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Record cocaine seizures across Europe

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The market for cocaine in Europe is ‘now the biggest in the world and still growing’, says a new report from the Insight Crime think tank. Last year saw France record a 49 per cent increase in seizures alongside a 25 per cent rise in Belgium, while Portugal is also becoming a ‘key hub’ for cocaine trafficking to Europe.

Rates of coca cultivation and cocaine production are continuing to rise, with production in Colombia increasing by more than 50 per cent in 2023 alone.

Belgium remains the main European destination for cocaine imported via maritime traffic, however, with the port of Antwerp the primary entry point. Brussels is facing rising rates of drug-related violence as a result, the report continues, with an ‘unprecedented surge in the frequency and intensity of shootings’.

As the Belgian authorities have increased security measures traffickers have increasingly been looking at other entry points, with Spain seizing large amounts of cocaine from semi-submersible submarines and speedboats. The UK Border Force, meanwhile, seized almost 15 tonnes of cocaine worth more than £1bn in a single three-month period last year – ‘equivalent to the weight of a London double decker bus’.

The findings reflect the data from the latest European wastewater analysis by EUDA and SCORE, which saw a 22 per cent increase in cocaine residue detected between 2024 and 2025. Separate wastewater analysis by the Home Office analysis showed an estimated £9.8bn cocaine consumption in England alone in the year to July 2025.

The UK Border Force seized almost 15 tonnes of cocaine worth more than £1bn in a single three-month period last year

Rates of coca cultivation and cocaine production are continuing to rise, with production in Colombia increasing by more than 50 per cent in 2023 alone. Prices, however, are ‘not falling as increased supply would suggest’, the document states. ‘The cocaine industry seems immune to normal market pressures.’

As the traditional markets of Western Europe and the US become saturated, traffickers are also looking to develop new markets ‘where prices are higher and risks are lower’ the report continues, with South Korea seeing 300 per cent increase in seizures last year and Australia registering a 40 per cent increase. ‘Complementary to this, we are seeing the growing involvement of European mafias in the cocaine business, not just to Europe but worldwide,’ Insight Crime states.

Traffickers are also evolving their transportation methods in response to improvements in port security and container scanning with ‘growing discoveries of semi-submersible vessels or narco-subs’, the report says. Gangs are increasingly mixing their cocaine with different chemicals or organic matter for transportation, or converting it into liquids to bypass the growing scanner capacity at ports. ‘By moving liquid cocaine to evade modern scanners and using alternative transportation like sailing vessels, criminal organizations are making the global cocaine trade more innovative and geographically diverse than ever.’

Meanwhile, the tobacco and vapes bill has now come into law, ‘delivering a historic step towards a smoke-free UK’. The bill passed its final stages in the House of Commons last week. The legislation ‘marks a turning point for the nation’s health’, said health secretary Wes Streeting. ‘By ending the cycle of tobacco addiction for future generations, we are taking one of the boldest steps in decades to prevent illness before it even begins.’

‘This is a truly watershed moment in public health. It is no longer a question of if smoking will end but rather a question of when,’ added ASH chief executive Hazel Cheeseman. ‘Smoking has prematurely taken millions of lives in the UK over the last 50 years. Ridding our society of the pain and suffering it causes is a gift to future generations.’

 InSight Crime 2025 cocaine seizure round-up available here

State of the Family Support Sector 2026

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Family Support
The purpose of this survey is to look at the current state of play of drug and alcohol family support.

Adfam has launched its State of the Family Support 2026 survey. Conducted every three years, this survey gathers vital insights into the current landscape of drug and alcohol family support, including service delivery, sustainability, funding, and partnerships.

The findings will help identify changes across the sector, highlight emerging trends, and explore the opportunities and challenges facing organisations, and what this means for families.

The survey is for anyone working at an organisation that supports families affected by substance use and takes 10-15 minutes to complete and can be done anonymously.

Open until Monday 1st June 2026.

