For healthcare professionals
Practice resources on substance use
Practical, source-attributed information for clinicians, pharmacy teams, students and educators. Clinical decisions should always be made against current national guidance and local pathways.
Clinical building blocks
Screening, assessment and treatment
Each item names the authoritative source to consult — we summarise, we do not substitute for guidance.
Screening and assessment
Validated tools are widely used in UK practice — AUDIT and AUDIT-C for alcohol, and structured substance use histories for drugs. Use the current version published by the originating body or your local service.
Source: NICE guidance; NHS alcohol screening resources
Brief intervention
Short, structured conversations delivered opportunistically. Effective in primary care and community pharmacy for alcohol, and useful for raising drug use non-judgementally.
Source: NICE public health guidance
Withdrawal risk
Alcohol and benzodiazepine withdrawal can be medically serious. Identify dependence before advising anyone to stop, and refer for a planned regimen where indicated.
Source: NICE clinical guidelines on alcohol-use disorders
Opioid substitution treatment
Prescribed, monitored treatment reduces mortality and stabilises engagement. Familiarise yourself with local shared-care arrangements and supervised consumption pathways.
Source: UK clinical guidelines on drug misuse and dependence ('Orange Book')
Naloxone supply
Take-home naloxone can be supplied to people likely to witness an opioid overdose. Know your local supply route and offer training with the kit.
Source: UK Government naloxone guidance; local ADP arrangements
Blood-borne viruses
Offer testing and vaccination proactively. Hepatitis C treatment is short, well tolerated and curative for most people, and re-testing should be offered after ongoing risk.
Source: NHS and UKHSA guidance
Referral pathway
A six-step consultation structure
- 1Ask routinely and neutrally, in the same tone as any other health question.
- 2Assess risk: what is used, how, how often, route, tolerance, injecting, mixing, and recent breaks in use.
- 3Address immediate safety: overdose risk, naloxone, withdrawal risk, mental health and safeguarding.
- 4Offer harm reduction regardless of whether the person wants to stop.
- 5Refer or signpost to the local community drug and alcohol service, and document what was offered.
- 6Follow up and make it clear the person is welcome back if things change.
Communication
Talking about substance use without creating distance
Do
- Normalise the question: "I ask everyone about alcohol and drugs."
- Reflect back what you hear before advising.
- Be explicit that you will not judge or discharge them for honest answers.
- Use person-first language in notes, letters and handovers.
- Offer choices rather than instructions.
Avoid
- Labels such as "abuser", "addict", "clean" and "dirty".
- Making harm reduction conditional on abstinence.
- Assuming a request for analgesia is drug-seeking.
- Documenting behaviour in ways that prejudice future clinicians.
- Warnings without a practical offer of support.