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Interesting things
about alcohol and
other drugs
November 2015
Andrew Brown @andrewbrown365
What do people in receipt of opioid
substitution therapy think about services
Source: How can opioidsubstitution
therapy (and drug treatment and
recovery systems) be optimised to
maximise recovery outcomes for
service users?
The probability of sustained cessation
amongst injecting drug users in
Edinburgh
“OST [opioid substitution therapy] was
associated with reduced time to cessation,
and there was some suggestion of
increased time to relapse too. The
likelihood of prolonged cessation is greater
for women, increases with age, and
decreases with time since last relapse.”
Source: Factors affecting repeatedcessations of injecting drug use and
relapses during the entire injectingcareer among the EdinburghAddiction
Cohort
Number of injecting drug users in Bristol
2,770
This is 0.9% of the
population aged 15-64
years
Source: Problem drug use
prevalence estimation
revisited: heterogeneityin
capture-recapture and the
role of external evidence
Proportion of the incarcerated population
who are injecting drug users
40% in Canada
40% in Australia
50% in the United States
80% in Europe
Source: Characterising Hepatitis C Virus Transmission Dynamics in a High-RiskIncarcerated Population
Number of TB cases with a social risk
factor in England in 2014
In 2014, among cases with
known social risk factor a total
of 9.4% of cases (538/5,708)
had at least one:
● 3.4% had a current or a
history of homelessness
● 3.3% of imprisonment
● 3.3% of drug misuse and
● 3.3% of alcohol misuse.
Source: Tuberculosisin England:
annual report
Numbers in treatment in Wales in 2014-15
by substance
Source:
http://gov.wales/docs/d
hss/publications/15102
9annual-reporten.pdf
Use of Community Order requirements
for Drugs, Alcohol and Mental Health in
England and Wales
Source: Community
sentences since 2000:
How they work – and why
they have not cut prisoner
numbers
The 10 least commonly used
requirements of a youth rehabilitation
order (YRO): 2013/14
9,767 YROs were imposed in 2013/14:
One quarter contained just one
requirement, with a further 35%
containing two.
The most commonly used was
supervision which accounted for more
than a third of the total. Almost 15% -
2,635 in total - were curfews.
Source: The state of youth
justice 2015: an overview of
trends and developments
Call outs for Scottish Ambulance Service
related to New Psychoactive Substances
2,229
Call outs in 2014 were
related to NPS, or 6 per day
on average.
£268
Average cost of a call out for
the Scottish Ambulance
Service
Sources: http://www.bbc.co.uk/news/uk-scotland-34405727
http://www.isdscotland.org/Health-Topics/Finance/Publications/2014-12-02/Costs_R910_2014.xls
Percentage change in seizures of
selected drugs in Scotland
Source: Drug Seizuresby Police
Scotland,2013-14
Looked after children in England
1,680
The number of Looked After Children in
England identified as having a substance
misuse condition.
570
The number who refused treatment for
their identified substance misuse
condition.
10.8%
The proportion of the looked after
population aged 16 and 17 years old with
an identified substance misuse condition.
Source: Outcomes for
childrenlookedafter by
local authorities
Use of naloxone (the opioid overdose
medicine) in the community
9%
of naloxone kits distributed are likely to be used for peer administration within
the first three months of supply for every 100 people who use drugs trained.
Source: Exploring the Life-Saving Potential of Naloxone: A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone
(THN)Programmes for Opioid Users
Monthly heroin overdoses seen by the
London Ambulance service
There were 410 heroin
overdoses recorded by the
London Ambulance Service
in the last 12 months.
This compares with 252 in
the same period 5 years
ago.
A rise of 63%.
Source: Monthly Ambulance Service Incidents,
Borough
Monthly cocaine overdoses seen by the
London Ambulance Service
There were 375 cocaine
overdoses recorded by the
London Ambulance Service
in the last 12 months.
This compares with 215 in
the same period 5 years
ago.
A rise of 74%.
