Like other areas of community service, the work done in the AOD sector is guided by key values and principles. Protecting the individual’s human rights, ensuring access and fairness, maintaining confidentiality and promoting social justice are just a few examples. In addition, the AOD sector also supports the philosophy of harm reduction as a fundamental principle.

Chapter 3 focuses on the integration or implementation of the fundamental AOD principles and values. Integrating the core values and principles of AOD work into practice means incorporating these principles into the day-to-day work of professionals in the AOD field. This involves practically applying the core values and principles when working with clients and other stakeholders. 

This chapter is an essential part of the unit, as it outlines the fundamental principles and values that guide the work of professionals in the AOD field.

The core values and principles of AOD work are based on a holistic, client-centred approach that emphasises the importance of treating each client with unique needs and circumstances. The following principles and values are outlined in the chapter:

★ Person-centred approach 

Centres around the treatment process of the client and involves tailoring interventions and support to meet each client’s individual needs and circumstances.

★ Harm minimisation

Reduces the negative consequences of AOD use for the individual and their community. Harm reduction strategies can include educating, reducing risk and supporting safer use.

★ Non-judgmental approach

Approaches clients without judgment or prejudice, recognising that AOD use is a complex issue with multiple causes.

★ Cultural competence

Recognises and respects the diversity of clients’ cultural backgrounds, values and beliefs. AOD workers are aware of clients’ cultural differences that may impact the treatment process.

★ Collaborative approach

Emphasises the importance of working collaboratively with other professionals, such as doctors, psychologists and social workers, to provide comprehensive care to clients.

The chapter also provides examples of how these principles and values can be integrated into AOD work. For instance, professionals can use a client-centred approach by involving clients in developing their treatment plans rather than imposing a pre-determined schedule. This might involve developing a treatment plan with the client, considering their goals, preferences and unique challenges.

Similarly, harm reduction can be integrated by educating clients on safer substance use practices and access to resources such as clean needles and overdose prevention medication. This might involve educating on safer substance use practices, distributing clean needles or providing access to overdose prevention medication.

In prescription medication use, harm reduction strategies can involve educating patients on the appropriate use of medications to avoid overdose or other adverse effects. For example, patients may be advised to take their medication as prescribed, avoid combining it with alcohol or other drugs and properly store their medicine to prevent accidental ingestion by children or pets.

In illicit drug use, harm reduction strategies can involve providing access to clean needles, overdose prevention medication and other resources to reduce the risk of harm associated with injection drug use. This may include providing access to sterile syringes, promoting safer injection techniques and offering access to overdose prevention medication such as naloxone.

Sometimes, individuals may inject drugs independently, even if it is not considered the safest substance use practice. In these cases, harm reduction strategies such as providing access to clean needles and overdose prevention medication can help reduce the risk of harm associated with injection drug use.

It is important to note that harm reduction is not intended to encourage or condone substance use but to provide individuals with the tools and resources to reduce the harm associated with it. By promoting harm reduction strategies, AOD support workers can help individuals reduce their risk of harm and improve their overall health and well-being.

Overall, integrating the core values and principles of AOD work into practice means practically applying these principles to provide clients with effective, respectful and culturally competent care. This involves understanding each client’s diverse needs and circumstances and working collaboratively with other professionals to provide comprehensive care.

Integrating the core values and principles of AOD (Alcohol and Other Drugs) work into practice is important for several reasons:

• It promotes ethical practice.

The core values and principles of AOD work emphasise the importance of ethical practice, including client autonomy, informed consent and confidentiality. By integrating these values into practice, professionals in the AOD field can ensure they provide ethical and responsible care to their clients.

• It enhances client outcomes. 

AOD work requires a holistic approach that considers the physical, psychological and social factors that influence an individual’s use of drugs and alcohol. By integrating the core values and principles of AOD work into practice, professionals can provide comprehensive care that addresses all aspects of a client’s life, leading to better client outcomes.

• It promotes professionalism.

AOD work is a complex field that requires specialised knowledge and skills. By integrating the core values and principles of AOD work into practice, professionals can demonstrate their commitment to professionalism and ongoing learning.

• It ensures consistency in care.

AOD work involves working with clients who may have complex and unique needs. By integrating the core values and principles of AOD work into practice, professionals can ensure that they provide consistent care that meets the needs of all clients, regardless of their circumstances. 

In summary, integrating the core values and principles of AOD work into practice is essential for promoting ethical practice, enhancing client outcomes, promoting professionalism and ensuring consistency in care.

In this chapter, you will learn how to:

• Assess AOD practice values, and ensure support and interventions are person-centred 
• Apply a harm minimisation approach to maximise support for the AOD client
• Support the client’s rights and safety, including access and equity of services

3.1 Assess AOD Practice Values, Ensure Support and Interventions Are Person-Centred 

Clients experiencing alcohol and other drugs (AOD) problems have unique needs and circumstances. Thus, it is important to assess the AOD practitioner’s values and ensure their interventions are person-centred. This is to guarantee that the client’s needs are the focus of the intervention.

In the context of this unit, values refer to the fundamental beliefs and principles underpinning effective alcohol and other drugs practice. Values play a crucial role in shaping the attitudes and behaviours of AOD workers, and they can influence how AOD services are delivered.

AOD practice values are centred around the needs of the individual and emphasise the importance of providing person-centred support and interventions. AOD support workers should collaborate with clients to develop goals and strategies tailored to their needs and circumstances. A person-centred approach values the individual’s autonomy and recognises that each person’s journey towards recovery will be different.

AOD practice values also emphasise treating clients with respect and dignity, regardless of their circumstances or choices. This includes avoiding judgment or stigmatisation and promoting an inclusive and non-discriminatory approach to service delivery.

Other key values include the following:

Empathy

Confidentiality

Cultural competence

Professionalism

• Empathy: The ability to understand and relate to the experiences and emotions of clients
• Confidentiality: The ethical obligation to protect the privacy and confidentiality of client information
• Cultural competence: The ability to work effectively with clients from diverse cultural backgrounds
• Professionalism: The commitment to upholding professional standards of practice and ethics.

By incorporating these values into their practice, AOD support workers can provide effective, person-centred support and respectful, inclusive and culturally appropriate interventions.

Here are some of the importance of assessing AOD practice values and ensuring support and interventions are person-centred. 

Client-centred approach	Assessing AOD practice values and ensuring that interventions are person-centred means focusing on the client and their unique needs, preferences and circumstances. This approach helps build a trusting and supportive relationship between the practitioner and the client, which is essential for successful outcomes.
improved client outcomes	Person-centred care is associated with better client outcomes, including increased satisfaction with care, improved health outcomes and reduced likelihood of relapse. By aligning their values with person-centred care, practitioners can enhance their clients’ chances of successful results.
Reducing stigma	Assessing AOD practice values can help practitioners identify and address any personal biases or stigmas they may hold towards clients who use AOD. This approach can reduce the stigma associated with AOD use and create a more supportive and accepting environment for clients
Ethical practice	person-centred care is an honest approach to care that prioritises the client’s autonomy and self-determination. By ensuring that interventions are person-centred, practitioners can ensure that they are providing ethical and respectful care to their clients.

1. Assess AOD Practice Values 

Alcohol and other drugs (AOD) practice values are essential components of the framework for providing AOD treatment that is both efficient and moral. AOD workers can use the values to guide working with people, families and communities affected by alcohol and other drugs. 

Assessing AOD practice values involves evaluating the extent to which AOD treatment services and practitioners adhere to the values that emphasise effective and ethical AOD practice. This can be done through various methods, such as client feedback, peer review, accreditation processes and quality assurance frameworks. Assessing AOD practice values can help identify areas for improvement, promote best practices and ensure that AOD treatment services deliver high-quality, respectful, culturally responsive and evidence-based care. It can also help build trust and confidence in AOD treatment services among clients, families and communities. Overall, assessing AOD practice values is essential for ensuring that AOD treatment services are effective, ethical and responsive to the needs of their clients.

3.1.1. The AOD sector is guided by a range of values and philosophies that may include but are not limited to the following: 

Harm minimisation

Recovery

Person-centred approach

Empowerment

Health promotion (as per the Ottawa Charter

• Harm minimisation is a key principle of AOD practice. It aims to lessen the negative effects of drug use on individuals and society.  Minimisation is based on the idea that reducing the harm caused by AOD use is a much more realistic and achievable goal than complete abstinence. All practice approaches models of care, treatment modalities, policies and procedures, planning, performance, supervision, training and quality activities should be based on this fundamental principle of the AOD sector. 

The following are the key pillars of harm minimisation: 

• Pragmatism: The harm minimisation philosophy is pragmatic, recognising that it is not possible to eliminate all drug use. Instead, the focus is on reducing the negative consequences of drug use.

• Human rights: Harm minimisation recognises that people who use drugs have the right to be treated with dignity and respect and to receive appropriate care and support.

