Phoenix Futures Header Banner

DDN December 2016

screen-shot-2016-12-05-at-13-19-11Welcome to our latest issue…

This year has held more political turbulence than most of us can stomach. Alongside that, the ongoing onslaught on budgets and growing demands on the sector have ramped up the pressure with no easy way forward.

But we mustn’t be lost for words. At the recent Hit Hot Topics conference, American neuroscientist Professor Carl Hart said ‘When there is injustice we need to take risks. When Obama was in office, we went to sleep and claimed victories for things that weren’t victories… You know the score with Trump. It’s better to know the score than to hear pretty lies. Go to work.’

Dr Judith Yates’ article, ‘A name not a number’, demonstrates why it’s our duty to do more. Heroin-related deaths have doubled – yet what are we doing with these statistics? The work of DRD inquiry groups is being stifled by financial cuts, but we know that the vast majority of drug related deaths are of people who are not engaged in treatment – and more than half of them have never been in services.

Simple inexpensive actions, says Dr Yates, can make all the difference, and this is echoed in many moving stories at the Addaction conference. But as Stephen Molloy warned, talking about essential service user activism, ‘We’ve become the deserving versus the undeserving… if we don’t challenge, governments will carry on doing what they’re doing.’

Our next issue of DDN is out on Monday 6 February. Keep in touch at www.drinkanddrugsnews.com and @DDNmagazine

 

PDF Version / Virtual Magazine

Doctors call for urgent tobacco control plan

More than 1,000 doctors and other healthcare professionals have written an open letter to prime minister Theresa May and health secretary Jeremy Hunt calling for a new tobacco control plan to be published ‘without further delay’.

The signatories, which include five former royal college presidents, say the move is essential to tackle health inequalities. Despite the previous Tobacco control plan for England expiring in 2015, no publication date has been given for a new document. ‘If the prime minister is really committed to social justice she needs to put her weight behind publication of a new tobacco control plan without further delay,’ the letter states.

Although smoking prevalence in England has halved in the last 35 years – with less than a fifth of adults now smokers – the highest rates of smoking are found in disadvantaged communities. The letter praises previous efforts to address smoking, such as standardised packaging, advertising curbs and taxation measures, but says more funding is needed for smoking cessation services and awareness campaigns.

The open letter is published in the BMJ, where an editorial also stresses that a future tobacco plan would need to include support for young people to make ‘sound decisions’ regarding health issues. ‘National surveys into smoking, drinking and drug use in schools have shown that smoking amongst young people has fallen consistently over the years and that lessons on smoking have had some impact,’ it says. ‘However, such lessons do need to be contextualised by inclusion in a mandatory, properly planned PSHE programme for all pupils taught by well trained, confident and competent teachers and one that avoids “shock horror” approaches.’

Smoking rates have fallen steadily since the introduction of the first tobacco plan for England, 1998’s Smoking kills, demonstrating ‘the importance of having a clear strategy in place’, according to ASH chief executive Deborah Arnott. ‘We have made great progress in reducing smoking, the leading cause of premature death and disability in this country,’ she said. ‘But we can’t rest on our laurels if we are to continue to drive down smoking rates.  We need the government to implement the promised new tobacco control strategy without further delay.’

Open letter at www.bmj.com

Irish liver cancer rates up 300 per cent in two decades

High cancer rates ‘simply a result of drinking too much’.

The number of primary liver cancers in Ireland increased by more than 300 per cent between 1994 and 2014, according to figures from the country’s National Cancer Registry.

More than 270 patients were diagnosed in both 2013 and 2014, compared to an average of around 60 in the mid-1990s, says Cancer trends: primary liver cancer, with rates three times higher in men than in women. ‘The increase in alcohol consumption observed in Ireland in recent decades is likely to have had a strong influence on the increase observed in HCC [hepatocellular carcinoma] incidence, particularly in men,’ it states. Men in urban areas were also 64 per cent more likely to develop liver cancer than those in rural districts, with male incidence in Dublin ‘statistically significantly higher than the national average’.

