Why is it an issue?
The 2010 Drug Strategy published in December 2010 sets out the Government’s approach to tackling drugs, which is key causes of societal harm, including crime, family breakdown and poverty. Together, they cause misery and pain to individuals, destroy families and undermine communities. The strategy has two overarching aims by which success will be measured against:
- To reduce illicit and other harmful drug use.
- To increase the numbers recovering from their dependence.
The strategy is structured around three key themes:
- Reducing demand
- Restricting supply
- Building recovery in communities
The fundamental difference between the new strategy and previous strategies is the movement away from harm reduction to a shift in focus towards recovery. The strategy also sets out a shift in power to local areas that will have responsibility for designing and commissioning services which meet the needs of their local communities.
What’s the local picture and how do we compare?
How do we compare?
- There has been little change in the primary drug use within the treatment population since 2008/09. Opiate users remain the largest group in drug treatment in Wakefield in 2009/10, at 85% (n=1846). This matches the figure for Yorkshire and Humberside (85%, n=23398), although it is higher than the national findings (81%, n=167,200); with 50% using opiates only (n=102,598) and 31% (n=64,602) using opiates and crack as the primary drug. (Adults Drug Needs Assessment 2010).
- The percentage of primary crack and cocaine users in treatment is far lower with 1% (n=32) using crack and 3% (n=55) using cocaine in 2009/10. While the level of crack use is similar to the figures for Yorkshire & Humberside (2%, n=591), it is lower than the national figures where 5% (n=10328) are reported as using crack only. Cocaine use in Wakefield however, is higher than the level seen across Yorkshire & Humberside (2%, n=557) and lower than the level seen nationally (6% percent, n=12415). (Adults Drug Needs Assessment 2010).
- The percentage of crack use as a secondary drug of those in treatment in Wakefield was to be (13%) which is lower than for Yorkshire and Humberside (22%, n=6060) and nationally (21%, n=45070). (Adults Drug Needs Assessment 2010).
- The demographic profile of adults in treatment during 2009/10 shows that most service users were male; 76% (n=1642) and 24% (n=532) were female.). However the proportion of males is a little higher than both the regional and national figures (both of which were 73% male and 27% female). (Adults Drug Needs Assessment 2010).
- Comparison with the ethnicity of adults in treatment in Yorkshire and Humberside during 2009/10 shows that Wakefield has a slightly smaller proportion of non-white clients in treatment; 6% (n=1898) are non-white clients in Yorkshire and Humberside compared with 4% (n=81) in Wakefield. (Adults Drug Needs Assessment 2010).
- The age of adults in treatment in Wakefield was similar to that found regionally with 30-34 year olds being the most common age range of those in treatment. However nationally the greatest proportion of those in treatment was the over 40 group. (Adults Drug Needs Assessment 2010).
- The proportion of injecting drug users starting a new treatment journey in Wakefield (25%, n=161) is higher than that found in Yorkshire and Humberside Wakefield (21%, n=1783). The proportion of drug users that have never injected was lower in Wakefield (36%, n=228) than that found in Yorkshire and Humberside (38%, n=3284). However, it should be noted that there is a greater proportion of missing data for Yorkshire and Humberside (7%, n=633) than for Wakefield (3%, n=18) which may affect the comparison. (Adults Drug Needs Assessment 2010).
- Clients who started a new treatment journey, accommodation need were recorded. In 2009/10, 25% (n=157) of adults starting a new treatment journey had a housing problem which is higher than across Yorkshire and Humberside (20%, n=1733 had a housing problem). (Adults Drug Needs Assessment 2010).
- There were 427 exits from drug treatment services in 2009/10. Half of the treatment exits in 2009/10 were unplanned (50%, n=212). Although there has been an improvement in the proportion of unplanned exits, the figure for Wakefield in 2009/10 is higher than both regionally (32%, n=2308) and nationally 37% (n=24251). There were 94 planned exits in 2009/10 (22%). The figure for Wakefield in 2009/10 is lower than the regional figure (29%, n=2072) and even more so than the national figure (38%, n=24851). (Adults Drug Needs Assessment 2010).
- The number of exits recorded as onward referrals for Wakefield (29%, n=122) is lower than for Yorkshire and Humberside (39%, n=2813) but higher than nationally (25%, n=16410). (Adults Drug Needs Assessment 2010).
What’s the trend and what can we predict?
- The majority of adults in treatment during 2009/10 were White British or Irish (95%) and this mirrors the findings in 2008/09 (95%). There have been small increases since last year in the proportion of both Asian clients (from 1% to 2%) and Other White clients (from 0% to 1%).
