How can I effectively support a patient in recovery from substance use disorder during their follow-up appointments?

To effectively support a patient in recovery from substance use disorder during follow-up appointments, it is essential to establish and maintain a respectful, supportive, and collaborative relationship that actively involves the patient in developing and reviewing their care plan. This includes assessing their medical, psychological, social, and occupational needs, as well as their history of substance use and previous treatment experiences, to tailor ongoing support and interventions accordingly ¹,².

During follow-up, healthcare professionals should help patients identify triggers and vulnerable situations that may lead to relapse, and collaboratively explore alternative coping strategies to manage these risks ². Maintaining patient engagement with services is critical, and follow-up appointments should focus on sustaining motivation, reinforcing positive behaviours such as abstinence or reduced use, and providing information about harm reduction, including reducing exposure to blood-borne viruses ¹,².

Psychosocial interventions, particularly cognitive behavioural therapy (CBT), should be considered for patients with comorbid mental health conditions or those stabilised on opioid maintenance treatment, as these can support relapse prevention and address underlying psychological issues ². Where appropriate, contingency management techniques that offer incentives for positive behaviours may also be integrated into the care plan to encourage sustained recovery ¹.

Biological testing (e.g., urine or oral fluid samples) can be used as part of a comprehensive assessment during follow-up but should not be the sole method of monitoring progress ². Regular review of the care plan should include collaboration with other care providers and, if relevant, mental health services, especially if there are concerns about self-harm or suicide risk ¹.

Follow-up should also consider the patient’s social context, including family involvement where beneficial, through education and support to promote effective coping behaviours and reduce stress related to substance use ². For patients with complex needs or those who have relapsed, urgent reassessment and consideration of alternative or additional community, residential, or inpatient support may be necessary ².

From the literature on alcohol use disorder management, regular ambulatory follow-up is recommended to monitor treatment adherence, detect early signs of relapse, and provide ongoing psychosocial support, with the duration and frequency tailored to individual patient needs and risk profiles (Benyamina and Reynaud, 2016). This aligns with guideline recommendations emphasizing personalised, continuous care to optimise recovery outcomes ¹,².