Integrated Monitoring System Annual Report Cheshire and Merseyside 2016/17 December 2017 Mark Whitfield, Howard Reed, Christopher Leech, Beccy Harrison and Jim McVeigh Public Health Institute, Faculty of Education, Health and Community, Liverpool John Moores University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET www.ljmu.ac.uk/phi [email protected] 0151 231 4314 twitter.com/PHI_IMS ISBN: 978-1-912210-22-0 (web) ACKNOWLEDGEMENTS With thanks to the management, staff and individuals from all contributing services, without whose cooperation this report could not have been produced. We would also like to thank Petra Collins, Karen Critchley, Stuart Smith and Jane Webster for their help with proofing the report, Vivian Hope for his comments and suggestions and to Stuart Smith for his attention to detail in inputting data into the system. Public Health Institute Faculty of Education, Health and Community Liverpool John Moores University Henry Cotton Building 15-21 Webster Street Liverpool L3 2ET Mark Whitfield Intelligence and Surveillance Manager [email protected] 0151 231 4314 Howard Reed Intelligence and Surveillance Systems Manager [email protected] 0151 231 4036 PREVIOUS REPORTS The drug and alcohol treatment in Cheshire and Merseyside report series This Integrated Monitoring System Annual Report Cheshire and Merseyside 2016/17 report is adapted from a series of reports that highlight intelligence on drug and alcohol treatment in Cheshire and Merseyside. The previous reports were: Alcohol Treatment in Cheshire and Merseyside, 2004/05 (Brown et al, 2006) Alcohol Treatment in Cheshire and Merseyside, 2005/06 (McVeigh et al, 2006) Alcohol Treatment in Cheshire and Merseyside, 2006/07 (McCoy et al, 2007) Alcohol Treatment in Cheshire and Merseyside, 2007/08 (McCoy et al, 2009) Alcohol Treatment in Cheshire and Merseyside, 2008/09 (McCoy et al, 2010) Alcohol Treatment in Cheshire and Merseyside, 2010/11 (Hurst et al, 2012) Alcohol Treatment in Cheshire and Merseyside, 2011/12 (Hurst et al, 2013) Drug and Alcohol Treatment in Cheshire and Merseyside, 2012/13 (Whitfield et al, 2013) Integrated Monitoring System Annual Report Cheshire and Merseyside, 2013/14 (Whitfield et al, 2014) Integrated Monitoring System Annual Report Cheshire and Merseyside, 2014/15 (Whitfield et al, 2015) Integrated Monitoring System Annual Report Cheshire and Merseyside, 2015/16 (Whitfield et all, 2016) All the reports above are available at: www.ljmu.ac.uk/phi 2 Integrated Monitoring System Annual Report 2016-17 FOREWORD On behalf of the Public Health team in Warrington, I am pleased to be asked to reflect on the Integrated Monitoring System (IMS) database and its impact for Warrington. Warrington has been using the IMS database for many years now, and it has certainly helped in how we commission our services – both in the community and in our pharmacies. In the main, the clients using NSP (Needle Syringe Programme) are not actively receiving treatment – so a challenge for all of us is how can we support this cohort and ensure they receive the right messages. The need for the information provided by the IMS is important, given the growing issues affecting drug and alcohol users. If our activities are evidence based, then this information has a place in how effectively our services are delivered. Key national issues around drug related deaths, changes in drug using patterns and the ever increasing numbers affected by alcohol are at the forefront of our minds. It is known that drug related deaths continue to rise across the region and the IMS data gives a much clearer picture of those people actively injecting prior to death. For those attending the NSP who use steroids, this population group has increased by 11% over the last 12 months while psychoactive NSP has had a slight dip. Of course, all of this is under an umbrella of revised and changing resources. In Warrington we work with our community services and pharmacies to show them the IMS data – so that they understand what they are completing and why. This has been a big learning curve and now providers understand what the information tells us as commissioners. This sharing of information enables a better service provision for our service users. The information provided within this report has many uses to support the local commissioning of a range of services and we hope you will find it useful and valuable. Cathy Fitzgerald Head of Substance Misuse and Commissioning Development Public Health - Warrington Integrated Monitoring System Annual Report 2016-17 3 CONTENTS Acknowledgements ................................................................................................................................................................ 2 Previous reports ..................................................................................................................................................................... 2 Foreword ................................................................................................................................................................................ 3 List of Tables ................................................................................................................................................................................... 7 List of Figures .................................................................................................................................................................................. 9 Executive Summary .............................................................................................................................................................. 11 Introduction ......................................................................................................................................................................... 14 1. Literature and Current Research ............................................................................................................................. 16 Setting the scene - alcohol ............................................................................................................................................................ 16 Some facts and figures about alcohol use, alcohol-related consequences and treatment ............................................ 16 Setting the scene - drugs ............................................................................................................................................................... 17 Some facts and figures about drug use, drug-related consequences and treatment .................................................... 18 National, regional, and local literature ................................................................................................................................. 19 Alcohol ............................................................................................................................................................................ 19 Drugs ............................................................................................................................................................................... 22 Examples of research within the Public Health Institute .............................................................................................................. 26 National IPED Info Survey ............................................................................................................................................... 26 Health responses to New Psychoactive Substances (NPS) ............................................................................................. 26 Evaluation of the North Yorkshire Horizons Drug and Alcohol treatment and recovery service ................................... 27 An exploration of the role of alcohol in the life experiences of the homeless population in Merseyside ..................... 27 Alcohol’s harm to others: The harms from other people’s alcohol consumption in Wales ........................................... 27 2. Integrated Monitoring System - Summary .............................................................................................................. 28 2.1. IMS Cohort summary: ..................................................................................................................................................... 28 2.2. Annual IMS figures 2013-14 to 2016-17 ......................................................................................................................... 30 Annual Numbers Recorded, for All IMS Individuals ........................................................................................................ 30 Annual Numbers Recorded, by Cohort Groups .............................................................................................................. 32 2.3. Cross Matching - IMS, NDTMS, and Criminal Justice datasets ........................................................................................ 33 Combined client group - Cheshire and Merseyside ........................................................................................................ 33 Combined client group - Local Authority areas .............................................................................................................. 34 IMS individuals matching to NDTMS ..............................................................................................................................