Welcome to the Drug Strategy blog!

Posted on March 7, 2011 12:01

As the Home Office Minister with responsibility for drugs and alcohol, I’m delighted to be launching this blog pilot and to invite your comments as key delivery partners.

The new strategy is aimed at supporting and enabling those dependent on drugs and alcohol to recover fully, reducing the demand for drugs and taking an uncompromising drive to crack down on those involved in the drugs trade.

It also addresses the issue of so-called "legal highs" through the development of temporary banning orders, improving the forensic analytical capability to detect new psychoactive substances and establishing an effective forensic early warning system.

As we shift power and accountability to local areas to tackle the damage that drugs and alcohol dependence cause our communities, we really want to hear from you, on your challenges and successes in achieving the ambitions of the strategy.

I know you’ll be keen to be updated by us too, particularly on centrally led areas of strategy delivery as they begin to get underway.

For example, there has understandably been considerable interest in the Payment by Results (PbR) pilots for drugs recovery that are being led by the Department of Health. Sixteen local areas in England were short-listed as potential pilot sites, twelve of whom submitted full proposals last week. You can see the list of partnerships that have chosen to go to full proposal stage at the bottom of this page. Next month the successful pilot sites will start work with the PbR project team to begin co-designing the detail of the pilots, with the aim that they are up and running from October 2011.

I’m aware there is some concern being expressed about the process of setting up the PbR pilots, primarily a misconception that we are deliberately excluding providers from being considered as part of the pilots. This is not the case. Local partnerships hold the budgets and so must be in charge of creating their own offer to ensure it meets local needs. That is why we are working through these partnerships whilst recognising the absolute need to draw upon the expertise of providers, commissioners and others in the sector.

I know some of you are worried that local partnerships will not change their commissioning to support the new strategy’s greater ambition for recovery. Let me make it clear, as we did in the strategy, that to build a recovery focussed system, local areas will need to jointly commission services that deliver "end to end" support. Close links will need to be built between community, in-patient and residential treatment and rehabilitation providers, who in turn will need to forge close links with aftercare services.

There are clear indications that some areas are already developing this approach, in order to deliver recovery outcomes. For example David Oliver, the Head of Drugs and Alcohol at the Home Office, visited Liverpool recently and saw a service which has refocused its efforts from a harm minimisation to a recovery approach.

I’ve asked David to take forward the blog over the next two weeks. Whilst he won’t be able to acknowledge every comment personally, he will respond regularly on the main themes arising from your comments, so please do get involved.

Finally, you will remember that we sought the views of those involved in the drugs sector to support the development of the new drug strategy. A big thank you to those of you responded. The publication of the strategy established the framework to deliver our ambitions to restrict supply, reduce demand and build recovery. As we move forward into implementation, I hope that the blog will develop as a useful way to continue to engage with you. It will run initially for two weeks and then be evaluated to see if this is a helpful way to share views and ideas, successes and challenges.

I look forward to reading your comments.

James Brokenshire

Potential PbR pilot areas: Lincolnshire, Enfield, Middlesbrough, Lancashire, Stockport, Wigan, Wirral, Oxfordshire, Surrey, Kent, Wakefield and Bracknell Forest.

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61 responses to Welcome to the Drug Strategy blog!

  • Steve Rolles said...

    March 7, 2011 17:23

    Whilst acknowledgeing the importance of service provision and the debates going on in that sector I am concerned that issues around drug enforcement, both in the UK and internationally, are in danger of being overlooked.

    Whilst enforcement issues were not prominent in the drug strategy consultation or strategy document, enforcement actvities (within and beyond the strategy budgets) do still absorb far more resources than all service provision combined, and whilst there is some evidence that treatment/recovery, prevention and harm reduction can deliver positive, there is little or none to suggest enforcement has been effective hostorically at reducing drug production, supply or use.

    There is however considerable evidence to suggest enforcement has created signifincat personal and social harms associated with the vast international trade, controlled exclusively by criminal entrepreneurs - causing havoc from Colombia and Afghanistan to the streets of the UK.

    Not only are the enforcement/policy related harms -associated with the illegal trade- rarely discussed, they remain almost entirely absent from the current political discourse.

    Nowhere in the strategy is there any discussion of how the impact of enforcement on should be measured. There has, for example, never been any measure of drug availability - this despite the fact that its reduction remains the primary goal of supply side enforcement. Nor are any such measures proposed (seizures/arrests are a meaningless proxy measure).

    This seems like a significant oversight given the volume of taxpayers money being directed into this enterprise, and level of scrutiny and debate being directed at outcomes in other areas of the strategy such as treatement/recovery. When the drug strategy has been subject to independent or external scrutiny the lack of evideence in support of the efficacy of enforcement efforts, and the poor level of evaluation more broadly, is raised time after time.

    I hope that we can see some meaningful suggestions for how supply control policy will be developed from the Home Office over the next two weeks - including, specifically, how the impact of enforcement availability, use, and unintended harms (domestic and international) will be assessed during the lifetime of the strategy.

    Reply to Steve Rolles's comment

    • Tom Lloyd replied...

      March 8, 2011 11:46

      May I endorse Steve Rolles’s comments with my observations based on over 30 years of policing at all ranks in urban and rural areas of the UK. While there are occasional "successes" in terms of prosecutions of drug users and dealers the overall impact of law enforcement efforts in this country has been marginal at best.

      There has been no cost benefit analysis to justify the huge costs of these ineffective efforts, or efforts made to assess the unintended consequences of criminalising so many citizens whose drug abuse and addiction needs help and support not ostracism and punishment. And what evidence is there to show that enforcement activity is an influential a factor in determining levels of drug use when compared with the influence of culture, fashion, peer pressure, etc. ?

      While the control and regulation arguments are gaining much greater credence and support in this country (although sadly not engaged in by politicians), I imagine it will be some time before we benefit from a real evidence-based discussion and the policy and legal changes that will inevitably follow.

      Although the argument that government control and regulation of drugs will severely impact on criminal profits from the drug trade is very persuasive (if not simply obvious), it is clearly the case that serious and organised crime will remain a pressing problem for the country, albeit not enjoying the obscenely large profits from today’s illegal drugs market.

      So, still operating within the current framework and at a time when all public services are under great financial pressure it makes a great deal of sense to refocus our ineffective, costly and counter-productive enforcement efforts away from the users and low-level dealers (often users themselves) and increase efforts against serious and organised criminals.

      We will also release resources for effective treatment and rehabilitation including prescribing heroin which has been so successful wherever adopted in other countries and in the trials within the UK.

      With real leadership from the Home Office, tapping into the growing understanding of the need for change, we can shift resources from the ineffective punishment of the needy to their effective treatment and increasingly focus on the successful pursuit of the most dangerous criminals in the country.
    • Nik Morris replied...

