Community drug teams are usually NHS based services which provide an individual with an easy access to information, advice related to counselling, drug treatment etc (Home Office, 2007). Structured day care programs are also offered by some community drug teams. These programs offer intensive community-based support, treatment and rehabilitation to the individuals. These programmes run for a fixed period of time and usually require that an individual achieve a specific level of attendance by attending these programs on a regular basis (Home Office, 2007).
Street-based agencies These agencies are similar to community drug teams but are usually run by the independent sector rather than the NHS. Similar to the drug community teams they also provide an individual with an easy access to information, advice and counseling services etc (Home Office, 2007). Drug Dependency Units These units are based in the NHS hospitals and provide treatment on an out-patient basis. The treatment in these units is provided by multidisciplinary teams comprising of psychiatrists, nurses, psychologists, social workers etc.
They provide detoxification services, prescription of substitute drugs, counseling support, structured day care programs and group work on out-patient basis (Home Office, 2007). Tier 4a: Specialist Services (Residential) Service Inpatient Detoxification In-patient detoxification units are specialized units either in NHS hospitals or private clinics. In these units, drug detoxification is carried out in medically supervised environment. The process of detoxification is most commonly used for opiate group of drugs and the most common substitute drug used is methadone in the UK (Home Office, 2007).
Though substitute drugs are available for people dependent on amphetamines, they are not commonly used. At present no substitute treatments are available for overcoming physical dependence in individuals who abuse crack or cocaine (Stimson & Metrebian, 2003). In the process of detoxification, firstly the individual who is dependent on drugs is given small doses of drugs (usually opiates) in a gradually decreasing controlled manner over a period of days or months.
If the person experiences withdrawal symptoms on reducing the dose of the illicit drug, he is given methadone (usually orally) in medically controlled dosages. Methadone is chemically similar to the opioid drugs; therefore it combines with the same receptors in the brain where the illicit drug also combines. Thus the substitute drug is able to prevent the emergence of withdrawal symptoms associated with physical dependence on drugs. As a result the individual does not experience much physical discomfort when he reduces his dosage of drugs and is able to maintain remission (Stimson & Metrebian, 2003).
Detoxification can be achieved both, in the inpatient setting in a hospital or in out-patient setting in the community. Residential Rehabilitation On its own, detoxification is rarely useful. Most individuals dependent on heroin tend to experience a relapse soon after completion of treatment (Leshner, 1999). In order to prevent relapse in patients who have undergone treatment for substance abuse disorder, there are facilities for residential rehabilitation of these patients. These programs are usually provided by the independent sector.
They offer structured programs, psychological and social support, crisis intervention strategies (for preventing relapse), counseling services and non-pharmacological therapy, both in controlled residential settings and hospital environments (Home Office, 2007). Though different rehabilitation programs vary from each other regarding their programme structure, intensity and duration of interventions, most of residential rehabilitation services help the users in preventing relapse (Home Office, 2007).