Alcohol Policy UK

Alcohol & Gambling: Alcohol Concern report explores links and recommendations

Alcohol Concern Cymru and the Royal College of Psychiatrists (RCPysch) Wales have published a joint report on the links between alcohol misuse and gambling, exploring key policy implications and recommendations.

Download 'A losing bet? Alcohol and gambling: investigating parallels and shared solutions' [pdf]

The press release includes warnings from professionals who identify links in addictive behaviours and the limited recognition of problem gambling and associated research. The report includes a "snapshot" survey of 66 people from which one in six respondents who had sought help for alcohol misuse said they had also experienced problems with gambling. BBC report here.

Mark Leyshon from Alcohol Concern Cymru said:
 
“Both alcohol misuse and excessive gambling can be regarded as significant public health problems, with adverse consequences to individuals and the wider society... It is likely, however, that mechanisms proposed in the alcohol field, such as restricting the availability of alcohol, tightening marketing rules, and providing tougher measures to protect the young, may be equally effective in curtailing problematic gambling.

Professor Jim Orford from Gambling Watch UK backed the report’s findings:
 
“The field of gambling studies has a great deal to learn from its alcohol counterpart, which is much better and longer established. Gambling Watch UK welcomes this report and fully endorses its recommendations. Problem gambling is now as prevalent as the problematic use of illicit drugs, but gets minimal attention by comparison. We need to start taking it far more seriously.”

The report’s key recommendations include:

• Further research into: the effects of curtailing gambling opportunities, the identification of problematic gambling, and new treatments that can be used to tackle this issue
• Access to treatment for both alcohol and gambling problems to be available and well-funded, and screening for gambling problems should be routine in substance misuse services
• Greater protection to children and young people against potentially addictive products such as alcohol and gambling
• A national database to capture the scope of problems associated with gambling, and this should feed into national strategies for managing addictions.

GamCare provides support, information and advice to anyone suffering through a gambling problem. Gambleaware also offers signposting and support and information on Gamblers Anonymous is here. See here for alcohol support or call Drinkline 0800 917 82 82.

DrugScope briefing 'Public Health Reforms: What they mean for drug and alcohol services' & RCGP briefing on Primary Care treatment

Drugscope, the national organisation representing the drug treatment sector, has published a briefing exploring the public health reforms and their expected impacts on drug and alcohol services.

Download The Public Health Reforms: What they mean for drug and alcohol services [pdf]

The briefing explains the key changes including:

In April 2013, the National Treatment Agency for Substance Misuse will be abolished and its key functions transferred into Public Health England. Most of the current budget for drug and alcohol services will be transferred to Directors of Public Health employed by Local Authorities, who will also be statutory members of the new Health and Wellbeing Boards.

Directors of Public Health (DPH) will be responsible for delivering public health outcomes in their local area, will control the bulk of drug and alcohol funding and will oversee a department or directorate that will be responsible for delivering the outcomes from the local Health and Wellbeing Strategy. Health and Wellbeing Boards (HWBs) will set out local strategies through the development of Joint Strategic Needs Assessments (JSNAs) and Joint Health and Wellbeing Strategies (JHWSs). A new executive agency, Public Health England (PHE), will take the national lead on public health issues from April 2013.'

The briefing also gives a detailed exploration of key issues such as 'What will happen to Drug (and Alcohol) Action Teams (DATs)?' and 'what will be the role of Public Health England (PHE) in providing the sort of national co-ordination that the NTA has provided?'.

On the subject of 'How much will be invested in drug and alcohol services in the new system' the briefing details:

On 10 January 2013, the Government announced the ring fenced public health grants for upper tier and unitary local authorities for 2013-14 and 2014-15. A total of £2.66 billion in 2013 -14 and £2.79 billion in 2014-15 will be available to local authorities to spend on public health services for their local populations. This money absorbs an estimated £800 million to a £billion plus of current drug and alcohol funding. This means that approximately a third of the local authority grant for public health will be comprised of money that has to date been invested in drug and alcohol interventions, including what was contained in the 2012-2013 pooled treatment budget and the former health support component of DIP (total around £460 million).