Although liver cancer rates in Ireland are higher than in the UK, they are still below those in many European countries, with Italy, France, Spain and Romania at the top of the list. Survival rates in Ireland are poor, however, with the latest estimate of five-year survival standing at less than 20 per cent.

The figures were ‘startling’, said the Irish Cancer Society, with the high incidence rates ‘a result of decades of people in Ireland simply drinking too much,’ according to its head of research, Dr Robert O’Connor. ‘One in five of all alcohol-related deaths are due to cancer. But our consumption of alcohol is increasing – in 2010 it was 145 per cent higher than the average amount drank in 1960,’ he said.

Document at www.ncri.ie

‘One Life’ – the DDN National Service User Involvement Conference

screen-shot-2016-12-05-at-15-27-4423 February 2017, Birmingham
Registration from 9am; main programme runs from 10am-4pm

Drug-related deaths are up; targeted investment is down. There is so much that we, as a community, can do to reverse this situation.

We know what works and we have the personal stories to prove it. Let’s get the message out that service user involvement is alive and well – and makes a difference.

This year’s event is the ten-year anniversary conference and our chance to demonstrate that each and every life matters.

Our programme covers all areas – new drug treatment, alcohol, mental health, naloxone, outreach, BBVs, detox, prescribing, conquering stigma – and ways that the recovery community can engage those not in treatment.

The ‘Big Discussion’ session will tackle the crucial issues and look at what we need to do about the situation. Come with your thoughts and experiences and contribute to the conference’s message that we will not be passive to the scandal of DRDs.

Take part in a highly engaging ‘conversation café’ to learn from other groups and inspirational individuals, and share ideas and initiatives.

Be part of the vibrant exhibition, showcasing your group or organisation’s activities.

Listen, speak, participate, network, and join the call for action.

It’s the biggest and best one yet. See you in Birmingham!

Special ‘early bird’ anniversary delegate price – just £49 person (plus VAT and booking fee). Book by the end of January 2017 to catch this special rate!

Click here to book and secure your place.

Thinking of exhibiting?
This established and well-regarded event brings together 500 delegates – individuals, groups and services from all over the country, including the movers and shakers who make service user involvement happen and galvanise recovery communities. Do you have a product, service, or information campaign that our service user community needs to know about? Then please get in touch – we want to help you to reach them in the best way possible. Reserve your space now!

For group bookings, service user stands, and exhibition and sponsorship opportunities contact ian@cjwellings.com 

Government promises to ‘transform’ mental health support

Prime minister Theresa May has announced a range of measures to ‘transform’ mental health support across the country. Tackling the ‘burning injustice’ of mental ill health would be part of the government’s wider commitment to ‘wholesale social reform’, she told the Charity Commission’s annual lecture.

Theresa May: Government is committed to tackling ‘burning injustice’ of mental ill health.

Mental ill health commonly affects younger people and those on lower incomes, with some estimates putting the annual economic and social cost at more than £100bn, close to the equivalent of the entire annual NHS budget.

Among the plans announced are a ‘rapid expansion’ of digital and online mental health services, more alternatives to hospital care such as community clinics, a ‘major thematic review’ of young people’s mental health services led by the Care Quality Commission (CQC), and action to improve mental health support in the workplace. There will also be a review of the controversial ‘health debt form’, which can see people charged up to £300 for documentation from their GP to prove they have mental health issues.

Not only was mental health ‘dangerously disregarded as a secondary issue,’ she said, it was also ‘shrouded in a completely unacceptable stigma’. The plans would start with ‘ensuring that young people get the help and support they need and deserve’ before issues became entrenched and risked blighting lives, she stated. ‘This is a historic opportunity to right a wrong and give people deserving of compassion and support the attention and treatment they deserve’.

Chief executive of mental health charity Mind, Paul Farmer, said that although his organisation welcomed the announcement, the proof would be in the ‘difference it makes to the day-to-day experience of the one in four who will experience a mental health problem this year’, while Rethink Mental Illness said it was ‘cautiously optimistic’.

