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Agenda item

Alcohol and Drug Abuse -Update


Emma Stubbs, Senior Commissioning Manager, Public Health, was present at the meeting and made a presentation to the Committee. (Copy interleaved) Service user and Peter Kane and Dr.Liz McGrath were also present representing Camden and Islington NHS Trust, the service provider.


During the presentation the following main points were made –


·         New estimates of the number of crack and/or opiate users (OCU’s) and alcohol in Local Authorities were published in 2017. These prevalence estimates give an indication of the number of people in a local area that are in need of specialist treatment, and the rate of unmet needs gives the proportion of those not currently in treatment

·         Cohort and estimated number – OCU’s 2168, Islington Unmet need 55.5% and national unmet need 51.7%. Opiate cohort and estimated number 1749, Islington unmet need 45%, and national unmet need 43%. Crack cohort and estimated number 1642, Islington unmet need 58%, national unmet need 62%. Alcohol cohort and estimated number 3674, Islington unmet need 76%, and national unmet need 78%

·         The Home Office estimated that in 2010/11 that the cost of illicit drug use in the UK is £10.7 billion per year. This figure includes 8% health service use, 10% enforcement, 28% deaths linked to eight illicit substances, and 54% drug related crime

·         Research has shown that for every £1 invested in drug treatment there is £2.50 benefit to society and of those people engaged in treatment in 2015/16 if they had not been in treatment it would have cost the NHS an additional £1billion

·         It is estimated that structured treatment prevented crimes in 2010/11, with an estimated saving to society worth £1billion in today’s prices, and further money was saved from former drug users sustaining their recovery

·         Impacts of substance abuse – Family history of addiction, socio-economic deprivation, homelessness, unemployment, poor working conditions and job insecurity, mental are more likely to use illegal drugs, poor mental health is linked to drug misuse and vice versa, and there are strong links between health inequalities and drug use, but the picture is complex

·         Better Lives update – the Better Lives new adult Islington drug and alcohol service started on 1 April 2018

·         Camden and Islington NHS Foundation Trust are the lead provider working in partnership with WDP and Blenheim

·         There were significant logistical challenges in the first 6 months of operation, and Camden and Islington have invested significant amounts of money into refurbishing buildings, in order to give service users, their families and staff comfortable and welcoming environments in which to transform their lives

·         As buildings have been refurbished, the services usually provided from these sites have had to be relocated elsewhere. This has caused some anxiety to service users, but through regular meetings, and by involving service users in planning, service users are now more aware of the reasons for the changes and are more comfortable with the plans

·         All eligible staff have been transferred over to the new providers, and the remaining key vacant posts, such as the Borough Service Manager, have been successfully appointed to. Better Lives held a successful team building day to welcome all staff to the new service, and to clearly set out a vision for the new service

·         There has been positive feedback from partners about the proactive and flexible engagement of staff from Better Lives which includes: working alongside community safety colleagues in the Stroud Green area, attendance at a range of community events over the summer, including most recently StreetFests in Finsbury Park, the provision of services at the Floating Hub, as part of the GLA funded No Second Night Out pilot, working with Children’s Services around the Keel Project (supporting families affected by DVA, mental health and substance misuse)

·         New areas of work – Better Lives are launching a pilot project based in GP practices to work with people who are being prescribed benzodianzepines and opoides, and who may be showing signs of dependence. The project will support people with a medication review, and work with those who would like to reduce their reliance on medication

·         In terms of borough performance, there has been a significant increase in the number of new service users entering treatment, compared to the same period last year: there has been an increase in the number of opiate users accessing treatment, and a 78% increase in the number accessing treatment for alcohol. New to treatment in Q1 2017/18 there were 78 opiate and 79 alcohol users, and in Quarter 1 2018/19, there were 111 opiate users and 141 alcohol users new to treatment, a significant increase

·         Further positive signs include – Zero clients re-presenting to the service in Q1, following the completion of treatment, indicative of successful maintenance of recovery. An increase of people in treatment referred via criminal justice routes (Police, Courts, Probation,CRC), 20.8%, compared with 18% last year – this was an area of the pathway where it has been wanted to see improved engagement and referral for some time. There has been more Naloxene provided to at risk/vulnerable residents in Q1 and Q2 this year, than the same period of last year (78 kits compared with 36 last year)

·         What is working well in relation to the family service – Referrals – during the first quarter of service delivery 2018/19 there has been a 167% increase in the number of referrals to the Better Lives Family service, (15 in Q1 2017/18, compared with 40 in the same quarter 2018/19. Also with regard to direct work with families, during the first quarter of service delivery 2018/19, 59 Islington families were being supported. During the same quarter 2017/18, 39 Islington families were provided with a service

·         Performance looked to be similar for quarter 2

·         In future the service would be looking to go into the community and family homes and for there to be safe areas for residents suffering from DV

·         In relation to the transfer of buildings it was noted that the service had various ways of communicating with users, such as leaflets, adverts in bus shelters and word of mouth, which was often the most effective means of communication and there had been no drop off in engagement

·         There had been more residents coming into treatment after referral since the service started

·         Members welcomed the improvement in the service since the new contract had started and service users felt the service was working more effectively

·         It was noted that work is also taking place with community safety colleagues and partners

·         It was stated that the service was developed with service users and the service would continue to evolve to meet local needs

·          A service user stated the most important improvement had been the contact with the key worker of clients

·         In terms of families, as it had been shown that intergenerational family clients were presenting, there would be more of a focus on prevention strategies and there is work going on with Children’s Services in this area

The Chair thanked Emma Stubbs, Dr.Liz McGrath, Peter Kane and the service user for attending

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