Tobacco, alcohol, drug misuse
In 2011, 1 in 5 (18%) of all deaths of adults aged 35 and over were estimated to be caused by smoking. Smoking was responsible for 36% of all deaths from respiratory diseases, and 28% of all cancer deaths were attributable to smoking.1 It is not only a major cause of disease such as lung cancer, COPD, lung disease and heart disease, but also of poor health functioning. Smoking amongst all groups in Kirklees has decreased from 2008 to 2012, but 1 in 5 (19%) Kirklees residents aged 18 and over still smoke, rising to 1 in 4 (24%) in Dewsbury and 13% (1 in 8) of all women in Kirklees smoked during pregnancy, similar to national levels2. Likewise, many people with existing long-term conditions were still smoking in 2012 with 1 in 4 people with COPD (26%) and asthma (24%), 1 in 6 (17%) people with heart disease and 1 in 3 (31%) people with depression identified as current smokers.
Second-hand smoke is a major risk to the health of non-smokers, especially children. In 2009, more than 2 in 5 (42%) 14-year-olds lived with an adult who smoked. In 2012, 37% of smokers in Kirklees reported smoking most of the time when other people were in the house.
Tobacco: Why is this issue important?
Smoking kills and causes long-term illnesses. In 2011, 1 in 5 (18%) of all deaths of adults aged 35 and over were estimated to be caused by smoking. Most died from lung cancer, chronic obstructive pulmonary disease (bronchitis and emphysema) and coronary heart disease. It was also a major cause of ill health, leading to approximately 1.5 million hospital admissions nationally in 2010/111. More than 8 out of 10 adults who had ever smoked regularly began as older children or teenagers. Those who started smoking when they were young were three times more likely to die of a smoking-related disease 3. Having a low birth weight increases the risk of ill health and death for an infant and smoking in pregnancy increases the risk of having a low birth weight baby by 3.5 times. There is also a dose response relationship, i.e. the more cigarettes smoked, the lower the birth weight4.
Second-hand smoke is a major risk to the health of non-smokers, especially children. Family and household smoking increases the risk of sudden infant death, lower respiratory tract infections, middle ear infections and wheeze asthma5. As smoking is higher in more deprived families, so most of the burden of disease falls on the most disadvantaged children and has an effect on development and behaviour, all of which is avoidable5.
Tobacco: What significant factors are affecting this issue?
Children are most likely to become smokers if they also use alcohol or drugs, are disengaged from education or have poor educational outcomes, or have mental or emotional problems. There is also a strong association with living with peers or family who smoke. Young people are also influenced by price and availability, restrictions on smoking in public places and advertising and product placement. Each year, in England alone, around 330,000 children under 16 first try smoking and most smokers start smoking regularly before they are 18. Smoking is also associated with income levels and socio-economic class and ethnicity as described below.
Tobacco: Which groups are most affected by this issue?
Children and young people7
Locally, in 2009, far fewer 14-year olds (33%) had tried smoking than in 2005 (47%) and 2007 (44%). Girls were more likely to have tried smoking than boys were at this age (36% compared with 31%) and white 14-year-olds were more likely to have tried smoking than south Asians (34% compared with 29%). The mean age of first smoking remained unchanged at 12, although 1 in 5 started before they were 10, which is unchanged since 2007. Of 14-year-olds who smoked, black and south Asian boys were more likely to start smoking earlier. 10% of all 14-year-olds smoked weekly or more often compared with18% in 2007.
In 2012, in Kirklees 1 in 5 (19%) adults 18 and over smoked, although this is comparable with the national rate of 20%. There was little difference between men (19%) and women (18%), although smoking did decrease with age as in previous years: 1 in 4 (23%) aged 18-44, 1 in 5 (18%) aged 45-64 and 1 in 10 (10%) aged over 65. In comparison to 2008, where 1 in 4 black people smoked, in 2012, this had dropped to 1 in 6 (15%). This is slightly lower than 1 in 5 white (19%) and 1 in 6 (15%) Asian people. Only 1 in 5 (22%) current smokers wanted to continue smoking with just over half (53%) wanting to quit. 1 in 6 (16%) smokers intended to quit within the next six months.