• Demand reduction. This focuses on preventing an individual’s AOD uptake and delaying their first use. It also aims to reduce harmful use and support people in their path to recovery.

• Supply reduction. This focuses on controlling illicit drugs and precursor availability. It ensures that there are low chances of people having access to AOD, which might lead to more issues.

• Public health: Harm minimisation recognises that drug use is a public health issue and that strategies to minimise harm must be evidence-based and prioritised according to public health considerations

• Community involvement: Harm minimisation recognises that drug use affects individuals, their families, communities, and society. Therefore, community involvement is essential in developing and implementing harm minimisation strategies.

• Harm reduction: Harm minimisation recognises that drug use carries risks and that reducing the risks associated with drug use is an important goal. Reducing risks is done by ensuring a safe environment. Examples of harm reduction approaches include providing clean needles and syringes and promoting safe injection practices.

• Non-judgmental approach: Harm minimisation recognises that drug use is a complex issue and that people who use drugs should not be stigmatised or judged. Instead, harm minimisation approaches seek to engage with people who use drugs in a non-judgmental way and to provide them with the care and support they need to minimise harm.

Further ReadingThere will be a more detailed discussion about harm minimisation in the following subchapter. You may also read more about harm minimisation on the link below: Harm Minimisation

• Recovery is a value that emphasises the potential for positive change and personal growth for individuals affected by AOD use.

Recovery is a crucial component of addiction treatment. It is often influenced by particular values. These values include respect for oneself and others, responsibility for one’s recovery efforts, openness to the recovery process and a focus on self-care practices. In addition, recovery-oriented approaches emphasise supporting each individual’s recovery journey and allowing them to make their own decisions.

The following are the key philosophies of recovery:

• Self-determination: Recovery is based on the philosophy that individuals with substance use disorders can make choices and take responsibility for their own lives. The recovery process is self-directed and person-centred, empowering individuals to make choices about their treatment and recovery.
• Holistic approach: Recovery recognises that addiction is a complex disorder that affects individuals physically, mentally and socially. Therefore, recovery is a holistic approach that addresses all aspects of an individual’s life, including physical health, mental health, relationships and spirituality.

• Strengths-based: Recovery is a strengths-based philosophy that focuses on an individual’s strengths rather than weaknesses. The recovery process builds on an individual’s existing resources and abilities, helping them to identify their strengths and to use them in their recovery.

• Continuous process: Recovery is a constant process that requires ongoing support and care. It is not a one-time event but a journey involving setbacks and successes. The recovery process is lifelong and requires a continuing commitment to maintain.

• Supportive community: Recovery recognises the importance of supportive communities in the recovery process. Individuals in recovery benefit from the support of peers who have experienced similar challenges and can provide guidance and encouragement. Recovery communities may include support groups, mutual aid organisations or recovery-focused treatment programs.

• Hope: Recovery is founded on the philosophy of hope, recognising that recovery is possible for individuals with substance use disorders. The recovery process provides individuals with the tools and resources they need to overcome addiction and lead fulfilling lives in recovery.

Recovery-Oriented Approach

The principles of a recovery-oriented approach include understanding that each person is different and should be supported to make their own choices, listened to and treated with dignity and respect. Each person is the expert in their own life, and support should assist them in achieving their hopes, goals and aspirations. Recovery will mean different things to different people.

Here are some principles of recovery approach in the AOD Sector: 

Understanding that each person is different and that their recovery plan must be tailored to their individual needs and preferences.

Understanding that the person’s family and community play a vital role in supporting their recovery.

Understanding that each person should be treated with dignity and respect. 

Understanding that the person must be actively involved in deciding on the measures they must take towards recovery.  

A recovery approach should drive everything you do as an AOD worker and be reflected in your attitude, words and actions. This means being respectful and non-judgemental and using words that are easily understood (no jargon or technical terms related to the field of alcohol and other drugs). 

In a recovery-oriented approach, it is important that you: 

Support each person to have control over their life regardless of their emotional experiences

See each person as an individual and not just focus on their mental health condition

Acknowledge individual differences, such as age, gender, culture, beliefs and support networks

Try to understand each individual’s situation and experience, as each person is different

Understand that mental health conditions vary significantly from person to person, including how often someone has a period of unwellness and for how long

Remember that each person’s journey is unlikely to be a straight path but more likely to be a mix of achievements and setbacks

Be optimistic and support the person to have a meaningful life, based on their choices, goals, strengths and abilities

Help build independence.

This list of points is important in a recovery-oriented approach to mental health conditions and addiction and substance use disorders recovery. Clients in AOD recovery may go through a range of emotional experiences, including shame, guilt, anxiety and depression. During their recovery journey, they may also experience cravings, relapses and withdrawal symptoms.

In addition to experiencing emotional experiences related to AOD recovery, individuals in AOD recovery may also have co-occurring mental health conditions that require attention in the recovery-oriented approach. These conditions can range from depression and anxiety disorders to more severe ones like bipolar disorder, schizophrenia and personality disorders. A recovery-oriented approach should acknowledge and address the individual’s mental health conditions as part of their overall treatment plan, which may include a combination of therapy, medication and other evidence-based interventions. 

Like mental health conditions, substance use disorders can also vary significantly from person to person, including the frequency and severity of substance use, co-occurring mental health conditions and the impact on their social and family life.

Recovery-oriented approaches in AOD treatment should also focus on building resilience, independence and self-determination. Clients should be supported to take control of their lives, make meaningful choices, set achievable goals and identify and use their strengths and abilities to achieve them. The recovery process may not always be a smooth path, but individuals can achieve long-term recovery with the right support and tools.  

• A person-centred approach or person-led approach addresses the client’s broader needs than just their substance abuse. Considering a person’s family, significant others, cultural background and other requirements, this approach encourages people to be active, equal partners and participants in their treatment planning. 

The other requirements include housing and living situations, employment and financial status, physical and mental health and legal and justice system involvement. By addressing these requirements, AOD support workers can provide more effective and comprehensive care to individuals seeking help for substance abuse.

A person-led approach is where the person is supported to lead their own care and treated as a person first. The focus is on the person and what they can do, not their condition or disability. Support should focus on achieving the person’s aspirations and be tailored to their needs and unique circumstances.

A person-led approach:

• Supports the person, at the ‘centre of the service’, to be involved in making decisions about their life
• Takes into account each person’s life experience, age, gender, culture, heritage, language, beliefs and identity
• Requires flexible services and support to suit the person’s wishes and priorities
• Is strengths-based, where people are acknowledged as the experts in their life with a focus on what they can do first and any help they need second
• Includes the person’s support networks as partners.

A person-led approach should support and enable a person to build and keep control over their life. 

Source from What is a person-led approach?, under CC BY 4.0, © State of New South Wales NSW Ministry of Health 

The following are the key principles of a person-centred approach:  

▶︎ Respect for the individual

▶︎ Holistic approach

▶︎ Collaborative approach

▶︎ Individualised care

▶︎ Continuous improvement

▶︎ Recovery-focused

• Respect for the individual

A person-centred approach is based on treating each individual with dignity and respect. The process recognises that everyone is unique in their values, beliefs and experiences.

• Holistic approach

A person-centred approach is holistic, recognising that an individual’s physical, emotional, social and spiritual needs are interconnected. The approach aims to address all of these needs in a coordinated and integrated manner.

• Collaborative approach

A person-centred approach is collaborative, with healthcare providers working with individuals and their families to develop care plans that reflect their needs and preferences.

• Individualised care

A person-centred approach recognises that each individual is unique, with their own needs and preferences. The strategy aims to provide care tailored to the individual rather than a one-size-fits-all approach.

• Continuous improvement

A person-centred approach focuses on continuous improvement, with healthcare providers regularly seeking feedback from individuals and their families to improve the quality of care. The approach is also committed to ongoing learning and development to ensure that healthcare providers have the skills and knowledge to provide high-quality care.

• Recovery-focused

The person must be supported to achieve recovery instead of just simply managing their symptoms brought on by the use of alcohol and drugs.

• Empowerment is a value that seeks to promote the individual’s ability to take control of their life and make positive choices.

Empowerment can be developed by:

• Being respectful and non-judgemental
• Building a relationship where the person feels comfortable discussing their feelings and what they want

• Focussing on strengths and abilities
• Supporting and encouraging involvement in decision-making
• Respecting the decisions a person makes about their own life. 

Empowerment is a key part of recovery, as well as person-centred and holistic approaches.

Source from What is empowerment?, under CC BY 4.0, State of New South Wales NSW Ministry of Health 

The following are the key principles of empowerment:

• Relate. Relate means accepting a person for who they are and willingly understanding their feelings and experiences.
• Communicate. Communicate means supporting a person and giving them the ability to make informed decisions towards their recovery.
• Respect. Respect means to recognise a person’s opinions, feelings and choices and to empower them to take control of their lives.
• Educate. Educate means giving clear instructions and helping a person understand and become aware of their rights and options

• Health promotion is a value that emphasises the importance of addressing the broader determinants of health and promoting health and well-being across the lifespan. It focuses on helping clients identify and realise their aspirations, satisfy their needs, and change or cope with the environment to reach a state of complete physical, mental and social well-being. 

