Nurse views sought on UK alcohol treatment guidelines

The key role played by nurses in supporting people with alcohol-related problems is highlighted in first-of-its-kind UK clinical guidance for alcohol treatment services.

The government has this week launched a consultation on the new draft guidelines, which aim to give a clear consensus on best practice for treating harmful drinking and alcohol dependence.

The draft guidelines promote interventions recommended by the National Institute for Health and Care Excellence (NICE) and are modelled on the ‘orange book’ UK guidance for drug use treatment.

Nurses are mentioned throughout the draft alcohol treatment guidence, plans for which were first announced in 2019.

The new document stressed that each local area where alcohol treatment services are provided needed to have a workforce with the “full range of competencies”, which it said should include nurses.

For specialist inpatient medically assisted withdrawal units, the guidelines stated that all units needed both registered mental health and general nurses.

They added that all units “require specific nursing competencies”, including registered nurses with “enhanced skills and experience of assessing and managing complex medically assisted withdrawal”.

“What we can do as nurses with alcohol treatment is really powerful”

Gill Campbell

However, according to the draft guidelines, inpatient care should be reserved for cases where safety concerns exist, otherwise medically assisted withdrawal care should take place in the community.

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They also stressed the need for all alcohol treatment systems to have the “resources, time and expertise” to provide clinical placements to help train future alcohol specialists, including student nurses.

Gill Campbell, head of nursing at drug and alcohol support charity Turning Point, welcomed the draft guidelines and said she hoped they could raise the profile of substance use nursing.

Gill Campbell

She told Nursing Times: “We’ve wanted something along the same lines as the orange book that came out [for drug treatment services] a while ago, so I really do welcome them and welcome how comprehensive they are.”

In particular, she welcomed the reference to the complex needs of this group of patients and the call for practitioners to help reduce any “stigma” that people with alcohol-related problems might feel.

She was also pleased to see the call for all the services that play a role in this space to work more jointly together, in a model described in the document as “a multi-agency team around the person”.

For example, the guidelines said that people with both alcohol and mental health problems should be able to get help for both conditions “in a shared approach”.

Ms Campbell, who has worked in substance use for more than 20 years, said nurses were perfectly placed to help achieve the ambitions of the guidelines.

“It’s really interesting in terms of the role of the nurse, because what we can do as nurses with alcohol treatment is really powerful,” she told Nursing Times.

“There’s a lot of associated comorbidities with alcohol, including mental illness and physical illness, and as nurses, we can really make an impact not only onto the individual, but to the wider treatment system.

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“And I think our involvement, very visibly, in alcohol treatment and support can work towards the reduction of that stigma and discrimination, and increase that role of partnership working across the treatment system.

“And I think we’ve got a really, really big role in the advocacy for those individuals and their families, as well as the direct treatment and support that we can give them,” said Ms Campbell.

She said the inpatient nurse staffing requirements set out in the document were a “good thing, because it’s recognising the complexity and the skills required to support things like medically assisted detoxes, which is a clinical intervention and it should be done by nurses”.

However, she said the national shortage of nurses also affected alcohol teams, and noted how the NHS Long Term Workforce Plan did not cover third-sector providers, which deliver many of these services.

It was her hope that, once launched, the guidelines could help to raise awareness of substance use nursing as a career.

“It’s a really great career to work in substance use as a nurse because there are really great career opportunities but it’s also a really diverse role […in terms of] your daily work,” she said.

“So these guidelines will hopefully raise the profile and actually show what the career opportunities and development opportunities are.

“And maybe we [will] see universities doing more around substance use as well and really put this back on the agenda around about how this is an issue for all of us, it’s not a specialist niche issue.

“All nurses will experience somebody with alcohol dependency throughout their career… and we have a responsibility to be skilled and understand what that is,” Ms Campbell added.

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Looking ahead, she warned that continued funding would be needed to support the implementation of the guidelines over the long term, as a £532m investment from the government comes to an end in 2025.

The consultation on the new guidelines will close just before midnight on 8 December 2023, and nurses working in alcohol treatment are among those encouraged to take part.

Minister for public health, Neil O’Brien, said: “To maximise the impact of our £532m investment into substance misuse treatment, it is vital that treatment for those with alcohol dependence is informed by the best scientific and medical expertise, as well as the views of those with lived experience.

“This consultation will help us develop guidance to ensure alcohol treatment services are of consistently high quality, providing stronger pathways to recovery for those in need of treatment for alcohol dependence.”

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