignity and individual autonomy, and should be able to exercise the right to make their own choices, take risks, and engage in activities of their choice.
A service or organisation in the AOD sector can implement the Convention by ensuring that clients with AOD issues are informed of their rights and are supported to make their own decisions about their treatment and care, even if those decisions involve some level of risk. Meanwhile, a worker can work in accordance with this Convention by respecting the choices and decisions of clients with AOD issues and providing support and guidance to clients to help them make informed decisions about their treatment and care.
The NDIS aims to support people with disabilities to live their lives as they choose and exercise their independence and control. This includes recognizing their right to take risks and make decisions that may involve a degree of risk.
A service or organisation in the AOD sector must create policies and procedures that support clients with disabilities and their families to make informed decisions about the risks they want to take and ensure that staff are trained to support clients in these decisions. Workers must work collaboratively with clients with disabilities and their families to identify and assess the risks associated with different courses of action and support their choices while also managing any potential risks. You must also check the legislation implemented in your state/territory. For example, if you are from NSW, the Disability Inclusion Act 2014 No 41 promotes the rights of people with disabilities to take risks and make their own decisions. A similar legislation within your state/territory and industry might be available as well.
Practice standards are essential guidelines establishing the quality of practice expected in a particular field or sector. They provide a framework for delivering effective and safe client services while maintaining ethical and professional standards. In the Australian context, the alcohol and other drugs sector has several relevant practice standards.
One of the key standards is the National Alcohol and Other Drug Workforce Development Framework, which outlines best practice principles such as evidence-based practice and harm minimisation.
The National Practice Standards for the Mental Health Workforce and state-specific guidelines also provide the knowledge, skills, and attitudes required by those working in the AOD sector. For example, in Victoria, the Department of Health and Human Services has developed the AOD Clinical Practice Guidelines, which provide best practices in assessing and treating AOD issues.
Individuals and organisations in the AOD sector must understand these standards and apply them to ensure clients receive high-quality services. This includes regular training and professional development opportunities and establishing policies and procedures reflecting best practice principles. By adhering to practice standards, practitioners can provide the best care to clients and contribute to a well-respected and valued sector.
The application of practice standards in organisations and individual practice in the AOD sector involves several key steps:
AOD support workers must understand the applicable practice standards. This may involve reading the guidelines, attending training or professional development sessions and discussing the standards with colleagues and supervisors.
Once individuals understand the practice standards, they can begin to incorporate them into their work. This may involve using evidence-based interventions, implementing harm minimisation strategies, and ensuring that clients are treated in a respectful and non-judgmental manner.
Organisations in the AOD sector are responsible for ensuring that their staff are trained in and adhere to these practice standards. This may involve developing policies and procedures that reflect the principles of best practice, providing regular training and professional development opportunities and monitoring the quality of services offered to clients.
One way organisations can support the application of practice standards is by conducting regular clinical supervision and peer support sessions. This allows staff to discuss their work with others, receive feedback and support and identify areas where they may need further training or development.
Another important aspect of applying practice standards is continuing assessment and quality improvement. This may involve monitoring client outcomes, collecting feedback from clients and staff and reviewing policies and procedures to ensure they remain current and reflect the latest research and best practice guidelines.
Here are some examples of legal considerations AOD workers must take note of in relation to practice standards:
➤ International Standards on Drug Use Prevention
➤ National Quality Framework for Drug and Alcohol Treatment Services
➤ NSW Health Clinical Care Standards: Alcohol and Other Drug Treatment
These standards provide guidance on effective strategies and interventions for preventing drug use through evidence-based approached and involvement of all relevant stakeholders in drug use prevention efforts. A service or organisation in the AOD sector can implement this through adopting evidence-based drug prevention programs and practices in their service delivery.
This can also be applied in AOD work practice by providing education and awareness-raising activities that promote healthy lifestyles and discourage drug use.
This framework sets national standards for the provision of AOD treatment services. A service or organisation in the AOD sector can use this in developing policies and procedures that meet national standards. This can be applied in AOD work practice by ensuring all service delivery is in line with the national standards.