RCGP & SMMGP briefing on primary care treatment commissioning

A briefing on Primary Care Drug and Alcohol Treatment: Commissioning and Provision Against a Backdrop of Localism has been produced by The Royal College of General Practitioners (RCGP) and Substance Misuse Management in General Practice (SMMGP). The briefing considers the future impact of the changing commissioning environment on primary care drug and alcohol treatment.

The Cabinet Office and the LGA are launching an academy to help senior public servants improve commissioning, reports the Guardian.

Changes to alcohol treatment recording; Alcohol PbR update

Planned alcohol Outcomes for NDTMS dataset April 2013

The National Treatment Agency for Substance Misuse (NTA) have announced  alcohol treatment data outcomes will be included as part of the core NDTMS dataset for drug and alcohol treatment services. See here for the NTA's summary report [pdf].

As part of a consultation earlier this year, alcohol consumption was agreed as the key indicator of successful treatment outcomes. Therefore from April 2013, services will be required to be monitor alcohol consumption through NDTMS at start (assessment) and finish (discharge) of treatment via the two following measures:

• How many days in the last 28 have you had an alcoholic drink?
• On an average drinking day in the last 28, how many units of alcohol were consumed?

In addition, a secondary outcome measure will assess physical and psychological health as part of the core dataset as currently included in the drug Treatment Outcome Profile (TOP) form. Poor physical and mental health is strongly associated with alcohol misuse so, tool, from April 2013 NDTMS will also assess at start and finish:

• Client’s rating of physical health status (extent of physical symptoms and bothered by illness) – scored 0-20 (poor to good)
• Client’s rating of psychological health status (anxiety, depression and problem emotions and feelings) – scored 0-20 (poor to good)

The most recent alcohol treatment statistics are available in the Statistics from the National Alcohol Treatment Monitoring System (NATMS) 1st April 2010 - 31st March 2011. See here for NICE alcohol guidance on treatment and commissioning.

The NTA will cease to exist as of April 2013 as its functions will come under Public Health England.

Alcohol Payment by Results (PbR) update

A progress statement on the alcohol PbR pilots identifies the current status of the project:

'Packages of care', based on NICE guidance have been developed to support each cluster and treatment outcome measures are being explored. Four pilot areas have been testing out these products and how they can report costs for treatment based on the currencies / clusters.

When they are fit for purpose, we will make them available for future use by local authorities and alcohol treatment providers'

See here for a Alcohol PbR overview presentation.

Latest from the IBA blog: first INEBRIA 2012 report; 'mystery shopping' for IBA?; Brief Advice 'bullets' & more

A selection of recent posts from the IBA blog, which aims to promote news, links and ideas relating to alcohol brief interventions are included below:

• INEBRIA 2012: research into practice?
• IBA ‘mystery shopping’ experiences: the good, the bad and the…
• ‘Mystery shopping’ for IBA in Primary Care?
• How intense an intervention is IBA? And competencies needed?
• How ‘opportunisitic’ can IBA be – a step too far?
• Brief advice bullets: try lower strength drinks?
• Brief advice bullets: alcohol disrupts sleep
• Is IBA ‘girly’?

The blog also inlcudes an about IBA page and quick reference IBA tools & resources page. Previous popular posts include:

• IBA for children and young people: evidence, guidance and resources?
• Extended Brief Interventions: who, when, where, and other questions?
• Is self-completing the AUDIT OK for IBA?

The IBA blog was set up to promote learning, understanding and the delivery of IBA through news, links and ideas on IBA from a range of contributors. It also aims to highlight other resources and links such as INEBRIA and the Alcohol Learning Centre IBA pages.

'Part of the Picture': binge drinking over twice as common amongst lesbian, gay and bisexual people

The Lesbian & Gay Foundation have released the Part of the Picture 2009-2011 report exploring substance use amongst lesbian, gay and bisexual people in England.

