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Interesting things about alcohol and other drugs - August 2017

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One in a regular series of slide sets on interesting data about alcohol and other drugs (and the wider issues to do with multiple needs) from a UK perspective.

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Interesting things about alcohol and other drugs - August 2017

  1. 1. Interesting things about alcohol and other drugs August 2017 Andrew Brown @andrewbrown365
  2. 2. Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure) 10,730 12,620 14,430 16,340 17,960 19,800 21,590 22,030 22,970 22,900 24,270 25,040 26,810 1,270 1,290 1,390 1,400 1,210 1,220 1,230 1,130 1,220 1,230 1,100 1,210 1,300 0 5,000 10,000 15,000 20,000 25,000 30,000 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 Withdrawal state Withdrawal state with delirium Source: Alcohol-related hospital admissions – Statistical tables for England (PHE, 2017)
  3. 3. Suspected or definite risk factors and needs in families engaged in the Hertfordshire Family Safeguarding Partnership 15% 23% 26% 36% 38% 38% 44% 46% 49% 53% 69% 0% 10% 20% 30% 40% 50% 60% 70% 80% Parental learning difficulties Personality disorder Alcohol misuse Other mental illness Illegal drug use Social isolation Housing problems Financial problems Wider family relationship problems Domestic violence Depression or anxiety in parents Identified by social workers assessment 9% 9% 18% 19% 20% 26% 41% 0% 10% 20% 30% 40% 50% Drug or alcohol problems Child’s school attendance Arguments or fights Social isolation Reported a mental health diagnosis Child’s behaviour or wellbeing Elevated levels of stress and anxiety Identified in parental interviews
  4. 4. Change in life scaling since referral for parents in the Hertfordshire Family Safeguarding Partnership 3.4 3.75 3.32 3.32 7 3.6 5.56 6.25 0 1 2 3 4 5 6 7 8 Is Mental Health Practitioner working with family? Is Domestic Abuse Officer (perpetrator) working with family? Is Domestic Abuse Practitioner (victim) working with family? Is (Substance Misuse) Recovery Worker working with family? No Yes Source: Family Safeguarding Hertfordshire Evaluation Report (DfE,2017) “Life ratings are generally lower for those families where an adult worker is allocated at the point of referral, indicating that they are working with families with more substantial problems. On average, at referral, their life rating was between 0.5 and 0.8 lower. “There was some variation in impact on life rating between different adult workers. In particular, where one was working with the perpetrator of domestic abuse, the participant, who was usually the victim, did not note any positive effect on family life. “For 3 of the 4 adult worker roles, there were very large positive differences where an adult worker was involved.The positive shift was almost twice as high where an adult worker was involved for mental health, substance misuse or with a victim of domestic abuse.”
  5. 5. Changes in local authority reported budgets for substance misuse services (£ thousands) £408,451 £183,296 £72,178 £38,835 £56,534 £386,173 £178,412 £66,003 £37,201 £48,205 £- £50,000 £100,000 £150,000 £200,000 £250,000 £300,000 £350,000 £400,000 £450,000 Treatment for drug misuse in adults Treatment for alcohol misuse in adults Preventing and reducing harm from drug misuse in adults Preventing and reducing harm from alcohol misuse in adults Specialist drug and alcohol misuse services for children and young people 2016-17 2017-18 Source: Local authority revenue expenditure and financing (DCLG)
  6. 6. Estimated central government spend (£ million) on the Drug Strategy 2010, early intervention activity group, England, 2010/11 to 2014/15 £269 £254 £253 £221 £215 £0 £50 £100 £150 £200 £250 £300 2010-11 2011-12 2012-13 2013-14 2014-15 £million “Updated estimates suggest that central government spend on early intervention activity under the Drug Strategy 2010 may have fallen from around £269 million in 2010/11 to around £215 million in 2014/15.These estimates are necessarily based on large assumptions and must be interpreted with caution. It is not possible to ascertain whether this fall in spend since 2010/11 is due to disinvestment in early intervention activity, or other factors, for example changes in third sector provision or how local areas allocate funding.” Source: An evaluation of the Government’s Drug Strategy 2010 (Home Office, 2017)