Your state/territory might also have practice standards set for your work or industry. For example, the NSW Health Clinical Care Standards: Alcohol and Other Drug Treatment provides guidance for the assessment, treatment and ongoing care of individuals with AOD-related problems in NSW.
Applying practice standards in organisations and individual practice in the AOD sector is a continuous learning, reflection and improvement process. By ensuring that staff are trained in and adhere to these standards, organisations can provide high-quality and effective services to clients and contribute to a sector that is respected and valued by the wider community.
2.2.9 Mandatory Reporting
The AOD sector supports individuals and communities affected by substance use disorders. However, in some cases, AOD support workers may encounter situations where they are legally obligated to report certain information to relevant authorities, such as when a client risks harming themselves or others. This obligation is known as mandatory reporting and is designed to protect the public and prevent harm to vulnerable individuals.
Mandatory reporting refers to the legal obligation of AOD treatment and support service providers to report certain information to relevant authorities, such as when a client risks harming themselves or others. This obligation aims to protect the public and prevent harm to vulnerable individuals.
In the AOD sector, mandatory reporting may involve reporting suspected child abuse or neglect, domestic violence, and threats of harm to oneself or others. The specific requirements and procedures for reporting can vary depending on the jurisdiction but typically involve informing the relevant authorities, such as child protection services, the police or mental health crisis teams.
It is essential for AOD service providers to be aware of their legal obligations regarding mandatory reporting and to inform their clients of these requirements at the outset of treatment. This helps to establish trust and transparency between the provider and the client and ensures that clients are fully informed about their rights and responsibilities.
Organisations in the AOD sector should have clear policies and procedures for mandatory reporting, including guidelines on identifying and responding to situations that require reporting. AOD service providers should receive appropriate training and support to ensure they can fulfil their legal obligations effectively.
Regarding individual practice, AOD service providers should be aware of the specific reporting requirements in their jurisdiction and stay up-to-date with any changes to these requirements. They should also develop skills in identifying and responding to situations that require reporting, such as recognising signs of child abuse or domestic violence.
In summary, mandatory reporting is essential to the AOD sector and aims to protect the public and prevent harm to vulnerable individuals. AOD service providers are legally obligated to report certain information to relevant authorities. Organisations and individual providers must know these requirements and have appropriate policies, procedures, and training to ensure effective reporting.
Here are some ways that mandatory reporting related to alcohol and drug use can be applied in organisations and individual practice:
Organisational application |
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Developing and implementing clear policies and procedures for mandatory reporting, including guidelines on identifying and responding to situations requiring reporting. Ensuring all staff members know their legal obligations regarding mandatory reporting and receive appropriate training and support to fulfil these obligations effectively. Establishing procedures for documenting and reporting incidents to the relevant authorities, as well as for maintaining confidentiality and protecting the privacy of clients. Reviewing and updating policies and procedures regularly ensures they remain current and effective. |
Individual application: |
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Being aware of the specific reporting requirements in your jurisdiction and staying up-to-date with any changes to these requirements. Developing skills in identifying and responding to situations that require reporting, such as recognising signs of child abuse or domestic violence. Establishing trust and transparency with clients by informing them of their rights and responsibilities regarding mandatory reporting at the outset of treatment. Document any incidents requiring reporting and follow organisational policies and procedures for reporting these incidents to the relevant authorities. |
It is important to note that the specific ways mandatory reporting related to alcohol and drug use is applied in organisations and individual practice can vary depending on the jurisdiction and the nature of the AOD service being provided. However, transparency, confidentiality and effective communication with clients and relevant authorities remain key to any effective approach to mandatory reporting in the AOD sector.
Mandatory reporting is crucial to ensuring the safety and well-being of clients and the wider community. However, mandatory reporting is just one aspect of the broader framework of record management that is essential to delivering quality services. Proper record management is critical in supporting effective communication, collaboration and decision-making within and across organisations. It also helps to ensure compliance with legal and ethical requirements and provides evidence of the services’ quality. Therefore, a thorough understanding of record management principles is essential for AOD support workers to uphold professional standards and provide safe and effective care.
