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Journal Article

Citation

Whitehead R, Wells C. Lancet 2022; 400(Suppl 1): S11.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/S0140-6736(22)02221-8

PMID

36929953

Abstract

BACKGROUND: Substance misuse has extensive effects on individuals and communities, ranging from the poor health of people who use drugs to the pressure placed on health care, social services, and the criminal justice system. Strategies to curtail the supply and demand of drugs and reduce these effects typically focus on supply, with less emphasis placed on the drivers of demand. We piloted and evaluated a public health approach for understanding the drivers and effects of substance misuse in a local area, and how these might be targeted for prevention through multi-agency partnership action.

METHODS: A cross-sectional mixed methods analysis was conducted, using multi-agency data. 3 years of data provided by criminal justice agencies (police, youth justice, and probation), drug treatment services, social care, education, and hospitals were used to profile the local demand and effect of drugs on individuals and communities in a coastal town in southern England. The experiences of local professionals who support people who misuse drugs, or people affected by drug misuse, were collected via an online survey that was disseminated to relevant partnership organisations, including homelessness charities and drug treatment providers. A public health framework identifying relevant risk and resilience factors in the community was developed by combining the multi-agency data and survey responses The methodological efficacy of this approach to inform partnership action was evaluated via a survey with the project's stakeholders.

FINDINGS: Community housing, mental health, and cycles entrenching substance misuse were identified as risk factors that increase individual-level, interpersonal-level, and community-level vulnerabilities to the harms of drug misuse, violence, and exploitation. Evaluation found this mixed-methods analysis for understanding risk and resilience to be a valuable approach to enable public health and community safety leaders to develop a framework for partnership action to reduce the negative effects of drug demand in the community.

INTERPRETATION: Analysis of multi-agency data helped to further a shared understanding in local partners of the drivers and effects of drug demand at a local level; and, through a public health lens, clearly identified the role that local organisations can play in minimising the harms of substance misuse and exploitation. FUNDING: No funding received.


Language: en

Keywords

Adolescent; Humans; Cross-Sectional Studies; Social Work; Cities; *Mental Health; *Substance-Related Disorders/epidemiology/prevention & control

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