      March 8, 2011 13:17

      That’s an Excellent comment from Mr Rolles. A full cost analysis of the current drug strategy, tied to a full enquiry into the "unintended consequences" associated with "prohibition", would be something that could get close to answering the most obvious of questions, "Has the last 40 years of "Criminalising" drug users worked?", and, "Have we seen a decrease in drug use, drug addiction(Including Alcohol and Pharmaceutical), drug related crime(Stealing to fund habit), and "organised" criminal behaviour?, over the last 40 years". If we can find the answers to these questions, I believe we may at last begin to deal with the current problems faced by the government of today. I can see merit in the government approach but would like to see more of an effort into finding out why past policies have failed.
    • Posted by administrator

      David Oliver - Head of Drugs and Alcohol Unit replied...

      March 8, 2011 14:23

      You raise in your post a number of issues that I know Transform feel strongly about. In relation to your point on impact assessment, the Government has committed to using evidence to drive the very best outcomes for individuals and communities. The Government is currently developing an evaluation framework to assess the effectiveness and value for money of the Drug Strategy. If the current evaluation evidence is considered too sparse or weak to provide a satisfactory assessment of value for money, we will identify the extent to which evidence gaps can be filled and the standard of evaluation improved.
    • Gart Valenc replied...

      March 8, 2011 14:44

      @ David Oliver,

      I would appreciate it if you could let as know whether your «evaluation framework to assess the effectiveness and value for money of the Drug Strategy» will be as thorough and comprehensive as the Impact Assessment made on this very 2010 Drug Strategy?


      Gart Valenc
    • Steve Rolles replied...

      March 9, 2011 16:50

      David - thanks for your response and apologies for the typos in my post (netbook + writing on the train).

      How we evaluate the efficacy of supply side enforcement is not merely the concern of Transform. It is clearly a matter for public concern given the issues at stake and money being spent.

      The historical void in scrutinising supply side interventions that has been a running theme through previous drug strategies (as have commitments to evidence based policy) - and there is nothing in the new strategy to suggest how this shortcoming is to be addressed.

      Value For Money studies would be very welcome (although they are quite different to Impact Assessments). I hope you can assure us that unlike the VFM studies of the drug strategy from 2001 and 2007 (only emerging years after writing, following tortuous FOI battles with Transform) forthcoming VFM studies will be made publicly available.

      Both studies noted that evaluation of supply side enforcement was inadequate, but that what limited evidence there was did not support a conclusion that it was effective or value for money.

      So at least you have a starting point, your own Home Office research, regards whether the evidence ’is considered too sparse or weak to provide a satisfactory assessment’ (The recent reports from the NAO and Public Accounts Committee also provide some useful pointers).

      These are conclusions that have also been supported by one of your predecessors as head of the drug strategy unit, Julian Critchley, who noted that:

      "during my time in the Unit, as I saw more and more evidence of ’what works’, to quote New Labour’s mantra of the time, it became apparent to me that the available evidence pointed very clearly to the fact that enforcement and supply-side interventions were largely pointless. They have no significant, lasting impact on the availability, affordability or use of drugs."

      It is on this last point, re availability, that my original question was directed - and to which I hope you are able to give a more specific answer:

      Will you be developing any kind of measures of availability and any targets for its reduction - by which to measure the impact/efficacy/VFM of supply side enforcement? If not, how will enforcement efficacy be measured?

      Additionally - will there be any way in which stakeholders might be able to feed into development of these supply side evaluation frameworks?

  • Nik Morris said...

    March 7, 2011 20:45

    Why is this approach still insisting on making drug users "criminals"? Can we not have a purely medical approach, that would allow users to be treated as "Equals"? Drug use is not a crime!

    Reply to Nik Morris's comment

  • Knux Vee-one said...

    March 7, 2011 21:40

    Hey look, this needs to stop, with all drugs, but as a user of cannabis I will focus on that. Consider the facts. For every drug farm that is shut down another five pop up in its place to meet the demand. If all the farms in the UK are shut down then the flow wouldn’t stop, it would just be imported from other countries, the money would eventually end up in the hands of terrorists. The drugs war has failed, I’ve never met a single drug dealer that would check for I.D. like a government regulated system would. Think of all the money that is currently just going to the criminals, the government could earn a huge chunk off this huge demand that has no sign of going away. Surely it is a basic human right as an adult to have the choice of which substances we put into our own bodies. Personally I don’t drink alcohol but I do enjoy a smoke, I don’t enjoy having to visit a criminal element to buy my product, I don’t know where my money is going or what my herb has in it. I also have to travel home on foot feeling like a criminal with the intention of safely returning to my house so I can safely consume my choice of substance. Although I still fear having my door kicked in by the police over the choices I have made in my life. Seriously the drug war is failing, has failed and always will fail. Every single farm closed down will be replaced to fill the demand in the market, this in turn leads to more immigrants to tend to these farms, overpopulation leads to crime and violence. The money the ’big-cats’ and the tenders are making goes straight back to their country, the UK doesn’t see a penny. I also wouldn’t be surprised if this money was also funding terrorism. Please I am begging you as a citizen, for the good of the UK please legalize cannabis and give the responsible adults a choice, you won’t be sending the wrong message, you’ll be saving the children from a future of criminality. Thank you for reading, I hope my views are appreciated.

    Reply to Knux Vee-one's comment

  • Julian said...

    March 7, 2011 21:41

    Please can you take a more compassionate stance on medical cannabis.

    It even helps Autistic people like me.

    Thank you and God Bless

    Reply to Julian's comment

    • jules replied...

      March 11, 2011 12:34

      Well said, Julian. I am prescribed Sativex (the medical cannabis) as I have multiple sclerosis. Next time you visit your GP ask him/her about this drug, as it is now licensed in the UK, or so I believe. Unlicensed cannabis and illegal cannabis are two completely different matters and should be treated as such, but unfortunately isn't always the case.

      Good luck
  • jim said...

    March 7, 2011 21:44

    "The new strategy is aimed at supporting and enabling those dependent on drugs and alcohol to recover fully,"

    Since when was alcohol not a drug? why do you define them separately?

    Reply to jim's comment

    • jim replied...

      March 8, 2011 17:31

      Can someone please offer and official stance on my question about why you define alcohol separately from drugs?
    • Carole King replied...

      March 9, 2011 14:37

      I asked yesterday, why "drugs" doesn't include alcohol and tobacco. Especially given the news today - from the government (so it's from the horses mouth) that 80,000 a year *DIE* from smoking. How many people a year DIE from heroin ?

      If the government is *serious* about trying to reduce the harm done by drugs, it needs to act serious. By twisting semantics (in a self-referential madness) and saying "oh, we mean ILLEGAL" drugs, all people see is a bankrupt policy propping up vested interests. Did you vote for that? I didn't.
    • SR replied...

      March 9, 2011 16:24

      Medical and research science seems to have proven that addiction is a inherited, chronic, incurable brain disorder. "Recover fully" seems a false hope and pop myth.
    • terry replied...

      March 9, 2011 20:33

      I agree why does the government not include Alcohol when all the doctors in the land are telling them it is the Number 1 killer
    • Dave replied...

