Substance Misuse Treatment Investment. Cost Benefit Analysis

Transcription

1 PP03 Appendix B Substance Misuse Treatment Investment Cost Benefit Analysis Sam Tearle, Principal Manager DAAT March 2011

2 1. Rates of Substance Misuse in West Sussex 1.1. It is estimated that in West Sussex there are; Drug Misuse Problem Drug Users (Opiates and/or crack); 2,408 Opiate users; 1,937 Crack Users; 1,722 Alcohol misuse Binge Drinkers; 60,000 (20%) men, 24,000 (8%) women Harmful or Hazardous Drinkers; 136,000 (23%) Dependant Drinkers; 24,000 (4%) 2. National Treatment Agency Long Term Study of the Outcomes of Drug Users Leaving Treatment (2010) 2.1. Each Local Authority is required to upload monthly data to the National Treatment Agency (NTA) giving a detailed breakdown of all those in the local the substance misuse treatment system. This data includes all new entrants, retentions rates and reasons why individuals left the treatment system Last year the NTA analysed the long term results for those entering the treatment system four years ago (41,475 people). This included analysing crime data over this period and matching those arrested for drug related offences with those in the treatment system during this period. This is the first long term study of its kind Key Findings; There is strong evidence to suggest that sustained recovery from addiction was found for almost half (46%) of those discharged from the treatment system during % of those who left the treatment system during this period did not return to the treatment system for the subsequent four years. Almost half of those discharged from the treatment system did not have any further drug related contact with the criminal justice system during the subsequent four years. For those who did re-offend after leaving the treatment system 65% went back into treatment. Comparisons were made for those leaving treatment during and showed significant similarities in long term outcomes. A MORI Poll found that over three quarters of the public believe that drug treatment is a sensible use of taxpayers money. They particularly rated that the greatest benefit was that it makes their communities safer and reduces crime rather than it improves a drug users well being. 2

3 3. Drug Treatment Value for Money Tool Kit 3.1. Following close work with the Department of Health and the Home Office, the NTA developed a Value For Money Tool Kit in This can be applied to Local Authorities which, for the first time, identifies the costs and benefits of drug treatment The costs and benefits are applied to the Spending Review period ( ). When applied to the West Sussex the results are as follows; If no drug users were treated by specialist services during the period the cost of the total amount of harm (costs to public services) including harm to children, families and communities total 252.2m Based on current levels of spending in West Sussex on drug treatment it is calculated that 19.6m will be spent during the Spending Review period. The total benefits accrued for this period as a result of the above spend is calculated to be 70.9m The total benefits are broken down as 36.1m Crime cost savings and 34.8m Health cost savings. During the Spending Review period the Cost Benefit Saving ratio is estimated to be 1 : Alcohol Treatment Cost Benefit Analysis 4.1. In 2008 West Sussex DAAT undertook some research to calculate the annual costs to society and the NHS of alcohol misuse in West Sussex. The total cost was calculated to be around 300m per annum m Crime related costs 96m Workplace productivity costs 70.5m Domestic and social costs (impact on family members and communities) 25.5m NHS (hospital admissions, GP services, premature deaths) 45m NHS costs if alcohol related disease costs are included 4.2. The Department of Health (DOH) have published research that demonstrates; 6% of all hospital admissions are alcohol related 35% of all A&E and ambulance costs are alcohol related 70% of A&E attendance at peak times is alcohol related 4.3. In West Sussex two distinct types of alcohol interventions are commissioned; 3

4 Structured specialist treatment for dependant and harmful drinkers. In 2006 the NTA carried out research into the Review of the Effectiveness of Treatment for Alcohol Problems. This report found strong evidence that treatment for alcohol problems is cost effective; Alcohol misuse has a high impact on health and social care systems where major savings can be made. Drinking places major costs on the criminal justice system, especially with regards to public disorder Overall for every 1 spent on treatment, 5 is saved elsewhere Structured Brief Interventions (SBIs). An SBI aims to raise awareness of the harms attached to a persons drinking, offer advise about how a person can reduce their alcohol consumption and where to seek specialist treatment. They can be delivered by a wide range of non-substance misuse specific professionals and are especially effective when delivered in Primary Care and A&E settings. An SBI can be a single session or up to twelve more focused sessions. Over the last two years the DAAT have commissioned the training of a wide range of professionals to be able to deliver SBIs. The DOH have published evidence that SBIs are cost effective; For every eight people who receive a SBI one will reduce their drinking within lower-risk levels Patients who received an SBI in A&E made a half less visits in the subsequent twelve months SBIs have been found to reduce alcohol consumption by up to 20% in higher risk drinkers. Overall the cost benefit ratio of investment in the delivery of SBIs is calculated at 4 : 1 5. Specialist Drug and Alcohol Services for Young People A Cost Benefit Analysis 5.1. In 2009 the Government commissioned a a major piece of research to calculate the cost benefits of the provision of young people s substance misuse services It analysed the immediate cost of crime committed by a young substance mis-user, the NHS costs associated with treatment and the costs associated with substance misuse related deaths of young people The study also looked at the longer term costs incurred if young substance mis-users became problematic drug or alcohol using adults. As young substance mis-users are likely to be NEET (not in education, employment or training) it also considered the longer 4

5 term costs of lower wages and poorer employment prospects in adulthood The cost benefit ratio calculated for each 1 spent on young person s substance misuse treatment is calculated as; 4.66 : 1 Immediate benefits 8.38 : 1 Long term benefits 6. Carer Support 6.1. In West Sussex, carer support for substance mis-users is delivered through a Big Society model, the Families & Friends Network (FFN). 12 County Wide drop in centres, support groups, outreach support and a telephone help line are operated by a dedicated network of around 30 volunteers who are recruited, trained and supervised by 1.65FTE DAAT employees. The total cost of this provision including salaries, volunteer expenses and venue costs is 69,300 per annum The FFN supports in excess of 1000 families per year in West Sussex There is a clear cost benefit ratio that has been developed by the UK Drug Policy Commission that supports this investment; In the absence of dedicated carers support the cost to the NHS and Social Care of supporting family members of a substance mis-user is estimated at 9,741 per family In addition it is estimated that the value that the care the family provides to the substance mis-user is 3,935 per annum. 5