One of the most challenging aspects of recovery is that it is an ongoing process….it never really ends. When an addicted person stops using and embraces abstinence, the real journey begins. Holding onto a substance-free lifestyle is seldom a straightforward path; rather it is often marked with peaks and valleys where a return to drug or alcohol use for a time – a relapse – punctuates periods of abstinence. Show
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) estimates that nearly 90% of people in recovery for alcohol use relapse at least once over a four-year period. The National Institute on Drug Abuse (NIDA) reports that relapse rates for people in recovery for all types of substance use averages around 40-60%. These statistics, while alarming, are consistent with the relapse rates for other chronic illnesses. For instance, people with hypertension and asthma have about a 50-70% rate of failing to consistently maintain their treatment regimes, and people with diabetes have about a 30-50% rate of relapse from their treatment regimes. To better manage the risks for potential relapse, the drug and alcohol treatment community has developed guidelines to help people in recovery recognize risky situations and develop proactive strategies to deal with them before they get out of hand. Categories of RiskThe risk for relapse falls into three general categories: high risk, moderate risk and low risk.
Factors That Predispose You to Risky BehaviorBasically, you are at risk for relapse if you fail to follow the strategies that support your recovery and, instead, put yourself in circumstances that are similar to those under which you used before. But you don’t simply “find” yourself in these circumstances. There are underlying reasons that usually lead to straying from the recovery path:
Triggers for Risk and How to Manage ThemCertain specific kinds of situations are more likely to lead to risky behavior. You can remove yourself from high risk situations if you recognize them early and have a plan to move away immediately.
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📌 This page was last updated on 8 September 2022 Most recent changes:
A high-risk setting is defined as:
High-risk settings include:
Key information for high-risk settingsEntering a high-risk settingHigh-risk settings should require all staff and visitors to complete a health screening tool, which could include using the Check In CBR app. Staff or visitors are not permitted to attend high-risk settings if they are: People who have completed their 5 day isolation period must not enter a high-risk facility for a further 2 days (that is, on day 6 and day 7 where the date of the test is day 0), unless they have prior permission from the facility or are seeking urgent medical care. Example: A person undertakes a PCR on 1 October which returns a positive result. They must isolate until the end of 6 October (5 days). They cannot enter a high-risk facility for a further 2 days. This means they cannot enter on 7 October (day 6) and 8 October (day 7) unless they have permission from the facility or are seeking urgent medical care. Household and high-risk contacts are advised to limit their entry into a high-risk facility from days 8 to 14 following their last exposure. If entry is necessary, these individuals should seek approval from the relevant facility prior to entry and let the facility know if they experience COVID-19 symptoms. People who are restricted from entering high-risk settings can attend hospitals for urgent health care at any time. Staff and visitors entering high-risk settings are required to wear a mask. VisitorsPeople who have COVID-19 and are in isolation under a Public Health Direction are not permitted to enter high-risk settings unless they are seeking urgent medical care. For non-urgent care or compassionate reasons (e.g. end of life visits), people in isolation can only attend high-risk settings if they have an approved exemption from ACT Health, supported by the relevant facility. People in isolation will need to apply for an exemption from ACT Health by emailing . Exemptions will only be considered in exceptional circumstances. The following people should also avoid visiting high risk settings:
People in these categories may be permitted to enter the facility for compassionate reasons (e.g. end of life visits), with prior approval from the facility. People who have recently entered the ACT are able to enter high-risk settings, as long as they pass the screening questions. For more information about visitors please see advice for staff and operators of aged care facilities. Entry screening questionsHigh-risk settings are recommended to use the following questions, also now available on the Check In CBR app, to screen all staff and visitors. These questions apply regardless of COVID-19 vaccination status.