Take part via this link: https://www.surveymonkey.com/r/99XMMTL

DDN magazine is a free publication self-funded through advertising.

ddn magazine partnersWe are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of Adfam

Suspected Scottish drug deaths up by more than 30 per cent

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There were 330 suspected drug deaths in Scotland between December 2025 and February this year, according to the latest Public Health Scotland (PHS) figures – 31 per cent up on the previous quarter, and 16 per cent higher than the corresponding period last year.

Scottish Ambulance Service naloxone administration incidents fell by 10 per cent compared to the previous quarter

Scottish Ambulance Service naloxone administration incidents, however, were 10 per cent down on the previous quarter, says the Rapid action drug alerts and response (RADAR) quarterly ​report. Drug-related attendances at emergency departments were also 6 per cent lower than the previous quarter, while drug-related hospital admissions overall were down by 21 per cent.

‘Drug-related harms remained at a high level in the most recent quarter,’ the document states. ‘While some harm indicators have decreased, they remain higher or similar to the same period in 2024 and there has been a marked increase in suspected drug deaths compared with both the previous quarter and the same period in the previous year.’ Contamination of the drug supply continues to be ‘common and widespread’, it continues, with nitazene-type opioids detected in post mortems at high levels. Earlier this year PHS warned that anyone using street drugs should assume they were contaminated with other substances.

Cocaine was the most commonly reported main drug in treatment assessments, while the benzodiazepine market ‘continued to shift’, with increasing reports of new substances and changing tablet types. The agency regularly received reports of fake medicines, the report adds, most commonly referring to benzos, gabapentin and pregabalin – these were ‘often seen in legitimate-looking packaging (including boxes and blister packs) but when tested contamination is common’.

‘The emergence and establishment of a highly toxic drug supply, in addition to widespread polysubstance use, has increased the risk of overdose and the likelihood of death, despite the estimated number of people with opioid dependence remaining stable,’ the document states. ‘A coordinated multi-agency approach that prevents drug harms and enables access to treatment, care and recovery support remains critical.’

Widening pathways of low-threshold access to care via proactive outreach alongside ‘enabling meaningful engagement in settings other than drug treatment services’ were necessary early interventions in a period of heightened risk, it says. ‘Scotland continues to be impacted by a period of rapid drug market change during which there remains a very high likelihood of sudden, localised spikes of severe harms.’

The Scottish Government published its new ten-year drug and alcohol plan last month.

Rapid action drug alerts and response (RADAR) quarterly ​report available here

Longer opening hours ‘significantly’ increase alcohol-related ambulance call outs

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Extended late-night opening hours for bars and pubs can significantly increase alcohol-related ambulance call outs as well as levels of reported crime, says a report from the University of Glasgow in partnership with the universities of Stirling and Sheffield.

There were also ‘no meaningful economic benefits’ from longer opening hours, it adds, meaning they were ‘unlikely to revitalise the night time economy’.

There were ‘no meaningful economic benefits’ from longer opening hours, says the report, meaning they were ‘unlikely to revitalise the night time economy’

The study, which is the first of its kind in the UK, looked at the impact of extended opening in bars and pubs across Glasgow and Aberdeen. Longer and more widespread licensing extensions in Aberdeen led to an 11 per cent increase in ambulance call outs along with an 8 per cent increase in reported crime, while in Glasgow – where far fewer venues had extended opening, and those that did had more regulated extensions – there was no comparable increase in either call outs or crime. Almost 40 Aberdeen venues were granted late-night extensions of up to three hours, while Glasgow saw just ten venues granted a one-hour extension. These were nightclubs that had ‘already implemented specific safety measures’ the researchers point out.

Scotland saw more than 31,000 alcohol-specific hospital admissions in 2022-23, with alcohol estimated to be involved in more than 15 per cent of all ambulance call outs. Last year a Public Health Scotland report projected that the number of Scots living with chronic liver disease would increase by more than 50 per cent by 2044 – an additional 23,100 people.

