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Discussion on Multiple Needs

Posted on July 30th, 2015

What is ‘multiple needs’?

‘Multiple needs’ is a term used to refer to the co-morbidity of severe multiple disadvantages (SMD) such as homelessness, substance misuse and difficulties with the criminal justice system, along with occurrence of mental health disorders.

What are the statistics?

– 92% of people with SMD issues also report difficulties with mental health.

– 55% of people with SMD issues have been formally diagnosed with a mental health disorder, by a healthcare professional

– £112 million has been invested into an 8 year programme that aims to improve the treatment and lives of individuals with multiple needs, by 2020, and shall be spread throughout 12 areas within England

– 58,000 individuals in England have experienced at least one SMD within 1 year

– 164,000 individuals in England experienced an overlap of 2 or more SMD issues within 1 year

– White men, aged 25-44 are most likely to suffer SMD

– Over the course of a year, the average local authority may expect to deal with 1,470 SMD cases

– 72% of male offenders and 71% of female offenders have two or more mental health problems

Causes of SMD

A poor childhood and upbringing have been consistently identified as an important predictor of SMD. For example, 85% of individuals who had 3 SMD’s also experienced a traumatic experience during childhood. This group consisted of 42% who had run away from home, 29% who had grown up watching their parents struggle with drug and/or alcohol problems, and 17% where the parent had a mental health disorder.

Another possible cause for the co-existence of SMD and mental health issues is that they are both caused by overlapping factors. For example, drug abuse and mental health issues can be caused by underlying brain deficits, genetic vulnerabilities and early experience of extreme stress or trauma.

The Generalised Sequence of Life Events of those with Multiple Needs

  1. Substance misuse
  2. Transition to street lifestyle
  3. Confirmed street lifestyle
  4. ‘Official’ homelessness

Outlined by a team of professionals from the Heriot-Watt Univeristy (2010).

Making Every Adult Matter (MEAM)


MEAM are a coalition of 3 foundations, Clinks, Homeless Link and Mind. Clinks are a charity that works on aiding and improving the lives of convicted and released offenders. Homeless Link is a charity that aims to improve the lives of homeless people, and Mind is a mental health charity.


To improve multiple needs outcomes and mental health outcomes by the year 2020.


  1. To use feedback from individuals experiencing difficulties with mental health and multiple needs, to shape the new strategy.
  2. To reduce health inequalities for people with multiple needs.
  3. Ensuring that high-quality, mental health support is available to all those that need it.
  4. To ensure that individuals are diagnosed correctly.
  5. To form a clear cross-government strategy and commitment to those with multiple needs.

What has been done?

8 local areas were aided by the MEAM coalition, to provide appropriate ways to implement the elements of the MEAM approach. These areas are Westminster, Cambridge, Oxford, Exeter, Lichfield and Tamworth, Derby, Blackburn/Wigan, North Tyneside, Sunderland, York and Norwich. Despite being in place for just over a year, the programmes have seen a significant improvement in the wellbeing of individuals with multiple needs. There has also been a significant decrease in costs, a reduction of 26.4%!

In a review of the coalition of MEAM, Gulbenkian found that the MEAM approach has provided a valuable framework for the lengthy process involved in improving the lives of those with SMD. The approach has also sparked an interest in other national funders, which could result in an increase in speed and improvement of the MEAM approach.

Overall, the MEAM approach has received positive feedback whilst duly acknowledging that the approach will take time to be implemented thoroughly.

The need for an EU strategy to reduce healthcare costs related to alcohol use

Posted on July 24th, 2015

The need for an EU strategy to reduce healthcare costs related to alcohol use

The cost of treatment and care for people with alcohol-related ill-health has significantly risen in recent years and will continue to rise, unless strategies are put in place to try and reduce the problem. In 2006, the EU came together to design and implement a common strategy in response to the extensive health impact of the high level of alcohol consumption amongst EU countries. In 2006, the EU data showed that alcohol consumption has remained relatively stable for most Member states between 2002 and 2006, with a trend towards higher consumption in 8 countries. The Commission’s Impact Assessment (2006) revealed that alcohol consumption was the 3rd largest risk factor for ill-health in the EU (after blood pressure and tobacco). It also estimated that alcohol was responsible for around 195,000 deaths each year in the EU. Alcohol related deaths include accidents, suicide, liver disease, cancer and neuropsychiatric illnesses. Finally, the World Health Organisation (WHO) estimated that alcohol is the cause or around 7% of all ill-health and early death in the EU. It is not only the tragic loss of life and health that must be considered, but also the huge cost of treatment and care. In 2006, the cost of alcohol-related healthcare to EU societies was approximately €125 billion. So has the 2006 EU Alcohol Strategy seen any improvements? In 2009, the EU produced a progress report, and revealed that the strategy has been successful, in that EU member states have increased resources and tactics for reducing harm caused by alcohol. The strategy mainly focused on; revising and enforcing age limits for alcohol consumption, tightening restrictions on alcohol advertisement, emphasising the risk of drinking during pregnancy (France introduced a mandatory warning on all alcohol products) and reducing road traffic accidents related to alcohol (all EU members, except the UK, Ireland and Malta, have lower alcohol-consumption limits whilst driving for inexperienced and professional drivers). This being said, statistics suggests more still needs to be done to tackle the issue, as Europe is still the world’s heaviest drinking region. The extensive consumption is putting strain on healthcare systems and government finances causing significant socio-economic damage. The estimated social cost of alcohol misuse in Europe (2010) was €155.8 billion or which €82.9 billion was not for healthcare e.g. was from loss of productivity due to absence from work etc. Moreover, the true social cost is probably significantly higher as these figures do not take into account costs to people other than the drinker. In April (2015), the EU healthcare secretaries met to discuss the effectiveness of the strategy and possible improvements. They reviewed the global aim to reduce alcohol-related harm by 10% and concluded that it was necessary for the EU to continue focusing on; pricing and tax measures, marketing and restrictions on the availability of alcoholic beverages, legal measures to reduce drink driving, and the raising of public awareness, in order to meet the aim. They also stated that the EU would only support member states in the “three P” areas (Prevention of illness, Promotion of healthy living and Protection). They also set out a plan for a new Alcohol Strategy to strengthen the current one. This included the possible introduction of an Alcohol Minimum Unit Price (MUP) across the EU, as results from Scotland have suggested this could be successful.

