person-centred support. The 2017
strategy was not gripped firmly
enough by government to bring
about transformational change.
This strategy should be driven by
an effective inter-departmental
approach, united behind a shared
vision.
The monitoring unit could
bring some welcome political
attention to a field that has been
fundamentally shaped in the past
decade by the twin challenges of
austerity and localism. Austerity
has seen more than a quarter
of our funding lost and localism
has meant that loss has not been
evenly distributed.
I
t would be wrong to directly
link all our challenges with
the move of drugs and
alcohol to local authority
control. But there is an
unquestionable issue over
priority. Funding evidence-based
and life-saving drug and alcohol
services will never be the first
thing on the list for local politicians
dealing with substantial funding
pressures.
However, a successful central
unit will require a careful balancing
between the local and the national.
The unit should have sufficient
powers to encourage local areas
into action where appropriate,
reducing the local variation in
support and working effectively
with Public Health England with
clearly delineated roles and
responsibilities. Most importantly,
the development of the unit must
be supported by sufficient new
funding and political investment to
ensure its long-term potency.
While more money is not the
answer to all of our questions it is a
good response to a great many, as
the unprecedented scale of the cuts
has forced local authorities to make
very difficult decisions. Increases
in public spending could enable
the support of a greater number
of people. There are over 314,000
people in England who use heroin or
crack problematically, and 586,000
with an alcohol problem. Many
aren’t currently receiving help. More
support means an increase in family
stability, fewer children taken into
care, fewer blue light call outs, fewer
emergency admissions to hospital
and fewer people caught up in the
criminal justice system.
T
he prime minister
has spoken
extensively about his
commitment to the
areas represented
by new Conservative
MPs. These areas – many of which
are ex-industrial – have experienced
high levels of drug-related deaths
and multiple disadvantage. If the
government is serious about this
commitment then an investment
in the health and happiness of
our most vulnerable citizens, as
well as technological or transport
infrastructure spending, is surely
necessary.
The proposed removal of the
ring-fence around vital public
health funds has been postponed
by at least a year and will not
now happen until April 2021 at
the earliest. This is good news,
although of course not in itself
sufficient to guarantee a high-
quality treatment and recovery
Drug-related costs, £billions
Source: Dame Carol Black’s Review of Drugs, Feb 2020
Crime and criminal justice services – £9.3
Drug-related deaths – £6.3
Adult family and carers – £1.0
Other – £0.9
Enforcement – £0.7
Children’s social care – £0.6
Community treatment and prevention – £0.6
WWW.DRINKANDDRUGSNEWS.COM
‘The illegal drug
market has long
existed but has
never caused
greater harm
than now.’
Dame Carol Black
system in England. Therefore we
recommend that the ring-fence
around the public health grant is
maintained for good and that the
lost public health funding at local
government level is restored.
New policy developments can
help make the case for joined-up
and connected services. Previous
attempts to deliver treatment and
recovery services have hit a ceiling
due to siloed approaches. Our policy
and research discourses are catching
up with what those touched by
addiction have always known – that
only a connected response can work
for a problem that does not reside in
any one department of human life
but sprawls across them all. Work
to support a citizen’s drug problem
is almost useless if they have no
home, fragile mental health or
paralysing trauma.
Considering addiction with
reference to other domains of
multiple disadvantage will enable
the strategy to catalyse change
in allied areas. The 2017 strategy
made welcome recognition of the
fact that addiction is both cause
and consequence of poverty and
trauma – we were pleased to see
£46m in the recent budget for a
programme of coordinated work
on multiple need, and we also
hope that the second part of Dame
Black’s review will make the case
for effective partnership work,
something the voluntary sector has
always been good at.
The new strategy and monitoring
unit should also refocus political
attention on alcohol treatment.
Whilst it’s welcome to see the issue
of problem gambling being pulled
into the political mainstream,
it’s perplexing to see almost no
mention of alcohol at a time of
quiet crisis in alcohol treatment.
There is a clear correlation between
disinvestment and the diminishing
numbers of people getting help
– over 16,000 fewer alcohol users
were supported this year compared
to 2013-14, while 82 per cent of
people who need specialist help are
not getting it.
The government’s response
to alcohol must be brought ‘up to
speed’, with the strategy outlining
how a greater number of alcohol
users – and their children – can be
reached and supported. The fact
that stigma can force people to the
margins and prevent them getting
life-saving help should be recognised.
T
he linking of different
forms of addictions
in the new strategy
must be used as a
chance to combat
the stigma around
drug use. The second part of the
Carol Black review also provides a
valuable chance to acknowledge
the negative role stigma can play
in stopping people getting help
– supporting recovery can be a
powerful way of addressing wider
health and social inequalities.
My final message to government
would be: we know what works.
We are equipped with a range
of interventions from opioid
substitute therapy to motivational
interviewing, from needle exchange
to residential rehab, which can be
drawn upon by skilled workers to
meet the needs of their clients at
the exactly the right time.
If the field is provided with
sufficient resource and appropriate
structures we can unleash
the transformative power of
treatment and recovery to change
lives, reunite families, support
communities – and save the state
money while we’re at it.
Oliver Standing is director of
Collective Voice
APRIL 2020 • DRINK AND DRUGS NEWS • 13