Smoking is also linked to socio-economic status, income and ethnicity. Just over 1 in 3 (35%) of 18-44- year- olds in Kirklees earning less than £10,000 smoked compared to 1 in 4 (28%) earning £10,001-£20,000 and 1 in 5 (22%) earning £20,0001 to £30,000. There was a similar pattern in all age groups. In 2012 in Kirklees, 23% (1 in 4) of current smokers were routine and manual workers, a group who are 1.6 times more likely to smoke than those who work in other professions8. Smoking rates in routine and manual workers (R&M) varies locally from 1 in 7 (14%) in Denby Dale and Kirkburton, to 1 in 4 (26%) in Dewsbury. Nationally, 27% of R&M workers smoked in 20101, compared with 13% of those in managerial and professional groups1.
Women of childbearing age (WOCBA) and pregnant women
Smoking amongst women aged 18-44 years in Kirklees decreased from 1 in 4 in 2005 (24%) and 2008 (23%) to 1 in 5 (21%) in 20128. Just over 13% of all women in Kirklees smoked during pregnancy in 2011-12, similar to national levels2. There is wide variation across Kirklees in non- south Asian women smoking during pregnancy, from 2% in Denby Dale and Kirkburton to 26% in Batley and 32% in Dewsbury. Over half of white women who had an infant die smoked during pregnancy9.
Those with long-term conditions, including mental health8
Locally, in 2012, many people suffering from smoking-related conditions continued to smoke: for example 1 in 4 people with COPD (26%) and asthma (24%), 1 in 6 (17%) people with heart disease, 1 in 5 (18%) with high blood pressure and 1 in 4 (23%) people who have had a stroke. All of these have increased slightly from 2008 levels. Over 1 in 3 (31%) people with depression were current smokers in 2012. Only 1 in 7 (14%) of current smokers rate their general health as bad, with over half (51%) rating it as good. This rises to 56% amongst current women of a childbearing age smokers and 64% amongst current routine and manual smokers.
Tobacco: Where is this causing greatest concern?
In 2012, as in 2008, Dewsbury had the highest levels of adults smoking at 1 in 4 (24%). Lowest smoking levels were in Denby Dale & Kirkburton at 1 in 10 (10%), which had decreased from 12% in 2008. In Dewsbury, 2 in 5 (39%) of 14-year-olds had tried smoking, significantly higher than all other areas. More 14-year-olds smoked weekly or more in Dewsbury (13%) and Batley (11%), and least in Denby Dale & Kirkburton (4%).
Tobacco: Views of local people
“My mum smokes, my dad smokes, my mum’s boyfriend smokes, my grandma smokes, my auntie smokes ….” (young male smoker, Batley)*
Local insight12 from Batley has highlighted key issues for residents in routine and manual occupations regarding reasons for continuing to smoke and/or barriers to wanting to stop.
- Insight from the routine and manual group shows that they gain more satisfaction from smoking than other life experiences.
- For men, being able to have a drink and a smoke with their friends and colleagues was seen as a ‘working class right’ and promoted group based relaxation.
- Smoking offered women ‘me time’, the opportunity to leave all their worries behind them, if only briefly, and time to be alone.
- These women disliked advertising that made them feel they were jeopardising the health and wellbeing of family members: “It doesn’t matter what advertising or leaflets or campaigning you do, people enjoy smoking.”12
Tobacco: What could commissioners and service planners consider?
The national tobacco action plan outlines key strands of tobacco control. These prioritise stopping the promotion of tobacco, making it less affordable, effective regulation of tobacco products, helping tobacco users to quit and reducing exposure to second-hand smoke. Priority actions for Kirklees reflect these priorities and are:
- Comprehensive tobacco control via the creation of an overarching Tobacco Alliance.
- To prevent the uptake of smoking by challenging social norms around smoking.
- Support for smokers to quit smoking through appropriate stop smoking support.
- Working to increase awareness around the risks of second-hand smoke and encouraging the establishment of smoke-free homes and cars.
- Statistics on Smoking: England 2012. The Health and Social Care Information Centre 2012. www.ic.nhs.uk
- Statistics on Women's Smoking Status at Time of Delivery: England, Quarter 4, 2011/12 www.ic.nhs.uk
- Department of Health. Our Health and Wellbeing Today London: DH Publications. 2010.
- Department of Health and Human Services (US) (2000). ‘Healthy people 2010: Understanding and improving health 2nd edition.’ Washington DC: US Government printing office.