For instance, the Ottawa Charter for Health Promotion promotes healthy AOD-related behaviours to combat alcohol and other drugs (AOD) use. The five components of health promotion are outlined in the charter:

Developing personal skills

Reorienting health services

Strengthening community action for health

Building Healthy Public Policy

Creating supportive environments for health

These components can be used to encourage healthy AOD use behaviours. To lessen the detrimental effects of AOD use on individuals’ health, for instance, beneficial public policies that regulate the sale and marketing of alcohol or supportive environments that discourage excessive drinking can be implemented. 

There are also different strategies that you can use for health promotion. These strategies are the following: 

Advocate

Advocating for more proactive and conscious plans towards the AOD sector can help in providing a diverse range of support that will cater to the needs of people affected by alcohol and other drugs.

Enable

Enabling people who are affected by alcohol and other drugs, regardless of status or gender, to have access to programs and activities that promote health leads to higher chances of recovery and improving their well-being. 

Mediate

Having professional and social groups mediate between their differing interests for the pursuit of health brings collaborative effort in addressing issues concerning the AOD sector. 

Additionally, the charter emphasises the significance of substance abuse prevention and risk reduction. Substance abuse is recognised as a public health problem.

The following are the key philosophies of health promotion as per the Ottawa Charter:

Holistic approach

Health promotion is based on a holistic approach, recognising that health is a complete physical, mental and social well-being and not merely the absence of disease or infirmity. The approach addresses all aspects of an individual’s life, including physical, emotional, social and environmental factors.

Empowerment

Health promotion is about empowering individuals and communities to take control of their health. The approach recognises that individuals can make decisions about their health and seeks to provide them with the tools and resources needed to make informed choices.

Equity

Health promotion is committed to promoting health equity, recognising that some individuals and communities are at greater risk of poor health outcomes than others. The approach addresses the underlying social, economic and environmental factors contributing to health inequalities.

Partnership

Health promotion is a collaborative approach that involves partnerships between individuals, communities and organisations. The approach recognises that health promotion is everyone’s responsibility and seeks to build partnerships that can work together to promote health and prevent disease.

Sustainable development

Health promotion is committed to sustainable development, recognising that the health of individuals and communities is closely linked to the environment’s health. The approach seeks to promote sustainable development practices that protect the environment and promote the health of individuals and communities.

Empirical knowledge

Health promotion is based on practical knowledge, recognising the importance of research and evidence-based practice. The approach seeks to use the best available evidence to inform practice and continuously evaluate the effectiveness of health promotion programs and interventions.

Depending on the context and purpose of the assessment, the following AOD practice values can be assessed using various methods and strategies. For each value, the following table enumerates some general approaches that can be used: 

AOD Practice Values

Assessment Methods and Strategies

Harm minimisation

Examine the policies and guidelines of AOD services and programs to find ways to reduce harm, such as the following: Programs that teach people how to use needles and syringesWays to prevent overdoses, safe injecting facilities on how to use drugs safely and getting support for it. Use relevant indicators like overdose rates, blood-borne virus transmission, hospital admissions and community feedback to evaluate the effectiveness of harm reduction interventions. Conduct surveys with AOD service users and stakeholders to learn how harm-reduction practices affect their lives and communities. Conduct research or audits to identify gaps or barriers in harm reduction services and advocate for improvements.

AOD Practice Values	Assessment Methods and Strategies
Recovery	Reviewing AOD service and program models that prioritise recovery principles such as peer support, holistic care and goal-oriented planning.Collecting data on recovery outcomes such as abstinence rates, improved mental health and well-being, employment and education achievements and social connectedness.Using recovery-oriented assessment tools to guide treatment planning and monitor progress.Engaging with service users and their families to understand their recovery goals, needs and preferences and tailoring services accordingly.
Person-centred approach	Reviewing AOD service and program models that prioritise person-centred principles such as respect, empathy, collaboration and cultural responsiveness.Using validated person-centred assessment tools to gather information about the individual’s goals, strengths, needs and preferences and using this information to develop a personalised care plan.Collecting feedback from service users and their families about their experiences of care, including aspects such as communication, participation, autonomy and choice.Providing training and support for AOD staff to enhance their person-centred skills and attitudes.

AOD Practice Values	Assessment Methods and Strategies
Empowerment	Reviewing AOD service and program models that prioritise empowerment principles such as self-determination, education, advocacy and community participation.Using empowerment-focused assessment tools to identify the individual’s strengths, resources and barriers to empowerment and using this information to develop a tailored support plan.Measuring empowerment outcomes such as self-efficacy, self-esteem, sense of control and participation in decision-making and advocacy activities.Providing opportunities for service users and their families to engage in peer support, education and leadership roles within the AOD sector.
Health promotion	Reviewing AOD service and program models prioritising health promotion principles such as health literacy, prevention, early intervention and social determinants of health.Collecting data on health-related outcomes such as physical health, mental health, social support and quality of life.Using health promotion assessment tools to identify risk factors, protective factors and opportunities for prevention and early intervention

In general, assessing AOD practice values involves evaluating the beliefs, attitudes and behaviours of AOD workers to determine whether they align with person-centred values and principles. 

Here are some ways to assess AOD practice values:

Self-reflection

Feedback from clients

Observations

Review of policies and procedures

• Self-reflection

AOD support workers can self-reflect to assess their values and how they may impact their practice. This involves reflecting on personal biases, attitudes and beliefs and considering how these might influence client interactions.

• Feedback from clients

AOD support workers can solicit feedback to gain insight into their service delivery experiences. This can involve seeking feedback on communication, respect and inclusivity and using this information to improve service delivery.

• Observations

Supervisors or colleagues can observe AOD support workers during client interactions to assess the extent to which they exhibit person-centred values and principles. This can involve observing interactions for empathy, cultural competence and respect.

• Review of policies and procedures

AOD support workers can review their organisation’s policies and procedures to ensure they align with person-centred values and principles. This can involve reviewing policies related to confidentiality, client-centred care and cultural competence.

By assessing AOD practice values, AOD support workers can identify areas for improvement and work towards providing more effective, person-centred support and interventions. This can ultimately lead to improved client outcomes and a more positive impact on the broader AOD sector.

3.1.2. Ensure Support and Interventions are Person-Centred

Alcohol and other drugs (AOD) use is a significant public health issue, and various interventions have been developed and implemented to address this issue. These interventions aim to address the complex and multifaceted nature of AOD use and support individuals in achieving and maintaining recovery.

Among the most common interventions are counselling, pharmacotherapy and social support.  

• Counselling  

Counselling is a common intervention for alcohol and other drugs (AOD) clients. It involves talk therapy to help individuals with substance use problems explore their thoughts, feelings and behaviours related to substance use. The goal of counselling is to help individuals gain insight into their substance use,develop coping strategies and make positive life changes.

Counselling for AOD clients can be provided by various professionals, including psychologists, social workers and addiction counsellors. Counselling sessions are typically conducted in a one-on-one or group setting and may be delivered in multiple formats, such as face-to-face, telephone or online.

Counselling sessions for AOD clients may cover a wide range of topics, including:

• Substance use patterns and triggers
• Mental health concerns, such as anxiety and depression
• Family and relationship issues
• Employment and financial issues
• Legal problems related to substance use
• Harm reduction strategies
• Relapse prevention planning

Counselling interventions for AOD clients are often based on evidence-based practices, such as cognitive-behavioural therapy (CBT), motivational interviewing (MI) and mindfulness-based interventions. These approaches are effective in helping individuals with substance use problems to make positive changes in their lives.

• Pharmacotherapy

Pharmacotherapy is a treatment approach for (AOD) clients that involves medication to manage withdrawal symptoms, cravings and other physical and psychological symptoms associated with substance use. 

Pharmacotherapy aims to help individuals with substance use problems reduce their use of drugs or alcohol and increase their chances of successful recovery.

There are several types of pharmacotherapy interventions available for AOD clients, including: 

• Opioid substitution therapy (OST)

This involves the use of medications, such as methadone or buprenorphine, to help individuals with opioid addiction to manage their withdrawal symptoms and cravings. OST is typically provided in a clinic or pharmacy setting and may be accompanied by counselling or other support services.

• Naltrexone

This medication is used to help individuals with alcohol or opioid addiction to reduce their cravings for these substances. It works by blocking the brain receptors responsible for the pleasurable effects of alcohol and opioids.

• Acamprosate

This medication is used to help individuals with alcohol addiction to manage their cravings and reduce their risk of relapse. It works by balancing the levels of certain neurotransmitters in the brain that are affected by chronic alcohol use.

• Disulfiram

This medication is used to help individuals with alcohol addiction reduce their drinking by causing unpleasant physical reactions, such as nausea and vomiting, when alcohol is consumed.