There are several legislation that requires AOD workers and organisations to report any incident or reasonable suspicion that a child is at risk, such as:
Convention on the Rights of the Child
Family Law Act 1975
Children and Young Persons (Care and Protection) Act 1998 No 157
The convent requires state parties to take appropriate measures to protect children and young people from the harmful use of drugs and to prevent them from getting involved with the illicit production and trafficking of such dangerous substances.
In this legislation, any person who has reasonable grounds to suspect that a child has been or is at risk of being abused or neglected is required to report the case to the relevant child welfare authority. AOD use or abuse by parents or caregivers can be considered a form of child abuse or neglect if they pose a risk of harm to a child’s safety or well-being.
Mandatory reporting is also commonly found in different state/territory legislation. For example, the Children and Young Persons (Care and Protection) Act 1998 No 157 requires individuals who, in the course of their work, form a reasonable suspicion that a child is at risk of significant harm due to their parent or caregiver’s use of AOD, then they must make a report to the NSW Department of Communities and Justice.
Records Management
Records management in the AOD context refers to creating, storing, maintaining and using records of client interactions, services provided and other relevant information. Effective record management is essential for ensuring high-quality care and complying with legal and ethical requirements.
Records management is essential in both individual and organisational AOD practice. It involves the creation, maintenance, and disposal of records related to AOD treatment and care. Here are some ways records management is applied in organisations’ AOD practice:
Maintaining accurate and up-to-date records of their clients, including their medical history, assessment results, treatment plans, progress notes and discharge summaries.
Maintaining the confidentiality and privacy of their clients’ records.
Complying with various regulations and standards, such as the National Quality Standards for Drug and Alcohol Treatment Services.
Facilitating communication and coordination between different AOD practitioners and service providers involved in an individual’s care.
Good records management can help AOD workers meet their professional and legal obligations, such as those related to confidentiality, privacy and documentation standards. By taking the time to manage their records carefully and thoroughly, AOD workers can improve their clients’ outcomes and protect their own professional integrity.
Here are some legislations that you can consider reviewing for you to better understand records management:
Title of Document | Summary | Application in AOD work | |
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International | ISO 15489-1 | This outlines the principles and concepts relevant to the creating, capturing and managing of records and record systems. | A service or organisation in the AOD sector can implement this by establishing a Records Management Policy that outline the requirements for managing records in compliance with ISO 15489-1.This can be implemented in the AOD work practice by ensuring that records are created accurately and completely. Records must also be labelled appropriately and reviewed and updated as necessary |
National | Privacy Act 1988 | This Act outlines the Australian Privacy Principles contained in Schedule 1. Specifically, APP 6 refers to the need to take reasonable steps to protect personal information from misuse, interference, loss and unauthorized access, modification or disclosure. | A service or organisation in the AOD sector can implement this by maintaining accurate and current records of all personal information from the clients, and take appropriate measures to ensure that the information is kept secure.This can be implemented in the AOD work practice by protecting the security of the information you collect from clients by using appropriate security measures such as passwords and encryption. |
State/Territory | Health Records and Information Privacy Act 2002 No 71 | The Health Privacy Principle (HPP) 5 outlined in Schedule 1 of this Act provide guidelines on how health agencies can implement data security to take reasonable steps to protect personal health information from misuse, loss, and unauthorised access, modification, or disclosure. | A service or organisation in the AOD sector can implement this by developing a records management policy that complies with the requirements of this legislation, including the creation, maintenance and disposal of records.This can be implemented in the AOD work practice by ensuring that all records are accurately and promptly recorded in the appropriate system, including client records, medication records and incident reports. Please take note that states and territories may have different legislations on records management. You have to check the legislation active and used in your area. In this example, the Health Records and Information Privacy Act 2002 No. 71 is a legislation used in NSW. |
To perform effective record management, AOD support workers should follow these steps:
Overall, effective record management is critical to ensure the delivery of safe, high-quality
Record all client interactions |
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It is crucial to document them, including assessments, treatment plans, progress notes and discharge summaries. |
Use standardised documentation |
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Use standardised forms and templates to ensure consistency in documentation across the organisation. |
Ensure confidentiality |
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protect the privacy and confidentiality of clients by storing records securely and limiting access to authorised personnel |
Maintain accuracy and completeness |
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Ensure that records are accurate, complete and up-to-date and regularly review and update them as needed. |
Retain records according to legal requirements |
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follow legal and ethical requirements for retaining and disposing of records. |
Overall, effective record management is critical to ensure the delivery of safe, high-quality care. It enables AOD support workers to provide evidence-based interventions, collaborate effectively with other professionals and ensure compliance with legal and ethical requirements.