- Passive Smoking and Children. A Report by the Tobacco Advisory Group of the Royal College of Physicians, March 2010.
- NICE Public Health Guidance 23. School Based Interventions to Prevent Smoking. National Institute of Health and Clinical Excellence, February 2010.
- NHS Kirklees, Kirklees Council and West Yorkshire Police. Young People’s Survey (YPS). 2009.
- NHS Kirklees and Kirklees Council. Current Living in Kirklees (CLIK) survey. 2012.
- NHS Kirklees. Infant Mortality Report 2010.
- Family Nurse Partnership. Kirklees Wave 3A Annual Report. 2012
- Maddams, J, Utley, M and Moller, H. 2012. Projections of cancer prevalence in the United Kingdom, 2010-2040. British Journal of Cancer.
- McGarry (2008) Smoking in Kirklees. Accent MR.*
*All respondents (nine in total) were aged 20–40 and medium to heavy smokers with this defined as smoking 20 or more cigarettes per day.
Tobacco: Date this section was last reviewed
Kirklees has higher than average alcohol consumption and liver disease mortality rates in males. The local evidence identifies that those who are middle aged and have higher incomes are more likely to consume alcohol more frequently, but problematic drinking patterns (>7 units on a typical drinking day) are more prevalent in those with low household incomes, in those with routine and manual (R&M) occupations and 18-34 year old males and females. Those who binge drink are also more likely to smoke and take drugs. Over a third of women of childbearing age (WOCBA) and 20% of those with a long term condition drank in excess of the recommendations. Trends indicate that while males appear to be reducing their binge drinking habits, women of childbearing age appear to be binge drinking more than in 2005. The drinking behaviour of parents, carers and other family members is a strong influence on their children’s alcohol use. 4 out of 5 (82%) of those surveyed were not concerned about the amount of alcohol they consumed.
Alcohol: Why is this issue important?
Alcohol is the second biggest lifestyle health risk factor after tobacco use. Regularly drinking over the recommended daily limit can lead to short term (e.g. disturbed sleep, feeling stressed, memory loss) and long-term adverse effects (e.g. raised blood pressure and CHD, liver disease, cancers, mental health problems, stomach ulcers)1. Alcohol misuse is currently grouped into four areas: lower risk (recommended daily levels), increasing risk, higher risk and alcohol dependency2. Synthetic estimates for Kirklees from the Yorkshire public health observatory found that almost 1 in 4 (23%) of the population were “increasing risk drinkers” while 1 in 16 (6%) were “higher risk drinkers” and 1 in 20 (5%) were alcohol dependent3. Binge drinking in Kirklees (drinking 7 or more units for females/males on a typical drinking day) was 21%, similar to national figures of 1 in 5 (20%)3. It is estimated that alcohol is a factor in 1 in 3 (30%) sexual offences, 1 in 3 (33%) burglaries, and half of street crimes in the UK1. The 2011 “Your Place Your Say” survey5 found that approximately 1 in 3 (30%) respondents perceived drunk or rowdy behaviour as a problem in Kirklees5. Higher risk drinking also contributes to increased risky sexual behaviour, absenteeism, and drug misuse6. Whilst most 14-year olds in Kirklees do not drink, those that drink regularly are more likely to smoke and use illegal drugs7. Similarly, adults (especially 18-44 year olds) who binge drank were almost twice as likely to smoke, and 2.5 times more likely to have used illegal drugs in the last five years8.
In Kirklees, hospital admission rates for alcohol conditions and alcohol related death rates increased between 2006 and 2010 and alcohol related mortality (overall and liver disease) for males in Kirklees was higher than the regional and national average in 20109.
Alcohol: What significant factors are affecting this issue?
External and environmental factors such as the physical environment, work and income can influence the amounts and the manner in which people drink11. Alcohol was 69.4% more affordable in 2007 than it was in 198012 and Kirklees has the fifth highest number of licensed premises in Yorkshire and Humber3.
The local evidence identifies that those who have higher incomes and are in the least deprived IMD are more likely to consume alcohol above recommended drinking levels and less likely to abstain. However, problematic drinking patterns (>9 units on a typical drinking day) are more prevalent in those with low household incomes/within the most deprived IMD quintile8.
Alcohol: Which groups are most affected by this issue?