Meanwhile, a new report from the Health Foundation think tank states that average healthy life expectancy in the UK – defined as the number of years someone can expect to live in good health – fell by two years in the decade to 2022-24, to just over 60 for both men and women. The vast majority of areas saw a decline over the decade, with a 20-year gap opening up between the most and least deprived areas.

The vast majority of areas saw a decline over the decade, with a 20-year gap opening up between the most and least deprived

‘Of 21 high-income countries, the UK is one of only five that saw healthy life expectancy fall between 2011 and 2021, and had the second steepest decline,’ the document states. ‘As a result, the UK has fallen from 14th to 20th out of these countries – only the United States now has a lower healthy life expectancy.’ The economic and human costs were ‘huge’, said Alcohol Focus Scotland, with high levels of alcohol-related illness and death forming ‘part of the picture’.

The findings reinforced the ‘growing evidence’ about declining health in the UK, the report continues, with successive governments failing to take the long-term action needed to address it. Cross-government action was needed on the wider factors that shape people’s health, it adds, with a ‘shift to prevention and a new strategy to address economic and health inequalities.’

Impact of later trading hours for bars and clubs on alcohol-related ambulance call-outs and crimes in Scotland is published in the journal BMJ Public Health and available here

 Healthy life expectancy trends in the UK: a watershed moment available here

What We Learned About England’s State-Funded Residential Rehab

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A New Picture from FOI Analysis

By James Armstrong, Director of Marketing & Innovation

Over the last decade, England’s residential rehab sector has been quietly shrinking. Rehab placements have fallen by almost 50 per cent, and the number of available services has declined by a similar proportion. At the same time, service quality and regulatory expectations have never been higher. Yet despite this increased scrutiny, very little is known about the true size, shape, or functioning of England’s state-funded rehab system today.

James Armstrong, Director of Marketing & Innovation (left)
James Armstrong, director of marketing and innovation (left)

To help fill that gap, Phoenix Futures submitted Freedom of Information (FOI) requests to every local authority in England, asking for details of budgets and expenditure on residential rehab over the past three years. What we received back offers one of the clearest pictures in years of how rehab is funded in England, who controls the money, and what it means for the future.

Read the full report 

 

 

DDN magazine is a free publication self-funded through advertising.

ddn magazine partnersWe are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of Phoenix Futures

‘If someone asks for help, we help’: Cornwall service supports 4,100 a year

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Around 4,100 adults are supported each year by drug and alcohol charity WithYou in Cornwall, the charity reveals, reflecting both the scale of need and the importance of accessible, person-centred services.

Of those accessing support, 37 per cent are struggling with opiates, 33 per cent with alcohol, and 30 per cent with a range of other substances. The figures highlight the complexity of need across the county, with many people requiring tailored and flexible support.

At the heart of the service is a simple principle – that help should be easy to access.

‘There’s no referral criteria,’ says Will Whittaker, team leader for outreach. ‘If someone comes in or rings up and says ‘I want help’, we’ll help them. I’m really proud to work at a place that does that.’

That open access approach underpins a wide range of support, including one-to-one sessions with key workers, peer support groups, medication, needle exchange services, and the distribution of naloxone. The service also provides support for families and friends, recognising the wider impact of substance use.

Alongside clinical and harm reduction interventions, WithYou supports people with the practical aspects of rebuilding their lives – from accessing housing and managing debt to developing life skills such as cooking and budgeting. The service also offers pathways into employment and runs a residential rehabilitation programme.

‘We work in a person-centred way, we’re not looking at a one-size-fits-all,’ explains key worker Amy Chiswell.

That flexibility extends to more specialist provision for groups with particular needs. The Armed Forces Community programme supports around 600 veterans and their families, recognising the specific experiences of military life and using those strengths to support recovery.

The Women’s Team works with more than 100 of the most disadvantaged women in the area, providing holistic support that goes beyond substance use to address wider challenges, often in partnership with other services.

For staff, the impact of the work is clear.

