Session 15 Provide Counselling To PWUD and PWIDs

Session 15
Provide counselling to People Who Use Drug(PWUD) and People Who Inject
Drugs(PWIDs)
Presented by
Ms. Brenda G
Learning tasks
• Define drug abuse and substance use
• List drugs commonly abused by PWIDs and
PWUDs
• Explain WHO assessment tool (ASSIST V3.0)
• Assess the client using the ASSIST V.3.0 tool
• Counsel the client to stop drugs abuse or
substance use
• Refer accordingly
Define drug abuse and substance use
Drug abuse is extreme desire to obtain and use increasing amount
of one or more substance.
Drug abuse is generic term for the abuse of any drug including
alcohol and cigarettes.
Drug abuse is not the same as drug dependence or drug addiction
Drug dependence or drug addiction indicates a psychological or
physical dependence on the drug to function.
Drug dependence requires the symptoms of withdraw if the drug
is discontinued, whereas drug abuse does not.
Substance abuse is excessive use of psychoactive drugs such as
alcohol, pain medications or illegal drugs.
Drugs commonly abused by PWIDs and
PWUDs
• Alcohol
• Cigarettes
• Methadone
• Oxycodone
• Marijuana
• Heroin
• Cocaine
RISK FACTORS OR BEHAVIOUR
• Family history. More common in some
families and likely involves an increased risk
based on genes.
• Peer pressure . Is a strong factor in starting to
use and misuse drugs, particularly for young
people
• Lack of family involvement. Difficult family
situations, lack of bond with parents, lack of
parental supervision
• Mental health disorder. Using drugs can become a way
of coping with painful feelings such as anxiety,
depression and loneliness
• Taking a highly addictive drug
WHO assessment tool (ASSIST)
ASSIST is an abbreviation of Alcohol, Smoking and

Substance Involvement Screening Test .This was
developed by WHO by international group of
substance abuse researchers to detect and
manage substance use and related problems in
primary and general medical care settings.
Primary health care professionals are well
positioned to provide interventions targeted to
all substances irrespective of their legal status.
PROJECT PHASES
• The ASSIST has undergone significant testing
in three sequential phases I,II, and III.to
ensure that is feasible(can be done easily),
reliable(well founded), valid(officially
acceptable), flexible(easily modified) and
comprehensive(large content/scope)
How to assess the client using the ASSIST
Version 3.0 tool
• The WHO ASSIST phase III Project consisted of
a randomized controlled trial of a brief
intervention with person who screen positive
for moderate risk for
cannabis ,opiate ,cocaine, or amphetamine-
type stimulant use on the ASSIST.
ASSIST V3.0........
• The WHO ,ASSIST is a questionnaire that screens for all
levels of problem or risky substance use in adults. The
ASSIST (V3.0) consists of eight questions covering
tobacco, alcohol, cocaine, cannabis, amphetamine-type
stimulants inhalants, hallucinogens, opioids, and other
drugs
• A risk score is provided for each substance and score are
grouped into low risk, moderate risk and high risk
• The risky score determines the level of intervention
recommended (treatment as usual ,brief intervention or
brief intervention plus referral to specialist treatment)
ASSIST V3.0.......
• The following are the clinical form and client
materials during assessment.
• Refer to handouts..ASSIST V3.0

Counselling the client to stop drugs abuse
or substance use
I. Cognitive Behavioral Therapy

• Cognitive behavioral therapy is a psycho-social intervention
that aim to reduce symptoms of various mental health
conditions, substance abuse and anxiety disorders.
• CBT focuses on learning to reduce problematic behavior
associated with substance abuse.
• A key theme in CBT is anticipating risky situations and
applying coping strategies, such as avoidance or self-control,
to prevent relapse.
• CBT is one of the most popular therapies in addiction
medicine, and counselors use it to treat a variety of
addictions.
Counsell......
During CBT, patients learn to recognize and modify
risky behavior by using a variety of skills. They learn
the underlying causes of problematic behavior so they
can fix the problems at their source. They’re able to
recognize cravings or triggers and develop strategies
for handling those situations. Research shows that
patients who learn skills during CBT are able to apply
them during real situations later in life.
Counsell.......
II. You may also be offered family or couples
counselling. Often addictions impact those close to
us and in many cases, it can be beneficial to work
together towards recovery.
III. Talking therapies: Therapy can be offered in a
group or individual setting and will be focused on
teaching you new ways of coping with drug
cravings whilst tackling any coexisting conditions or
underlying causes.
Counsell....
. The following conclusions regarding counselling individuals
with substance abuse problems have been highlighted.
1. All counsellors, no matter what work setting or client, will
counsel individuals with presenting or related problems of
substance abuse.
2. Counsellors counsel and empower individuals with
substance abuse problems versus treat the substance abuse
problem.
3. Counsellors must be able to establish the same open,
collaborative, therapeutic relationship in counselling
individuals with substance abuse problems as they do with
4. Counsellors must focus the counselling relationship on
addressing the client's presenting problems directly and
identifying client need for change.
5. Counsellors must be able to implement counselling
intervention strategies perceived as appropriate by both the
counsellor and the client.
6. Counsellors must know community resources and procedures
for referral to be able to insure access to effective and
appropriate support services for clients.
Key points
Research has proved CBT can effectively treat
addiction to:
Alcohol
Marijuana
Cocaine
Methamphetamine
Nicotine
Reviews questions
1. what is drug abuse and drug substance

2. List drugs commonly abused by PWIDS.
3. Mention methods of counseling to stop drugs
abuse
References
• American Psychiatric Association (1994). Diagnostic
and statistical manual (4th ed.), Washington, D.C.:
Author.
• Austin, L. (1999). The counseling primer.
Philadelphia, PA: Accelerated Development,.
• https://www.drugrehab.com/treatment/
types_of_therapy.

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Session 15

ASSIST is an abbreviation of Alcohol, Smoking and

• Refer to handouts..ASSIST V3.0

I. Cognitive Behavioral Therapy

1. what is drug abuse and drug substance

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