Guidance

How to use the ASSIST-Lite screening tool to identify alcohol and drug use and tobacco smoking

Updated 7 April 2021

© Crown copyright 2021

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated. To view this licence, visit nationalarchives.gov.uk/doc/open-government-licence/version/3 or write to the Information Policy Team, The National Archives, Kew, London TW9 4DU, or email: psi@nationalarchives.gov.uk.

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at https://www.gov.uk/government/publications/assist-lite-screening-tool-how-to-use/how-to-use-the-assist-lite-screening-tool-to-identify-alcohol-and-drug-use-and-tobacco-smoking

Introduction

Health and social care professionals are well placed to provide interventions targeted at all substances. This tool will help you to identify risky drug and alcohol use and tobacco smoking, and respond in an evidence-based way. This will contribute to reducing premature mortality and morbidity.

The ASSIST-Lite (Alcohol, Smoking and Substance Involvement Screening Tool – Lite) is a shortened version of the ASSIST screening tool which was developed for the World Health Organization (WHO) by an international group of researchers. Its function is to help detect and manage substance use and related problems in healthcare settings.

The ASSIST-Lite has been modified and licensed for use in health and social care settings throughout the UK. The ASSIST-Lite tool is copyrighted so you will need permission to use it. You can request permission by using the simple processes outlined and overseen by NHS Digital.

Two versions of the ASSIST-Lite have been developed. One version is specifically adapted for use in mental health settings, the other is for use in all other health and social care settings.

Both versions of the tool include the alcohol use disorders identification test – consumption (AUDIT-C) for identifying health risk from alcohol consumption. The adapted version of the ASSIST-Lite tool for mental health settings has been added to the mental health services dataset.

Alcohol and drug use and tobacco smoking identification and brief advice should be part of your routine practice. This guidance is designed to help you meet your responsibility to ensure evidence-based interventions are available and competently delivered.

This guidance is not intended to dictate the precise intervention and treatment for each individual service user that you work with. Rather, it is designed to guide you to provide the right balance of interventions, working in line with training, competence and organisational policies and procedures.

Public Health England (PHE) has published guidance on meeting the needs of people with co-occurring drug and alcohol, and mental health conditions. This guidance states that health, social care and other frontline services should respond collaboratively, effectively and flexibly to prevent exclusion.

You should offer compassionate, non-judgemental and accessible care centred around the service user’s needs. Delivering alcohol, tobacco and drug identification and brief advice will help you to take an inclusive approach and ensure better outcomes for your service users.

Why you should use the ASSIST-Lite tool

Alcohol and drug use and tobacco smoking are among the most significant health (including mental health) risk factors in England. Supporting your service users to reduce drug use, quit smoking and drink less alcohol will :

  • reduce premature mortality and morbidity
  • reduce the burden on the NHS
  • reduce health inequalities
  • improve health and mental health treatment outcomes

The ASSIST-Lite will help you to identify alcohol, drug and tobacco smoking-related risk and deliver appropriate evidence-based interventions.

All health and social care practitioners should routinely support reducing alcohol and illicit drug consumption and quitting smoking as part of health care to improve physical and mental health outcomes. This must involve:

  • asking all service users if they drink, take illicit drugs or smoke, and delivering appropriate interventions including brief advice
  • using alcohol, drug and tobacco dependence treatment pathways for support

Physical health impact of alcohol and drug use and tobacco smoking

Alcohol

In England, 22% of adults drink alcohol at levels above the UK Chief Medical Officers’ low-risk guideline, increasing their risk of alcohol-related ill health.

Alcohol consumption contributes to over 200 health conditions, including cancers, cardiovascular conditions, depression and liver disease. The toxic effect of both long-term and short-term alcohol use can lead to hospital admission.

The economic burden of alcohol is estimated to be between 1.3% and 2.7% of annual Gross Domestic Product (GDP). Around three-quarters of the alcohol-related cost to the NHS is incurred by people whose alcohol use causes ill health.

