Telford and Wrekin Council has been revamping its approach to substance misuse in recent years.
It has worked with a variety of partners from schools and the police to social enterprises to develop initiatives focussed on preventing problems developing and helping to build recovery.
The challenge
Telford and Wrekin Council published its drug and alcohol strategy in 2014.
It set out a new vision for services and support that was based on not just treating patients, but building recovery as well as preventing substance misuse by reducing demand, changing behaviour and restricting supply.
It said there was a “clear” need to transform services to tackle the problems locally. Evidence suggests there are 1,000 opiate users and 4,000 dependent drinkers.
But there are also worrying signs that there are many more at risk of developing serious problems.
It noted high rates of cannabis use among young people, while an estimated 24,000 people were classed as binge drinkers and 34,000 as higher or increasing risk drinkers.
The solution
With the help of partners and service users, the public health team has commissioned a series of initiatives based on prevention, early intervention, reducing supply and supporting recovery post-treatment. This includes:
- Local theatre groups being invited into secondary schools to organise substance misuse-themed plays.
- Roadshows known as Crucial Crew delivered to pupils in year six to prepare them for secondary school featuring warnings and advice about cannabis, drinking and legal highs.
- Public awareness campaigns, including information stalls, being run in the town centre.
- Brief interventions on alcohol becoming a core part of the work of the Healthy Lifestyle Hub, which provides advice to people on everything from stopping smoking to improving diet.
- Front-line staff, including GPs, social workers, Job Centre workers and housing officers, getting training on how to broach the subject, what advice to give and where to signpost and refer people to.
- Local hotels and licensed premises being engaged to adopt safer practices when it comes to selling drinks and preventing antisocial and aggressive behaviour.
- Peer-led recovery programmes being funded to provide help to people from others who have been through the same journey.
Telford and Wrekin Director of Public Health Liz Noakes said: “It is much better for both the individual personally and the council financially to try to prevent alcohol and drug problems and support people through their recovery by those who truly understand to make sure they don’t relapse, than it is to keep people treatment.”
Impact
The reach of the initiatives has been impressive across a range of settings.
In schools, more than 1,500 secondary school pupils saw the substance misuse productions, while a record 51 primary schools and over 2,000 students took part in Crucial Crew.
The Healthy Lifestyles Hub delivered 4,000 brief interventions last year. Training-wise, around 250 front-line staff have completed the basic drug and alcohol awareness training in the past two years and a similar number done more specialist motivational interviewing and cognitive behavioural therapy sessions.
Meanwhile, Telford After Care Team (TACT), a community social enterprise, which offers adults who have been through treatment on-going support through peer-to-peer help, access to training and activities, such as gardening, arts and walking groups, has been going from strength-to-strength.
Last year nearly 600 people were supported. The majority were people with alcohol problems, but one in five were people fighting drug addictions. One client who was helped described the support as “priceless”.
They said: “With their help and encouragement I’ve been able to learn many new skills and coping strategies that have enabled me to turn my life around and find a positive new meaning within it.”
Indeed, the success of TACT has convinced Telford and Wrekin Council to fund Recharge, a community interest company which is aimed at the under 21s. It gives young people peer-led recovery support through one-to-one sessions and various groups and activities.
What is more, progress is beginning to be seen in terms of treatment outcomes, mortality rates and hospital admissions. The number of admissions are falling for alcohol-specific conditions, drug-related mental health and behavioural disorders and poisoning by illicit drugs, while years of life lost from alcohol-related conditions have fallen and alcohol-specific mortality rates are no longer significantly worse than the national average.
Lessons learned
Joint work with partners, such as the police, probation and local voluntary organisations has been crucial.
As the work on preventing substance misuse and aiding recovery has developed, it became clear there was a difference in the numbers completing alcohol treatment and the numbers completing drug treatment. Nearly half finished their treatment for alcohol misuse last year, up from a third three years previously. By comparison, just 5 per cent completed treatment for opiate addiction.
Performance for drug problems tends to be worse than alcohol, but nonetheless Telford and Wrekin Council decided change was needed.
Senior Public Health Commissioner Stacey Norwood said: “The services were being run separately – there was one for drugs, one for alcohol and one for clinical treatment.
“It was too complex, we needed one single seamless system which could support people in need holistically.”
How the approach is being sustained
After extensive engagement with service users, professionals and stakeholders, Telford and Wrekin Council decided to alter its approach to treatment and recovery.
In April 2018 it launched a new singleprovider model service known as STARS (Substance Misuse Treatment Recovery Service).
STARS has been tasked with working closely with the local recovery organisations.
The coming year will also see a refreshed drug and alcohol strategy.
Telford and Wrekin Council believes both will put the tackling substance misuse agenda on a strong footing for the future.
Councillor Arnold England, the Cabinet Member for Communities, Health and Wellbeing, said: “Never before have we had such a strong partnership of professional organisations and volunteer groups working together to tackle substance misuse in our borough. We’re very proud.”
Contact details
Stacey Norwood Senior Public Health Commissioner Telford and Wrekin Council [email protected]