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A significant amount of people in the ACT are impacted by Alcohol and Other Drug (AOD) issues, including people with insecure accommodation and experiencing homelessness. Many of these individuals also experience mental health challenges and other health conditions. Residential withdrawal services in the ACT have a high demand and limited supply of services, therefore non-residential services can improve access to health services. The provision of quality primary health, AOD and outreach support services is of key importance to tackling these issues and improving the health inequities experienced by these individuals
The Karralika Programs Non-Residential Withdrawal Support Service (NRWSS) supports people with anticipated mild to moderate withdrawal symptoms, to safely withdraw or reduce their substance use in the comfort of their own home. CHN commissioned Karralika Programs to pilot the program in 2018. Due to its success, in 2021 CHN was successful in achieving a Community Health and Hospitals Program Grant to expand the program so up to 4 Registered Nurses could be employed.
Over the last year, there were 1,532 direct client contacts. Of those, 57 clients received most of their treatment at home, 36 clients at the non-residential treatment site, 14 clients at a residential AOD service and 2 through outreach. At times, the residential rehabilitation service requested the NRWSS when they admitted someone who was still in a withdrawal state or when the client has briefly lapsed, been discharged and then readmitted and required NRW support or treatment.
Clients utilising the service provided overwhelmingly positive feedback by rating their physical and psychological health and overall quality of life at the beginning and end of the NRWSS. The mean score for the clients self-rated physical health, psychological health and overall quality life all increased significantly throughout the course of the program, illustrating the significance of non-residential withdrawal support services in empowering individuals to self-manage their AOD related health issues, mental health and improve their holistic wellbeing.
Client story
Amelie* (not her real name) lived in a “granny flat” at the back of her supportive father’s house. Amelie had a history of drinking alcohol since the age of 13, with periods of sobriety. She worked full-time in the same job for many years, despite her alcohol use issues. Amelie had attended residential rehabilitation and 2 different day programs. She was undergoing counselling and taking antidepressant medication, to avoid using alcohol to self-medicate.
Amelie reported to be consuming 14 – 20 standard drinks per day, which led to a lot of absenteeism at work. Amelie reported that her drinking had caused problems by exacerbating her experiences of depressive episodes and mood swings. She had experiences of self-harm and two suicide attempts. She also said that drinking made her gain weight and suffer from insomnia.
Amelie and the NRW Nurse developed a treatment plan, in collaboration with her GP. The NRW Nurse saw Amelie every day in her own home for that first week of withdrawal and conducted an alcohol withdrawal scale during each visit. The Nurse ensured Amelie was using her Valium as advised. In the second week, the NRW Nurse conducted 3 home visits and phoned Amelie on alternate days.
The NRW program worked with Amelie for 2 weeks, while she re-established AOD counselling and commenced going to two Alcoholics Anonymous (AA) meetings per week. Amelie did not want to do rehabilitation at this time, as she did not want to leave her workplace. After 3 weeks in the program, Amelie was discharged as she was engaged with AA and counselling and had maintained sobriety in that time.