‘I get something out of it as well, that’s the beautiful thing about it,’ says community engagement co-ordinator Billy Horton. ‘We build people’s confidence, their self-esteem, their self-worth. Seeing that happen, you feel it too.’

Amy agrees that the human element is central to the service. ‘If you’ve got empathy then you’re already showing someone something that they might never have encountered before,’ she says.

WithYou has recently launched a film featuring the voices of clients and staff, aiming to raise awareness of the service and the work taking place across Cornwall. The film captures the commitment of the team, as well as the experiences of people accessing support.

‘Everyone is here because they want to be, because they care and have a real passion for the work,’ says Amy. ‘You can feel that when you walk into the office.’

community engagement co-ordinator Connor Harmsworth
Community Engagement Co-ordinator Connor Harmsworth

For community engagement co-ordinator Connor Harmsworth, that sense of purpose is what sets the service apart.

‘You’ll never work anywhere else like WithYou,’ he says.

As demand continues to grow, services like WithYou remain a vital part of the local response – offering accessible, flexible support to people at different stages of their journey, and helping to ensure that when someone asks for help, there is someone there to listen.

DDN magazine is a free publication self-funded through advertising.

ddn magazine partnersWe are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of WithYou

Giving prison leavers OST on final day cuts drug death risk by more than 50 per cent

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Providing prison leavers with OST on their final day in custody was associated with a 50 per cent reduced risk of all-cause mortality and a 54 per cent reduced risk of a drug-related death in the four weeks following release, according to analysis by OHID and the Ministry of Justice (MoJ).

Overdose rates are notoriously high in the period immediately after release, largely the result of reduced tolerance.

People receiving OST on their final day in prison were ‘significantly less likely to die from drug-related causes’ within four weeks of release

The report looked at the outcomes for prison leavers in substance misuse treatment in England between 2018 and 2022, analysing more than 270,000 prison spells and linking data from the MoJ’s Prison National Offender Management Information System (p-NOMIS), the ONS mortality register and NDTMS statistics.

Almost 40 per cent of prison spells completed between August 2018 and December 2022 were matched to a prison-based substance misuse record, with spells of between eight and fourteen days more than twice as likely to matched to treatment record than spells of seven days or under. Prison spells for theft had the highest rate of treatment, at more than 60 per cent.

Drug use rates are particularly high for prisoners serving short sentences, with a 2025 MoJ report finding that three quarters of those serving a year or less had an identified substance misuse need. According to NDTMS figures, nearly half of prisoners receiving treatment said opiates were one of their problem substances, while Dame Carol Black’s Independent review of drugs stated that ‘people with serious drug addiction’ now occupy one in three prison places.

There were almost 2,900 deaths linked to prison spells in the analysis data set, 293 of which occurred within four weeks of leaving prison – of these, more than 60 per cent were drug-related deaths. ‘The first week after release had the highest risk of death, with 48.5 per cent of all deaths in the first four weeks after release occurring in the first seven days,’ says the report.

‘This study found that people receiving OST on their final day in prison were significantly less likely to die from drug-related causes within four weeks of release,’ the report concludes. ‘This finding supports previous research and emphasises the effectiveness of OST as a harm reduction strategy, and its potential to save lives during the critical period immediately after release from prison.’

According to the report, prison spells for theft had the highest rate of treatment, at more than 60 per cent.

According to a National Audit Office (NAO) report from earlier this year, the prison service had been too slow in responding to the ‘substantial, increasing and rapidly changing’ threat from drugs in the prison estate, including the increasing problem of synthetic drugs. Security weaknesses – such as around the use of drones to smuggle drugs into prisons – needed to be ‘addressed with more urgency’, it stressed, with the age and condition of many prisons making them particularly vulnerable to smuggling.

A report from HM Inspectorate of Prisons last year concluded that drugs were now undermining ‘every aspect’ of prison life, with rising levels of assaults and a negative impact on rehabilitative work. Former justice secretary David Gauke’s sentencing review, meanwhile, concluded that capacity pressures had brought the prison system ‘dangerously close to collapse’.

