interesting things about alcohol and other drugs - august 2016
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Interesting things about alcohol and other drugsAugust 2016ANDREW BROWN@ANDREWBROWN365
Monitoring of alcohol consumption in primary care among adults with bipolar disorder
Apr 2000 - March 2002
Apr 2002 - March 2004
Apr 2004 - March 2006
Apr 2007 - March 2009
Apr 2009 - March 20011
Apr 2011 - March 2013
0100200300400500600700800900
88.6168.3
244.7307.5
388
837.4People with bipolar disorder People without servere mental illness
Rate
of a
lcoh
ol r
ecor
ding
per
10
00 p
erso
n-ye
ars
The current high alcohol recording rates in people with bipolar disorder is very encouraging, especially given evidence that assessment of alcohol use alone (without subsequent intervention) can lead to reductions in hazardous drinking (Kypri et al., 2007, McCambridge and Day, 2008, McCambridge and Kypri, 2011). Nevertheless screening is just a first step in the management of AUDs in people with bipolar disorder. To fully address the high prevalence of AUDs in this population, appropriate effective interventions need to be delivered, where indicated by the screening. Further research is needed to determine the extent to which alcohol interventions are implemented in people with bipolar disorder.
SMI QOF in effect
Alcohol screening added in SMI QOF
Source: Monitoring of alcohol consumption in primary care among adults with bipolar disorder: A cross-sectional and retrospective cohort study, Hardoon, Sarah L. et al. Journal of Affective Disorders , Volume 198 , 83 - 87
Proportion of injecting drug users who are under 25 in Unlinked Anonymous Monitoring Survey
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150%
2%
4%
6%
8%
10%
12%
14%
16% 15%14%
15%
13% 13%
11%
9% 9%
6% 6%
4%
Source: People who inject drugs: HIV and viral hepatitis monitoring
Hepatitis C prevalence in people who inject drugs by age; England, Wales and Northern Ireland
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150%
10%
20%
30%
40%
50%
60%
70%Under 25 25 to 34 35 and over The prevalence of antibodies to the hepatitis
C virus (anti-HCV) among the survey participants across England, Wales and Northern Ireland was 50% (95% CI, 49%-52%) in 2015. This is significantly higher than the anti-HCV prevalence of 45% (95% CI, 44%-47%) seen in 2005, but similar to the prevalence in 2013 and 2014. However, the level seen during the last decade, though a little higher than at the end of the 1990s, is much lower than those found in the early 1990s when prevalence was over 60%. By country, anti-HCV prevalence in 2015 was as follows: Northern Ireland, 27% (95% CI, 21%-35%); Wales, 53% (95% CI, 47%-59%); and England, 52% (95% CI, 50%-54%).
Source: People who inject drugs: HIV and viral hepatitis monitoring
In 2009 a phased change in the sample type from oral fluid to dried blood spot (DBS) started. The sensitivity of the anti-HCV tests on these two sample types are different.
Levels of needle and syringe sharing and injection into the groin among the participants in the Unlinked Anonymous Monitoring Survey of PWID who had injected during the preceding four weeks
Londo
n
East o
f Eng
land
South
East
South
West
West Midla
nds
North W
est
Yorks
hire &
Humbe
r
East M
idland
s
North E
astWale
s
Northe
rn Ire
land
0%
10%
20%
30%
40%
50%
60%
15% 16%21% 22%
4%
15% 15%19% 16% 13%
17%24%
36% 37%42%
32%
46% 48%
29%
39% 40%46%
Direct Sharing Injecting into groin
Source: People who inject drugs: HIV and viral hepatitis monitoring
Together, these findings indicate that unsafe injecting continues to be a problem and that there is a need to maintain and strengthen public health interventions that aim to reduce injection related risk behaviours. The impact of public health interventions which aim to prevent HIV and hepatitis C infection through injecting drug use by reducing these risks, such as needle and syringe programmes and opiate substitution therapy, have been shown to be dependent on their coverage. The provision of interventions that aim to reduce infections among PWID should be regularly reviewed to ensure that the coverage of these is appropriate to local need.
