Whole Population Prevention:
There is no locally co-ordinated campaign that addresses whole population prevention. Key messages need to be developed to respond to trends of use emerging for different age groups and showing evidence of harm.
Screening and Brief Interventions in primary care:
The evidence base clearly states that this should be in place across primary care settings for all patients or as a minimum those at risk. There is currently no co-ordinated programme of screening in place within primary care.
Treatment and Recovery Access, treatment models, age appropriateness of treatment:
There is evidence that older (40/50 plus) substance users are reluctant to seek support from traditional services, because of the model of service provision and concerns over stigma at accessing a drug and alcohol service. We need to think differently about what services are offered (not just for this age group), across the health system and in different settings, to avoid this stigma.
Psychology and psychological support:
For older adults with alcohol dependence issues.
Dual Diagnosis psychology/psychological support:
Gap in provision for those who don’t have Serious Mental Illness but suffering from significant other mental health issues as well as issues with drugs, alcohol, and other lifestyle behaviours.
Rapid access to prescribing is a protective factor against drug related deaths. Same day prescribing models are in place in other parts of the country, longer waits are in place locally with Carmarthenshire having the third highest drug related deaths in Wales. Local model reliant on GP capacity for prescribing.
Service User Involvement:
Good local service involvement but little involvement of service users within planning process.
Harm Reduction Learning and Implementation:
Review of alcohol deaths as well as drug deaths needed, and we need to establish non-fatal reviews.
Fundamental to an individual’s ability to recover. Limited options available locally and housing reallocation policies often detrimental to recovery.