Checkpoint! Let’s Review Privacy, confidentiality and disclosure laws protect the information of persons from misuse.States and territories also apply their own privacy laws. These are based on national legislation, such as the Privacy Act 1988. Informed consent is a concept under privacy, confidentiality and disclosure relating to the actions and steps an organisation must perform before using the information provided by individuals. Duty of care is a legal concept that refers to the responsibility of individuals and organisations to take reasonable care to prevent harm to others. Practice standards are essential guidelines establishing the quality of practice expected in a particular field or sector. They provide a framework for delivering effective and safe client services while maintaining ethical and professional standards. |
As an AOD support worker, it is important to have a good understanding of the different models and frameworks that guide evidence-based practice in this field. This will help you to provide the best possible care to your clients. The purpose of this subchapter is to introduce you to evidence-based models and frameworks in AOD work and to provide you with some guidance on how to identify, review, and apply this information in your practice.
Evidence-based models and frameworks are both approaches that guide AOD workers in providing effective interventions to clients with AOD issues. The key difference between the two is the level of specificity in their guidance. An evidence-based model is a specific approach that has been tested through research and has demonstrated effectiveness in helping clients with AOD issues. These models provide a step-by-step guide for AOD workers to follow to deliver a structured intervention. On the other hand, evidence-based frameworks provide a more general set of principles and guidelines that can be adapted to meet the needs of individual clients.
To provide clients with tailored support, AOD workers must first identify the different models and frameworks within the AOD field. To recall the definition of identification, refer to Subchapter 2.2. For the purpose of this subchapter, identifying may refer to the process of becoming familiar with and recognising whether a model and framework can be categorised into the following:
Historical |
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Developed in the past and is no longer widely used in current AOD practice Have been influential in the development of the field, but they are either no longer used or supported by current research evidence. |
Current |
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Widely accepted and used in current AOD practice Supported by a strong body of research evidence and are considered best practice. |
Emerging |
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Gaining recognition and acceptance in the AOD field Relatively new or have limited support, but hold promise for improving AOD interventions and outcomes. |
Identifying evidence-based models and frameworks commonly involves learning about concepts and approaches used to understand and address issues related to AOD influence. The process may involve:
Reading relevant research articles is a key step to identifying evidence-based models and frameworks related to AOD use or treatment. Here are step-by-step procedures for this process:
Attending training sessions or seminars related to AOD use or treatment can provide valuable opportunities for learning about new models and frameworks and networking with other professionals in the field. Here are step-by-step procedures for this process:
Collaborating with colleagues or experts in the field of AOD use or treatment can provide valuable insights and perspectives on evidence-based models and frameworks. Here are step-by-step procedures for this process:
As an AOD support worker does all of the above, they will identify some of the several evidence-based models and frameworks that can be identified in AOD work according to the category listed above.