Prison leavers in substance misuse treatment: 4-week outcomes is available here

Tobacco and vapes bill to pass into law

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The tobacco and vapes bill has now passed its final stages in the House of Commons. It is expected to receive royal assent and become and become act of parliament next week.

Hazel Cheeseman: ‘A decisive turning point for public health’

The bill, which aims to create a ‘smokefree generation’, passed its final House of Lords stage last month and was then returned to the commons for consideration of amendments. As well as phasing out the legal sale of tobacco to anyone born after January 2009, the bill will also as tighten the regulations around vape flavours and packaging to make the products less appealing to children. First introduced by the previous government, it was then shelved following the announcement of a General Election. The current government reintroduced the bill in November 2024.

More than a million people in the UK quit smoking last year according to a recent report from UCL, while the latest ONS figures showed that the number of vapers has now overtaken the number of smokers for the first time.

The tobacco and vapes bill clearing its final parliamentary stage was a ‘decisive turning point for public health’, said ASH chief executive Hazel Cheeseman. ‘The end of smoking, and the devastating harm it causes, is no longer uncertain. Over the past 50 years smoking has claimed millions of lives across the UK, leaving a legacy of preventable pain and loss. Ending its harm is a lasting gift to generations ahead and families everywhere can now feel secure that their children can grow up free from the harm of tobacco.’

This year’s Global Forum on Nicotine, which aims to advance the dialogue on strategies for reducing tobacco-related harm, takes place in Warsaw on 3-5 June. Details and registration available here

Insider access

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Families can play a vital role in helping to break the cycle of substance use and reoffending, says Robert Stebbings.

For individuals that are struggling with drug or alcohol dependence and in contact with the criminal justice system, these interactions are often not a one-off. Without timely and effective support on release, the same pressures remain – and can lead to relapse, reoffending, and a return to custody. 

Behind so many of these individuals is a family coping with the consequences. Relatives can provide vital stability, but often at significant emotional and practical cost. Their experiences will vary when it comes to having a loved one in prison. For some, imprisonment brings anxiety about their loved one’s wellbeing – for others, it offers temporary relief, knowing their whereabouts and that they’re accounted for. That relief is often short-lived, as release can bring renewed uncertainty and strain.

Family-aware approach

Probation services are key to bridging custody and community, but their focus is typically on the individual. While this is understandable, it sometimes risks overlooking the constructive role families can play. Families are more than just bystanders in this process. They are often the first to notice signs of relapse, provide accommodation, support attendance at appointments, and offer encouragement. Yet they also experience financial strain, stress, and emotional overwhelm. 

A more family-aware approach within probation could help create channels for relatives to be meaningfully involved and make the transition from prison to community more sustainable for both individuals and their families. One family member told us about her experience engaging with probation services, pointing to how draining the process can be.  ‘I’ve always made loads of phone calls to probation, to find out who the probation officer was, whether I’m still his next of kin, to ask for his permission to let me know if he goes to prison again,’ she said. ‘I’ve found it incredibly emotionally stressful. I used to think “I’ve got to make a phone call” – and I’d have a couple of days being in a state about it before making the call. Then when I’ve done it, there’s all the fallout from that, just feeling emotionally exhausted and depressed. It takes a huge chunk out of you and your wellbeing.’

Why it matters

The importance of family connections in reducing reoffending has been highlighted before. The 2017 Farmer Review, commissioned by the Ministry of Justice, concluded that strong family ties need to be ‘a golden thread’ running through the prison system and the agencies around it. It showed that when people in prison can maintain constructive relationships with their families, they are more likely to settle back into the community and less likely to return to crime. This reinforces the case for involving families in probation – not as an afterthought, but as a key stakeholder in the resettlement journey. 

