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Drugs & Alcohol

Introduction

The misuse of both drugs and alcohol is an issue in Reading. Currently the main concern is the increase in local misuse which is growing year on year.

In December 2015, a Drug and Alcohol Misuse Needs Assessment was written which quantifies the extent of misuse of alcohol and drugs in Reading; the effect this is likely to have on people and thus on health and social care and other services, and on prevention and early interventions and, the nature of current services and treatment demand for substance misuse; and what might be done to better meet identified needs.

Although this is a summary of the findings, a full copy of the drug and alcohol needs assessment can be accessed via the following link http://www.reading.gov.uk/media/4501/Item-15-Appendix/pdf/Item_15_Appendix.pdf

What do we know?

Alcohol misuse, mainly in the adult population, is a far greater problem than drug use in Reading, as elsewhere. Principally, this is because of the sheer number of people who drink alcohol in our society (a very large majority) and the increasing proportion who do so in ways that risk injuring their health. Based on current guidelines, we estimate that at least some 30,000 Reading residents are drinking to hazardous levels and 4,500 are drinking to harmful levels. As these figures are based on national self-reported drinking levels, research shows that people significantly under-report their drinking, we can infer that people's true drinking levels are even higher than this. It is noteworthy that Reading has high rates of alcohol-specific mortality and morbidity from chronic liver disease in both men and women.  These rates indicate a significant population who have been drinking heavily and persistently over the past 10-30 years. Liver disease is one of the major causes of mortality and morbidity increasing in England with deaths reaching record levels having risen by 20% in the last decade.

Whilst locally the numbers of drug-related admissions and drug-related deaths are proportionally smaller, what is clear is that drug misuse, particularly of opiates and crack cocaine, places an enormous strain on the families of drug users, including their children; can have a serious negative impact on the long-term health and well-being of family members; and that many drug misusers have a myriad of health and social problems which require interventions from a range of providers.

The most commonly used drugs, such as cannabis, opiates and crack cocaine, are illegal, uncontrolled novel psychoactive substances (also known as 'legal highs' and 'club drugs') are relatively easily available.

Drug and, especially, alcohol misuse is a significant cause of both violent crime and acquisitive crime. Whilst we know that acquisitive crime, mainly associated with drug use, is declining, violent crimes and assaults (including domestic abuse) are increasing and are a significant factor in personal and family problems, often placing children at risk.  

Many young people receiving interventions for substance misuse have a range of vulnerabilities that require specialist support and intervention. Those in treatment often report being victims of domestic violence; having contracted a sexually transmitted infection; experiencing sexual exploitation; being more likely not to be in education, employment or training; and being increasingly likely to be in contact with the youth justice systems. 

More needs to be done to encourage and enable front-line personnel in education, health and social care, and across other relevant sectors, to sustainably raise awareness of the risks of drug and alcohol misuse and how to avoid it.

Education, health and social care front-line personnel also need to be enabled and encouraged to do more to identify people at risk of misusing drugs and/or alcohol, to provide brief interventions, and to refer to appropriate services. It would be appropriate to extend this to other services too, which may come into contact with vulnerable adults and young people, such as housing and the police.

National & Local Strategies

Drug Strategy 2010 - Drug strategy 2010 - Publications - GOV.UK

What is this telling us?

Alcohol misuse is a much bigger issue in Reading than drug misuse: it affects far more people individually and has much wider societal impacts. Significant problems are related to both, but especially to alcohol misuse, and are getting bigger year-on-year in Reading, as elsewhere.

The lives of most drug users and of a sizeable group of alcohol misusers are complex and often chaotic. A multidisciplinary approach that truly joins up the various different services provided (for example, general practice, A&E, other hospital services, community services, specialist drug and alcohol services, social services and voluntary and community services) will enable benefit for them and their families and for society more generally.

What are the inequalities?

There is a need to develop services for people who use NSPs. Currently, there are only one or two specialist units in the country yet this is becoming an increasing problem. The scale of physical and mental health risk in using NSPs is not clear, and, for many, it may be that 'recreational use' of these substances, and cannabis, is no more an issue that the 'recreational use' of alcohol. However, it is important that, for 'recreational' users of both drugs (such as cannabis and NSPs) and alcohol, there are services available to help those at risk of dependency and significant harm.

Other inequalities highlighted in the Drug and Alcohol Needs Assessment are:

  • alcohol misuse - there are very many more people in Reading who could benefit from specialist treatment than are able to receive it under current arrangements; and
  • prevention - there are many people in Reading with either (or both) 'early' misuse of alcohol and drugs who could benefit from specialist intervention to help them avoid a decent into more damaging use of substances.
  • ensures that all health and social care services, and those of the police and judicial system, work together more effectively so that people do not fall into gaps between services and so that it is simple to provide care between different agencies without the service user having to try to negotiate their way from one to another;
  • provides services of all types in different locations to improve engagement and thus outcomes;
  • enables and encourages front-line staff in all sectors, to do much more to identify people at risk of misusing drugs and/or alcohol and to provide brief interventions, and refer to appropriate services; and
  • enables different policies and services and the enforcement of regulations, to take account of the cumulative impact of drug and alcohol misuse to enable greater benefit to people's health and to the community more widely.

Links to the other following section:

Liver Disease

Children & Adolescent Mental Health

Crime

References

Drug and Alcohol Needs Assessment - http://www.reading.gov.uk/media/4501/Item-15-Appendix/pdf/Item_15_Appendix.pdf

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