We welcome your opinion:
www.drinkanddrugsnews.com
If treatment is to survive it needs to make a more convincing
case and reach out to new groups, argues Paul North
heroin cohort dies and leaves treatment, so does the money to support them.
The challenge that treatment must confront, and a surefire way of creating
funding, is to connect public need with public concern – raising awareness of an
issue to attract new referrals, whilst at the same time educating society on the
benefits of doing so. This is no small task for treatment and requires innovative
outreach. The truth though is that if treatment does not find treatment-naive
groups and make a convincing case for supporting them, the government is
unlikely to give out funding on the off-chance of success. There needs to be a
clear justification for funding, and concern to match it.
Creating public concern often requires a good narrative, and these narratives
must also be backed up by data and evidence. The first step then is to prove the
need, by evidencing that there are hundreds of thousands of people who require
support. All these people who would benefit so much from treatment need to
walk in through the front door – these stats then need to find themselves on the
desks of commissioners as well as the local press. At a local level, let people
know the great work the treatment service is doing and encourage others to get
support. Identify a group and prepare them for treatment, get them on NDTMS
and prove treatment still has a use outside of the heroin cohort.
he first group that treatment could target is an easy win. Last year,
23.8m opiate prescriptions were dispensed in the UK. Use of painkillers
has risen by 80 per cent in ten years and is costing the NHS billions of
pounds – there are no doubt hundreds of thousands of people using
opiates problematically on prescription. They are easily accessible, in
every community across the UK, and reducing their use would save the NHS
millions of pounds. Furthermore such an approach would bring significant health
benefits, as it is estimated that up to 90 per cent of prescribed opiates are
ineffective at addressing chronic pain. Treatment services are essential if such a
reliance is to be reduced – without a planned therapeutic intervention a situation
similar to that in the US could emerge where those taken off ineffective
prescriptions simply seek out illicit opiates.
It is clear that a very strong economic and health argument could be made for
engaging this group. Save money, put some of it into treatment and reduce the
vast numbers of people on poorly managed opiate prescriptions.
The next key group is the hundreds of thousands of cannabis users that do
not enter treatment. Last year we showed in Liz McCulloch’s report Black sheep
that cannabis presentations have risen by 55 per cent in ten years. My report
Street lottery estimated that this equates to 200,000 cannabis users in the UK.
Cannabis represents both the fastest growing cohort of drug users, and the most
commonly used drug among young people and adults. As outlined in Black sheep
treatment has not yet made a convincing case for engaging this group as we are
ignorant of the health and economic benefits of doing so. This group require
bespoke outreach interventions and campaigns to engage. Without any effort at
all the group has doubled in size in ten years. Imagine what it would look like if
treatment made a more concerted effort.
If services around the country looked up from managing the heroin cohort
and engaged treatment-naive groups then the money would emerge – the
T
www.drinkanddrugsnews.com
national press would have a story, further educating the public on the changing
face of treatment and encouraging others to seek support. The issue of funding
services would then likely receive far more public support. Such a strategy would
unite public concern with public support, thereby validating funding.
This is not about ditching the important service that treatment provides for the
heroin cohort. It is about ensuring i n years to come it can continue to do so
effectively. Treatment needs to stay well funded and healthy to support heroin
users at a time when overdoses are at an all- time high. Those on the frontline of
drug treatment know full well the importance of continued support for this group.
This is an exciting proposition for those working in treatment. The chance to
explore a new frontier and engage groups who have historically avoided support.
A chance to show government the innovation that the sector is capable of and
share the life-changing work that has been going on in key-work rooms up and
down the UK for years.
To those who are sat with overwhelming caseloads, complex clients and
demanding targets, the only way out of that picture is to adapt. The heroin
cohort created treatment but if services don’t act they might also spell the end
of it. They are no doubt a vulnerable and difficult cohort to work with who need
bespoke support, but they are not the key to future funding. If treatment does
not grasp this opportunity quickly and make a convincing case for more money
then it will disappear into irrelevance, and only have itself to blame.
Paul North is head of communications at Volteface, @Paul_North
Graph data from Beyond the tipping point at www.recovery-partnership.org
April 2018 | drinkanddrugsnews | 17