Lee Collingham shares his highlights from the GPs’ conference on managing drug and alcohol problems
Dr Stephen Willott, clinical lead for alcohol and drug misuse at NHS Nottingham City and conference chair, introduced the event’s theme as addressing drug-related deaths, which not only continue to rise in England but are twice the European average.
It was a shock to learn alcohol-related deaths aren’t recorded as DRDs, and Dr Willott appealed for a fresh approach moving forward. The average age of deaths had also risen from 35 in 1995 to 41 in 2016, with evidence proving opiate substitute therapy (OST) was highly effective in helping people get their life back on track. It was also noted that England’s localised agenda is a barrier to not only the widespread provision of naloxone, but also to it being provided to prisoners on release.
Prof David Nutt, former advisor to the ACMD, then talked about how opiate and cocaine-related deaths were at their highest ever, and that there was a need to push for allowing cannabis for medical use in England, as it was in 18 other countries around the world.
He mentioned how alcohol and tobacco, though both legal, were responsible for the majority of deaths, with 80,000 a year dying from tobacco related illnesses and 25,000 from alcohol – compared to opiates being responsible for around 2,000 deaths a year. He also thought the recovery agenda had been the main cause for the rise in drug-related deaths. Next, Dr Cathy Stannard, a consultant in pain management, questioned the use of opiate-based painkillers as the most effective solution for the long-term management of pain. She talked about the importance of getting it right or facing a public health disaster and mentioned that pain was strongly affected by mood, with those affected by anxiety and stress responding less well to the medication.
The morning finished with a choice of sessions on subjects ranging from the future of drug treatment to end of life care. Posters on display included ’seasonal influenza immunisation’, ‘opiate analgesic dependence’ and ‘ the difference between buprenorphine prescribing and methadone for injecting opiate users’. This year’s poster award went to Kathryn Chadwick and Zoe Black from Sheffield Social Care Trust, on leg ulcer management for the problematic user.
Interesting presentations in the afternoon included Professor Ken Wilson from the Cheshire and Wirral Partnership Trust around ‘brains, booze and hospitals’. He explained how brain injury is the biggest concern for problematic drinkers, causing the frontal lobe to shut down and leading to problems with memory.
For me, the highlight of the day was the news from Professor Graham Foster, professor of
at Queen Mary University Hospital London, that there is a pot of £70m available for the treatment of hepatitis C. He explained that, from January, there’ll no longer be the need for combination therapy, with the release of a new licensed drug that will not only allow patients to take just one pill a day, but actually cure hep C.
Lee Collingham is a volunteer user involvement worker and advocate.