In 2014-15 there were 295,244 adults in alcohol and drug treatment services across England.
The latest official statistics on drug-related deaths in England showed the highest number of substance misuse related death since these records began and highlights a worrying rise in the number of older, more vulnerable drug users dying from heroin overdose.
Alongside this trend, alcohol-related hospital admissions have risen with over 300,000 in 2013/14.
While the harm alcohol and drug use causes to individuals is well known, such as addiction, liver disease or blood-borne viruses, there is also a significant burden of harm to the families and carers of people with an addiction, as well as society as a whole.
Substance misuse is estimated to cost the UK £10.7 billion each year from health service costs, drug-related crime and economic costs such as premature deaths. This is likely to be an underestimate as health data is limited and several harms, such unemployment and homelessness, are not included in the calculations.
Alcohol and drug treatment services play a crucial role in the local response to these harms and in reducing these costs; for example, the last Trends in Drug Misuse Deaths in England briefing showed that around 60% of drug-related deaths were people who had not been in treatment at all, or in the previous 5 years.
The evidence shows us that alcohol and drug treatment helps people to recover and is value for money. Treatment is associated with immediate and long-term savings to the public purse, e.g. every £1 spent on drug treatment, saves £2.50.
But, what support is available to help local areas allocate limited resources on the most cost-effective treatments?
PHE economic tools
PHE produces several tools to help Local Authorities and public health commissioning teams understand and inform their spending. Different tools are useful for different purposes and it’s important to know which one to use to get the most out of them.
For example, the SPOT (Spend and Outcome Tool) provides a broad overview of spend against a selection of relevant outcomes, allowing local authorities to make comparisons across some public health interventions.
Whilst is if often used by Health and Wellbeing boards and councillors, providing a high-level overview of spend and outcomes, it does not estimate value for money or return on investment.
The alcohol and drugs Value for Money tools bring together a range of tools to support local authorities, specifically alcohol and drugs commissioners, to explore ways in which the existing substance misuse budget can be spent to maximise cost-effectiveness.
Alcohol and Drugs Commissioning Tool
Developed by our Drugs and Tobacco team, this tool supports areas in understanding and improving cost-effectiveness. The Cost Calculator helps commissioners estimate local spend and unit costs, while the cost-effectiveness section helps answer a variety of questions on treatment interventions and the use of existing resources.
The Tool compares spend on the treatment system with outcomes of different types of treatments accessed by opiate users, non-opiate users and alcohol only (i.e. leaving treatment free of substance(s) of dependency).
Social Return on Investment (SROI)
Focusing on social return on investment (SROI) can help local authorities make informed decisions about how to spend their money effectively on services that improve lives, opportunities, health and wellbeing.
PHE’s guide explains the necessary stages to carrying out an SROI evaluation – what they are and why they are useful.
PHE will soon be releasing an SROI tool to further support local authorities in assessing the cost-effectiveness of alcohol and drug treatment, making the case for investment. The tool will estimate crime, health and social care benefits.
The Families Toolkit
Families for which parental substance misuse is an issue often have multiple complex needs. In addition to drug and alcohol dependency, they may experience problems with housing, unemployment, education and domestic violence, all of which can cause severe and lasting problems.
The costs of addressing these can be substantial and, because it falls across multiple agencies, it can be difficult to calculate.
The Families Toolkit is designed to complement the Social Return on Investment tool so that commissioners can demonstrate the social and economic benefits of alcohol and drugs interventions to the individual, their family and the wider community.
The evidence shows us that substance misuse treatment is effective in helping people recover and, in doing so, provides cost savings. These tools support local areas giving them the information to confidently continue investing in these services.
For information on either the SPOT or the Commissioning Tool, please contact: HealthEconomics@phe.gov.uk
All Alcohol and Drugs Value for Money tools are available from: https://www.ndtms.net/ValueForMoney.aspx