Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Committee Room 2 - 02/10/2006 09:30:00 AM)
Item: A1 Minutes
HEALTH SCRUTINY SUB COMMITTEE
ALCOHOL and DRUGS MISUSE
2 OCTOBER 2006
Present Councillor R Harrison (in the Chair)
Councillors Campbell, Carr, Chaplow, Crosby, A Gray, Hamilton, Harrison, Holroyd, Hunter, Priestly, Stansfield and Wade
Also Present F Jassat and G Tompkins
Apologies were received from Councillors Agnew, M Iveson and Porter.
1. Welcome and Introduction Councillor Harrison thanked everyone attending and introduced Alyson Learmonth, County Durham PCT, Gill Eshelby Deputy Head of Service and Kate Martin Assistant Head of Service County Durham Youth Engagement Service and Phil Shaw, Anti Social Behaviour Co-ordinator, Wear Valley District Council.
2. Declarations of Interest Councillor Hamilton, as a Member of Teesdale District Council’s Licensing Committee, Councillor Stansfield as a magistrate and Councillor Crosby as a mentor at Deerbolt Youth Offending Institution.
3. Notes of the Working Group and Members Bulletin from the meeting held on 20 September 2006 The Working Group approved the notes of the meeting and the members bulletin of the meeting held on 20 September 2006 (for copy see file).
4. Consequences of Alcohol and Drugs Misuse in relation to health, Crime and Disorder, Education and Employment and Family and Society. A presentation was received from Alyson Learmonth, of County Durham PCT about the impact of alcohol use on health.
When alcohol is used it changes the circulation and digestive systems. Small amounts of alcohol stimulate gastric juices and the appetite, but large amounts cause inflammation of the stomach lining. Alcohol also reduces inhibitions and increases confidence though it affects motor skills and lowers ability to perform simple tasks. Alcohol also depresses the nervous and respiratory systems. As a result of the calorie content of alcohol, heavy drinkers are likely to gain weight and become obese. Alcohol is broken down by the liver and habitual drinking increases tolerance as the liver breaks it down faster. Eventually however the liver will be unable to cope and will fail.
There are many health consequences of excess consumption of alcohol. These include:
- Cancers of the mouth, digestive system and breast.
- Circulatory conditions such as strokes, heart disease and hypertension
- Gastrointestinal problems including inflammation of the pancreas, cirrhosis of the liver and hepatitis.
- Injuries involving accidents, assaults, domestic violence suicide and poisoning. It is estimated nationally that 1 in 11 live in household where their parents abuse alcohol. It is likely that the percentage is higher in the north east region.
- Mental health problems.
- Foetal alcohol syndrome i.e. heavy drinking heavily when pregnant.
Whilst the levels of safe weekly consumption has been defined for adults (21 units for men and 13 for women), there is no safe limit or risk free drinking for children and young people. It is hard to predict the long-term consequences for the health of children and young people who drink heavily.
It was explained that young people are more likely to binge drink and are at risk of experiencing a coma at lower blood alcohol levels than adults. This can develop into hypoglycaemia, hypothermia and breathing difficulties. Nationally a thousand young people under 15 years of age need emergency treatment for alcohol poisoning each year. This needs to be monitored closely as the level of admissions may be higher.
Alcohol consumption is associated with unsafe sex and sexual assault. It also leads to increased incidents of accidents and violence and is associated with crime and anti social behaviour. It is known that consumption of alcohol reduces pupil’s school performance and 14% of school exclusions are related to drinking alcohol at school
It was suggested that to begin to deal with this issue will need a multi agency approach including
- Alcohol education to be provided in schools and informal youth settings.
- Provision of diversionary activities.
- Raise awareness of parental drinking.
- Effective enforcement of age restrictions.
- Fully utilise school nurses and other preventive services.
- A & E based interventions and monitoring.
- Codes of practice regulating the merchandising of alcohol to young people.
- Planning process - many regeneration schemes are based on sale of alcohol.
Issues Aggression towards A& E staff - cause of staff stress
Parental Responsibility/Parental Control - poor performance at school caused by pupils who drink during school hours and by the disruptive behaviour of parents who are heavy drinkers.
Delivery of services - The DAAT includes alcohol as a core part of its work although the focus on alcohol is not as clear as that of drugs. It is perceived that as alcohol plays such a large part of everyday life there is a lack of priority when it comes to dealing with alcohol issues. Therefore a clearer and consistent approach is needed when dealing with drugs.
Enforcement - Due to the easy availability of alcohol there is a need for enforcement of existing legislation and implementation of proof of age schemes.
County Durham Youth Engagement Service A presentation was received from Gill Eshelby and Kate Martin of County Durham Youth Engagement Service on the impact of alcohol and drug misuse on youth crime, education, training and employment and family and society.
The County Durham Youth Engagement Service (CDYES) has been successful in preventing offending. Since 2000 the service has halved the number of young people entering the youth justice system and has reduced the rate of re-offending by 14.8% over a period of 12 months.
The risk factors involved in the misuse of alcohol and drugs were explained. The type of offences involved is usually high in number but is of a low level. These offences have the highest impact on local communities and increase the fear of crime. Alcohol and drug misuse makes it difficult for young people to engage in education, training and employment, as it is likely that attendance and performance will be poor and will prejudice their future opportunities. As result of anti social behaviour there is a risk that the whole family could be evicted from their home and result in family breakdown and homelessness. Alternatively a family may reject a young offender in order to protect the rest of the family.