Illicit drugs

Estimates show that around 1 in 11 16 to 59 years olds in England and Wales have used an illicit drug in the last year, with 1 in 3 using at some point during their lifetime.

Although the number of people with serious drug problems is relatively small, illicit drug use can have a big impact on individuals, their families and the wider community. Heroin and crack are the drugs that pose the biggest risk of harm to individuals and society, and there are an estimated 314,000 people using these drugs in England.

People who experience drug-related harm might seek help from a wide range of health and social care services. This could include acute medical, primary care and psychiatric services.

Tobacco

Tobacco smoking is the leading cause of preventable illness and premature death in England. It is also one of the main causes of health inequalities.

The General Practice Patient Survey data shows that tobacco smoking rates are declining in England. Prevalence in adults (aged 18 and above) has decreased from 17.1% in 2013 to 2014, to 14.5% in 2018 to 2019.

In adults with a long-term mental health condition, smoking rates have fallen from 35.3% in 2013 to 2014 to 26.8% in 2018 to 2019. The prevalence of smoking in this population is much higher than the general population despite the same levels of motivation to quit.

Tobacco smoking is not a lifestyle choice but a chronic relapsing condition needing treatment. It costs the NHS in England approximately £2.6 billion a year to treat diseases caused by smoking, but every £1 spent on stop smoking support saves £10 in future health care costs and health gains.

In England, an estimated 1 in 4 patients in acute hospital beds and 64% of patients in secure mental health units are smokers. So, many smokers can be reached through hospitals and other health services. However, an Action on Smoking and Health (ASH) survey of mental health trusts in England has found that this unique opportunity is not being seized to its full extent.

Mental health impact of alcohol and drug use and tobacco smoking

Drugs and alcohol

It is very common for people to experience problems with their mental health and alcohol or drug use at the same time. This is also known as having co-occurring conditions. Research shows that:

High prevalence of these co-occurring mental health and alcohol and drug use conditions has been found among:

  • people presenting to hospital emergency departments in mental health crisis
  • children, young people and adults in alcohol and drug treatment
  • people in prison and those in the criminal justice system
  • people experiencing severe and multiple disadvantages

People with co-occurring conditions often have multiple needs. For example, poor physical health alongside social issues such as debt, unemployment or housing problems. Evidence tells us that people with co-occurring conditions are more likely to be admitted to hospital and have higher risk of other health problems and early death.

National guidance on commissioning and providing better care for people with co-occurring conditions states that:

  • people are often unable to access care from services when intoxicated or experiencing mental health crisis
  • mental health services sometimes exclude people because of co-occurring alcohol or drug use
  • people diagnosed with serious mental illness may be unable to access alcohol and drug services due to the severity of their mental illness

Tobacco

People with mental health problems, including anxiety, depression and schizophrenia, are much more likely to smoke and tend to smoke more heavily than the general population. Evidence shows that the more severe the mental health condition, the higher the smoking prevalence. In 2014 to 2015, smoking prevalence was:

  • 16.4% in all adults (aged 18 and above)
  • 28% in people with anxiety or depression
  • 34% in people with a long-term mental health condition
  • 40.5% in people with serious mental illness

People with mental health problems die on average 10 to 20 years earlier than those who do not experience mental health problems. Smoking is the biggest cause of this life expectancy gap.

Evidence

Alcohol and drug screening tools can help professionals identify those needing intervention. The ASSIST-Lite is proven to be effective in identifying risky illicit drug use. The AUDIT-C alcohol identification tool, which is used in the UK version of the ASSIST-Lite, is proven to be effective in identifying health risk from alcohol consumption.

Research has shown that brief advice, taking only 5 to 10 minutes, is effective at bringing about changes in alcohol and tobacco use.

Research has also shown that providing simple alcohol brief advice results in:

Brief interventions for cannabis have been found to significantly increase the likelihood of abstinence.

Providing very brief advice (VBA) for smoking is the single most cost effective and clinically proven preventative action a healthcare professional can take.

