Reader in Social Epidemiology
areas of expertise
Dr Gordon Hay joined the Public Health Institute in November 2012 as a Reader. Prior to that appointment he was researcher at the Centre for Drug Misuse Research at the University of Glasgow. His research has focused on the application of epidemiological and statistical methodologies within the area of drug or alcohol use and in his new position he aims to further develop this work more into other areas of public health. Gordon’s main research has been developing and applying statistical methods to estimate the number of people who use drugs such as heroin or crack cocaine. Traditional surveys are often inappropriate therefore other approaches, such as the capture-recapture method, have been developed. He has carried out such work at the local, national and international level and has led a programme of research studies that have produced the annual estimates of opiate / crack cocaine use in England. He is the UK Scientific Expert to the EMCDDA for their Problem Drug Use Key Indicator and has carried out a range of projects for the EMCDDA and other international organisations such as the UNODC in various countries including the Baltic States and Turkey. Gordon has collaborated with qualitative and quantitative colleagues in a number of studies, including research that quantified and sought to understand benefit uptake by drug or alcohol users for the DWP. He has been involved in a number of large-scale evaluations, such a multi-method evaluation of the UK Government funded programme of drugs prevention projects within Health Action Zones. He also led studies looking at the social and economic costs of drug use and the likely size of the Scottish drugs market. Gordon’s PhD at the University of Strathclyde used mathematical models to examine the spread of HIV amongst people who inject drugs and he still maintains an interest in blood-borne virus epidemiology and drug-related mortality and has continued to publish in these areas.
Dr Gordon Hay's Publications
Evaluation of Rapid Access to Alcohol Detoxification Acute Referral (RADAR)
Alcohol-related presentations to hospital have been increasing in the United Kingdom, with one of the major causes of such admissions being the occurrence of acute withdrawal symptoms. In response to this, the RADAR (Rapid Access to Alcohol Detox Acute Referral) service was established in Greater Manchester as an innovative pathway from A&E departments into specialist detox facilities. The RADAR service has four main aims: reducing the burden on acute trusts, improving clinical outcomes for service users, providing improved experience for service users in a therapeutic setting and demonstrating cost-effectiveness. The Centre for Public Health conducted an evaluation of RADAR to explore experiences and cost-effectiveness. Service users and stakeholders described positive experiences and felt that RADAR provides specialist support which makes a difference to people’s lives. Six months after discharge, just over half of those who could be contacted reported either being abstinent or being controlled drinkers. This reduction in the levels of alcohol consumption resulted in fewer contacts with Acute Hospitals, with reductions in both the number of A&E attendances and nights in hospital being reported. The cost-effectiveness analysis of RADAR suggests that the service is cost-effective, with a projected saving of £ 1,320,921 over a 12 month period.
Estimates of the Prevalence of Opiate Use and/or Crack Cocaine Use, 2011/12: Sweep 8 report
This report provides estimates of the prevalence of opiate and/or crack cocaine use at the regional and national level in England for 2011/12. It is a follow up to series of comparable prevalence estimates for 2004/5, 2005/6, 2006/7, 2007/8, 2008/9, 2009/10 and 2010/11. Estimates of the prevalence of opiate use, crack cocaince use and drug injecting (by users of opiates and/or crack cocaine) are also presented. Two prevalence estimation methods have been used; the capture-recapture method and the multiple indicator method. The capture-recapture method examines the overlap between different sources of data on individual drug users that are available at the local level to estimate the size of the hidden drug using population at the DAT area level. The multiple indicator method models the relationship between the capture-recapture estimates and readily available drug indicator data, such as numbers of drug offences in an area. It then applies that relationship to the areas where capture-recapture estimates are not available and provides estimates of drug use for those areas. The DAT area estimates are then summed to provide regional and national estimates.