Medical professionals like doctors or pharmacists typically provide pharmacotherapy interventions for AOD clients. They may be combined with other interventions, such as counselling and support services. The specific type of pharmacotherapy intervention used will depend on the individual’s substance use history, medical history and other individual factors.

• Social support 

It involves providing social and emotional support from family, friends, peers and support groups to help individuals with substance use problems manage their addiction and work towards recovery.

Social support can take many different forms, including: 

• Family support

Support from family members can be crucial in helping individuals with substance use problems to manage their addiction and work towards recovery. This may involve emotional support, practical assistance and encouragement to seek treatment.

• Peer support

Peer support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), provide a supportive environment where individuals with substance use problems can share their experiences, learn from others and receive encouragement and support.

• Professional support

Professional support services, such as addiction counsellors or social workers, can provide individuals with substance use problems with individual or group counselling, education and support to help them manage their addiction and work towards recovery.

• Community support

Community-based organisations and programs, such as harm reduction programs or sober living communities, can provide individuals with substance use problems with support and resources to help them manage their addiction and work towards recovery.

Professionals and community organisations typically provide social support interventions for AOD clients. These interventions can be combined with other interventions, such as pharmacotherapy and counselling, to help individuals with substance use problems manage their addiction and work towards recovery.

Ongoing research and evaluation of these interventions will continue to ensure their effectiveness and responsiveness to the evolving nature of AOD use.

When working in an alcohol and other drugs context, it is essential to ensure that support and interventions are person-centred. Person-centred support and interventions mean that the individual’s needs, preferences, goals and values are at the centre of the support and intervention plan.

Here are some ways to ensure that support and interventions are person-centred: 

• Conduct an assessment.

Conduct an assessment to understand the individual’s needs, strengths, challenges and goals. The assessment should be comprehensive and consider physical, emotional, social and environmental factors.

• Involve the individual in the planning process.

Involve the person in the planning process and work with them to develop a support and intervention plan that aligns with their goals and values. The person should be an active participant in the planning process and have a say in what interventions are implemented.

• Use a strengths-based approach.

Focus on the individual’s strengths and build on them. A strengths-based approach acknowledges that everyone has strengths and that these strengths can be used to help overcome a challenge. 

• Consider cultural and linguistic diversity.

Ensure that support and interventions are culturally sensitive and appropriate for the individual’s cultural and linguistic background. Take into account the individual’s beliefs, values and traditions when planning interventions.

• Regularly review and adjust the plan.

Regularly review and adjust the support and intervention plan to ensure that it continues to meet the individual’s needs, goals and preferences. It is essential to remain flexible and make changes as necessary.

Ensuring that support and interventions are person-centred requires a holistic approach that considers the individual’s needs, preferences, goals and values. By doing so, individuals can receive the support and interventions they need to overcome challenges and achieve their goals.

Aside from what was already mentioned, it is important to ensure that support and interventions are person-centred when working in an alcohol and other drugs context for several reasons: 

• Increased engagement

When support and interventions are person-centred, individuals are more likely to engage in the process and actively participate in their recovery. This can lead to better outcomes and greater empowerment and control.

• Individualised approach

A person-centred approach recognises that every individual is unique and has their own set of needs, preferences, goals and values. By tailoring support and interventions to the individual, they are more likely to be effective and better meet the individual’s needs.

• Improved quality of care  

When support and interventions are person-centred, it can lead to improved quality of care. By considering the individual’s needs, preferences, goals and values, the support and interventions provided are more likely to be relevant, appropriate and effective.

• Respect for individual autonomy

A person-centred approach respects the individual’s autonomy and decision-making ability. By involving the individual in the planning process and respecting their preferences and goals, the individual is more likely to feel heard and respected.

• Greater satisfaction

When support and interventions are person-centred, individuals are more likely to be satisfied with the care they receive. This can lead to improved motivation, increased engagement and better outcomes.

In summary, a person-centred approach to support and interventions in an alcohol and other drugs context can lead to increased engagement, better outcomes, improved quality of care, respect for individual autonomy and greater satisfaction.

To understand the discussions in this subchapter better, refer to the case study below: 

Mike Mike is an AOD support worker committed to helping people with alcohol and drug addiction issues. Mike believes in the values and philosophies of the AOD sector, including harm minimisation, recovery, a person-centred approach, empowerment and health promotion (as per the Ottawa Charter). Mike has worked with several clients, including two individuals with alcohol and drug issues, in ways consistent with these values and philosophies.Client 1: JohnJohn is a 45-year-old man who has been struggling with alcohol addiction for several years. He had been to rehab twice but relapsed both times. When he met Mike, he was in a state of despair and had lost all hope of recovery. Mike used a person-centred approach to understand John’s needs, preferences and strengths. Mike worked collaboratively with John to develop a harm minimisation plan that would enable John to reduce his alcohol intake gradually. Mike used motivational interviewing techniques to empower John to take responsibility for his recovery. Mike also referred John to a health promotion program to help him develop healthy habits, such as exercise and a balanced diet. Over time, John reduced his alcohol intake and improved his overall health and well-being. John was grateful for Mike’s support and acknowledged that Mike’s approach had helped him turn his life around. Client 2: Mary Mary is a 25-year-old woman who has been using drugs for several years. She had a history of trauma and had been diagnosed with depression and anxiety. When she met Mike, she was in a state of distress and had low self-esteem. Mike used a person-centred approach to understand Mary’s needs, preferences and strengths. Mike also recognised the importance of trauma-informed care in Mary’s case. Mike worked collaboratively with Mary to develop a recovery plan to address her drug use and mental health needs. Mike used motivational interviewing techniques to empower Mary to take control of her life. Mike also referred Mary to a health promotion program to help her develop healthy coping strategies, such as mindfulness and relaxation techniques.

Over time, Mary reduced her drug use and improved her mental health. She also developed a sense of empowerment and became more confident in making positive changes in her life. Mary acknowledged that Mike’s approach helped her regain control over her life and improve her overall wellbeing.ConclusionMike’s approach to working with clients with alcohol and drug addiction issues is consistent with the values and philosophies of the AOD sector. Mike uses a person-centred approach to understand the client’s needs, preferences and strengths. Mike also recognises the importance of harm minimisation, recovery, empowerment and health promotion in supporting clients’ wellbeing. Mike’s work with John and Mary shows the positive impact of an AOD support worker committed to these values and philosophies.

3.2.Apply a Harm Minimisation Approach to Maximise Support for the AOD Client 

In Subchapter 3.1, you learned about harm minimisation as one of the AOD practice values essential for ensuring that AOD treatment services are effective, ethical and responsive to the needs of their clients. 

The harm minimisation approach widely utilised in the AOD field is the focus of this subchapter. Specifically, you will learn more about applying this harm minimisation approach.

This approach recognises that substance abuse is a complex problem and that people will continue to use drugs despite the risks. Harm minimisation’s primary objective is to reduce the negative effects of substance use on individuals, their families and the community. When working with AOD clients, this subchapter emphasises the significance of employing this strategy to maximise their support and enhance their overall well-being. It provides an overview of the fundamental principles of harm minimisation and the methods that can be used to lessen the negative effects of substance use.

Working with AOD clients can put you in several risks. You need to be knowledgeable on how these risks affect AOD work practice and what strategy should you use to mitigate the identified risk.

Here is a table that shows the risks associated with AOD work, how these risks affect work practice and the appropriate strategy to mitigate the risk: 

Risk	How the risk affects AOD work practice	Strategy to mitigate the risk
Physical harm	AOD workers often work with clients who are experiencing intoxication or withdrawal symptoms, which can increase the risk of physical harm to the workers. Intoxicated clients may exhibit unpredictable or violent behaviour, which can lead to physical attacks on the worker.	This risk can be mitigated by having appropriate safety procedures in place, including training for workers on how to manage aggressive or violent behaviour and having a clear protocol for responding to incidents of violence or aggression.
Emotional burnout	AOD workers may feel emotionally drained in trying to address clients’ complex needs, especially those who do not progress in their treatment. This can lead to a decreased ability to empathise with clients, which can ultimately impact the quality of care provided.	AOD workers may benefit from access to counselling services, which can help them manage stress and emotional challenges related to their work. This can include individual counselling or group counselling.
Ethical issues	AOD workers may face ethical issues at work, such as finding a way to respect the client’s autonomy with the need to protect them from harm particularly if the client’s decision-making capacity is impaired by AOD use.	Establish clear policies and procedures for handling ethical issues to avoid client rights violations. These policies and procedures should outline the ethical principles that guide AOD work, such as respect for client autonomy, informed consent, confidentiality, and non-discrimination, among others.

Fundamental Principles of Harm Minimisation

The fundamental principles of harm minimisation include: 

Focus on reducing the harms of drug use rather than on stopping drug use altogether. 

This recognises that some drug use may be inevitable and the goal should be to minimise the negative consequences.