Smokers who combine stop smoking aids with expert support are 3 times more likely to quit successfully. A Cochrane review showed that smoking cessation interventions are effective for hospitalised patients regardless of the reason for their admission.

Research has shown that the quit rate among hospitalised patients who are referred to stop smoking services is 9.3%, compared to 3% to 4% among those who quit unaided. Identifying and recording smoking status, along with providing effective routes to stop smoking support, increases the uptake of these interventions.

Guidelines and organisational standards

Using the ASSIST-Lite screening tool will help you adhere to the following National Institute for Health and Care Excellence (NICE) clinical guidance on alcohol and drug use, smoking and mental health conditions:

  1. Alcohol-use disorders: prevention, Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence recommend routine identification and advice for those drinking at levels that significantly increase their risk of harm.
  2. ‘Drug misuse prevention: targeted interventions’ and ‘Drug misuse in over 16s: psychosocial interventions’ recommend assessing whether groups at risk are vulnerable to risky drug use, and brief interventions. This should occur during contact with statutory and other services, including mental health services.
  3. ‘Stop smoking interventions and services’ and ‘Smoking: harm reduction’ recommend identifying people who smoke, advising them to stop smoking and ensuring that they are given the support they need including stop smoking aids.
  4. ‘Assessing and managing coexisting severe mental illness (psychosis) and substance misuse’ recommend that healthcare professionals in secondary care mental health services are competent in the recognition, treatment and care of adults and young people with psychosis and co-occurring drug and alcohol use.
  5. ‘Recognising and managing depression in adults’ recommends that comorbidities including alcohol and drug use should be included in the assessment of someone with depression referred to specialist mental health services.
  6. ‘Reducing smoking in acute, maternity and mental health services’ recommends routine identification of people who smoke and offering help to stop, including intensive support in acute and mental health services.

The NHS Standard Contract requires that providers:

  • deliver alcohol identification and brief advice
  • deliver very brief advice (VBA) to all patients who smoke
  • identify inpatients who smoke tobacco and offer brief advice or referral to specialist stop smoking support

Delivery of VBA for smoking cessation also forms part of the NHS Long Term Plan. By the end of 2023 to 2024 all inpatients, pregnant women and higher risk outpatients who smoke should be given NHS funded treatment for tobacco dependence.

How to use the ASSIST-Lite tool: a step-by-step guide

The process is made up of the following steps:

  1. Screen at-risk service users using the ASSIST-Lite tool.
  2. Deliver an appropriate level of intervention based on the level of risk identified for each substance.
  3. Review risk at a future appointment.

Step 1: screening

Using the ASSIST-Lite tool will help you identify service users whose alcohol and drug use and tobacco smoking may be increasing their risk of physical, psychological or social harm.

NICE guidance on targeted interventions recommends that you routinely:

  • screen all adults for alcohol misuse
  • ask all adults about their smoking status
  • assess whether people in groups at risk are vulnerable to drug misuse (you can do this by using the drug screening questions in the ASSIST-Lite)

NICE guidance on psychosocial interventions recommends routine drug screening in settings where drug misuse is common, such as mental health and criminal justice services. In more general healthcare settings, you should ask patients about drugs if they have problems that suggest they are using drugs, such as chest pain in a young person, acute psychosis, or mood and sleep disorders.

The screening results will help you to talk to your service users about changing their alcohol and drug use and tobacco smoking. The tool is not designed to diagnose dependence on drugs or alcohol, but to identify those who may benefit from further assessment.

It should take you around 5 to 10 minutes to complete the ASSIST-Lite. This will depend on whether the service user smokes, drinks at levels that put their health at risk, or uses illicit drugs or medicines not as prescribed. It will also depend on how many different substances the individual uses.

The ASSIST-Lite tool can be used during assessments, care planning, one-to-one or review sessions as appropriate. For inpatient settings, you should screen patients as soon as they are admitted and again before they are discharged.

