Drink and Drugs News DDN Feb2018 - Page 6

Cover story The hearT of The MaTTer Can we meet six basic challenges to repair a fragmented treatment system, asks Paul Hayes rexit continues to dominate mainstream debate. But far more important to most people, particularly the poor, the marginalised, and the ‘left behind’ is the cumulative impact of years of austerity and the continuing failure of the economy to grow. The prime minister’s promise to overcome the ‘burning injustices’ which blight so many lives, seems distant. The reality of sluggish growth, falling wages, and slow but steady degradation of the services on which the poor and vulnerable rely, provide the context in which drug and alcohol treatment providers work and our service users live. Below are six of the key challenges facing the drug and alcohol treatment system during 2018. As the government recognised in last year’s drug strategy, truly effective interventions depend on their cumulative impact. People need adequate access to physical and mental health treatment, a realistic prospect of a job, a safe place to live, and enough income for food and clothing. Since the financial crash of 2008, the cumulative impact of squeezed budgets and changes in policy have placed strains on service users’ capacity to survive and recover, which treatment providers cannot address in isolation – no matter how brilliantly they implement the drug strategy or how assiduously they abide by the clinical guidelines. B ******* ALCOHOL ******* Only one person in six who needs alcohol treatment is able to access it. Alcohol harm is concentrated in our poorest communities, with 30 per cent of all alcohol consumed by 4 per cent of the population. The health damage, the societal consequences and the costs to the NHS are well understood. Despite this, the government has thus far resisted publishing an alcohol strategy identifying how it will reduce the overall harm of alcohol use and in particular how it will close the gap between the growing need for treatment and shrinking capacity. There is growing political pressure for the government to be more active in social policy, and an alcohol strategy would be the ideal place to begin. 6 | drinkanddrugsnews | February 2018 ******* DRUG-RELATED DEATHS ******* The Local Government Association, PHE, and the ACMD have all identified treatment for England’s heroin-using population as the key to reducing drug- related deaths. Being ‘in treatment’ is a protective factor: deaths are significantly lower within the 60 per cent in contact with services than the 40 per cent who are not. Every local authority commissioner and provider should be striving to understand why people do not access services and find the most effective way to reach them. However, with providers extended to the limit to meet the needs of the 60 per cent, resourcing will be fundamental to success. ******* DISINVESTMENT ******* In 2012/13, total spend on drug and alcohol treatment in the community and prison was more than £1bn. It is now around £750m. Local authorities are increasingly focusing their commissioning