Andy Ryan is Head of Recovery and Addiction Services at Changing Lives. Following the publication of the cross-government Drugs Strategy earlier this week, Andy shares his thoughts on what the recovery sector and society’s wider response to addiction could look like.
The Government’s cross-departmental Drugs Strategy, published earlier this week marks a significant and welcome shift in the landscape for treatment and recovery. Not only does the Strategy recognise addiction as a chronic health condition, but it takes on board all of the recommendations from Dame Carol Black’s independent review of drugs, including a £780 million funding boost for treatment and wider recovery support following almost a decade of disinvestment.
Some early media announcements were concerning, with a strong focus on crime and being ‘tough on drugs’, but actually much of the Strategy delivers what we have been asking for – a whole-person approach which seeks to remedy the effects of longstanding underinvestment in the sector in recent years. We now await the finer details of how this Strategy and the associated funding will be implemented. The potential is there to make real change – and it is on us all to shape, challenge and deliver what has been clearly recognised in both the Strategy and Dame Carol Black’s report.
So much of our response to drug harm rests not on the drugs themselves, but on how we view and respond to addiction. The new Strategy has the potential to create an energy for moving from harm to hope, and I am optimistic that it is the start of a narrative that acknowledges what addiction actually is for people and how intergenerational factors come into play.
We see addiction as an experience in someone’s life, and not their identity. When people come to our recovery services at Changing Lives we talk about them, who they are as people, rather than the substances they consume or the symptoms they exhibit. We move past the stigmatising labels – addict, alcoholic, offender – and create space for people to reflect, make sense of the life they have experienced and look at their strengths, their dreams, their ambitions.
While the Drugs Strategy contains many positive elements to support people experiencing addiction, I ultimately still want to see a single approach to addiction that focuses less on the difference between drugs or alcohol or gambling, and more on the person, families and communities and why people are open to addictions forming in their lives.
Addiction in all its forms – whether that’s drugs, alcohol, gambling or other addictive substances or activities – is a public health crisis that requires a public health response, not a criminal justice one. Without a doubt we need strong addiction and recovery support pathways for people in prison and on probation, but this should be within the context of moving people into support that is rooted in their communities, that integrates treatment with wider recovery support such as housing and employment, and ultimately helps people move on from intergenerational cycles of behaviour and activities around drugs and crime from which they may have been unable to escape on their own.
And these pathways should be dynamic and flexible to meet the challenges that any recovery journey can present. We need to be reasonable and rational in what we expect of people as they seek to make changes in their lives, and recognise that years of conditioned and habitual behaviour don’t just go away overnight.
We need to get the balance right between quality and quantity. The funding increase may feel like a real and much needed boost, but there is a risk that this will simply alleviate the effects of underinvestment in recent years, rather than moving us further forward. We have amazing teams across the country that have worked so hard over the past few years to minimise the impact of funding cuts and deliver the best possible support and options. Yet caseload sizes have become unmanageable, meaning many addiction and recovery services can only do the bare minimum of interventions and harm reduction, with no flexibility to properly deliver therapeutic interventions that address why people use drugs and help them develop alternative coping mechanisms. We need to ensure that recovery services are given the time and flexibility to get the interventions right.
We also need to think about who isn’t – as well as who is – accessing support from treatment and recovery services. The Strategy references, but doesn’t spend much time on, how to reach groups who struggle to access treatment, including women, older populations, and people who are racially minoritised. Instead there’s a lot in the Strategy about a carrot and stick approach (with emphasis on the stick) – go into treatment or go to court/prison. If you use drugs, we’ll take away your passport. This is based on the assumption that, when threatened with a negative consequence, people will choose to stop using drugs. Years of working in the sector have shown me a cold and worrying fact. The life of a person experiencing drug addiction is already littered with negative consequences – the impact on their family, their community, their self-esteem and worth. If negative consequences stopped people experiencing addiction from using drugs then we wouldn’t be in this crisis as the lifestyle, on a daily basis, stacks up more than enough consequence to consider stopping.
Addictive substances and behaviours offer the ability to dissociate, to switch off from these negative consequences, so by making life more challenging we can inadvertently increase the desire to use rather than decrease it. Instead we need to give people something to fight for and the tools that they need to do so. We need to support whole families and look at what is going on in their lives and their communities that is resulting in intergenerational cycles of crime and addiction. We need to start asking the right question of society – not why the addiction but why the suffering for so many? Instead of a war on drugs we need a war on poverty, inequality, exploitation and abuse.