Triage launch Dry Out Now to help combat addiction

Posted on July 24th, 2015

After the recent British Drugs Survey revelation that one in five UK adults have tried a banned narcotic substance, Triage is pleased to announce its new UK-wide service to combat addiction – Dry Out Now.

The premise is simple but effective. Dry Out Now provides expert, confidential consultation on a huge range of addiction issues. As with other Triage services, Dry Out Now is open every single day and offers free consultation for those affected by the perils of drug dependency.

The solutions on offer range from expert advice on local treatment services in a person’s area, to locating rehab services for more severe instances. Dry Out Now is dedicated to ensuring a person’s treatment is tailored uniquely to them, and that they never pay over the odds for any chosen rehab service. As Dry Out Now is not financially linked to any specific clinics, clients have peace of mind, knowing they are independent and on their side in finding the most suitable treatment.

A spokesperson for Triage said: ‘Dry Out Now has a central mission – to provide impartial advice, and easy access to effective rehabilitation treatments.’

Additionally, Dry Out Now prides itself on providing a range of resources to help those who suffer from addiction to get their lives back on track. These resources range from a confidential alcohol assessment questionnaire which can help an individual decide whether treatment may be necessary, to a library of expert advice guides which can be downloaded straight from the site. Dry Out Now also keeps its clients up to date with any news about new treatments or centres near them via email, so they feel supported and informed while fighting the battle against addiction.

Dry Out Now maintains the reputation for discretion and excellence already long established by the Triage group. For more information, please visit

A third of Scottish drug-related deaths are parents

Posted on July 23rd, 2015

A third of Scottish drug-related deaths are parents….

According to ISD Scotland, a third of people dying from drug-related illness/accidents in Scotland are parents. This means that around 270 children are being affected. In 2013, two thirds of drug-related deaths were people aged over 35 and were thus more likely to be parents. Similarly, people who make ill-informed decisions, live in more impoverished areas with poorer education are more likely to both, take drug and have more children at a younger age. The loss of a parent can lead to a variety of life-changing consequences. Children who lose a parent may have to go into foster care if the other parent is not able to look after them. This is not only traumatic for the child but also puts more strain on already struggling county councils. Furthermore, it has been found that children who have suffered significant stress or trauma during childhood are more likely to use drugs as a form of relief during adolescents and adulthood. Clearly more needs to be done to reduce this issue.

The Community safety minister (Paul Wheelhouse) stated that ‘by providing further context around these deaths, and by studying the contributing factors, we can ensure that more families in Scotland can avoid the painful loss of a loved one to drug use’. Although this suggests the strategy will aim to prevent not cure the problem, which is always the best approach, it will most likely be a long process and years of research and statistics. It may be that a better approach would be to put in place some more short term strategies. These could include faster intervention when a person’s drug-abuse is getting dangerous, better training for teachers in how to spot children who may be having a troubled home life and more emphasis on support and guidance for those over 35 as many services focus on youth and younger adult age-groups.

Another vulnerable group in Scotland are men living in deprived areas. From 2009 till 2014 three quarters of those who died from drug abuse-related deaths were males and half were living in the most deprived areas. Even more significantly, more than half had been in contact with drug treatment services, while just over a quarter had been admitted to hospital for an acute or psychiatric stay in the 6 months before their death.  These are concerning figures as even-through it is impossible for drug treatment services to prevent all drug-related deaths, it is clear that more could be being done within these services in regard to spotting and intervening in cases where suicide or accidental overdose is likely. It is also apparent that it is not only drug services that are failing to intervene in severe cases but also other mental health and psychiatric services. It is almost certain that the failings are due to a lack of finances for drug and alcohol services, charities and the NHS.

