• Robert Whitehead and Catherine Wells.
• Public Health and Social Research Unit, West Sussex County Council, Chichester, West Sussex, UK.
• Lancet. 2022 Nov 1; 400 Suppl 1: S11S11.

BackgroundSubstance misuse has extensive effects on individuals and communities, ranging from the poor health of people who use drugs to the pressure placed on health care, social services, and the criminal justice system. Strategies to curtail the supply and demand of drugs and reduce these effects typically focus on supply, with less emphasis placed on the drivers of demand. We piloted and evaluated a public health approach for understanding the drivers and effects of substance misuse in a local area, and how these might be targeted for prevention through multi-agency partnership action.MethodsA cross-sectional mixed methods analysis was conducted, using multi-agency data. 3 years of data provided by criminal justice agencies (police, youth justice, and probation), drug treatment services, social care, education, and hospitals were used to profile the local demand and effect of drugs on individuals and communities in a coastal town in southern England. The experiences of local professionals who support people who misuse drugs, or people affected by drug misuse, were collected via an online survey that was disseminated to relevant partnership organisations, including homelessness charities and drug treatment providers. A public health framework identifying relevant risk and resilience factors in the community was developed by combining the multi-agency data and survey responses The methodological efficacy of this approach to inform partnership action was evaluated via a survey with the project's stakeholders.FindingsCommunity housing, mental health, and cycles entrenching substance misuse were identified as risk factors that increase individual-level, interpersonal-level, and community-level vulnerabilities to the harms of drug misuse, violence, and exploitation. Evaluation found this mixed-methods analysis for understanding risk and resilience to be a valuable approach to enable public health and community safety leaders to develop a framework for partnership action to reduce the negative effects of drug demand in the community.InterpretationAnalysis of multi-agency data helped to further a shared understanding in local partners of the drivers and effects of drug demand at a local level; and, through a public health lens, clearly identified the role that local organisations can play in minimising the harms of substance misuse and exploitation.FundingNo funding received.Copyright © 2022 Elsevier Ltd. All rights reserved.

16 keywords...

hide…