If a person answers yes to any of the above questions, they should not enter the facility, unless prior approval from the facility is granted. Note: a recovered case (that is, someone who has completed their COVID-19 isolation within the last 28 days) is not required to follow the risk mitigation guidance for household and high-risk contacts. Recovered cases can use their clearance SMS/email as proof of their status if they answer “yes” to questions 2 and 3 above. Note: ACT Ambulance Service personnel undertake screening at the beginning of the shift and implement risk mitigation measures for relevant individuals. No further screening or action needs to be taken at the individual facility level for ACT Ambulance personnel. Check in CBR Health Screening ToolACT Health has expanded the functionality of the Check in CBR app to include a Check in CBR Health Screening Tool, which is available for use in high-risk settings only (at this stage). The health screening questions on the app mirror those under ‘Entry screening questions’ on this page. The health screening tool is not mandatory for use by providers but provides an optional, consistent and familiar resource for individual facilities to use and implement if their current system is no longer adequate. A new Check in QR code is not required, however facilities are required to notify ACT Health that they wish to incorporate the Tool into their existing Check in CBR QR Code. Those facilities who have not previously registered for Check in CBR can also apply for the Check in CBR Health Screening Tool. To register for access to the health screening tool, high-risk settings should complete this form. For more information see Check In CBR app. Residents leaving facilities
Strategies to reduce likelihood of transmission in staffHigh-risk settings should limit contact between staff who are working different shifts. For example:
Mask advice for high-risk settingsSurgical face masks must be worn by staff and visitors who are 12 years and over in high-risk settings. Visitors and staff may remove their masks under certain circumstances such as eating and drinking. Staff who work in high-risk settingsWhat does a staff member need to do if they are identified as a contact?The staff member needs to advise their manager that they are a contact as soon as possible and follow the advice applicable to their contact classification. For more information see the information for people exposed to COVID-19. What does the staff member’s manager need to do?Refer to the tools used to assess high-risk community sites and consider staffing and risk mitigation issues in relation to that staff members quarantine and return to work. Staff who are contacts returning to work in a high-risk setting*
CHECC sites should refer directly to CHECC advice on COVID-19 requirements for staff working in ACT Health facilities for information about management of household and high risk (close), moderate risk (casual) contacts among ACT Health facility staff. *This advice should also be followed for providers of home-based care. Return to work should be overseen by the organisation providing care. Visiting or returning to work in a high-risk setting after having COVID-19*Staff members who have completed their COVID-19 isolation period but are less than 7 days since their positive COVID-19 test (i.e. in the 2 days after completing their 5 day isolation period) must follow the instructions of their facility regarding permission to return to work. Key considerations for assessing if a staff member or visitor who has completed their isolation period but is less than 7 days since their positive COVID-19 test (i.e. in the 2 days after completing their 5 day isolation period) should be granted approval to visit or work in your facility or service, are outlined in the additional measures for recently cleared COVID-19 cases. This includes examples of additional risk mitigations that a facility may want to require in order to allow return to work or a visit to the facility. Repeat testing is not required prior to recommencing work. For more information see recovering from COVID-19. COVID-19 exposures in a high-risk settingHigh-risk settings and facilities will activate their COVID-19 business continuity planning and contact tracing following any relevant exposure or outbreak. ACT Health will continue to support high-risk settings and facilities who have exposures or outbreaks. Tools used to assess COVID-19 exposures in high-risk community sitesThese tools are updated over time so please refer to the website for the most up to date version. Facilities/workplaces should use the ACT risk assessment matrix to assess the risk to clinical and non-clinical staff and residents/clients of high risk settings who are exposed to a COVID-19 case while in that setting. This individualised risk assessment approach acknowledges the importance of the continuity of healthcare services and takes into account the PPE that the staff member was wearing, and the type of contact they had with the case to determine whether the staff member is considered to be a contact. Actions for staff identified as contacts from a COVID-19 exposure at a high risk community site Staff identified as contacts in these risk assessments or from outside of work exposures should follow return to work advice below. Staff who are identified as household or high-risk contacts from a COVID-19 exposure in the community or workplace may be allowed to return to work in the event of workplace shortage with use of relevant risk mitigation strategies. This should be discussed with your manager or designated contact at your facility. Additional information supporting workplaces following an exposure to COVID-19 is available:
Please refer to the aged care page for more information regarding managing an exposure in aged care settings, including advice on how to manage a resident who is a household or high-risk contact. Please refer to the disability care page for more information regarding exposure in disability care settings, including advice on how to manage a resident who is a household or high-risk contact. Staff should wear appropriate PPE for contact with residents/clients of a high-risk setting who are in isolation or quarantine. PPE use during a COVID-19 exposure or outbreak in a facilityDuring a COVID-19 outbreak, staff will need to wear appropriate PPE to protect themselves from exposure to COVID-19. Appropriate PPE means:
Please ensure you have adequate supplies of PPE available immediately for use in a COVID-19 outbreak. Residents and clients of a high-risk settingResidents or clients who test positive for COVID-19 should receive their usual care. Those providing this care will need to wear PPE (including P2/N95 mask and eye protection) in order to protect themselves and other clients and residents. Residents or clients who test positive for COVID-19 will be cleared from isolation by ACT Health 5 days after their positive test date. They should continue to follow the public health guidance for the relevant high-risk setting, these include managing residents, patients or detainees in high-risk settings with COVID-19 with additional precautions, including isolation, for 7 days after their positive test, or until their symptoms have significantly improved, whichever comes later. Managing COVID-19 in disability care settingsFor steps you should take if a COVID-19 case has had contact with a disability client or provider while infectious, please refer to the Public health guidance for acute respiratory illnesses in disability residential care facilities page. This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction. Managing COVID-19 in Residential Aged Care FacilitiesFor steps you should take if a COVID-19 case has had contact with a residential aged care facility resident or staff member while infectious, please see the residential aged care facilities page. This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction. Medical contraindications or temporary exemptions to COVID-19 vaccinationCOVID-19 vaccination has become a mandatory condition of employment for some workforces and situations in the ACT. In these situations and under public health directions, people will be required to provide evidence of their COVID-19 vaccination status, or of an authorised exemption to vaccination. Please see information for employees that require vaccination. It includes information related to exemptions to vaccination. |