Children, young people and families
Alcohol drinking during any stage of childhood can harm a child’s development and young people who begin drinking before the age of 15 are more likely to experience problems related to their alcohol use15. The drinking behaviour of parents, carers and other family members is a strong influence on their children’s alcohol use and a family history of alcoholism is associated with an increased risk of alcoholism in children15. Locally, of 14-year olds who drank, over half (56%) reported their family as their primary source of alcohol with only 1 in 8 (12%) buying it for themselves7.
Adults: in Kirklees in 20128
- Only 7.4% of males and females did not drink any alcohol. Over half of those who were Asian did not drink alcohol in comparison to just 5% of those who were white.
- 60% of males and 40% of females drank alcohol at least 2-3 times per week. Those drinking alcohol more than four times a week were more likely to be aged between 45-64 and those earning in excess of £40,000.
- Those who were more likely to drink in excess of recommendations (<4 units on a typical drinking day) were households with an income greater than £20,000; males aged 25-34 (58%) and females aged 18-24 (58%); those in sales and customer service positions (64% M and 44% F); R&M males (56%) and females in managerial positions (42%).
- Those who were more likely to binge drink (>7 units on a typical drinking day) were males overall (33%) and females aged 18-44 (43%), male and female single parent (33%), obese males (31%), R&M males (35%), males working in skilled trade occupations (39%) and as process, plant or machine operatives (38%), and females working within sales and customer service occupations (24%).
- Overall, 82% of those surveyed were not concerned about the amount of alcohol they consumed whilst 12% were concerned and planned to reduce their intake.
Children and young people in Kirklees in 20097
- The age at which children have their first drink has essentially remained the same at 11.1 years (2007) to 11.5 years (2009).
- 2 in 3 (66%) children have tried alcohol by age 14, fewer than in 2007 (72%) and 2005 (84%).
Women of childbearing age (WOCBA: 18-44 years old)8
It is recognised that alcohol has detrimental effects on the health status of women of reproductive age and on the foetus, and locally, 1 in 4 (26%) of this group reported binge drinking. The majority of these women were white (29%), in the most deprived IMD category (37%), had a long-term limiting illness (31%) and workless (31%), and single (35%). For WOCBA with dependent children, 1 in 4 drank <7 units on a typical drinking day. Approximately 87% of this group were not concerned about the amount of alcohol they consumed. Of those who were concerned only 17% planned to reduce their alcohol consumption.
People with long-term limiting illness and specific long-term conditions (LTCs)8
1 in 5 (19%) of those with a long-term limiting condition drank at least 7 units on a typical drinking day. Overall, males with LTCs were more likely to drink more than females and people with depression and pain had higher than average drinking levels.
Those drinking below recommended alcohol guidelines were more likely to fall within the Health Conscious Realists (HCR) category; while those at or above the current alcohol guidelines were more likely to fall within the Live for Today (LFT), Unconfident Fatalists (UF) or Hedonistic Immortals (HI) categories. There are a proportion of those who do drink in excess of current Government guidelines but who fall within the HCR category, which may indicate that they are not aware that they are consuming alcohol at levels which are detrimental to their health.
Alcohol: Where is this causing greatest concern?
- Birstall & Birkenshaw (29%), Spen (29%) and Huddersfield South (27%) had the highest percentage of binge drinking in males and Huddersfield South (23%), Dewsbury (23%) and Birstall & Birkenshaw (21%) had the highest percentage of binge drinking in females. Furthermore, 32% and 34% of WOCBA in Birstall & Birkenshaw and Dewsbury binge drank.
- 84% of respondents in Dewsbury, Spen and Huddersfield South were unconcerned about the amount of alcohol they consumed and this figure rose to 90% of WOCBA in Spen and Dewsbury.
Local trends in alcohol consumption
Trends in alcohol consumption appear to have flattened out between 2005 and 2012 in those drinking at lower levels (data not shown). Those drinking at least 7 units on a typical drinking day has decreased in males (both white and BME males) while it has increased in females; especially in women of childbearing age.
Alcohol: Views of local people
Drinking at the outlined levels is viewed as the norm and local insight reflected that many local people consider Government health messages around alcohol unrealistic. Also, this insight identified limited recognition of specific long-term effects of excessive alcohol consumption and that peer pressure, along with habit, routine and boredom were all reasons teenagers and young adults choose to consume excessive alcohol.