The tool has the following structure:

  1. Question 1 covers tobacco.
  2. Questions 2 to 4 cover alcohol.
  3. Questions 5 to 7 cover cannabis.
  4. Questions 8 to 10 cover stimulants.
  5. Questions 11 to 13 cover sedatives and sleeping medications.
  6. Questions 14 to16 cover opioids.
  7. Questions 17 to 18 cover other psychoactive substances including use of medications not as prescribed.

The first question of each section asks whether the respondent has used the substance within a given period of time. For example, the drug-related sections ask about use of illicit drugs or medicines not as prescribed within the last 3 months. If the respondent does not use the substance in question you can skip to the next section.

As you ask the questions, score each response in the column on the far right-hand side. Based on your service user’s answers to each question, they are allocated a score of:

  • 0 to 1 for tobacco
  • 0 to 12 for alcohol
  • 0 to 3 for cannabis, stimulants, sedatives and opioids
  • 0 to 1 for use of any other psychoactive substance or medicines not as prescribed

To help you use the screening tool, it includes:

  • lists of the most commonly used illicit drugs and medicines often used not as prescribed
  • other slang terms for these substances (you can also look at FRANK for further information on slang terms for drugs)
  • an alcohol unit guide
  • links to useful information sources

When you’ve asked all the questions, add up the total score for each section in the ‘Your score’ box. Depending on the level of risk identified in each section, appropriate action is suggested in the ‘Scoring and actions’ section on pages 3 and 4.

Step 2: actions

Possible actions range from ‘no indicated action’ where the tool has identified low or no risk use, to actively referring high-risk service users to other services. Where someone is at ‘low risk’ and no action is indicated by the ASSIST-Lite score, it is good practice to reinforce their current behaviour to encourage them to maintain it.

Any further assessment and treatment intervention for alcohol, drugs and medicines not as prescribed must be in line with:

Brief advice: an overview

For people identified as ‘increasing risk’, and some identified as ‘higher risk’, the tool indicates that brief advice should be given by the health and social care professional who completed the screening.

Brief advice can be a short, informal but structured conversation or a leaflet. It should be delivered by health and social care professionals where appropriate, based on screening scores.

You can give brief advice as part of routine care during assessments, one-to-one sessions, review or discharge. You should offer brief advice for each substance (alcohol, tobacco and each category of illicit drug or misused medicine) where risk is indicated.

VBA for smoking cessation can take about 30 seconds. Alcohol and drug brief advice typically takes 5 to 10 minutes.

Brief advice is delivered based on the core principles of motivational interviewing (MI). MI takes a collaborative approach based on empathy and acceptance of your service user’s circumstances. Your aim is to evoke answers that will help your service user to gain insight into their current situation and options for change. Brief advice can be structured using the FRAMES approach outlined below.

The goal of brief advice is to reduce the risk of harm from tobacco smoking and alcohol consumption and drug use. By raising a service user’s awareness of the risk associated with their alcohol and drug use or tobacco smoking, brief advice can act as a powerful catalyst for changing behaviour.

You should use the screening results to motivate your service user to commit to SMART target goals. SMART goals are:

  • specific, in that the desired behaviour changes and actions to be taken are described simply and precisely
  • measurable
  • achievable, given the circumstances, resources and time available
  • relevant and meaningful to the individual
  • time-bound

If the goal is SMART, it is more likely to be effective. A SMART goal should not be too difficult or easy. Small goals (often short-term) are more likely to be effective than significant, longer-term goals. Your service users are more likely to realise their goals if they develop the plan themselves. SMART goals following alcohol, drug and tobacco screening could focus on:

  • reduced drug or alcohol consumption
  • abstinence or quitting
  • accepting a referral to stop smoking support or specialist alcohol or drug treatment

There are widely-used, evidence-based models for delivering alcohol and tobacco brief advice, which are outlined below.

Very brief advice for smoking cessation: ask, advise, act

Very brief advice (VBA) for smoking aims to identify service users who smoke and support them to make a quit attempt. You can provide VBA in as little as 30 seconds. The intervention is made up of 3 core components: ask, advise and act.

