Comment: The 2017 UK Government Drug Strategy #Addiction #Recovery

“The drug strategy 2017 sets out how the government and its partners, at local, national and international levels, will take new action to tackle drug misuse and the harms it causes.” – Home Office

That’s all well and good but, is it fit for purpose, is it much more than a political soundbite platitude and most importantly, what are the impacts on addiction and recovery services moving forward?

The Government say the policy will – a) Reduce illicit and other harmful drug use and b) Increase the rates recovering from their dependence. Along with many professionals and service delivery organisations, I can applaud the strategy but I remain sceptical about any realisation of outcomes. A strategy is just a vision or plan, not tasks and actions for now.

Who will this ‘new’ Home Office drugs strategy help? Not today’s users (Henry Fisher – policy director at Volteface writing in The Guardian)

DrugWise, the well-respected provider of evidence-based information on drugs, alcohol and tobacco, are also sceptical. They say any policy approach should be balanced over the four key themes (see HERE).

  1. Reducing Demand: requires a “more targeted action for the most vulnerable…” and “greater emphasis on building resilience and confidence among our young people…”
  2. Restricting Supply: will require a “smarter approach to restricting the supply” (their pun not mine) and must “reflect changes in criminal activity” to “tackle drugs alongside other criminal activity.”
  3. Building Recovery: the policy misses any “ambition for full recovery by improving both treatment quality and outcomes for different user groups; ensuring the right interventions are given to people according to their needs…” There has to be “…the delivery of an enhanced joined-up approach to commissioning and the wide range of services that are essential to supporting every individual to live a life free from drugs.”
  4. Global Action: can only be truly effective by “…sharing best practice and promoting an evidence-based approach to preventing drug harms.”

Despite the Government promising – “more robust evaluation, including better segmentation of recovery rates” for “new initiatives” the policy document unsurprisingly forgets; the likely and severe impacts of significant reductions in the funding for both drug treatment and health promotion, in the seven years since the previous published strategy. (See also – The seven year itch – Russell Webster).

The Collective Voice (statutory and third sector service delivery organisations) appears initially optimistic. They “welcome the strategy as a serious and realistic platform” but only if it is delivered in a manner which will “improve society’s collective efforts to minimise the various harms flowing from illegal drug use” (see HERE).

Andy Burnham, the Mayor of Manchester has rightly identified many “hollow” aspects of the policy, one that for many working in the field of addictions provides little more than a few platitudes to mitigate against growing problems, irrespective of any (arguably) manipulated statistics which apparently evidence declining drug use.

“Public safety will be put at risk and emergency services stretched to breaking point unless the government provides funds over and above its “hollow” new drugs strategy” (Andy Burnham)

The new strategy makes the great effort to promote the importance of ‘evidence-based’ policy, then succeeds to mostly ignore much of the advice previously provided by the Advisory Council on the Misuse of Drugs. Very few of the ACMD’s evidence-based recommendations have been taken on board.

Talking about ‘evidence-based’ – whatever happened to the so-called Recovery Agenda, something that most professionals would say was actually working?

The proactive Commissioning for Recovery guidance, published by the then National Treatment Agency for Substance Misuse (NTA) almost a decade ago, has now mostly fallen by the wayside for many service providers. Despite being designed to “improve the availability, capacity and effectiveness of treatment for drug misuse” which it did; too many services have since become fixated with short-term treatment strategies and solutions, almost at the expense of true addiction recovery. This factor alone increases the not insignificant rate of representations in the ‘revolving-door’ of addiction recovery. Irrespective of any statistical manipulation to evidence KPI governance.

The new strategy attempts to put ‘prevention’ to the forefront of the drugs agenda, which isn’t such a bad thing for a strategy document however; whilst appearing to suggest a measurable shift towards evidence-based drugs education, I can’t realistically envisage a ‘cure-all’ for our social ills around substances.

Building real recovery from alcohol and drug misuse is a complex and long-term issue, and isn’t something which can be resolved with short-term interventions alone.

Although this strategy is encouraging, it is essential that all of these proposals are supported with relevant funding and investment. Everyone should have the best chance in life, but we are only able to continue our work to support these people with adequate support and investment. (Change, Grow, Live)

Commissioned drugs and alcohol services may be working to provide better psychosocial interventions, harm minimisation and substance replacement support however; if this is all we want to provide, should it also be at the expense of those in need of more long-term recovery support? Is sustained ‘recovery’ no longer the priority for government services and public health providers? Are we happy as a society to be saying; “get better within 28 days or you’re on your own” – which alone impacts upon sustained recovery. Sadly, this is the type of service I’m starting to see on a far more regular basis today.

Adopting this stance also serves to inflate ‘disease model’ thinking around addiction recovery. It promotes beliefs around medication requirements for ‘treatment’ of the ‘illness’ or condition being experienced. This might be a nice little earner for the pharmaceutical industry but is also detrimental to the health and wellbeing of the individual.

Drug use affects families and communities across the country and we will be working tirelessly to promote the benefits of treatment, to reduce the unfair stigma often faced by our service users and are committed to ensuring that all agencies pool their resources and expertise to generate long term benefits. (Change, Grow, Live)

The number of people with serious drugs dependency issues may be relatively small and yes, far bigger numbers are dependent on alcohol (or drinking to risky levels) however; if there is any genuine desire to really do something about these issues, the new policy will do little more than undermine previous long-term sustainable recovery outcomes of the past.

Whilst we welcome the focus on alcohol abuse, it is disappointing to see it treated as a subset of this long-awaited drug strategy. There is a lack of concrete strategy on mental health, dual diagnosis or joining up systems to treat those who need it, as the responsibility instead falls to local authorities to agree this approach. These are all factors which can play a part in substance misuse, and how it is treated, and we would look for clear national direction to effectively tackle these issues as a whole. (Change, Grow, Live)

Despite going some way towards mitigating against any media fuelled ‘scare tactics’, the strategy does little to improve the here and now in addiction recovery. A factor which is sadly compounded by the ever-decreasing funding faced by most commissioned drug and alcohol services.

Ok, so the strategy publishes an admirable stance but put simply, it is little more than a collection of politically motivated words to explain a long-term ‘vision’ and hopefully improve popularity of support for declining standards in our public service delivery. If anyone was looking for a significant sea-change in our social problems relating to substances any time soon they will I feel, be sadly disappointed.

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