August 2015 - slides

Interesting things you may have missedAugust 2015Andrew Brown

Levels of Blood Borne Viruses amongst people who inject drugs in England, Wales and Northern Ireland

“The impact of public health interventions which aim to prevent HIV and hepatitis C infection through injecting drug use, such as needle and syringe programmes and opiate substitution therapy, has been shown to be dependent on their coverage. In addition to these interventions, increasing the treatment of hepatitis C infection in PWID should also reduce the transmission of hepatitis C among PWID.”Source: https://www.gov.uk/government/statistics/people-who-inject-drugs-hiv-and-viral-hepatitis-monitoring

Proportion of people who inject drugs in England, Wales and Northern Ireland who share needles

Direct sharing was found to vary across England, Wales and Northern Ireland, ranging from 12% (95% CI, 5.5%-22%) in the East of England to 23% (95% CI, 17%-30%) in the South West of England.

Source: https://www.gov.uk/government/statistics/people-who-inject-drugs-hiv-and-viral-hepatitis-monitoring

The number of needles/syringes (to the nearest 1,000) reported to have been distributed by injection equipment provider outlets in Scotland in 2013/14

4,475,000

Source: Hepatitis C in the UK 2015 report

UK public health recommendation

Commissioners of BBV prevention services for people who inject drugs need to sustain or expand, as appropriate, the current broad range of provision (including opioid substitution treatment and needle and syringe programmes) to minimise transmission of hepatitis C, including among people who inject new psychoactive substances or image and performance-enhancing drugs.

Plans announced in the budget to tackle illicit sales of tobacco and alcohol

Tackling illicit tobacco and alcohol: This package of measures receive a ‘high’ uncertainty rating. It provides HMRC with additional resource to tackle illicit tobacco and alcohol. The yields are based on how effective the additional resource will be at stopping illicit excise entering the UK market. The most uncertain part of the costing is the behavioural element. This includes both a displacement effect as criminals learn how to circumvent the rules and the response of individuals who will now be forced to buy higher priced duty paid goods.

Office for Budget ResponsibilitySource: https://www.gov.uk/government/publications/summer-budget-2015/summer-budget-2015 Source: http://budgetresponsibility.org.uk/economic-fiscal-outlook-july-2015/

Drug incidents recorded on public transport in London

Source: http://www.theyworkforyou.com/wrans/?id=2015-06-24.3976.h&s=

There has been a 65% fall in in the number of drug incidents recorded by Transport for London on public transport in the capital over the period 2008/9 to 2014/15

Suicide and self-harm incidents in prisons in England and Wales

52The number of self-inflicted deaths in prisons in England and Wales in the 12 months to March 2013. In the 12 months to March 2014 this had risen to:

88 Source: http://www.crimeandjustice.org.uk/publications/uk-justice-policy-review-volume-4

Crimes in England and Wales relating to (or estimated to be related to) drug use in 2013/14

Sources:https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/447083/2015_07_20_Police_funding_consultation_doc.pdfhttp://www.ons.gov.uk/ons/rel/crime-stats/crime-statistics/year-ending-september-2014/stb-crime-in-england-and-wales--year-ending-september-2014.html#tab-Summary

“we think it [heroin and crack use] currently accounts for some 45% of acquisitive crimes and over a third of fraud committed in England and Wales . Crime related to heroin/crack use is primarily driven by the offender’s need to fund their dependence and their immersion in a generally chaotic and criminal lifestyle.”

803,463 Theft offences

23,886 Robbery offences

63,810 Fraud offences

20,016 Drug trafficking offences

157,641 Drug possession offences

the approximate number of individuals received into a secure environment each year with a diagnosable drug or alcohol dependence

60,000

Source: Service specification No. 29: public health services for people in prison

The availability of drugs in prisons

“The positive random mandatory drug testing (MDT) rate remained below target in most prisons but continued to be a poor indicator of illicit drug use, as MDT did not detect NPS or most commonly abused medicines. Inadequate staffing meant that some prisons struggled to meet their random MDT requirements, and this year 59% of establishments did not consistently complete all requested suspicion MDTs in line with Prison Service requirements.”

Source: https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2015/07/HMIP-AR_2014-15_TSO_Final1.pdf

Substance use issues in adult prisons in England and Wales and their treatment

“Following the transfer of the commissioning of prison substance misuse services in England to NHS England we have seen considerable variation in psychosocial provision, but most services had an appropriate focus on recovery, and there was some impressive innovation.”

