Representatives
from Public Health will be in attendance to provide an update on progress made
following the panel’s investigation into Opioid dependency.
Minutes:
The Chair introduced representatives from the Council’s
Public Health Department and Foundations Medical Practice to provide an update
on actions relating to the Panel’s report into opioid dependency.
The Panel heard there was a significantly higher death rate
relating to drug misuse in the North East than in other English regions. Based
on 2018-20 figures Hartlepool and Middlesbrough had two of the highest rates
for drug misuse or poisoning deaths, with only Blackpool showing higher
figures.
The latest provisional data for alcohol related deaths
showed there had been a significant increase in deaths from alcohol causes
between 2019 and 2020. Indeed, while the data was needed validating it was
possible alcohol related deaths in 2020 increased by 66% which equated to
approximately 100 people. Although there were complex factors to explain this,
government data showed alcohol consumption had undoubtedly increased since the
covid-19 pandemic.
The Clinical Partner from Foundations Practice explained
that Foundations Medical Practice was a specialist practice that supported
individuals suffering from substance misuse, especially through the Heroin
Assisted Treatment project (HAT). The programme was created in light of
Middlesbrough’s high drug related deaths and drug related harms. While the main
treatment was methadone between five and 10 percent of individuals in receipt
of this failed to benefit from it. Failure to benefit from such treatment often
led to individuals being trapped in a cycle of criminal activity.
It was noted that participation in programmes like HAT
required significant commitment both to receive and maintain treatment. However,when individuals did so
they could link in with other care coordinators to address any other complex
needs they may have, including mental and physical health needs.
The Pane heard HAT had been operating for two years since
October 2019 and was funded for 10 individuals and that the programme was full.
The Panel was shown a walkthrough video of the clinic and how treatments were
administered.
The programme had been independently evaluated by the
University of Teesside and was undergoing evaluation by Durham University and
the London School of Tropical Medicine to understand the programme’s impact.
The results of the evaluation will be available in April 2022 however preliminary
results showed a high level attendance and that regular attendance benefitted
participants everyday lives.
The programme had seen full engagement by participants who
had also benefited from other, non-compulsory, enhancements such as psychosocial
interventions.
Overall, participants reported significant improvements in
their mood, psychological health, mental health and social situations with some
having been street homeless prior to engaging with the programme.
As a result of the programme there had been a 60% reduction
in criminal behaviour as well as a reduction in the median crime severity score
with anecdotal evidence from the Police to support this.
The Panel was shown examples of similar successful
facilities in different parts of Europe and heard some had been operating for
20 years with no drug related fatalities despite the number of injections that
took place within them.
The Panel heard several other projects and initiatives were
linked to HAT including project ADDER (Addiction, Diversion, Disruption,
Enforcement and Recovery) as well as key stakeholders such as the Strategic
Homelessness lead. For all projects there was a need for a flexible system-wide
approach and to continue setting up relevant governance and steering structures
such as the Lived Experience Board.
It was noted that given various changes within the NHS, the
role of Health Scrutiny was crucial to hold the various agencies to account.
A Member queried how easy it was for people to access the
HAT programme given the level of commitment involved and what support, if any,
was provided to participant’s families especially where Children were involved.
It was clarified that those engaging the programme were more prepared to travel
and to commit to the regularity of the treatment, with many of the individuals
on the programme lived relatively close to the clinic. It was also commented
that most participants in the programme had a substance misuse problem for at
least 20 years and had experienced some life trauma, such as a disconnectedness
to children, but that treatment helped to reconnect them. The Panel also heard
that access to services was very open, with some individuals self-presenting
being prescribed alternative medication within 20 minutes.
The Panel heard that £300 million investment was being made
by government toward drug enforcement and disruption and in line with Dame
Carol Black’s recommendations, £780 million of investment would be made over
three years towards treatment and recovery. This also meant that Project ADDER
would be extended for two years to March 2025.
A Member queried if individuals could be redirected to other
alcohol and drug services. It was clarified that across all drug and alcohol
services, including Project ADDER and Changing Futures approximately 2,000
people received treatment in one form or another. While it was difficult to
measure numbers of participants, more exact usage figures would become clearer
in the following 12 months.
A Member sought clarification between assisted treatment and
overdose prevention and their uses between Scotland and England respectively.
It was clarified that that assisted treatment was evidence based and supported
by the Home Office and classed as a pharmaceutical intervention. Overdose Prevention,
however, was not supported in the same way and was, strictly, illegal. The
Member suggested that lobbying be undertaken to class overdose prevention the
same as assisted treatment in order to help as many individuals as possible. It
was also clarified there was a misconception surrounding Overdose Prevention
sites in that it was believed they encouraged increased drug use. This was not
the case, however, and instead removed existing drug misuse from the street
into a more controlled environment.
It was agreed that lobbying, in the form of written
representations, should be undertaken by the Panel but it was acknowledged that
changing the status of Overdose Prevention sites was a challenge.
It was noted that services were improving and adjusting to such
a degree that more and more people were able to stabilise their lives even if
complete abstinence was not possible. Switzerland was used as an example
whereby both Assisted Treatment and Overdose Prevention sites operated side by
side which had radically altered drug misuse in the country.
It was further clarified that as part of the additional
funding from government, £300 million would be used for enforcement purposes
over the first three years of a wider 10 year strategy.
The Chair thanked all involved for the presentation.
ORDERED that:
1.
Efforts be made for the Panel to visit the
Overdose Prevention Ambulance
2.
Statistics presented to Members regarding drug
and alcohol deaths be circulated.
3.
The Panel produce written representations in
support of Overdose Prevention Sites that can complement the work of Assisted
Treatment sites.
4.
The information presented be noted.