ghp September 2015 | 69 health and social care Substance Abuse: The Frontline Substance abuse is a particularly difficult to deal with, as addicts tend to have their perspective skewed by their need for a particular substance and a loss of inhibitions which can easily be misinterpreted as aggressive behaviour or another illness. In particular, substance misuse alters behaviours, with figures by the Health and Social Care Information Centre from 2014 showing that there were 7,104 admissions to hospital with a primary diagnosis of a drug-related mental health and behavioural disorder. This is an 8.5% increase from 2012/13 when there were 6,549 such admissions. There were 13,917 admissions with a primary diagno- sis of poisoning by illicit drugs. Overall there has been a 76.7% increase since 2003/04 when there were 7,876 such admissions. Overall, between 2003/04 and 2013/14 admissions have decreased by 11% to from 7,869 to 7,104. Alarmingly, these figures also showed that there were 1,957 deaths related to misuse of illicit drugs in 2013, which is an increase of 321 from 2012 when there were 1,636 such deaths. This is a stark warning of the effects of substance abuse, which can often be addictive, with substanc- es such as alcohol, cocaine and heroin all particu- larly addictive with the potential to cause patients serious harm. The report found that cocaine, ecstasy, LSD and ketamine use had increased between 2012/13 and 2013/14, all of which are potentially addictive substance. However, the symptoms of drug abuse and addiction can often be overlooked by those visiting homes, for example home carers, who may potentially misdiag- nose addicts and treat them incorrectly. For example, the National Institute on Drug Abuse highlights the symptoms of heroin withdrawal as such: “Symptoms of withdrawal include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and leg movements.” However, these could equally be confused with other illnesses, leading carers or other professionals sent to an addict’s house to take them to hospital needlessly or expose both themselves and the patient to unnec- essary stress and potential harm. Alan Long, the Managing Director of the Mears Group, which provides home care workers in various fields, such as care and property maintenance to local authorities, as well as offering some services to private clients, commented on how his firm ensures the safety of its staff. “Before sending any of our employees into a situation we always conduct a risk assessment first. When we feel that we are able to continue with the care or the repair of the property or individual then we do so. Our visiting officers are trained on all aspects of risks that our care worker might come across, whether that be a dangerous dog or if the property is unsafe, through to substance abuse or the individual having a particular form of mental health problem.” These risk assessments are vital to ensuring that carers know what they are dealing with when entering a property to deal with a patient. Ultimately homecare industries, including but not limited to care, need to ensure that staff are provided with full training to ensure they deal with substance abuse correctly in order to ensure the safety of their staff as well as the patients they are caring for. The full report from HSCIC, entitled Statistics on Drug Misuse, England 2014 is available online here. As the Government increasingly moves frontline care from the community to private homes, we examine how agencies urgently need to educate their staff on how to recognise and interact with substance abusers.