The original article presented the assumed and non-judgmental profile of a person in active addiction and compared the costs of services provided to them as follows:

• Regular use of NHS and GP services

• Social care provision

• Receiving benefits, including housing benefits

• Costs of drug-related crime

• Costs of criminal justice involvement

It then compared these extrapolated costs over 2.5 years with the costs involved in treating that person for 24 weeks in a residential treatment centre, and then 104 weeks of supported abstinence-based housing. The minimum cost saving over the period was £ 109,760 – so even leaving moral, ethical and humanitarian considerations aside, the financial savings speak loudly in favour of treatment.

But much has changed in

the abstinence-based treatment sector in the last four years, prompting a need to revisit the costs and priorities of treatment versus the costs associated with doing nothing. Costs have heavily impacted the residential sector in the same way they have everywhere else – our economics are those of running a hotel whilst adding a full daily treatment programme and some medical and detoxification services on top. Food, energy, trade service and maintenance costs have all rocketed, along with wages, inflation and taxation.

Rehabs are resilient and have become adept at doing more with less, but there are limits – and fee increases have been unavoidable. Sadly, not all have survived, and we’ ve seen a reduction in the number of services and beds available. The most significant of these closures has been amongst services that offer detoxification – making waiting times longer and building pressure on services as a result.

Client profiles have also changed, with increasingly complex clients presenting for residential treatment and a need for services to adapt and accommodate a broader range of personal, physical and mental health needs. There have been significant increases in the use of drugs like ketamine and pregabalin, with serious

impacts on clients who in some cases are barely into their twenties. Sadly, rough sleeping and homelessness-related deaths have continued to rise, and this combination of factors underscores the urgent need for outcomes-based treatment.

Residential treatment builds recovery assets and leads to people leading self-reliant lives, yet still there is a lack of investment in the residential sector. We still rely on tendering processes, spot purchasing with no ring-fenced money, or incentives for local authorities to meet targets set years ago and left unmonitored. So while there’ s greater need for residential treatment and move-on housing, there’ s less provision.

Politicians and civil servants understand the case for rehab, but their colleagues in the Treasury need to see the hard numbers. The numbers are easy to calculate for a package of 2.5 years of residential rehab and housing – I have those figures for ANA Treatment Centres and ANA WORKS Housing CIC, our move-on supported housing service, and from other providers in the Choices group. But when considering our profile of a person in active addiction, the cost calculations become far more complex.

Our hope is that we’ ll be listened to – because of the

Politicians and civil servants understand the case for rehab, but their colleagues in the Treasury need to see the hard numbers.

potential savings to central and local budgets, and so that clear referral pathways into longer term packages of abstinencebased rehabilitation and housing can be established.

We need help to make these calculations. With agreed assumptions, those savings from the public purse can be quantified. The figures need to be as accurate as possible and stand up to scrutiny. The savings will be significant, so if you’ re reading this and know of people or organisations that can calculate these costs please contact me. You will be helping to give us more of a voice, saving significant amounts of public money, and dramatically improving lives.

Richard Johnson is CEO of ANA Treatment Centres and ANA WORKS Housing CIC, and co-director of the Choices group. Contact: rjohnson @ anatreatmentcentres. com

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