Introduction

This book is written from the prespective of working within multidisciplinary community-based treatment services for drug misusers. In the UK these are not a minority type of service subsumed under more institutionalized treatment, but rather they represent the main model of treatment delivery in this specialty in most areas. They are primarily clinical, with most of the work comprising counselling of various kinds for the drug misusers who have been referred, along with medical input and the provision of pharmacological treatments. The teams are part of the National Health Service, with funding usually coming jointly from health and social services. Typically most workers are community psychiatric nurses or social workers, with much overlap in the type of casework undertaken. The extent to which teams are involved in nonclinical projects, such as needle exchange schemes, outreach, drug information or relatives' groups, depends largely on the availability of other services, particularly from the nonstatutory sector, and carving out a suitable role for a clinical community drug service is an important challenge. Many lessons have been learnt as such services have emerged from the shadow of the previously dominant drug dependence units (DDUs), as a brief history of this process of development will illustrate.

Historical development

The formation of nonmedical multidisciplinary community drug teams (CDTs) was recommended in a highly influential report of the Advisory Council on the Misuse of Drugs, the UK's central advisory body which is set up by statute (Advisory Council on the Misuse of Drugs 1982).