Overall, certain subgroups of the population of Kirklees drink alcohol in excess of recommendations and this may have adverse public health and economic implications. There appears to be a significant proportion of women of childbearing age and people with certain long-term conditions who drink excessively. It would appear that the public still find the alcohol-related Government health messages confusing, are unaware of the long-term effects of excessive alcohol intake and believe that their drinking patterns are “normal” as 4 out of 5 people in Kirklees are unconcerned about their level of drinking.
Alcohol: What could commissioners and service planners consider?
Priorities for the Kirklees Alcohol Strategy include:
- Ongoing support for the development of work around earlier identification of alcohol misuse within primary care and other settings.
- Ongoing development work to skill up the wider frontline workforce across Kirklees to signpost, give brief advice and support, more targeted to needs.
- Significant work to engage acute hospital trusts more in accident and emergency and hospital-based alcohol services.
- More campaigns highlighting the effect of alcohol misuse in children, women of childbearing age and adult males.
- Consolidation of specialist treatment capacity for dependent drinkers.
- Development of a Liver Prevention Strategy to promote earlier diagnosis and treatment of liver disease.
- Support for minimum pricing and community safety initiatives to better manage the on and off trade and night-time economy.
- Drinkaware (ND). Available from: http://www.drinkaware.co.uk/ (accessed on 15th of January 2013.
- Department of Health. Signs for Improvement: Commissioning Interventions to Reduce Alcohol-related Harm. London: DH Publications; 2009.
- YHPHO. NHS Yorkshire and the Humber, Healthy Ambitions – Staying Healthy Alcohol Main and Alcohol Supporting Information; 2010. Available from: http://www.yhpho.org.uk/resource/item.aspx?RID=79123 (accessed on 6th of January 2013).
- Davies SC. Annual Report of the Chief Medical Officer, Volume One, 2011, On the State of the Public’s Health. London: Department of Health; 2012.
- Your Place – Your Say Survey; 2011.
- APHO. Technical Briefing 1; Sources of Data on Lifestyle Risk Factors in Local Populations; 2005. Available from: http://www.apho.org.uk/resource/item.aspx?RID=39441 (accessed 12 December 2012).
- Young People Survey; 2009.
- Ipsos Mori. Current Living in Kirklees Survey; 2012.
- North West Public Health Observatory (ND). Local Area Profiles for England: Kirklees.
- (WHO, 2001)
- HM Government. The Government’s Alcohol Strategy. The Stationery Office. London; 2012.
- ONS. Affordability of Alcohol in the UK. Trends in the Affordability of Alcohol in the UK; 2008.
- ONS. Smoking and Drinking Among Adults in 2009; A Report on the 2009 General Lifestyle Survey. London; 2011.
- Marmot. Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England Post 2010; 2010.
- Kirklees Partnership. Joint Strategic Needs Assessment for Kirklees 2010. Health and Wellbeing. Key Issues for the People of Kirklees; 2011.
- WHO. Handbook for Action to Reduce Alcohol Related Harm; 2009. Available from: http://www.euro.who.int/__data/assets/pdf_file/0012/43320/E92820.pdf (accessed on 15th January 2013).
Alcohol: Date this section was last reviewed
Drug misuse: Headlines
Misuse of drugs is strongly associated with a range of physical and mental health problems such as blood borne viruses including hepatitis B and C and is strongly associated with a range of social issues including school absenteeism, safeguarding, troubled families, homelessness and unemployment. It can also lead to significant crime and disorder, affecting families, local communities, and local economies.
Drug misuse among adults and young people has fallen steadily in Kirklees, reflecting the national picture, and only 1 in 125 (0.8%) of the population aged 18 and over in 2010/11 used heroin and crack cocaine. Crack and heroin users represent an ageing population as fewer young people use Class A drugs, though there remain 460 people with the most serious problems outside treatment. Overall drug use in younger people and adults is falling. Cannabis remains the most popular drug used, though for the first time the Current Living in Kirklees (CLIK) survey has picked up use of “legal highs” which have been used by 24% of people who reported drug use in the last five years.
Drug misuse: Why is this issue important?
