The latest plan for reducing the harms caused by substance misuse has highlighted a number of areas of concern.
Published by Health and Social Care, the 2027-32 Combined Substance Use Strategy for Guernsey and Alderney says the normalisation of high levels of alcohol consumption and the increasing normalisation of cannabis use need to be addressed.
The strategy, published today, is the result of years of research which in turn should help improve the health of islanders for years to come, said Public Health.
Public Health and the Health Improvement Commission jointly led the development of the 2027–32 strategy, continuing the work set by the 2021-26 strategy, with support from teams across the public, private, and charity sectors.
By putting together an overarching plan in place, Dr Nicola Brink MBE, Guernsey’s Director of Public Health and Medical Officer of Health, said the strategy gives the island’s health teams “a coordinated approach to substance use”.
“In the last strategy, we looked at making it a joint drug, alcohol, and tobacco strategy, and then during the course of that strategy, we added vaping,” she said. “These strategies are agile, and will change with time.”
The plans are always open to evolution, changing as new information comes forward, and the public’s perceptions on the prevalence of substances shifts, she said.
“Agility in any strategy is absolutely key, so it can’t be set in stone for the next five years, because things change, and we’re very fortunate to have the strategies overseen by a substance use technical team.
“That technical team is a multidisciplinary team, and what it enables us to look at is how we’re doing, how we’re progressing on the key performance indicators of the strategy, but also what’s new, what’s emerging, and what we should be doing about it.”
The issues to be tackled
The new strategy has a focus on tackling problems around the misuse of medicinal cannabis and ongoing concerns around alcohol.
Since the law was changed to allow cannabis to be prescribed in 2020, there has been an impact on the black market – with data now showing that around half of users are consuming cannabis prescribed to someone else.
Dr Brink said that the regulation of medicinal cannabis is “absolutely a priority in the strategy,” adding that planning to tackle the problem is “being led by the Chief Pharmacist”.
She said health teams “are worried about the diversion of medicinal cannabis”, adding that “this is something that we feel needs to be looked into, practically.”
Dr Brink said “no one here is saying that medicinal cannabis should be stopped, but we know it’s being diverted.”
She said health teams “know there’s a problem associated with that, and so it’s how we tighten up on that, and it’s used more effectively”.
The strategy also features some striking numbers in terms of alcohol consumption and its impact on the island’s overall health.
“Alcohol is our main issue that came up time and time again,” said Dr Brink, who added that the link between mental health and wellbeing and alcohol consumption was visible.
“You saw the association with anxiety and poor mental health, but then also, if you look at the other harms caused by alcohol, of course you have the obvious liver disease, alcohol consumption can be associated with development of dementia, and you have the alcohol cancer associations as well.”
With almost a quarter of adults over-consuming alcohol from a health perspective, it’s little surprise that it forms a major part of the strategy, with tackling stigma being one of the main pillars propping up the island’s health plans for the next 5 years.
“Really it’s looking at going back to the pillars of those strategies of awareness, stigma, reduction, the prevention part, the provision of the services, and, of course, policy and legislation to create a healthy environment.”
Tobacco
The new strategy includes success stories such as the dramatic decline in smoking locally, with the latest data showing Guernsey approaching ‘smoke free status’ but also a noticeable rise in vaping amongst the islands’ students.
The mobile nature of having a combined strategy, and the ability to adapt and evolve as Guernsey’s substance use scene changes is one of the major benefits according to Amy Sharp, a Public Health Practitioner, who was credited with much of the work used in the five year strategy.
“The strategy really builds on the progress of the previous strategy. Within that strategy, we’ve seen vaping legislation being brought in, and I think that really shows how the strategy can respond to emerging concerns.
“Vaping wasn’t originally in the previous strategy, but due to concerns that were coming out about youth vaping, it has since been added in, and we really want to build that for the new strategy, and kind of have a focus on responding to those concerns as they arise.”
Partnership of purpose
The strategy heavily relies on the complex and interconnecting nature of Guernsey’s health services.
Not only do they work within Government, but within the private and charity sectors too. They also rely heavily on a web of connections that span the island, said Dr Simon Sebire, the Chief Executive of Guernsey’s Health Improvement Commission.
“They are a system of connected pieces with different people responsible for different sections, but they all interact with one another, and so that’s why the strategy looks like it does.”
He added that if “it’s a systemic problem,” then you need “a systemic solution going forward, and one that you can then keep adapting over time, bringing in new partners or flexing how you work”, and that “it has to be that way, because something rigid and single focussed wouldn’t be effective.”
The system works through these partnerships and the island’s self reporting nature, a problem arises so the public lets the officials know, and that starts the domino effect.
It triggers a call to action from a legislation perspective, from a government angle, and through the lens of charities helping ensure our island is healthy and happy, as well as from the view of safeguarding through the involvement of law enforcement.
Dr Brink was asked if she could see a further adoption of this partnership model. If Guernsey could see more collaboration in tackling health issues as they arise.
“Absolutely 100%”, she said, adding that “it’s a partnership across health and social care, it’s partnership with the medical specialist group primary care, and it’s partnership with third sector organisations.”
However the way that Guernsey’s public interacts with services also receives praise from the Director Public Health and Medical Officer of Health, who said she’d “also really like to give a shout out to partnership with people with lived experience”.
“Our technical team have people with lived experience, and what they can do is help guide us through what they feel is an effective partnership working with what they feel are the right services. So it’s, in essence, a partnership with the community as well.”
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