1. Alcohol Prevention in Halton

2. Northwest - 39 regions Local Authority Under 18’s alcohol specific hospital admissions Over 18’s alcohol attributable hospital admissions Halton6 th highest9 th highest Local Authority Under 18’s alcohol specific hospital admissions Over 18’s alcohol attributable hospital admissions Halton8 th highest15 th highest England - 326 regions

3. NICE Guidance on Alcohol Education Encouraging children not to drink Delaying the age at which young people start drinking Reducing the harm it can cause among those who do drink nice.org.uk/PH7

4. Chief Medical Officers December 2009 An alcohol-free childhood is the healthiest and best option The importance of parental influences should be communicated to parents / carers and professionals Parents / carers need advice on how to respond to alcohol use and misuse by children Support services must be available for children and young people who have alcohol-related problems and their parents

5. Alcohol training is available for teaching staff Healthy Schools – health information / support offered Healthitude programme The Alcohol aspect of the programme includes information such as: What do you know about alcohol The harm alcohol causes Recovery position Alcohol and the law Alcohol Prevention in Halton Children and Young People

6. Alcohol Prevention Alcohol Identification and Brief Advice (IBA) Training What is Identification and Brief Advice (IBA)? IBA is the terminology used for targeted screening and the provision of brief advice session, which should be delivered opportunistically It takes 3 minutes (Commissioning training for behaviour change interventions guidelines for best practice)

7. How effective are they? Brief advice given to someone drinking at above the lower risk limits will result in 1 in 8 reducing their alcohol consumption Drinkers may reduce consumption by as much as 20% as a result of brief intervention Heavy drinkers are twice as likely to cut down after receiving brief advice compared to no intervention For every £1 spent on alcohol services it is estimated that £5 will be saved across health and wider public services

8. Who do we train in IBA in Halton? The training suitable for any one who has the opportunity to give brief alcohol advice Key Groups for 2013/14; GPs and Practice Staff Police, Community Safety & PCSOs Midwives School Nurses Teams working with adult services Teams working with CYP services

9. What is included in the training? The training is bespoke to the target group but generally includes: Units of alcohol and the different strengths Foetal Alcohol Spectrum Disorder (FASD) Individual level of alcohol risk: (lower risk, increasing risk, higher risk and dependency) The long and short term effects of alcohol Alcohol and the law Screening for levels of alcohol use using an AUDIT screening tool How to use a Patient Information leaflet to give brief advice Care pathway following IBA & referral into local alcohol services

10. Screening tools – AUDIT C Questions Scoring system Your score 01234 How often do you have a drink containing alcohol? Never Monthly or less 2 - 4 times per month 2 - 3 times per week 4+ times per week How many units of alcohol do you drink on a typical day when you are drinking? 1 -23 - 45 - 67 - 810+ How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? Never Less than monthly MonthlyWeekly Daily or almost daily Scoring: A total of 5+ indicates increasing or higher risk drinking. An overall total score of 5 or above is AUDIT-C positive. SCORE

11. Remaining AUDIT questions Questions Scoring system Your score 01234 How often during the last year have you found that you were not able to stop drinking once you had started? Never Less than monthly MonthlyWeekly Daily or almost daily How often during the last year have you failed to do what was normally expected from you because of your drinking? Never Less than monthly MonthlyWeekly Daily or almost daily How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session? Never Less than monthly MonthlyWeekly Daily or almost daily How often during the last year have you had a feeling of guilt or remorse after drinking? Never Less than monthly MonthlyWeekly Daily or almost daily How often during the last year have you been unable to remember what happened the night before because you had been drinking? Never Less than monthly MonthlyWeekly Daily or almost daily Have you or somebody else been injured as a result of your drinking? No Yes, but not in the last year Yes, during the last year Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down? No Yes, but not in the last year Yes, during the last year TOTAL Scoring: 0 – 7 Lower risk, 8 – 15 Increasing risk, 16 – 19 Higher risk, 20+ Possible dependence SCORE Score from AUDIT- C (other side)

12. AUDIT- C Screening Tool & Alcohol Information Leaflet

15. Patient/Client who is drinking within the lower risk guidelines of 2-3 units a day (Women) 3-4 units a day (Men) or (Scores 0-7 on the AUDIT screening tool) These patients don’t need intervention. They are a Lower Risk drinker and should be congratulated for drinking within the recommended guidelines, which will support them to maintain this behaviour. Patient/Client who is drinking More than 35 Units per week (Women) More than 50 Units per week (Men) Or (Scores 16-19 on the AUDIT screening tool) These patients are at an increased risk of health problems because of their Increasing Risk level of drinking and should be given, simple, structured brief advice. These patients are very likely to be experiencing problems that are related to their Higher Risk drinking and they require an extended brief intervention/referral Patient /client who is drinking at higher levels and displaying possible signs of dependency Or ( Scores 20+ on the AUDIT screening tool) Patient/Client who is drinking 15-35 units per week (Women) 22-50 Units per week (Men) Or (Scores 8-15 on the AUDIT screening tool) These patients will need a full assessment of their drinking and you should consider referral to a specialist alcohol service. Extended brief intervention could be offered by yourself or patient client can attend Ashley House. If the patient is under 19 then referral should be made to Young Addaction Patient/client can attend Ashley House. If the patient is under 19 then referral should be made to young Addaction. Useful Contacts Health Improvement Team 01928 593005 Ashley House, Halton Integrated Recovery Service (CRI) Tel: 0845 601 1500/0151 422 1401 No referral required patient/client to present: Mon-Fri 9.00am-4.30pm Late night Tuesday until 7.00pm www.ashleyhousehalton.co.uk Young Addaction Tel: 01928 580242 www.youngaddaction.org.uk