Substance misuse in older people

Action is needed to deal with growing levels of substance misuse in people aged over 50, claims BMJ editorial 

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Researchers in the UK and Australia said the number of people aged over 50 who were experiencing problems from substance misuse was growing rapidly and the numbers receiving treatment were expected to treble in the US and double in Europe by 2020.

In both the UK and Australia, dangerous levels of drinking are declining, except among people aged 50 years and older, they said. One of the authors warns that the issue goes beyond drinking, citing illicit drugs such as cannabis, and commonly prescribed medications such as opioid painkillers as also being an issue.

Full  editorial:  Rao, R. & Roche, A.  Substance misuse in older people: Baby boomers are the population at highest risk  BMJ 2017;358:j3885

Related : Baby boomers’ drink and drug misuse needs urgent action, warn experts | The Guardian

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The Role of Science in Addressing the Opioid Crisis

Opioid misuse and addiction is an ongoing and rapidly evolving public health crisis, requiring innovative scientific solutions | New England Journal of Medicine

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Image source: Marina Caruso – Wellcome Images // CC BY-NC-ND 4.0

In response, and because no existing medication is ideal for every patient, the National Institutes of Health (NIH) is joining with private partners to launch an initiative in three scientific areas: developing better overdose-reversal and prevention interventions to reduce mortality, saving lives for future treatment and recovery; finding new, innovative medications and technologies to treat opioid addiction; and finding safe, effective, nonaddictive interventions to manage chronic pain. Each of these areas requires a range of short-, intermediate-, and long-term research strategies

Full reference: Volkow, N.D. & and Collins, F.S. (2017) The Role of Science in Addressing the Opioid Crisis.  New England Journal of Medicine. Issue 377: pp.391-394

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

2017 drug strategy

The drug strategy 2017 sets out how the government and its partners, at local, national and international levels, will take new action to tackle drug misuse and the harms it causes.

The strategy builds on the government’s existing approach to preventing drug misuse, supporting people to recover from dependence and restricting the supply of drugs, with new action to:

  • promote a smarter, partnership-based approach
  • enhance the balanced approach across the three existing strands (reducing demand, restricting supply and building recovery) with a fourth strand on global action
  • provide stronger governance for delivering the strategy, including a Home Secretary-chaired board and the introduction of a National Recovery Champion
  • expand the data we collect on levels of drug misuse and recovery from dependence, and develop a set of jointly-owned outcome measures to drive action across a broader range of local services

Full document: Drug Strategy 2017

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:

Preventing drug misuse deaths

Public Health England has published Health matters: preventing drug misuse deaths.

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Image source: http://www.gov.uk/

There were 2,300 drug misuse deaths registered in England in 2015. This represents an increase of 8.5% on the year before and the highest figure on record.

This guidance outlines how providers and commissioners can prevent deaths from drug abuse.  It sets out the scale of the problem, factors causing the rise in drug misuse deaths, preventing drug misuse deaths and a call for action for local authorities and the NHS.

The Office for National Statistics publishes data on deaths from drug poisonings in England and Wales and is broken down by cause of death, sex, age and substances involved in the death.

Substance use, subjective well-being and interpersonal relationships among young people in foster care and private households

Long S.J. et al. (2017) BMJ Open. 7:e014198

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Objective: To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11–16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships.

Conclusions: Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions and interventions to reduce substance use and improve well-being in FC should include a focus on supporting healthy social relationships.

Read the full article here