In February 2019 Professor Dame Carol Black was appointed to lead a major 2-part review into drug use and its continuing impact on society, in particular, the way in which the drugs market fuels crime and serious violence, and how services are supporting individuals impacted by substance misuse.
Last month, Dame Carol published the final part of her review which focused on prevention, treatment and recovery from drug addiction, and made recommendations for significant changes to the ways in which services were commissioned. An early finding from her research was that around 3 million people used illicit drugs in England and Wales in 2020, and that the “…total cost to society of illegal drugs is around £20 billion per year, but only £600 million is spent on treatment and prevention”
These findings gain more significance when measured against the background of record-high drug related deaths, a figure which has tragically continued to rise year on year for the past 8 years.
Dame Carol also highlighted the strong links between the illicit drug market and rising levels of violent crime, including county lines activity which has seen increased levels of knife-crime and the criminal exploitation of children and vulnerable adults.
In the second part of Dame Carol’s review, she concluded that existing provisions for prevention, treatment and recovery are inadequate and fail to make significant changes in the lives of the people impacted by substance misuse in the UK. The report includes 32 recommendations for improving drug policy.
Key Findings and Recommendations
Dame Carol Black’s exhaustive review of the drug and alcohol sector found that lack of funding has led to failures in client outcomes and that many front-line workers are overworked and feel demoralised.
She recommends a ‘whole-system approach’ in supporting individuals impacted by substance misuse, including the requirement of local authorities to develop effective joined-up working between health, housing, criminal justice and employment support service
|Prison and Probation:
Of particular focus in the review was the role the prison and probation services could play in supporting people whose use of substances had led them into a cycle of criminal activity, incarceration and relapse.
The review found that “…people with serious drug addiction occupy one in three prison places”, with the majority of these prisoners often relapsing into drug use and offending behaviour shortly after release due to the limited time in prison treatment and lack of a structured integration pathway back into the community.
Dame Carol recommended that more police diversion and community services, alongside court ordered referrals into treatment, should replace custodial sentences for drug-related, non-violent crimes. Naturally the demand on treatment services will increase, so it’s imperative this demand is met with increased funding.
Also key is the pathway from prison into treatment, with one of the recommendations being that the Ministry of Justice improve collaboration with different departments to ensure a smooth transition from a custodial setting to a community one, particularly where an individual requires ongoing substitute prescribing.
Accessing employment for anyone recovering from drug / alcohol problems remains incredibly difficult, with employers reluctant to hire people who they perceive as ‘untrustworthy’, a component of the societal stigma with which this cohort is associated.
Historically, treatment services have not focused as much attention on finding clients work, beyond signposting to specialist agencies like DWP. With workforces already overstretched and juggling caseloads of 80+ clients, this is perhaps not surprising.
But finding effective employment is a crucial part of recovery as it not only financially provides individuals and their families, but it also offers people a chance to ‘fill the gap’ left by abstinence with a purposeful and worthwhile activity.
The Individual Placement and Support (IPS) initiative has since been piloted across 7 treatment services, with early findings indicating it has been successful in getting individuals in drug and alcohol treatment back into work.
Dame Carol Black recommends an increase in funding across the treatment sector to extend the IPS initiative and implement it across all treatment services in England.
One way of reducing the £20bn cost to society would be the development of an effective strategy of ‘preventative interventions’, targeted at children and Young People, with the urgent need of such a strategy highlighted by a recent report showing that “…drug use among children aged 11 to 15 has increased by over 40% since 2014, reversing a previous long-term downward trend”.
The government has the power to implement policies and include ‘Preventative Interventions’ to the school curriculum, which, it’s hoped, would lead to a reduction in the number of young people who initiate drug use in the first place.
Involving Service Users:
The involvement of service users in decision making, strategy and delivery of treatment services is a key recommendation of Dame Carol’s report.
Dr. Keith Humphries, who also contributed to the report, advised “…it is very important that people in recovery are at the table at all discussions … we need that expertise and that wisdom.”
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