Increased government investment in probation is very welcome, particularly in expanding the workforce and its capacity to provide support. However, for individuals whose offending is driven by substance use, success often depends on what happens beyond formal supervision and compliance checks. It means connecting people to treatment, securing stable housing, and, where possible, rebuilding family relationships. Supporting families to set healthy boundaries when needed is also crucial, especially when the person’s behaviour puts them at risk. Understanding these dynamics could improve the effectiveness of probation interventions for both families and the individual.

Breaking the cycle

Reducing reoffending among individuals struggling with substance use is challenging, but there are opportunities to improve outcomes. This includes by strengthening links between probation, treatment providers, housing and family support services, by recognising and responding to the pressures faced by relatives and by giving them clear information and guidance.

Robert Stebbings is policy and communications lead at Adfam
Robert Stebbings is policy and communications lead at Adfam

Across the justice system, the aim is clear – safer communities and fewer people trapped in cycles of crime. Families can play a crucial role in helping to achieve this, yet support for families in their own right is often overlooked. When they are informed, supported and included, the chances of recovery increase.

While reoffending rates among people with drug or alcohol dependence remain stubbornly high, strengthening probation is a chance to change that. Not just by boosting workforce capacity and improving supervision, but by bringing families in from the very start and creating a more effective route to recovery. If we are serious about breaking the cycle of reoffending, families must be treated not as an afterthought, but as essential partners.

This article is based on the views and experiences of families Adfam has come into contact with as part of our work.

If you’re part of a family experiencing the stress and uncertainty of someone’s time in custody, here are a few trusted organisations you can turn to for guidance and support:

Adfam offers information and guidance for families affected by substance use. adfam.org.uk

Prisoners’ Families Helpline (England and Wales) offers free, confidential emotional and practical support to families affected by imprisonment. www.prisonersfamilies.org

Children Heard & Seen supports children and carers dealing with parental imprisonment through one-to-one work, peer groups, creative resources, and virtual sessions. childrenheardandseen.co.uk

Nacro is a social justice charity offering advice, housing support, substance misuse recovery, and resettlement services for ex-offenders and their families. www.nacro.org.uk

Half of Welsh care homes have supported residents with alcohol dependence

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Nearly half of care homes in Wales have supported residents with alcohol dependence, according to a report from Alcohol Change UK. However, fewer than one in five staff had received any alcohol-related training, and less than half of the facilities had a written alcohol policy.

External support ‘also appears limited’, the report says, with just over 63 per cent of respondents ‘rarely or never’ consulting external professionals about alcohol-related issues.

The findings are based on a snapshot study of participating facilities – ‘we cannot claim it represents the experiences of every care home in Wales,’ says the charity, ‘but it provides a window into the kinds of situations staff are navigating, and where more support may be needed.’

The study is based on an online questionnaire for care home professionals along with visits to seven facilities late last year, which included interviews and focus group sessions with managers, staff, residents and family members. External support ‘also appears limited’, the report says, with just over 63 per cent of respondents ‘rarely or never’ consulting external professionals about alcohol-related issues. ‘One detailed account described a crisis in which staff contacted 11 agencies over a weekend without securing support, leaving them feeling vulnerable and underprepared,’ it states.

All care homes should consider having specific alcohol policies, the report urges. While the charity’s research did not show that policies ‘automatically’ reduced harm, clear guidance could give staff confidence, increase transparency, and support consistent decision making, it states. Alcohol awareness training should also be improved, it says.

Another emerging challenge was the growing number of younger residents with alcohol-related brain damage, particularly Korsakoff’s syndrome. Managers anticipated that shifting generational drinking patterns would lead to ‘different expectations among future residents entering care’, says the report. ‘Staff recognised these shifts and expressed interest in training to prepare for a changing population.’

While residential care homes are regulated services with duties of care, they are also people’s homes, which means the issue of alcohol ‘raises tricky questions’, the charity acknowledges. ‘Moving into residential care does not mean losing your rights. Many residents still want to enjoy a drink. For some, it helps them feel normal and helps them to feel at home. How do we respect choice while keeping people safe?‘

A 2024 report from the University of Bedfordshire and the Care Quality Commission (CQC) concluded that there was an ‘urgent need to improve the quality of care in relation to alcohol, particularly for people with alcohol dependence’ – including inreach from community alcohol services. Policies varied widely across the sector, it said, ranging from blanket bans on alcohol to one facility that had an open bar.

