Agenda item

This paper is to give an update on the outcomes of young people’s and adult’s drug and alcohol treatment, including a young people’s update.

The Drug and Alcohol Team and Young People’s Drug and Alcohol Commissioner gave a presentation to the Select Committee, a summary is set out below.

Drug Misuse

Parental drug use is a risk factor in 29% of all Serious Case Reviews.

A typical heroin user spends around £1,400 per month (2.5 times the average mortgage).

Alcohol Misuse

27% of serious case reviews mention alcohol misuse.

Alcohol misuse accounts for 17% of road fatalities.

B&NES Adults in treatment

More than 70% of adults in treatment in B&NES are complex & have multiple needs.

Growth in Alcohol Clients

Between 2012-13 and 2014-15 the number of clients in treatment to address alcohol misuse rose from 388 to 647 and the providers are working very flexibly to meet capacity.

It is estimated that there 200 are ‘Blue Light’ clients in B&NES costing the community more than £7 million per annum (Source Alcohol Concern). Agencies have been trained and provided information and practical tips on working with these clients.

Alcohol Concern is extending the project to support the families of ‘Blue Light’ clients and B&NES have again confirmed their desire to be part of this.

Recovery outcomes for B&NES alcohol clients

The rate of successful completions for B&NES alcohol clients is consistently high at between 46% – 50%.  This is considerably above the national average.

56% of parent’s successfully complete alcohol treatment. B&NES investment in local services has attracted a good deal of worthy commendation for its hospital alcohol liaison service, and for alcohol recovery outcomes. PHE recognises that alcohol has been a strategic priority for some time and an effective drug and alcohol treatment service is an essential component underpinning this wider treatment system.

Opiate / Non Opiate recovery rates

Supporting opiate users to overcome dependence is challenging, in B&NES currently 6.4% of opiate clients have successfully left treatment (who have not relapsed) compared to national performance of 7%.

Over 70% of adults in treatment have either ‘high’ or ‘very high’ complexity (e.g. poly drug and injecting use). There are good outcomes for other drug users in B&NES where approximately 40% successfully leave treatment (and do not relapse).

Harm Reduction

The rates for Hepatitis B vaccination and Hepatitis C testing remain much higher than the national average (B&NES is amongst the top performing areas with approximately 94% of eligible clients tested for Hepatitis C compared to 80% nationally and over 60% of B&NES clients have completed a course of Hepatitis B immunisations compared to 30% nationally.)

A needle and syringe exchange programme (NSP) continues to be delivered from treatment centres in Bath and Midsomer Norton, and pharmacies throughout B&NES to reduce the risk of blood borne viruses; reduce drug litter; and deliver harm reduction advice to service users on over-dose prevention, safer sex and reducing risk-taking behaviour. 

During 2015/16 the providers changed how they deliver NSP to the most vulnerable or hard to reach clients (complex opiate users and steroid users) working with pharmacists and gyms to raise awareness with all injecting drug users of the harm caused by injecting drugs. 

Young People’s Needs Assessment and Performance

An increase in the complexity of issues faced by young people (e.g. mental health, parental substance misuse, crime etc).

Increase in cases of children at risk of sexual exploitation (a project has been established to identify and respond to presenting needs).

The needs assessment found that 34% of adults in treatment are parents who have their children living with them at least part of the time. A key aim is to prioritise support for families, and to reduce the risk to children within the home.

Performance continues to be excellent with 97% of young people successfully completing their specialist support – compared to 80% nationally (with low re-presentations, 2% locally compared to 7% nationally)

Children & Young People Health & Wellbeing Survey 2015

The Health Related Behaviour Survey (SHEU) was undertaken in primary schools and 12 secondary schools with 3048 pupils from year 8 and 10 taking part. There is a positive downward trend, for example:

The numbers who drank alcohol in the last week: 15% of boys in 2015 compared to 24% of boys in 2013 and 12% of girls compared to 21% of girls in 2013.

The numbers who smoked cigarettes at least sometimes: 12% of boys in 2015 compared to 21% of boys in 2013 and 8% of girls compared to 11% of girls in 2013.

Re-Model

Fully integrated recovery treatment system

There will be a greater focus on community based treatment and the dry house for detox/community rehabilitation alongside a reduction in out of area rehabilitation and detoxification.

The detox suites and dry house rehabilitation beds are a cost effective alternative to hospital or in-patient detoxification programmes costing less than £150 per week to detox/recuperate in the dry house compared with £1,000-£1,500 per week in an out-of-area in-patient detox; or £700-/£1,000 per week in an out-of-area rehabilitation facility.

DHI submitted an application for funding via the Government’s PHE capital programme, and have been successful in obtaining £750,000 towards the purchase of the dry house to secure the future of this service, based on the outcomes and cost effectiveness of the service. 

Councillor Tim Ball commented that high percentage alcoholic drinks were more readily available these days and suggested that these should be subject to a higher tax rate.

Councillor Lin Patterson asked is 1-2-1 counselling available.

The Drug and Alcohol Team and Young People’s Drug and Alcohol Commissioner replied that it was available and the number of sessions would be agreed through a client’s Care Plan.

Councillor Eleanor Jackson commented that during a recent clean up exercise in Radstock a great number of legal / non-legal highs and syringes were found. She wondered how many people actually use the current needle exchange service and suggested it could be incorporated into local pharmacies.

The Drug and Alcohol Team and Young People’s Drug and Alcohol Commissioner replied that some pharmacies do already carry the service.

Councillor Vic Pritchard said that we should not lose sight of how far we have come with the services that we provide and praised the positive theme of the report.

The Select Committee RESOLVED to note the:

(i)  Current Drug and Alcohol performance figures.

(ii)  Progress being made by providers on implementing service re-modelling.

(iii)  Young People’s Needs Assessment had been undertaken to review current performance of young people’s drug and alcohol services and to identify key priorities as part of the Early Help Strategy.