Source: https://www.justiceinspectorates.gov.uk/hmiprisons/wp-content/uploads/sites/4/2015/07/HMIP-AR_2014-15_TSO_Final1.pdf

Substance use by children and young people in the secure estate

Source: Service specification No. 29: public health services for people in prison

Frequent (once a month or more) drug use by students

A survey of 1,000 students about their drug use suggests that frequent use is more prevalent than is recorded by the Crime Survey for England and Wales where only 2.4% of students said they took drugs more than once a month. Source:

http://www.studentmoneysaver.co.uk/article/more-people-think-cannabis-should-be-legal-than-tobacco/

Alcohol use by Welsh adults

2 in 5 (40 per cent) adults reported drinking above the recommended guidelines on at least one day in the past week, including around a quarter (24 per cent) who reported binge drinking – however people do not necessarily drink at these levels regularly. Around half (52 per cent) of adults reported either not drinking, or drinking less than once a week.

Source: http://gov.wales/statistics-and-research/welsh-health-survey/?lang=en

Prescriptions for Substance Misuse (including alcohol, nicotine and opioid dependence)

2014

Items dispensed 5.2mNet ingredient cost £79.7m

Since 2013

Items dispensed ↓ -9.1% Cost (NIC) ↓ -17.3%

Since 2004

Items dispensed ↑ 22.0%Cost (NIC) ↑ 10.8%

Source: http://www.hscic.gov.uk/catalogue/PUB17644

When did young people in specialist services start using?

Source: http://www.addaction.org.uk/news.asp?itemid=3883&itemTitle=Young+People%27s+Health+Partnership+Briefing%3A+Substance+Misuse&section=80&sectionTitle=News&postComment=NO

Number of suicides by people who had been in touch with a mental health service in the previous 12 months, and with a known history of drug or alcohol misuse

Of those suicides in England where a patient had been in touch with mental health services in the previous 12 months over half (54%) had a history of drug and/or alcohol misuse. On average there were 671 deaths a year in this group.In Scotland 69% of mental health patient suicides, had a known history of drug and/or alcohol misuse, an average of 168 deaths per year.In Wales an average of 41 deaths per year were to patients, 57% of suicides in mental health patients.

Source: http://www.bbmh.manchester.ac.uk/cmhs/research/centreforsuicideprevention/nci/

Homicides in England

On average between 2003 and 2013 in England there were 49 homicides where the victim had a known history of drug and/or alcohol misuse per year. In Scotland there were a further 12 homicides per year and in Wales an average of 2 per year.

For England this was roughly one in every twelve homicides that took place during that period (49 out of 558 per year). For Scotland it was almost 14% (12 out of 88). In Wales it was 7.6% (2 out of 26).

Between 2003 and 2013 25 patients with a history of alcohol misuse and 19 patients with a history of drug misuse were convicted of committing a homicide.

Suicide by people in a community justice pathway

“During 2005, 1658 (36% of general population suicides) had a history of lifetime justice contact and 596 (13% of general population suicides) had been in an active, or recent community justice pathway in the 12 months preceding death.”Source: http://bjp.rcpsych.org/content/early/2015/06/22/bjp.bp.114.154831.full-text.pdf+html

Proportion suicides in England and Wales where there has been contact with the criminal justice system

36%

Odds ratios for suicide amongst people in England and Wales with experience of the Criminal Justice System by legal status at death

“Our results suggest the need for prioritising effective ways to assess suicidality among those who pass through the justice system. These contact and release periods present an opportunity to recognise, signpost and deliver interventions to vulnerable people at elevated risk of suicide.”

Source: http://bjp.rcpsych.org/content/early/2015/06/22/bjp.bp.114.154831.full-text.pdf+html

Proportion of people with mental health issues who are regular smokers in England

Source: www.natcen.ac.uk/media/21994/smoking-mental-health.pdf

Regulations to allow wider access to naloxone in England from 1 October 2015

Source: http://www.legislation.gov.uk/uksi/2015/1503/memorandum/contents

“These Regulations amend the Human Medicines Amendment Regulations 2012 (“the 2012 Regulations”). They do so in order to allow drug treatment services provided by or on behalf of NHS bodies and local authorities (LAs) to supply Naloxone Hydrochloride for administration in emergencies involving a heroin overdose.”

These Regulations will allow drug services to obtain stocks of Naloxone Hydrochloride and supply it to anyone requiring access for use in an emergency involving a heroin overdose. This will include drug users, their family members and carers. It will also include other people likely to come into contact with drug users such as hostel managers.

The expected impact on the public sector, charities or voluntary bodies will be an increase in the availability of naloxone and a reduction in fatal opioid overdoses. It is expected that the cost associated with this wider availability, e.g. training and storage, would be minimal.

Needs of people seen by Making Every Adult Matter (MEAM) North Tyneside in 2014-15

Data from MEAM indicates that nearly three-quarters of MEAM clients (n=23) were assessed as not engaging with services. This was supported in our interviews and there was a consensus that many MEAM clients have a history of weak engagement with services… Many MEAM clients were regarded as having ‘burned all their bridges’ and had limited accommodation options as they were regarded as ‘high risk’.

Change in risk scores of people engaged by MEAM North Tyneside in 2014-15

Overall, across all domains, the total average starting score for clients when accessing MEAM was 32, and the completed average risk-related score was 18.