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In part 2 of her Review of Drugs, Dame Carol Black argues for a significant increase in funding for drug treatment.

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Multi-million pound investment

This is the latest in a series of blog posts I’m writing covering the detail of  Dame Carol Black’s   second part of her independent Review of Drugs which sets out a way forward on drug treatment and recovery for the government and which was published earlier this month (8 July 2021). In the opinion of myself and many others, the Review is the most important drugs report of the century so far. This week’s post looks at Dame Carol’s recommendations for a substantial boost in funding for drug treatment and wider recovery support. You can read the full series of posts summarising both Part 1 and Part 2 of the Review of Drugs here.

Part 1 of Came Carol’s review  showed that funding for treatment fell by 17% overall between 2014 to 2015 and 2018 to 2019 for adults and a staggering 28% for young people.  The amount of unmet need for treatment has grown over this time while the treatment workforce is declining in “number and quality”.

Dame Carol advocates a strong ‘invest to save’ case for drug treatment. Although Part 1 of the review showed that the societal costs of drug misuse are £20 billion each year, in 2020 to 2021 only £650 million was spent on drug treatment. Every £1 currently spent on harm reduction and treatment gives a combined health and justice return on investment of £4.  Dame Carol argues strongly that failure to invest will inevitably lead to increased future pressures on the criminal justice system, health services, employment services and the welfare system.

On current estimates of prevalence, in order to provide a full range of high-quality treatment and recovery services for adults and young people with a drug dependence, significant investment is needed on top of the current expenditure, rising from £119 million in year one to £552 million in year 5.

This additional investment is urgently needed to provide:

  • increased treatment capacity to meet need, including to respond to newer non-opiate patterns of drug use, and to expand and improve services for children and young people
  • increased drug treatment capacity to respond to criminal justice priorities set out in the sentencing white paper, including increased use of community sentences with a requirement for drug treatment, and getting more prisoners into treatment within three weeks of release
  • expansion in the number of professionally qualified workers (psychiatrists, psychologists, nurses and social workers), and development of training to improve the skills of drug workers and peer recovery workers
  • increased provision of inpatient detoxification and residential rehabilitation
  • expansion of local areas’ support for peer-led grass-roots recovery communities and peer mentoring, complementing professionally led services
  • increased overdose prevention, harm reduction and syringe exchange programmes
  • an innovation fund for research into what interventions, and what methods of delivery, are most effective at deterring recreational drug users

Investment for broader support

Dame Carol makes the point that improved treatment services will not be enough on their own to help people achieve and maintain recovery, arguing that a broader package of services is needed, involving also well-coordinated housing and housing support, employment support, and mental health services.

Dame Carol sets out specific, costed funding requests:

In addition to the mainstream support provided by Jobcentre Plus, DWP should provide additional investment, estimated at £6 million in year one rising to £16.5 million from year 3, to roll out nationally a dedicated employment support programme for people in drug treatment.

Dame Carol estimates that an additional investment of £150 million over a 5-year period would be needed to provide housing support services to individuals in treatment alongside the expansion of Individual Placement and Support. 

An extra £5 million per year is needed by MoJ for probation health and justice co-ordinators so that they can play a full part in local area partnerships. 

NHSE is improving mental health services by additional investment of £2.3 billion per year. Part of this should be used to increase the specialist mental health support available to people with drug dependence.

If you would like to see a detailed breakdown of these costs as well as the estimated benefits which would come from this additional investment, Dame Carol has provided a detailed Annex to the report (Annex C) which you can read here


Thanks to Pretty Drug Things for the images in this post. Pretty Drug Things  explores different visual aesthetics and marketing techniques used in either promoting or demonising different psychoactive substances in our society.

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