  1. Ask the service user if they smoke and record this information. This is covered by question 1 of the ASSIST-Lite.
  2. Advise the service user on the best way of quitting, suggesting a combination of medication and specialist support.
  3. Act by actively referring the service user to stop smoking support and providing access to stop smoking medications. You should record whether the referral was made and whether the service user accepted the referral.

Service users who have a mental health condition and attempt to quit smoking, supported or unsupported, should have the dosage of their medications reviewed. This is because some psychotropic medications are affected by smoking and service users taking these medications may be able to have their dosage reduced. The Maudsley Prescribing Guidelines in Psychiatry gives details about psychotropic medications known to be affected by smoking and provides actions to take when a service user on these medications stops or starts smoking.

You can find information and advice on quitting smoking on the NHS Better Health platform.

Alcohol and drug brief advice

Alcohol and drug brief advice can be delivered using the FRAMES approach. FRAMES is an acronym summarising the components of a brief intervention. These are:

  • feedback
  • responsibility
  • advice
  • menu of options
  • empathy
  • self-efficacy

Feedback: give feedback on the service user’s screening score. For example, “your answers indicate your alcohol use could be placing your health at risk”. You can also share relevant information about the risks associated with their current alcohol and drug use. You could introduce the subject of risk by asking open-ended questions such as “which risks associated with cannabis use concern you?” or “what do you know about the effects of alcohol?”.

Responsibility: emphasise that their smoking, drinking or drug use is their own responsibility. For example, “how surprised are you about your results?” or “what you do with this information about your drug use is up to you. I am just letting you know the kinds of harm that can be associated with your current pattern of use”.

Advice: give advice on reduction or explicit direction to change, but only when the service user requests it or gives you permission to do so. For example, “the best way to reduce your risk is to cut down or stop using”.

Menu of options: explore the options for change. For example, “if you wanted to cut down, what might work for you?”.

Empathy: adopt a warm, reflective and understanding approach. For example, “it sounds like …”, “I hear that you’re worried about making changes to your drug use”.

Self-efficacy: encourage optimism about the behaviour change. For example, “I’m sure you can do it”, “I’ve seen you make positive changes in other areas of your life” or “I’ve seen other people make positive changes to their drinking”.

The NHS alcohol brief advice tool can help you to structure alcohol brief advice. This tool outlines:

  • what the scores mean
  • units and low risk consumption guidelines
  • how someone’s drinking compares to the general population
  • the potential risks from drinking at different levels
  • the benefits of, and tips for cutting down

This tool also includes space for people to identify a personal alcohol reduction target.

The cannabis health check-up tool can help you to structure cannabis brief advice. It outlines:

  • what the scores mean
  • the risks associated with cannabis use
  • how someone’s cannabis use compares to the general population
  • the benefits of cutting down or quitting cannabis
  • tips for reducing cannabis use and related risks
  • signposting to sources of advice, support and treatment

It also includes space for people to set their own goals to reduce cannabis use and risk.

You can find detailed information on illicit drugs and medicines that are commonly used not as prescribed, including the associated mental and physical health risks, on the FRANK website.

Handling high risk drug use and potentially dependent alcohol use

Brief advice is not appropriate for people who may be dependent on alcohol or drugs.

Clinical guidelines recommend advising service users not to stop using alcohol or drugs if there are concerns that they are highly dependent due to the risk of withdrawal. You should seek a specialist drug or alcohol assessment if the service user’s results from the ASSIST-Lite or the full alcohol use disorders identification test (AUDIT) indicate that the service user has dependent drinking or high-risk drug use.

The specialist assessment will determine if they are dependent, their level of dependence and the risk of withdrawal. You should seek specialist assessment from a drug and alcohol treatment service, hospital alcohol care team (ACT) or doctor or nurse with appropriate specialist training.

