Agenda item

To receive the report of the Executive Director – People, providing an update to the panel on the current landscape and work undertaken to tackle substance misuse in Enfield following the introduction of the national drug strategy, ‘From Harm to Hope’.

Cllr Alev Cazimoglu (Cabinet Member for Health and Social Care) and Dudu Sher-Arami (Director of Public Health) introduced the report of the Executive Director – People and Director of Public Health, providing an update on work undertaken to tackle substance misuse in Enfield following the introduction of the national drug strategy ‘From Harm to Hope’. There was funding related to the strategy though it was not known if any further funding would be made available beyond March 2025. Enfield’s Combating Drug and Alcohol Partnership (CDAP) was highlighted as working well: involving key partners and overseeing and driving forward delivery against the strategy. The Panel had also requested an update regarding use of nitrous oxide, and the actions taken to stop its use were set out in the report. The law had also recently been updated to classify nitrous oxide an illegal Class C drug. The report also provided an update on delivery of treatment and recovery support across Enfield.

Further details were presented by Andrew Lawrence (Head of Commissioning – CYP and Public Health).

Data on prevalence of opiate and crack use had shown a much higher increase in Enfield than neighbouring boroughs, primarily resulting from a large increase in clients being recorded on the Probation Offender Assessment System. Targets for an increase in numbers of people in treatment in Enfield had been raised.

The successes of the three sub groups of CDAP were listed in the report, and the key priorities for 2024/25. It was confirmed that the adult treatment centre would be moving from the current site at Claverings, and that the Lived Experience Representative Organisation (LERO) would be enhanced.

In respect of nitrous oxide, there were early interventions, misuse awareness workshops in schools, training, and discussion at the Headteachers’ Forum.

Questions were invited from Members.

The Chair asked about results from the national drugs and alcohol strategy and associated funding. It was advised that referrals were increasing in Enfield. Barriers around some referral pathways were recognised, and there was more work to come in relation to mental health and prison release, but progress was being made. It was confirmed there was enough capacity in the system currently, but there was the risk to funding after 2025.

In response to Members’ queries regarding working with funding uncertainty, this had affected the way that work had been planned so as to bolster treatment capability and adding referral pathways to ensure people are effectively treated. The changes in the ways of working could be done without additional funding. It was advised that Directors of Public Health across London were advocating for the funding and making sure decision-makers understood the implications of those funding decisions. Outcomes and performance were the best way to make the case. This investment in substance misuse had been greatly welcomed in Enfield and partnerships had been developed.

Members asked about increased alcohol usage, and mental health issues, since the Covid-19 pandemic. It was confirmed that alcohol use had remained at static levels since the pandemic. Mental health needs were a running theme throughout, but there was now increased capacity through the recruitment of a dual diagnosis worker to support mental health needs and linked to substance misuse. Co-operation between all services had improved by CDAP partnership work.

It was advised that there were different types of treatment available to those abusing alcohol, but an individual had to want to address the issue. It was confirmed that people could self-refer. There was communications work planned to sell the idea of recovery and seeking treatment. It was also important to raise awareness across all organisations to know of the services offered in respect of treatment, de-stigmatise substance misuse, increase understanding of harm and recognise when support was needed.

In response to Members’ questions, it was confirmed that relapse prevention was part of the programme offered.

In response to Members’ queries about links to hospital A&E departments where substance misusers may present frequently, it was confirmed that there was an in-reach programme at North Middlesex University Hospital, with a worker based within the hospital able to see patients and have in-person conversations.

Members asked about the lived experience representative. There was currently a single person active in the role, but officers wished the LERO to be developed with diverse representatives.

The Panel AGREED:

To Note

I. The work being done by Enfield’s Combating Drug and Alcohol Partnership (CDAP) across its three subgroups focusing on Treatment and Care, Clinical Governance and Criminal Justice.

II. The increase in prevalence estimates for the number of opiate and crack users in Enfield.

III. The use of nitrous oxide amongst individuals in the borough including associated litter (cannisters and balloons) and the legal changes for this substance.