Download Part of the Picture: Lesbian, gay and bisexual people’s alcohol and drug use in England (2009-2011) [pdf]

Key findings include:

• 34% of gay and bisexual males, and 29% of lesbian and bisexual females, reported binge drinking at least once or twice a week
• Binge drinking is more than twice as common amongst lesbian, gay and bisexual people when compared with the wider population
• Lesbian, gay and bisexual people demonstrate a higher likelihood of being substance dependent
• Significant barriers exist to seeking information, advice or help about substance use issues amongst lesbian, gay or bisexual people

In highlighting the high prevalence of binge drinking the report uses the definition of drinking more than twice the recommended guidelines in one session, though the term has often been contested.

The Part of the Picture (POTP) research project is a five-year partnership between The Lesbian & Gay Foundation (LGF) and the University of Central Lancashire (UCLan). It aims to establish a national database of lesbian, gay and bisexual (LGB) people’s drug and alcohol use; to use the database to inform local and national policy and practice in addressing the drug and alcohol use of LGB people; and to improve knowledge and understanding of the needs of LGB people amongst drug and alcohol agencies through dissemination of the research findings.

JSNA support pack for drug and alcohol commissioners

A JSNA support pack for substance misuse commissioners has been published by the National Treatment Agency.

From April 2012, Public Health will sit within Local Authorities and will be responsible for the commissioning of drug and alcohol services. It is intended that there will be a more integrated approach to treatment with a strong focus on recovery.

The overarching principle is that "drug and alcohol commissioners work closely with all relevant partners to commission services based on outcomes". Pilots into Payment by Results for alcohol treatment and drugs are also underway.

There are 4 main tenets to the new JSNA support pack.

1. Improved access both to early, preventative interventions and to treatment
2. Treatment should be recovery-orientated, effective and protective
3. Treatment should deliver recovery-orientated outcomes
4. Sustained recovery is key.

The pack is intended to support the development of a local needs assessment, planning and delivery of treatment services prior to the establishment of Public Health England. Although the focus of the document is mainly on commissioning for drug use, the basic principles apply for commissioning services for dependent alcohol users.

Full NICE alcohol quality standards and commissioning guidance is set out for alcohol treatment services.

Latest Findings alcohol research: parenting, web-based and student interventions reviewed

Recent research from the drug and alcohol Effectiveness Bank:

Parenting intervention has remarkable impact on teen drunkenness
In this initial developer-led trial in one county in Sweden, routine parent-school meetings encouraging commitment to take a strong stand against underage drinking had a remarkable impact on adolescent drunkenness.

Benefits fade after fine-tuning prevention to high risk personality traits Addressing the substance use promoting tendencies of the personality traits of London schoolchildren at particular risk of substance misuse led to persistently lower drink-related problems, but after a year drinking itself was not significantly affected.

Parent-child intervention prevents heavy drinking in Dutch teens In this Dutch study, promoting parental rule setting and classroom alcohol education together nearly halved the proportion of adolescents who later went to drink heavily. Rarely have such strong and sustained drinking prevention impacts been recorded from these types of interventions.

Preventing drinking and drug use among students in London This bulletin highlights three attempts to prevent substance use among London school or college students. The first two used the same system to adjust counselling to the personality of the student and had at least some short-term success, even when using school staff as counsellors. The third individualised the approach via motivational interviewing but without success.

UK trial of web-based alcohol prevention program for college students
Would the US tactic of telling college students how little the average student really drinks work with their hard-drinking British counterparts? This UK trial was not altogether convincing, but the US evidence is on balance positive.

National alcohol treatment statistics report (NATMS) 2009/10

[update: see here for Statistics from the National Alcohol Treatment Monitoring System (NATMS) 1st April 2010 - 31st March 2011]

The second national report on alcohol treatment has been released by the National Treatment Agency (NTA):

'Statistics from the National Alcohol Treatment Monitoring System (NATMS) 1st April 2009 – 31st March 2010' [pdf]

Excerpts from the executive summary include:

