Friday, 26 September 2014

Smoking, Drinking and Drug Use among Young People in England 2014

I'm a member of the advisory group for the Smoking Drinking and Drug Use survey, which publishes the figures on English school pupils' substance use on an annual basis; so it is great to see this short animation telling the story of the way that the data helps policy makers and others understand what's been happening over the years.

Being able to dig into the data that comes with the report is critical to improving our understanding of the earliest use of substances, both in terms of trends and in respect of some of the more subtle correlations that the survey allows us to examine.

Because the same questions are asked year after year the survey really helps give a detailed understanding of young people's behaviours. For example, it has been fascinating to watch the changes in the amount of street drinking that this age group takes part in - which has declined while (among those who do drink) the proportion that say they drink at parties has increased.

One of the roles we have on the advisory group is to try and help the designers to adapt the questions; adding new ones as new issues emerge, and taking out redundant ones where we can.  The questionnaire this year will include some new questions about e-cigarette use, something on energy drinks and we've tried to include questions that will help tease out whether pupils are using novel psychoactive substances (NPS sometimes called 'legal' highs).

There are some tricky issues in all of this, for example we know from talking to different services that NPS use can vary substantially between areas and the subtlety of these local differences may be lost in a national survey.  We also know that the names for NPS may or may not be recognised by young people - brand names and street names vary.  Helpfully the survey designers do test the questions directly with young people before the survey goes out to into the field, so we can try to ensure that we don't make too many mistakes.

Thursday, 11 September 2014

10 things about alcohol and other drugs you may have missed

These slides are a way of capturing some of the interesting information about alcohol and other drugs that I come across in my reading.

As you'll see the ones below include data on drug related deaths in England and Wales, local government spending on substance misuse services, mental and behavioural problems for adult prisoners, prisoners testing positive for drugs, the use of custodial sentences for drugs offences in England and Wales

It should be clear where I've sourced the information from (but if not and you'd like to know then do get in touch)

It is also worth saying that if there are any errors in the presentation they are almost certainly mine rather than the original authors.

Earlier slide packs are available here.

Monday, 8 September 2014

The Unusual Suspects

Photo by Flickr user Rick Payette
Last week I took part in a session at the Unusual Suspects Festival, an event which brought together individuals and organisations that are delivering social change with the aim of exploring how collaboration and social innovation can work in sync to help address some of society’s most pressing challenges.  A group of us from the Making Every Adult Matter (MEAM) coalition looked at the issues of collaboration that have been thrown up by working together on multiple and complex needs. 

MEAM is a coalition of the membership bodies for service organisations across homelessness (Homeless Link), drugs (DrugScope), mental health (Mind), and criminal justice (Clinks) which came together in 2009 to improve practice and policy for those with multiple and complex needs and who struggle to stay engaged with services.

Without running through all of the contributions that were made at our session – I’ve collected together the Tweets that I and others sent out if you’re interested and the slides we presented are below – there were a number of themes that came up across the presentations.

Collaboration is messy and trust is key
We talked about how frustrating collaboration can be and that sometimes it may feel that it would be easier if we did things by ourselves; but that doing so would mean that we’re less likely to achieve all that we could.  We explored how within MEAM we have learnt to accept that collaboration can be a messy business, but that this mirrors the complexities of the issues we’re trying to address, and leads to better outcomes.

It is through developing trust in each other and a deeper understanding of each other’s expertise that we have achieved outcomes that are truly shared.  And remembering and exploring the focus of the MEAM coalition has been an important loadstone for the work we’ve done together.

Being able to have open conversations, both with partners and with our funders, has also been critical to deepening the relationships. We know that sometimes MEAM will be at the front of some of the partner’s work and at other times it may not be a priority, but that this doesn’t mean that we’re not equal partners.  We know that sometimes we aren’t as visible on issues as we would be if we were to speak as individual organisations, but we believe that we are stronger by standing together.

We also know that trust is important in the direct work that the MEAM coalition has facilitated. Those working to support individuals with multiple needs in local areas explained how building towards mutually agreed outcomes and at a pace set by individual beneficiaries seems to have borne more fruit than working in silos. We heard about one case where small steps towards a trusting relationship with a client started with buying a bike lock and ended with the client engaging with drug treatment and taking steps towards recovery.

Resources are at the heart of getting it right
Across MEAM there has never been a desire to build the coalition as a separate organisation, and that has determined how resources have been allocated.