      March 9, 2011 20:44

      I would like to second this question. Since this website is dedicated to drugs strategy I'd like to make a contribution: the first change in strategy should be for all and sundry to stop using the phrase "drugs and alcohol" and use simply "drugs" or, if desperate, "drugs including alcohol".
    • Marc Mc Cann replied...

      March 10, 2011 10:51

      Alcohol... is considered a food. unlike other psychoactive substances.
  • Darryl Bickler said...

    March 7, 2011 22:16

    I am a founder member of the Drug Equality Alliance and my interest is in the Rule of Law. I wish to to see a safer and world for the users of all kinds of drugs, and that includes more tolerance of use that does not unduly impact upon society and less tolerance for use that does.

    What in my experience is most alienating about drug policy is how it veers off course from what was envisaged by parliament in 1970 whilst the MODA was being drafted. The Act concerns itself with the misuse of any drug that might lead to social problems; this was a laudable objective, yet policy has interpreted this quite differently. Firstly policy has abandoned the hapless misusers of alcohol and tobacco due to the spurious claim that these people are using ’legal drugs’. The law set out to protect us all against the harms caused by any drug, old or new. Yet for some reason you talk about alcohol and drug strategy as if the two things were discrete commodities. They are not.

    The Act then aims to make arrangement to supervise the supply of ’controlled drugs’ so as to ameliorate the misuse of these drugs that might give rise to social problems, see Sections 7, 22 and 31.

    Because government has again constructed the law in my view incorrectly; they fail to differentiate between the [peaceful] users of controlled drugs that do not fairly fall within the direct concern of the Act, and those that do. This is akin to treating persons using small amounts of alcohol in their homes in much the same way as a person whom is drunk and disorderly. In fact for peaceful users of controlled drugs they are denied not only any opportunity of purchasing tested and pure substances with proper consumer protection and guidance, but the whole experience is subject to an oppressive air of opprobrium and characterised by a complete loss of rights. This treatment actually undermines the whole potentially positive aspect of the use of some drugs by fostering mistrust, suspicion and secrecy.

    My only point is that we are not controlling drugs at all - we are controlling persons. All persons use drugs and if we wish to do it sensibly and effectively then it must be fair. There must be no discrimination between alcohol USERS and other recreational drug USERS in principle.

    Reply to Darryl Bickler's comment

  • lord boss said...

    March 7, 2011 23:27

    what is your estimated success rate ?

    Reply to lord boss's comment

  • Trevor said...

    March 8, 2011 08:24

    Well done on so far not legalising Cannabis. The case for legalising it has not been made, science is often manipulated on both sides to be fair but the bottom line is we already have enough problems in society with "legal" things like Alcohol.

    To legalise yet another recreational substance sends out the wrong message to young people and as a former drug user who started on Cannabis, I would be against any legalisation.

    Reply to Trevor's comment

  • Marolin Watson, Hope UK said...

    March 8, 2011 11:55

    As a drug and alcohol education charity for children and young people, Hope UK welcomes the Drug Strategy’s emphasis on harm prevention and recovery from addiction. This is a welcome change from the harm minimisation and harm reduction goals of previous policy which were not ambitious enough and helped to create something approaching a ’social norm’ of substance use.

    Reply to Marolin Watson, Hope UK's comment

  • Posted by administrator

    David Oliver - Head of Drugs and Alcohol Unit said...

    March 8, 2011 14:40

    There have been a number of posts along a similar theme, advocating liberalisation and decriminalisation as a way to deal with the problem of drugs and we have published a representative sample. I hope that those who have taken the time to comment understand the need to keep this blog focussed on its aim as a forum for key delivery partners to share ideas about the implementation of the drug strategy. This Government does not believe that liberalisation and legalisation are the answer and this blog is not intended to be a discussion forum around the drugs legal framework, on which this Government has already made its position clear.

    Reply to David Oliver - Head of Drugs and Alcohol Unit's comment

    • Rory replied...

      March 8, 2011 15:26

      May we continue to ask for a Value for Money impact assessment?
    • Jason Reed replied...

      March 8, 2011 16:59

      David Oliver:

      "This Government does not believe that liberalisation and legalisation are the answer and this blog is not intended to be a discussion forum around the drugs legal framework, on which this Government has already made its position clear."

      Can I ask what the intentions of this blog are then? What areas of discussion are permitted?
    • Peter Ternell replied...

      March 8, 2011 21:19

      "shifting power and accountability to local areas to tackle the damage that drugs and alcohol dependence cause..." sounds great until you consider the wider context. Firstly the socio-economic drivers for crime and drugs are growing due to recession and unemployment etc. Secondly, the resourcing of many key services has been severely reduced.

      My local Youth Offending Team has just been informed of a 30% reduction in Home Office funding for 2011-12, for example. Local Police, Probation & NHS are all suffering cuts, and the voluntary sector's funding has been decimated. Local capacity for prevention, treatment and detection will be sharply reduced, because of the necessary priority upon violent crime.

      Speaking plainly, Mr Brokenshire, it seems you are just trying to distance yourself from the obvious consequences of these cuts.
    • Tom Lloyd replied...

      March 9, 2011 09:33

      You decided not to publish my previous post which is unfortunate as the main thrust was not to argue for government control and regulation but to advocate a change of focus for law enforcement from prosecuting users and low-level dealers to concentrating more resources on serious and organised crime.

      It seems to me that is very relevant to "sharing ideas about the implementation of the strategy", particularly as it is based on over 30 years of police experience at all ranks as well as a great deal of evidence from around the world and the UK.
    • Danny Kushlick replied...

      March 9, 2011 11:18

      Dear David

      Firstly, thank you for setting up this blog. It seems a pity to only run it for two weeks though.

      I don’t want to raise the issue of legalisation (i.e. regulation, not ’liberalisation’), but I would like to pick up on your comment about what the Government ’believes’. The point of effective policy making is to evaluate policy options on the basis of evidence, rather than belief. Drug policy is particularly susceptible to being driven by ideology and fear mongering, rather than science, and it is incumbent upon policy makers and civil servants to apply normal standards of evidence evaluation to the process of policy development.

      However, it is received wisdom that drug policy is different. That there is an essentially moral ’element’ to it and that exploration of alternative policy options must be supported by ’the public’. The latter point is made problematic by the fact that alternatives are made toxic by government declarations of "sending out the wrong messages", and the like.

      Added to which, a recent document from the Centre for Social Justice ’Outcome Based Government’ demonstrates in forensic detail how unfit for purpose Government, parliament and the civil service is to deliver useful policy generally.

      Its innocuous title belies what is a devastating critique of government’s systemic failure at every level, in delivering effective outcomes. In this kind of environment it is obvious how counter productive policy can be implemented and actively supported by the bureaucracy. And how difficult it can be to shift it.

      The National Audit Office has also been highly critical of the evaluation of the drug strategy and there is enormous cynicism that the evaluation of the current strategy will be genuine. Lastly, the Home Office has been at some pains to keep robust value for money evaluation out of the public domain.