Recognise that there are different levels of harm associated with drug use and other strategies may be required to address them. 

For example, methods for reducing the damage associated with injecting drug use may differ from those for reducing the harm associated with alcohol use.

Recognise that drug use is a complex social issue that cannot be addressed through a single approach. 

Effective harm minimisation strategies require a comprehensive, integrated process involving various stakeholders, including health professionals, government agencies, community organisations and drug users.

Respect the rights and dignity of drug users and involve them in developing and implementing harm minimisation strategies. 

This includes recognising that drug users are not a homogenous group and that their needs and experiences may vary widely.

Use evidence-based approaches to develop and implement harm minimisation strategies. 

This includes using research and evaluation to inform decision-making and to ensure that harm minimisation strategies are effective and efficient.

Recognise that harm minimisation is a long-term process that requires sustained commitment and resources. 

This includes ongoing support for research and evaluation and funding for implementing harm minimisation strategies.

Overall, the fundamental principles of harm minimisation involve a comprehensive and evidence-based approach that focuses on reducing the harms associated with drug use while respecting the rights and dignity of drug users.

The harm minimisation approach is important because it strengthens many practices and strategies used in drug and alcohol work. AOD workers must understand the principles of harm minimisation and be able to apply them in their work with clients. 

To maximise support for alcohol and other drug clients using a harm minimisation approach or what they also call as prevention strategies, consider the following strategies:  

• Support group

A support group is a gathering of individuals who come together to provide emotional, psychological and sometimes practical support to one another. Support groups can provide a safe and non-judgmental space for individuals to share their experiences, struggles and successes.

• Education

AOD clients are taught about the risks and consequences associated with AOD use and abuse. Education can be provided through various means such as individual counselling, group sessions, workshops and educational materials such as brochures and pamphlets.

• Client-centred approach

Recognise that each client has unique experiences, needs, and goals. Tailor the intervention to the individual’s specific circumstances to ensure maximum benefit.

• Provide education and information

Provide accurate and up-to-date information on the risks associated with alcohol and other drug use. This information should include short-term and long-term health, as well as social and legal consequences.

• Encourage safer use

Encourage clients to use alcohol and other drugs safely, such as avoiding injection and sharing needles, avoiding driving under the influence and using appropriate protective gear when using drugs.

• Support clients who choose abstinence

Support clients by providing them with the necessary resources, such as referrals to self-help groups and specialised treatment programs.

• Address social determinants of health

Recognise that social determinants of health, such as poverty, discrimination and inadequate housing, can contribute to alcohol and other drug use. Addressing these factors can help reduce the harm associated with alcohol and other drug use.

• Collaboration

Work collaboratively with other health professionals and organisations to provide a coordinated response to alcohol and other drug use.

• Offer a range of interventions 

Offer a range of interventions to suit the individual’s specific needs. These interventions may include the following:

Prevention strategies

Treatment interventions 

Harm reduction strategies

Cognitive behavioural therapy

Detoxification

Medication-assisted treatment

• Prevention strategies 

By targeting risk factors like peer pressure and social norms, prevention strategies aim to reduce the likelihood of AOD use, particularly among young people. They promote healthy behaviours and provide education, information and others. 

Prevention strategies for alcohol and other drugs (AOD) can take various forms. They can be implemented at multiple levels, including individual, family, school, community and society.

Prevention strategies usually start with identifying risk factors associated with AOD use, such as peer pressure, social norms, lack of parental supervision, mental health problems and trauma. By targeting these risk factors, prevention strategies aim to reduce the likelihood of AOD use, particularly among young people who are more vulnerable to the negative effects of AOD use.

One approach to prevention is to promote healthy behaviours and provide education and information about the risks of AOD use. This can be done through school-based programs incorporating substance abuse education into the curriculum, community initiatives providing information and resources for parents and youth and media campaigns promoting healthy lifestyles and discouraging AOD use.

Another approach is to limit access to AOD, particularly for young people who may be more likely to experiment with these substances. This can involve stricter enforcement of laws that prohibit the sale of AOD to minors and limiting access to AOD through policies such as raising taxes on alcohol and tobacco products, implementing zoning regulations that restrict the location of liquor stores and reducing the number of alcohol outlets in high-risk areas.

Prevention strategies can also be incorporated into interventions to help individuals struggling with AOD use. For example, treatment programs may include education and skills training to help individuals resist the urge to use AOD in the future. Family therapy may focus on reducing risk factors for AOD use within the family.

Overall, prevention strategies for AOD use are multifaceted and require a comprehensive approach that targets multiple risk factors at various levels. Effective prevention strategies can help reduce the harm caused by AOD use, improve public health outcomes and enhance the quality of life for individuals and communities.

• Treatment interventions 

The purpose of treatment interventions is to assist those who have already established a problematic pattern of AOD use. These interventions can be as brief as those delivered in primary care settings or as intensive as programs in a residential setting. Treatment may include social, psychological and medical support to assist individuals in achieving and maintaining recovery.

• Harm reduction strategies

Harm reduction aims to reduce the negative consequences of substance use, even if the individual is not ready or able to stop using drugs or alcohol completely. Harm reduction interventions can help individuals with substance use problems to stay safer and healthier and reduce the risks of negative consequences associated with their substance use.

Harm reduction measures can take many different forms, including: 

• Needle and syringe programs

These programs provide clean needles and syringes to individuals who use injectable drugs to help prevent the spread of blood-borne infections, such as HIV and hepatitis C.

• Opioid overdose prevention

This involves the provision of naloxone, a medication that can reverse opioid overdoses, to individuals at risk of opioid overdose, as well as training on how to administer the medication.

• Safer drug use education

This involves providing individuals with information on reducing the risks associated with drug use, such as avoiding sharing drug paraphernalia, using in a safe location and avoiding mixing drugs.

• Alcohol harm reduction

This may involve strategies to reduce the risks associated with excessive alcohol use, such as encouraging moderate drinking, providing safe transportation options and promoting responsible serving practices in bars and restaurants.

• Cognitive-behavioural therapy

This therapy aims to help clients identify and change negative patterns of thinking and behaviour that are associated with AOD abuse. Through CBT, clients can learn coping skills and strategies to manage cravings and triggers that may lead to AOD use.

• Detoxification

Detoxification may involve medication-assisted therapy, such as methadone or buprenorphine, to help AOD clients safely withdraw from AOD abuse in a controlled and supervised environment to minimise the risks of withdrawal symptoms and complications.

• Medication-assisted treatment

Medication-Assisted Treatment (MAT) is a form of evidence-based treatment that combines the use of medication with counselling and behavioural therapies to address substance use disorders. It helps clients who are struggling with substance use disorders achieve and maintain recovery by reducing their withdrawal symptoms, cravings and effects of drugs in their system.

Professionals and community organisations typically provide harm reduction interventions for AOD clients, including harm reduction programs, medical professionals and community-based organisations. These interventions can be combined with other interventions, such as counselling and social support, to help individuals with substance use problems reduce the negative consequences associated with their substance use and work towards recovery.

Harm reduction measures also include identifying risks associated with drug and alcohol use and implementing mitigation strategies to reduce client harm.

Refer to the following section to learn more about risk and mitigation strategies.

3.2.1 Risk and Mitigation Strategies 

AOD workers must be aware of the risks associated with drug and alcohol use and be able to implement mitigation strategies to reduce harm to their clients. 

Refer to the table for some examples of risk and mitigation strategies under harm reduction measures:

Risks	Mitigation Strategies
Overdose riskPeople who use opioids are at risk of overdose, which can be fatal	Providing training in overdose prevention and managementDistributing overdose-reversing medication (such as naloxone) Promoting supervised consumption facilities
Overdose risk people who use opioids are at risk of overdose, which can be fatal	Providing education on the dangers of impaired drivingPromoting alternative transportation (such as public transit or ride-sharing services)Advocating for policy changes to reduce impaired driving
Social and economic harmDrug and alcohol use can lead to social and economic disadvantages, including loss of employment, housing and relationships.	Providing support services (housing assistance, employment support and counselling)Promoting harm reduction strategies (such as controlled drug use) Advocating for policy changes that reduce social and economic harm.
Impaired driving risk People who use drugs or alcohol are at risk of impaired driving, which can lead to accidents and injury.	Providing sterile injecting equipment (such as needles and syringes)Promoting safe injecting practices (such as using a new needle each time, avoiding sharing equipment and using sterile water and filters)
Injection risk People who inject drugs are at risk of infection and disease transmission.	Infectious disease risk People who use drugs are at higher risk of contracting contagious diseases such as HIV, hepatitis B and hepatitis C.

Overall, there are many risks associated with drug and alcohol use, and AOD workers must be able to identify these risks and implement mitigation strategies to reduce harm to their clients. By using harm reduction measures, workers can help to minimise the negative consequences of drug and alcohol use and promote the health and well-being of their clients.

On the other hand, working with people affected by alcohol and other drugs can present a range of risks and challenges for workers in the drug and alcohol field. 

