Counselling for Alcohol Problems

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Richard Velleman

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  • Counselling in Practice

    Series editor: Windy Dryden

    Counselling in Practice is a series of books developed especially for counsellors and students of counselling, which provides practical, accessible guidelines for dealing with clients with specific, but very common, problems. Books in this series have become recognised as classic texts in their field, and include:

    • Counselling Suicidal Clients
    • Andrew Reeves
    • Counselling for Grief and Bereavement, Second Edition
    • Geraldine M. Humphrey and David G. Zimpfer
    • Counselling and Psychotherapy for Depression, Third Edition
    • Paul Gilbert
    • Counselling for Post-Traumatic Stress Disorder, Third Edition
    • Michael J. Scott and Stephen G. Stradling
    • Counselling Survivors of Childhood Sexual Abuse, Third Edition
    • Claire Burke Draucker and Donna Martsolf
    • Career Counselling, Second Edition
    • Robert Nathan and Linda Hill
    • Counselling for Eating Disorders, Second Edition
    • Sara Gilbert
    • Counselling for Anxiety Problems, Second Edition
    • Diana Sanders and Frank Wills
    • Counselling for Stress Problems
    • Stephen Palmer and Windy Dryden

    Copyright

    View Copyright Page

    Dedication

    To my mother and father, sadly not alive to see this book; to Sophie and Bryonie, my lovely daughters; to Lia, my first granddaughter; and to Gill, my partner, without whose encouragement none of the editions of this book would ever have been finished!

    List of Case Examples

    About the Author

    Richard is both a clinical and an academic psychologist and has always held dual posts, both in Universities and in the NHS. His research and practice interests cover a wide spectrum within mental health, with a particular interest in the impact of substance misuse and mental health issues on family members, especially children; as well as broader research and practice interests in counselling, substance misuse, and children and families. He has been awarded grants of more than £4,000,000 over his research career to date, and published over 200 items including twelve books, and many chapters and scientific journal papers.

    Richard has worked in the addictions and mental health fields for over 30 years. In the early 1980s he helped to establish Alcohol Concern, the national alcohol agency in England and Wales; and spearheaded the creation of the hugely popular Volunteer Alcohol Counsellors Training Scheme. In the mid-1980s he set up the non-statutory BADAS (Bath Area Drugs Advisory Service), the first drugs services in the Bath area. In 1994 he became the founding Head first of the Specialist Drug and Alcohol Services in the Bath Mental Health Care NHS Trust, and then also of the Somerset Drug Service. From 1999 to 2004 he was the Director of Strategic Development for the Avon and Wiltshire Mental Health Partnership NHS Trust, responsible for most of the Trust's specialist services (such as Drug and Alcohol, Forensic, Research and Development). He left the Trust Board in 2004 to concentrate once more on his research, writing and clinical work.

    Over the past 30 years he has worked with many national (AERC, NTA, Department of Health, Home Office, Scottish Executive) and international (EMCDDA, EU) bodies, and has served as an expert witness in many child protection cases relating to parental substance misuse or parental mental health problems.

    Preface to the Third Edition

    An Updated and Revised Edition

    When Sage approached me to write a third edition I was not keen, for exactly the same reasons as I outlined in my preface to the second edition. In many ways, I had said what I wanted to say in the first edition of this book, published in 1992, and the key points made then have not changed. They were that:

    • people are individuals who live in a social context, and they do things for individual and social reasons;
    • counselling draws out the client through a process of reflecting, clarifying, challenging, exploring;
    • these activities are done with, not to, the client;
    • alcohol use lies along a continuum: there is no simple dividing line between ‘alcoholic’ drinkers and the rest of the population;
    • individuals can move along this continuum in either direction;
    • individuals learn how to behave towards alcohol, and this is open to change;
    • if people continue to use alcohol despite developing problems, this must occur for reasons as well;
    • there are always reasons for people's behaviour: counselling is about helping people discover the reasons for their behaviour, and then empowering them to make changes.

    Further, the main theoretically driven intervention ideas discussed in the first edition – the Cycle of Change, Motivational Interviewing, Relapse Management, Controlled Drinking, and so on – again had not been overtaken by other, newer or more effective ways of intervening.