      Only when the Government and Home Ofice is prepared to use evidence, rather than belief, can we have a genuine debate about whether alternatives are worth exploring for the UK drug strategy.
    • Joe Muller replied...

      March 9, 2011 17:05

      I'll see if third time is lucky. In the current drug strategy with regards to pbr.. the phrase 'non problematic drug use is used', relating to the none use of heroin and crack at discharge from services.
      Does this not contradict the message that drugs destroy lives and communities from the last strategy (also quoted by Jack Straw)?
      If someone can be using drugs in a non problematic way, surely the message is lost and are we not criminalising people who do not have problems with drug use per se?

      I would really like to have an answer to this question, seeing as I may be having to roll it out and explain this to clients in my work.
    • Peter Sheath replied...

      March 10, 2011 20:07

      I welcome the new drug strategy and it's focus on recovery. I have worked in this field for many years and it is only over the last 3 years that we have seen any kind of leadership and direction. Much time has been spent arguing over the merits of one intervention over another, often becoming polarised as harm reductionists/Methadone maintenists directly opposed abstentionists.
      Fortunately we have moved on from this storming stage and found some common ground in recovery as a broad church alternative. I believe that we can all work together and create sustainable and vibrant recovery communities within our society. There are many such examples already out there, take a look at wired in, an on-line recovery community where professionals, service users and members of the general public come together. Look in to Pathways to Recovery in Warrington and see just how a prescribing service can become a recovery focussed gateway. Check out Sefton Integrated Recovery Service where you will see lots of partners working in harmony to improve peoples lives and guide them towards the growing recovery community. Call in on the Cheshire Recovery Federation, 2nd Tuesday in every month, go to wired in to find it.
      The next step is to create social enterprise opportunities for people in recovery, involving them in making a difference in the communities they have, so often, damaged. There are lots of things within any community that need fixing, turning this into opportunities for social enterprise is the next challenge.
  • Brett McAllister said...

    March 8, 2011 21:45

    Firstly, I salute the central ambition to take those dependent on drugs (including alcohol) to full recovery. I also support the PbR pilots, they are sure to inject innovation toward this aim.

    Dependent drug users are responsible for the majority of aquisitive crime and blight families and communities. To me full recovery from addiction is one part of a 'harm reduction/minimisation' strategy that should use all proven techniques to reduce the impact of dependent, problematic drug users on society. To help these people back from the horror of addiction is surely to reduce/minimise harm.

    In the same way, strictly controlled 'shooting galleries' for example, offer a proven, fast-acting solution to aquisitive crime, help to control the spread of desease and reduce deaths from overdose. Both approaches have good evidence behind them that they reduce the wider suffering caused by addiction to drugs, does it have to be either a 'recovery approach' or a 'harm reduction' approach?

    I am also worried that the word 'drugs' is still used very loosely with such large distinctions to be made between all of them. The vast majority of drug users in this country do not use addictive drugs but use drugs in a controlled way that is nothing like being dependant. All drugs are different and effective policy should be bespoke for each of them. For example the controlled drugs: MDMA, LSD and Magic Mushrooms have been objectively shown to be have a very limited adverse physiological and societal effect (Lancet, 2007). I would like to know why these drugs are still alongside devastating drugs like heroin and crack cocaine in our legal system, defying all reason?

    Reply to Brett McAllister's comment

  • susi Harris said...

    March 8, 2011 21:55

    Dear Mr Oliver

    I am concerned about the future of drug and alcohol commissioning. Not only will we have a completely new system, PbR, when it is eventually rolled out, but also we will have a new body responsible, in Public Health England, who will commission via health and Wellbeing Boards of local Authorities. People who have never done it before will be using a system that had never been tried before.

    At this time of a) cuts and b) a new drugs strategy which both incorporates alcohol and is newly focused on recovery, there will be a strong incentive for these new inexperienced bodies to get on with recommissioning services as fast as possible.

    What safeguards can you put in place to ensure this is not a complete disaster?

    Reply to susi Harris's comment

    • John Ellis replied...

      March 9, 2011 19:20

      "What safeguards can you put in place to ensure this is not a complete disaster?"

      Payment by result? I have wondered what is to be considered a result?
      clean for 3 months then payout.
      clean for a year then payout.
      clean for 5 years then a payout.
      What is a successful outcome and at what point should the payment for result be payed out?.

      There is a great danger this will become a quick money maker for new services that in turn will struggle to provide long term support unless rehabilitation is purely residential due to the chaotic lifestyle of the client.

      I have addicts in my community that have been failed for 30 years by health services, plus a new growing generation of addicts as cannabis becomes more expensive for vastly smaller amounts and legal highs are replacing it in the short term, which in turn is leading to one powder is much like another does the same job.
    • Anne Marie Ward replied...

      March 9, 2011 22:12

      Susi you make server valid points here there are indeed risks when commissioning is via health and Wellbeing Boards of local Authorities as the AOD moneys will no longer be ring fenced and it will depend on what each area defines as priorities for spend. AOD treatment are not a popular investment especially from local councilors who in general know very little about the impact of addiction and recovery in their communities. As you say, "People who have never done it before will be using a system that had never been tried before". This is risky but it is also full of opportunity especially if they work alongside people in long term recovery to guide them on that spend, it will be their experience of what works that could possibly safeguard that this is not a complete disaster.
      There has been a lack of recovery-focused understanding at commissioning and senior management levels. The resultant commissioning/bureaucratic culture has led to considerable waste and alienation within the field. However there needs to be a greater focus on communities/individuals being enabled to generate their own preventative solutions to drug and alcohol misuse through the development of enhanced ‘Recovery Capital' and new connections within (and across) communities. The treatment system needs to be values-based and locate itself around clear Recovery Principles that are owned by all stakeholders. A coherent national training programme should be developed to ensure we have a workforce that understands and can deliver evidence-based recovery-oriented services.
      Whoever ends up commissioning should be accountable to local Recovery Networks (people who have recovered consumers of services & recovery ‘allies') and Regional Recovery Boards (Consumers of services & key regional stakeholders). A National Recovery Board should be established to lead/support a new National Recovery Strategy and support the development of Regional Recovery Boards/Networks and Recovery-Oriented Services. I would like to see local Recovery Boards take on commissioning functions. This would ensure informed recovery-oriented commissioning and the development of monitoring that captures ‘real' recovery outcomes that would develop core principles and standards and implement coherent recovery focused training programmes, designed and delivered with the active involvement of people in recovery and recovering.
  • John Ellis said...

    March 8, 2011 22:47

    David Oliver - Head of Drugs and Alcohol Unit said...

    I hope that those who have taken the time to comment understand the need to keep this blog focused on its aim as a forum for key delivery partners to share ideas about the implementation of the drug strategy.
    Can we please have a key definition of key delivery partners?
    As Community Leaders seem to be barred from this discussion. Especially those with alternate views about the situation at ground zero and how best to intervene on the addicts behalf.

