Background

Jacquie is 23 and a single parent to her five-year-old son, Olly. She is currently undergoing treatment for heroin addiction and has regular sessions with Dr Clifford, a specialist in substance misuse.

Jacquie had been making good progress for several months. But her situation has recently deteriorated, as she has begun using heroin again. Today she arrives over an hour late for her appointment. She tells Dr Clifford that she is exhausted and struggling since falling out with her mother, who had been helping with Olly.

During their consultation, Jacquie says that getting Olly to school has been a struggle and there have been days when she has not had the energy to get up and get him there. Dr Clifford expresses concern about the impact her relapse could be having on Olly, particularly his missing school. He suggests that school may be a better environment for Olly on the days she is not doing so well. Dr Clifford mentions that involving social services and other relevant agencies or healthcare professionals could provide more support so she can focus on her treatment.

Jacquie is resistant. She insists it is just a bad patch, that she can get back on track and that social services have no place getting involved.

Jacquie says she has only used heroin a couple of times at night when Olly is asleep. She tells Dr Clifford that he must not tell anyone.