    What I did do, therefore, was to suggest that the publishers consult a number of individuals, in the UK and abroad, who were heavily involved with alcohol counselling. Some ran alcohol counsellor training, some ran substance misuse agencies which used counsellors, and some were otherwise involved and knowledgeable about alcohol counselling. I asked the publishers to ascertain if these individuals thought that it was a good idea to produce a new edition; and if they did, to find out what they thought needed changing or updating. These individuals all re-read the book, all stated that they did think that a third edition was warranted, and each person then came back with a list of hugely helpful suggestions for change. The changes made to this edition, then, are largely based on these suggestions. I thank in the acknowledgement section some of these people by name.

    I will outline the main changes that I made in a moment. But there were some that I did not fully implement. There was a set of comments about cultural and gender diversity. I understand what was meant by these suggestions, and indeed, I have added a couple of brief case vignettes at the start of the book related to people and cultures which are not so obviously ‘white British’. But the fundamental ethos of this book is that the model of counselling that I am putting forward here transcends both race and gender. What we do with people who have alcohol problems does not differ in any fundamental way depending on any combination of race, gender, disability and so on. We respect each person (and their family), we engage with each person or set of people, we explore problems with them, we help them to work out what they want to do, we support and empower them to do what they want to do. These fundamental things do not change, and to suggest that there are ‘special’ things that we need to do because a client happens to be female rather than male, or be homosexual rather than heterosexual, or to be Afro-Caribbean rather than Indian or white, seems to me to miss the point of the book. And I did not want to just add a host of non-white-British names to the book to pretend that the book is something different to what it is.

    One of the reviewers suggested that I might say something about what counselling means in a 2009/10 context, and what other options there are for interventions. I think that this refers to the fact that the way that we describe people who work within agencies which try to help people with alcohol problems has changed. Twenty years ago, most non-statutory alcohol agencies used volunteer counsellors, and many of their paid staff were also titled ‘counsellors’. This has now changed: many agencies no longer use volunteer counsellors, and many people within agencies are now called key workers or project workers or alcohol or drug workers, not counsellors.

    To my mind, this is unimportant (although I suppose that I could have altered the title of the book to read ‘Working with People with Alcohol Problems’ instead of ‘Counselling for Alcohol Problems’). My view is that certainly job titles change; but what we do when we work with our clients is very constant: we create a meaningful relationship with a client, and then we empower him or her to change in the direction that he or she wants to.

    The main changes I have made are these.

    • I have included the latest important research, where it is relevant. So (as examples) I have updated all of the information in Chapter 1 on the effects of alcohol, and on units; added quite a lot about the political context, also in Chapter 1; included the UKATT trial and some material about ethical frameworks in Chapter 2; re-ordered some of Chapter 3 and added a short section on power within the counselling relationship; added to Chapter 4 some material about hair tests in court settings; some research about follow-up, aftercare and relapse, and especially about getting clients to return, in Chapter 5; added material about compliance with agency polices, and writing reports and letters for the Courts, to Chapter 7; added a section on ‘alcohol and personality disorders’ to Chapter 8; and added quite a lot to Chapter 10 on the family, including a section on domestic abuse and seeing families safely.
    • I have also updated all of the references and suggestions for further reading contained at the end of each chapter, as well as updating all of the organisational details and websites referred to in the final appendix to the book.

    As well as all of these, I realised in revising the book that there is one key area where my views of counselling have changed over the twenty years since I wrote the first edition. This is in relation to the involvement of the family, and to confidentiality. In the first edition I was very clear that confidentiality was paramount, and that although family members might need help, maybe they should be seen by someone else in an agency, and that there were some dangers about getting them involved in one's counselling with problem drinkers. Further, that if one did involve them in the counselling, one then probably needed to go full-tilt into couples or family counselling.

    Over the last twenty years my views on this have changed. I now am very much more in favour of including family members in all aspects of a client's counselling, and (as I say in Chapter 10), 'I am increasingly taking a proactive position, suggesting to my clients that it might be helpful to invite close others to become involved in our counselling sessions. This moves us away from issues of ‘confidentiality’ because, in this scenario, the person with the alcohol problem and one or more people who are close to them are in the same room, and hearing what each other is saying.' And although it is still extremely useful for counsellors to know some of the basic ideas within coupleand family-oriented work, I no longer believe, if one does involve family members in the work that is ongoing with a problem drinking client, that they always need to be included in the counselling – there are a host of other ways in which affected and interested family members can be involved and included, as colleagues and I have written about elsewhere (Orford et al., 2009).