The table below shows some examples of risks and mitigation strategies that can help AOD workers to manage these challenges:

Risks	Mitigation Strategies
Violence and aggressionPeople affected by alcohol and other drugs can be more prone to violence and aggression, posing a risk to workers.	Providing education on reducing the risk of infection promoting vaccination providing access to testing and treatment for infectious diseases.
Infectious disease transmissionPeople affected by drugs can be at higher risk of infectious disease transmissions, such as HIV, hepatitis B and hepatitis C, through sharing of injecting equipment or risky sexual behaviour.	Providing training in de-escalation and conflict resolution ensuring that workers have access to safety equipment (such as panic alarms)Implementing safety protocols
Providing education on reducing the risk of infection promoting vaccinationProviding access to testing and treatment for infectious diseases.	Providing education on reducing the risk of infection promoting vaccination providing access to testing and treatment for infectious diseases.

By implementing mitigation strategies and taking a proactive approach to risk management, AOD workers can help to ensure that they can provide effective and safe support to their clients.

Applying a harm minimisation approach to maximise support for an AOD client involves working collaboratively with the client to reduce the risks and harms associated with their AOD use. Both AOD workers and clients have the rights to be protected and safe. AOD workers have the right to be protected from harm and to work in a safe environment, while clients have the right to receive safe and effective treatment.

A set of rights and responsibilities governs your work. Rights refer to your basic entitlements as a worker. Responsibilities refer to what work you must perform and in what manner. These rights and responsibilities are reflected in legislation. 

Your rights to work and rights in work are parts of your economic rights. According to the International Covenant on Economic, Social and Cultural Rights (ICESCR), these rights include: 

• Right to work
• Right to just and favourable conditions of work
• Right to initiate and participate in trade union activities

Based on the Right to work and rights in work, used under CC BY 4.0. © Australian Human Rights Commission 2017

Rights and responsibilities of workers

You also have rights protected by legislation on:

• Discrimination
• Fair work
• Work health and safety
• Privacy and confidentiality

The related legislation for each right is shown in the table below:

Rights	Related legislation
Right against any form of discrimination	Age Discrimination Act 2004Disability Discrimination Act 1992Racial Discrimination Act 1975Sex Discrimination Act 1984
Right to fair work	Social, Community, Home Care and Disability Services Industry Award 2010
Right to a healthy and safe workplace	Model WHS laws
Right to privacy and confidentiality	Privacy Act 1988

For a specific discussion, here are some legislation, codes of ethics or code of conduct that are related to the rights and responsibilities of workers: 

International Covenant on Economic, Social and Cultural Rights

Fair Work Act 2009

Work Health and Safety Act 2011 No. 10 

• International Covenant on Economic, Social and Cultural Rights

The Covenant recognises the right of all individuals to fair and favourable conditions of work, including equal pay for equal work without discrimination, with particular attention to ensuring that women have working conditions and pay equal to those of men.

A service or organisation in the AOD sector can implement this by providing workers access to training and professional development opportunities to enhance their skills and knowledge about AOD.

Moreover, this can be implemented in the AOD work practice by participating in seminars, trainings or workshops that can help improve how you deliver AOD-related services.

• Fair Work Act 2009

This is a national legislation that states employers must not request or require an employee to work more than the following number of hours in a week unless the additional hours are reasonable for a full-time employee—38 hours.

A service or organisation in the AOD sector can implement this by ensuring that all of its employees are paid at least the minimum wage required under the Act and that there is no discrimination in pay due to gender, race or other personal attributes.

In addition, this can be implemented in the AOD work practice by being familiar with employee rights such as entitlement to leave, minimum wage and protection from discrimination and unfair dismissal.

• Work Health and Safety Act 2011 No.10 

This legislation informs that while at work, workers must take reasonable care of their heir health and safety.

A service or organisation in the AOD sector can implement this by conducting risk assessments, providing training and equipment, and implementing effective policies to manage workplace hazards for employees, clients  and visitors

This can be implemented in the AOD work practice by taking an active role in identifying and managing workplace hazards and participating in workplace health and safety committees or other consultation mechanisms.

States or territories may have their own legislation on the rights and responsibilities of workers. In this example, NSW has Work Health and Safety Act 2011. No.10. You may check available and active legislation in your state or territory.

Rights and responsibilities of employees

Not only are the workers are protected but also there legislations that protect the employees. There are also ethical considerations and codes of conduct that outlines the responsibilities of the employees. 

Here are some international, national and state or territory legislations and ethical considerations that employees should consider reviewing: 

International Covenant on Economic, Social and Cultural Rights

Australian Standard of Employment Rights

Work Health and Safety Act 2011 No. 10 

• International Covenant on Economic, Social and Cultural Rights

This legislation discusses that state parties must take steps towards achieving the right to work, including training programs, policies, and techniques for economic, social, and cultural development and employment under conditions that protect individual freedoms.

A service or organisation in the AOD sector can incorporate this approach by offering technical and vocational guidance, and training programs, implementing policies and techniques that foster sustainable development, and promoting full and productive employment.

This can also be achieved through employers providing employees with technical and vocational guidance, along with comprehensive training programs. By doing so, they can ensure that employees have the opportunity to fully experience their right to fair and favourable working condition.

• Australian Standard of Employment Rights

This legislation promotes that employers should be committed to achieving a workplace that is free from discrimination and harassment based on protected attributes.

To implement this, a service or organisation in the AOD sector can adhere to the criteria of employment contracts, which involve offering just and equal compensation, as well as keeping workplace policies and procedures current and in accordance with applicable employment laws and regulations. Moreover, the implementation involves the employer regularly offering feedback, training and developmental prospects to their employees, fostering their professional growth and facilitating career advancement.

• Work Health and Safety Act 2011 No 10 

According to this legislation, the individual responsible for managing or controlling a workplace must take reasonable steps to ensure that the workplace, including the ways of entering and exiting it, as well as anything related to it, do not pose any risks to the health and safety of any person.

In order to implement this, a service or organization in the AOD sector can establish suitable health and safety policies and procedures, ensuring a secure work environment. They can provide staff with relevant training and resources to effectively handle risks, while consistently reviewing and updating risk assessments.

To apply this approach in AOD work practice, employers should provide employees with appropriate training, information, and supervision to safeguard their health and safety within the workplace.

As previously mentioned, Work Health and Safety Act 2011 No. 10 is a legislation used in NSW. You may check legislations used in your state or territory as legislations may vary. 

Rights and responsibilities of clients

Clients have their rights and responsibilities too. The right of clients may include:

Safe and effective treatment that is appropriate for their needs and medical history.

Treatment with dignity and respect and protection from abuse, neglect, or exploitation.

Informed of the risks and benefits of their treatment and to provide informed consent.

Safe and secure environment for treatment that is free from harm and risk.

  

It is the employer’s responsibility to ensure that the rights of workers and clients are protected and that all employees understand and fulfil their responsibilities.

For a specific discussion, here are some international, national and state or territory legislations or ethical considerations that are relevant to the rights and responsibilities of clients: 

• International Covenant on Economic, Social and Cultural Rights

The covenant recognises the right of every individual to enjoy the highest attainable standard of physical and mental health, including access to health care services, including substance abuse treatment.

In the AOD sector, a service or organisation can implement this by offering clients suitable healthcare and support services, aiming to help them reach the highest possible level of health. AOD workers can apply this work by informing clients about the comprehensive healthcare services available to address their specific needs related to AOD issues.

• Australian Charter of Healthcare Rights

This legislation states that people who use the Australian health system have the rights to receive care services that are safe and of high quality.

To implement this, a service or organization in the AOD sector can ensure that clients have access to safe and excellent care services while actively involving them in the decision-making process regarding their treatments. In the context of AOD work practice, this can be achieved by providing treatments that are both suitable and respectful of the client’s background. Moreover, it is essential to offer clients transparent and precise information about their treatment options, as well as the associated risks and benefits.

• Health Records and Information Privacy Act 2002 No. 71 

All organisations must safeguard the personal health information of clients and observe the rules related to its collection, use, disclosure, quality, security and access.

A service or organisation in the AOD sector can implement this by ensuring that they obtain the client’s explicit consent before collecting and utilizing their personal health information. This can also be achieved by informing clients about their rights outlined and granting them access to their own health information upon request.

Since you already know that each state or territory may have different legislation, the Health Records and Information Privacy Act 2002 No. 71 is a legislation used in NSW. You may check available and active legislation in your own state or territory that is relevant to rights and responsibilities of clients. 

Work role responsibilities and limitations

AOD work role have its responsibilities and limitations. Here are some legislations that are relevant to AOD work role responsibilities and limitations: 

International Standard Classification of Occupations (ISCO)

National Quality Framework for Drug and Alcohol Treatment Services

Health Practitioner Regulation National Law No 86a of 2009

• International Standard Classification of Occupations (ISCO)

Occupations under major group 2 include those related to the AOD sector, like substance abuse counsellors, are categorized under ‘Social work and counselling professionals’ while addiction psychiatrists are under ‘Health professionals’.