Characteristics of people who inject drugs in 2015 in England, Wales and Northern Ireland
Ever b
een in
priso
n
Ever b
een h
omele
ss
Ever tr
aded
sex f
or mon
ey, go
ods o
r drug
s
Curren
tly in t
reatm
ent fo
r drug
use
Ever u
sed a
need
le exch
ange
0%20%40%60%80%
100%
67% 74%
13%
70%90%
Source: People who inject drugs: HIV and viral hepatitis monitoring
Number of attendances at A&E in England recorded as having social problems (including chronic alcoholism and homelessness)
2013-14 2014-1538,500
39,000
39,500
40,000
40,500
41,000
39,507
40,867Please note:
During the period covered (2013-14 and 2014-15) not all NHS trusts have provided data submissions to A&E HES and data quality can be poor for some fields.
Source: Accident and Emergency Attendances in England - 2014-15
% change in the number of offences recorded, by offence type, in England and Wales between year ending March 2015 and year ending March 2016
Violence
again
st the
perso
n
Theft
offen
ces
Posse
ssion
of wea
pons
offen
ces
-20.0%-10.0%
0.0%10.0%20.0%30.0%40.0%
27.5%20.6%
1.3% 0.3%7.2%
-13.1%
16.4%
28.3%21.0%
Source: Crime outcomes in England and Wales 2015 to 2016
Trafficki
ng of
drug
s
Posses
sion o
f drug
s0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
25,402
122,155
Number of drug of -fences recorded
Number and proportion of permanent and fixed term exclusions for drug or alcohol from secondary schools in England
2008 - 2009
2009 - 2010
2010 - 2011
2011 - 2012
2012 - 2013
2013 - 14
2014 - 15
200
250
300
350
400
450
500
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
360 370 290 330 360 410 480
6.30%7.30%
6.50%7.50%
9.20%10.30%10.00%
Permanent exclusionsTotal drug and alcohol related exclusionsPercentage of exclusions that were drug and alcohol related
2008 - 2009
2009 - 2010
2010 - 2011
2011 - 2012
2012 - 2013
2013 - 14
2014 - 15
6,000
6,500
7,000
7,500
8,000
8,500
9,000
0.00%
0.50%
1.00%1.50%
2.00%
2.50%
3.00%3.50%
4.00%
8,220 8,470 7,570 7,360 6,590 7,280 7,900
2.70%3.00% 2.80% 2.90% 3.10%
3.50% 3.30%
Fixed term exclusionsTotal drug and alcohol related exclusionsPercentage of exclusions that were drug and alcohol related
Source: Permanent and fixed-period exclusions in England: 2014 to 2015
Number of prescription items for the treatment of alcohol dependence dispensed in the community in England
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150
20,00040,00060,00080,000
100,000120,000140,000160,000180,000200,000
Prescribed in primary care Prescribed in NHS hospitals
Source: Statistics on Alcohol, England 2016 (HSCIC)
Prescription items for the treatment of alcohol dependence per 100,000 population by Commissioning Region
North of England Midlands and East of England
London South of England0
100
200
300
400
500
600549
289
194280
Pres
crip
tions
per
10
0,00
0
Source: Statistics on Alcohol, England 2016 (HSCIC)
Babies Born In England diagnosed with neonatal abstinence syndrome.
2012 2013 2014 20150
100200300400500600700800900
1000934 897 849
789
Neonatal abstinence syndrome (NAS) is a group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the mother’s womb.
[It] may occur when a pregnant woman takes drugs such as heroin, codeine, oxycodone (Oxycontin), methadone or buprenorphine.
These and other substances pass through the placenta that connects the baby to its mother in the womb. The baby becomes dependent on the drug along with the mother.
