More on the Drug and Alcohol Health Integration Team

Background

The Drug and Alcohol Health Integration Team (HIT) is a team of public health experts, academics, doctors and other professionals, working together to reduce the harm caused by excessive alcohol use and substance misuse.

Excessive alcohol use is the third leading risk factor for morbidity in Western Europe. Liver disease is the fifth most common cause of death in the UK and is on the increase, primarily caused by excessive drinking and hepatitis C (HCV). Over 85 per cent of HCV in the UK is due to injecting drug use, and opiate-related deaths are a major contributor to premature mortality.

Excessive drinking may be associated with half of all violent crimes. The annual social and economic costs of problem drug use are estimated to be £12 billion (88 per cent associated with drug-related crime) and £21 billion for alcohol-related harm. Young people in the UK report some of the highest rates of alcohol consumption and hazardous drinking in Europe, and 50 per cent of those under 16 report heavy episodic drinking. Early and hazardous drinking in adolescence is associated with adult alcohol consumption and problems.

Drug and alcohol treatment services and interventions to prevent drug misuse and excessive drinking span secondary care, primary care, police, probation and other public services in the community, and extend to policies and powers administered by the local authority.

The team was formerly known as the Addictions HIT.

Aims and objectives

The overall aim of the Drug and Alcohol HIT is to maximise the use of the resources already available to reduce substance-related harm.

The HIT will focus on two treatment pathways:

• treatment and management of substance misuse and key health consequences
• treatment and prevention of excessive alcohol use and alcohol-related harm

Who's involved

The leading experts in alcohol and substance addiction in Bristol are involved in the team. The HIT steering group is made up of:

• HIT director: Kyla Thomas, Consultant Senior Lecturer in Public Health Medicine
• HIT director: Leonie Roberts, Consultant in Public Health, Bristol City Council
• HIT director: Katherine Williams, Substance Misuse Team Leader, Bristol City Council
• HIT director: Tim Williams, Clinical Director, Bristol Specialist Drug and Alcohol Service

For a full list of HIT members and collaborators, visit the who's involved page.

How patients and the public are involved

The Drug and Alcohol HIT includes patient and public involvement (PPI) as one of its key themes. The HIT will include service user representatives and a PPI lead on the team, and will use existing networks to enable involvement of a wide variety of service users and those affected by addiction.

Strategies to promote peer involvement in treatment (including diagnosis and management of hepatitis C, uptake of opiate substitution treatment and relapse prevention, and community alcohol detox) will be an important aspect of the HIT. User and peer involvement is critical and has shaped earlier research such as the Research for Patient Benefit 'Script in a Day' study, which stemmed from a series of focus groups with patients and peer support workers. Service users are also involved in a group looking at community treatment options for hepatitis C.

The team will consult with national bodies on specific projects, including the Hepatitis C Trust, with whom they have already worked.

Projects and activities

The Drug and Alcohol HIT's preliminary projects include:

• How to combine opiate substitution treatments (OST) and other interventions in order to reduce relapse and risk of death immediately after treatment
• How best to combine primary prevention interventions (OST and needle & syringe programmes) and HCV testing and HCV treatment scale-up in order to reduce HCV transmission and prevalence in the population
• Investigate the links between excessive drinking and antisocial behaviour (ASB) and violence and identify interventions to reduce alcohol-related ASB and violence
• Assess the availability and uptake of alcohol screening and brief interventions for young people, such as Drink Think, and the potential for expansion
• Develop and pilot an evaluation of the impact and cost-effectiveness of alternative models of alcohol detoxification
• Conduct a Health Impact Assessment of Bristol licensing policy
• Investigate the cost-effectiveness of interventions in needle exchange
• Evaluate implementation of contingency management in Recovery Oriented Drug and Alcohol Service (ROADS)
• Evaluate the delivery of recovery support to reduce the risk of relapse
• Identify the costs and effectiveness of managing 'high impact users', including problems with offending, housing, employment and benefits
• Conduct a Health Impact Assessment of new psycho-active substances
• Assess interventions to identify and reduce 'hidden harm' (children of addicted substance users)

Contacts

To find out more, please contact:

• Leonie Roberts, leonie.roberts@bristol.gov.uk or 0117 922 3171