Unit 375 Recognise when substance misuse is indicated and refer individuals to specialists

This unit focuses on recognising possible indications of substance misuse and responding appropriately, using your organisation’s procedures and the right referral routes. It supports you to notice concerns early, assess and monitor risk within your role, and keep clear records so people can access specialist help. The links on this page guide you through each learning outcome in more detail.

Substance misuse can involve a wide range of substances, including alcohol, medicines (prescribed or bought over the counter) and other drugs. In health and social care you may support individuals who are using substances in ways that affect their safety, health, relationships or ability to manage daily life. It can also affect families and others in the setting. Your role is not to diagnose or investigate, but to observe, listen, and take action that is proportionate and lawful.

One of the first skills you’ll develop is spotting indicators that something may not be right. These may be physical (for example changes in coordination, sleep patterns, appetite, hygiene or unexplained injuries), behavioural (such as agitation, secrecy, sudden risk-taking, or missed appointments), and social or emotional (like isolation, low mood, irritability, or changes in friendship groups). It’s important to remember that none of these signs automatically mean substance misuse. The same indicators can be linked to pain, mental health needs, trauma, bereavement, dementia, domestic abuse, medication side effects, or other health conditions. This unit helps you consider those possibilities and avoid jumping to conclusions.

How you respond matters. People may feel ashamed, frightened, or defensive, especially if they have been judged in the past. A calm, respectful approach often works best: focus on what you have observed and how it affects support, rather than making accusations. You might say, “I’ve noticed you’ve seemed unsteady and very tired in the afternoons. I’m concerned about your safety—can we talk about what might be contributing to that?” Keep your tone matter-of-fact. No drama.

Risk assessment and monitoring are central themes. Substance misuse can increase the risk of falls, neglect, exploitation, financial harm, accidental overdose, and unsafe behaviour that affects others. In some situations there may be immediate safeguarding concerns. You’ll learn to follow organisational procedures, consider who may be at risk (including children or other vulnerable adults), and take appropriate action if the situation changes. Reviewing risk matters because circumstances can shift quickly—what was low risk last week might be high risk today.

Information handling and confidentiality can feel tricky here, so the unit takes you through the principles. Individuals have rights and should be treated with dignity and respect. At the same time, confidentiality is not absolute. If there is a serious risk of harm to the individual or others, or a safeguarding concern, you may have a duty to share information with the right people. The key is to follow your policy, record your decision-making, share only what is necessary, and involve the individual wherever it is safe and appropriate to do so.

Good record keeping is one of the most protective things you can do. Write down facts, not assumptions: what you saw, what was said, when it happened, and what you did next. Avoid labels and emotive language. Clear records support continuity of care and help specialists make informed decisions. They also show that you acted responsibly within your role.

Referral is not just “passing the problem on”. It is a planned step to ensure the individual gets the right support at the right time. This unit helps you identify services that may be available locally and nationally, and how to refer in line with your organisation’s requirements. In many settings, you will raise concerns with a senior colleague, manager, safeguarding lead or nurse in charge, who will coordinate the next steps. In other roles, you may be responsible for completing referral documentation or making contact with agreed services. Either way, accuracy is vital.

You’ll also consider what information should be shared during a referral. This might include the individual’s details, consent status, relevant health information, risks identified, and any immediate safety concerns. It should also include what the individual wants, where possible. Person-centred practice still applies. Even when someone is struggling, they are not just a “case”; they are a person with strengths, goals and preferences.

Practical example: in a home care visit, you notice repeated missed doses of medication and unopened food in the fridge, alongside a strong smell of alcohol and a recent fall. Rather than trying to “sort it out” alone, you would record what you have found, discuss concerns with your line manager promptly, and follow the agreed escalation route so the person can be assessed and supported. Another example: in a supported living scheme, an individual returns home visibly distressed and says they have been pressured into sharing money for substances. That could indicate exploitation and a safeguarding risk. You would follow your safeguarding procedure immediately and ensure the person is safe, while recording facts clearly.

A final theme is keeping your own knowledge up to date. Substances, patterns of use, and local services change over time. This unit encourages you to use supervision, team briefings and training, and to check current organisational guidance so you know what to do in your setting. No one expects you to be an expert in substance misuse. They do expect you to act professionally, seek advice, and use the correct referral pathways.

By the end of the unit, you should be more confident recognising possible indicators, considering alternative explanations, assessing risk within your role, and making timely referrals. Use the links on this page to work through the outcomes, and keep relating them back to your day-to-day responsibilities, your boundaries, and the support available in your local area.

1 Be able to recognise indications of substance misuse

2 Be able to assess and monitor risk

  • 2.1 Assess the risk to the individual and to others which may result from substance misuse, in accordance with organisational procedures
  • 2.2 Review the assessment of risk and explain why this is important
  • 2.3 Demonstrate appropriate action which may be required in the light of changes to the situation and level of risk

3 Be able to handle information and maintain records

  • 3.1 Identify situations and actions taken in line with organisational requirements and explain the importance of doing so
  • 3.2 Identify the rights of individuals and the principle of confidentiality

4 Be able to refer individuals to appropriate services

  • 4.1 Identify the range of services relevant to substance misuse available locally and nationally
  • 4.2 Demonstrate how to refer individuals to services in line with organisational requirements
  • 4.3 Provide appropriate services with complete and accurate information about the situation in line with organisational requirements

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