Drugs strategy advocates “whole person” approach

Wednesday 8 December saw the publication of the new Drugs Strategy, entitled Reducing Demand, Restricting Supply, Building Recovery: Supporting People to Live a Drug Free Life.

Revolving Doors is delighted that all of the key recommendations in our response to the Drugs Strategy consultation document have been responded to in the strategy.

Recognition of multiple needs and the importance of addressing “the needs of the whole person” run through the document. It advocates “a ‘whole systems’ approach” incorporating “education, training, employment, housing, family support services, wider health services...prison, probation and youth justice”. Coexistence of mental health problems and polydrug use are recognised, and there are specific sections outlining plans to address homelessness and unemployment among drug users.

 

The strategy has a strong focus on recovery and promises to “offer every support for people to choose recovery as an achievable way out of dependency”. While we have some concerns as to how people will be “challenged” to recover fully, we welcome the recognition of recovery as an achievable goal. We welcome the focus on recovery rather than abstinence, which was outlined in pre-election Conservative publications.

 

Below are our recommendations and some quotes demonstrating how they have been responded to in the strategy:

 

  1.       The government should adopt an overall language and approach to substance misuse which challenges stigma, recognises multiple needs and promotes the potential for people to recover.

 

“We will work with providers and professional bodies involved in drug and alcohol treatment, mental health, employment, criminal justice, housing, and family services to promote a culture of ambition, and a belief in recovery.”

 

2.       While we welcome the cross departmental approach signalled in this consultation, we recommend that lead policy responsibility for reducing substance misuse is moved to the Department of Health. This would signal a shift to a health and wellbeing led approach to the problem.

 

“From April 2011, the Department of Health will assume responsibility for funding all drug treatment in prison and the community and, with the Home Office, will contribute towards [the Drugs Intervention Programme].”

 

  3.       Problem drug use rarely occurs without the coexistence of a range of other problems. Revolving Doors therefore welcomes the Government’s aim to take a “more holistic approach”.

 

“Individuals do not take drugs in isolation from what is happening in the rest of their lives. The causes and drivers of drug and alcohol dependence are complex and personal. The solutions need to be holistic and centred around each individual, with the expectation that full recovery is possible and desirable.” - Home Secretary’s foreword

 

  4.       There should not be an ‘either/or’ approach to harm-reduction or abstinence based treatments. Both have an important part to play in a staged journey with an end goal of abstinence.

 

“Substitute prescribing continues to have a role to play in the treatment of heroin dependence, both in stabilising drug use and supporting detoxification. We will continue to examine the potential role of diamorphine prescribing for the small number who may benefit, and in the light of this consider what further steps could be taken, particularly to help reduce their re-offending.”        

                                        

“We know that drug treatment can be very effective in preventing wider damage to the community...and together with initiatives like needle exchange schemes, can reduce the harms caused by dependence”.

 

  5.       The new strategy should promote the involvement of service users and former service users in the commissioning, design and delivery of services.

 

“We will [encourage] offenders who have recovered from drug and alcohol problems to become mentors or ‘Recovery Champions’.”

 

“We envisage local areas establishing ‘Recovery Champions’ [including] Community recovery champions – people who are already in recovery, who will be encouraged to mentor and support their peers and contribute to prevention in communities and schools.”

 

“Police will work with Community Safety Partnerships (CSPs), other criminal justice agencies, the public, drug services and drug users themselves to understand and disrupt the drug market.”

 

We welcome these statements, but are keen to work with the Government to explore how former and current service users can be more involved in service commissioning design and delivery. Much can be learnt from work putting service users at the centre of service design, such as that of RSA on Whole Person Recovery.

 

  6.       Support for young people making the transition from children’s to adult services must be improved.

 

“For the most vulnerable young people, a locally delivered multi-agency package of care – including treatment, supported housing, fostering and education support – is required. Attention will also be required to ensure that any transitional arrangements to adult services are effective at the local level.”

 

  7.       Continuity of support between prison and the community must be improved.

 

“When building a recovery focused system, we will encourage local areas not to commission services in isolation, but to jointly commission and deliver ‘end to end’ support...A key challenge is to ensure a ‘seamless transition’, particularly for those adults who move between the [criminal justice system] and community services. We will therefore encourage local areas to make the most of increasingly pooled funding to jointly commission recovery services.”

 

  8.       Revolving Doors welcomes the Government’s proposals for accommodation based community rehabilitation but urges that they include provision for people with multiple problems.

 

Although the strategy does not specifically mention provision for people with multiple problems, it does outline a range of best practice outcomes which reflect a recognition of the need to address a range of needs. 

 

“Key to successful delivery in a recovery orientated system is that all services are commissioned with the following best practice outcomes in mind:

 

• Freedom from dependence on drugs or alcohol;
• Prevention of drug related deaths and blood borne viruses;
• A reduction in crime and re-offending;
• Sustained employment;
• The ability to access and sustain suitable accommodation;
• Improvement in mental and physical health and wellbeing;
• Improved relationships with family members, partners and friends; and
• The capacity to be an effective and caring parent.”

 

  9.       Availability of alcohol treatment must be improved. The coexistence of drug and alcohol problems should be recognised and responded to.

 

“The investment made in the drug treatment system over the last decade has built capacity and enabled people to access treatment for a sufficient period of time to bring about substantial health gains. We now need to make the same progress in treating those with more severe alcohol dependence and to become much more ambitious for individuals to leave treatment free of their drug or alcohol dependence so they can recover fully.”

 

“Polysubstance abuse is increasingly the norm amongst drug misusers. This dependence commonly involves alcohol as well as drugs, and is therefore one of the key reasons why it makes sense to bring together the response to severe alcohol dependence and drug misuse into one strategy.”

 

Revolving Doors will seek to work with the Government and other stakeholders to ensure that the positive intentions set out in the new drugs strategy, and other policies such as the Ministry of Justice green paper launched on 7 December, lead to real change on the ground for people with multiple needs in contact with the criminal justice system.