The types of drugs causing such deaths are also changing. A survey between 2011 and 2013 found that the number of deaths due to heroine had remained the same but the percentage due to methadone fell from 56% in 2011 to 47% in 2013. However, more than 200 cases of alcohol related death between 2009 and 2013 were due to New Proactive Substances. New Proactive substances can be defined as: a new narcotic or psychotropic drug, in pure form or in preparation, that is not controlled by the 1961 United Nations Single Convention on Narcotic Drugs or the 1971 United Nations Convention on Psychotropic Substances, but may pose a public health threat comparable to that posed by substances listed in these conventions (Council Decision, 2005). The use of these substances is also known as ‘legal highs’ and are particularly hard to legislate against as every time one is made illegal, new versions are produced and sold almost immediately. The European Monitoring Centre for Drugs and Drug Addiction identified 73 new substances in 2012 alone. In response to the concerning figures the Community Safety Minister for Scotland stated that ‘ The Scottish government are in early discussions with the home office on how we will work together to create to new legislation to control for sale and supply of  NPS, both here in Scotland and also around the rest of the UK.’


Is Alcohol More Dangerous Than Cannabis

Posted on July 17th, 2015

A comparative study has been conducted on the risk of alcohol, tobacco, cannabis and other drugs. The researchers used a Margin of Exposure (MOE) approach to gather results. MOE compares the estimated intake with the known lethal doses. The MOE is officially defined as the ratio between the point on the dose response curve which characterises adverse effects in studies and the estimated human intake of the same compound. Ultimately, MOE calculates a ratio and the lower the ratio means the lower the risk for humans. (more…)

Triage Healthcare’s new solution to alcohol addiction

Posted on July 17th, 2015

Triage Healthcare have launched their new Dry Out Now campaign, created to increase the help available for alcohol addiction sufferers in the UK, working alongside the NHS and the demand for it in the community.

The new website aims to provide free and confidential advice regarding addiction treatment, offering help to individuals, family members or close friends who are worried about someone suffering from an addiction. The site provides evidence-based advice on what works and what does not, providing an online self assessment, success stories and information to encourage and aid family and friends.

The site will be of tremendous value to the NHS, rehabilitation centres in the UK and addiction sufferers and their family. One customer on the website, Colin, wrote: “We wish to express our deepest thanks to you for all your assistance in finding a residential treatment clinic to deal with our son’s alcohol addiction. Thanks to your intervention he was admitted to a clinic that same day and indeed was even picked up from the hospital and taken there by one of their staff.”

Triage Healthcare are known for their professional advice, only employing professionally qualified experts. The company’s mission is to help sufferers all over the UK overcome their addiction with the help of internet based contact and they’ve had large scale success rates so far. “Really appreciated your advice and your listening ear this afternoon,” wrote Philip, while Paddy commented saying: “Many thanks, I would like to congratulate you on an excellent service. Also thanks for sending this through so promptly.”

A spokesman for the new campaign added: “The family and friends of those suffering from a dependence on alcohol can often find themselves at a loss as to how to tackle the problem. We aim to give them good quality, professional advice, so they know how best to deal with their loved one’s addiction.”

For more information visit contains further information and methods of contact.

What is Substance Misuse Prevention?

Posted on July 14th, 2015

The main focus around supporting those with substance misuse problems usually focuses on treatment. However, it is just as important and more necessary for care providers to work on effective and successful substance misuse prevention strategies. The Advisory Council on The Misuse of Drugs (ACMD) comments on the discussions in substance misuse prevention. They stress there is a need to identify and understand the best approaches to substance abuse prevention. (more…)

How Government Guidelines Encourage Pregnant Women to Drink

Posted on July 7th, 2015

During pregnancy, health advisors advice pregnant mothers to adopt new habits to ensure the health of their unborn child. These generally include taking supplements, quitting smoking, lowering caffeine intake and stop drinking alcohol. However there are questions on whether or not alcohol can be consumed while pregnant, if so how much?

National Institute for Health and Care Excellence (NICE) advice women should abstain from alcohol completely during the first few months of pregnancy and drink no more than one or two units of alcohol twice a week. The Royal College of Obstetricians and Gynaecologists (RCOG) state; small amounts have not shown to be harmful. (more…)

Can Decriminalisation of Drugs Make a Difference?

Posted on July 2nd, 2015

The misuse of drugs within the UK has continually been a matter of contention for the Government due to the evolving nature of the problem. Despite expected differences in emphasis, most countries share a commonality with their approaches to drug misuse. Means of tackling the problem include measures to reduce the social and public-health impacts of misuse and addiction and enforcement to restrict the supply of illicit drugs. (more…)

How have anti-drink campaigns influenced attitudes?

Posted on June 25th, 2015

Has the £2-million-per-year campaign produced any tangible results over the last 10 years or are the attitude campaigns a waste of money?

The ‘THINK!’ campaign has been in operation for many years, it now operates a specialised campaign called the ‘Personal Consequences’ drink-drive campaign. This campaign targets young males, aged 17 to 29 years old, and has three key aims: (more…)

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