Nearly 2m drinkers should be sent for liver scans, says NICE

People drinking at potentially harmful levels should be sent for scans to detect early liver disease, according to new draft guidance from the National Institute for Health and Care Excellence (NICE). The proposed quality standard, which is out for consultation until early February, recommends that men drinking more than 50 units per week and women drinking more than 35 units – adding up to around 1.9m people in England – should be sent for cirrhosis scans by their GPs.

The document recommends two non-invasive tests – transient elastography and acoustic radiation force impulse imaging – to detect early signs of liver problems. While the first test is available in around 120 hospitals, the second is more recent technology and so far not as widespread. Ten years ago clinicians would usually have had to perform a liver biopsy to make a diagnosis.

More than 4,000 people a year die from liver disease in England and Wales, making it the fifth largest cause of death, while 700 more patients need transplants. NICE would welcome comments from ‘anyone who has been affected by liver disease’ for the consultation.

at-the-bar
Draft guidance proposes that people drinking more than recommended limits should be sent for liver scans.

‘Many people with liver disease do not show symptoms until it is too late,’ said deputy chief executive of NICE, Professor Gillian Leng. ‘If it is tackled at an early stage, simple lifestyle changes or treatments can be enough for the liver to recover. Early diagnosis is vital, as is action to both prevent and halt the damage that drinking too much alcohol can do. This draft quality standard makes a number of important suggestions to improve care for those with liver disease, from offering advice to less invasive testing.’

While the draft guidance has been welcomed by alcohol health organisations, free-market think tank the Institute of Economic Affairs (IEA) stated that the ‘average liver cirrhosis patient drinks vastly more than 35 units a week’ and that resources should be targeted on ‘chronic’ drinkers. ‘Unnecessarily testing millions of people on the basis of an arbitrary target would be a colossal waste of NHS resources,’ said its head of lifestyle economics, Christopher Snowdon.

Liver disease NICE quality standard: draft for consultation available at www.nice.org.uk until 2 February 2017

‘Don’t go cold turkey this January – get long-term help’

People with addiction issues should avoid going ‘cold turkey’ in January, according to national charity Change, Grow, Live (CGL).

‘New Year’s resolutions are great, but stopping alcohol or sedative drugs (like Valium or sleeping tablets) suddenly, if you use them most days, could land you in A&E or worse,’ said Ken Checinski, CGL’s lead consultant in the South East. ‘It’s better to seek advice for your addiction issues to understand the mental and general health risks of going “cold turkey”, and to get the right support to stop using drugs and alcohol, safely.’

The charity’s advice focuses on health checks, offering prescribing services rooted in harm reduction to help individuals recover at their own pace, and one-to-one support with a recovery professional.

Their ‘top tips for recovery in 2017’ include ‘Look after your mental health and wellbeing’, ‘Be inspired by connecting with peer mentors’ and ‘Know that there is light at the end of the tunnel – never give up.’

Tailored treatment needed for prescription drug misuse, says ACMD

pillsPrescription-only drugs are being widely diverted to supplement the use of illegal substances, according to a new report from the Advisory Council on the Misuse of Drugs (ACMD). However, diversion and illicit supply remains a ‘much smaller problem’ than in the US, it states.

Diverted prescription drugs are supplementing, rather than replacing, the use of street drugs like heroin, it says – either as a way of complementing their effects or to ‘tide over’ users until they can access illicit drugs.

More people are now seeking treatment for addiction to prescription drugs, it states, and there is growing anecdotal evidence from treatment services of clients whose opioid-dependency developed through use of over-the-counter codeine products. Use of diverted medicines can also increase the risk of overdose, it adds, while ‘unethical’ online sales of prescription drugs via unregistered pharmacies are also increasing, with some people using prescription drugs to manage the comedown from stimulants like cocaine. Alongside prescription opioids, the most commonly diverted drug types are benzodiazepines and ‘Z drugs’, as well as pregabalin, gabapentin and anti-psychotics.