A service or organisation in the AOD sector can implement this by ensuring that it has laid out clearly defined roles and responsibilities that are consistent with the classifications of its workers’ occupations. This can be implemented in the AOD work practice by ensuring that you are working within your defined scope of practice and doing your responsibilities as determined by your occupation’s classification under the ISCO.

• National Quality Framework for Drug and Alcohol Treatment Services

This legislation provides a framework to ensure that drug and alcohol treatment services across Australia meet a consistent standard of quality by laying out benchmarks for each guiding principle.

In order to implement this, a service or organisation in the AOD sector should ensure that the services and practices they provide align with the established framework, which includes meeting the applicable standards and guidelines. This can be achieved by adhering to the standards and guidelines outlined in the framework and ensuring that your work is in line with the organisation’s policies and procedures.

• Health Practitioner Regulation National Law No 86a of 2009

This outlines the obligations and responsibilities of registered health professionals in relation to professional conduct, health and impairment and notifications and complaints.

A service or organisation in the AOD sector can implement this by ensuring that all workers are registered under the National Law and are practicing within their scope of practice as defined by their registration. This can be implemented by maintaining your registration and performing your job role according to your scope of practice.

This legislation is available and active in NSW. You may check the legislation used in your own state or territory as it varies depending on your location. 

The presented legal and ethical considerations on work role responsibilities and limitations are relevant and important to the AOD work for the following reasons: 

• The National Quality Framework sets out the minimum standards for drug and alcohol treatment services in Australia. By following these standards, AOD workers can ensure that they are providing safe, effective, and high-quality care to their clients. The Framework also helps guarantee that AOD workers are working within their scope of practice and following best practices in the field.
• ISCO is a global standard for classifying occupations, including those in the AOD sector. By using this standard, AOD workers can ensure that their job responsibilities are clearly defined and aligned with recognised international standards. This guarantees that they are performing the requirements of their job role and that their qualifications and skills are recognised globally.

• The Health Practitioner Regulation National Law No 86a of 2009 outlines the requirements for registration, accreditation, and practice standards for health practitioners, including AOD workers, in Australia. By following this law, AOD workers can ensure that they are registered and accredited to practice in their field and that they are meeting the required practice standards.

Employers are responsible for providing a safe working environment for their employees, including AOD workers. This means that employers have a legal obligation to:

Identify and manage workplace hazards

Provide appropriate training and supervision

Implement effective risk management strategies to protect the health and safety of their employees

At the individual practice level, AOD workers have a responsibility to understand and follow the policies and procedures of their organisation, as well as to fulfil their duty of care to their clients. This may involve the following:

Adhering to professional standards and ethical principles

Using appropriate risk management strategies to promote harm minimisation

Collaborating effectively with colleagues and other professionals

The boundaries of an AOD support worker’s responsibilities are critical to their role in supporting individuals with substance use issues. These boundaries help to define the limits of their responsibilities, ensuring that they provide safe and effective care to their clients.

The key responsibilities of an AOD worker in the context of harm minimisation focus on reducing the negative consequences of drug use rather than solely focusing on abstinence. Some of these responsibilities are as follows:

Conducting assessments

Conducting a thorough assessment of the client’s drug use, identifying any risks or harm associated with the AOD use.

Developing treatment plans

Developing a comprehensive treatment plan that addresses the client’s specific needs, goals, and objectives. 

Providing education

 Educating clients about risks and harms associated with drug use and providing information on harm minimisation strategies, such as safer drug use practices.

Providing counselling

Providing individual and group counselling to support clients in reducing their AOD use and managing the negative consequences of it.

Encouraging harm reduction strategies

Encourage clients to adopt harm reduction strategies, such as reducing the frequency of AOD use, and avoiding high-risk AOD use behaviours.

However, there are also important limitations to their role, such as not being able to prescribe medication or diagnose mental health conditions. AOD workers also need to establish clear boundaries to ensure that they do not become enablers of drug use or become too emotionally invested in their clients’ recovery. 

By setting clear goals and maintaining a professional distance, AOD workers can help clients to take responsibility for their own recovery

AOD support workers to recognise their limitations and work within their scope of practice to provide the best possible care to their clients. Some of the limitations of an AOD support worker’s role include:

Inability to provide medical advice

They are not qualified to provide medical advice. If a client requires medical advice or treatment, the AOD support worker should refer them to a medical doctor.

Limited scope of practice

They are not qualified to diagnose mental health conditions or prescribe medication. If a client requires a diagnosis or medication, the AOD support worker should refer them to a qualified professional.

Ethical limitations

They should not provide support to a family member or friend, as this can create a conflict of interest and compromise the quality of care.

Limited influence on social determinants of health

They do not have direct control over social determinants of health, such as housing, employment, or education. 

At the organisational level, AOD support workers can fulfil this critical role by ensuring that their services are accessible, inclusive, and evidence-based. They can work to address systemic barriers that contribute to substance use and harm and advocate for policy changes. AOD support workers can collaborate with other professionals and services to ensure that clients receive comprehensive and holistic care and promote a team-based approach to service delivery.

At an individual level, knowing the boundaries of their responsibilities can help AOD workers to establish clear and realistic goals for their clients and maintain appropriate boundaries in their professional relationships. It can also help them to recognise potential ethical issues and avoid any conflicts of interest. AOD support workers play a critical role in the context of harm minimisation by supporting individuals and communities affected by substance use, reducing the negative consequences of drug use, empowering clients, collaborating with other professionals, and promoting social justice. 

Fulfilling your work role within the set limitations is important. If an AOD support worker goes beyond their role and limitations, it can lead to several negative consequences, including:

• Engaging in activities that are unethical or violate their professional standards, which can damage their professional reputation and potentially result in disciplinary action.

• Exposing themselves to legal liability if they engage in activities that are outside of their scope of practice or expertise.
• Unintentionally harming clients by providing advice or treatment that is inappropriate.

3.2.2 Work Health and Safety

AOD support workers are often exposed to a variety of occupational hazards that can pose risks to their health and safety. These hazards may include:

Exposure to infectious diseases

Violence or aggression from clients

Exposure to drugs or chemicals

Physical strain from moving and restraining clients

Therefore, it is crucial that AOD support workers take the necessary precautions to protect themselves and their clients from harm. By implementing effective WHS strategies, AOD workers and their employers can reduce the likelihood and severity of these hazards and protect the health and safety of everyone involved. 

Work health and safety (WHS) is a professional requirement to engage in safe work practices that ensure not only your own safety but also the safety of your colleagues, visitors and the public. WHS also involves ensuring that the workplace environment does not cause any physical or psychological harm. This workplace environment includes all places where any aspect of work is conducted. WHS is not optional. Your WHS responsibilities are required by government legislation and should be reflected in the policies and procedures of your workplace.

Your WHS responsibilities as a worker can be found in your state/territory’s WHS legislation. Below are some examples of worker responsibilities related to WHS:

Protect your own health and safety

Do not place others at risk

Treat others with respect

Report safety concerns

For more information on your responsibilities, you may access your state/territory’s WHS legislation. Safe Work Australia is the national government entity that develops and evaluates model WHS laws. From these model laws, states and territories develop and implement their respective WHS laws. These local laws ensure that WHS principles are effectively applied to their context. 

In the table below, you will find links to WHS legislation and regulations that apply to each state. 

State/territory	WHS legislation and regulations
Australian Capital Territory	Work Health and Safety Act 2011Work Health and Safety Regulation 2011 (ACT)
New South Wales	Work Health and Safety Act 2011
Northern Territory	Workplace Safety Laws
Queensland	Work Health and Safety Laws
South Australia	Work Health and Safety Act and Regulations
Tasmania	Work Health and Safety Act 2012Work Health and Safety Regulations 2012
Victoria	Occupational Health and Safety Act and Regulations
Western Australia	Work Health and Safety Act 2020 Work Health and Safety (General) Regulations 2022

For a specific discussion, here are some international, national, state or territory legislation relating to work health and safety: 

• ISO 45001

This is an international  outlines the requirements needed to implement and maintain a management system for occupational health and safety in the workplace.

A service or organisation in the AOD sector can implement this by conducting regular workplace hazard assessments, developing a comprehensive health and safety management system, and training staff in hazard identification and control. This can be applied in AOD work practice by following the policies and procedures to ensure safety at work. For instance, wearing PPE like gloves when administering medication or handling bodily fluids for testing to prevent exposure to infectious diseases.

• Work Health and Safety Act 2011 

Section 29 states that A person at a workplace must take reasonable care that his or her acts or omissions do not adversely affect the health and safety of other persons.

To implement this, a service or organisation in the AOD sector can establish policies and procedures to effectively manage workplace health and safety (WHS) risks. They can also provide comprehensive training to workers on WHS and ensure that all staff members are aware of their responsibilities in maintaining a safe work environment. This approach can be applied by adhering to WHS policies and procedures and promptly reporting any identified safety risks or incidents to the supervisor. 

