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Alcohol
Introduction
This section contains data, information and a summary profile in relation to the nature and impact of alcohol consumption amongst the residents of Oldham.Data Overview
Alcohol Treatment Services
Figure 1 below shows the numbers in treatment and new presentations amongst adults from Oldham from April 2014/March 2015 to April 2022/March 2023. Following a sharp decrease from the earliest census period to March 2019 numbers in treatment and those newly presenting have been on an upward trend, although, in the most recent period, rates of increase appear to be easing – in both instances the highest levels of engagement for seven years have been recorded.Across GM Oldham has the fifth highest rate of alcohol only clients in treatment services with 2.89 per 1,000 of the adult (18+) population. Tameside has the highest with 4.30 and Bolton the lowest with 2.16. Oldham’s rate is slightly less than the GMCA average (3.03 per 1,000), slightly higher than the North West rate (2.75) and significantly greater than the England average of 2.10.
Table 1 below shows the rate of unmet treatment for individuals affected by alcohol misuse and/or dependency. Although Oldham has a lower rate (76.9%) than the North West (78.3%) and England (80.1%) averages the differences are broadly marginal. The prevalence estimate for Oldham of the number of its residents involved in problematic alcohol consumption and not in treatment is 3,052 (or 16.93 per 1,000 of 18+ population). This is 25.9% greater than the national rate of 13.45 (per 1,000).
| Table 1: Unmet treatment need and prevalence for alcohol misuse and dependency in Oldham, North West & England (2020/21 - 2022/23) | |||
| Unmet treatment need | Numbers in treatment* | Prevalence estimate | |
| Oldham | 76.9% | 704 | 3,052 |
| North West | 78.3% | 21,489 | 99,242 |
| England | 80.1% | 119,861 | 602,391 |
| * denotes numbers in treatment are the sum of 'alcohol only clients' and those involved in combined use of alcohol and one or more non-opiates Source: NDTMS/OHID | |||
Summary profile of alcohol only clients in treatment in Oldham
Figure 2 below shows data in relation to the demographic make-up of Oldham’s alcohol only in-treatment population from 2020/21 to 2022/23. Historically 56%-62% of adult alcohol only users in treatment were male. Typically, around 95% are from White/White British ethnicities with less than 5.0% from Asian/Asian British backgrounds. The largest age cohorts are amongst the 40-49s and 50-64s. More than one-fifth (22.8%) of alcohol only clients live with children aged 0-17 years. Currently approximately one in seven (14.2%) have ‘contact with the criminal justice system’ – more than double the rate for the previous two years of approximately 6.5%
Referrals in to alcohol treatment services in Oldham
Figure 3 below shows referral sources amongst adult alcohol only clients newly presenting to treatment services over the past three years in Oldham. By far the most common referral amongst this user cohort is ‘Self, Family & Friends’ which typically accounts for 50%-60% of all referrals. In the 2022/23 ‘Criminal Justice’ accounted for one in seven (14.2%) of referrals – doubling its share shown for the previous two years. Referrals from ‘Hospital’ currently make up 10.2% of referrals while, at a lower level, referrals from ‘Other Health/Mental Health’ agencies have increased from less than 5.0% in 2020/21 to 5.9% in 2022/23.
Accommodation need and co-occurring mental health treatment need in alcohol only clients
‘Accommodation need’ status and ‘co-occurring mental health treatment need identified’ amongst Oldham’s alcohol only clients is shown in Figure 4 below. Excluding the data shown for 2022/23, due to data quality issues, urgent housing problems amongst this user cohort are typically very low, while less severe housing problems have been experienced by 8%-9%. This is broadly in line with national trends. Figure 4 also shows that co-occurring mental health treatment needs were typically identified in 67%-71% of clients from 2020/21 to 2022/23 – again similar to trends for England.