Some historical evidence-based models and frameworks are below:
Historical Model or Framework | Description | Role in AOD Practice |
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Moral Model | This model is commonly used in the Mid-19th century. This model suggests that addiction is a moral failing or personal weakness of the person since it is tied to religious and moralistic views. | It is no longer widely used in AOD work practice, as it stigmatises individuals with addiction and can lead to blame and shame rather than effective treatment. |
Psycho-dynamic Model | This model is commonly used in the Mid-20th century. This model views addiction as a psychological or emotional disorder that serves as a way for people to cope with emotional pain or avoid facing difficult feelings. | It is no longer widely used in current AOD work practice, as it fails to consider the biological and social factors that contribute to addiction. AOD work practice often takes a more holistic approach, considering not only psychological factors but also biological, social and environmental factors that contribute to addiction |
Historical Model or Framework | Description | Role in AOD Practice |
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Disease Model | Views addiction as a disease or illness where a person cannot control their intake of alcohol or drugs and thus can only be treated if they abstain. Here are evidence that supports the idea of the disease model: The occurrence of relapse among people dealing with addiction problems suggests that the condition is a disease that needs to be managed and monitored. Addiction brings changes to the brain, especially the prefrontal cortex, which is responsible for decision-making. People who receive treatment for addiction have better outcomes than those who do not, and continuous support is needed to prevent the person’s relapse. | The model emphasises the importance of abstinence and often involves the use of medication-assisted treatment (MAT) to manage withdrawal symptoms and cravings. The disease model also recognises the importance of psychological interventions, such as counselling and support groups, to address the emotional and social factors that contribute to addiction. |
Social Learning Model | Suggests that addiction as a result of social influence or engaging with other people who use drugs or drink alcohol. Here are some evidence that supports the social learning model: Those who have family members or friends who take AOD are more likely to experience the same. People who are under severe stress or have had a traumatic experience are more likely to get involved in AOD as a way of coping. Children whose parents are involved with AOD use are more likely to adopt the same behaviour when they grow up. | The social learning model is applied in current AOD work practice through counselling and peer discussion sessions which focus on helping the person find better ways to cope with their personal problems and get advice from other people who are in the same situation. Individuals can learn from each other’s experiences and receive support and guidance on how to cope with personal problems and challenges related to substance use. |
The table below summarises the strengths, limitations, effectiveness, and suitability of the historical evidence-based models and frameworks of AOD work.
Model/Framework | Strengths | Limitations | Effectiveness | Suitability |
Moral Model | Emphasises personal responsibility and choice | Can be stigmatising and simplistic | Effective for those who respond well to a values-based approach | Suitable for clients who value personal responsibility |
Disease Model | Acknowledges biological and genetic factors that contribute to addiction | Can be overly deterministic and may not address psychological and social factors | Effective for those who benefit from a medical approach and structured treatment programs | Suitable for clients who require a medical approach to treatment and have a strong need for structure. |
Psycho-dynamic Model | Addresses underlying psychological issues that contribute to addiction | Can be time-consuming and expensive | Effective for those who benefit from a deeper understanding of their motivations for drug or alcohol use | Suitable for clients who require a more comprehensive approach to treatment and have the resources to commit to long-term therapy. |
Social Learning Model | Emphasises the influence of social and environmental factors on drug or alcohol use | May not adequately address biological and psychological factors | Effective for those who benefit from peer or community-based interventions and harm-reduction strategies | Suitable for clients who require a community-based approach to treatment and may not respond well to traditional therapies. |
Below are some of the current evidence-based models and frameworks used in practice today:
Current Model and Framework | Description | Role in AOD Practice |
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Social-Cultural Model | Views addiction as a result of the influence brought by social and cultural factors like norms, values and beliefs. Here is evidence that supports the social-cultural model: Addiction rates widely vary across different cultures. There are societies with stricter cultures and hence lower rates of addiction where AOD are more easily accessed and have higher rates of addiction as compared to those who have strict regulations towards AOD. People residing in countries with financial and economic problems may turn to AOD to cope with their stress. | This model recognises that social and cultural factors can influence a person’s use of drugs and alcohol, and therefore, treatment programs should take into account the client’s social and cultural background to be effective. |
Current Model and Framework | Description | Role in AOD Practice |
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Stages of Change Model | Suggests addiction as a progressive condition that happens over time. It states that a person undergoes a series of stages as they change their behaviour and manner of AOD use. | Used in motivational interviewing and other approaches that focus on individual readiness for change. |
Motivational Interviewing | A client-centred approach that aims to increase an individual’s motivation and readiness to change. | Used in individual and group therapy settings, as well as in brief interventions and other settings. |
Cognitive Behavioural Therapy | Focuses on changing negative thoughts and behaviours related to substance use. | Help clients identify and change negative thought patterns and behaviours associated with substance use, ultimately leading to more positive outcomes in recovery. |
This table summarises the strengths, limitations, effectiveness, and suitability of the current models and frameworks used in practice today. The information presented in this table can help AOD support workers choose the most appropriate model for their clients’ needs.