    I have an excellent record with wallasey police force introducing them to mephedrone long before the press had even had a sniff of it. In-fact the CSO that took back the information was laughed at by his seniors and fellow officers as it being a misspelled wind up of methadone.

    Just because we are not paid oodles of money for our opinion it does not make it worthless.

    Today our new CCTV camera was fitted due to the HUGE problem we have been fighting for years Heroin and Crack Cocaine. At least our conservative councillors listen to the trouble we have with drugs. Isn't it time you did from your Ivory Towers?

    Reply to John Ellis's comment

  • Mohammad said...

    March 9, 2011 05:46

    Drug Abuse are the concerned of all. Each and every family are scared to learn that their kids are on drugs. But Then why so many indifferences. Uk is spending loads in their drug prevention, treatment and rehabillitation strategies. But yet there is something that need to be addressed urgently. The religious group, though little, yet they have a very important role to play in this fight. I believe that all religious groups within UK should be invited to participate in the national effort to combat this international threat. A national religious group workshop should be organized and the drug problem should be exposed to them. The religious organizations role are very important to vehicle positive messages. If they are given the right methodology and information, they can transmit these messages to their audiences and I believe that to some extent that would work. A national strategy should be developed where this approach should be given due consideration Parents with their busy life would not come to drug conferences etc, but they wont miss to meet their religious leaders. Hence all these leaders should be given the right methodology to inculcate the necessary information to parents and wider community. I am not saying that priests should replace our drug prevention leaders, but they should complement our work. A pilot project could be carried out in regions like Easton/St Paul in Bristol or east London. All those who could contribute should be invited to support this and at the same time all religious groups, whatever groups they are, should be invited to participate. After the workshop, a national strategy based on the outcome should be prepared. I am ready to help set up the core group. We have develop so many strategies with some successes, if we can get this one right, I think we shall make a big step ahead. All religious groups should have a better control on their own members.

    Reply to Mohammad's comment

    • SimonP replied...

      March 14, 2011 10:26

      Mohammad -great idea. Often, there may be cultural and religious reasons why someone who requires help, be they adult or young people, may be stigmatised for their alcohol and or drug use. What is also required are support services tailored towards particular communities - for example, in West Yorkshire, there are the Himmat and Ummid projects in Bradford and Huddersfield. These are aimed at young people who are disengaged and disadvantaged. Within the Jewish community, there is the Chabad Drugsline support service, historically operated from Redbridge but with plans to expand into North London.
  • William Staynes said...

    March 9, 2011 09:42

    Having spoken to those in Recovery, it is clear to see that Recovery is a unbelievably challenging time. I cannot see how it can help to keep banging on about the benefits of legalization. For the moment, lets discuss what we have.

    I think that the current drug strategy definetly provdes a refreshing approach but is it one that has really been thought through - most notably as regards the emphasis it places upon employment?

    It's true that for many, employment is a fantastic way of supporting and sustaining recovery from problem drug or alcohol use. Yet I wonder about the utility of putting so much emphasis on employment as the crucial indicator of successful recovery. Shouldn't the emphasis be on supporting personalised routes to a self-defined end point? And rather than narrowly aiming for jobs shouldn't we be focussing on supporting people to become job-ready and develop the entrepreneurial skills that are becoming increasingly necessary when job opportunities are shrinking?

    Reply to William Staynes's comment

  • Mark David Robbins said...

    March 9, 2011 15:30

    Why do you define Alcohol different from drugs?????

    Reply to Mark David Robbins's comment

  • Kenneth Eckersley said...

    March 9, 2011 19:09

    Because, since 1950, statistics, experience, history and every other bit of proof shows that the appointing of the health service to provide recovery from addiction has been a miserable failure (the reason the present government is saddled with finding new answers) - WHY are the NHS / NTA being allowed to go on being the lead government departments appointed (yet again) to formulate and implement the details of current policies.

    We have definitely learned some lessons. A results goal of lasting abstinence and PbR are both excellent ideas, but allowing the NTA / NHS to run the recovery show when they haven't a clue on how to provide lasting abstinence is a shot in one's own foot.

    Medical "treatment" just does not work. 12 Steps enjoys some success but is not medical. Methadone is medical, but succeeds in only 3% of cases.

    TRAINING addicts in do-it-for-yourself self-help recovery techniques returns 60% of addicts to the natural state of lasting relaxed abstinence into which 99% of the population are born, BUT no one at the NTA or the NHS want to talk about it.

    WHY? Because the psycho-pharmaceutical vested interests who benefit so much from the NHS don't want to lose their profitable prescription and counseling business.

    Convicts can be trained to run their own recovery centres themselves in their prisons - something we have been doing for 45 years, but is the Home Office or the Ministry of Justice interested?

    In local training centres, on a once only cost basis, addicts can bring themselves to lasting relaxed recovery, for half the cost to taxpayers of maintaining and supporting a methadone patient for just one year, and most of them live for 40 years.

    The reason for government resistance to the TRAINING idea is because of the black PR and denigration directed against it and its originators by the psycho-pharmaceutical fraternity since 1950.

    Unlike ministers in the last government, they know an effective recovery programme when they see one and, because that is the most difficult kind of competition for them to fight, they attack the people and their organisations, rather than their technology.

    All it takes is an unbiased inspection of the technology, and you will find a solution to our drugs problems.

    But such an inspection is best done by a policeman or a teacher than by a psychiatrist, doctor, neurologist or pharmacologist.

    Try it as Plan "B".

    Reply to Kenneth Eckersley's comment

  • Mike said...

    March 10, 2011 11:00

    I applaud the 2010 Drug Strategy emphasis on assisting those in recovery.
    It recognises a number of factors are important in the success of recovery of people. Good quality accomodation is one of those factors highlighted

    Unfortunately one part of government does not understand the implications of its policies on other parts of the government policy - I am referring to the changes in Housing Benefit, specifically the changes affecting the 25 to 35 yr age group.

    I have clients in this age group in single bedroom accomodation making progress in their recovery journey. With the changes in Housing Benefit they will be required to give up that accomodation and rent a room in shared accomodation. This could have a detrimental effect on their recovery - not only from the sense of moving 'backwards' in respect of their accomodation, but also from the possible negative impact of the people they are sharing accomodation with. It makes the journey that much harder.

    I have been in contact with the DWP. their reply was that local authorities have discretion to make additional awards to individuals. This is woefully insufficient. With due respect to the staff involved I would not expect them to have an understanding of the needs of someone recovering from an addiction.

    Reply to Mike's comment

  • Clare said...

    March 10, 2011 14:19

    Recovery is ideal. It is also something that an individual embraces when they are ready; you can't rush this. If PbR ends up being rolled out nationally, and harm minisation/reduction is ignored, does this mean that in areas with high levels of poverty and deprivation, (where cuts within councils will significantly impact on this "end-to-end" intention), that more substance misuse services be shut through lack of funds?
    Will more drug users be criminalised, excluded, have limited access to services due to closures?
    Will services be inclined to claim that Recovery is being met to get payment? Or have I got the Results part of PbR all wrong?