Drug misuse includes Class A drugs such as crack and heroin and also cannabis, cocaine, ecstasy and “legal highs”. It is associated with a range of health and social problems. Health problems can include mental ill health, blood borne viruses (HBV/HCV/HIV), earlier onset of age-related health conditions and poorer life expectancy. Smoking drugs and tobacco raises the risk of lung damage; a lifetime of drugs, alcohol and smoking raises the risk of cardiovascular disease for older drug users; undiagnosed or untreated hepatitis C can cause cirrhosis, liver failure, liver cancer and death; many injectors develop circulatory problems and deep vein thrombosis; arthritis and immobility are common among injectors.
Nationally about a third of the population admit taking illicit drugs at some stage in their lives and around 1 in 5 young adults say they have recently used drugs (mostly cannabis). Of the less than 2% of the population who have used opiates or crack in the past year, most will stop before they become addicted2. Increased risk of social problems is associated with dependent drug use, for example low educational attainment, limited employment experience, offending and homelessness. In short, drug misuse can blight lives and significantly limit life chances2.
Drug misuse: What significant factors are affecting this issue?
Demand for services and changing patterns of drug use
Kirklees has 2,572 problem drug users of heroin and crack cocaine (1 in 125, or 0.8% of the population) according to the last available estimate by the National Treatment Agency1. Of these, 860 were injecting drugs, 1,408 were in “effective treatment” in 2011/12 and 794 people in treatment reported having children. When engaged in treatment, people use fewer illegal drugs, commit less crime, improve their health, and manage their lives better – which also benefits the community1. The CLIK survey reports that 1 in 20 (7%) of Kirklees residents have used drugs in the last five years. Whilst 80% of this group have used cannabis and 5% heroin, the survey picked up use of “legal highs” by 24% of the drug-using group13. With little firm evidence about work and the health or community impact this is an emerging trend that needs to be addressed.
Mental health and offending behaviour
Occurrence of mental ill health amongst the drug treatment population is high with 3 in 4 experiencing one or more conditions4. The Kirklees dual diagnosis service currently supports 70 people with the severest co-morbidity of drug and mental health problems. Services for offenders have a long history of partnership working and integration in Kirklees and the Drug Intervention Programme works with 350 people in a partnership between treatment services and the Police.
The number of problematic drug users, admission rates for drug specific conditions and the number of individuals in contact with structured drug treatment services is closely linked to deprivation3. Most people accessing the adult treatment system are unemployed and not in education. Many have low basic skills, including literacy levels, and many are offenders or live in inappropriate accommodation5.
Injecting drug use and sharing of associated paraphernalia remains the greatest source of hepatitis C virus acquisition at 93%6. Transmission of HCV and HIV remains higher than in the late 1990s with 2 in 5 injecting drug users now infected with HCV and just over 1% with HIV6.
The development of community assets and social return
There are many local assets addressing the issue – recovery hubs in Dewsbury and Huddersfield provide peer-led support and aftercare and treatment services are popular with service users. Primary care services are increasingly an option as heroin use reduces. Drug services commissioning plans are engineering a shift towards recovery and re-integration for Class A drug users and “upstream” and therefore shorter interventions for younger substance users who are using cannabis, cocaine or legal highs. Building social capital at individual (self-help) and community levels (social care and family support) is designed to consolidate impact and we already know that for every £1 spent on interventions there is a social return of £5.831.
Drug misuse: Which groups are most affected by this issue?
The Government’s drug strategy says that specialist interventions should prevent young people’s drug and alcohol use from escalating, reduce harm young people cause themselves or others, and prevent them from becoming drug or alcohol-dependent adults. Specialist interventions in Kirklees are delivered according to a young person’s age, degree of vulnerability, and the severity of the problem. In 2011/12 164 children under 18 required support for substance misuse drug problems and over 90% were referred for help with cannabis and/or alcohol.
- 1 in 8 (12%) of all 14-year olds had tried illegal drugs – dropping from 2007 (16%) and 2005 (17%).
- Cannabis was the most tried drug; virtually all 14-year olds (94%) who had tried drugs had tried cannabis.
- Only 7.3% of those having tried drugs had been “out of control” monthly or more often.
- 163 young people under 18 are receiving support for drug misuse, primarily cannabis and alcohol.
Vulnerable young people
Vulnerable young people are at particular risk of substance misuse, especially looked-after children, young offenders, truants and pupils excluded from school, homeless young people and young people not in education, employment or training (NEET)9. Locally in 2008, half of local young people recorded as having a substance misuse issue were NEET and 1 in 7 young offenders required specialist treatment9.