Model/Framework | Strengths | Limitations | Effectiveness | Suitability |
Social-Cultural Model | 1. Considers environmental factors 2. Considers cultural norms and beliefs 3. Addresses social determinants of health | 1. May not work for individuals who reject cultural norms 2. May overlook individual differences 3. May not be effective in addressing internal factors | 1. Effective for minority populations with diverse backgrounds. 2. Effective in addressing health disparities. 3. Effective in addressing social determinants of health | 1. Suitable for clients from diverse cultural backgrounds. 2. Suitable for clients who are impacted by cultural and social factors. |
Stages of Change Model | 1. Helps to identify an individual’s readiness for change 2. Provides insight into behaviour change 3. Helps to develop appropriate interventions | 1. Assumes individuals progress through stages linearly. 2. Assumes all individuals progress through stages. 3. May overlook external factors influencing behaviour | 1. Effective in guiding interventions. 2. Effective in promoting long-term behaviour change. | 1. Suitable for clients who are ambivalent about change. 2. Suitable for clients who are motivated for change. |
Model/Framework | Strengths | Limitations | Effectiveness | Suitability |
Motivational Interviewing | Enhances motivation for behaviour change emphasises empathy and collaborationSupports client autonomy and self-efficacy | May not be effective for clients resistant to change.May not be effective for clients resistant to change.May not be suitable for clients in crisis. | Effective in addressing ambivalence (the state of having two opposing feelings at the same time).Effective in improving treatment engagement. | Suitable for clients who are resistant to change.Suitable for clients with mild to moderate substance use. |
Cognitive Behavioural Therapy | Helps to change negative thought patterns and behaviours focuses on present issues and solutions uses evidence-based techniques | May not be effective for clients with severe mental illness.May not be effective for clients with low cognitive functioning. | Effective in addressing co-occurring disorders.Effective in addressing substance use disorders.Effective in addressing mental health disorders. | Suitable for clients with mild to moderate co-occurring disorders.Suitable for clients who can actively participate in therapy.Suitable for clients with mental health disorders. |
Multimedia Cognitive Behavioural Therapy for Substance Use Disorders (CBT-SUD) is an evidence-based ‘talk therapy’ or counselling treatment, proven effective in treating alcohol and other drug use. CBT-SUD helps people make and maintain changes in their substance use, better cope with cravings and urges and improve skills related to alcohol and other drug use, including skills for managing mood, improving communication and solving problems. Introduction to Cognitive Behavioural Therapy for Substance Use Disorders |
Stages of change model
For a specific discussion, there are four stages of the change model. Here is a brief discussion of the four stages:
Precontemplation
Contemplation
Preparation
Action
There are several evidences that support the stages of the change model:
The stages of change model significantly help the way treatment programs are designed. Those who are still in the beginning stages are provided with educational seminars and counselling, while those who are at the latter stages are provided with a more structured and intensive treatment. The model recognises that people move through different stages in the process of changing their behaviour and that interventions should be tailored to the individual’s current stage of change.
One emerging evidence-based model is the public health model. The public health model of addiction is a population-based approach that focuses on preventing and reducing harm from substance use. This model is emerging in AOD practice, particularly in efforts to address the opioid epidemic and other public health crises related to substance use. Moreover, the public health model views addiction as a complex health issue that is a result of various individual, social and environmental factors and not just a person’s choice or behaviour.
