Acute Addiction Liaison Cover all acute inpatient areas

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Acute Addiction Liaison

• Cover all acute inpatient areas within Glasgow
  General Hospitals.
• Glasgow Royal Infirmary
• Stobhill
• Gartnavel General
• Southern General
• Victoria Infirmary
• Western Infirmary

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No. of referrals per hospital

• GRI- 86
• WIG- 39
• Stobhill- 43
• Victoria- 58
• SGH- 62
• GGH- 21

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Scale of the ProblemAlcohol Referrals to
addiction liaison average 3220 per year (92 of
all referrals)

• Estimated that at busier times 41 of all A/E
  attendances are alcohol related. (Dobson, 2003)
• Estimated that up to 20 of all patients admitted
  to hospital for non alcohol related issues
  drinking at excessive levels. (RCP, 2001)
• 5 of all discharges in Greater Glasgow had
  alcohol related diagnosis on discharge (Approx
  10,000)
• Estimated that in excess of 40 of patients at
  risk of withdrawal will go into withdrawal
• Only 37 of clinical notes mention alcohol.

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Glasgow and Drugs

• Glasgows problematic drug misusers account for
  over ¼ of the total number in Scotland. (Drug
  misuse database)
• Excess of 13000 problematic drug misusers in
  Greater Glasgow (Drug misuse database)
• Excess of 7000 people getting MMT in Glasgow 2008
• Estimated in excess of 10000 people with HCV in
  Greater Glasgow and Clyde with 90 acquired
  through intravenous drug use (Hep C action plan)
• Estimated that 40-50 of people on methadone are
  alcohol dependent.
• 1000 patients discharged from GGC with a drug
  diagnosis

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Service a Phone Call Away

• Support to Patients
• Effective Management of Withdrawals
• Full Assessment
• Priority Referrals
• Relapse Prevention Work
• Motivational Interviewing
• Opportunistic Interventions
• Community follow up and throughcare
• Education Health Promotion

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Patient admitted who is on or requires methadone
Acute Addiction Liaison process for admission/
discharge of patients on/ requiring METHADONE
YES
NO
Do you require any Advice drug treatment/ Withdraw
al management/ discharge
Patient known to Community Addiction Team (CAT)
Acute Addiction Liaison 418-4943 East CAT- 565
0200 North East CAT 276-3420 North CAT
276-4580 West CAT 276-4330 South West CAT
276-8700 Greater Pollok CAT 276-3010 South East
CAT 276-5040 South CAT 420-8100 Homeless
Addiction 552-9287 Glasgow Drug Crisis Centre
420-6969 Drug Court 274-6000 218 Project
331-6200 East Renfrewshire 577-3368 West
Dunbartonshire CAT 562-2311 East Dunbartonshire
CAT 588-5143 South Lanarkshire CAT 613-5126
NO
YES
NO
YES
Contact patients care manager to inform them of
admission. Contact patients methadone prescriber
to confirm last dose and date collected. Contact
patients prescriber/ dispenser on discharge.
Inform care manager
No Further Action
Telephone [phone] and leave a message if
no one is available. Answer phone service
available 24hrs
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Patient admitted with drug or alcohol
related problem/ dependence
Acute Addiction liaison referral system for
links into services, advice, motivational
intervention, relapse prevention, support and
education around addiction management
Patient known to Community Addiction Team (CAT)
YES
NO
Acute Addiction Liaison 418-4943 East CAT- 565
0200 North East CAT 276-3420 North CAT
276-4580 West CAT 276-4330 South West CAT
276-8700 Greater Pollok CAT 276-3010 South East
CAT 276-5040 South CAT 420-8100 Homeless
Addiction 552-9287 Glasgow Drug Crisis Centre
420-6969 Drug Court 274-6000 218 Project
331-6200 East Renfrewshire 577-3368 West
Dunbartonshire CAT 562-2311 East Dunbartonshire
CAT 588-5143 South Lanarkshire CAT 613-5126
Contact patients care manager at CAT to inform
them of admission, discharge plan
Does patient wish to referred to acute
Addiction Liaison
YES
NO
Telephone [phone] and Leave a message if
no one is available. Answer phone service
available 24hrs
Do you require any Advice regarding alcohol or
drug treatment/ withdrawal management, discharge
YES
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Progress

• Improved links between hospital wards and CATs
• Improved links between hospital wards and ARBD
• Reduction in number of clinical incidents related
  to alcohol withdrawal
• Improved care pathway
• Reduction in number of inappropriate referrals
• Liaison service within Gastro/hep C clinics

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The Future

• Liaison clinics within ACADs (Stobhill/ Victoria)
• Liaison clinics within Gartnavel Hep C/ Gastro
• Improved referral pathways into community alcohol
  services
• Commencement of detox in hospital, completed in
  community
• Research on effect of liver disease on methadone
  metabolism

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