Northern Ireland's Alcohol & Drug Treatment Charity- email: enquiries@nicas.info
- call: 02890 664434
Northern Ireland's Alcohol & Drug Treatment CharityOn 1 October 2008, NICAS held a conference to mark its 30 years working in the field of alcohol and drug misuse. The Conference was addressed by the Minister for Health, Social Services and Public Safety, Michael McGimpsey, Chief Medical Officer for Northern Ireland, Dr. Michael McBride and Chairman of the Belfast Health and Social Care Trust, Pat McCartan.
NICAS Director, Dr Claire Armstrong said “Last year we had a 22% increase in demand for our treatment services but with no increase in funding to support this.”
“Over the years, alcohol has been the most frequent reason for people seeking help from NICAS, with three quarters of clients finding their drinking has become a problem. This trend is continuing. We are also seeing more people with physical damage caused by heavy drinking at a younger age than we would have in the past.”
NICAS believes that a lack of funding for addiction services such as theirs is a false economy. Dr. Armstrong said “Research has found that community-based alcohol treatment programmes like those provided in NICAS save more money than they cost to run. For every £1 spent on treatment, £5 was saved from the bill for dealing with the consequences of drinking. The study concluded that the average cost of treating one person was £175 – but that treatment saved nearly £900 in reduced health and social care, including the impact on police and the criminal justice system.”
“Alcohol addiction remains a high-profile issue, but we don’t want to see treatment services becoming the ‘poor relation’. NICAS is working at the sharp end of alcohol dependency – the work requires highly dedicated and trained staff, but the rewards in terms of improved health and well-being for people and their communities are great. Further investment is required to ensure that people in have access to the kind of treatment services they need.”
Health Minister, Michael McGimpsey today paid tribute to the community and voluntary sectors for their work with those with alcohol and drug dependency.
Mr McGimpsey addressed the Northern Ireland Community Addiction Service (NICAS) conference entitled ‘Alcohol, Drugs and Addiction – How important is treatment in the community?’ which marked the charity’s 30 years of providing treatment and support to those with substance misuse issues.
Speaking after the conference and a visit to the NICAS premises, the Minister said: “I want to take this opportunity to acknowledge the work of the many volunteers and organisations in the community and voluntary sector who work with those affected by substance misuse.
“These organisations provide education and training, treatment and support and advice and guidance. It is a difficult but important job, and the people working in this field make a real difference to the lives of many individuals who misuse alcohol and drugs – and indeed to the wider community affected by substance misuse.
“Addressing the harm related to alcohol and drug misuse in Northern Ireland is a key priority for me and my Department. I want to acknowledge the work that NICAS has undertaken on substance misuse issues over the last 30 years, and I wish them well in the future.”
According to the latest figures, the majority of clients (around 70%) that NICAS supports have alcohol issues, and the Minister stated: “It is clear to me that Northern Ireland continues to have an unhealthy relationship with alcohol.
“The fact that a majority of the work that NICAS undertakes is related to alcohol misuse, reinforces the fact that alcohol is clearly Northern Ireland’s drug of choice. And during my recent experience with frontline emergency staff, I was able to witness the impact that alcohol misuse and excessive consumption has, both in the short and long term.
“I am determined that my Department will continue to clamp down on alcohol misuse through the New Strategic Direction on Alcohol and Drugs, through my discussions with the drinks industry, with the PSNI and government as a whole.”
NICAS was established in 1978 as the Northern Ireland Council on Alcohol, mainly providing information about alcohol and its effects. In the 1980s, the need for treatment for alcohol and drug addiction was recognised and lead to the organisation being re-named as NICAS, the Northern Ireland Community Addiction Service. An initial a training programme for volunteers who would provide a counselling service for people with an alcohol problem was developed. Within three years they were replaced by qualified permanent staff, the model that NICAS uses today.
This kind of service was a relatively new concept then because people who had addiction problems usually had to wait until they hit “rock bottom” before they would be considered for any intervention and if they were offered help they were admitted to hospital. The new community based service required every single aspect to be developed. Referral procedures, an appointment system, an intervention programme and suitable premises from which to work were but a few of the requirements.