The report wants to see the development of tailored treatment for people who are dependent on prescription or over-the-counter drugs, as well a ‘watch list’ of medicines that could potentially be misused. It also calls on prison healthcare commissioners to ‘embed responsibility’ for the issue into healthcare provider specifications.

‘The diversion of prescription-only medicine damages patient-doctor relationships and can create an atmosphere of distrust,’ said ACMD chair Professor Les Iversen. ‘The use of medicines supplied illicitly is dangerous – it is essential that tailored treatment is developed for users who have become dependent on prescription or over-the-counter medicines.’

The government has also announced that Owen Bowden-Jones, consultant in addiction psychiatry at Imperial College and clinical adviser to PHE, will take over the role of ACMD chair from January. ‘The ACMD plays a hugely important role in ensuring the government has the evidence it needs to tackle the misuse of drugs, and I am confident Dr Bowden-Jones will continue to drive this work forward as we strive to prevent the harms caused by drug misuse,’ said minister for vulnerability, safeguarding and countering extremism, Sarah Newton.

Diversion and illicit supply of medicines at www.gov.uk

Address ‘blind spot’ around older drinkers, charity urges

More needs to be done to help older adults avoid alcohol-related harm, says a new report from the International Longevity Centre (ILC-UK). Retirement is a ‘danger point’ for problem drinking, states the document, with recent retirees more likely to drink every day.

Nearly a third of over-50s in the ‘professional occupational classes’ drink between five and seven days a week, with stress, boredom and ‘lack of control over work and retirement worries’ contributing to the higher consumption levels of those still in work, it says.

older-drinkers
Recent retirees are more likely to drink every day, says the new report from ILC-UK.

The report, which was commissioned by Drink Wise, Age Well, wants to see both the government and employers do more to help the over 50s ‘avoid serious alcohol problems in later life’. This could include counselling and workplace policies that treat alcohol like ‘any other health issue’, as well as making it easier for older people who’ve had an alcohol problem to return to the workforce. Just 16 per cent of employers said they would consider employing someone with a previous alcohol problem, the document points out. GPs should also consider the effects of retirement when giving alcohol health advice, it says.

‘Retirement is like a cliff edge and often older people go from having a busy schedule and colleagues to interact with, to days where they might not see anyone or even have a conversation on the phone,’ said chief executive of older people’s charity the Royal Voluntary Service, David McCullough. ‘It doesn’t take long for loneliness to set in and drinking a little more than they should each day can quickly become the norm. It’s vital that people facing retirement or those recently retired remain mentally and physically active and engaged in their community, and we would urge employers to ensure they have the necessary support and guidance in place to help employees with what can be a very steep transition.’

Easing the transition – older adults and the labour market at drinkwiseagewell.org.uk

Leeds volunteers thanked for their vital role

The vital role of volunteers was recognised by Forward Leeds, at a celebratory meal to thank them for their ‘fantastic commitment’ throughout the year.

The charity’s volunteers put in a total of 905 hours of work between them in November alone – almost a working week per month for each volunteer. The volunteer programme attracts around ten applications a month to support adults and young people to make healthy choices about alcohol and drugs and reduce risk-taking behaviour.

Work takes place at three centres across Leeds, plus a young persons’ hub and a recovery academy. The academy provides education, training and employment support, as well as activities including a gardening group, yoga sessions and music production workshops.

The get-together was ‘a great opportunity for volunteers to meet each other as they are usually all busy, coming in at different days and times,’ said Ann Hall, volunteer development manager, adding ‘We are always keen to support volunteers in achieving their end goal, whether that is to gain skills and experience or to be ready for paid employment.’

If you are interested in volunteering for Forward Leeds you can fill in a form on their website, www.forwardleeds.co.uk, give them a call on 0113 887 2477 or email volunteering@disc-vol.org.uk

forward-leeds
Left to right: Forward Leeds volunteers Paul Jaruga, Martin Butterfield, Darren Bloomfield and Ramin Pourreza