Reducing Alcohol-Related Harm Susie Talbot/Joe Keegan Cambridgeshire DAAT March 2014

The Cambridgeshire Drug and Alcohol Action Team is a multi-agency partnership working to implement the National Drug/Alcohol Strategies. We commission agencies to provide specialist treatment and targeted prevention work for substance misusing clients who live in Cambridgeshire.

Objectives  Raise awareness of the harm from alcohol misuse  Highlight role of Identification and Brief Advice (IBA)  Provide training opportunities for Adult Social Care Staff and Care Providers

Pressured into illegal acts Loss of Employment Relationship Difficulties Parenting Capacity Vulnerable Housing Poor Mental Health Financial Difficulties Poor Physical Health Impacts on Individuals

5Alcohol interventions in Primary Care

Impacts on Family Members Financial Difficulties Physical Health Can compromise care arrangements Emotional stress Stigma Pressured into illegal acts Isolation Pressure on family relationships

Alcohol Use in Cambridgeshire  Synthetic estimates of prevalence suggest that 26% of men and 17% of women in Cambridgeshire drink over government guidelines.  Districts with highest rates of drinking and hospital admissions and deaths include: Huntingdonshire (drinking levels), Cambridge (alcohol specific hospital admissions), Fenland (alcohol related hospital admissions), Cambridge and Huntingdonshire (alcohol specific deaths) and Cambridge and Fenland (alcohol related deaths).  There are estimated to be around 12,000 alcohol dependent people in Cambridgeshire. Only 1,000 people are coming forward and receiving support from commissioned alcohol treatment services at any time (Tier 3).

Alcohol Use & Older People  There are estimated to be 15,000 older people over 65 drinking at potentially harmful levels across the county.  1 in 3 alcohol problems in older people develop in later life (late onset)  Older men are almost as likely to exceed drinking guidelines as younger men  There has been a steady increase in the amount of alcohol consumed by older people in recent years across different surveys and consumption methods  Excessive use of alcohol contributes to increased falls and accidents, incontinence, dementia, parkinson's disease, depression and self neglect  Older people more likely to be treated successfully especially those with late onset drinking

Motivators for Older People  Staying healthy and independent.  Sleeping better.  More energy to go out and socialise.  Improved memory.  Save money.  Less likely to fall.

Professional Barriers  Lack of awareness that alcohol misuse is a potentially important problem for older people.  Reluctance to ask embarrassing questions of older people.  Attitude that older people are too old to change their behaviour.  Belief that it is wrong to ‘deprive’ older people of their ‘last pleasure in life’.  Inability to identify signs and symptoms of alcohol problems in older people.

Alcohol, Mental Health & Learning Difficulties  Studies have indicated that 75% of users of drug services and 85% of users of alcohol services may experience mental health problems but such prevalence is not captured in data as many individuals are undiagnosed and untreated. Despite the significant numbers of people presenting with dual diagnosis, referrals to alcohol services from mental health services remain very low.  Cambridgeshire's mental health JSNA found:  Excessive alcohol consumption could be a cause of mental ill health, or a resulting factor.  Alcohol is responsible for much psychiatric co-morbidity – with chronic heavy drinkers likely to suffer from depression, anxiety, and/or more serious cognitive impairment and psychosis.  Centre for Mental Health found “there has undoubtedly been real progress on this issue. However, support for people with a dual diagnosis, including those with a range of multiple needs, is still frequently inadequate”  Foetal alcohol syndrome is the largest non hereditary cause of Learning Disabilities

Issues alcohol and mental health  Despite a countywide Dual Diagnosis strategy being in place there is more work needed to deliver joined up services  There is a need to highlight the contribution of excessive alcohol consumption to poorer mental health  A need to raise the skill level of staff in mental health services around identifying harms from alcohol

Reasons people with learning disabilities may misuse alcohol Social isolation – a desire to ‘fit in’ Poverty and mental health issues – linked to use in general population Information and support less accessible Professionals need specialist support More people with LD living independently in the community Poor health education and GP awareness Source: alcohol/drugs-and-alcohol-for-people-with-learning-disabilities/ alcohol/drugs-and-alcohol-for-people-with-learning-disabilities/

The offer from the DAAT  Provision of free Identification and Brief Advice Training to staff in Adult Social Care. The 3 hour course covers enable staff to:  Increase alcohol awareness knowledge  Identify those drinking above lower risk levels  Give simple brief advice  Make referrals to appropriate services The training will provide staff with simple NICE recognised tools and aims to give them the confidence to use them.

The offer from the DAAT cont 04/02/16Stanton House, Huntingdon10: :00 19/04/16CPDC, Cambridge14: :00 21/06/16Young people March, March14: :00 29/09/16CPDC, Cambridge14: :00 28/11/16Young people March10: :00 Trainer/s: Joseph Keegan Alcohol Strategic Lead - Cambridgeshire Safer Communities Partnership Team E-learning module is also available. Please note the e-learning is not tailored to local adult social care training needs in Cambridgeshire. Just follow the link below:

Where to get further Info  For local services for adults: Inclusion – treatment-system  For resources for service users e.g. drink diaries:  For copies of IBA resources: