Guest blog: Neil Dunne, research assistant with the Neurobehavioral Addiction Group within the Department of Public Health & Primary Care at the Institute of Population Health, School of Medicine, Trinity College Dublin
Trinity College Dublin in conjunction with the North Dublin Regional Drug and Alcohol Task Force, recently launched a report titled “North Dublin Regional DATF Alcohol Research 2023: An exploration of the nature and extent of alcohol use within North County Dublin” attended by Hildegarde Naughton- the Minister of State in charge of the National Drugs Strategy and featuring data from North Dublin’s treatment centres, schools, service users and their families, and service staff.
The report can be contextualised as a look at two circumstances of alcohol use in North Dublin, firstly those who are relatively beginning their experience with alcohol, focusing on its perception and use among secondary school students, followed by those who have been through alcohol-related treatment. This data was complemented by a collection of the opinions of people who used or worked at alcohol services, presenting on-the-ground perspectives on what needs to be changed.
Young people’s drinking habits
Planet Youth, an organisation based in Iceland that aims to reduce substance use in teens primarily through parental involvement and supervision, provided surveys given to students aged 14-16 in North Dublin Secondary Schools that asked them about their friends, homelife, what their opinions of alcohol were, and if they drank it.
Less than 50% of all students thought that alcohol was harmful, indicating a need for increased education on alcohol-related harms. Perhaps dissuaded by previously employed scare-mongering approaches to substance use education in schools, when students first experience alcohol, for which the vast majority will not feature any major life-threatening consequences, may think “well what were they talking about, this isn’t that bad”. A holistic approach that highlights all the different ways alcohol can negatively impact their lives rather than one based on worst case scenarios and fear would improve students’ knowledge of alcohol-related harm.
Interestingly the results of these surveys showed that students who identified as female were more likely to drink, where alcohol use disorders were historically seen as a primarily male issue, highlighting the narrowing gender-gap in alcohol consumption and related harms. A large part of the survey focused on the students’ domestic life and highlighted a parent’s impact on the students’ alcohol use. Students who thought they were worse off financially, experienced their parents- fight, get drunk often, or have more relaxed attitudes towards drinking were more likely to drink themselves. Throughout the data it was shown that the more involved parents were in their child’s social life, the less likely the students were to drink.
Limitations
The report acknowledges the limitations of Planet Youth, including the cost that comes with employing it. While the survey results indicate that parents should aim to both increase the time they spend with their children and heavily supervise them, it does not create space for those parents for which this may not be possible. A single parent working two jobs to make ends meet may not have the time or resources to dedicate to increasing quality time, daily family dinners, and ferrying them to and from extra-curricular activities – all suggestions for parents by Planet Youth to reduce teen substance use. The organisation’s assumption of a nuclear family and its reflected solution base puts forward a narrative that when the students are engaging in substance use, its due in part to parents being capable in enacting the above suggestions, not acknowledging that many may be interested but incapable due to socioeconomic factors like an ever-increasing cost of living crisis. An image of a future goal was expressed through the need for a continuous Irish-based substance use dataset that can assess substance use and measure the effects of new services and treatments at a community level. This would lead to a nuanced community approach to alcohol and drug use, allowing needs-based tailoring for individual communities and providing ongoing data on what is and isn’t working.
Adults in treatment
On the other side of the spectrum, the report dove into those who had exited treatment for alcohol-related issues. Using data from North Dublin’s treatment centres, the majority were males over the age of 40 who had been dependent on alcohol. Concerningly, the most common reason for exiting treatment was not a resolution of the issue but a “no-show”, where treatment ceased because patients stopped showing up. Echoing the need for the family’s involvement revealed in the student data, most of the treatment cases were admitted by themselves and did not have familial support. The report recommends improving the continuity of care and increased collaboration between treatment centres and further programmes, aiming to create a recovery bridge that helps patients easily transition from initial treatment services like detox to longer-term facilities like recovery communities.
Recovery and collaboration
The final source used was the opinions of service users, their families, and service staff. Through a series of facilitated discussions, these groups highlighted a number of issues to be addressed, mainly reflective of their positions. The service users and their family members expressed appreciation for fellowship groups like AA, but some stressed that they would like to see a balance of these groups with those that build recovery capital like professional development services. They went on to emphasise the crucial role of GPs as a common first point of contact for those looking for treatment, suggesting that GPs should be given more power and resources to approach alcohol-related issues. Family-members of the service users emphasised how important the support networks available to families were and hoped that further services for family members like counselling could be developed alongside those for service users.
The staff group desired more inter-agency collaboration, evaluation and updating of existing services, improving the initial assessment process to ensure comprehensive and speedy initiation of treatment. A third group consisting of experts in the field by lived and professional experience highlighted the increasing number of both female and older people seeking treatment for alcohol treatment, as well as a need for dual-diagnosis services- those that treat mental health and substance use needs. The report recommends addressing the concerns of the groups, emphasising a need to integrate medical (like GPs and A&Es) and substance use services, and developing aftercare services that go beyond initial medical treatment to help build recovery capital.
Take-home messages
The report featured several key-take home messages. Primarily, increasing the involvement of the familial unit, acknowledging that this may not always be possible, from students first experiencing alcohol to those currently engaged in treatment would benefit people struggling with alcohol-related harms. Increasing the available treatment options to include a range of medical and psychosocial options that cater to expanding treatment demographics like the rising numbers of women or older people seeking help, as well as developing services that expand on personal and social development beyond the initial treatment period is sorely needed. Expansion and evaluation of alcohol harm-reduction and prevention in schools is dearly needed to address the dangerous perceptions many students have surrounding alcohol. While introducing these recommendations would be beneficial, continuation of monitoring at a community level is needed to evaluate if the plans put in place were working, where collaboration between communities was encouraged to share success stories.
