Transcript A Brand Identity for Salford

Drugs and Alcohol Needs
Assessment 2011/12:
Dissemination of findings
Introduction and background:
• Annual Needs Assessment
• Funding
• Needs Assessment - historically looked only at drug misuse
• National Drug Strategy was published in 2010
• Flexibilities in funding
Introduction and background continued:
• 2012/13 System Tender;
• Identification of trends
• Changing patterns of use
• Gaps in service provision
• Innovation
Drugs and Alcohol: Achievements over
last 5 years
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Year on year increase on numbers in treatment and retained
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Increased funding into treatment system
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More offenders being attracted to and entering treatment (via DIP)
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Forest Bank – continued to build on and strengthen relationships
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Reduction in drug related crime
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Increase in community based provision (i.e. pharmacies, GPs)
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Accessible delivery of community based services –
i.e. support groups from UCAN centres
Drugs and Alcohol: Achievements over
last 5 years continued
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Reduction in deaths as a result of Overdoses
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Attracted a younger cohort
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Re-design of system
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Waiting lists down
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More throughput
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Innovation e.g. SHINE
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Reduction in hospital related admissions
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Priority for Bolton Community Strategy
Needs Assessment 2011/12
Aims and Objectives:
• What works well, and for whom in the current system and
unmet needs across the system
• Where there are gaps for drug users in the wider
reintegration and treatment system
• Where the system is failing to engage and/or retain people
• Hidden populations and their risk profiles
• Enablers and blocks to treatment and to reintegration
Needs Assessment 2011/12
The Needs Assessment reports on:
• Prevalence of Opiate / Crack User (OCUs) in Bolton.
• Prevalence of alcohol users in Bolton
• Numbers in treatment, retention in treatment and
treatment outcomes.
• The profile of the population in treatment.
• Areas of interest and gap analysis – exploring the
potential for treatment provision to be improved.
Needs Assessment 2011/12
Some examples of data sources used:
• Annual National Treatment Agency (NTA) data for Needs
Assessment
• Monthly & quarterly NTA reports
• Agency data – Monthly performance reports; population data
• PCT Health Survey data
• Local Alcohol Profiles for England
• Test On Arrest
• Previous Needs Assessments
• North West Public Health Observatory reports
• National guidance and strategy documents
Drugs – headline findings:
• OCU estimate down - 2,272 Opiate or Crack users
• Of these 1,180 (52%) are in effective treatment.
• Not known 417
• Treatment penetration continues on an upward trend and is again at
an all-time high
• For the period June 2010 to May 2011 we see 83% of OCUs and 76%
of all presentations are retained into effective treatment.
Harm Reduction:
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The proportion of the ‘in treatment’ population who inject has increased
dramatically (32% - 50%)
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Whilst HBV and HCV interventions are prominent, actual take up of these remain
low.
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The recommendation for enhanced provision from pharmacy needle exchanges
has been taken forward
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Specific interventions for amphetamine injectors was recommended – this is an
on-going priority
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Overdose prevention and basic life support training to staff, drug users and
significant others should be continued, including in prisons
Drugs – headline findings:
Amphetamines
• The number of new amphetamine users who presented to treatment services
in 2009/10 was 67 the number presenting in 2010/11 increased very slightly to
75
• The proportion of the139 amphetamine users in treatment who were injectors
in 2009/10 was 55% (n=77); the proportion of the 256 in treatment who were
injectors in 2010/11 increased significantly to 70% (n=180).
The worrying conclusion is that there is a significant increase in primary
amphetamine use, allied to a trend of injecting.
Types of Drug Use
Heroin
1,158
(1,248)
Crack
852
(885)
262
(339)
Fig. 1: Home Office estimates of the patterns of PDU drug use
(2010 data in brackets)
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Continuing trend toward combined opiate and crack use.
Bolton’s OCU population is ageing – implications include increasing risk of poor
health or death, and rising demands on medical and social services.
Increasing trend of poly drug use, both among recreational users (non-OCUs) and
OCUs, including alcohol – which may exacerbate risk factors such as long-term
health damage and risk of overdose.
OCU use being replaced by range of drugs.
No under 18yrs OCU presentations.
