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Current services in relation to need

Background papers: Lifestyle and wider determinants :: Alcohol [Update in progress] :: Current services in relation to need

Figure 1:The range of alcohol treatments and interventions
Figure 1:The range of alcohol treatments and interventions

It is estimated that 36,520 adults in Medway are drinking at 'increasing risk' levels or 'high risk' levels.[1] The most appropriate intervention for these drinkers is Identification and Brief Advice (IBA); most recent national research (as yet unpublished) suggests that very brief intervention, not necessarily using accredited tools but designed for local use and targeted populations, is also effective.

Department of Health commissioned research describes how intervening with men aged over 35 who regularly drink over 50 units could reduce alcohol-related admissions nationally by 13,000 over three years; this group of drinkers is shown to contribute greatly towards alcohol-related hospital admissions.

To date 19 GP practices have received IBA training complete with referral pathways. Health and Lifestyle Trainers have received IBA and Motivational Interview training and complete an IBA with every contact. Contraceptive and Sexual Health (CASH) services have received IBA training and requirement to deliver IBA is included in the contract. IBA is also included in the NHS Medway Healthchecks programme.

In order to reduce population prevalence and reduce ARHA we should aim to provide very brief Identification and Brief Advice to key recommended groups: NICE recommends the following groups in particular be routinely targeted with IBA. Those:
• with relevant physical conditions (such as hypertension and gastrointestinal or liver disorders)
• with relevant mental health problems (such as anxiety, depression or other mood disorders)
• who have been assaulted
• who are at risk of self-harm or domestic abuse
• who regularly attend Genito-Urinary Medicine (GUM) clinics or repeatedly seek emergency contraception.

There are an estimated 11,782 dependent drinkers in Medway. DH guidance states at least 15% of dependent drinkers should be able to access services.[2] In Medway services should therefore have capacity for around 1,800 service users. Data for 2009/10 from the National Drug Treatment Data Monitoring Service showed 466 people accessed alcohol services in Medway (a quarter of the DH guidance).

In August 2011 the local Drug Interventions Programme (DIP) team were commissioned to provide alcohol screening and referral within custody.


References

[1]   North West Public Health Observatory. Local Alcohol Profiles for England 2010;
[2]   Department of Health. Signs for improvement - commissioning interventions to reduce alcohol-related harm 2009; Department of Health. http://www.skillsforhealth.org.uk/component/docman/doc_view/129-ad-commissioning-guidelines.html .