    There is another point that I want to make about this book. The book is primarily about processes – structures, ways of organising one's thinking. Key chapters (35) are really all about process – the process of counselling, the process of change, the process of relapse, etc. My view is that these processes are central. We do not help people by having millions of therapeutic techniques at our fingertips, available to ‘sort people out’, although often such techniques are useful. Instead, we help people by understanding (and enabling our clients to understand) what is happening, and this is based on a clear understanding of these processes.

    Finally, I want to reiterate the ending of the preface to the second edition, about the status of the ideas in this book. I make many suggestions throughout the book, and clearly I believe that my suggestions are sensible. But it is important to emphasis the fact that these are just suggestions. As I say throughout, there is a huge range and diversity of approaches in this field, and we have not reached the stage where there is one dominant paradigm within the alcohol interventions area. Hence the ideas and techniques described within this book should be seen as a tool kit from which people can select techniques as they seem appropriate. It is important that counsellors do not undertake things that they are not comfortable with, and that they do not do things which countermand the policies under which the agency with which they work operates. All the ideas in this book will be useful for some counsellors; few will feel they are completely appropriate for everyone. It is important to recognise the difference between suggestions and prescriptions; and these are suggestions, not prescriptions.

    Orford, J., Templeton, L., Copello, A., Velleman, R., Ibanga, A. and Binnie, C. (2009) Increasing the involvement of family members in alcohol and drug treatment services: the results of an action research project in two specialist agencies. Drugs: Education, Prevention and Policy, 16 (5), 379–408.

    RichardVelleman, April 2010

    Preface to the Second Edition

    Why a New Book, What Is New, What Is Changed

    In some ways, there is no need for a second edition of Counselling for Alcohol Problems. The basic thrust of the first edition was encapsulated around eight main points, and these have not changed. The eight points are that:

    • people are individuals who do things for individual reasons;
    • there are always reasons for people's behaviour;
    • counselling draws out the client through a process of reflecting, clarifying, challenging, exploring;
    • these activities are done with, not to, the client;
    • alcohol use lies along a continuum: there is no simple dividing line between ‘alcoholic’ drinkers and the rest of the population;
    • individuals can move along this continuum in either direction;
    • individuals learn how to behave towards alcohol, and this is open to change;
    • if people continue to use alcohol despite developing problems, this must occur for reasons as well.

    Furthermore, the main theoretically driven intervention ideas discussed in the first edition – the Cycle of Change, Motivational Interviewing, Relapse Management, Controlled Drinking, and so on – have not been overtaken by other, newer or more effective ways of intervening.

    On the other hand, because this book has been utilised as a main core text for many of the courses in the UK which train counsellors to deal with alcohol problems, it is vital that the book is as up to date as possible. In the decade since the first edition, new evidence has emerged about the efficacy of some of the interventions discussed here (and particularly, Project MATCH has reported, with key evidence over how effective some of the ideas, such as motivational or cognitive-behavioural approaches are, which are supported in this book); new medications have been developed to help deal with withdrawal symptoms; new methods of identification have been tried out; and new controversies have emerged. Furthermore, Project MATCH has also suggested that encouraging people to use Alcoholics Anonymous, which uses an approach which I did not favour in the first edition, may also be very effective. Finally, the issue of dealing with people with both alcohol problems and mental health difficulties and/or illicit drug problems as well, has become far more widespread. This second edition has attempted to incorporate the most important of all of these new findings. And of course, many of the addresses and telephone numbers in the ‘useful addresses’ section at the end have changed and hence been updated, and email and website addresses (much more useful and well used than they might have been in the early 1990s) have been added where they are available.

