Psych CASC / OSCE · Addiction psychiatry — public health and systems
Explain harm reduction and naloxone to a sceptical family — CASC communication station
MRCPsych/FRANZCP-style communication station: explain harm reduction, NSP, OAT mortality rationale, take-home naloxone teaching, and negotiate against unsafe detox-only pressure without colluding with stigma.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 24-year-old man who injects opioids is about to leave ED after a non-fatal overdose. His mother believes needle exchange and take-home naloxone will 'encourage him to use more' and wants him sent to a 7-day detox with no medication. He is ambivalent about methadone but willing to carry naloxone.
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. Examiner may play mother and/or patient. [1]
Candidate instructions. Explain harm reduction in plain language. Teach take-home naloxone use. Explain why needle exchange does not equal “encouraging drugs.” Discuss medication treatment and why a 7-day detox-only plan is high risk after overdose. Negotiate a collaborative safety plan. Check understanding. [2][3]
References5ShowHide
- [1]Hawk M, et al. Harm reduction principles for healthcare settings Harm Reduct J, 2017.PMID 29065896
- [2]McDonald R, Strang J Are take-home naloxone programmes effective? Addiction, 2016.PMID 27028542
- [3]Sordo L, et al. Mortality risk during and after opioid substitution treatment BMJ, 2017.PMID 28446428
- [4]Volkow ND Stigma and the Toll of Addiction N Engl J Med, 2020.PMID 32242351
- [5]Aspinall EJ, et al. Needle and syringe programmes and HIV transmission Int J Epidemiol, 2014.PMID 24374889