Working Well - Safety
Dependency on addictive substances can cause significant harm to individuals and communities. Addictive behaviours are responsible for not only harm to substance users but also is a major factor in the increased demand for children’s social care due to parental substance misuse.
Consuming alcohol s associated with a number of health conditions including liver, psychiatric, neurological and cardiovascular conditions. The social impacts of alcohol consumption include domestic violence, homelessness and relationship breakdown.
It is estimated that around 1 in 10 adults (16-59 years) nationally have used an illicit drug in the last year. The more problematic drugs (such as heroin or crack cocaine) have an estimated 301,000 users nationally.
Smoking causes significant harms to health and it is the leading cause of preventable death in the North East. The annual cost of smoking in the North East is estimated to be around £127.5m and costs local authorities at least £46.5m in social care costs (Fresh 2019).
The Public Health Outcomes Framework (PHOF), a suite of measures designed to full at the full range of public health, looks at substance misuse in four measures.
The first of these measures is PHOF 2.14 – Smoking prevalence in adults. Here Hartlepool has a smoking prevalence of 18.6%. This is the 19th highest level in England and the 3rd highest in the north east.
Hartlepool’s rate has been declining for six consecutive years, which mirrors the national trend of gradual decline over this period, but still remains at a level statistically inferior to the England average.
PHOF 2.15 looks at successful completion of treatment, split across opiate, non-opiate and alcohol treatment.
For opiate treatment, Hartlepool has a successful completion rate of 6.3%.
This is a level statistically similar to the England average, but lower than the north east average. Hartlepool’s rate is on a three year trend of statistical similarity with England, after spending three years statistically inferior to the England average. The gap between Hartlepool and the England average is the smallest it has been in the eight year reporting period.
For non-opiate treatment, Hartlepool has a successful completion rate of 22.7%
This is significantly below the England average and continues a four year trend of Hartlepool being significantly below the England average.
For alcohol treatment Hartlepool has a rate of 24.0%.
Hartlepool’s figures are significantly worse than the England average, and also substantially lower than the preceding year. Hartlepool had been on a increasing trend, with statistical similarity to England in 2016, before a decline of 12.5% in 23017.this puts Hartlepool below both its 2016 and 2015 successful completion levels for alcohol treatment.
Representation levels for those who successfully completed treatment show that Hartlepool is on an improving trend for non-opiate and alcohol treatment, but a worsening trend for opiate treatment.
For PHOF 2.15iv – Deaths from drug misuse, Hartlepool has seen a dramatic rise over the last three years.
Hartlepool’s 2015/17 rate of 14.6 per 100,000 population is an almost 200% increase on the 2012/14 rate. Hartlepool’s 2015/17 rate is the 2nd largest in England.
Within treatment the level of early unplanned exits, non-successful exits from treatment before 12 weeks of treatment have been completed, is above the national average for all four treatment groups.
Hartlepool is losing more people before 12 weeks, which is the point at which treatment is deemed to be effective, than the national average. For opiate treatment Hartlepool’s rate of early unplanned exits is nearly twice the national average.
Hartlepool’s level of unmet treatment need within substance misuse is better than the national average.
Hartlepool has a smaller level of unmet need across all four of the substance groups measured, however for both crack and alcohol more than half of those who have a need for treatment are not currently receiving any treatment.
The proportion of the substance misuse population living with children has shown differing patterns depending on the substance group of the clients. For opiate users the proporion living with children has declined over the five year reporting period by more than 50%. Of the four substance categories, only non-opiates has increased its proportion of users living with children, it is also the only substance category where Hartlepool's rate is above the England average.
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Hartlepool currently offers a range of services to adults who are aged 18 years and over, who are concerned about their own or someone else’s drug taking and drinking behaviour. This includes legal and illegal drugs, novel psychoactive substances (known as “legal highs”) and misuse of over the counter and prescribed medicine.
This consists of the following and is always tailored to individual need.
- Comprehensive assessment of need, identifying the next steps in a treatment journey ensuring this is person centred to offer interventions which identify risk and protective factors to support change.
- Psychosocial Intervention using NBPS Model (Neurological, Biological, Psychological & Sociological). This is delivered in a range of ways from 1:1 session to group work sessions in the community.
- Working in partnership with other professionals to ensure that a complete wrap around service is given to meet individual needs.
- Prescribing service and community detox.
- Residential rehabilitation in exceptional cases.
- Pharmacy based Needle Exchange and Harm Minimisation.
- Prevention by the offer of Naloxone kits for opiate users.
- Immunisation for Blood Bourne Viruses (BBV).
The whole Drug & Alcohol service is currently being restructured. The new service will include an improved offer to those in need as part of an overarching treatment offer.