MEMORANDUM 3
Submitted by Addaction
ABOUT ADDACTION
Addaction is a leading national provider of
community drugs and alcohol treatment services. We saw approximately
40,000 clients last year. Founded in 1967 by a parent whose son
died from a drugs overdose, we have grown rapidly in the last
decade. We run community-based services, Day Programmes for arrest
and referral, operate DTTOs, offer harm reduction services, and
also run several Therapeutic Communities within HM Prison Service.
We expect our clients to examine themselves
honestly and openly, and so must we if we are to meet their needs.
Our aim is continual self-improvement through the delivery of
quality services. We are the only charity in the field with a
Directorate for Development and Improvement and an Audit Committee
who regularly evaluate the quality of service provision.
CURRENT DRUGS
POLICY
The Government's Drugs Strategy set high targets
for success, and consequently has raised high expectations. The
strategy, rightly, has placed tackling drugs misuse high on the
political agenda. Since June 2001, responsibility for Government
policy has moved into the Home Office. We believe this move is
a significant reflection of the commitment of government to deliver
a successful strategy and implement effective policy.
1. The change in departmental responsibility
following the last election came in the wake of an intense and
critical media campaign arguing for de-classification of cannabis
and a change in legislation regarding medical prescription of
heroin.
2. The relationship between the Government's
Policy on poverty and social exclusion and policy on drugs is
not clear, yet, it is clear to us as a treatment provider, that
there is a clear connection between poverty and drugs misuse.
ADDACTION'S
RESPONSE
(a) From a drug treatment perspective, Addaction
believes there is not enough clear evidence on cannabis use in
relation to patterns of addiction, which could underpin with confidence
a liberalisation or relaxation of the law, however, the law needs
to be consistently applied which would suggest that cannabis be
classified to category "C" schedule of the Misuse of
Drugs Act,
(b) The media rarely does justice to the
subject of drugs misuse. The media find the subject too complex.
Rarely do we see stories focusing on success in treatment. In
the arguments put forward to support de-classification and new
legislation, addiction itself has been pushed out of the picture.
(c) The vast majority of the most problematic
drugs misusers bring with them other problems such as a history
of abuse, neglect, poor education and social deprivation. Unless
other problems are dealt with at the point of entry into treatment,
these problems will continue to trigger repetitive drug using
behaviour. Treatment providers have a key role to play not only
in evaluating need, but in making constructive interventions and
offering real help with the whole range of social problems.
2. Our guiding principle in campaigning
on drugs policy and issues is to only comment on issues we know
something about and to argue for more treatment and better treatment,
planned in a unified geographical strategy. Our views are encapsulated
in the following statement:
The provision of treatment services that work
has to become embedded in every locality, and every relevant institution,
so that no one with problematic use faces a postcode lottery,
and where no one who wants to address their drugs misuse is allowed
to fall through the net.
3. There are profound weaknesses in both current
accessibility to services and in the quality of many services.
Addaction's response:
(a) We welcome the establishment of the National
Treatment Agency as the prime opportunity to introduce clarity
and cohesion into a geographically un-coordinated and disparate
field of service provision. We want to see the NTA establish comprehensive
standards for service delivery and monitoring of service quality.
WE ALSO
WANT TO
SEE:
(b) a clear and well-publicised directory
of drug services and clear information on how to access these
services;
(c) a reduction in the over-emphasis on methadone
regimes at the expense of abstinence-based programmes;
(d) far greater resources spent on treatment;
(e) a far greater emphasis on appropriate
"throughcare". Currently throughcare programmes are
so minimal as to pose a threat to the genuine long-term success
of prison-based drugs services;
(f) a change in the way treatment services
are commissioned. Commissioning is often too short-term and bureaucratic.
Insecurity militates against achieving continuity of staffing
and constrains service provision;
(g) a dilution of the plethora of umbrella
groups and a reduction in the confusing array of policy bodies
which currently promotes mystification not clarity;
(h) an end to the denuding of residential
centres. More are needed, not less;
(i) a standardised data-set including activity
and outcomes enabling the delivery of clear strategic management
information;
(j) greater incentives to encourage more
drug workers into the field;
(k) an increase in the availability and accessibility
of quality staff training;
(l) a co-ordinated strategy building on the
key role parents have to play in combating drugs misuse;
(m) clarification of the role of DPAs which
has a budget of £9 million;
(n) greater understanding of role of relapse
in recovery by the judiciary;
(o) principles of Harm Reduction services
re-directed to become a platform to move towards abstinence;
(p) Waiting lists at statutory drugs services
are unacceptable (up to 12 months). These services do not need
more money but redesign, reconfiguration and modernising. Methadone
maintenance should be episodic, not for life.
4. We particularly want to see intervention
at an early stage with Young People who either misuse drugs or
are at risk of misusing drugs.
High on the list of priorities in our view is
the need to deliver early intervention for Young People who misuse
drugs or are at risk of misusing drugs integrated into prevention
and education strategies. In particular, approximately 60,000
children in care in England and Wales who are at high risk of
drug misuse, crime and prostitution, and require special tailored
programmes in prevention and rehabilitation. Currently, only a
handful of specialised services exist.
5. Assessment of evidence and recommendations
for application in the UK, on the increasing positive outcomes
in the USA, where every rehabilitation service has maintained
strong links with Alcoholics Anonymous and Narcotics Anonymous.
It is true that treatment is a two-way street—people
have to want to be treated, and in that sense, they "treat"
themselves. No statutory service can expect to provide life-long
maintenance and support to individuals, AA and NA are programmes
for change. They are well-established, and offer a maintenance
programme that may be used by individuals at no cost, as little
and as often as they wish, taking from the programme as little
or as much as they feel necessary for the rest of their lives.
6. Drug Action Teams vary widely in terms
of effectiveness and knowledge of the field, yet ultimately, the
power to commission and fund treatment services lies with them.
Commissioning of services need a thorough review
and should be based on needs analysis and evidence based treatment
and care. Quality of commissioning varies enormously from DAT
to DAT.
October 2001
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