It is estimated that 25% of all young people who commit crime use alcohol or drugs. Amongst regular offenders this rises to 40%. To help prevent this young people on youth justice board programmes are screened via Onset, a national screening tool which identifies the risk factors which contribute to young people committing crime. In addition young people being supervised by CDYES are screened via ASSET (a comprehensive assessment procedure, developed by the Youth Justice Board, to identify risk factors that may predispose young people towards offending). Once young people’s needs are identified the majority of interventions are at tier 2 and are provided in house. Tier 3 interventions are dealt with by XS. Tier 2 interventions are dealt with by Drug workers who are seconded to CDYES from DISC at cost of £64k per annum from the Young Peoples pooled substance misuse budget. CDYES employs 3 Substance Misuse nurses who are deployed to XS which is funded by the Youth Justice Board at a cost of £88k. CDYES also lead on the Countywide Positive Futures programme which is a sport-based social inclusion programme aimed at 10-19 year olds. This aims to engage young people in sport and healthy activities.
Analysis of first time entrants in 2005/06 revealed that 13% had infrequent or minor offending linked to occasional substance and alcohol abuse. This will be tracked to see if this is a rising trend. Most young people who are likely to receive an ASBO are 14 to 17 year olds. It has been identified that 28% of ASBO breaches are related to the use of alcohol, usually involving consuming more than 21 units per week. Nearly half of all ASBO breaches will result in a custodial sentence.
Of the Priority Prolific Offenders (PPO’s), 61% are dealt with at tier 2 and 32% are dealt with at tier 3. This involves either providing education and awareness or guidance on the level of drinking. A new 6 month evaluation project will target PPO’s you have an identified substance misuse or alcohol need and this will focus on hidden harm. The results from the project will be reported next year.
The challenges facing CDYES include
- Funding issues - 2 DISC workers for 2007/08 and a Youth Crime Prevention post for 2008 - funding not yet confirmed
- LAA stretch targets
- Prevention of offending - County Durham’s target is almost double the national level.
- ASB - reducing the perception of ASB
- County Durham is significantly under performing the Youth Justice Board national performance measure in relation to substance misuse.
Questions Issues How do dissuade young people from misusing alcohol and drugs? - Provide diversionary activities i.e. get them involved in sport or other activities. If young people participate in sport or physical activity it is less likely that they will want to abuse their health.
How many young people are involved - 13% of first time entrants to the youth justice system use alcohol or drugs (approximately 130 young people).
Where does the funding come from? - It comes from the Youth Justice Board and the County Council and much of it is given in the form of grants.
Anti Social Behaviour A presentation was received from Phil Shaw Anti Social Behaviour Co-ordinator for the Wear and Tees Community Safety Partnership about the impact of anti social behaviour on society.
Anti social behaviour is any activity which impacts in a negative way on other people and usually includes acts such as intimidation/harassment, rowdy behaviour criminal damage/vandalism, street drinking etc. ‘Carrier bag culture’ and the easy availability of alcohol by young people can be a significant problem in some communities and is a contributory factor in anti social behaviour and the fear of crime. Some young people who are unable to buy alcohol use ‘proxy buyers’ or groups of them may intimidate shop staff into selling them alcohol.
It was explained that the Wear and Tees Community Safety Partnership aims to reduce alcohol related nuisance and disorder which will help improve quality of life in communities and make public places safer and more enjoyable. This is done by targeting young people at school (years 7-11) and college with education and awareness as part of the PSHE syllabus. It has become necessary to begin raising awareness with primary school pupils in years 5 and 6.
It is estimated that less than 2% of the population are responsible for 45% of all nuisance behaviour. This is a major contributory factor in the fear of crime and the perception of what could happen.
The consequences for young people who become involved in anti social behaviour are becoming the subject of an anti social behaviour order, a fine, a term of imprisonment or being evicted from their home.
Work will continue to tackle the underlying causes of anti social behaviour through further work with schools and colleges and a multi agency approach of prevention, intervention and necessary enforcement where this proves necessary.
Issues Stricter enforcement of existing legislation on the sale of alcohol.
Easy availability of alcohol - parental responsibility.
Deterrence - zero tolerance of problem behaviour.
Difficulty in engaging with a hard core of young people who don’t want to be engaged.
Need to identify what is happening to 12 -18 year olds
5. Conclusions and Next Steps Feisal Jassat outlined the key issues arising from the meeting:
Need to do something re: parental responsibility
Partnership working so that we are more joined up and making best use of resources
Our approach to responding to need is at best "patchy" - The Local Area Agreement is an opportunity to bond agencies/services together.
Need to ensure we protect children and young people and therefore alcohol misuse must be seen as a priority and given the resources to plan and deliver.
There is a need for consistent funding - staff should not have to spend time pursuing resources.
Principles of prevention, intervention and enforcement are key drivers that provide a framework for what we do and need to do.
Effective deterrence is an issue which needs to be considered.
We must identify examples of good practice, (i.e. diversionary schemes to reduce entrants to the criminal justice system) build on it, consider cost benefit analysis of what we do so that we can demonstrate impact and measure outcome.
. Date of Next Meeting The next meeting will take place on Friday 13 October 2006 at 11.00 a.m.