NICE issues quality standard for alcohol misuse

The National Institute for Health and Clinical Excellence (NICE) has published a quality standard for the national health service on the treatment of alcohol dependence and harmful alcohol use.

The quality standard defines clinical best practice within this topic area. It provides specific, concise quality statements, measures and audience descriptors to provide the public, health and social care professionals, commissioners and service providers with definitions of high-quality care. The standard covers the care of children (aged 10-15 years), young people (aged 16-17 years) and adults (aged 18 years and over) drinking in a harmful way and those with alcohol dependence in all NHS-funded settings. It also includes opportunistic screening and brief interventions for hazardous and harmful drinkers. The quality standard addresses the prevention and management of Wernicke’s encephalopathy but does not cover the separate management of other physical and mental health disorders associated with alcohol use. The main elements of the standard are:

1. Health and social care staff receive alcohol awareness training that promotes respectful, nonjudgmental care of people who misuse alcohol.

2. Health and social care staff opportunistically carry out screening and brief interventions for hazardous and harmful drinking as an integral part of practice.

3. People who may benefit from specialist assessment or treatment for alcohol misuse are offered referral to specialist alcohol services and are able to access specialist alcohol treatment.

4. People accessing specialist alcohol services receive assessments and interventions delivered by appropriately trained and competent specialist staff.

5. Adults accessing specialist alcohol services for alcohol misuse receive a comprehensive assessment that includes the use of validated measures.

6. Children and young people accessing specialist services for alcohol use receive a comprehensive assessment that includes the use of validated measures.

7. Families and carers of people who misuse alcohol have their own needs identified, including those associated with risk of harm, and are offered information and support.

8. People needing medically assisted alcohol withdrawal are offered treatment within the setting most appropriate to their age, the severity of alcohol dependence, their social support and the presence of any physical or psychiatric comorbidities.

9. People needing medically assisted alcohol withdrawal receive medication using drug regimens appropriate to the setting in which the withdrawal is managed in accordance with NICE guidance.

10. People with suspected, or at high risk of developing, Wernicke´s encephalopathy are offered thiamine in accordance with NICE guidance.

11. Adults who misuse alcohol are offered evidencebased psychological interventions, and those with alcohol dependence that is moderate or severe can, in addition, access relapse prevention medication in accordance with NICE guidance.

12. Children and young people accessing specialist services for alcohol use are offered individual cognitive behavioural therapy, or if they have significant comorbidities or limited social support, a multicomponent programme of care including family or systems therapy.

13. People receiving specialist treatment for alcohol misuse have regular treatment outcome reviews, which are used to plan subsequent care.

The full quality standard can be downloaded from http://www.nice.org.uk/ guidance/qualitystandards/ alcoholdependence/home.jsp