    The main changes, therefore, to this book are:

    in Part 1, where

    • drinking guidelines have been updated in line with current government recommendations, some of the prevalence and other factual information has been updated, and some of the ideas around causation have been revised (Chapter 1);
    • considerably more has been added on medical help (including further information on new therapeutic drugs and on withdrawal symptoms), and further information is included on evidence-based approaches, especially the results of project MATCH (Chapter 2);

    in Part 2, where

    • the Cycle of Change ideas have been updated in line with latest thinking, and the newer ideas of the role of readiness, importance and confidence in the change process have been introduced (Chapter 3);
    • further information has been added on assessing clients' stage of change, on new therapeutic drugs, on withdrawal symptoms, on assessing the physical effects of alcohol consumption, and on the evidence-base underpinning various intervention methods has been added, as has a brief discussion on the notions of craving and addiction (Chapter 4);
    • dealing with lapse situations is further discussed, and ideas about ‘programmed lapses’ are further clarified (Chapter 5);
    • problems arising in group settings (such as literacy, or clients drinking) are briefly discussed (Chapter 6);

    in Part 3, where

    • common problems and difficulties are further discussed, including how best to deal with the disclosure of traumatic events, and working with (and dealing with confidentiality across) other agencies (Chapter 7);
    • a brief chapter has been added on ‘co-morbidity’ – working with people who have both alcohol problems and another major problem (Chapter 8);
    • the evidence is discussed that some drinking is good for you (Chapter 9);
    • the latest evidence is discussed on how some forms of coping by family members with the drinking of their relatives is more effective than others (Chapter 10);

    and in the Appendices, where

    • information on facilities and how some of them work has been updated, as has the information within the ‘Useful Addresses’ section.

    Where appropriate, the references have been updated throughout.

    Finally, I would like to comment on the status of the ideas in this book. I make many suggestions throughout the book, and clearly I believe that my suggestions are sensible. But it is important to emphasis the fact that these are just suggestions. As I say in the preface to the first edition, there is a huge range and diversity of approaches in this field, and we have not reached the stage where there is one dominant paradigm within the alcohol interventions area. Hence the ideas and techniques described within this book should be seen as a tool kit from which people can select techniques as they seem appropriate. It is important that counsellors do not undertake things with which they are not comfortable, and that they do not do things which countermand the policies under which the agency with which they work operates. All the ideas in this book will be useful for some counsellors; few will feel they are completely appropriate for everyone. It is important to recognise the difference between suggestions and prescriptions; and these are suggestions, not prescriptions.

    RichardVelleman, September 2000

    Preface to the First Edition

    What Is This Book About?

    This book is about how to deal with alcohol problems. It is useful and practical, and contains advice and suggestions which people who deal with alcohol-related problems can use on a day-to-day basis.

    Why Is It Needed?

    Many counsellors work with clients who have problems with their use of alcohol – either as the main problem, or as one of many.

    Many counsellors prefer to avoid the alcohol-related issues. Some hope the alcohol will cease to be a problem once other problems are dealt with; others avoid the issue because they are uncertain about how best to deal with it.

    This book addresses these difficult areas, providing clear guidance and outlining the practical steps counsellors can take to deal with alcohol-related problems.

    It is timely for such a book to be written. There is no practical guide which currently deals with these issues. Furthermore the past twenty years have brought many fresh insights, and many changes of attitude towards drinking problems; hence there is a need for effective practice to be summarised.

    This book will be of interest to a wide range of practitioners, including specialist alcohol workers, general counsellors, clinical psychologists, social workers, and probation workers, and especially to the many volunteer counsellors who are responsible for much of the counselling which occurs in alcohol advisory services across the country. I hope also that it will be of interest to members of the general public.

    What Is Its Orientation?

    There is a huge range and diversity of approaches to understanding and dealing with alcohol problems. This implies that the alcohol field has not reached a stage of development where one clear set of ideas or one clear theory is accepted as the best or most useful way of understanding and dealing with these problems. People produce data, and speculation based upon this, concerning the influence of external factors such as culture, politics, economics, the media, and advertising; others study internal factors such as biology, genetics, personality, and socialisation. There is little conclusive evidence, however, concerning the aetiological role or significance of any of these factors in alcohol-related problems, which may be created by a multiplicity of genetic, biochemical, psychological, social and environmental factors. It therefore is one of the central arguments of this book that one should not attribute a single cause – or even the same patterns of causes – as the one thing which leads to alcohol problems. Instead, it is suggested that counsellors approach clients as individuals, attempting to understand, and hence enabling the client to understand, what he or she is doing, and why he or she is doing it.