Treatment Outcomes:
Retention and Exits
• Retention of new clients in effective remains high – during
Q1-Q4 there was between 85 – 87% OCUs
• Care planned exits – improved in year but still an on-going
priority - 37% of all treatment exits were care planned in
Q4
Alcohol, findings:
• Estimated;
• 47,336 increasing risk drinkers
• 14,118 Higher risk drinkers
• 54,187 Binge drinkers
• The potential for alcohol problems therefore is focused on less than a third
of the Bolton population.
• Bolton reports lower than the North West average across a range of
indicators included alcohol attributable and alcohol specific hospital
admissions.
Alcohol, findings:
• The Single Point of Contact has created fast access to triage, BI and
intermediary interventions
• 630 alcohol misusers were in treatment
• 48% of all alcohol exits are planned and alcohol free or occasional users
Trends in alcohol use:
• Heaviest drinking areas are the more affluent ones
• Volumes and complexity very high
• Health impacts lower than expected
• Health impacts linked to deprivation
• Increase of drinking in the home
• Greater amounts being consumed in the home
Recovery:
Recovery is a process through which an individual achieves
sustained control over their substance use which maximises health
and well-being and participation in the rights, roles and
responsibilities of society.
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Unemployment - ETE provision is becoming increasingly important, the
Government’s focus on welfare reform, with the aim of getting people
off long-term benefits and back into work, will have a substantial impact
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Housing needs - 20% of new drug clients and 11% of new alcohol
clients in 2010/11 had housing problems or were of no fixed abode
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Reintegration – lifestyle / health & wellbeing
Hidden Harm:
The ACMD report ‘Hidden Harm’ (2003) focussed attention on the
impact of parental problem drug use on children, estimating that the
parents of 2-3% of under 16 year olds are opiate/crack users. In
addition, an Alcohol Concern publication estimated the numbers of
children affected by parental alcohol use
Bolton estimate
For children under 16 years old in Bolton this approximates to;
• 14,350 living with hazardous drinkers and 3,890 living with dependent
drinkers.
• Between 1074 and 1611 children living with opiate/crack users
• A substantial proportion of new treatment starts in Bolton are parents or
have children residing with them (51% for drugs and 60% for alcohol).
Dual Diagnosis:
Dual Diagnosis is the term used to describe concurrent mental
health and drug/alcohol problems.
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Only 16% of new drug presentations and 11% of new alcohol presentations are
reported as having a mental health issue.
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All evidence indicates that a high proportion of drug and alcohol treatment
clients in Bolton are likely to have concurrent mental health needs.
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There has been a concerted programme for raising of awareness about dual
diagnosis, and appropriate training for frontline staff in partner organisations
(such as Police, Probation, Jobcentre Plus) to enable full understanding of
pathways and protocols.
Over to you…….
• What does all this mean for you?
• What have we missed?
• Are there other priorities we should be considering?
• What are your priorities?
Challenges:
Drugs
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During the year 2010/11 in the North West 48% of all clients ‘completed
treatment’ where as in Bolton 38% did so;
Low but increasing numbers of inter agency transfers (201 this year,
last year 179);
Rising cost of substitute prescribing.
Alcohol
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The profile of drinkers presenting to treatment remain weighted towards
the heavier end;
Both the volume of alcohol consumed and the complexity of additional
problems of those presenting to treatment is much greater than the
national average;
The impact of drinking upon health; particularly those in the more
deprived communities.
Frequent Flyers
Frequent attenders to hospital with alcohol related illness which may or
may not result in an admission. This group of patients
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The Alcohol Learning Centre places Alcohol Frequent Flyers as one of
the ‘High Impact Changes’ when looking at a cost and benefit to
additional interventions.
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In Bolton the top 43 frequent flyers received a total of 290 episodes of
care costing nearly £650k in the last year.
Frequent flyers in Bolton
Substance Misuse: The future
• Changing profile of drug misuse
• Necessity to produce more for less – decreasing budgets
• Identification of opportunities to bring together drugs and alcohol
treatment systems
• Implementation of digital strategy
• Engagement and ‘buy-in’ from partners
• Information and advice for different drug groups
• Development and promotion of specific provision for identified
substance misuse groups
• Overdose Prevention Training
• Recovery Strategy