- The highest proportion of adults in treatment in 2009/10 fell in to the 30-34 age group (30%) and the 25-29 age group (22%). The overall distribution is very similar to that seen in 2008/09, although there has been a decrease in the proportion of 25 to 29 year olds in treatment from (27%), in 2008/09). Indeed overall it is evident that the treatment population is becoming older. This is an ongoing trend which has been identified in previous years. The age of adults in treatment in Wakefield was similar to that found regionally with 30-34 year olds being the most common age range of those in treatment. However nationally the greatest proportion of those in treatment was the over 40 group
- A total of 638 referrals were made into adult drug treatment services in 2009/10 compared to 635 for 2008/09; an increase of 0.5%. The majority of referrals in 2009/10 into drug treatment were self referrals (52%) compared to (46%) in 2008/09. However compared to Yorkshire and Humberside and nationally there was a decrease in the referrals (4% and 3%) respectively.
- The majority of referrals in 2009/10 were to the three Community Drug Teams followed by Wakefield DIP. Wakefield DRR and Hemsworth Drug service have seen the greatest increases in referral numbers to their agencies since 2008/09 equating to a (100% and 92%) increase respectively.
- The proportion of referrals who currently inject remained relatively stable between 2008/09 and 2009/10, with a slight decrease; (25%) in 2009/10 compared to (27%) in 2008/09. There was a slight increase in the numbers of service users who had never injected (36%) in 2009/10 compared with (35%) in 2008/09. A more noticeable increase is apparent in the number of previous injectors in 2009/10 at (36%) compared with (30%). These changes would suggest that harm reduction advice is increasingly effective. Although there has been an improvement in the referrals who currently inject and have never injected still remain higher than Yorkshire and Humberside (21%) current injectors and (28%) who have never injected.
- For those clients who started a new treatment journey, accommodation need is recorded. In 2009/10, (25%) of adults starting a new treatment journey had a housing problem. This is higher than 2008/09 where (22%) had a housing problem. The accommodation need in Wakefield during 2009/10 was higher than across Yorkshire and Humberside (20% had a housing problem).
- There were 427 exits from drug treatment services in 2009/10. This compares to 334 exits in 2008/09; an increase of 28%. Half of the treatment exits in 2009/10 were unplanned (50%) compared to (60%) in 2008/09. Although there has been an improvement in the proportion of unplanned exits, this is still higher than both regionally and nationally.
- Drug Related Deaths shows that 28 drug related deaths occurred in the Wakefield PCT area from 2005 to 2007. While there was a stable trend between 2005 and 2006 with 6 deaths occurring each year, a notable increase occurred in 2007 (16 deaths). It was noted that an increase in drug related deaths may be associated with an ageing treatment population. Most of the drug related deaths within this timescale were males, in the 31-39 or 20-30 age category.
- The national treatment Agency (NTA) recently published independent research from the Centre for Drug Misuse research at the University of Glasgow (prevalence data) in a report which indicates that the number of people who use heroin and crack in England is decreasing. An NTA Summary of the research also highlights an estimate of a 12% reduction. The trend identified by Glasgow University reflects the reduction in new presentations to service recorded by the National Drug Treatment Monitoring System (NDTMS) in recent years, and is consistent with the NTA view of an aging drug using population in England.
What are we doing and what can be done differently?
- Emerging patterns in drug use are closely monitored and reviewed to ensure that treatment services continue to meet the needs of the local drug using population.
- Developing effective outcome-based commissioning of the substance misuse treatment system that is able to respond to changing trends.
- Continuing to develop and improve systems to exchange data/information to ensure that available data accurately reflects the local picture of trends/patterns in drug use, the local drug using population profile and movement in and around the system.
- Developing a comprehensive communications and social marketing strategy.
- Enhancing engagement with “new and emerging” and traditionally underserved communities to improve access to treatment.
- Using needle exchange services to engage effectively with steroid users.
- Developing a comprehensive training package where attitudes towards drug users may need to be challenged and where there is a need for increased understanding of the issues affecting the local drug using population.
- Further development of the recovery agenda to promote the goal of obtaining a substance misuse free life and successful re-integration into the community with a focus on drug free exits for those who are seeking abstinence.
- Ensuring that appropriate wraparound services are available to meet the needs of drug users.
- Continuing to involve services users in planning, delivery and advocacy.
- Developing aftercare services to offer relapse prevention and to assist with wider support needs such as housing, employment, etc.
- Assessing the needs of service users in relation to demand for Tier 4 services.
- Improving pathways between criminal justice substance misuse services and courts and between community criminal justice agencies and prisons to maximise treatment outcomes for offenders.