When delivering alcohol and drug brief advice, you should advise service users that:

  • it can be dangerous to stop drinking or taking drugs too quickly without proper support
  • they should seek medical advice and specialist assessment before they stop drinking if they have physical withdrawal symptoms (like shaking, sweating or feeling anxious until having their first drink of the day)
  • stopping opioid use suddenly in an unplanned way increases the risk of unpleasant withdrawals, loss of tolerance and overdose
  • they should not suddenly stop taking opioids or some prescription medications, and should only withdraw from these after having a comprehensive assessment and with an agreed plan
  • alcohol, opioids like heroin, benzodiazepines, gabapentinoids like pregabalin and gabapentin, and some other drugs are depressants, meaning they can slow breathing and cause unconsciousness
  • using any combination of depressants (unless they are prescribed as medicines and used as directed) increases the risk of overdose and death

Further assessment

The ASSIST-Lite tool indicates when you need to conduct further clinical assessment to determine a service user’s appropriate care and treatment package. This will depend on the level of risk associated with their drug and alcohol use. Further assessment could include:

  • other screening tools such as the full AUDIT where higher risk and potentially dependent drinking has been identified
  • assessing the quantity (or ‘dose’), frequency and pattern of drug use, how the drugs are taken (orally, smoked or inhaled, by injection), and how long they have been using at current levels
  • specialist assessment to determine the severity of dependence and associated risks, especially risk of alcohol or opioid withdrawal

Treatment intervention within service

Depending on your level of training and competence, you should consider offering an evidence-based treatment intervention as part of your care plan. This could include motivational enhancement interventions, motivational interviewing, and pharmacotherapy. NICE guidance on the prevention of alcohol use disorders recommends that an extended brief intervention should be delivered where brief advice does not lead to a reduction in higher risk drinking.

Specialist drug and alcohol treatment services can support and guide other professionals to deliver evidence-based treatment interventions.

A comprehensive offer of care requires joint working to address a service user’s physical health, social care, housing, mental health, alcohol and drug use, and tobacco smoking, as well as their other needs. This offer of care should take account of a service user’s specific needs, recognising that increased levels of need, risk and vulnerability will require increased support.

PHE guidance on co-occurring mental health conditions and substance use disorders outlines the need for agreed pathways which will help multiple agencies work together to deliver care.

Other interventions

Anyone scoring more than 8 on the AUDIT-C or more than 16 on the full AUDIT should be considered for a referral to receive a liver screen test. This will check for signs of cirrhosis or advanced liver fibrosis. This is in line with the NICE guidance on cirrhosis in over 16s.

Obesity induced fatty liver can progress to cirrhosis and liver failure, but obesity can also make the impact of alcohol consumption on the liver worse. The effect of a combination of high BMI and alcohol is greater than the combined effect of the two separately.

In simple terms, for a person with a BMI of over 35, the risk of liver disease doubles with any level of alcohol consumption. It is important that people with high BMI, particularly those with obesity induced fatty liver, are asked about their alcohol consumption. This should be followed by brief advice or an active referral into specialist alcohol treatment, as appropriate.

‘Active’ referral into a specialist drug and alcohol treatment service

If you feel your service user’s alcohol or drug use is causing them harm, explain the connection between their alcohol or drug use and their health problems and suggest a referral for specialist intervention. This could be a direct referral, for example “we have a drug and alcohol worker here once a week, how would you feel about booking an appointment to see them?”. It could also involve finding your service user’s local specialist service and actively referring them.

Referral pathways between local health and social care providers and specialist drug and alcohol treatment and recovery services should be clearly agreed and mutually understood. If this is not the case, you can find local specialist alcohol and drug treatment and stop smoking support:

You could do this with your service user to show them their local service’s website, which could encourage them to visit the site again later.

Referral into specialist treatment should not be a one-off action. An active referral will help your service user to get specialist support and treatment. An active referral involves:

  • calling or emailing the alcohol or drug treatment service and completing any necessary referral paperwork
  • discussing your service user with the specialist service
  • arranging an appointment
  • checking a service user has attended and continues to attend
  • continuing to share information
  • joint work with specialist services as appropriate

Most drug and alcohol services accept self-referrals and offer drop-in assessment sessions, where you do not need an appointment.

