Repairing the damage
This is the third in a short series of posts looking into the detail of the new drug strategy published last week and which I summarised here. Today’s post looks at what the document has to say about rebuilding our drug treatment system after the disinvestment highlighted by Dame Carol Black in her two-part Review of Drugs (which I summarised at the time in this series of posts). Of course, government strategies are also political documents so, rather than talking about repairing or rebuilding, the Chapter is titled: Delivering a world-class treatment and recovery system.
Reinvestment
To be fair to the government, it has both accepted Dame Carol’s report and promised to invest an additional £780 million in drug treatment over the next three years. The strategy also promises to adhere to Dame Carol’s other primary recommendations; to adopt a whole system approach which will expand treatment capacity, rebuild the workforce, give local leaders more power and accountability and put in place strong partnerships education providers, local authorities, the NHS and criminal justice agencies. Of course this last is exactly what Drug (and Alcohol) Action Teams were until they were disbanded over the last decade. But again, we can hardly fault the government for acknowledging that local authority-led Health and Wellbeing Boards have, on the whole, shown pretty little leadership where drugs & alcohol have been concerned.
The plan is to target areas with the highest need first before rolling out across the country (you can see details of the funding plans in the graphic below). The government sets out a fairly ambitious set of targets to be achieved by March 2025, some of which are specific:
- nearly 1,000 deaths prevented, and lives saved
- a phased expansion to deliver at least 54,500 new high-quality drug and alcohol treatment places, a 19% increase on current numbers
- treatment contributing to around 740,000 crimes prevented, of which 140,000 are neighbourhood crimes such as burglary, robbery and theft
- 21,000 new treatment places for opiate and crack users, 53% of opiate and crack users in treatment
- 30,000 new treatment places for non-opiate users, including a further 5,000 more young people in treatment
- at least 7,500 more treatment places for people who are either rough sleeping or at immediate risk of rough sleeping – a 33% increase on the current numbers
- a treatment place for every offender with an addiction
- 24,000 more people in long-term recovery from substance dependency
- increased referrals from police, courts and probation into drug treatment
- more people recovering from addiction in sustained employment
- more people recovering from addiction in stable and secure housing
Accountability
The strategy promises a new national commissioning quality standard which will set out the full range of treatment and recovery interventions that local areas should provide for their population based on an assessment of need. It also acknowledges that the field has lost many expert staff over the last decade and pledges to rebuild the sector’s health professional workforce (including psychiatrists, doctors, nurses and psychologists) and improve the level of skill and training among drug workers and peer recovery workers.
The paper also promises to improve housing and employment opportunities for people in recovery and includes a commitment to invest in a peer mentoring programme in England, Wales and Scotland, where mentors will work in partnership with Jobcentre Plus and treatment staff.
Criminal justice
The government clearly agrees with the Probation Inspectorate’s assessment that most of the services whose role was to identify and engage into treatment drug using offenders have “withered on the vine” and pledges an additional £120 million to engage offenders with “recovery-focused treatment services”. This money will fund mandatory and voluntary testing regimes in prison, support for prisoners to engage with community treatment ahead of their release and increasing the use of intensive drug rehabilitation requirements for those on community sentences. The strategy also promises to put funding back into drug testing on arrest with the positive results notified to Liaison and Diversion schemes.
In another move which is basically a return to the disbanded Drugs Intervention Programme, there is a commitment to pilot problem-solving ‘substance misuse courts’ where the offender is seen regularly by the same judge. Judges will be given a new power to impose “new brief temporary custodial penalties for non-compliance.”
The white paper also promises more investment in prison drug treatment with a commitment to providing the full range of evidence-based treatment interventions including recovery-focused work as well as long-acting buprenorphine. There is also a welcome pledge to make naloxone available to both prison and probation hostel staff to try to prevent fatal opiate overdoses.
There is also the promise of a renewed focus on continuity of treatment on release from prison, utilising RECONNECT and the chance for people to have pre-release video appointments with community-based treatment providers.
Conclusion
The government has planned to publish annual progress reports on the implementation of the strategy so that we can judge its impact. In the next post in this series, I will focus on the strategy’s renewed focus on reducing the demand for drugs.
Thanks to Elena Mozhvilo for kind permission to use the header image in this post which was previously published on Unsplash.
One Response
Having long term lived experience of recovery from addiction,I offer my services to this worthy government sponsored project in its new drug strategy