    Other concerns lie with the 'Postcode lottery', which we all know isn't limted to drug users and services. The said "end-to-end" approach to enable recovery needs money; where will this come from when taxpayers money is stretched, there are hundreds of jobs being lost, not to mention being spent on Bonuses for banks?!
    In short, giving drug users a REAL chance at Recovery requires money and consitency for the Drug strategy to be fair for all. Is this realsitic given the current financial climate?

    Allgedly, my local CAMHS has a 13 week waiting list, for Emergency appointments? In my own personal view, Mental health services have a major part to play in prevention of the development of 'problem' drug use.
    What are government plans for improving this provision? Will postcode lottery apply to this also?

    To me, the bottom line is Poverty. One word that covers an endless list of inequality and the greater propensity to drug use, educational exclusion, social exclusion, mental illness, homelessness, bullying, crimianl activity etc etc etc. Young people I work with often come from poverty; they want money and kudos.
    To them what better way to gain this when they have been kicked out of school? Get excitement and protection from 'elders', development of a sense of belonging and acquisition of money? Get 'high', forget your stress and to start selling drugs of course. I think we call it survival, or more appropriately, Social Capital.

    Finally, Cannabis is a classic example of the failings of the War on Drugs. It is much stronger than it's ever been, i'ts not controlled, the strength of what is commonly available on the streets is significant in attributing to the increased cases of mental illness. Will the new Drug strategy change this?

    Reply to Clare 's comment

  • arthur mac arthur said...

    March 10, 2011 18:02

    This blog really isn't going to work if you take too long to moderate messages.

    It needs to be done within minutes, rather than days


    Reply to arthur mac arthur's comment

  • Adam said...

    March 10, 2011 19:23

    Firstly, I'd like to say that limited discourse is better than none at all so I hope some commenters will bear that in mind and show a little restraint.

    I'd like to ask David Oliver whether there's a place in these Payment by Results pilots (or elsewhere) for diamorphine prescription. The drugs strategy gave it a small mention but I haven't heard much about this since the Randomised Injecting Opioid Treatment Trial, which is a pity as its evidence-base seems quite strong. What plans does the HO have in this area? And if service providers wish to use heroin assisted treatment for a subset of patients, is there HO support in place to allow them to do so?

    Reply to Adam's comment

  • kiki d said...

    March 10, 2011 23:01

    I can't believe so few people have posted on this blog. Are you moderating or censoring? Love kiki x

    Reply to kiki d's comment

  • colin preece said...

    March 10, 2011 23:43

    From coercion to cohesion:
    Treating drug dependence
    through health care, not punishment
    Discussion paper based on a scientific workshop
    UNODC, Vienna
    October 28-30, 2009

    United Nations A/65/255
    General Assembly
    Distr.: General
    6 August 2010

    Right of everyone to the enjoyment of the highest attainable
    standard of physical and mental health

    76. Member States should:
    • Ensure that all harm-reduction measures (as itemized by UNAIDS) and
    drug-dependence treatment services, particularly opioid substitution
    therapy, are available to people who use drugs, in particular those among
    incarcerated populations.
    • Decriminalize or de-penalize possession and use of drugs.
    • Repeal or substantially reform laws and policies inhibiting the delivery of
    essential health services to drug users, and review law enforcement
    initiatives around drug control to ensure compliance with human rights
    • Amend laws, regulations and policies to increase access to controlled
    essential medicines.

    Colin Preece LCA "Failure to comply with these recommendations violates the human rights of all drug users."

    Reply to colin preece's comment

  • Olivia said...

    March 11, 2011 09:35

    Interesting points being raised about alcohol. We need to provide young people with more information through a medium that they find credible and trust worthy. I have often found that young people are often very informed about drugs but lack a basic understanding of the harmful effects of alcohol abuse.

    Reply to Olivia's comment

  • Pat Thompson, Catch22 said...

    March 11, 2011 13:29

    Our experience of delivering services shows that the treatment provided to young people is a real alternative to the adult system, working with a very different notion of ‘problematic’ substance misuse. There are very few under-18s who could be classed as ‘problem drug users’ in the adult sense. For example, the 1 in 5 young people in the 18 to 24 age group seeking help from adult services for cocaine problems in 2008-09 were not ‘problem drug users’. Crime reduction objectives have not driven this approach to the same extent as the adult treatment system and there has been a clearer focus on health, mental health and social inclusion.

    Young people’s specialist substance misuse treatment is a care-planned, specialist harm reduction intervention aimed at alleviating current harm caused by a young person’s substance misuse; twin factors in the approach are the medical and psycho-social needs of the young person.

    Young people need specific services as they have particular needs that are different from adults. As ring fenced funding for these services is removed, a worry going forward is how young people will get the support when they need it.

    The fact that young adults are finding their way into services is encouraging, as is the developing role of psychosocial interventions in the adult system. But adult services are often inhospitable to young people, and may be able to offer only limited help for some of the problems they have. A clear example is the split between drug and alcohol services, which is ill-suited to work with poly-drug users. Catch22 is a founding member of the T2A Alliance calling for such a change.

    We should now grasp some of the challenges to our fundamental assumptions and structures for treating young people’s substance misuse. We have an opportunity to rethink what we understand by ‘problem drug use’, how we assess need, what outcomes we should aim for and how we set about achieving them. It also calls into question the age boundaries that divide services.

    Reply to Pat Thompson, Catch22's comment

  • Keith Stevenson said...

    March 11, 2011 14:54

    There have been lots of comments about defining the difference between alcohol and drugs, lots of stuff about legalising this or that and taking it out of the criminal justice system and all these points are valid and have their place. But I think that most of us, at the coal face" are concerned primarily with recovery. Recovery for all those who realise that they want to turn their life around be it from alcohol, legal or illegal drugs. My main concern is the quality of the recovery service that people can access to help them get clean and remain clean. If there is not a properly joined up service giving a truly holistic approach then we are stopping people reaching their full potential for recovery. We have to give hope through a recovery system that includes "treatment", whatever form that takes, addressing housing issues, training and qualifications for work even though the possibility of work is remote and giving support for as long as it takes. I just ask that those of us who are trying to offer such a service are helped along the way by the powers that hold the purse strings and thereby promote real and lasting abstinence for those who want it.

    Reply to Keith Stevenson's comment

  • Steve said...

    March 11, 2011 17:00

    Why can i not find your moderation policy using the link provided!

    Reply to Steve's comment

    • Julian replied...

      March 14, 2011 13:50

      They actually have two links to the moderation page, one works, the other doesn't. Good luck!
  • Ray said...

    March 12, 2011 19:11

    Recovery and abstinence only work when the addict himself 'wants' to come off.

    Reply to Ray's comment

    • Kenneth Eckersley replied...

      March 15, 2011 21:00

      You are quite right Ray.

      The statistics of forty-five years of recovering addicts to the natural state of relaxed abstinence into which they were born reveal that there are 16 to 20% who just have no desire to stop using, for the usual three main reasons.