• There were 111,381 clients in contact with structured treatment aged 18 and over who cited alcohol as their primary substance in 2009/10. This is an increase of 11,283 (11%) from 100,098 clients in the previous year.
• There were a further 31,733 clients who cited alcohol misuse as a secondary problem to other primary problematic substances.
• Clients’ median age at their first point of contact with treatment in 2009/10 was 41 and 65% of clients in treatment were male.
• Most clients were White British (97,089 or 88%), while other ethnic groups each accounted for no more than two percent of clients.
• Where reported, 26,662 (37%) were self referrals and 15,166 (21%) were referrals from GP’s. Onward referrals from other substance misuse services together accounted for 8,474 clients (12%).
• More than three quarters (54,242 or 79%) of all clients waited less than three weeks to commence treatment.
• The most common intervention type received was ‘structured psychosocial’ with 45% of clients receiving this in their latest journey (50,379 interventions).
• Where reported, one in twenty five clients (2,416 or 4%) had No Fixed Abode on presenting for treatment; a further 10% of clients (6,510) had other housing problems.
• Of the 63,632 clients exiting treatment in 2009/10; 30,533 (48%) were no longer dependent on alcohol and a further 4,640 (7%) were transferred for further treatment within the community

Also available is local level alcohol treatment data (register here for restricted access). The NATMS alcohol data is a subset of the NTA's NDTMS data sets on drug treatment. See the the NTA site here for further information and last year's national report.

In 2005 the Alcohol Needs Assessment Research Project (ANARP) was published but calls for further investment in alcohol treatment continue.

NTA seek views on 'building recovery' approach to treatment

The National Treatment Agency for substance misuse (NTA) is seeking views on a new service framework to deliver the new drug strategy. The consultation page asks 'what should a recovery-oriented drug treatment system look like?', highlighting:

Among the key issues for discussion are whether treatment for drug and alcohol dependence should be closely integrated, and how all treatment inside prisons and out in the community can be better brought together in a seamless service.

The new framework should also reflect the importance of assessing and meeting the wider physical, mental and social needs of substance misusers, and promote a new culture of ambition that enables people to choose recovery.

See here for the consultation questionnaire [pdf] whilst queries can be sent to yourviews@nta-nhs.org.uk. The consultation suggests submissions of evidence and/or examples of good practice to support responses. Consultation closes on 4 May 2011.

A separate Home Office consultation on More effective responses to anti-social behaviour runs until 03 May 2011. It proposes to streamline a number of existing anti-social behaviour powers, though is not expected to significantly affect existing alcohol-related powers.

News and comments Dec 2010: reaction to Drugs Strategy, Public Health White Paper and Licensing reforms; further news

Early responses to the new 2010 Drugs Strategy have been released by Drugscope, Addaction and the NTA. Reports from the BBC, Guardian and a Telegraph comment. Follow DS Daily for more.

Following the release of the public health White Paper, a summary of alcohol references have been highlighted on the ALC. An article in the Independent asks whether Lansley's policies are 'Nudge or Fudge', the Telegraph reporting 'no more nanny state'. The Guardian published a supportive GP comment and a radical critique on responding alcohol misuse. The Conservative MP Sarah Wollaston expressed support for minimum pricing in an outspoken interview on public health policy.

Following the announcement of the Licensing Act changes, there have been many reports and comments from the trade journals such as the Morning Advertiser (MA) and The Publican. The MA have continued to highlight concerns for the on trade and accusations of policy makers paying lip service to pubs. Another report, Government explains off-trade inaction is backed by a comment on 'the government assault on progress' whilst trade chiefs have said the reforms could cost them £1m per week. Publican reports have included will the late-night levy become a legal battleground? but also highlighted MPs speak up for pubs in Westminster debate.

Other news reports

As home drinking becomes an increasingly popular topic for debate, the Telegraph reports Supermarket sells smaller wine bottles to curb home drinking.

Drinkaware have suggested soaps should change their portrayal of alcohol from 'perpetuating a false and potentially damaging view of alcohol'. A research report suggested that little or no representation of the everyday effects of excessive drinking may normalise a false belief of consequence free binge drinking. Drinkaware are meeting with TV producers to advise soaps to better depict the risks associated with alcohol. See more here.

In other news, binge drinking doubles heart risk a British Medical Journal report finds. Research from Mintel expects a fall in Christmas alcohol sales this year reports the BBC. Underage test purchases are 'not effective' according to a study which says a more holistic approach is required. The Publican reports students are unhappy over media's portrayal of drinking habits.