The following discussion discusses the public health model’s strengths and limitations in addressing substance use disorders. The model focuses on prevention and early intervention and recognises the complex factors contributing to addiction. It involves a range of strategies, disciplines and stakeholders.
Strengths:
Focuses on prevention and early intervention, which can reduce the burden of substance use disorders on individuals, families, and communities.
Takes a multi-level approach to addressing substance use issues, from individual to community to societal levels.
Recognises the complex and interrelated factors contributing to addiction and the need for a systems approach to addressing substance use issues.
Limitations:
Need for multi-sectoral collaboration and coordination among various stakeholders and disciplines.
May not be suitable for individuals with a substance use disorder who require treatment or recovery support.
Limited in its effectiveness in addressing addiction issues deeply rooted in social and economic disparities.
Effectiveness:
Reduces substance use and related harms at the population level.
Addresses the opioid epidemic and other public health crises related to substance use.
Suitability:
Suitable for individuals at risk of developing substance use disorders
Suitable for communities and societies grappling with issues of substance use and related harms.
Strategies involved:
Prevention and education strategies which aim to reduce the likelihood of substance use initiation and promote healthy behaviours.
Harm reduction strategies aim to reduce the negative consequences of substance use, such as overdose and infectious disease transmission.
Treatment and recovery support strategies aim to help individuals with a substance use disorder achieve and maintain recovery.
Policy and advocacy strategies aim to create supportive environments and policies that facilitate healthy behaviours and reduce the harm associated with substance use.
Research and evaluation strategies that aim to generate knowledge about substance use and related harms and to inform the development of evidence-based interventions.
Disciplines involved:
The public health model consists of various fields and stakeholders, including healthcare providers, public health professionals, community organisers, policymakers, researchers, law enforcement and individuals with lived experience of substance use.
The public health model of addiction takes a systems approach to addressing substance use issues. This means it recognises that substance use is not solely an individual problem but is influenced by various social, cultural, economic and environmental factors. Therefore, this model addresses the underlying systems and structures contributing to substance use and related harms.
The systems approach focuses on working across multiple sectors, such as healthcare, law enforcement, education and social services, to address substance use at various levels, including the individual, community and policy. It also involves collaboration between stakeholders, including individuals with lived experience of substance use, community members and service providers.
By taking a systems approach, the public health model of addiction can address the complex and multifaceted nature of substance use issues. This approach allows for a comprehensive response that addresses the underlying causes of substance use and related harms rather than just treating the symptoms.
Here are some evidence that supports the public health model:
Community-based treatment and intervention programs are effective in reducing rates of addiction among members of the community and promote social responsibility.
Public health programs for addiction are cost-effective and can be sustainable over the long term.
Promoting ways to reduce the harms associated with AOD use is more effective in reducing harm among the public rather than focusing on abstinence.
There are common public health strategies that are used in AOD work practice, these are:
After identifying the relevant models and frameworks, an AOD worker will then review the information gathered. A review may refer to the process of critically examining and evaluating the different models and frameworks. This is done so that AOD workers will be able to apply the relevant information to their daily practice and responsibilities.
Here are the steps for reviewing the relevant models and frameworks:
▶︎ Identify the purpose of your review.
▶︎ Identify the models or frameworks you want to review
▶︎ Assess the quality of the evidence
▶︎ Evaluate the applicability of the model or framework
▶︎ Consider the practical implications
▶︎ Synthesise and report your findings
Below are aspects of AOD models and frameworks that AOD workers must review and apply to practice:
➤ Applicability to different situations and contexts
➤ Evidence base
➤ Strengths and weaknesses
➤ Underlying assumptions and theories
➤ Effectiveness in practice
When considering models or frameworks, it is important to determine their appropriateness for specific populations or issues. For example, an AOD support worker using the ‘Stages of Change’ model may find it more suitable for motivated clients to change their behaviour than those who are resistant.
Reviewing evidence base may involve looking at studies or research that have evaluated its effectiveness in practice.
