Is misuse of chemicals the primary problem?
Has the attempt to control the drugs/alcohol use been successful so far?
Has the attempt to abstain from drugs/alcohol use, been unsuccessful so far?

 

Many of the people who use drugs and alcohol are relatively stable people. They are not chronically or acutely chemically dependent. Even if they are in the very early stages of dependency they may have a supportive and intact family and social network and be fully employed.

 

Ordinarily these people do not require residential care but can be helped within the community with advice, information or referral to a community-based drug and alcohol service, counselling, and/or the support of a self-help group. If a period of residential care does become necessary it may be possible that a short intensive course of say six-week duration will be sufficient to address their need with on-going support being provided for within the context of a 12 Step Fellowship, local church or other community-based resource.

 

A more comprehensive residential care intervention is required when chemical dependency has become unmanageable and chaotic. Serious chemical dependency can result in a range of conditions, both physical and psychological, and people can become quite ill.

 

Other issues which can affect this narrow band of people include:
•    Being unable to sustain motivation at home
•    Being unable to access or to benefit from community-based services
•    Being unable to sustain a credible harm reduction approach
•    May have unstable housing
•    May have a seriously disturbed and deprived pre-dependency social history
•    May be living in an abusive and dangerous domestic environment and require a place of safety and treatment.

 

People who do require more comprehensive residential care are usually drawn from the narrow band of drug and alcohol misusers who are very chaotic, and/or have become chronically or acutely ill. Recovery for such people may begin with a short intensive programme of residential treatment or a full course of rehabilitation (6-9 months).