Most of the posts that are focused on delivering our shared MEAM agenda are ‘embedded’ in the organisations that make up the coalition – so my colleague Sam, who is managing the Voices from the Frontline project, sits at the desk next to me, but works with a team that sits in Homeless Link, Clinks and Mind.

But we also reflected that having a small ‘core’ MEAM team that focusses solely on how to progress the coalition’s aims has been at the heart of the progress we’ve made.

Similarly, in the direct work that localities have undertaken using the MEAM Approach, bringing shared resources to bear on the issues that service users have identified as their priority has been crucial.

Give it away
At a period of time where many organisations (including DrugScope) are thinking about how we create new forms of income MEAM is taking a slightly different tack.

MEAM has chosen to ‘give away’ the approach that we’ve developed to working with people with multiple and complex needs – providing information and advice via the MEAM Approach website.

It isn’t that MEAM partners don’t want to be paid for what we do but our view has been that it is more important to share with others how we’ve worked and to see if that leads to new contacts and subsequently new opportunities that are mutually beneficial to us and to people with multiple needs.

Anyone can see the detail of how we’ve worked and this has helped (we think) develop a sense that with patience and a person-centred approach, things do turn round for the people we’ve been trying to support.

So where next?
We concluded by reflecting that we need to make sure that we’re listening to and reflecting on the stories and priorities of the people who find themselves with multiple needs.  Thinking we know all of those stories and that we’ve nothing left to learn would be a terrible mistake.

My sense of the discussion we had at the festival was that the partners involved in MEAM retain a strong commitment to the aims that brought us together in the first place.  We see both the continuing failures in society to reduce the most extreme harms that this group suffer and the potential to make a step-change, should our and others’ efforts in this area bear fruit.

Wednesday, 3 September 2014

Sharp rise in drug deaths is a cause for concern

Last year the Office for National Statistics consulted on making savings by stopping the analysis they do on drug related deaths.  Fortunately that consultation concluded that this was a “high impact output with widespread support” and as a result we have this year’s report, which shows that the recent trend of falling numbers of people dying as a result of drug use was sharply reversed in 2013.

Deaths that were attributed to illegal drug use rose by 20% in 2013 to 1,957 contributing to the overall number of drug deaths (both legal and illegal) which at 2,995 are the highest levels since 2001.

Over half of all drug related deaths involved an opiate, and for men in their 30s this rose to two in three (68%).  The most commonly recorded opiates were heroin and/or morphine which were seen in 765 deaths a 32% increase from 2012.  They also record 429 deaths where methadone was detected.

The ONS suggest that the end of the ‘heroin drought’ which has seen rising purity of street heroin may explain the increase in the number of deaths associated with the drug.

But there are a number of other drugs where 2013 is the year with the highest number of deaths since records were started.  These include:

  • Amphetamines including ecstasy (120), 
  • New Psychoactive Substances (60), 
  • benzodiazepines (342), and 
  • tramadol (220)

Also worth noting is that while alcohol deaths are recorded separately, in 30% of the cases in this report there was a mention of alcohol or long term conditions associated with alcohol abuse, in addition to drugs, in the coroners’ reports.

Men in their 30s, followed by those in their 40s, had the highest mortality rates as a result of drug use. And the ONS point out that:
The male mortality rates in these two age groups were significantly higher than the rates in all other age groups, and much higher than females of any age.
However, in a background note, they do point out that nearly 1 in 7 deaths among people in their 20s and 30s were drug related.

Marcus Roberts, DrugScope’s Chief Executive, in our response to these figures says:
DrugScope has grave concerns over the significant increase in the number of drug-related deaths registered in England and Wales last year.  The figures mark a reversal of the recent downward trend and appear to show the sharpest increase since the early 1990s.  Of course, this is about more than just numbers; each death represents a tragedy for the individual concerned, their family and friends.
In 2012, the Advisory Council on the Misuse of Drugs (ACMD) reported to the Home Secretary that naloxone saves lives and ‘fits with other measures to promote recovery’, concluding that the drug should be made more widely available.  While the government (in 2014)  accepted this recommendation, the current date for implementation is still a year away, in October 2015.

In our media release, we call on the Home Office and Department of Health to reconsider that timetable, “so that this life-saving medication can be used sooner, to prevent more people from dying.”