    Individual understanding does not mean the counsellor needs to engage in a deep, long-term relationship with the client, although in some cases it could; helping clients to reach this level of understanding can sometimes be achieved in only a few sessions. Nor does it mean clients cannot begin to deal with their problems until this understanding is reached: clients can begin to change their behaviour immediately counselling commences – and indeed, most will have started this change process before coming to see you; unless they start to understand themselves better, however, the change will not in most cases be maintained.

    How Is the Book Organised?

    The book is divided into three sections. The first outlines the various approaches to alcohol-related problems, including causes and intervention.

    The second section looks at the general area of intervention through counselling; the specific techniques that practitioners have developed and found useful over the years; the problem of relapse and how to understand and deal with it; and the issues of working in groups.

    The third and final section examines a variety of difficult situations which may arise – or which counsellors often fear may arise – and looks at some of the particular problems which crop up for volunteer counsellors. It examines and explains some of the myths of working with problem drinkers; and it discusses working with the spouses and other family members of problem drinkers, both individually and as part of couple or family counselling.

    RichardVelleman, September 1991

    Acknowledgements

    Acknowledgements for the Third Edition

    My grateful thanks go again to the variety of individuals who responded to Sage's request for suggestions as to how this book could be changed. Especial thanks go to (in alphabetic order): Annette Fleming, John Marletta, Barbara McCrady, Tim O'Farrell, Don Shenker, and Peter Steel for their thoughtful and careful reviews and suggestions for how the book could usefully be updated. I have used most of their suggestions, while (as they would of course expect) disagreeing with some of them.

    As always, the book is much better as a result of their suggestions; but all of the remaining faults are mine.

    Acknowledgements for the Second Edition

    My grateful thanks go to the variety of individuals who responded to my request for suggestions as to how this book could be changed. Especial thanks go to: Chris Johnstone for his host of extremely useful and helpful suggestions, to Anne Lingford-Hughes for her useful and clear updates on some of the newer drugs and other medical material, and also to Colin Bradbury, Ian Dickinson, Derek Fearnside, and Michael Hutchinson for their ideas. As with the commentaries on the manuscript of the first edition, I learnt a great deal from these suggestions, and incorporated many of them. I know that the book is considerably improved because of these; and the remaining faults are all my own!

    Acknowledgements for the First Edition

    My grateful thanks go to Gill Velleman and Sara-Jane Aris, who read and commented on the manuscript. I am especially grateful to Ken James, who provided a mass of highly detailed suggestions aimed at improving my style and phrasing. I learnt a great deal from them all, and incorporated very many of their suggestions and ideas.

    I also want to acknowledge my debt to Thelma Fisher, for clarifying many of my ideas during our joint teaching of social work students during her time at the University of Bath. I have shamelessly borrowed from her handouts.

    Finally, I want to thank Pip Mason for producing Managing Drink. The pack is full of good ideas, and thoughts as to how to present them; I have used many of them.

  • Appendix: Useful Addresses and Websites

    Information and Advice Centres exist throughout the UK, the USA, Canada, Australia, and many other countries. The following organisations will be able to put you in touch with local agencies and act as a source of extra information and resources.

    In the UK
    National Alcohol Organisations

    Alcohol Concern has a useful ‘Links’ section with names, descriptions and website addresses of a wide range of organisations: alcohol organisations covering all of England and Wales as well as useful contacts of organisations in other fields or with a campaigning, policy development or information role:

    http://servicesdirectory.alcoholconcern.org.uk/nationalanduseful.jsp

    Some of the main ones are:

    • NICAS, the Northern Ireland Community Addiction Service
    • 40 Elmwood Avenue
    • Belfast, BT9 6AZ
    • Tel: +44 (0) 2890 664434
    • Fax: +44 (0) 2890 664090
    • Email: enquiries@nicas.info
    • www: http://www.nicas.info/
    • TACADE (Advisory Council on Alcohol and Drug Education)
    • Old Exchange Buildings
    • 6 St Ann's Passage
    • King Street
    • Manchester, M2 6AD
    • Tel: +44 (0) 161 836 6850
    • Fax: +44 (0) 161 836 6859
    • Email: ho@tacade.co.uk
    • www: http://www.tacade.com/
    • Institute of Alcohol Studies
    • Alliance House
    • 12 Caxton Street
    • London, SW1H 0QS
    • Tel: +44 (0) 20 7222 4001
    • Fax: +44 (0) 20 7799 2510
    • Email: info@ias.org.uk
    • www: http://www.ias.org.uk/index.html
    • National Treatment Agency for Substance Misuse
    • 6th Floor, Skipton House
    • 80 London Road
    • London, SE1 6LH
    • Tel: +44 (0) 020 7972 1999
    • Fax: +44 (0) 020 7972 1997
    • www: http://www.nta.nhs.uk/
    • Adfam – Families Drugs and Alcohol: Supporting families affected by substance use
    • 25 Corsham Street
    • London, N1 6DR
    • Tel: +44 (0) 20 7553 7640
    • Fax: +44 (0) 20 7253 7991
    • Email: admin@adfam.org.uk
    • www: http://www.adfam.org.uk/
    • Al-Anon
    • Al-Anon Family Groups UK & Eire
    • 61 Great Dover Street
    • London, SE1 4YF
    • Tel: +44 (0) 20 7403 0888
    • Fax: +44 (0) 20 7378 9910
    • Email: enquiries@al-anonuk.org.uk
    • www: http://www.hexnet.co.uk/alanon/info.html
    • Al-Anon Information Centre
    • Mansfield Park Building Unit 6
    • 22 Mansfield Street
    • Partick
    • Glasgow, G11 5QP
    • Tel: +44 (0) 141 339 8884 (Helpline: 10am – 10pm, 365 days a year)
    • Al-Anon Information Centre
    • Peace House
    • 224 Lisburn Road
    • Belfast, BT9 6GE
    • Tel: +44 (0) 28 9068 2368 (Helpline: 10am – 1pm Mon – Fri; 6pm – 11pm
    • Mon – Sun inclusive)
    • Al-Anon Information Centre
    • Room 5, 5 Capel Street
    • Dublin 1
    • Eire
    • Tel: +353 (0) 1 873 2699 (Helpline: 10.30am – 2.30pm Mon – Fri)
    Other National Organisations
    • British Association for Counselling and Psychotherapy (BACP)
    • BACP House
    • 15 St John's Business Park
    • Lutterworth
    • Leicestershire, LE17 4HB
    • Tel: +44 (0) 1455 883300
    • Email: bacp@bacp.co.uk
    • www: http://www.bacp.co.uk
    • British Association for Behavioural and Cognitive Psychotherapies (BABCP)
    • Imperial House
    • Hornby Street
    • Bury, BL9 5BN
    • www: Tel: +44 (0) 161 705 4304
    • Fax: +44 (0) 161 705 4306
    • Email: babcp@babcp.com
    • www: http://www.babcp.com/
    • In the USA
    • National Institute on Alcohol Abuse and Alcoholism (NIAAA)
    • 5635 Fishers Lane, MSC 9304
    • Bethesda, Maryland 20892-9304
    • USA
    • Tel: Communications/Public Info: 301-443-3860
    • www: http://www.niaaa.nih.gov
    • National Clearing-house for Alcohol and Drug Information (NCADI) (a service of the Substance Abuse and Mental Health Services Administration in the US Department of Health & Human Services.)
    • PO Box 2345
    • Rockville, Maryland 20847-2345
    • USA
    • Tel: 1-800-729-6686; or 1-800-487 4889 or toll-free on: 1-877-SAMHSA-7
    • Fax: (240) 221-4292
    • Email: info@health.org
    • www: http://www.health.org/
    • Higher Education Center for Alcohol and Other Drug Prevention
    • Education Development Center, Inc.
    • 55 Chapel Street
    • Newton, Massachusetts 02458-1060
    • Tel: (800) 676-1730
    • Fax: (617) 928-1537