Alcohol related conditions hospital admissions
Table 2 below hospital admissions episodes for alcohol related conditions for Oldham, GMCA, North West and England by sex in 2021/22. Admissions episodes for alcohol related cardiovascular conditions is higher (worse) in Oldham than England for both males and females. For admissions episodes relating to alcoholic liver disease, Oldham’s performance is similar to England’s for males and females but lower than GMCA and North West averages. In relation to admissions episodes for mental and behavioural disorders due to alcohol use Oldham’s value for males and females are significantly lower (i.e. better) than averages for all other geographies shown.Table 2 also shows admissions for unintentional injuries amongst males (95.6 per 100,000 population) in Oldham as similar to the England average (91.1). Amongst females in Oldham, however, the rate (15.2) is higher (i.e. worse) than the England average (12.9). For admissions relating to intentional self-poisoning by and exposure to alcohol the rate for males in Oldham (30.9 per 100,000) is similar to the England (28.7) and GMCA (32.2) averages. Amongst females for the same condition the Oldham rate (23.1 per 100,000) is significantly lower (i.e. better) than GMCA (38.0), North West (46.6) and England (38.6) averages.
| Table 2: Alcohol related conditions hospital admission episodes per 100,000 population in Oldham, GMCA, North West and England (2021/22). | |||||
| Condition | Sex | Oldham | GMCA | North West | England |
| Admission episode for alcohol related cardiovascular conditions | Male | 1,522 | 1,527 | 1,459 | 1,388 |
| Female | 245 | 254 | 246 | 223 | |
| Admission episodes for alcoholic liver disease | Male | 199.6 | 272.2 | 256.0 | 213.1 |
| Female | 109.1 | 236.8 | 131.7 | 99.6 | |
| Admission episodes for mental and behavioural disorders due to alcohol use | Male | 84.5 | 110.8 | 126.8 | 96.0 |
| Female | 23.7 | 43.1 | 59.1 | 39.8 | |
| Admissions for unintentional injuries | Male | 95.6 | 102.5 | 103.6 | 91.1 |
| Female | 15.2 | 15.4 | 15.2 | 12.9 | |
| Admissions for intentional self-poisoning by and exposure to alcohol | Male | 30.9 | 32.2 | 35.6 | 28.7 |
| Female | 23.1 | 38.0 | 46.6 | 38.6 | |
| Source: ONS/HES/OHID | Higher than England | Similar to England | Lower than England | ||
Alcohol related mortality & deaths in treatment
In Table 3 below the rates per 100,000 population for alcohol-related mortality are shown for Oldham, GMCA, the North West and England. For both ‘alcohol specific mortality’ and ‘mortality due to chronic liver disease’ Oldham’s rates, although broadly similar to GMCA and North West averages, are far higher than those for England. Table 3 also shows that the Oldham rate for ‘alcohol-related mortality’ (56.0 per 100,000) as significantly higher than the England average (38.5), as well as the averages for GMCA (49.2) and North West (47.8).| Table 3: Alcohol-related mortality in Oldham, GMCA, North West and England per 100,000 population (2021) | ||||
| Mortality | Oldham | GMCA | North West | England |
| Alcohol specific mortality | 15.9 | 15.8 | 14.6 | 10.9 |
| Mortality due to chronic liver disease | 19.3 | 18.1 | 16.8 | 12.2 |
| Alcohol related mortality | 56.0 | 49.2 | 47.8 | 38.5 |
| Source: ONS/OHID | Higher than England | Similar to England | Lower than England | |
| Table 4: Proportion of alcohol only clients accessing treatment who died in Oldham, GMCA, North West & England (Q4 2022/23) | ||||
| Number of client deaths | Number of clients in treatment | Deaths as a proportion (%) of those in treatment | Oldham ranking in GMCA & North West | |
| Oldham | 6 | 475 | 1.26% | 5th lowest in GM (out of 10 LAs) 10th lowest in NW (out of 23 LAs) |
| GMCA | 87 | 6,152 | 1.41% | |
| North West | 203 | 14,517 | 1.40% | |
| England | 1,156 | 84,870 | 1.36% | |
| Source: NDTMS/OHID | ||||
Alcohol units consumed (monthly) amongst adult alcohol only clients in treatment in Oldham
Figure 5 below shows the units of alcohol consumed amongst adult alcohol only clients in treatment in Oldham 2020/21 to 2022/23. The proportion of this user cohort who indicated that they consumed zero units was, typically, less than 5.0%. It can be observed that those citing the consumption of ‘1-199 units’ and ‘200-399 units’ have moderately decreased over the three census period on view. Indications for ‘600-799 units’ per month have broadly remained similar over the same period.Figure 5 also shows that higher levels of consumption have increased. This is particularly the case in relation to alcohol only clients indicating the consumption of ‘1,000+ units’ per month which has risen by more than two percentage points (which represents an increase of 12.6% in the actual number of clients indicating as such). At best ‘1,000+ units’ is the equivalent of consuming 1.25 bottles containing 700ml of 40% proof spirits per day or 3.64 bottles containing 750ml of 12% proof wine per day or 12.83 pints of 4.5% proof lager/beer per day.