Review

If you remain in contact with a service user who was identified as having higher risk or possibly dependent alcohol or drug use, or who is a current tobacco smoker, you should use the ASSIST-Lite screening tool again at a future one-to-one or review session. This allows you to assess any changes to their alcohol and drug use and tobacco smoking since your last meeting.

Tools, resources and training

Tools, resources and training for health and social care professionals

Further ASSIST and ASSIST-Lite training

The University of Adelaide has a range of resources to help professionals to use the ASSIST and ASSIST-Lite tools and to offer linked brief advice. This includes e-learning and instructional films.

Please note that these training resources are for the original Australian version of the ASSIST-Lite, not the adapted version for use in the UK. So, the recommended actions featured in the training films are different from those included in the UK versions of the tool.

Alcohol

The NHS alcohol brief advice tool will help you to deliver brief advice on alcohol.

The 5 AUDIT tools will help you to identify health risk from alcohol consumption.

PHE published Alcohol: applying All Our Health to help health and social care professionals understand alcohol harm prevention and think about local resources that can help people whose drinking carries health risks.

Drugs

The cannabis health check-up tool can help you to structure cannabis brief advice.

The NHS website offers advice and information on getting help to address drug use.

PHE published Misuse of illicit drugs and medicines: applying All Our Health to help health and social care professionals identify, prevent and reduce drug-related harm, and identify local resources and services that can help those who use drugs.

Health Education England (HEE) provides a free e-learning course offering a shorter version of the ‘All Our Health’ guidance on the risky use of drugs and medicines not as prescribed.

Drug and alcohol services

The FRANK drug and alcohol service directory will help you to find local alcohol and drug services.

The NHS website can also help you to find local drug and alcohol services.

Smoking

PHE published Stop smoking options: guidance for conversations with patients, which helps clinicians talk to service users about the different treatment options for stopping smoking.

PHE published Smoking and tobacco: applying All Our Health to help health and social care professionals understand the activities and interventions that support smokers to stop smoking, so they can think about the local resources and services that could help their service users to quit. Health and social care professionals can also access training resources to develop skills in motivating and supporting smokers to quit.

Brief advice

HEE provides a free e-learning course that covers both alcohol and tobacco brief advice.

HEE also provides a range of comprehensive e-learning courses on alcohol identification and brief advice. The courses include evidence from more than 60 controlled trials over 30 years. There are courses for different settings, including hospitals, primary care, community pharmacy and dental teams.

The National Centre for Smoking Cessation and Training provides free e-learning courses for delivering very brief advice on stopping smoking. It also provides resources focused on supporting stopping smoking in secondary care, mental health and pregnancy services.

Co-occurring conditions

PHE published guidance on commissioning and providing better care for people with co-occurring mental health, and alcohol and drug use conditions.

PHE published Health matters on smoking and mental health. This edition of Health Matters focuses on smoking among people with a range of mental health conditions, from low mood to more severe conditions like schizophrenia and bipolar disorder.

Resources for service users

Alcohol

One You offers advice and information on cutting back on alcohol.

The Have a Word alcohol unit wheel is an interactive tool to help calculate the number of units and calories in alcoholic drinks consumed. It’s available to download at Health Education England’s alcohol identification and brief advice programme page

The NHS website includes information about alcohol, including units, risks, binge drinking, the health benefits of cutting down and tips for cutting down.

The NHS Drink Free Days app helps people to pick their days to skip alcohol and get practical support to stick with it.

Anyone worried about their own or someone else’s drinking can contact Drinkline, the national alcohol helpline, on 0300 123 1110.

Drugs

FRANK is a free drug advice service that is primarily aimed at young people and parents. Advice is available from FRANK 24 hours a day online, by phone, by email and by text message.

The NHS website offers advice and information on getting help to address drug use

Mutual aid

Mutual aid services offer peer support and connection with a community of people who are in recovery. Mutual aid can supplement a structured alcohol or drug treatment programme. Local mutual aid groups may include:

Smoking

NHS Better Health offers a variety of stop smoking aids, specialist support and links to other resources including the Smokefree app which provides daily support and motivation.

Back to top