Source: Monthly Ambulance Service Incidents,
Borough
Monthly ‘binge drinking’ attendances for
the London Ambulance Service
In the last 12 months the
London Ambulance Service
reported attending on
someone under the age of
40 suffering from an alcohol
related illness on 29,219
occasions.
This compares with 33,690
times 3 years ago - down by
13%.
Source: Monthly Ambulance Service Incidents,
Borough
Polysubstance use by drug users in
treatment in Northern Ireland
“There was a marked difference
between the number of drugs used by
clients in prison in comparison with
those who were not in prison. Almost
half of clients not in prison (49%) had
one drug of misuse compared with 12%
of clients in prison. The proportion of
clients in prison using five drugs (27%)
was four times that of clients not in
prison (7%).”
Source: Statistics from the Northern Ireland drug misuse database: 1 April 2014 – 31 March 2015
11% of people in treatment for drug
problems in Northern Ireland have ever
injected
Of those who have injected in last 4
weeks:
16.9% shared equipment,
78.7% always used new
equipment,
80.9% used a needle or
syringe exchange
Source: Statistics from
the Northern Ireland
drug misuse database: 1
April 2014 – 31 March
2015
First time convictions in Northern Ireland
in 2013/14
“There were 11,610 first time
entrants (or disposals relating
to first offences) to the
criminal justice system in
2013/14. Of these, 10.4%
(1,205) were in the 10 – 17
year old age group and 29.0%
(3,366) in the 18 – 24 year old
age group.”
Source: First time entrants to the justice
system in Northern Ireland
People with mental ill health receiving
hospital treatment
“Getting appropriate support for
physical healthcare for people
with mental ill health is essential.
Those with mental ill health die
earlier and reasons for this are
often linked to physical health
needs, with many of the
contributory factors being
potentially avoidable. These
factors, coupled with mental ill
health, mean that this group have
very complex care needs.”
Source: People with mental ill health and hospital use
Acquisitive offences with loss, broken
down by offence type
“Research suggests that around 45 per cent of
acquisitive crime is committed by crack or
opiate (mainly heroin) users, who frequently
self-report that they require rapid access to
cash in order to buy drugs (Morgan, 2014).
Indeed, the primary motivation to commit
crime for most burglars interviewed by
Hearnden and Magill (2004) was the need to
fund regular drug use.”
NB The distribution of criminal gains from theft
is heavily skewed. In 2013/14, just 2 per cent of
all thefts accounted for 46 per cent of the total
value of goods stolen.
Source: Crime and the value
of stolen goods
Estimated social and economic costs of
serious and organised crime
“As of 31 December 2014, there were
around 5,800 organised crime groups
(comprising approximately 40,600
individuals) operating in the UK. The
social and economic costs of serious
and organised crime are estimated to
be £24 billion per year, mostly as a
result of drug supply (with a cost of
£10.7 of billion) and fraud (with a cost
of £8.9 billion). Less is known about
cyber and ‘hidden’ crimes such as
Modern Slavery.”
Source: UK national risk
assessment of money laundering
and terrorist financing
One in five of 34,472 new cases in 2014 for
Europol were about drug trafficking
“About one third of all organised
crime groups (OCGs) in the EU
are involved in the production and
distribution of illicit drugs. The
value of the European opiates
market has been estimated at
approximately EUR 12 billion.”
Source: General Report on EuropolActivities2014
Number of offenders convicted for
causing death or injury by a motor vehicle
driver, England and Wales
Source:
http://www.parliament.u
k/business/publications/
written-questions-
answers-
statements/written-
question/Lords/2015-10-
05/HL2423/
5%
Reasons young people became homeless
in 2014 and their support needs
Source: Young and homeless 2014
● 26% substance misuse
(illegal drugs)
● 23% mental health
● 22% offending history
● 13% alcohol misuse
● 8% use of ‘legal’ highs
Comparative risk assessment of alcohol,
tobacco, and illicit drugs for individuals
using the margin of exposure approach
Margin of Exposure (MOE) is a
novel approach to compare the
health risk of different
compounds and to prioritize
risk management actions... the
lower the MOE, the larger the
risk for humans.