At the organisational level, it is important to identify and manage risks associated with AOD work and implement appropriate WHS policies and procedures to ensure a safe workplace for the AOD worker and a safe treatment place for the clients. The employer should also provide adequate training and supervision to AOD workers to ensure they understand their WHS obligations and have the skills and knowledge to manage risks effectively.

For example, organisations can provide training on effective risk management strategies, ensure that staff has access to appropriate personal protective equipment (PPE), and have protocols in place for managing challenging behaviours and situations.

At the individual AOD support worker level, WHS applies to their practice in a harm minimisation by ensuring that they take appropriate measures to manage risks associated with their work. This may include:

Using PPE when necessary

Implementing appropriate infection control procedures

Managing challenging behaviour in a safe and respectful manner

Reporting safety concerns

AOD workers should also report any hazards or incidents promptly and work collaboratively with their employer and colleagues to identify and address any WHS concerns.

3.3 Support the Client’s Rights and Safety, Including Access and Equity of Services 

It is crucial to ensure that AOD clients receive respectful and non-discriminatory services. People who seek support for alcohol and other drug issues may already experience stigma, marginalisation and discrimination, and it is crucial to provide a safe and supportive environment that promotes their wellbeing. 

Supporting the client’s rights and safety is also a legal and ethical obligation for workers in the AOD sector. Clients have the right to make informed decisions about their health and well-being, and the worker must ensure that they receive accurate and comprehensive information. 

In addition, providing equitable services is essential to address the needs of a diverse range of clients, including those who may face additional barriers to accessing services due to their cultural background, socioeconomic status or other factors. 

Supporting the client’s rights and safety, including access and equity services, is therefore critical to promoting positive outcomes for clients and ensuring that AOD workers meet their obligations to provide safe and effective services.

This subchapter aims to equip AOD workers with the necessary skills and knowledge to provide safe and respectful services to their clients. The AOD sector serves diverse clients, each with unique needs and circumstances. Therefore, AOD workers must know their client’s rights, including accessing services free from discrimination and promoting equity. This subchapter covers the ethical and legal obligations of workers in the AOD sector and strategies to support client rights and safety, including effective communication, informed consent and risk assessment.

3.3.1 Support the Client’s Rights and Safety

Supporting the client’s rights and safety is critical to providing effective and compassionate care in the AOD sector. Clients are often vulnerable and may face significant barriers to accessing care, such as stigma, discrimination and limited resources. AOD workers are responsible for ensuring that clients receive safe, equitable and respectful care that upholds their rights and promotes their well-being. To support the client’s rights and safety, AOD workers can take the following steps: 

1. Conduct risk assessments 

Risk assessments are essential to ensuring client safety in the AOD sector. Workers should conduct risk assessments to identify potential risks to the client’s safety and well-being, such as harm to themselves or others. Risk assessments may involve asking clients about their history of substance use, mental and physical health and any other factors that may impact their safety.

1. Respect client autonomy

Clients have the right to make their own decisions about their health and wellbeing,  including whether to seek treatment for alcohol or other drug issues. Workers should respect client autonomy by providing accurate and comprehensive information about the risks and benefits of treatment options and supporting clients in making the right decisions.

2. Practice informed consent

Informed consent is essential to supporting client rights and safety in the AOD sector. Workers should obtain informed consent from clients before providing any treatment or intervention, including medication-assisted treatment (MAT) or other evidence-based interventions. Informed consent involves providing clients with all the relevant information they need to make an informed decision about their treatment, including potential risks and benefits.

3. Comply with legal and ethical obligations 

AOD workers have legal and moral responsibilities regarding client rights and safety, including confidentiality, privacy and informed consent. Workers should be aware of their obligations and strive to uphold them in all aspects of their work, including documentation, communication with other healthcare providers and reporting any suspected abuse or neglect.

• Use effective communication

Communication is key to building client trust and promoting safety. AOD workers should use clear, respectful and non-judgmental language when communicating with clients and be aware of cultural and linguistic differences that may impact communication. Workers should also be mindful of the impact of stigma and discrimination on clients and strive to provide a safe and supportive environment that promotes their well-being. 

• Promote equity

Providing equitable services is essential to addressing the needs of a diverse range of clients in the AOD sector. Workers should be aware of the potential barriers to accessing services that clients may face due to their cultural background, socioeconomic status, or other factors.

AOD workers should strive to provide services that are accessible to all clients. This may involve providing interpreter services, adapting services to meet the needs of specific client groups, or advocating for policy and system-level changes that promote equity in the AOD sector.

3.3.2 Support the Client’s Access and Equity of Services 

Supporting the client’s access and equity of services is critical to ensure all clients receive effective and comprehensive care. Access and equity refer to the availability and fairness of services provided to clients, including those with specific needs or barriers to access. Several strategies support access and equity for clients, including delivering culturally appropriate and accessible information, addressing potential obstacles to accessing services and advocating for policies and systemic changes that support access and equity.

It is important to understand the range of services available to clients seeking support for alcohol and other drugs (AOD) issues. These services can vary depending on the specific needs of the client and the resources available in their community. Understanding these services is essential for AOD workers, as it provides comprehensive and effective support to clients seeking help.

The key services available to AOD clients include the following:

Assessment and intake

Counselling services

Withdrawal management

Rehabilitation

Harm reduction services

Peer support

Aftercare.

• Assessment and intake

This is the first step in accessing AOD services and involves meeting with a trained professional to discuss the client’s needs, concerns and goals for treatment. An assessment may include questions about the client’s substance use, mental health, physical health and social support.

• Counselling

Offers individual and group counselling sessions to help clients better cope with their problems associated with AOD use. These sessions provide a safe and supportive environment for clients to express their thoughts and feelings, learn new coping strategies, and develop the skills necessary to make positive changes in their lives.. 

• Withdrawal management

For clients experiencing withdrawal symptoms due to substance use, withdrawal management services may be provided. This can involve medical monitoring, medication-assisted treatment and other supports to manage symptoms and promote a safe and comfortable withdrawal process.

• Rehabilitation

Offers AOD treatments and therapies to address the root cause of AOD use and to come up with plans for recovery of the client. These approaches aim to help clients understand their motivations for using drugs or alcohol, identify triggers for use and develop coping skills to manage cravings and avoid relapse

• Harm reduction services

Harm reduction services focus on reducing the negative consequences of substance use rather than requiring abstinence. These services may include needle exchange programs, overdose prevention education and safer use education.

• Peer support services

Peer support services involve connecting clients with others who have experienced similar challenges related to substance use. This can include peer mentoring, support groups and other programs that promote connection and social support

• Aftercare

Aftercare services are provided to clients after they have completed a primary treatment program and may include ongoing counselling, support groups and other services to help clients maintain their recovery and avoid relapse. 

The services available to AOD clients are diverse and can be tailored to meet each client’s specific needs. By providing comprehensive and individualised support, you can help clients to achieve their goals and lead fulfilling lives free from the negative consequences of substance use. 

How to Support the Client’s Access and Equity of Services

Several strategies can be used to support the AOD client’s access and equity of services. Some of these strategies include:

• Providing culturally appropriate and accessible information
• It is important to ensure that information about AOD services is accessible and understandable for all clients, regardless of their cultural background or language proficiency. 
• This can involve translating materials into different languages, using plain language and working with community organisations to ensure that information is disseminated effectively.

• Supporting clients with complex needs

• Clients with complex needs, such as those experiencing homelessness or mental health issues, may face additional barriers to accessing AOD services.
• To support these clients, it is important to provide integrated and coordinated care, working with other service providers to ensure that they receive the support they need to address their needs.
• Addressing potential barriers to accessing services

• Barriers to accessing AOD services can include financial, geographic and social factors. It is important to identify and address these barriers to support access and equity. 
• This can involve providing free or low-cost services, offering transportation assistance and working with community partners to identify and address social barriers to entry.
• Advocating for policies and systemic changes

• In addition to addressing immediate barriers to access, it is important to advocate for broader systemic changes that support access and equity. 
• This can involve advocating for policies that promote affordable housing, education and training, employment opportunities and policies that promote access to AOD services for marginalised communities.

Supporting the client’s access and equity of services is critical to ensuring all clients can access effective and comprehensive care for their AOD issues. By using strategies such as providing culturally appropriate information, addressing potential barriers to access, advocating for systemic change and supporting clients with complex needs, you can help to ensure that AOD services are accessible to all who need them

Further Reading Another way to find support is to access the Alcohol and Drug Information Service (ADIS). You may read about it in the link below: Navigating the AOD service system

Multimedia The video below talks about Next Step Drug and Alcohol Services (Next Step), which provide a range of treatment services for people experiencing problems associated with their alcohol and other drug use, as well as support for families.Next Step Alcohol and Drug Service