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The highs and lows of the 2017 Drug Strategy

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Introduction

The 2017 national Drug Strategy was published this morning and sets out the Government’s intentions for delivery across the UK. The document is clear and bold in its intent and there is much that we welcome. This blog attempts to summarise the key messages and implications whilst offering helpful observations about what else is needed.

The Strategy recognises that drug misuse continues to cost £10.7bn per year - £6bn of which being drug related crime. It recognises the success that has been made under previous strategies in: increasing numbers in treatment, expanding the numbers of people of successfully leaving treatment services and the significant reductions in drug related crime.

It also recognises the very real challenges that those of us involved in the treatment system are familiar with including: an ageing treatment population with increasingly complex health problems, declining numbers of people entering treatment, falling numbers of opiate users primarily who are overcoming their addictions and a frightening increase in the rate of drug related overdoses and deaths.

All of these issues are compounded by changing patterns of drug use, production and supply that were unheard of even a decade or so ago be it; synthetic drugs, purchased through the ‘dark web’ and delivered by drones.

The impact of these changes is seen in communities and amongst some of the most vulnerable clients groups across the country.

The strategy is broad in its approach balancing prevention and harm reduction with longer term recovery and social reintegration. We also particularly welcome the emphasis on evidence based approaches to treatment.

Two of the headline grabbing highlights of the new strategy are:

A cross government drug strategy board will be established and chaired by the Home Secretary – overseeing the delivery of the drug strategy and its impact upon: health, justice, housing and employment.
A national recovery champion will report directly to this Board on progress being made locally against an agreed set of national performance measures (which will include both recovery rates but also frequency and types of drug use).

It is intended that this centrally driven approach will help drive up standards and erode the variances in delivery that are seen around the country.

The Strategy has four stated aims. Click each item to read more.

1. Reducing demand

A strong focus upon Public Health and Wellbeing providing expert guidance to universal services like midwifery, school nurses, youth and community workers etc to build children and young people’s resilience and hopefully prevent them from using drugs in the first place. An explicit commitment to evidence based interventions rather than scare tactics is welcomed as is the focus upon involving colleges and universities in promoting health and well-being.

The strategy also places great emphasis on targeted prevention activities with those groups most at risk including: young people who are NEET, offenders, sex workers, homeless people and veterans.

It also helpfully emphasises the challenges of NPS and proposes establishing a new NPS expert clinical network and intelligence sharing system. This is broadened to also include Chemsex and the sexual health risks that are inherently encountered as well as both the illicit us of prescribed medications and performance and image enhancing drugs.

2. Reducing supply

There remains a core focus upon disrupting supply routes, tacking organised crime and working with Police and Crime Commissioners and other justice partners. The strategy explicitly re-states Government intention not to decriminalise drugs – a subject we can expect to generate much debate. There is a commitment to building capacity in several of the countries at the centre of drug production – be that Afghanistan, Pakistan or Peru. There are measure to try and strengthen border capabilities, tackle domestic cannabis production and establish a Home Office working group to tackle drug supply gangs that operate across county lines

Drug Related Offending – remains a priority with 45% of acquisitive crime still associated with heroin and crack users. This equates to some 2 million crimes a year. The strategy encourages the wider use of test and arrest and custody based liaison and diversion schemes to better identify drug using offenders with a stated aspiration to better integrate these schemes with community based mental health and treatment services. It also helpfully encourages enforcement agencies to provide rehabilitative as well as punitive interventions. All of these initiatives are well embedded within CGL services.

Prison – the strategy recognises the particular challenges and risks facing the prison estate and those held within it. It recognises the intent of the Prison Reform programme and the commitment to provide integrated health and care services under greater direct control Governors to ensure local needs are met. There are plans to enhance existing drug testing regimes and strengthen approaches to reducing supply alongside a renewed focus upon integrated health approaches within prisons and also with community services.

3. Building recovery

We particularly welcome the stated ambition to ensure that treatment is tailored to meet the needs of different cohorts of drug users at local levels. It is also positive that the strategy recognises that long-term recovery will not be achieved without effective partnerships that involve: housing, mental health and employment.

We particularly welcome the central oversight and national measures that will provide much greater transparency and accountability over local spend and performance as a way of driving up consistent quality across the country.

There are interesting sections about responsibilities upon local commissioners to strengthen governance and quality assurance system and to use a range of performance management and collaborative approaches that could be used without the need for formal re-tendering of services which it is acknowledged can be disruptive in terms of staff engagement.

We welcome the explicit requirement that service users have a full stake in the decision making processes as well as the explicit references to the proven effectiveness of Peer Lead initiatives.

The Building Recovery section is powerful in that it explicitly describes a balanced system, based upon evidence that should be tailored to specific cohorts of clients. Balancing a focus upon reductions in harm and the risk of BBV’s, reducing drug related deaths alongside approaches that nurture longer term recovery is both pragmatic and sensible.

National measures including longer-term recovery rates, progress made by different cohorts of clients, treatment penetration rates alongside positive outcomes related to housing, offending, mental health and employment are all welcomed and provide for a broad and balanced treatment system.

4. Global action

There are strong commitments throughout the strategy at international cooperation, intelligence sharing and monitoring to better track patterns and prevalence of drug use, identify best practice and the global impact of drug policies in tackling harms, reducing the spread of HIV and other BBV’s and promoting human rights.

 

Conclusion

There is much to welcome about the new Drug Strategy which recognises both the successes of national approaches alongside some of the specific challenges we now face in terms of both new patterns of drug use and an ageing cohort of opiate users presenting with increasingly complex health problems.

We particularly welcome the emphasis on using evidence, nationally agreed measures and central senior ministerial oversight of how the strategy is to be implemented.

The good intentions and sensible approaches described within the Strategy are of course entirely dependent upon adequate resourcing at both national and local levels if we are to address the very real issues of rising drug related deaths.

It must also be noted of course that alcohol provision is barely referenced within the strategy despite the harms and costs associated with alcohol misuse. We would therefore urge the Government to apply the same level of commitment and energy to reviewing and publishing a new National Alcohol Strategy as they have with this one.

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