Source: Comparative risk assessment of alcohol,
tobacco, cannabis and other illicit drugs using the
margin of exposure approach

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Interesting things about alochol and other drugs - November 2015

  • 1. Interesting things about alcohol and other drugs November 2015 Andrew Brown @andrewbrown365
  • 2. What do people in receipt of opioid substitution therapy think about services Source: How can opioidsubstitution therapy (and drug treatment and recovery systems) be optimised to maximise recovery outcomes for service users?
  • 3. The probability of sustained cessation amongst injecting drug users in Edinburgh “OST [opioid substitution therapy] was associated with reduced time to cessation, and there was some suggestion of increased time to relapse too. The likelihood of prolonged cessation is greater for women, increases with age, and decreases with time since last relapse.” Source: Factors affecting repeatedcessations of injecting drug use and relapses during the entire injectingcareer among the EdinburghAddiction Cohort
  • 4. Number of injecting drug users in Bristol 2,770 This is 0.9% of the population aged 15-64 years Source: Problem drug use prevalence estimation revisited: heterogeneityin capture-recapture and the role of external evidence
  • 5. Proportion of the incarcerated population who are injecting drug users 40% in Canada 40% in Australia 50% in the United States 80% in Europe Source: Characterising Hepatitis C Virus Transmission Dynamics in a High-RiskIncarcerated Population
  • 6. Number of TB cases with a social risk factor in England in 2014 In 2014, among cases with known social risk factor a total of 9.4% of cases (538/5,708) had at least one: ● 3.4% had a current or a history of homelessness ● 3.3% of imprisonment ● 3.3% of drug misuse and ● 3.3% of alcohol misuse. Source: Tuberculosisin England: annual report
  • 7. Numbers in treatment in Wales in 2014-15 by substance Source: http://gov.wales/docs/d hss/publications/15102 9annual-reporten.pdf
  • 8. Use of Community Order requirements for Drugs, Alcohol and Mental Health in England and Wales Source: Community sentences since 2000: How they work – and why they have not cut prisoner numbers
  • 9. The 10 least commonly used requirements of a youth rehabilitation order (YRO): 2013/14 9,767 YROs were imposed in 2013/14: One quarter contained just one requirement, with a further 35% containing two. The most commonly used was supervision which accounted for more than a third of the total. Almost 15% - 2,635 in total - were curfews. Source: The state of youth justice 2015: an overview of trends and developments
  • 10. Call outs for Scottish Ambulance Service related to New Psychoactive Substances 2,229 Call outs in 2014 were related to NPS, or 6 per day on average. £268 Average cost of a call out for the Scottish Ambulance Service Sources: http://www.bbc.co.uk/news/uk-scotland-34405727 http://www.isdscotland.org/Health-Topics/Finance/Publications/2014-12-02/Costs_R910_2014.xls
  • 11. Percentage change in seizures of selected drugs in Scotland Source: Drug Seizuresby Police Scotland,2013-14
  • 12. Looked after children in England 1,680 The number of Looked After Children in England identified as having a substance misuse condition. 570 The number who refused treatment for their identified substance misuse condition. 10.8% The proportion of the looked after population aged 16 and 17 years old with an identified substance misuse condition. Source: Outcomes for childrenlookedafter by local authorities
  • 13. Use of naloxone (the opioid overdose medicine) in the community 9% of naloxone kits distributed are likely to be used for peer administration within the first three months of supply for every 100 people who use drugs trained. Source: Exploring the Life-Saving Potential of Naloxone: A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone (THN)Programmes for Opioid Users
  • 14. Monthly heroin overdoses seen by the London Ambulance service There were 410 heroin overdoses recorded by the London Ambulance Service in the last 12 months. This compares with 252 in the same period 5 years ago. A rise of 63%. Source: Monthly Ambulance Service Incidents, Borough
  • 15. Monthly cocaine overdoses seen by the London Ambulance Service There were 375 cocaine overdoses recorded by the London Ambulance Service in the last 12 months. This compares with 215 in the same period 5 years ago. A rise of 74%. Source: Monthly Ambulance Service Incidents, Borough
