Alcohol Misuse Panel - Public Health Dorset

Alcohol Misuse Panel

Introduction

Alcohol misuse is a pattern of drinking that results in harm to a person’s health, interpersonal relationships or ability to work. Alcohol dependence, also known as alcohol addiction, is a chronic disease and is associated with experiencing withdrawal symptoms, loss of control, or alcohol tolerance.  As well as causing serious health problems, long-term alcohol misuse can lead to social problems for some people, such as unemployment, divorce, domestic abuse and homelessness.  

Reducing alcohol-related harm is a key Public Health priority.

Alcohol Misuse JSNA Needs Assessment


Current picture

According to estimates of the number of adults in England with an alcohol dependency potentially in need of specialist treatment published by the Government for 2018-19, in BCP there are approximately 4388 people with an alcohol dependency, this is 1.37% of the adult population (18+).  In Dorset there are 3284 people with an alcohol dependency, this is 1.06% of the adult population. 

During 2020-21 there were 760 people with an alcohol dependency in structured alcohol treatment in BCP.  This is an engagement rate of 17% of those in the community who are estimated to be alcohol dependent.  In the same time period there were 874 people in structured alcohol treatment in Dorset.  This is an engagement rate of 27% of those in the community who are estimated to be alcohol dependent.

The latest hospital admissions data published by Public Health England (Local Alcohol Profiles for England) shows an England average of 664 hospital admissions per 100,000 adults for alcohol related conditions.  In BCP the figure is higher, at 862, while in Dorset it is lower, at 557.  For young people the England average for hospital admissions for alcohol specific conditions is 31 per 100,000 young people.  The figure is higher in BCP and Dorset, with 60 and 47 respectively. 

Alcohol specific hospital admissions

Alcohol related hospital admissions
 

Triangle of need

The number of people across Our Dorset who at risk of alcohol misuse are represented by the Triangle of Need. This diagram illustrates the population at risk (aged 16+) measured by the units of alcohol drunk per week.

Local Insights

To develop a shared understanding of alcohol locally, workshops were held with alcohol treatment practitioners, health and care providers, police, service user representatives and other system partners.  When asked what the local causes and effects of alcohol misuse were, key elements of discussion included:

  • People using alcohol as self-medication in relation to mental health – it is socially acceptable to use alcohol to unwind. As alcohol is a mood depressant, using it to relieve stress, low mood or any poor mental health issue becomes a downward spiralling circle.
  • The availability and low cost of alcohol - with 24 hour availability and the considerable cost difference between alcohol bought at a supermarket, and that bought in a pub or club, people are increasingly drinking at home, or “pre-loading” before going out.
  • Readiness for change - to receive successful treatment it is vital that people first recognise they have an issue, then it is important that they are able to access the appropriate treatment.
  • Older people with an alcohol dependence are experiencing particular problems - for them to live independently they need support at home, but it is difficult to provide the support as care workers are often reluctant to attend.
  • Is the budget weighted appropriately between drug and alcohol services, compared to the needs of the population?  Is there any evidence that separate drug and alcohol services would make a difference? 

JSNA Alcohol System Challenges

These local insights highlighted the following key challenges for tackling alcohol misuse in our area:

  • There have been budget cuts for alcohol treatment at a time when alcohol related hospital admissions are rising. 
  • Differences in professional opinion in what works and a variation in expectations of what treatment is given is a blocker to collaborative working between partners which feeds into the system pressures. Clear and consistent pathways around detox, psycho-social interventions and aftercare are vital.
  • How can we increase community knowledge and understanding of the harm that alcohol can do when it is so socially acceptable?  What are the best messages around alcohol to have an impact on young people?
  • How can we effectively influence the local level availability and cost of alcohol?
  • How can we build resilience at younger ages, so that in times of stress alcohol is not the go-to coping strategy?
  • How can we build service consistency and appropriate treatment for people with dual diagnosis (issues with both mental health and alcohol) and design the best pathway for people with co-existing mental health and alcohol issues.


The embedded Kumu map, below, is interactive:

  • hover the mouse over an element of interest to see its immediate relationships
  • left click and hold to refocus the map on that element
  • to return to the wider map, left click and hold on any ‘white space’ in the map.

For greater interactivity and access to side panels containing additional information and links, follow the link under the embedded Kumu map (how do I read a systems map).

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