In total there were an estimated 298,752 opiate and/or crack cocaine users aged 15 to 64 in England in 2010/11 (95% confidence interval (CI) 294,858 – 307,225). This converts to 8.67 per thousand population aged 15 to 64 (95% CI 8.55 – 8.91). The estimated prevalence of opiate use was 7.59 per thousand population aged 15 to 64 (95% CI 7.52 – 7.80) and the estimated prevalence of crack cocaine use was 4.95 per thousand (95% CI 4.81 – 5.12). The estimated prevalence of drug injecting was 2.71 per thousand population aged 15 to 64 (95% CI 2.64 – 2.81). Nationally, there was a fall in the prevalence of opiate and/or crack cocaine use between 2009/10 and 2010/11; however this was not statistically significant. There was also a slight non-statistical drop in the prevalence of opiate use from 264,072 in 2009/10 (95% CI 260,023 – 271,048) to 261,792 in 2010/11 (95% CI 259,260 – 269,025). The estimates for the period 2010/11 also show a statistically significant decrease in the levels of crack cocaine use from 184,247 in 2009/10 (95% CI 177,534 – 195,526) to 170,627 (95% CI 165,877 – 176,692). The injecting prevalence rates have also significantly decreased between 2009/10 and 2010/11, going from 103,185 (95% CI 100,085 – 107,544) to 93,401 (95% CI 90,974 – 96,974).
Dr Gordon Hay's Papers
“Once you’ve been there, you’re always recovering”: exploring experiences, outcomes, and benefits of substance misuse recovery
Drugs and Alcohol Today, (2016) Vol. 16 Iss: 1, pp.29 - 38, 2016.
Abstract: Purpose: – Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose of this paper is to explore these factors, and understand how service user experiences align to current understandings of “recovery capital”. Design/methodology/approach: – This paper draws on qualitative interviews with 32 individuals from six UK recovery communities, including those commissioned by a statutory service (n=8) and a peer-led recovery community (n=24). Findings: – Meanings of recovery differed between people in abstinence-based communities and those not; however, all had consistent views on their own recovery outcomes and the benefits they believed recovery brought. All viewed recovery as a process; a continuous journey with no end-point. Internal motivation, peer support, social networks and daily structure were integral to supporting individuals achieve and maintain recovery. Key benefits of recovery reflected recovery capital and included positive relationships, sense of belonging, increased self-worth and confidence, employment and education. Research limitations/implications: – This research shows that recovery experiences and outcomes are not centred entirely on the individual but are wider, more holistic. Maintaining recovery involves being connected to themselves and to the wider environment: family, friends, peers and society. Although the recovery capital model has many elements that were discussed by the participants of this research, the discourse they used does not align with the model. To validly measure and quantify recovery outcomes, individuals need to identify with the measures themselves. Practical implications: – From policy and commissioning perspectives, these findings suggest benefits of recovery that were viewed by participants as indicators of success: demonstrate elements which support recovery; and highlight key social value outcomes which people attribute to recovery. Social implications: – These “softer”, qualitative benefits should be considered by policy-makers, commissioners, statutory and non-statutory services in order to evidence outcomes. However, it should also be recognised that a temporally static approach to assessing recovery may be in contradiction to the meaning and perspectives held by those in recovery communities who conceptualise it as a long term and ongoing process. Originality/value: – This paper adds to understandings of experiences and meanings of recovery, with a particular focus on the measurement of outcomes and their meanings, and the role of abstention and continued drug use within the recovery process.
Lorna Templeton, Christine Valentine, Jennifer McKell, Allison Ford, Richard Velleman, Tony Walter, Dr Gordon Hay, Linda Bauld, Joan Hollywood
Drugs: Education, Prevention and Policy.
Abstract: Aims: Overdoses contribute disproportionately to drug-related deaths (DRDs) in the UK, yet little is known about the experiences and needs of those who are bereaved by such deaths, and how their experiences and needs might differ from other bereavements associated with substance use. Methods: An interview study with 32 adults in England and Scotland (part of a larger study). Findings: Five themes describe the core experiences of this group of bereaved people: drug use, the death, official processes, stigma, and overdose awareness and prevention. Together, these findings offer new insights in to the key features of this type of bereavement; for example, living with substance use including previous overdoses, difficult circumstances surrounding the death, having to negotiate the complex procedures involved in processing the death, the stigma such deaths attract, and feelings of guilt, self-blame and an unworthiness to grieve. Conclusions: There are ways in which bereavement following an overdose differs from bereavement following other deaths associated with alcohol or drugs. Understanding the experiences and needs of this marginalised group can help improve support for them. Furthermore, this group’s experience of witnessing and/or responding to previous overdoses indicates the value in prevention programmes targeting relatives/friends.
Hepatitis B Prevalance in Denmark – An estimate based on Nationwide registers and a National Screening Programme
N Hansen, Dr Gordon Hay, S Cowan, P Jepsen, H Bygum Krarup, Niels Obel, N Wels, Peer Christensen
21st November, 2013.