Focus on the Addictions Health Integration Team

At the time of year where many of us will be feeling the effects of over indulgence, the work of the Addictions Health Integration Team (HIT), which focuses on reducing the harm of excessive alcohol and substance misuse, feels especially relevant.

Liver disease is the fifth commonest cause of death in the UK, and the only major cause of death that is increasing. In contrast to many other European countries the UK has a growing problem with cirrhosis and liver disease which is associated with increases in alcohol consumption. Other indicators of excessive alcohol use, including hospital admissions, injury, and antisocial behaviour also are increasing. There seems to be a reluctance within government, however, to tackle excessive drinking through legislation – such as raising the minimum price and reducing access.

Alongside their work on excessive alcohol use, the team also focuses on the treatment and management of substance misuse and its key health consequences.

The team is led by Matthew Hickman, Professor of Public Health and Epidemiology, University of Bristol, Barbara Coleman, Service Manager Public Health, Bristol City Council, Katherine Williams, Substance Misuse Team Leader, Bristol City Council and Tim Williams, Clinical Director, Bristol Specialist Drug and Alcohol Service.

Projects and activities

The team is working on a number of projects. One project will look at low ‘dead space’ syringes, where less fluid is retained in the syringe following injection, helping reduce infection when needles are shared. The team is interviewing people who inject drugs to understand whether there are any unintended consequences of switching from high to low dead space syringes, and whether additional interventions to promote the use of low dead space syringes are required.

The team is also aiming to conduct a systematic review looking at whether addressing malnutrition in alcohol dependent people could prevent cognitive deficit and alcohol related brain damage. Another piece of work led by Professor Marcus Munafo will be an evaluation on the efficacy of straight beer glasses to reduce alcohol consumption in the general population. Drinkers tend to consume alcohol more quickly in curved glasses because they can’t judge the volume as readily as in a straight glass. Other projects are investigating the impact of opiate substitution treatment on drug related deaths, the cost-effectiveness of needle and syringe programmes, and the potential impact of a novel intervention to train agencies in contact with young people to conduct alcohol screening and brief interventions.

Find out more about the projects the team is undertaking. HIT Co-director Matthew Hickman presented at the NIHR CLAHRC West launch on the work of the Addictions HIT.

HIT Co-director Barbara Coleman said: “The creation of the Health Integration Team and CLAHRC West has given us the opportunity to consider care pathways for people with alcohol and drug problems and, critically, to develop and take forward evaluations that could improve the health of the population.”