01 · Substance use and safeguarding
Health, exploitation, unmet needs and access to help.
Open this area →LOOK Safeguarding Framework® · Public pathway guide
Substance use, alcohol
& safeguarding.
Four connected areas for recognising harm, understanding the person's circumstances and planning a coordinated response.
For practice in England. This guide supports professional reflection and discussion. It does not provide a clinical assessment, determine statutory thresholds or replace local safeguarding procedures. Legal routes differ elsewhere in the UK.
One pathway · Four connected areas
Start with the person and the evidence
Alcohol is a substance too. Separate sections make alcohol-specific issues easier to find; use all the areas relevant to the situation. Consider the person's strengths, relationships and wishes alongside possible harm. These prompts are not a score or a complete list of risks.
02 · Substance use and domestic abuse
Coercion, control and barriers to safety or treatment.
Open this area →03 · Alcohol and safeguarding
Dependence, daily functioning and cumulative harm.
Open this area →04 · Alcohol and domestic abuse
Safety, responsibility for abuse and coordinated support.
Open this area →Area 01
Substance use and safeguarding
Explore what is happening
- What substances or medicines are involved, and what has changed? Ask about mixing substances, overdose, withdrawal, injuries and interruptions to treatment; seek clinical advice on the risks.
- Is anyone controlling supply, money, housing or access to help? Explore debt, threats, exploitation and whether others are using the person's home against their wishes.
- What is the impact on food, sleep, hygiene, relationships and caring responsibilities? What support already helps?
Agree practical action
Coordinate healthcare, drug treatment and any safeguarding response. A GP or local drug service can help; people can approach a drug service directly. Ask specialist services about harm reduction, including overdose prevention and naloxone where opioids are involved. Confirm access and follow-up, rather than assuming a signpost has led to support.
Sources: NHS: getting help with drug use; GOV.UK: community pharmacy substance misuse services.
Area 02
Substance use and domestic abuse
Recognise control as well as use
- Does someone force or encourage substance use, control or withhold supply, interfere with medication or sabotage treatment?
- Are threats about disclosure, children, money or housing stopping the person seeking help? Is their substance use being used to undermine their account of abuse?
- Could substance use be a way of coping with abuse? Do not decide who is responsible for abuse simply by identifying who uses substances.
Plan support together
Offer a safe, private opportunity to talk and agree safe ways to make contact. Involve specialist domestic abuse and substance use services in a coordinated safety plan. Substance use does not excuse abuse. Responsibility remains with the person causing harm; treatment for their substance use alone is not evidence that abuse has stopped.
Where to find the relevant guidance
These are two separate Home Office documents. The links below open the relevant sections, with paragraph numbers to help you find the detail.
- Domestic Abuse statutory guidance — Perpetrator tactics, paragraphs 106–108: explains controlling or withholding substances, forced use and interference with treatment.
- Domestic Abuse statutory guidance — Alcohol and substance misuse, paragraphs 210–216: explains the overlap with abuse and barriers to support.
- Controlling or coercive behaviour statutory guidance — Controlling behaviours: the separate guidance explicitly includes using alcohol or drugs to control someone through dependence or access to substances.
Area 03
Alcohol and safeguarding
Look at change over time
- Consider falls, injuries, nutrition, repeated emergency attendance, self-neglect and difficulties managing daily life. What is becoming harder and who has noticed?
- Explore dependence and withdrawal with clinical support. Is there a plan when treatment, housing or care arrangements change?
- Changes in memory, judgement or ability to carry out plans may need specialist assessment. Do not diagnose alcohol-related brain damage from drinking history alone.
Do not advise sudden stopping where dependence is possible
Stopping alcohol suddenly can be harmful for someone who is physically dependent. Get medical advice before reducing or stopping. Severe withdrawal, including hallucinations, severe shaking or seizures, needs 999. NHS: alcohol support and withdrawal advice.
Support the person to make the particular decision in question. Drinking, an unwise decision or apparent agreement does not by itself establish capacity or incapacity. Where there is reason to doubt capacity, arrange a decision-specific assessment and consider how the person functions in daily life.
Sources: Alcohol treatment guidelines: assessment and planning; alcohol-related brain damage, assessment and capacity.
Area 04
Alcohol and domestic abuse
Understand the pattern of abuse
- Ask about fear, control, threats, physical or sexual harm and what happens before, during and after drinking. Include abuse occurring when the person causing harm is sober.
- Explore whether alcohol is used to control, discredit or isolate someone, and what makes support difficult to access.
- Speak privately and safely. Do not ask about abuse in front of a partner or relative who may be causing harm.
Keep safety central
Alcohol can increase the likelihood or severity of harm; it does not remove responsibility for abuse. Arrange specialist domestic abuse support alongside alcohol support. Use local risk assessment and escalation procedures, including an independent domestic violence adviser and a multi-agency risk assessment conference where indicated. Keep the safety of the person and children under review; attendance at alcohol treatment does not demonstrate safety.
Source: Alcohol treatment guidelines: people experiencing or perpetrating domestic abuse.
LOOK Safeguarding Framework®
Bring the whole picture together
Use these practice prompts to connect the evidence across the four lenses. They are prompts for professional judgement, not a validated risk tool.
L · Living Circumstances
What is happening with housing, relationships, health, income and daily care? Who offers safe support? Where and when does the person feel safer?
O · Obstacles & Barriers
What gets in the way of help: coercion, stigma, service thresholds, inaccessible appointments, communication needs or fragmented care? Who can remove each barrier?
O · Ongoing Risks & Escalation
What is changing or recurring? Bring together the chronology of harm, missed care and crises. Which change needs immediate action or a different response?
K · Keeping the Person in View
What does the person want, fear and value? How will their account, strengths and choices shape the plan? Whose voice is missing, including children's?
Finish with an owned, reviewable plan
Record what is known and uncertain; the person's priorities and safe contact arrangements; the action and named owner; whether the receiving service has responded; the review date or trigger; and what to do if help does not arrive or risk increases.
Use your organisation's approved recording system. Do not send confidential case information through the website's suggestion or contact form.
Help and next steps
Find the right support route
Drug and alcohol support
Speak to a GP or local specialist service. The NHS pages explain how to find treatment and include support for families affected by someone else's use.
NHS: help with drug use →NHS: alcohol support →Safety, care and advocacy
Use the local safeguarding or domestic abuse route for safety concerns. People and carers can also ask about care, wellbeing support and help to take part in decisions.
Safeguarding and domestic abuse help →People, families & carers →No referral is sent from this guide. Contact the relevant service directly and confirm the next steps.
Source links checked 20 September 2026. Read the linked guidance alongside current local procedures. LOOK Safeguarding Framework® is a registered trademark.