Today sees the release of Part Two of Dame Carol Black’s Review of Drugs. Part One, released in February 2019, looked at the illegal drug market and government intervention, whilst Part Two looks at treatment and recovery services for people experiencing addiction.
In our experience, addiction is often the result of difficult life experiences or limited life chances such as discrimination, poverty, exploitation and abuse. A clinical approach is not enough – people need therapeutic support that helps them make meaning of why addiction has developed for them. We welcome the Review’s acknowledgment that a person’s chance of recovery is determined not just by drug and alcohol services but by the opportunities available to address other factors in their life that intertwine with their substance use – housing, employment, domestic abuse, family breakdown etc.
There is a lot that we welcome within this review including:
- Increased funding for drug treatment and wider recovery support. Drug and alcohol services have been woefully underfunded for years and we welcome the Review’s recommendation of a package of funding not just for drug treatment itself but also for support in other areas such as employment and mental health. Holistic support is so important. As good as a drug and alcohol service may be, if there are not opportunities in the local area to address other areas that intertwine with their substance use, then it will be difficult for people to achieve and sustain long-term recovery goals. We particularly welcome the recommendation for longer commissioning cycles – this is so important to allow service providers to become properly embedded in a community and to allow space for innovative practice.
- Greater consistency of support. The Review highlights the current postcode lottery in drug and alcohol services. We welcome the recommendation for a national Commissioning Quality Standard that will specify the full range of treatment services that should be available in each local area, including outreach programmes and psychosocial interventions. We also welcome the recommendation for a workforce strategy, including funding for training. Whilst it’s great that the Review highlights the importance of people with lived experience working as peer supporters and mentors, we would argue that people with lived experience should be supported to work at all levels within drug and alcohol services, including the professionally trained and managerial roles.
- Reform of central government leadership. We welcome the Review’s call for a whole-system approach including the appointment of a minister responsible for coordinating a cross-department response. It’s great to see that the Government has already responded to this by introducing a new Joint Combating Drugs Unit. Up to now, nobody has taken ultimate responsibility for supporting those experiencing addiction, leading to underfunded services and a disconnect between the health approach to treatment and recovery and the criminal approach to the drug market. We hope this new unit will take things in a better direction.
- Prevention. We support recommendations to prevent addiction developing in the first place. Treatment and recovery services are reactionary and respond when a problem has already developed – we need to address the root causes of addiction before the addiction even develops, and must do more to break intergenerational cycles. We would have liked to see more recognition of the families of those experiencing addiction. Not only does their support play a crucial role in recovery, but family members are also sharing this painful journey and need support themselves.
We would have liked to see more about engaging with people for whom drug and alcohol services are currently inaccessible, and the role of the voluntary sector in overcoming barriers to treatment. Whilst the Review talks about getting young people into treatment and diverting people from the criminal justice system into treatment, it does not do much to address systemic barriers for certain individuals or groups. For example, women often tell us that they feel incredibly anxious entering a mixed-sex waiting room where they may encounter an abuser or drug dealer. We need more flexibility in support, including gender-specific sessions and specialist organisations or staff for marginalised communities such as racially minoritised people or the LGBTQ+ community. The voluntary sector plays a key role here as, not only do they have the expertise to deliver specialist outreach support, but they have often already built up relationships with people who struggle to access drug and alcohol services.
We must ensure that at the centre of all this we consider the person and not just the addiction. All too often people are labelled, stigmatised and have their identity split or defined for them – addict, rough sleeper, perpetrator, victim. We need a system that listens and responds to people as they are, empowering them to take steps towards recovery. To achieve this we need to see more co-commissioning and integrated and flexible services for people experiencing multiple disadvantage that support the whole person and build on their strengths and goals, rather than expecting people to navigate a complex landscape of services and fragmented support that only see and seek to address their deficits. We hope that the Government will listen to the recommendations in this Review and take the appropriate steps forward.