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Tagged In:  Alcohol, Substance Misuse

A combined report into the use of drug and alcohol services in England has revealed some interesting and quite surprising trends relating to those accessing support for substance misuse. 

At first glance, the Public Health England figures for those in alcohol treatment during 2014-15 compared to five years ago do not seem to show much change; in fact a rise of 3% from 86,385 in 2009-10 to 88,904 in 2014-15. However, under closer inspection, the demographics of those seeking support from substance misuse professionals has changed significantly. 

Older adults accessing more alcohol services

Being January, young people have been the focus of media coverage, with countless images released of those being drunk and disorderly as they saw in the New Year, but the figures from PHE paint a different picture. That’s not to say young people do not experience problems with alcohol, but those more frequently using alcohol services are older adults. The PHE report found that whilst alcohol service users aged 50 and over had risen by 44%, the number of 16-24 year-old service users had fallen by 34%. 

Differences in substance misuse service referrals

The research becomes even more interesting when we look at self-referrals. These, unsurprisingly account for 46% of alcohol referrals into treatment, which is broadly similar for other substances. When we look at other methods of referral though, the results are quite revealing. 33% of referrals for alcohol treatment were made through health services (including GPs). This is around 15% higher than the referral rate for other drugs, and in the criminal justice setting, 8% of alcohol referrals were made, versus 28% for opiate dependency. 

The reasons behind the disparity are of course dependent on a broad number of factors. Regardless, the success rate of people exiting support services without dependence is increasing. 

Successful treatment

Although the number of people using alcohol support services has remained relatively steady, the number of those recorded as being free from dependency has risen. 61% of service users successfully completed alcohol only treatments in 2014-15, compared to 49% in 2009-10.

The impact of those ‘mildly’ dependent on alcohol 

We do have to view this success within context though – broader estimates put the number of adults who are alcohol dependent at over 1.6 million in England alone. This is why PHE recently released a resource to support the 'commissioning and delivery of evidence based treatment interventions’.

Specifically aimed at NHS services, local authorities and public health policymakers, the resource aims to encourage the set-up of new treatments that work. The argument for doing so is quite simple; investing in targeted substance misuse services can create significant long-term savings, but more to the point, it can save lives. 

However, the process of engaging with and encouraging people with ‘low’ or ‘mild’ dependency, which NICE estimates to be around 84%, is not straightforward. Only 1.13% of this population receive specialist treatment as they are unlikely to consider their drinking as being problematic. 

Local commissioning of services 

Then of course, we need to consider the need and will to engage against a backdrop of the current commissioning landscape. Only last year we reported on Alcohol Concern’s review of alcohol treatment in England, which painted a largely positive picture of the benefits afforded by alcohol recovery services throughout England with work already underway to engage with those considered ‘mildly dependent’. 

Are we any further forward though? Well, PHE has stated that it intends to release additional tools to help local areas target people very much on a parochial basis and there does seem to be a renewed focus on providing support where it is needed. However, what we need to see is a shift in the general public’s perception of alcohol and what is classed as ‘dependency’. That will almost certainly take a considerable amount of time. 

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