Professor Matt Hickman, Barbara Coleman and Dr Tim Williams, Directors of the Addictions Health Integration Team (HIT), give an update on their work in 2014-15.
We aim to support the development and commissioning of evidence-based services to improve the health of people dependent on drug and alcohol, and reduce drug and alcohol related harm.
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 on the increase, caused primarily 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 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.
We have had a number of successes in NIHR funding bids. One piece of work will evaluate the impact of opiate substitution treatment on drug related deaths in the population using Clinical Practice Research Datalink. We are also looking at how to improve HCV case finding in primary care and specialist drug clinics in a randomised control trial in Bristol, North Somerset and South Gloucestershire, to test an algorithm in GP computer systems. An investigation of the cost-effectiveness of needle syringe progammes in Bristol will include a Cochrane systematic review of the impact of these programmes and opiate substitution treatment on HCV transmission.
A pilot of alcohol screening and ‘brief intervention’ in Avon & Somerset Constabulary custody suites and an evaluation of DrinkThink, an intervention developed in Bath and North East Somerset to train agencies in contact with young people, have both been funded by NIHR.
We are working with NIHR CLAHRC West on two projects. One is a qualitative investigation of user preferences and attitudes to low vs high dead space syringes. The other is a systematic review of whether addressing malnutrition in alcohol dependent people could prevent cognitive deficit and alcohol related brain damage.