We welcome the conversation around the Government’s new drugs strategy: From Harm to Hope, a 10-year drugs plan to cut crime and save lives. There is a lot we agree with and support in the new drugs plan, as well as areas we think need further discussion, covered in this blog.
To summarise, Director of Treatment Services at Help Me Stop, Sammy Manzaroli, said: ‘We very much welcome the new funding from Government for addiction treatment services, which is excellent and unexpected. We would welcome much clearer definitions around the type of addiction treatment that will be funded: what will the split be between harm reduction services and abstinence-based services? We also think it’s a regressive step to associate addiction so strongly with criminality, rather than a primary focus on addiction as a healthcare issue. We should not forget that substance use is not a moral failing, but a mental, behavioural, and neurodevelopmental disorder as classified by the International Statistical Classification of Diseases (ICD).’
Where we agree with the messaging in the Government’s 10-year drug plan
At Help Me Stop, we agree with the message in the Government’s 10-year plan about wanting to see an end to addiction. Addiction is a disease that affects millions of people in the UK, either directly, or as a relative or friend. Drug (and alcohol) addiction causes immense pain, suffering, isolation, and both physical and mental health issues, to so many. Alongside other treatment services in this country, we want to help end that cycle of suffering with high quality, affordable treatment.
We also want to see an end to child exploitation by county lines gangs, as well as consistent action to break down the supply of drugs (though where people are still addicted and need drugs, the suppliers will always find their way to them).
The report also states:
- ‘We will offer more support to people with drug addiction. Addiction is a chronic condition that requires earlier and better treatment, and sustained support. That will be combined with more funding to give more people better quality treatment, support for those who are in need of housing, and employment support to help people find a job that’s right for them.’
- By 2024/25, the Government will have ‘delivered a phased expansion of treatment capacity with at least 54,500 new high-quality treatment places – an increase of 20% – including: 21,000 new places for opiate and crack users, delivering 53% of opiate and crack users 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.’
At Help Me Stop, we have always called for much more investment in high quality addiction treatment services, right across the country, which provide intensive addiction treatment and achieve consistently high success rates. We want more people to be supported into sustainable recovery. Therefore, we welcome much more detail in the coming days and weeks around the Government’s and Local Authority plans to invest in a range of intensive, local, drug (and alcohol) addiction treatment services that work – including affordable, abstinence-based services.
Chris Cordell, Help Me Stop’s Director of Operations, said, “We need to embrace new ways of working, simply repeating the same thing and hoping for a different outcome is not the way forward. Evidence based treatment has moved on; Dayhabs modelled on the US model of Intensive Outpatient Programmes deliver highly effective outcomes, at much lower cost than residential treatment. Not everyone needs residential rehab as their first opportunity of recovery; not everyone with a drug problem needs a detox. That being said, detox is woefully underfunded and not as available as it should be. The fact that there is no NHS inpatient detox in London is staggering, which is why we will be delivering our own in 2022.
‘Then there is intensive online treatment, reaching people at their heart of their homes and places of work, reducing the barriers to face to face treatment and the shame some people feel crossing the physical threshold of services. We hope that these innovative, accessible, effective and cost-sensitive models are embraced.
‘We wholly support the effort going into helping the 300,00 individuals using opiates/ crack, but let us not forget that 67% of people who are using substances are employed. What treatment programmes will be available to these people? Treatment cannot be a one stop shop, a once size fits all. My twenty years of working in this field has shown me this, time and again. There are more opportunities out there now for GPs and other healthcare professionals to refer to, enhance and embrace patient choice.’
Mixed messaging in the Government’s 10-year drug plan
The Government’s plan says, ‘Within a decade, we will deliver a world-class treatment and recovery system in England. An additional £780 million over three years will be committed to begin to take this forward, implementing Dame Carol Black’s key recommendations. We will treat addiction as a chronic health condition, breaking down stigma, saving lives, and substantially breaking the cycle of crime that addiction can drive.’ At Help Me Stop, we applaud this investment into services and the pledge to break down stigma around addiction by treating it as a healthcare issue – but the plan gives mixed messages.
In the foreword by the Prime Minister, the focus is predominantly on criminal activity, associated with 300,000 heroin and crack cocaine addiction, and tough, punitive measures for people who ‘offend’. ‘These serial offenders should be properly punished for the crimes they commit,’ the Prime Minister writes, going on to say that ‘they should also be given the chance to get off drugs and turn their lives around.’ The emphasis is on addiction as a criminal justice issue first, as a deterrent for further drug use, then a healthcare issue second. This is the wrong way round for us, because prison sentences and punishments do not treat addiction. Addiction is an illness that does not discriminate. It affects rich and poor, men and women, young and old, all races and cultures. Those 300,000 people who are addicted to heroin and crack cocaine may be the most visible and ‘problematic’ to society, but that is simply a matter of economics. Like wealthier people who are addicted to drugs (and/or alcohol), they are being driven by an addiction that is a mental and physical illness. Addiction is often preceded by substantial, untreated trauma, often in childhood, from which people need intensive and specialist therapy to recover. Addiction recovery is NOT a quick fix or something that can be punished out of the system. It requires patient, sustained, compassionate care for all who suffer, and often their family members too. As one client of Help Me Stop said, “I didn’t have a drug problem, I had a me problem”. Evidence has shown us that intensive psychological therapies that get to the underlying reasons for someone using drugs addictively, along side peer support like that of Narcotics Anonymous, Cocaine Anonymous or SMART recovery, help people stop and stay stopped.
The Governments 10-year plan also states, ‘For adults taking recreational drugs, who are too often sheltered from the serious violence, human exploitation, severe addiction and crime of the drugs trade, there will be tougher consequences which will be felt more strongly than today. A White Paper next year will consider a series of escalating sanctions such as curfews or the temporary removal of a passport or driving licence, and increased fines.’ At Help Me Stop, we believe that possibly such punitive measures may deter a few people who are not addicted to drugs, but nevertheless are using problematically and may be on their way to addiction. These measures will not deter people who are suffering with an addiction, however. Once again, we are punishing people with a mental, behavioural and neuro-developmental disorder, turning their health issue into a crime issue.
Chris Cordell says, “The report talks about recreational cocaine users using every 30 days. This just doesn’t stack up, as research has shown that in London alone 23kg is used every day. A&Es have been flooded with cocaine users, leading to a doubling of the number of UK cocaine users being admitted to A&E in the last two years. There has also been a huge increase in cocaine-related deaths. Certainly, at Help Me Stop we have seen a huge increase in cocaine users realising that their use is more problematic than they thought and wanting to put a stop to things before their world crashes down. What we do know that investing in effective treatment works. It saves money and more importantly it saves lives.’