      We also find that those amongst the other 80 to 84% who have been using for around two years basically want to quit.

      On a proven "do-it-for-yourself" recovery to abstinence programme about 60 to 65% will succeed first time through a 22 week (5 month) residential programme, but between 19 and 24% will need a second time through a similar shorter programme.

      These figures do not apply to medical "treatment" programmes, but only to self-help TRAINING programmes of the type being delivered across 43 countries in 169 training centres - including prison units run by inmates themselves.

      Note that successful 12 Steps systems do NOT use medical interventions, drugs or medication, but are very humane fraternal support operations with a sound basic technology which all AA, NA and CA members learn.

      Recovering oneself to abstinence is a health procedure - in the same way as exercise and massage can recover usage of an earlier injured limb - but there is no medication involved.

      C.E.O. Addiction Recovery Training Services (ARTS),
      a not-for-profit community support operation.
  • Recovery focussed said...

    March 14, 2011 10:06

    Well done the government for implimenting a strategy that looks to have some meaningful direction.

    I work in the supported housing for people in recovery and what they are getting just now from the services certainly would not be deemed a recovery focussed service.

    I have had to show clients what the NICE guidelines direction is on getting clean and when they have taken this info to the services the services are to scared to risk it, why?

    Services in my area, Devon, have for to long sat back on the cash cow that is harm reduction/minimisation, now the government is telling them through this strategy "Time to buck up your ideas"

    And about time too.

    We have an amazing opportunity to create frameworks that will enhance peoples lives and no longer stand for the pertuating misery of state sponsored addiction.

    Reply to Recovery focussed's comment

  • Kenneth Eckersley said...

    March 14, 2011 10:52

    Statistics of the last 60 years make it quite clear that whilst substance addiction is a health matter, it is not a condition which is handled by medical interventions.

    As a consequence, whilst the NTA's pilots are all focused on medically based recovery programmes, should there not be a Plan "B" based on the vastly greater successes of TRAINING addicts in d0-it-for-yourself recovery to abstinence techniques.

    One of these is obviously 12 Steps, but there are others at least twice as successful which have been delivering lasting relaxed abstinence for 45 years at 169 training centres in 43 countries, to thousands of addicts / students

    Let's bear in mind that to be able to accept remuneration on a Payment by Results basis and remain solvent, a provider first needs an abstinent result in at least 60% of cases, and self-help delivers that and better.

    CEO Addiction Recovery Training Services,
    a not-for-profit community support operation

    Reply to Kenneth Eckersley's comment

  • Joe Carter said...

    March 14, 2011 18:55

    I welcome the invitation to comment through this blog on the themes of the new Drug Strategy. At Racing Welfare (The Jockey Club’s Charity) we feel that key to building a foundation of supported recovery in the UK Racing Industry has been to recognise addiction as part of humanity, not apart from humanity, and to simplify an understanding of it:

    • Acknowledging that all of us experience life emotionally: Everyone engages in behaviours as a way of managing feelings, some of us struggle to control these behaviours.
    • Obsession and compulsion are experienced by everyone: Addiction is simply the top end of a scale that we all sit on.
    • Those of us at the top of that human scale could be described as addicted: Here the power of obsession and compulsion can be too great to control.
    • We focus on recovery from ‘addiction’, not just drugs and alcohol: People can become dependant on many behaviours (not just substances).
    • Encouraging exploration of all addiction support options: Viewing professional services and mutual aid options as both valuable and integrative.
    • Seeing recovery as the process of finding behaviours that affectively manage feelings: Honouring, valuing and accepting our experiences.

    As a professional in this field I find it valuable to disclose and celebrate my own recovery from addiction. I see the goal of this new drug strategy as respectful and empowering to people experiencing active addiction; to live a drug-free life. I believe the following would positively inform the strategies development and delivery:

    • The steering of this strategy needs to involve at the highest level, professionals with personal experience of addiction and recovery from it: Direct service user input is also crucial.
    • Professionals delivering treatment are pivotal: Treatment providers need to believe that living free from active addiction is possible for anybody if the goal of this strategy is to be achievable.
    • The importance of self-help groups: I have heard treatment providers state ‘12-step is not for everybody’. If the message was ‘12-step can work for anybody’ it could further open the choices for people to find their recovery. All professionals involved in developing strategy or delivering treatment would benefit from attending an open meeting of AA and NA, and see first hand what is involved.
    • For people in active addiction, meeting someone in recovery can be crucial: Recovery is contagious.

    Reply to Joe Carter's comment

  • Addictions UK said...

    March 15, 2011 08:51

    Addictions UK welcome this new blog from Government.

    The more people that access this site with comments may lead the Home Office to support recovery policies and to be bold and radical in this regard.

    We are a provider and supporter of abstinence programmes although we recognise the importance of harm minimisation for those who reject abstinence. We will inform others of this blog.

    We hope the Home Office Blog is continued after 21 March - it is a good way of seeking the views of people with an interest in Government Policy. We agree with the comment that moderating the blogs should be administered more quickly.

    Reply to Addictions UK's comment

  • Cal D said...

    March 17, 2011 13:23

    I am Cal D and have completely turned my life around from an incredibly serious drug and alcohol addiction that could easily have killed me.

    I remember at the peak of my active addiction firmly not believing it was at all possible to change, stop or recover.
    I remember at the time genuinely resigning myself to death as being the only solution and even if I had believed change might be possible I still did not know who to contact, where to go or how to begin to create change and recovery.

    I’ve been lucky and I’m not prepared to stand on the sidelines and watch others suffer when the ‘recovery wheel’ has already been invented.
    I have spent the last while planning The Recovery Roadshow.

    The Recovery Roadshow’s mission is to help people, who want a new life, by pointing them to the starting line of ‘the road of recovery’.
    The road of recovery from alcoholism, smoking, drug addiction, obesity & various eating disorders, gambling, depression, domestic abuse, bullying, bereavement issues, PTSD and other similar health topics.

    The Recovery Roadshow will;

    1 Create a definitive on-line ’Recovery Portal’ for the UK public to search for help and support from the various ’life problems’ mentioned above.
    The Recovery Portal will be free and will act like the Recovery Yellow Pages for the UK public.
    All the thousands of recovery agencies and organisations in the UK will be invited to submit their contact details, also free of charge.
    Nothing like this exists at the moment and sufferers and their families just do not know where or who to turn to for help so the ‘Recovery Portal’ will solve this enormous problem.

    2 Establish a continuous annual circuit around UK with approx 80 roadshow events.
    The main recovery players have all agreed TRR is needed and have indicated they will support the roadshow events however I am short of a little bit of funding for a few months and need help today David Oliver please!

    My personal mission is to help others achieve the quality of life that they want and deserve by sharing my recovery experiences and sharing the information I have gathered through my journey of recovery and beyond.
    I love helping others and will always try to inspire and motivate others to experience and enjoy life beyond their wildest dreams too.

    Cal Dunan

    Reply to Cal D's comment

  • Ben Lodge said...

