When more than one substance is involved, a Swiss assessment should examine the combined pattern rather than select one drug and ignore the rest. Bring a timeline of alcohol, prescribed medicines, nonprescribed tablets, and other substances, including when they are used close together. The clinician should identify immediate risks, any withdrawal concerns, existing treatment that needs continuity, and the professionals responsible for the next phase of care.
Explain the sequence, not just the names
“I use alcohol, cocaine, and sleeping tablets” is a useful start, but it does not show how their effects may overlap. Describe what happens across a day or an episode. Which substance comes first? Is another used to prolong an effect, manage distress, or try to sleep afterward? Are prescribed medicines taken on the same days? Timing can be important even when substances are not swallowed together.
Infodrog’s Swiss mixed-use information describes combined use as taking psychoactive substances simultaneously or close enough together for effects to overlap. It warns that some combinations, including alcohol and benzodiazepines, can be fatal. A combination should not be assumed safe because each component is familiar or because the person has used it before.
Use everyday language if that is easier. You can say “a tablet to sleep after a long night” and then provide the packaging or name if known. If you cannot identify a product, write “unknown” rather than guessing. The assessor needs an honest record, including uncertainty, to decide what further questions or investigations are appropriate.
Create one shared substance and medication record
A practical record should include the product or substance, whether it is prescribed, the reason for use, the approximate timing, and any symptoms associated with it. Add the name of the prescriber and pharmacy where relevant. Include over-the-counter medicines and supplements as well as substances you think of as drugs. Ask the clinician which information needs to be confirmed from records.
For each item, describe whether use is regular, occasional, or limited to particular situations. An irregular pattern can still matter. Someone may take a prescribed medicine daily and combine it with alcohol only on weekends, while another person alternates stimulants and sedatives across several days. These examples illustrate why the same list of names can conceal different clinical questions.
Bring this record to every relevant service and ask who will maintain the current version. A therapist, addiction physician, psychiatrist, and general practitioner may each know only part of the picture unless information is deliberately connected. Our addiction assessment guide explains how to organize a concise brief without turning preparation into a barrier to seeking help.
Separate current intoxication, withdrawal, and continuing treatment
These are three different clinical tasks. Current intoxication or poisoning concerns may require urgent assessment. Withdrawal planning asks what could happen when a regularly used substance is reduced or stopped. Continuing treatment examines the pattern of use and the needs that remain after an immediate phase. The same person may need all three, but the order should be decided clinically.
Do not assume that the substance causing the most visible social problem is the only one relevant to medical safety. A person may ask for help with cocaine while also being physically dependent on alcohol or a sedative. The clinician needs to know about that dependence before planning abrupt changes. Conversely, an existing prescribed treatment may need to continue while other concerns are assessed.
Ask the service to explain its priorities. Which concern requires action today? Which can be assessed over subsequent appointments? What treatment must remain uninterrupted? Our multiple-substance withdrawal guide focuses on the questions to take to a qualified team, without offering a home withdrawal schedule.
Use emergency help when the situation is unsafe
If someone is unresponsive, has severely abnormal breathing, collapses, has a seizure, or appears in immediate medical danger, call 144 in Switzerland. Give the dispatcher the information you have about substances, medicines, timing, and symptoms. Do not wait until every substance has been identified. Follow the dispatcher’s instructions rather than trying to counteract one drug with another.
The official Swiss emergency directory also lists 112 for general emergencies and 145 for poison information. Tox Info Suisse provides medical advice for poisoning or suspected poisoning through 145. A routine counseling appointment is not a substitute for urgent medical care.
After an emergency, ask how the episode will be incorporated into the continuing plan. Request a copy of relevant discharge information and clarify which clinician should receive it. The event may identify questions about medication, mental health, or support that deserve follow-up beyond the immediate hospital visit.
Keep established opioid treatment connected
If you receive opioid agonist treatment, tell every relevant clinician and bring the confirmed prescribing and dispensing details. The FOPH opioid treatment overview describes a Swiss pathway involving authorized prescribing, psychosocial support, and possible pharmacy dispensing. Other substance use should be assessed within that context rather than leaving responsibility for the existing treatment unclear.
Before entering a residential program or changing services, ask who has accepted responsibility for continuity. Has the receiving clinician reviewed the plan? Has the pharmacy arrangement been confirmed? What happens if admission is delayed? A general statement that a provider “treats all addictions” does not answer these operational questions.
Do not stop or alter established medication on the basis of a program’s marketing language. Discuss any proposed change with the responsible clinician. The plan should explain the clinical reason, monitoring, and follow-up in terms you understand.
Ask how the assessment handles mental health
Mood, anxiety, unusual experiences, sleep disturbance, and trauma-related symptoms can become difficult to interpret when several substances are involved. Describe when each symptom occurs and what was present before the current pattern developed. Ask the clinician which questions can be answered now and which require observation or further assessment.
A useful team does not require you to choose whether the “real problem” is mental health or substance use before getting help. It should identify current needs and explain how they will be investigated. If different professionals contribute, ask who coordinates the overall formulation and how the plan changes when new information emerges.
Our integrated dual-diagnosis care guide discusses coordination between addiction and mental health services. The label alone is not evidence of integration. Ask for the names, roles, and communication arrangements that make it real.
Compare services using the same questions
Different services may emphasize different parts of care. Use a consistent set of questions so that a polished brochure does not obscure a missing capability. The following comparison is an editorial framework for inquiries, not a claim that every Swiss provider uses the same model.
| Need to clarify | Question for the service |
|---|---|
| Combined assessment | Who reviews the full medication and substance-use history together? |
| Withdrawal risk | Which clinician decides whether supervised withdrawal or hospital care is needed? |
| Existing prescriptions | Who confirms continuity before admission or transfer? |
| Mental health | How are psychiatric concerns assessed and coordinated with addiction care? |
| Medical capability | Which services are onsite, external, or unavailable? |
| Follow-up | Which receiving clinician is confirmed before the current phase ends? |
Ask the provider to distinguish personal support from nursing, prescribing, and emergency care. If an external hospital is part of the safety plan, clarify how transfer is arranged. A program should be able to explain both the care it offers and the circumstances that require another setting.
Use Swiss support routes to find the right entry point
The Federal Office of Public Health addiction help page links to counseling services, SafeZone, and the Swiss addiction service directory. When contacting a service, state that several substances or medicines are involved and mention any immediate concerns. Ask whether the appointment includes medical assessment or whether a separate doctor’s appointment is needed.
Verify the service’s age group, language, referral process, availability, and payment arrangements. If you live in one canton and seek care elsewhere, ask how follow-up and relevant authorizations will be coordinated. If you are traveling internationally, establish how the Swiss plan will connect with the clinician who will see you afterward.
Online counseling can help you organize questions and find a local route. It does not establish a prescription, assess every medical risk remotely, or replace emergency services. Choose the contact according to the task you need completed.
Build a plan that can adapt to changing patterns
Substance use may change during treatment. Tell the team promptly if you begin using something else, return to a previous substance, or use a prescribed medicine differently. A plan based on an outdated history may miss the concern you now need help with. Ask how to report changes without waiting for the next scheduled review.
Choose progress measures that reflect the whole situation. These might include attending care, completing medical follow-up, reducing dangerous combinations, improving daily functioning, or following an agreed prescription plan. The clinician should interpret changes in context rather than judging progress through one isolated number.
Before leaving the assessment, confirm the next appointment, the responsible clinician, and the contact route for urgent and nonurgent problems. You should understand the order of care and which questions remain open. A connected Swiss plan makes the combined pattern visible and keeps treatment responsibilities clear as the situation changes.