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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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

Evidence review on drug misuse treatment published

The review by Public Health England shows the drug misuse treatment system in England is performing well.

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Public Health England (PHE) published a comprehensive review of the evidence on the drug misuse treatment system in England. In comparison with other countries and the international research, it shows the system is performing well but some areas need improvement. Some of the findings include:

  • 60% of all opioid users are in treatment – among the highest reported internationally
  • 97% of all users start treatment within three weeks, which compares favourably with other countries
  • there is a very low rate of HIV infection among injecting drug users (1%) in England

The review gives policy makers and local areas an objective assessment of what drug treatment outcomes are achievable, and compares outcomes in England to the evidence and to other drug treatment systems

It reviews the impact of housing problems, unemployment and social deprivation on treatment engagement and outcomes. The review also considers how drug treatment will need to be configured to meet future need and recommends an appropriate set of measures or indicator for treatment evaluation.

Read the full review:

Specialist substance misuse services for young people

A rapid mixed methods evidence review of current provision and key principles for commissioning

Public Health England (PHE) commissioned The Children’s Society to undertake scoping research in early 2016, to understand some of the opportunities and challenges currently facing those now responsible for commissioning and delivering young people’s specialist substance misuse services and to outline some critical good practice principles.

Four main commissioning principles have been developed for the commissioning and provision of specialist substance misuse provision for young people, based on the findings, research and evidence based guidelines.

This document is designed to provide prompts around some core principles for consideration when local authorities are commissioning specialist substance misuse provision, but is not intended to be a comprehensive commissioning guide.

Full review available here