Drug and Alcohol HIT reflects on 2021-22

Over the past year our Drug and Alcohol HIT has developed a renewed energy and focus. This is timely as the harms caused by drugs and alcohol have come into the spotlight across government departments due to rising drug-related deaths and increased alcohol-specific death rates.

This year we held three successful wider network meetings on trauma informed approaches, co-producing our plans for 2022/23 and improving services for women.

Working with people with lived experience

We have considerably increased the involvement of people who use drugs and alcohol in our work, including surveying people who use drugs and alcohol to understand how well the work of the HIT meets their priorities, and holding two workshops with Developing Health and Independence (DHI) service users in South Gloucestershire which explored views on our work and helped inform our priorities for next year. Finally, we welcomed an additional and valued public contributor and DHI peer to our leadership group.

Reducing health inequalities

We have been working on research looking at reducing levels of blood stream infections among people who inject drugs:

• REducing bACTerial infections (REACT) study developed and piloted a personalised, behavioural intervention, including provision of resources to support people who inject drugs care for their veins and make changes to help prevent bacterial infections.
• Related to REACT, a pilot of the universal supply of Chlorhexidine wipes across BNSSG to reduce MRSA bacteraemia is underway.
• Our HIT has been overseeing the development of a ‘Reverse Care Liver Disease Pathway’ caused by alcohol. It aims to look back at the pathway from liver disease mortality to wider determinants of health, identifying those factors that contribute to harmful levels of drinking and ultimately liver disease, and identify any potential inequalities.
• We also worked with the Sexual Health Improvement HIT to deliver HIV Awareness training to Drug & Alcohol practitioners across Bristol, North Somerset and South Gloucestershire.

Improving mental health and wellbeing

We commissioned trauma informed approaches training for local drug and alcohol providers. All respondents found the training either helpful (69%) or very helpful (31%) in supporting them as practitioners to deliver services.

We supported a stakeholder workshop to disseminate research findings on improving success of Opioid Substitution Therapy and addressing stigma faced by people in treatment. Read a blog about the event.

COVID-19

Living under coronavirus and injecting drugs (PWID) qualitative study in Bristol has been published in the International Journal of Drug Policy with an accompanying news story on the ARC West and HPRU websites, a PolicyBristol policy briefing and blog. It has also been disseminated through PHE’s Unlinked Anonymous Monitoring (UAM) Survey Anniversary webinar and an Addictions Professionals webinar to an academic, policy and service delivery audience.

The research informed local service delivery during the height of the pandemic and its recommendations continue to have relevance. For example, policy makers should consider the evidence for less frequent and unsupervised drug treatment. Research is needed to explore the effect of recent changes on the outcomes of treatment and mortality, to inform policy decisions.