Treatment exits, successful completions and re-presentations
Figure 6 below illustrates treatment exit status amongst alcohol only clients in Oldham from 2020/21 to 2022/23. It can be observed that ‘planned exits’ amongst this user cohort have fallen by approximately five percentage points, from 60.9% in 2020/21 to 55.7% in 2022/23. Over the same period ‘unplanned exits’ remained broadly consistent – between 36% and 37%. Those who were ‘transferred – in custody’ accounted for 4.0% of exits in 2022/23 compared to 0.0% in 2020/21.
Figure 7 below shows trends for successful completions of treatment and re-presentations to treatment amongst Oldham’s alcohol only clients from 2015/16 to 2022/23. It can be observed that successful completions slumped from a high of 54.0% in 2016/17 to a low of just 19.8% in 2018/19. Since then the rate of successful completions amongst this user cohort has been on an upward trend with 34.9% recorded for 2022/23. Oldham’s most recent rate is lower than the North West average of 39.2% but similar to the England average of 36.0%. Oldham’s rate is also similar to the GMCA average of 35.3%.
Figure 7 also shows re-presentation rates. Re-presentations are defined as where an individual presents to treatment within 6 months of a successful completion of treatment and is, therefore, not considered to be a ‘new presentation’. Oldham’s performance has been characterised by fluctuating rates from a low of 2.1% in 2016/17 – its best rate – to a high of 16.9% in 2021/22. In the most period, 2022/23, Oldham re-presentation rate was 9.6% which is similar to the North West average of 9.7% but higher (i.e. worse) than the average of 7.5% for GMCA. The lowest (i.e. best) rate across the North West was recorded by Bury with 1.5% while the highest was found in Sefton with 19.0%. Amongst the ten borough that comprise GMCA Bury had the best rate while Rochdale had the worst rate with 15.4%.
Sub-intervention reviews (SIRs)
Table 5 below consists of the top ten rates for the most frequently used sub-intervention reviews amongst Oldham’s alcohol only clients in comparison to England averages. Oldham rates are worse than England’s in half of the sub-intervention reviews listed which include ‘motivational interventions’ (65.3% in Oldham compared to 77.0% for England); ‘evidence-based psycho-social interventions to support relapse prevention’ (7.4%for Oldham which is half the England average of 15.0%); and a similar difference can be observed for ‘peer support’. Where Oldham is better than the national average is ‘recovery check-ups’ (62.8 compared to 39.0%) and ‘vitamin B & C supplement to prevent/treat Wernicke’s encephalopathy/Wernicke-Korsakoffs’.| Table 5: Sub Intervention and Treatment Modality Reviews for adult only clients in treatment services in Oldham and England (2022/23) | |||
| Top 10 Interventions (Oldham) | Oldham | England | |
| Motivational interventions | 65.3% | 77.0% | |
| Recovery check-ups | 62.8% | 39.0% | |
| Cognitive/behavioural relapse prevention | 19.0% | 18.7% | |
| Mutual aid | 9.1% | 25.0% | |
| Peer support | 8.5% | 17.5% | |
| Evidence based psycho-social interventions to support relapse prevention | 7.4% | 15.0% | |
| Family and social network | 5.1% | 4.5% | |
| Acamprosate - Alcohol relapse prevention | <5.0% | 5.8% | |
| Vitamin B&C supplement to prevent/treat Wernicke's encephalopathy/Wernicke-Korsakoff's | <5.0% | 2.9% | |
| Complementary therapies | <5.0% | 3.7% | |
| Source: NDTMS / OHID | Worse than England | Similar to England | Better than England |
Further Information & Resources
Oldham Drug & Alcohol Needs Assessment 2022This Needs Assessment has been compiled in order to provide detailed analysis and information with regards to both past and current performance of drug and alcohol treatment provision in Oldham.
OHID Local Alcohol Data Profiles
More data and information is available on OHID's Local Alcohol Data Profile
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