  • 16. Monthly ‘binge drinking’ attendances for the London Ambulance Service In the last 12 months the London Ambulance Service reported attending on someone under the age of 40 suffering from an alcohol related illness on 29,219 occasions. This compares with 33,690 times 3 years ago - down by 13%. Source: Monthly Ambulance Service Incidents, Borough
  • 17. Polysubstance use by drug users in treatment in Northern Ireland “There was a marked difference between the number of drugs used by clients in prison in comparison with those who were not in prison. Almost half of clients not in prison (49%) had one drug of misuse compared with 12% of clients in prison. The proportion of clients in prison using five drugs (27%) was four times that of clients not in prison (7%).” Source: Statistics from the Northern Ireland drug misuse database: 1 April 2014 – 31 March 2015
  • 18. 11% of people in treatment for drug problems in Northern Ireland have ever injected Of those who have injected in last 4 weeks: 16.9% shared equipment, 78.7% always used new equipment, 80.9% used a needle or syringe exchange Source: Statistics from the Northern Ireland drug misuse database: 1 April 2014 – 31 March 2015
  • 19. First time convictions in Northern Ireland in 2013/14 “There were 11,610 first time entrants (or disposals relating to first offences) to the criminal justice system in 2013/14. Of these, 10.4% (1,205) were in the 10 – 17 year old age group and 29.0% (3,366) in the 18 – 24 year old age group.” Source: First time entrants to the justice system in Northern Ireland
  • 20. People with mental ill health receiving hospital treatment “Getting appropriate support for physical healthcare for people with mental ill health is essential. Those with mental ill health die earlier and reasons for this are often linked to physical health needs, with many of the contributory factors being potentially avoidable. These factors, coupled with mental ill health, mean that this group have very complex care needs.” Source: People with mental ill health and hospital use
  • 21. Acquisitive offences with loss, broken down by offence type “Research suggests that around 45 per cent of acquisitive crime is committed by crack or opiate (mainly heroin) users, who frequently self-report that they require rapid access to cash in order to buy drugs (Morgan, 2014). Indeed, the primary motivation to commit crime for most burglars interviewed by Hearnden and Magill (2004) was the need to fund regular drug use.” NB The distribution of criminal gains from theft is heavily skewed. In 2013/14, just 2 per cent of all thefts accounted for 46 per cent of the total value of goods stolen. Source: Crime and the value of stolen goods
  • 22. Estimated social and economic costs of serious and organised crime “As of 31 December 2014, there were around 5,800 organised crime groups (comprising approximately 40,600 individuals) operating in the UK. The social and economic costs of serious and organised crime are estimated to be £24 billion per year, mostly as a result of drug supply (with a cost of £10.7 of billion) and fraud (with a cost of £8.9 billion). Less is known about cyber and ‘hidden’ crimes such as Modern Slavery.” Source: UK national risk assessment of money laundering and terrorist financing
  • 23. One in five of 34,472 new cases in 2014 for Europol were about drug trafficking “About one third of all organised crime groups (OCGs) in the EU are involved in the production and distribution of illicit drugs. The value of the European opiates market has been estimated at approximately EUR 12 billion.” Source: General Report on EuropolActivities2014
  • 24. Number of offenders convicted for causing death or injury by a motor vehicle driver, England and Wales Source: http://www.parliament.u k/business/publications/ written-questions- answers- statements/written- question/Lords/2015-10- 05/HL2423/ 5%
  • 25. Reasons young people became homeless in 2014 and their support needs Source: Young and homeless 2014 ● 26% substance misuse (illegal drugs) ● 23% mental health ● 22% offending history ● 13% alcohol misuse ● 8% use of ‘legal’ highs
  • 26. Comparative risk assessment of alcohol, tobacco, and illicit drugs for individuals using the margin of exposure approach Margin of Exposure (MOE) is a novel approach to compare the health risk of different compounds and to prioritize risk management actions... the lower the MOE, the larger the risk for humans. Source: Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach