The North Dublin Regional Drugs and Alcohol Task Force (North Dublin RDATF)¹ held a two-day alcohol event on 8–9 October 2015.¹ The first day consisted of a conference on the topic ‘Alcohol through the ages: from the cradle to the grave’. It was open to all service providers working with people affected by alcohol. Speakers included the following:

• Dr Adam Winstock, consultant addiction psychiatrist and Director of the Global Drug Survey, gave the keynote address.
• Dr Suzi Lyons, Health Research Board, set the national context using routine surveillance data.
• Dr Gerry McCarney from Sassy – Substance Abuse Service Specific to Youth spoke about alcohol treatment challenges in emergency medicine, and adolescents and alcohol use. 
• Aoife Dermody along with Marie Lawless presented the first results from the CARE (Community Alcohol Response and Engagement)  community-based  intervention, an initiative of the Ballymun Local DATF , which was rolled out in partnership with the North Dublin RDATF and the Fingal/Cabra LDATF.²
• Megan O’Leary from the National Family Support Network presented on the impact of alcohol on the family and carers.
• Monica Hynds and Robert Dunne from Barnados discussed parental alcohol use and the impact on children.
• Dr Winstock discussed physical complications from alcohol, diagnosing dependence and brief screening and interventions.

 The second day comprised clinical training for treatment providers and GPs, delivered by the indefatigable Dr Adam Winstock.  Topics covered included alcohol assessment, monitoring and management of alcohol withdrawal, and maintaining abstinence with pharmacotherapies. Eighty professionals attended this training.

 The main ‘learnings’ from the two days are summarised below.

• More robust local data on alcohol consumption and help-seeking behaviours are required. Compiling data from easily accessible digital health applications, for example the ‘Drinks meter’,³ which incorporates screening and brief intervention tools (including Audit C) and has the potential to gather information on a large number of people within the task force area, could provide meaningful data in relation to alcohol use and assist with the planning of services.  The North Dublin RDATF is planning to use this app across a number of services. 
• There is value in community-based outpatient alcohol treatment approaches incorporating both medical and psychosocial interventions.
• Alcohol needs to be more strongly emphasised in the new National Drugs Strategy due to be adopted in 2016. Although nationally there is acceptance that marketing, availability and supply are key issues in relation to tackling alcohol problems, there is very little emphasis on treatment despite the level of need.
• Screening and early alcohol interventions need to be provided in order to improve outcomes for service users and to reduce the negative impacts on individuals, families and the wider community.  Many primary care providers, i.e. GPs and pharmacists, are well placed to work alongside community-based services to deliver these interventions but they need appropriate training and resources to do so.
• The National Drugs Rehabilitation Framework⁴ needs to be updated to include alcohol in a more meaningful way.  The HSE and national treatment policies continue to focus mainly on opiates.
• Feedback from clinicians indicates that they feel they are not getting enough training and development opportunities for alcohol treatment, particularly as the emphasis is often on opiate treatment.
• Greater integration is needed between medical professionals, mental health specialists and project/case workers in community-based psychosocial services.
• A minority of service users need alcohol detoxification, and many of these could be safely managed in the community if adequate medical, pharmacological and social support were available. 
• The impact of problematic alcohol use on families (i.e. children, adults, parents and service users) should be factored into any strategic planning for alcohol.
• A more targeted focus on prevention and assessment for foetal alcohol syndrome is needed.  This should be specifically outlined in the forthcoming National Drugs Strategy. 

(Suzi Lyons and Bríd Walsh)

¹ For more information see http://www.ndublinrdtf.ie/

² See Dermody, A and  Banka P (2015) Evaluation of CARE (Community Alcohol Response and Engagement) pilot project: Ballymun, Finglas and North Dublin. Dublin: Ballymun Local Drugs & Alcohol Task Force /Quality Matters. http://www.drugsandalcohol.ie/24700/

³ See http://drinksmeter.com/

⁴ See http://www.drugsandalcohol.ie/13502/1/National_Drugs_Rehabilitation_Framework_2010.pdf