People with co-occurring conditions: commission and provide services

Better care for people with co-occurring mental health and alcohol/drug use conditions: A guide for commissioners and service providers | Public Health England

This Public Health England (PHE) guide, developed with the support of NHS England,  should be used by the commissioners and providers of mental health and alcohol and drug treatment services, to inform the commissioning and provision of effective care for people with co-occurring mental health and alcohol/drug use conditions. It also has relevance for all other services that have contact with people with co-occurring conditions, including people experiencing mental health crisis.

The guidance has been co-produced with members of the expert reference group for co-existing substance misuse with mental health issues, and in consultation with experts through experience, service providers, practitioners, commissioners and policy leads.

It aims to support local areas to commission timely and effective responses for people
with co-occurring conditions. It encourages commissioners and service providers to
work together to improve access to services which can reduce harm, improve health
and enhance recovery, enabling services to respond effectively and flexibly to
presenting needs and prevent exclusion.

Full document available via Public Health England

Liver disease financial costs

The financial case for action on Liver disease. Escalating costs of alcohol misuse, obesity and viral hepatitis | The Foundation for Liver Research

This report makes the financial case for concerted preventative action through public health measures to tackle the three main causes of liver disease: alcohol misuse, obesity and viral hepatitis. It summarises the escalating financial costs to the health and care system as well as the wider societal costs related to the three lifestyle-related factors.

Full report: The financial case for action on liver disease

The effect of moderate drinking on brain structure

A new study on BMJ.com, examines the effect of moderate drinking on brain structure. Heavy drinking is known to have a deleterious effect on our brains, and is linked to dementias. However, for sometime it’s been thought that moderate drinking is actually protective.

In this Podcast, Anya Topiwala, clinical lecturer in old age psychiatry at the University of Oxford, discusses the association between alcohol consumption and those structural elements.

Reference to the research: Topiwala, A et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ 2017; 357 (Published 06 June 2017)

Mapping the availability of alcohol

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A new study published in the International Journal of Environmental Research and Public Health has found that alcohol is more easily available to buy in the most deprived areas compared to less deprived postcodes.

The study, funded by the National Institute for Health Research’s School for Public Health Research and Alcohol Research UK,raises concerns about the availability of alcohol, especially in deprived areas which are more affected more by alcohol-related health problems.

Read the full study: Mapping patterns and trends in the spatial availability of alcohol using low-level geographic data: a case study in England 2003–2013

Related: Pubs numbers fall as convenience stores spread. University of Sheffield

Alcohol information databases

Public Health England has published Alcohol licensing: information databases.

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This guidance provides information about a number of information databases that hold useful data about mortality, drug use and other relevant topics for public health teams who are involved in licensing decisions. It also includes information about data-sharing agreements.

The databases covered are:

Reactions on Twitter to updated alcohol guidelines in the UK

Stautz K. et al. (2017) BMJ Open. 7:e015493

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Objectives: In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter.

Conclusions: This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media.

Read the full article here

Alcohol advertising and public health

Petticrew M. et al. (2017) Journal of Epidemiology & Community Health. 71. pp. 308-312.

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Background: Alcohol consumption is influenced by a complex causal system of interconnected psychological, behavioural, social, economic, legal and environmental factors. These factors are shaped by governments (eg, licensing laws and taxation), by consumers (eg, patterns of alcohol consumption drive demand) and by alcohol industry practices, such as advertising. The marketing and advertising of alcoholic products contributes to an ‘alcogenic environment’ and is a modifiable influence on alcohol consumption and harm. The public health perspective is that there is sufficient evidence that alcohol advertising influences consumption. The alcohol industry disputes this, asserting that advertising only aims to help consumers choose between brands.

Conclusions: A wide evidence base needs to be drawn on to provide a system-level overview of the relationship between alcohol advertising, advertising restrictions and consumption. Advertising aims to influence not just consumption, but also to influence awareness, attitudes and social norms; this is because advertising is a system-level intervention with multiple objectives. Given this, assessments of the effects of advertising restrictions which focus only on sales or consumption are insufficient and may be misleading. For this reason, previous systematic reviews, such as the 2014 Cochrane review on advertising restrictions (Siegfried et al) contribute important, but incomplete representations of ‘the evidence’ needed to inform the public health case for policy decisions on alcohol advertising. We conclude that an unintended consequence of narrow, linear framings of complex system-level issues is that they can produce misleading answers. Systems problems require systems perspectives.

Read the full abstract here