Source: Medline Plus
Source: BBC Analysis/Freedom Of Information Requests
Change in local government budgeting for substance misuse services
2015-16 2016-17 £-
£100,000,000 £200,000,000 £300,000,000 £400,000,000 £500,000,000 £600,000,000 £700,000,000 £800,000,000 £900,000,000
£1,000,000,000
£558,864,000 £408,451,000
£208,059,000
£183,296,000
£62,466,000 £56,534,000
£141,434,000
£104,983,000
£72,178,000 £38,835,000
Stop smoking services and interven-tions
Specialist drug and alcohol misuse services for children and young people
Preventing and reducing harm from alcohol misuse in adults
Preventing and reducing harm from drug misuse in adults
Treatment for alcohol misuse in adults
Treatment for drug misuse in adults
Source: Local authority revenue expenditure and financing (DCLG)
Offenders aged between 14 and 20 found guilty at all courts of drug offences, England and Wales
2011 2012 2013 2014 20150
2,0004,0006,0008,000
10,00012,00014,00016,000
13,719
11,74810,584
9,2078,395
Source: Ministry of Justice written question – answered on 5th July 2016
Proportion of cannabis used with tobacco by country
AustriaBelgium
FranceGermanyHungary
Republic of IrelandDenmarkPortugal
SpainNetherlandsSwitzerland
United KingdomBrazil
United StatesCanadaMexico
AustraliaNew Zealand
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%89%91%
88%87%89%
81%87%
90%86%88%
91%77%
7%4%
16%7%
52%21% “Our results are consistent with…
other previous research suggesting tobacco smoking is more problematic for those who also use cannabis, and we were also able to adjust for the frequency of cannabis and tobacco use. Our results suggest that tobacco routes of administration are associated with a reduced motivation to use less tobacco and more negative effects of cannabis, which may account for the poor tobacco-related cessation reported previously.”
Source: Hindocha C, Freeman TP, Ferris JA, Lynskey MT and Winstock AR (2016) No Smoke without Tobacco: A Global Overview of Cannabis and Tobacco Routes of Administration and Their Association with Intention to Quit. Front. Psychiatry 7:104. doi: 10.3389/fpsyt.2016.00104
Average treatment costs for those engaged by the liaison and diversion trial
Substance misuse Alcohol misuse Mental health £-
£200 £400 £600 £800
£1,000 £1,200 £1,400 £1,600 £1,800
£1,606 £1,505
£1,236
Source: Evaluation of the Offender Liaison and Diversion Trial Schemes
Level of need identified and numbers accepting and declining contact in offender liaison & diversion trial
Gang involvementSocial and communication difficulty
Learning disabilityFinancial
Abuse victimPhysical disability
AccomodationSuicide / self-harmSubstance misuse
AlcoholMental health
02,0
004,0
006,0
008,0
0010
,000
12,00
0
Accepted Declined Among those with a mental health need identified the most prevalent mental health category was depressive illness (34%), with schizophrenia or other delusional disorder being the second most prevalent (22%). There was the option of identifying and recording more than one mental health need. The majority of cases (77%) were identified as having only one mental health need, 20 per cent were identified as having two different needs, while three per cent were identified with three.
Source: Evaluation of the Offender Liaison and Diversion Trial Schemes
Prisoners saying that they had a problem with drugs or alcohol on arrival in prison
Alcohol Drugs0%5%
10%15%20%25%30%35%40%45%
30%
41%
16%
25%
Women Men
Source: HM Chief Inspector of Prisons for England and Wales Annual Report 2015–16
It is easy/very easy to get drugs/alcohol in this prison
Alcohol Drugs0%5%
10%15%20%25%30%35%40%
Women Men
Source: HM Chief Inspector of Prisons for England and Wales Annual Report 2015–16
Local prisons
Category B training prisons
Category C training prisons
Young adult prisons
Open prisons
0% 20% 40% 60%
36%
31%
42%
31%
34%
Drugs