Today, NICAS has three branches all staffed by qualified, dedicated people. We have a highly valued service in general and in particular specific services for the Elderly and for those whose offence is related to an alcohol/drug problem. The theme for all intervention is prevention, i.e. stepping in early before the damage is too severe. When clients come to NICAS and an assessment is carried out, it is often followed by an individualised treatment programme to meet the client’s needs. NICAS also provides support and information for people affected by someone else’s addiction problem. With the current profile of alcohol and drugs, the need for community based professional treatment continues to grow. 2007 saw a 22% increase in demand for our counselling services compared with the previous year. NICAS aims to continue this work in the years to come.
In order to address the growing number of offenders presenting with drug and alcohol related problems before the courts, a joint initiative between the Probation Board for Northern Ireland (PBNI) and the Northern Ireland Community Addiction Service (NICAS) was established in 2003 – The Rapid Assessment and Treatment Service for Drug and Alcohol Misusers (RATSDAM).
This partnership is currently funded by the Northern Ireland Eastern Drug & Alcohol Co-ordination Team for a period 2 ½ years up to March 2009. The purpose of the service is to provide a fast track assessment and treatment programme for offenders within the Greater Belfast area. Referrals to the programme come from the PBNI Assessment Unit at the pre-court stage, where there is an indication that offending behaviour is linked to substance misuse.
Once suitability for the treatment programme has been established individual counselling sessions are offered. The treatment programme, based on a cognitive behavioural model, examines the links between the individual’s substance misuse and their offending behaviour. Motivational Interviewing is also employed on a session-by-session basis in order to encourage individuals during the process of change. Sessions are offered on a weekly basis over eight weeks and ongoing liaison with the supervising Probation Officer is maintained at each stage. There is scope for a limited number of additional sessions, if it is felt that these would benefit the individual.
NICAS has a lengthy history of providing expert assessment and treatment for those experiencing substance misuse problems. These skills, coupled with the considerable expertise in the probation service have been utilised in order to implement an effective treatment and rehabilitation programme for probation clients.
Research conducted between the period 1st October 2006 to 31st March 2008 highlight the very positive outcomes in terms of reduction in dependency and co-morbid depression levels. For instance,
Over the last decade there has been increasing recognition among health and social care professionals and funding organisations that the numbers of older people who have issues with alcohol are increasing and they are identified as a vulnerable group in the current Northern Ireland Alcohol and Drug Strategy 2006-2011.
The literature on addiction acknowledges the hidden nature of alcohol misuse by older people mainly because they are not as visible in the work force or the criminal justice system, because they under report what they drink due to shame and because the symptoms are often confused with general issues of old age (Peressini and McDonald, 1998, Dar, 2006). Research by Peressini and McDonald (1998) emphasized the importance of early detection and intervention in successful treatment of the issues older people have with alcohol and concluded that providing training on alcohol awareness to staff working with older people was a crucial factor in improving detection. Over the last ten years a programme of half and full day training has been provided by NICAS to health and social care staff and this has raised awareness and may be contributing to older people accessing the service or being referred. Feedback from those attending indicates that the training is relevant to their work
Generally the literature would indicate that older people do respond positively to treatment provided it is:
Older people “span all walks of life, economic and employment status and cultural and social backgrounds” (Schulman. 1998). Their needs in relation to treatment vary widely. Some can access traditional treatment services. Some can avail of individual counselling but need it to be home based due to ill health or caring responsibilities. A significant number need more complex service provision due to reasons of homelessness, ill health and, or cognitive impairment. Work with this group is often slower and more long-term and involves multi professional liaison.
The success of such a flexible approach to service provision is reflected in the feedback from clients. Of these who completed post treatment change questionnaires 37% reduced their alcohol consumption during treatment, 27% were abstinent and 16% were abstinent with 1-3 fallbacks. Anecdotally people report that having the choice of domiciliary service has facilitated their access to treatment and is often the prime reason for them agreeing to it.
The most recent NISRA statistics show that there has been an increase in the last 10 years in the number of older people drinking above recommended limits, particularly among females. This alongside the demographic trend which projects by 2036 one in four people in Northern Ireland will be of pensionable age would indicate that demand for age appropriate flexible treatment programmes will increase. NICAS has built up a firm base of experience and valued service provision in this area. It would be hoped that with more secure funding the service would continue to develop and to meet the ongoing need.