  7. 7. Central government spend (£ thousand) on media and information activity under the Drug Strategy 2010, 2010/11 to 2014/15 £23 £1,392 £1,520 £146 £166 £0 £200 £400 £600 £800 £1,000 £1,200 £1,400 £1,600 2010-11 2011-12 2012-13 2013-14 2014-15 £thousand There has been substantial variation in central government spend on drug-related media and information across the Drug Strategy 2010, with around £23,000 spent in 2010/11 and £1.5 million in 2012/13 (Table 4.1). Estimates are based on actual central government spend and have been rounded. This variation is due to marketing activity for FRANK undertaken in addition to routine web-based activity. This only took place in two years of the strategy: in 2011/12, £1.2 million was spent and a further £1.5 million was spent in 2012/13. Source: An evaluation of the Government’s Drug Strategy 2010 (Home Office, 2017)
  8. 8. Estimates of central government spend (£ million) on adult drug misuse services, England, 2010/11 to 2014/15 108 118 109 £479 £484 £489 £426 £433 £599 £605 £611 £532 £541 0 100 200 300 400 500 600 700 2010-11 2011-12 2012-13 2013-14 2014-15 £million Substance misuse treatment in prisons Spend on structured treatment Total spend on adult drug misuse services The central government spend on adult drug treatment was £541 million in 2014/15, of which £433 million was spent on structured treatment. A further £25 million was spent on substance misuse (including alcohol) services for those under 18. In 2013/14 £109 million was spent on treatment in prisons. But while spend on adult drug treatment (excluding prisons) remained stable for the first three years of the strategy, there are signs that spend may have fallen in 2013/14. Source: An evaluation of the Government’s Drug Strategy 2010 (Home Office, 2017)
  9. 9. Estimated benefits (£ million) from spend on non-prison structured drug treatment for adults, 2010/11 to 2014/15 £1,197 £1,179 £1,221 £1,065 £1,083 £0 £200 £400 £600 £800 £1,000 £1,200 £1,400 2010-11 2011-12 2012-13 2013-14 2014-15 £million At a system level DTORS estimated that for every £1 spent on structured drug treatment £2.50 was saved to society.This leads to an estimated £1.1 billion in benefits from structured treatment spend in 2014/15, meaning the benefits from structured treatment alone were greater than the total spend on the entire treatment system that year. As there is good evidence for the effectiveness and cost-effectiveness of the specific interventions within non-structured treatment, it is possible that the total benefits of the treatment system will be even higher.This suggests that the treatment system is providing good value for money, as well as considerable benefits to individuals and wider society. Source: An evaluation of the Government’s Drug Strategy 2010 (Home Office, 2017)
  10. 10. Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds 22% 34% 43% 52% 57% 16% 11% 9% 42% 51% 47% 41% 55% 10% 8% 3% 0% 10% 20% 30% 40% 50% 60% Excessive alcohol use Illicit drug use Academic pressures overall Previous self- harm Suicidal ideas Family history of mental illness Family history of substance misuse Witness to domestic violence Under 20 (n=285) 20-24 (n=106) Source: Suicide by Children and Young People (NCISH, 2017)
  11. 11. Support needs of longer term homelessness service users in Liverpool City Region 27% 68% 37% 68% 16% 37% 25% 6% 0% 10% 20% 30% 40% 50% 60% 70% 80% Disability Current mental health problem Assessed by psychiatrist in the past Criminal conviction Current probation order Currently using drugs Sleeping rough prior to assessment In custody prior to assessment Blood, I., Copeman, I., Goldup, M., Pleace, N., Bretherton, J. & Dulson, S. (2017) Housing First Feasibility Study for the Liverpool City Region, London: Crisis.
  12. 12. Estimated demand for Housing First in Liverpool 2018- 2028 310 346 410 468 519 543 555 554 538 514 480 0 100 200 300 400 500 600 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 Initially the numbers required reflects the significant backlog of need. Over time this dissipates as the numbers of the initial clients decreases, and after the seventh year of the programme the number of units required begins to reduce. However, this projection is dependent on the rest of the system – the prevention activities and the housing-led offer to those who do not need the more intensive Housing First support. If these are not functioning well, the demand for Housing First would increase. Blood, I., Copeman, I., Goldup, M., Pleace, N., Bretherton, J. & Dulson, S. (2017) Housing First Feasibility Study for the Liverpool City Region, London: Crisis.