This may involve looking at the theoretical underpinnings, the evidence base and any critiques or limitations identified. In application, an AOD worker may evaluate the strengths and weaknesses of the ‘Stages of Change’ model and note that it has a strong theoretical foundation backed up with statistical evidence but may not be as applicable to certain populations or cultural contexts.
Considering how the model or framework views addiction, recovery and the role of the AOD worker, an AOD worker should evaluate whether assumptions such as change are a process that happens over time rather than a single event. The worker then decides which model and framework works best for their and the client’s perspectives.
AOD workers should look at outcomes data, client feedback and personal observations. An AOD worker may decide to pilot the model with a small group of clients and track their progress over time to determine its effectiveness in their setup.
Once you have reviewed the evidence-based models and frameworks of AOD work, the next step is to apply this information to your specific context.
Applying information about evidence-based models and frameworks of AOD work involves using the insights gained from your review to inform your practice. This may include selecting and adapting a model or framework to suit your specific context and needs, integrating it into your existing practices and systems, and evaluating its effectiveness in achieving desired outcomes. It may also involve working collaboratively with colleagues, stakeholders, and clients to ensure that the model or framework is implemented effectively and sustainably. Ultimately, the aim is to use evidence-based approaches to improve outcomes for individuals, families and communities affected by alcohol and drug use.
Here are some specific steps in applying information about evidence-based models and frameworks of AOD work:
⇣- Select the most appropriate model or framework
⇣- Identify key components and principles
⇣- Adapt the model or framework
⇣- Integrate the model or framework into existing practices and systems
⇣- Evaluate effectiveness
⇣-Collaborate with stakeholders
Based on your review of the evidence, select the model or framework that is most appropriate for your specific context and needs.
Identify the key components and regulations of the model or framework, including the theoretical underpinnings, goals and techniques used.
Adapt the model or framework to suit your specific context, considering any unique features of your setting, population or program.
Integrate it into your existing methods and procedures, ensuring that it complements and enhances your current approach rather than replacing it.
Regularly evaluate the effectiveness of the model or framework in achieving desired outcomes and make adjustments as necessary.
Work collaboratively with colleagues, stakeholders, and clients to ensure that the model or framework is implemented effectively, sustainably, culturally and linguistically appropriate.
By following these steps, you can effectively apply information about evidence-based models and frameworks of AOD work to improve outcomes for individuals, families and communities affected by alcohol and drug use.
To recall, identifying, reviewing and applying information about evidence-based models and frameworks in AOD work must involve the following steps:
Overall, AOD workers identify and review information relevant to evidence-based models and frameworks so the application of their approaches will be able to:
To recall, identifying, reviewing and applying information about evidence-based models and frameworks in AOD work must involve the following steps:
Overall, AOD workers identify and review information relevant to evidence-based models and frameworks so the application of their approaches will be able to:
Provide structured and effective interventions that are tailored to the needs of individual clients.
Increase the likelihood of successful outcomes for their clients.
Maintain consistency and quality of care across different practitioners and settings.
Demonstrate accountability and transparency in their practice by using approaches that are grounded in research evidence.
Improve their practice continuously by staying up-to-date with the latest research and refining their interventions based on feedback from clients and colleagues.
When identifying, reviewing, and applying evidence-based models and frameworks for alcohol and other drugs work, AOD support workers must take note of the following information:
This includes the fundamental assumptions, concepts and principles that form the basis of a particular model or framework. Understanding the theoretical underpinnings is essential in determining the suitability of a model or framework for a specific AOD intervention.
The model or framework should be supported by empirical evidence, such as research studies or evaluations, to demonstrate its effectiveness in addressing AOD issues.
Consideration should be given to the target population, including their age, gender, culture and other relevant factors. The model or framework should be appropriate for the specific needs of the people.
The model or framework should have a clear scope and purpose, such as prevention, harm reduction or treatment.
The model or framework should be practical and feasible to implement in real-world settings. This includes consideration of the necessary resources, training requirements and support systems.