Agenda item

Report ES15082

The report on Drug Misuse in Bromley was presented to the Committee by Dr Nada Lemic, Director of Public Health. The report was drafted to provide members with information on drug misuse in Bromley, and the Committee were asked to note the report, and to consider and comment on the issues that it raised.

Dr Lemic summarised the main points of the report, and the Deputy Borough Commander stated that he had nothing to add. It was noted that most people in Bromley started to take illicit drugs in their early twenties, and that as well as addictions to these substances, individuals also experience addictions to prescription only medicines and over the counter medicines. The Committee heard that Bromley had a lower rate of drug use than England and London in all categories. The main substances that individuals were addicted to were opiates and alcohol. The population receiving treatment for substance misuse were predominantly white males in the 40 to 49 age group. Mortality rates related to drug abuse and drug poisoning had been increasing since 1993, with heroin and morphine as the most commonly implicated drugs. 

The Committee heard that drug abuse in Bromley was also the cause of blood borne infections, mental health issues and increased hospital admissions. It was also noted by the Committee that drug misuse had various socioeconomic impacts; these included healthcare costs, crime, homelessness and family breakup. It was also the case that productivity was lost, and unemployment increased in proportion to the severity and misuse of drugs and alcohol.

The Committee were briefed concerning the various intervention programmes provided by Bromley Drug and Alcohol Service. Dr Lemic informed Members that the way in which effective treatment was gauged was by calculating the number of individuals that had been in treatment for three months or more. It was the case that in 2014-2015, 462 individuals effectively engaged in treatment in Bromley-- which equated to 89% of the treatment population. The main measure of successful treatment was the proportion of people that successfully completed treatment and did not return for six months. Bromley had a higher proportion of successful completers than the national value in all categories of substance misuse. 

The Chairman drew attention to section 6.1 of the report that was concerned with the main aims of drug treatment, and asked why the main aim of the treatment was not to get people to quit drugs. She also referred the Committee to the bar charts relating to section 6.4 of the report that dealt with treatment outcomes for adults. The bar charts provided data concerning what was regarded as “Successful Treatment Completion” based around the criteria that adults did not refer back for treatment with six months. The Chairman was interested to know what happened to these individuals in the longer term. The Chairman also pointed out that there was no mention of budgets in the report.

Dr Lemic responded that treatment was concerned with three issues prior to the possibility of abstinence in the future. The first aim was to reduce the level of harm that an individual was doing to him/her self. A secondary aim was to reduce socio economic impact, and a third priority was concerned with “maintenance”. “Maintenance” was the term applied to keeping patients alive and well, and this was regarded as a good outcome. In terms of outcomes, Dr Lemic stated that outcomes were primarily looked at in terms of completion or non-completion of treatment. No budget figures were available on the night, but Dr Lemic estimated that the total spend for drug and alcohol treatment for adults and children was in the region of £1.4m. Dr Lemic agreed to circulate a breakdown of costs post meeting to Members.

(Post meeting note—this information has now been circulated)

Councillor William Harmer asked why it was the case that there was a high percentage of drug abuse and misuse in the 44-49 age range. Dr Lemic answered that it was difficult to give a definite answer but she felt that the fact that Bromley was an affluent area was significant. In Bromley the profile of those that engaged in risky behaviour was white middle class men who often had well paid stressful jobs, and could afford their drug habit.

Cllr Benington noted that there was no reference to “skunk” in the report, and asked if any data was available concerning this. Dr Lemic responded that she had confined her report to those that were being treated. Data concerning “skunk” users was not good as they were not engaging in treatment. Cllr Michael Tickner asked how a distinction was made between alcohol use, and alcohol mis-use. Dr Lemic explained that this would be determined by looking at alcohol caused conditions, and alcohol related conditions.

Cllr Cartwright asked how many people were being treated in Bromley annually. Dr Lemic referred the Committee to section 4 of the report where it stated that during 2014-2015, 730 people had made contact with drug and alcohol services, this compared with 863 for the previous year.

Cllr Judi Ellis reminded the Committee of the problems caused by drug dealers in cars. She asked if drug dealers shared information with the police when they were arrested. The Deputy Borough Commander answered that in most cases these individuals did not share information with the police. They may sometimes provide geographical data, but generally not names. Cllr Ellis asked if the drugs were coming from within the borough. She also commented that in various places, needles had been found in alleyways. Dr Lemic stated that a significant proportion of individuals obtained drugs from London, where many of them worked in the City.  Cllr Ellis was reassured that drug abuse did not seem to be a significant teenage problem. Dr Lemic highlighted that with younger people, the more serious problem was alcohol abuse rather than drug abuse.

Cllr Charles Rideout wondered why children under the age of 15 would start experimenting with drugs. Dr Lemic stated that it was not clear why this was the case. It has been observed that alcohol and drug mis-use levels had shown significant differences between schools. Cllr Stephen Wells asked how “Looked after Children” were handled. Dr Lemic clarified that LAC children were dealt with in the same way as other children.

Cllr Pauline Tunnicliffe commented that £1.4m was a lot of money for seven hundred people. She asked that in view of the financial pressures facing the Council, would dealing with drug and alcohol abuse still be a priority for the future. She asked if more of these people could be referred to the private sector for treatment, and fund the treatment themselves. Dr Lemic responded as follows:

·  Bromley had a low budget spend per head

·  The budget was reducing, and had reduced by a third

·  Services had been rationalised

·  There was a statutory responsibility to treat people 

Cllr Judith Ellis expressed concern regarding cases of foetal alcohol syndrome in the babies of mothers who drank alcohol while pregnant. She wondered if there were effective ways of monitoring the children in these family units where  the parents were being treated for alcohol abuse. Dr Lemic answered that there was a health visiting service that was operational to provide antenatal support, and that this service worked closely with the midwifery service. It was also the case that the Family Nurse Practioners Programme could provide nursing support to pregnant mothers if required. 

Members noted that a person testing positive for drugs on arrest was obliged to attend a drugs assessment. However, they would have to voluntarily accept treatment for there to be any chance of a successful outcome. Cllr Tickner asked if the police were able to work with housing providers to use disruption tactics by moving people to alternative accommodation if that was appropriate. Dr Lemic stated that this was something that she would need to look into.

Cllr Thresher wondered what more could be done to work pro-actively with schools, and what support services could get involved in this work. Dr Lemic clarified that Dr Jenny Selway was the Lead for Schools. It was the case that in most cases, schools were independent, and were often not keen to engage  in rehabilitation programmes as they were concerned about reputational damage. Precious Adewunmi (BYC) felt that teachers should be trained to identify and take appropriate action concerning drug and alcohol mis-use.

Cllr Stephen Wells enquired if young people referred on to recovery programmes by the Youth Justice System were paid for by the YJS. Dr Lemic responded that this was not the case, and that the cost was borne in the normal manner by Public Health.

The Chairman thanked Dr Lemic for answering questions, and for presenting the report, and felt that it would be a good idea for an update report to come to the Committee in the future.

RESOLVED that the report be noted, and that an update report be brought to a future meeting of the Committee