Department for Work and Pensions

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Care and mobility considerations

Many people abuse drugs and experience only minor mental, physical or social disability.

Substance dependence in the absence of chronic physical or mental complications should not be expected to give rise to significant care and mobility needs.

Episodes of acute intoxication on their own cannot be prevented by reasonable supervision, although intermittent intervention by another person at specific times may reduce the risk at those times.

Withdrawal symptoms usually last for several days only and should not require long term help from another person.

Self neglect in people with substance dependency in the absence of chronic physical or mental complications may require short-term help from another person. However, such help should not be long term once substance use has been discontinued.

During periods of rehabilitation the person may require support from others but this should not amount to a need for attention or supervision.

The onset of chronic physical or mental complications is likely to imply moderate or severe disability.

Mild Functional Restriction

Category Description

Disabling Effects

People with a mild functional restriction are likely to be those who have some of the following -:

  • Use drugs recreationally only
  • Have no symptoms of dependence
  • Have no associated psychiatric symptoms
  • Have no associated physical problems
  • Have no associated social problems
  • Have had no hospital admissions for drug dependency
  • Live at home
  • Not be on care plan
  • Be under GP care only

Mobility

They should not have any physical problem with walking.

They should not have difficulty finding their way around unfamiliar places and should not require guidance or supervision.

Care

They would not normally exhibit significant self-neglect and would not normally put themselves or others at risk of danger.

They should not normally have any significant functional loss that will result in a reduction of their ability to carry out normal day-to-day activities.

Moderate Functional Restriction

Category Description

Disabling Effects

People with a moderate functional restriction are likely to be those who have some of the following:

  • Have been drug dependent for <10 years
  • Have non psychotic psychiatric symptoms
  • Have mild or moderate physical problems, for example local complications or non-disabling systemic complications.
  • Have mild or moderate social problems, for example relationship problems, work related problems, unemployment and engagement in criminal activity.
  • Have had no hospital admissions in the last 12 months
  • Live at home or in be in short term residential accommodation
  • Be under the care of the community drug team or GP with special interest in substance misuse with or without social services involvement.

Mobility

They should not have any physical problem with walking.

They are unlikely to have difficulty finding their way around unfamiliar places and are unlikely to require guidance or supervision.

Care

They would not normally exhibit significant self-neglect and would not normally put themselves or others at risk of danger.

They may have difficulty in carrying out normal day-to-day activities in a timely fashion, due to, for example, impaired concentration and motivation. For example they may require encouragement to prepare meals, take medication (but this is likely to be limited to once or twice a day) and get out and about, but this is unlikely to be a long term need.

Severe Functional Restriction

Category Description

Disabling Effects

People with a severe functional restriction are likely to be those who have some of the following -:

  • Have been drug dependent for >10 years
  • Use multiple drugs
  • Have persistent severe psychiatric symptoms
  • Have severe physical problems, for example chronic liver failure secondary to hepatitis or moderate or severe disability secondary to HIV/AIDs
  • Have had hospital admissions in the last 12 months
  • Be socially isolated and have a chaotic and disorganised lifestyle
  • Have persistent self neglect
  • Have bizarre behaviour towards other people
  • Live in long term residential accommodation or homeless
  • Be under the care of specialist substance misuse services (the community drug team) with or without involvement from social services

Mobility

They may have difficulty walking if they have a severe drug related physical problem such as leg ulceration or other vascular complications from injecting drug misuse, e.g. chronic deep vein thrombosis, amputations etc.

They may have difficulty finding their way around unfamiliar places and may require guidance or supervision.

Care

They may exhibit significant self-neglect and may put themselves or others at risk of danger.

They may have a significant functional loss that will result in a reduction of their ability to carry out normal day-to-day activities.

Amended June 2008