When to intervene? Discussing theories of behaviour change, such as:
Suitable for individuals who are misusing substances, and for those suffering from a mental health crisis, or those dealing with both.
Cognitive Behavioural Therapy – Understanding automatic negative thoughts and feelings that may trigger unhealthy behaviours leading to addiction. Talking therapy helps the individual understand and manage overwhelming problems by breaking them down into manageable parts, acknowledging feelings and developing coping mechanisms.
Introducing substitute drugs, such as methadone to ease symptoms of withdrawal, keeping individuals off the streets and encouraging positive social networks.
Offered to people in limited contact with drug services if concerns about drug misuse are identified (NICE, 2007).
Self-help groups should be identified and offered to those not ready or willing to engage in professional services.
Pryd i ymyrryd? Trafod damcaniaethau sy'n gysylltiedig â newid mewn ymddygiad, fel:
Yn addas ar gyfer unigolion sy'n camddefnyddio sylweddau, a'r rheini sy'n dioddef argyfwng iechyd meddwl, neu'r rheini sy'n ymdrin â'r ddau.
Therapi Ymddygiad Gwybyddol – Deall syniadau a theimladau negyddol awtomatig a all arwain at ymddygiad afiach gan arwain at ddibyniaeth. Mae therapi siarad yn helpu'r unigolyn i ddeall a rheoli problemau llethol drwy eu rhannu'n gydrannau hylaw, cydnabod teimladau a datblygu dulliau ymdopi.
Cyflwyno cyffuriau amgen, fel methadon, i liniaru symptomau diddyfnu, gan gadw unigolion oddi ar y strydoedd ac annog rhwydweithiau cymdeithasol cadarnhaol.
Cynigir i bobl nad oes ganddynt lawer o gysylltiad â gwasanaethau cyffuriau os nodir pryderon eu bod yn camddefnyddio cyffuriau (NICE, 2007).
Dylid nodi grwpiau hunangymorth a'u cynnig i'r rheini nad ydynt yn barod i ymgysylltu â gwasanaethau proffesiynol.
Additional support and guidance can be found using a variety of voluntary services, which include advice, information, signposting, local support groups and therapies (for individuals, families and groups). Additional support refers to both users and those directly affected by substance misuse, examples of these organisations include:
(Adfam.org, 2019)
(NCPCC, 2019)
Gellir dod o hyd i gymorth ac arweiniad ychwanegol gan ddefnyddio amrywiaeth o wasanaethau gwirfoddol, sy'n cynnwys cyngor, gwybodaeth, atgyfeirio, grwpiau cymorth lleol a therapïau (i unigolion, teuluoedd a grwpiau). Mae cymorth ychwanegol yn cyfeirio at ddefnyddwyr a'r rheini y mae achosion o gamddefnyddio sylweddau yn effeithio'n uniongyrchol arnynt. Mae enghreifftiau o'r sefydliadau hyn yn cynnwys:
(Adfam.org, 2019)
(NCPCC, 2019)
Consent to treatment means a person must give permission before they receive any type of medical treatment (NHS, 2019). Consent must be voluntary and informed (having the mental capacity to understand the situation they are in). The patient must not feel they are being influenced to make a decision and they must understand the risks and benefits involved in their treatment. Consent must be obtained in written form, not verbally.
It is important to consider GDPR to ensure that any data collected is protected. The Mental Capacity Act should also be considered to make sure that the person has the mental capacity to make any decisions/give consent.
Consent is the most straightforward exception. If a patient consents to information being disclosed, you can act on that permission, providing it has been freely given. However, if patients refuse to allow disclosure - whether to relatives, the press or employers - you must respect their refusal. Furthermore, you should not inform relatives about a patient’s status/diagnosis/treatment without first getting the patient’s permission (unless, of course, another exception applies). The public interest justification for disclosure usually turns on the threat of serious harm to others. You should still seek the patient's consent unless it is not practicable to do so, for example because:
Mae cydsyniad i driniaeth yn golygu bod yn rhaid i berson roi caniatâd cyn iddo dderbyn unrhyw fath o driniaeth feddygol (NHS, 2019). Rhaid i'r cydsyniad fod yn wirfoddol ac yn wybodus (rhaid bod gan yr unigolyn y galluedd meddyliol i ddeall ei sefyllfa). Ni ddylai'r claf deimlo bod unrhyw un yn dylanwadu arno i wneud penderfyniad a rhaid iddo ddeall y risgiau a'r buddiannau sy'n gysylltiedig â'i driniaeth. Rhaid cael cydsyniad ar ffurf ysgrifenedig, nid ar lafar.
Mae’n bwysig ystyried Rheoliad Diogelu Data Cyffredinol (GDPR) er mwyn sicrhau y caiff unrhyw ddata a gasglwyd ei amddiffyn. Dylai’r Ddeddf Galluedd Meddyliol hefyd gael ei hystyried er mwyn sicrhau bod gan y person y galluedd meddyliol i wneud penderfyniadau/rhoi cydsyniad.
