Concerns and Experiences of Alcohol and Other Drug Healthcare Staff Regarding Intoxication Detection and Driving...

Accurate detection and management of intoxication is critical in healthcare, particularly in alcohol and other drug (AOD) settings. While alcohol intoxication is often reliably assessed, drug intoxication is harder to detect. For clients receiving opioid agonist treatment (OAT), intoxication status can impact safety, treatment planning and driving eligibility. This study explores AOD healthcare staff confidence, training and concerns in managing intoxication and driving safety amongst OAT clients.

A cross-sectional survey was conducted with staff across 12 public AOD clinics in New South Wales, Australia. Data were collected on self-reported confidence and training regarding client intoxication and driving safety, concerns and experiences managing intoxicated OAT clients, and substances of concern for intoxication and driving safety.

Seventy-nine staff (58% nursing, 19% allied health, 17% medical, 6% other) completed the survey, with a median of 7 years' AOD experience. Two-thirds reported confidence managing intoxicated OAT clients, and 87% felt adequately trained. Key barriers to managing suspected intoxication included risk of aggression (72%), concern about upsetting clients (44%), and risk of incorrect assessment (38%). Half of staff (55%) reported encountering an intoxicated client in the past year. Substances of greatest concern for client intoxication and driving safety were benzodiazepines (95%), heroin (94%), alcohol (92%) and amphetamines (87%).

While many AOD staff feel relatively confident identifying and managing client intoxication, they reported concerns around managing such scenarios. Ongoing training, alongside tools or structured frameworks, may support healthcare staff to better detect and manage intoxication and driving safety of clients.