In such a multi-faceted sector, it is not easy to find a way of categorising workers that is satisfactory in every setting. However, there are clear distinctions between those who work day in and day out with substance misusers, those who deal with a significant number of substance misusers as part of a larger work portfolio and those who only occasionally meet a case of substance misuse. The levels of knowledge, skills and competence expected of these different broad groups of workers in relation to substance misuse are clearly different and any framework of performance standards, training and qualifications must recognise this. See PROFILES for real life examples.

Tier 1	Tier 2	Tier 3	Tier 4
Non substance misuse specific services requiring interface with drug and alcohol treatment. Their role will be to provide as a minimum screening and referral of substance misusers to tier 2 and 3 services. Universal provision of drug information and education. E.g. Youth Worker, Education Welfare Officer, Practice Nurse, A&E Worker Open access drug and alcohol treatment services.	Their role is to engage drug and alcohol misusers in treatment and reduce substance related harm following basic assessment. Targeted drug education to at risk groups and early intervention. E.g. Youth Justice Worker, Criminal Justice Worker, Triage Co-ordinator. Structured community based drug and alcohol treatment services.	These services will provide structured interventions following a detailed assessment and agreed care plan with the client. E.g. Substance Misuse Social Worker, Specialist Nurse, Clinical Psychologist. Residential services for drug and alcohol misusers. Supported detox in the community (home) supported by specialist workers.	These services are for individuals with a high level of presenting need eg detoxification, residential services and/or related specialist services such as HIV/Aids and Hepatitis services. E.g. Drug Counsellor in residential services, Hepatitis Worker.

The sector is multi faceted cuttings across many different professions and sectors in their own right.  In order to help explain this, workers can be categorised into three main substance misuse portfolios areas.

Specialists – those whose entire work involves working directly with substance misuse.  Often their job title includes the word ‘drug’ or ‘alcohol’.  For example: Telephone Drugs Advisor, Addiction Nurse.

Generic Workers with a Substance Misuse Portfolio– those who work frequently with vulnerable people who have had contact with substance misuse in their lives be it personally or with someone they know. For example: Housing Officer, Prison Officer.

Generic Workers with an Occasional Substance Misuse Portfolio- those who come across substance misuse from time to time in their job.  For example: Teaching Assistant, Hospital Receptionist.

We have estimated how many people will work with substance misuse in their job.   From the chart you will see that there are a large number of workers whose job is affected by substance misuse to some degree. For more examples of jobs with a substance misuse portfolio, click here – the darker the blue the larger the substance misuse portfolio.