Cydsyniad yw'r eithriad mwyaf syml. Os bydd claf yn rhoi cydsyniad i chi ddatgelu gwybodaeth, gallwch weithredu'n unol â'r cydsyniad hwnnw, ar yr amod y rhoddwyd y cydsyniad yn wirfoddol. Fodd bynnag, os bydd cleifion yn gwrthod caniatáu i chi ddatgelu gwybodaeth - boed i berthnasau neu gyflogwyr - rhaid i chi barchu'r gwrthodiad hwnnw. At hynny, ni ddylech hysbysu perthnasau am statws/diagnosis/triniaeth claf heb gael caniatâd y claf yn gyntaf (oni fydd eithriad arall yn gymwys, wrth gwrs). Mae'r cyfiawnhad dros ddatgelu sy'n gysylltiedig â budd y cyhoedd fel arfer yn ymwneud â bygythiad o niwed difrifol i eraill. Dylech geisio cydsyniad y claf o hyd oni bai nad yw'n ymarferol gwneud hynny, er enghraifft, am y rhesymau canlynol:
Care plans should include specialists who are readily available to discuss a patient’s concerns about their misuse of substances. Person-centred care plans are motivated and structured around the direct input from the patient, which should include achievable learning agendas to empower and reinforce a steady recovery from substance misuse.
Care plans for those who abuse substances should include support for the decision to stop using, strengthen coping skills, understand unhealthy behaviours/practices, promote family involvement, and information about treatment, prognosis and diagnosis.
The patient should be made aware of additional support within their care organisation (educational programmes), local services (support groups) or via other outlets, such as support via social media or over the phone. It is important to encourage patients to seek out help voluntarily and take responsibility for some of their treatment. Additional support should be extended to family and friends, as they are an integral part of the care plan and success of recovery.
Dylai cynlluniau gofal gynnwys arbenigwyr sydd ar gael ac yn barod i drafod pryderon claf am gamddefnyddio sylweddau. Mae cynlluniau gofal sy'n canolbwyntio ar y person yn gymhellol ac wedi'u strwythuro o amgylch mewnbwn uniongyrchol gan y claf, a ddylai gynnwys agendâu dysgu ymarferol er mwyn grymuso ac atgyfnerthu proses wella gyson o sefyllfa lle roedd y claf yn camddefnyddio sylweddau.
Dylai cynlluniau gofal ar gyfer y rheini sy'n camddefnyddio sylweddau gynnwys cymorth iddynt wneud penderfyniad i roi'r gorau i ddefnyddio, atgyfnerthu sgiliau ymdopi, deall mathau o ymddygiad/arfer afiach, hyrwyddo cyfranogiad y teulu a gwybodaeth am driniaeth, prognosis a diagnosis.
Dylai'r claf fod yn ymwybodol o'r cymorth ychwanegol o fewn ei sefydliad gofal (rhaglenni addysgol), gwasanaethau lleol (grwpiau cymorth) neu drwy allfeydd eraill, fel cymorth drwy'r cyfryngau cymdeithasol neu dros y ffôn. Mae'n bwysig annog cleifion i gael gafael ar help yn wirfoddol ac i gymryd cyfrifoldeb dros elfennau o'u triniaeth. Dylid cynnig cymorth ychwanegol i deulu a ffrindiau hefyd, gan eu bod yn rhan annatod o'r cynllun gofal ac o lwyddiant y claf wrth wella.
Organisations are committed to providing a safe and positive working environment for all services users and staff to promote health, safety and well-being. Organisations and employees must adopt a supportive and constructive approach when dealing with individuals experiencing drug and/or alcohol dependencies or addictions. Policies and procedures will differ between organisations, but should have the following points in common:
All employees must ensure that they have read and understood their organisation’s policies and procedures and take personal responsibility to update their own knowledge through the course of their employment.
Mae sefydliadau yn ymrwymedig i ddarparu amgylchedd gwaith diogel a chadarnhaol i'r holl unigolion sy'n defnyddio eu gwasanaethau ac i bob aelod o staff er mwyn hybu iechyd, diogelwch a llesiant. Rhaid i sefydliadau a gweithwyr cyflogedig fabwysiadu dull gweithredu cefnogol ac adeiladol wrth ymdrin ag unigolion sy'n profi dibyniaethau neu sy'n gaeth i gyffuriau a/neu alcohol. Bydd gan wahanol sefydliadau wahanol bolisïau a gweithdrefnau, ond dylai'r pwyntiau canlynol fod yn gyffredin rhyngddynt:
Rhaid i bob gweithiwr cyflogedig sicrhau ei fod wedi darllen a deall polisïau a gweithdrefnau ei sefydliad a chymryd cyfrifoldeb personol dros ddiweddaru ei wybodaeth tra y bydd wedi'i gyflogi gan y sefydliad hwnnw.