Agenda item

This report provides Board members with information on the impact of drug and alcohol use in York and work being done to prevent harm to and support recovery for users. Members are asked to provide comments and feedback and consider signing the North Yorkshire and York ‘Dual Diagnosis Pledge’.

This report provided Board members with information on the impact of drug and alcohol use in York and work being done to prevent harm to and support recovery for users. Members are asked to provide comments and feedback and consider signing the North Yorkshire and York ‘Dual Diagnosis Pledge’. The Joint Consultant in Public Health was in attendance to present the report and respond to questions.

Key points raised during the presentation of the report included:

·        That although York was relatively affluent and had overall good health outcomes, this was not the case when looking at consumption of alcohol.

·        Issues around the availability of alcohol, levels of harm of self-reported levels of alcohol consumption (especially during lockdowns), GP referrals and hospital admissions had been explored.

·        Health conditions known to be attributable to overconsumption of alcohol included several types of cancer, cardio-vascular disease, dementia, diabetes and poor mental health.

·        In York, hospital admissions for both directly and indirectly alcohol caused health conditions were higher than other areas, with multiple deaths each year.

·        There was a cohort of people in York with varying levels of addiction, and it was noted that the numbers of people receiving treatment for addiction was likely vastly lower than those using addictive substances.

·        The number of people dependent on heroin and crack cocaine, which were the largest two cohorts of drug users both in York and nationally was rising.

·        Use of novel psychoactive substances was increasing, especially among children and young people.

·        Drug related deaths in the UK had risen year on year for over a decade. The number in York was usually around the low 10s each year.

·        School services report that the use of drugs by children and young people was increasing and that parental alcohol and drug abuse was also increasing.

·        A new national 10 year drug strategy had been announced by the government, which mentioned alcohol, but focused on substance use.

·        The national strategy’s aims were breaking drug supply chains, delivering a world class treatment and recovery system and achieving a generational shift in demand for drugs.

·        Funding attached to the strategy would increase spending around drugs and alcohol treatment and recovery in York by around 40%, which would place funding at similar levels to the early 2010s. This would enable the thresholds for treatment of individuals for misuse to lower.

·        Evidence showed that people who have both addiction and mental health issues (dual diagnosis), often have very poor outcomes and regularly do not receive the highest quality, joined-up service. There were often barriers to getting the right mental health treatment for a patient with addictions and vice-versa.

·        A Dual Diagnosis Pledge had been written by all treatment and prevention services in the area with the involvement of primary care and others in York and North Yorkshire was attached at Annex A of the report. This sought to engender a number of cultural changes to do with these services, including not asking whether the patient’s mental health issues or addiction manifested first, improved communication and training on addiction and mental health issues.

Comments/questions from members included:

·        It was important not to let the criminal implications of drug abuse overshadow the importance and impact of alcohol misuse.

·        A local community approach to the wider determinants of substance misuse was needed, considering accommodation, employment opportunities etc.

·        Excessive alcohol use remains much more socially acceptable than similar levels of substance use.

·        People were often asked to choose between their mental health or their addiction problems, which made more work on dual diagnosis important.

·        It was important to embed concerns about drugs, alcohol and dual diagnosis into the new Joint Health and Wellbeing Strategy.

·        Limitations of the Trieste model of mental health care were discussed which did not acknowledge dual diagnosis or the potential for neuro-divergent people to self-medicate with drugs and alcohol to ‘normalise’ their behaviour.

·        Ring-fencing of funding for drug and alcohol abuse was needed because users were amongst the least likely to advocate for their health needs, since very often people who turn to drugs come from difficult and disadvantaged backgrounds.

·        There were calls for separate drug and alcohol strategies, because of the differing social attitudes towards them.

·        More consideration for the role of drugs and alcohol in the exploitation of children was requested. Child exploitation involving drugs and alcohol was at a higher rate in York than the national average.

Resolved:

i.             That the trends and needs around drugs and alcohol in the City of York be noted with members’ comments.

ii.            That the new ten year national drugs and alcohol strategy and its implications for partners in York be noted with members’ comments.

iii.          That the proposals to work more closely in partnership with North Yorkshire area, including towards a combined North Yorkshire and York Drugs and Alcohol Strategy be noted with members’ comments.

iv.          That the Chair sign the Dual Diagnosis Pledge on behalf of the City of York Health and Wellbeing Board.

v.           That the Chair will write to HM Government indicating the Board’s support for 50p per unit as a minimum for alcohol pricing.

Reason: To support the work done on alcohol and drug use in York