  13. 13. Views of 16-24 year olds on aspects of government drug policy. -80 -60 -40 -20 0 20 40 60 80 100 Overall effectiveness of government’s current policies on illegal drugs More or less focus on treatment and rehabilitation in govt policy Feel about more services for testing the contents of drugs at certain venues NegativePositive Source: YouGov / VICE Survey Results (YouGov, 2017)
  14. 14. Categories of underlying cause of deaths amongst a group of heavy drinkers in Edinburgh and Glasgow 0 10 20 30 40 50 60 Liver Respiratory/ Cardiovascular Disease Neoplasia (exc liver) External Alcohol abuse plus other causes Other/ unknown/pending Edinburgh Glasgow The percentage of the original sample (n=639) of heavy drinkers who died during the time period of the study (Dec 2012- Feb2015) was 16.4% (N=105) with a gender ratio of 3.0:1.0, male: female. (In the original sample the ratio was 2.5:1.0). The mean age at death was 51.1 years. At initial recruitment interview just under one quarter of these drinkers self-reported illicit drug use, 62% smoking and 55% as having a mental health condition. While the mean age at death of the women was lower than that of men, this difference was not significant. Overall Glasgow participants differed from their Edinburgh counterparts in being younger at time of death and having more self-reported drug use. Source: Mortality among a cohort of heavy drinkers in Edinburgh & Glasgow (SHAAP, 2017)
  15. 15. Trends in police recorded possession and trafficking of cannabis and other drugs in Durham 553 609 607 772 699 550 652 688 590 490 0 100 200 300 400 500 600 700 800 900 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Cannabis - possession Other drugs - possession Drug trafficking Cannabis UsersWon’t Be A Priority For County Durham Police, Commissioner Says A police force will not prioritise people who grow small amounts of cannabis for themselves, in a move drugs reform campaigners hope will trigger “a much needed debate” about criminalising “countless young people” for possession. Officers in County Durham are far more likely to simply destroy the plants and seek to place their owner in recovery than prosecute them or take them through the courts, according to the elected official in charge of the force. Huffington Post UK - 23 July 2015 Source: Police recorded crime and outcomes open data tables (Home Office, 2017)
  16. 16. Trends in police recorded possession and trafficking of cannabis and other drugs in Cumbria 675 631 834 945 984 810 792 771 552 400559 539 491 550 550 465 430 380 330 338329 363 349 304 276 254 295 235 188 139 0 200 400 600 800 1000 1200 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 Cannabis Other drugs Trafficking As Durham police relaxes cannabis stance, is YOUR local force doing same? We asked them all Cumbria In the first instance of simple possession of cannabis we would adopt the ACPO national guidelines relating to the need to arrest/prosecute. Subject to a number of factors this may lead to an official warning. "We do prosecute persons not eligible for the official warning. We take formal action over the production and cultivation of cannabis.“ The Mirror - 24 JUL 2015 Source: Police recorded crime and outcomes open data tables (Home Office, 2017)
  17. 17. Proportion of patients with a serious mental illness with an alcohol consumption check, by CCG 0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00 80.00 90.00 100.00 Source: Mental health conditions packs (NHSE, 2017)
  18. 18. Would you tell a close friend that they drink too much? 0 10 20 30 40 50 60 70 80 18-24 25-49 50-64 65+ I would tell my friend I would not tell my friend Source: YouGov Survey (2017)
  19. 19. Prisoner survey responses on drugs, alcohol, medicines and mental health 65% 31% 7% 76% 42% 47% 23% 53% 0% 10% 20% 30% 40% 50% 60% 70% 80% Do you feel you have any emotional well being/mental health issues? Is it easy/very easy to get illegal drugs in this prison? Is it easy/very easy to get alcohol in this prison? Are you currently taking medication? Women Men “The proportion of new [male adult] prisoners with a drug and/or alcohol problem remained very high, most noticeably among those reporting a mental health problem.” “Our survey showed an increase in the proportion of women arriving in prison with drug and/ or alcohol problems.” Source: HM Chief Inspector of Prisons for England and Wales Annual Report 2016–17
  20. 20. Responses by adult male prisoners in England and Wales about drugs and alcohol, by ethnicity 21% 12% 40% 20% 9% 6% 32% 21% 49% 24% 13% 9% 0% 10% 20% 30% 40% 50% 60% Did you have a problem with drugs when you came into this prison? Did you have a problem with alcohol when you came into this prison? Is it easy/very easy to get illegal drugs in this prison? Is it easy/very easy to get alcohol in this prison? Have you developed a problem with drugs since you have been in this prison? Have you developed a problem with diverted medication since you have been in this prison? BAME prisoners White prisoners Source: HM Chief Inspector of Prisons for England and Wales Annual Report 2016–17 “During the course of the past year I have seen many prisons and other institutions operating under extreme pressure.The challenges thrown up by the prevalence of illegal drugs and other contraband, increasing violence, too many prisoners suffering from mental health issues, an ageing prison population and a prison estate that in many places is not fit for any purpose, let alone the decent detention of human beings, are stretching hard-working and well-intentioned staff to their limits. Reform is overdue.”
  21. 21. AUDIT-C scores for the UK armed forces: 1 June 2016 to 31 May 2017 7% 30% 59% 2% 4% 28% 64% 3% 8% 31% 56% 3%4% 32% 61% 1% 0% 10% 20% 30% 40% 50% 60% 70% 0 1-4 5-9 10-12 Tri Service Navy Army RAF • 37% (n = 40,440) of personnel who completed theAUDIT-C scored less than 5, indicating that they were potentially at lower risk of alcohol related harm and 7% (n = 7,142) of this group were non- drinkers. • 61% (n = 66,958) of personnel who completed theAUDIT-C scored 5+ indicating that they may potentially be at increasing risk or above of alcohol related harm. • 2% (n = 2,502) of personnel who completed theAUDIT-C scored 10-12 indicating that they may potentially be at increasing or higher risk and should be advised to see their GP. n = 109,459, 74% of all Service personnel Source: Alcohol Usage in the UK Armed Forces 1 June 2016 – 31 May 2017 (MoD, 2017)

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