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Drug & Alcohol Misuse

Drug and Alcohol Misuse is an issue, probably more than any other, where the service pressures and costs fall across a range of agencies in a wide range of settings - acute health services, Accident and Emergency, police cells, unrest in city and town centres and neighbourhoods, family problems, mental health problems, crime and unemployment.

There is therefore great potential to use Total Place to fully understand the costs of this issue, and identify the measures that can be taken to improve outcomes for service users, at a lower cost. The partner organisations that have been involved in this work to date are Leicester City Council, Leicestershire County Council, Leicestershire District Councils, the Voluntary Sector, Police, County and City NHS PCTs, University Hospitals of Leicester NHS Trust, Leicestershire Partnership NHS Trust, the Probation Service and Job Centre Plus.

Findings - What alcohol and drug misuse causes

  • In 2008, Leicester ranked highest in alcohol related sexual offences in England.
  • In 2008, Leicester ranked third highest in alcohol related violent crime in England.
  • In 2008, Leicester recorded the greatest number of alcohol related hospital admissionsin the East Midlands.
  • In 2008 Leicester recorded the third greatest number of alcohol mortality rates and chronic liver disease cases in the East Midlands
  • In the UK, up to 360,000 domestic violence incidents are linked to alcohol misuse (a third of total incidents) with serious consequences for children, family conflict and breakdown. Alcohol misuse by parents was identified as a factor in over 50% of child protection cases.

What alcohol and drug misuse costs

  • 15 units of strong white cider costs around £2.50 from a retailer. Drinking the equal number of units in pints would cost £15 in a pub.
  • £16 million is estimated to be spent by Leicester & Leicestershire Health Service to deal with alcohol related issues.
  • Alcohol also comes at a cost in terms of crime - local estimates of £80 million cost for violent crime.
  • It is estimated that residents of Leicester and Leicestershire spend over £120 million on alcohol.
  • The social and economic cost of drug abuse in terms of crime, absenteeism and sickness is in excess of £20 billion nationally.

Developing Ideas

The following are ideas currently being explored in depth within the pilot to meet the objectives of Total Place.

  • Reducing the availability of alcohol, especially for young people. Local action here could introduce a stronger consistent approach to licensing. National action is being sought around minimum pricing and the cessation of loss leading alcohol promotion. We would also be seeking more stringent sanctions against the sale of alcohol to under 18's.
  • An effective prevention agenda, particularly for young people, through imaginative social marketing. Explore opportunities to promote more positive ‘normative' behaviours of young people as well as the negative affects of alcohol & drug misuse. The opportunity to work more specifically with high risk families is also being considered.
  • Providing early, effective and best value, screening and appropriate interventions to help early stage misusers, before they progress to more problematic misuse, (i.e. through primary care, schools, job centres, housing, benefit agencies etc). This would include upskilling all the children's workforce to provide better advice and information around substance misuse.
  • Establish a Joint Commissioning framework for drug and alcohol funds from a locally pooled budget comprising full contributions from all the agencies who currently incur costs from drug and alcohol misuse. This new approach would include:
    • Asking the government to widen the ring-fence currently around the funding available for drug treatment, to include alcohol misuse. This would enable targeting of limited resources to best meet the local need and priorities. This will involve national policy change involving the National Treatment Agency.
    • Incorporating more effective and integrated commissioning beyond misusers' immediate treatment to incorporate the ‘wrap around' agenda. This agenda includes the fundamental elements of housing support, education, training and employment, life skills and family support, evidenced to be the most effective method of ensuring treatment is sustainable.
    • To review the balance in commissioning between preventative programmes and specialist treatment.
  • Integrated Offender Management - to ensure access to an effective substance misuse treatment pathway to ensure a complete end to end service for offenders.
  • Pilot a multi-agency emergency department to, primarily, treat the effects of street based alcohol misuse. Its aim is to provide a specialist, more appropriate service targeting substance misuse more widely as well as the immediate health need.
  • Recover some of the cost of dealing with misuse. Explore opportunities to recoup some of the significant costs of misuse from those responsible.