Transcript Document

Adult Drug Misuse
Kerry Anderson – Modernisation Manager, Public Health
18/07/2015
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Overview
• National & local drivers
• Local needs – demographics – prevalence
• Considerations/complexities
• Why the investment?
• Treatment model
• Challenges/issues
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National & Local Drivers
Drug Strategy 2010
Outcomes expected from drug treatment:
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Freedom from dependence on drugs or alcohol
Prevention of drug-related deaths and blood borne viruses
A reduction in crime and re-offending
Sustained employment
The ability to access and sustain suitable accommodation
Improvement in mental and physical health and wellbeing
Improved relationships with family members, partners and friends
The capacity to be an effective and caring parent
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National & Local Drivers
PH Outcomes Framework Indicator 2:15
“Number of drug users that left drug treatment successfully (free of drugs
of dependence) who then do not re-present to treatment again within 6
months as a proportion to the total numbers in treatment”
(Performance linked to PH Grant)
Joint Health & Wellbeing Strategy 2012-2018
“Improve our drug treatment system to increase the number of people
who move out drug free”
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Drug Treatment Profile
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1364 adults in drug treatment
1128 are Opiate users
236 are non opiate users
1277 adults in effective treatment
1072 opiate (-3%)
205 non opiate (-12.4%)
Male - 73% Female - 27%
2% BME
17 ex armed services
78% of those that have injected have been tested for Hep C
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Drug Treatment – Demographics - AGE
Age of service users in treatment (age at mid-year) annual comparison
2008/09
2009/10
35%
2010/11
2011/12
30%
2012/13
Q2 13/14
25%
20%
15%
10%
5%
0%
Under 20 20 – 24
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25 – 29
30 – 34
35 – 39
40 – 44
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50 – 54
55 – 59
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60 – 64
65+
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Drug Types – Primary Substance
Primary Substances
1000
Q2 2011
900
Q2 2012
800
Q2 2013
700
600
500
400
300
200
100
0
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Drug Types – Secondary Substance
Secondary Substances
200
Q2 2011
180
Q2 2012
160
Q2 2013
140
120
100
80
60
40
20
0
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New Treatment Journeys – Oct 2012 to Sept 2013
• In Sept 2013, we had 409 new treatment journeys in
previous 12 months (up 3.2% from 2012/13).
• 52 of these completed treatment successfully within 12
weeks
• 20% of these were currently injecting on treatment entry
• 26% had injected previously
• 26 (11%) had a dual diagnosis.
• 39 (16%) had some housing problems
• 69% of clients were unemployed at the start of treatment
(down from 83% 2012/13)
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RECOVERY COMMUNITY
(DRUG & TREATMENT FREE)
Rehab
Prison
PHARMACOLOGICAL
PSYCHO-SOCIAL
INTERVENTIONS
Disengage
Assessment of Need / Recovery Planning
Assertive Outreach (where needed)
Criminal
18/07/2015 Justice
Harm
Self
Presentation nameReduction
Other E.g.
10Rehab
RECOVERY SUPPORT
AFTERCARE
Drug Treatment Profile - complexities
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Dual diagnosis – 58 diagnosed with drug and MH issues
554 living with children of which 505 are opiate users
4 out of 59 new female presentations (YTD) pregnant
65% are poly drug users
351 offenders via CJ (25%)
80% entering treatment unemployed - 33% on JSA
40% completing treatment working
In treatment more than 4 years - 51.6% opiate users, 2.4%
non opiate
• Average time in treatment opiate users 5.1 years; Non opiate
0.6 years
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Drug Treatment - Complexity
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Performance against PHOF
Opiate clients
Baseline
2010
Latest
Local (%)
3.9%
5.1%
Completed and did
not re-present (n)
47/1213
57/1125
England (%)
6.6%
8.1%
40.1%
42.0%
Completed and did
not re-present (n)
79/197
105/250
England (%)
37.5%
40.1%
Non-opiate clients Local (%)
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Performance – re-presentations
Opiate clients
Baseline
period
Latest
period
Local (%)
13.2%
16.7%
Clients representing/total
completions (n)
5/38
4/24
8.2%
2.0%
5/61
1/50
Non-opiate clients Local (%)
Clients representing/total
completions (n)
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Invest in drug treatment – Why?
• Addiction goes hand in hand with poor health, homelessness, family
breakdown, offending
• Parental substance misuse - safeguarding
• Level of Heroin use in Stockton is higher than Blackburn, Coventry,
Southampton, Sunderland & Wolverhampton
• Average addict not in treatment commits crime costing average £26,074
per year
• Drug misuse causes premature death and disease – Hep B & C; HIV
• Drug treatment improves health and reduces drug related deaths – low
rates of HIV and Hep C in injectors compared to other European countries
• Treatment is cost effective and brings major health savings (NICE)
• Improves other outcomes – reduces reoffending, prevents emergency
admissions, improves wellbeing, cuts homelessness, safer communities
• Every £1 spent on drug treatment saves £2.50 costs to society
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Investment Locally
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PH Grant adult drugs recurrent = £3,746m
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PCC = £170k from previous DIP grant of £593k
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Commissioned drug treatment service provision £1.9m –
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Birchtree Practice
CRI Recovery Service
GP enhanced services
Specialist Family & Carer Support Service
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Recent procurement of services for drug misuse made cost savings of
£177,737 per annum
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Challenges/Issues
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Maintain a recovery oriented focus – “Medications in Recovery”
Poly drug use and increased alcohol use
NDTMS Core Data Set J
Early identification and early intervention
Identification of treatment naïve
Future of arrest referral
Future of IOM
Development of enhanced GP services for drug misuse
Addressing wider health and social care issues – access to GP, sexual
health, contraception, safeguarding of children, family focus
Emerging drug trends – prescription meds
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