JSNA Chapter: Drug and Alcohol Misuse in Havering Document details Name JSNA Drug and Alcohol Misuse in Havering Version number V6.0 Creation date 18/02/14 Status Published Lead author Louise Dibsdall (Public Health) Analysts / contributing authors Gemma Andrews (Corporate Policy and Partnerships) Mark Ansell (Public Health) Louise Dibsdall (Public Health) Rob Hayward (Public Health) Seema Patel (Public Health) Mark Ansell, Acting Director of Public Health Lead Directors Cynthia Griffin, Group Director Culture & Community Approved by JSNA Steering Group, 12th July 2014 Scheduled review date 2 years Version Draft Date Change / Approving Body V1.0 Initial draft 28th Interim progress to draft to be presented to JSNA February Steering Group 26th February 2014 2014 Amended order of chapter following feedback from 3rd March V2.0 Updated draft JSNA steering group, paying particular attention to 2014 troubled families and toxic trio. 12th March First complete draft to be presented to JSNA Steering V3.0 First full draft 2014 Group 27th March 2014 JSNA Steering Group approved progression of draft to 25th April CMT 11th April 2014. Revisions made to draft V4.0 Revised full draft 2014 following feedback from CMT; prepared for release for consultation 9th May 2014 Amendments Revisions to chapter following feedback from 30th May V5.0 following consultation exercise; submitted to JSNA Steering 2014 consultation Group for Final Approval 30th May 2014 Revised with comments from Communications team 30th June V6.0 Final and JSNA Steering Group; approved by JSNA Steering 2014 Group and signed off by Chair, 12th July 2014 Page 1 of 147 Contents Table of Figures ....................................................................................................................................... 4 1.0 Infographic Summary ........................................................................................................................ 8 2.0 Executive Summary ........................................................................................................................... 9 3.0 Introduction .................................................................................................................................... 15 3.1 Alcohol ........................................................................................................................................ 15 3.2 Drugs ........................................................................................................................................... 15 3.3 Toxic Trio and Troubled Families ................................................................................................ 16 3.4 Purpose of this JSNA Chapter ..................................................................................................... 17 4.0 The Scale of Substance Misuse in Havering .................................................................................... 18 4.1 Alcohol Misuse ............................................................................................................................ 18 4.1.1 What is Alcohol Misuse? ...................................................................................................... 18 4.1.2 How Many Adults Misuse Alcohol? ..................................................................................... 20 4.1.3 How Many Children and Young People Drink Alcohol? ....................................................... 23 4.1.4 Parental Alcohol Misuse ...................................................................................................... 28 4.2 Drug Misuse ................................................................................................................................ 29 4.2.1 The Law on Drugs ................................................................................................................. 29 4.2.2 The Prevalence of Adult Drug Misuse .................................................................................. 32 4.2.3 Prevalence of Drug Misuse in Children & Young People ..................................................... 36 4.2.4 Parental Drug Misuse ........................................................................................................... 39 5.0 Risk Factors for Drug & Alcohol Misuse .......................................................................................... 40 5.1 Toxic Trio (Mental Health, Alcohol Misuse, Domestic Violence) ................................................ 40 5.2 Family History ............................................................................................................................. 45 5.3 Income, Deprivation and Employment ....................................................................................... 46 5.4 Age .............................................................................................................................................. 50 5.5 Social Circumstances (Stress, Loneliness, Dementia, Peer Pressure) ......................................... 52 5.6 Gender & Pregnancy ................................................................................................................... 53 5.7 Ethnicity ...................................................................................................................................... 55 5.8 Criminal Behaviour & the Criminal Justice System ..................................................................... 58 6.0 The Harms Caused by Drugs and Alcohol ....................................................................................... 61 6.1 The Harms Caused by Drugs and Alcohol In Health Terms ......................................................... 61 6.1.1 Health Effects of Alcohol – short and long term .................................................................. 62 6.1.2 Health Effects of Drugs ........................................................................................................ 70 6.2 The Harms Caused by Drugs and Alcohol In Social Terms .......................................................... 77 6.2.1 Impact on Emergency Services ............................................................................................ 78 6.2.2 Safeguarding ........................................................................................................................ 79 6.2.3 Crime Burden ....................................................................................................................... 81 6.2.4 The Night Time Economy ..................................................................................................... 88 Page 2 of 147 6.2.5 Impact on the Environment ................................................................................................. 89 6.3 The Harms Caused by Drugs and Alcohol In Financial Terms ..................................................... 90 7.0 The Local Response ......................................................................................................................... 93 7.1. Principles of Effective Treatment ............................................................................................... 93 7.2 Adult Alcohol Services ................................................................................................................. 95 7.2.1 Screening for Alcohol Dependence – Use of the NHS Health Checks Programme .............. 95 7.2.2 Effectiveness and Use of Interventions and Brief Advice (IBA) ........................................... 97 7.2.3 Engagement in Alcohol Treatment Services ........................................................................ 99 7.2.4 Mutual Aid and Recovery ................................................................................................... 106 7.2.5 Adult Alcohol Treatment Outcomes .................................................................................. 106 7.2.6 Medications Available ........................................................................................................ 109 7.3 Adult Drug Services ................................................................................................................... 110 7.3.1 Engagement in Drug Treatment Services .......................................................................... 111 7.3.2 Adult Drug Treatment Outcomes....................................................................................... 117 7.4 Supporting the Recovery Agenda ............................................................................................. 121 7.5 Specialist Drug and Alcohol Services for Children and Young People ...................................... 124 7.6 The Social Response .................................................................................................................. 129 7.6.1 Regulation of the Night Time Economy & Licensing .......................................................... 129 7.6.2 Effective use of the Criminal Justice System ...................................................................... 131 7.6.3 Supporting Housing Needs ................................................................................................. 134 7.6.4 Financial Strategies ............................................................................................................ 136 8.0 What are the Gaps? ...................................................................................................................... 138 8.1 Screening and