    • Email: HigherEdCtr@edc.org
    • www: http://www.edc.org/hec/
    Elsewhere
    Australia
    • National Drug and Alcohol Research Centre (NDARC)
    • University of New South Wales
    • Randwick Campus
    • 22–32 King Street
    • Randwick, NSW 2031
    • Australia
    • Tel: +61 (0) 2 9385 0333
    • Fax:+61 (0) 2 9385 0222
    • Email: NDARC@unsw.edu.au
    • www: http://www.med.unsw.edu.au/ndarc/
    • National Drug Research Institute
    • Kent Street
    • Bentley
    • Perth, Western Australia
    • Australia
    • Mailing address:
    • GPO Box U1987
    • Perth, WA 6845
    • Tel: 61-8-9426-4200
    • Fax: 61-8-9486-9477
    • Email: enquiries@ndri.curtin.edu.au
    • www: http://ndri.curtin.edu.au/
    • National Centre for Education and Training on Addiction
    • Level 3B
    • Mark Oliphant Building
    • Science Park Adelaide
    • Bedford Park, SA 5042
    • Australia
    • Tel: +61 (0) 8 8201 7535
    • Fax: +61 (0) 8 8201 7550
    • Email: nceta@flinders.edu.au
    • www: http://www.nceta.flinders.edu.au/
    • Centre for Education and Information on Drugs and Alcohol (Ceida)
    • Private Mail Bag 6
    • Rozelle, NSW 2039
    • Australia
    • Tel: +61 (0) 2 9818 0401
    • Fax: +61 (0) 2 9818 0464
    • Email: library@ceida.cs.nsw.gov.au
    • www: http://www.ceida.net.au/
    • Australian Drug Foundation
    • 409 King Street
    • West Melbourne, VIC 3003
    • PO Box 818
    • North Melbourne, VIC 3051
    • Tel: +61 (0) 3 9278 8100
    • Fax: +61 (0) 3 9328 3008
    • Email: adf@adf.org.au
    • www: http://www.adf.org.au/
    Canada
    • Canadian Centre on Substance Abuse
    • 75 Albert Street, Suite 500
    • Ottawa, ON K1P 5E7
    • Canada
    • Tel: +1 613 235-4048
    • Fax: +1 613 235-8101
    • Email: info@ccsa.ca
    • www: http://www.ccsa.ca/
    • Centre for Addiction and Mental Health (formerly the Addiction Research Foundation (ARF))
    • Library
    • 33 Russell Street
    • Toronto, ON M5S 2S1
    • Canada
    • Tel: +1 416 595-6144
    • Fax: +1 416 595-6601
    • Email: isd@arf.org
    • www: http://www.camh.net/
    New Zealand
    • ALAC National and Central Regional Office
    • Level 13, ABN Amro House
    • 36 Customhouse Quay
    • PO Box 5023
    • Wellington, 6145
    • Tel: +64 (0) 4 917 0060
    • Fax: +64 (0) 4 473 0890
    • Email: central@alac.org.nz
    • ALAC Northern Regional Office
    • Level 2, Ascot Central
    • 7 Ellerslie Racecourse Drive, Greenlane East
    • PO Box 11791
    • Ellerslie, Auckland
    • New Zealand
    • Tel: +64 (0) 9 916 0330
    • Fax: +64 (0) 9 916 0339
    • Email: northern@alac.org.nz
    • ALAC Southern Regional Office
    • Level 4, Media Associates Building
    • 77 Hereford Street
    • PO Box 2688
    • Christchurch
    • New Zealand
    • Tel: +64 (0) 3 365 8540
    • Fax: +64 (0) 3 365 8542
    • Email: southern@alac.org.nz
    South Africa
    • South African National Council on Alcoholism and Drug Dependence
    • PO Box 663
    • Auckland Park 2006
    • Or
    • 5 Ryder Road
    • Bordeaux
    • Randburg, 2194
    • South Africa
    • Tel: +27 11 781 6410
    • Fax: +27 11 781 6420
    • Email: sanca@sancanational.org.za
    • www: http://www.sancanational.org.za/
    Switzerland
    • International Council on Alcohol and Addictions
    • Case Postale 189
    • CH 1001 Lausanne
    • Switzerland
    • Tel: +41 (21) 320 98 65
    • Fax: +41 (21) 320 98 68
    • Email: secretariat@icaa.ch
    • www: http://www.icaa.ch

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