Families and carers
Substance misuse by parents and/or other (significant) adults can strongly influence children. Nationally, 1 in 3 child protection plans and 62% of care proceedings were attributable to substance misuse. Effectively treating adults for substance misuse and supporting them to change their behaviour is a primary influence on their children’s behaviour9. There are estimated to be over 1,000 carers of substance misusers currently in treatment in Kirklees and in excess of 9,000 people living with misusers of all substances (including cannabis and alcohol)10. Carers often feel anxiety, depression, helplessness, anger and guilt associated with this11.
Drug misuse: Where is this causing greatest concern?
Both treatment and arrest data shows that adult drug use remains an issue in Huddersfield South. In 2008/9, 26% of those in Huddersfield South were in treatment, compared to 22% in Batley, Birstall & Birkenshaw, which had the highest percentage (24%) in 2007/8. Nearly 1 in 3 (31%) of those with a positive test for drugs at arrest lived in Huddersfield South, although for nearly 1 in 4 (23%) of those testing positive, their residence was unknown.
Fourteen year olds living in the Valleys reported the highest levels of occasional drug use (11% compared with a Kirklees average of 8%) and of monthly drug use (5% compared with a Kirklees average of 3%). Huddersfield South has the second highest rate of occasional drug use (9%) and Dewsbury the second highest rate of monthly drug use (4%).
Drug misuse: Views of local people
People in Kirklees are concerned about the relationship between drug use and crime. We also know that people who access treatment express good levels of satisfaction with their experience of treatment and support.
Drug misuse: What could commissioners and service planners consider?
The priorities are to engineer a shift, based on changing patterns of drug use, towards prevention and early intervention for non-dependent users, and recovery and re-integration for Class A drug users. This includes:
- Developing evidence-based interventions for young people in schools and other settings in accordance with emerging evidence.
- Developing segmented stepped care pathways into services that are based on supporting people as early as possible and as late as necessary.
- Ensuring that the whole system has a focus on recovery where necessary.
- Ensuring that the health needs of service users are being met, particularly around emotional health and wellbeing and blood borne viruses.
- Ensuring services are driven by quality standards, the evidence base and clinical effectiveness.
- Maintaining the focus on offenders and on the reduction of offending behaviour.
- Ensuring that parental problem drug and alcohol use and its impact on children is fully addressed by a more integrated approach to commissioning.
- Ensuring that people across Kirklees, from all backgrounds and localities, have equitable access to relevant services.
- Maintaining the focus on families and carers.
Drug misuse: References
- JSNA Support Pack for Strategic Partners for Adults and Young People, NTA 2013. SROI analysis; 2011.
- Centre for Drug Misuse Research, University of Glasgow. Estimates of the Prevalence of Opiate Use and/or Crack Cocaine Use in England 2008/9: Sweep 5 report; 2010.
- Marmot M. Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England Post 2010; 2010. Available from: http://www.marmot-review.org.uk/
- Weaver et al. Co-morbidity of Substance Misuse and Mental Illness Collaborative Study (COSMIC). London: National Treatment Agency; 2002.
- National Treatment Agency. View It; 2009.
- Health Protection Agency, Health Protection Scotland, National Public Health Service for Wales, CDSC Northern Ireland, CRDHB. Shooting Up: Infections Among Injecting Drug Users in the United Kingdom 2008. An Update: October 2009. London: Health Protection Agency; 2009.
- Home Office. Hidden Harm - Responding to the Needs of Children of Problem Drug Users. London: Home Office; 2003.
- NHS Kirklees, Kirklees Council and West Yorkshire Police. Young People’s Survey (YPS); 2009.
- Cairns C. Hidden Harm: Safeguarding the Children of Substance Misusers in Kirklees: An Overview of Prevalence and Practice; 2009.
- Copello A, Templeton L, Powell J. Adult Family Members and Carers of Dependent Drug Users: Prevalence, Social Cost, Resource Savings and Treatment Responses. London: UK Drug Policy Commission; 2009.
- Orford et al. Coping with Alcohol and Drug Problems: The Experiences of Family Members in Three Contrasting Cultures. London: Taylor and Francis; 2005.
- Communities and Local Government. The Place Survey, England 2008; 2009.
- Currently Living in Kirklees Survey, IPSOS Mori; 2012.
Drug misuse: Date this section was last reviewed