    March 18, 2011 01:26

    Hi, I am a nursing student in the south west of England, and I have a number of reflections on various components of the drugs strategy, but I’ve limited my response to what I consider the most pertinent observations I can make in the space available, which I believe are considerations that need to be stated with clarity and immediacy. Thank you very much for facilitating this excellent pilot, all criticisms are intended constructively.

    The document states that alternative strategies do not "address the risk factors which lead individuals to misuse drugs or alcohol." It also states that "the causes and drivers of drug and alcohol dependence are complex and personal."

    The risk factors leading to drug misuse are certainly complex, but to say they are strictly personal is a significant error. I would like to point out that throughout the document there is very little if any reference to the socio-economic risk factors for drug and alcohol misuse, such as standards of and availability of employment, education, policing, health services, housing, social capital, etc, all of which have been impacted severely by the budget deficit reduction cuts, thereby increasing risk factors for drug and alcohol misuse in direct proportion to the decrease in investment in those areas. The document is very careful to state that ‘Drug and alcohol dependence is a key cause of inter-generational poverty and worklessness’, but fails to accept the inverse, even while emphasising the significance of ‘whole systems approach’.

    Therefore, the challenge in terms of implementation of this strategy, is to achieve the aim of ‘reducing demand’, whilst operating against a background of risk factors increasing in severity, and protective factors decreasing in efficacy. Further, it is difficult to see how a comprehensive and effective strategy could so easily dismiss the range of risk factors in effect, and the considerable impact they have on people’s lives, especially when it struggles to recognise that causes of drug use extend beyond the individual into the society that surrounds (and should be supporting) them.

    I would encourage stakeholders in the strategy to anticipate and strategically prepare for the consequences of these socio-economic changes, rather than treating them as unavoidable, and sweeping them under the carpet. Overall I welcome the recovery focused backbone of this strategy, but as well as focusing on outcomes, we absolutely must focus on prevention, and to fail to do so is a major oversight.

    Reply to Ben Lodge's comment

  • Hester Brown said...

    March 21, 2011 12:18

    Westminster Drug Project (WDP) very much supports the general tone of the drug strategy, especially its emphasis on supporting the whole person and connecting up services to offer holistic, integrated help, rather than leaving people to negotiate all the hurdles of accessing separate services.

    We work in London and neighbouring counties delivering services across the spectrum from harm reduction to rehab in order to meet the needs of each individual. We are committed to improving continuity of care for service users.

    There is now an opportunity to incentivise partnership working to deliver shared outcomes which support continuity of care and the whole recovery journey. What we hope is that the government looks very carefully at the Payment by Results (PbR) pilots and compares them with other methods of improving outcomes, to make sure that whichever method is chosen:
    • really puts service users’ needs and experience at the heart of evaluation
    • genuinely encourages cooperation between the statutory agencies (criminal justice, NHS, social services departments etc.) and voluntary sector providers to bring down barriers to continuous and holistic care
    • recognises that everyone is different so the input each person needs in terms of type and duration of care will be different
    • doesn’t lead to a diversion of resources away from the most vulnerable
    • finds mechanisms to ensure that small and medium voluntary sector providers, which usually started out as small, local, ’Big Society’ initiatives to help vulnerable groups, can continue to bring their local and specialist expertise to the mix.

    We also really hope that the government will assess the impact of actual and potential local disinvestment in services - both drug and alcohol services and others like supported housing, mental health and ETE which help to build recovery capital - on the longer term cost benefits of such services. The National Audit Office concluded that £1 invested in drug treatment saved £2.50 in subsequent social and criminal justice costs. What will the impact of cuts today be on local economies tomorrow? In short, what safeguards will the government put in place to protect its drug strategy?

    Reply to Hester Brown's comment

  • Paul Taylor said...

    March 21, 2011 17:39

    I welcome this blog - may it continue. The treatment landscape has serious anomalies and public discussion can generate improvements.

    For five years I have managed a small VSO-probation partnership which aims to reduce alcohol related offending. It partly addresses the inequalities of access to treatment alcohol misusers may come up against.

    It works well - probation officers believe our contribution was helpful in over 90% of cases referred to us; over 90% of offenders we’ve seen believe it has helped them to reduce or eliminate their drinking.

    In the longer term, we know that re-offending, by a cohort of 128 seen in 2009 - 2010 and whose outcomes we were able to track, was down 40% against area and national figures. We checked these numbers, and we checked them again - it really is 40%.

    There’s a simple explanation. Those we see are convicted of alcohol related crimes - usually violence. [According to Home Office research - Findings 217 - alcohol was a feature in two thirds of domestic violence cases, for example. Moreover, almost half of convicted DV offenders were alcohol dependent.]

    Nearly all offenders I see tell me they regret the offences that got them arrested - they genuinely do not want to be the wrong side of a locked door again. Turning that aspiration into reality means getting to grips with their use of alcohol. If they don’t, almost certainly they will re-offend.

    We help people understand the impact of their drinking behaviour on themselves and others, and what needs changing. We’re good at working with criminal justice colleagues too.

    Oh to be funded on a PBR basis - we’re hitting 40% and PBR may pay out on outcomes nearer 7 or 8%. But alas, from 1st April the axe will fall and the service will cease to exist.

    Why? The indisputable fact is that if our intervention keeps one single offender out of prison, then the service is paying for itself.

    The answer is the Probation Trust does not fund places in prisons, nor indeed the police, courts, legal aid and so on, and can therefore make the case that this is a cut, in line with government requirements.

    But go up a level - to the Ministry of Justice and indeed the Home Office - and it makes absolutely no economic sense whatsoever.

    I, along with offenders and their case managers, would be very grateful for the Minister’s advice.

    Reply to Paul Taylor's comment

  • Professor David Nutt said...

    March 21, 2011 23:08

    The Independent Scientific Committee on Drugs makes the following broad points in response to the Coalition government’s drug strategy.

    1) The multi- criteria drug analysis scale of harm - as published in The Lancet in November 2010 -should form basis of the policy response to all drugs including alcohol

    2) Drug policy should be founded upon the peer reviewed natural and social science scientific evidence base.

    3) The proven health and social benefits of the harm reduction approach established over the last decades should not be discarded until alternative approaches such as abstinence-based therapies have been validated.

    4) The Misuse of Drugs Act should be reviewed, including a review of the impact of the Act on drug harms.

    5) The ISCD is concerned that a tendering of drug treatment services under the payment by results will lead to a cherry-picking of service users for treatment and an absence of a holistic approach to drug treatment.

    6) It is crucial that any drug strategy should have a particular focus on the well-being of the children of drug abusers.

    7) NICE guidelines should be followed as a part of the government’s drug strategy.

    8) Action on legal highs should be led by the ACMD rather than the Home Office and the ACMD should be properly funded to carry out the work that needs to be done over the coming years in the public interest.

    9) Ministers should be required to consult the ACMD before initiating a temporary banning order.

    Reply to Professor David Nutt's comment

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