While people’s drinking habits ‘do not disappear’ when they move into a care home, the ‘context changes significantly’, the Alcohol Concern report states. ‘Staff have responsibilities for residents’ health and safety. Other residents share communal spaces. Medication regimes may interact with alcohol. Cognitive changes may affect the capacity to make informed decisions.’ This meant that ‘care homes must find ways to respect residents’ choices, while fulfilling their duty of care.’

Understanding policy and practice on the use of alcohol in care homes for older people in Wales available here

Success of women’s health strategy will depend on its ability to help the most marginalised, says Change Grow Live

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The success of the government’s new women’s health strategy will depend on its ability to ‘deliver impact for the most marginalised and vulnerable women in society’, said Change Grow Live deputy chief executive Nic Adamson – women who are frequently missed by mainstream health services.

Nic Adamson: Substance use is ‘intertwined with trauma, poverty, inequality, caregiving responsibilities, domestic abuse and other health issues’

The strategy, which was published yesterday, aims to put women’s experiences ‘at the centre of care’ across the system and ensure their voices are listened to and acted upon, the Department of Health and Social Care (DHSC) states. This will include a new trial to explore how women’s feedback can be directly linked to provider funding, to make sure services are held accountable and ‘stamp out long-standing issues with women being ignored’.

The document also contains plans to help support women to reduce their alcohol consumption – including the introduction of the long-debated requirement for alcohol products  to display ‘consistent’ nutritional information and health warnings. The government will also publish outreach, single homeless and complex needs toolkits to improve support for women sleeping rough.

‘It’s encouraging to see continued government recognition that women have historically been under-served by systems largely designed around male bodies and male health experiences,’ said Adamson. ‘Last year, over 100,000 women accessed drug and alcohol treatment services. For each of them, substance use may be the reason for first engagement, but it is rarely the full picture. It is intertwined with trauma, poverty, inequality, caregiving responsibilities, domestic abuse, and other health issues.’

While these experiences were central to women’s health, too often mainstream services were ‘not designed to respond to this complexity’, she continued, with women falling through the gaps as a result. Change Grow Live had undertaken a comprehensive review of women’s experiences across its services, she said, with the aim of making support more accessible, inclusive and trauma-responsive.

The government’s new strategy would be complemented by the violence against women and girls strategy and sentencing reforms that could lead to a  specific women’s pathway for drug and alcohol treatment, she added. ‘These are positive steps, but they also highlight how fragmented policymaking in this space can be. The renewed women’s health strategy has a critical role to play in bringing this together, ensuring that women’s health is addressed through a genuinely joined-up, whole-system approach that reflects the realities of women’s lives.’

Renewed women’s health strategy for England available here

Mental health is biggest chemsex-related concern

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Mental health issues such as trauma, loneliness and isolation are the biggest chemsex-related concerns for LGBTQ+ people in London, according to a report from London Friend and LGBT HERO.

There are also significant barriers to accessing help, says Examining the drug, alcohol, and chemsex experiences of LGBTQ+ people and the healthcare staff supporting them, with 40 per cent of LGBTQ+ Londoners having never sought support and half unaware that chemsex-specific services even exist.

Mainstream services need to invest in training to ensure they are ‘LGBTQ+ competent’, the report says

The report paints a ‘stark picture of unmet need’, the organisations say, and challenges common assumptions about chemsex. Survey respondents ‘consistently’ linked their drug use to coping with poor mental health, with chemsex ‘often rooted not just in risk-taking behaviour, but in unmet emotional and psychological needs’. Shame and stigma, meanwhile, were identified as major barriers to support, with many respondents stating that mainstream drug and alcohol services ‘do not understand LGBTQ+ lives’, leaving them feeling excluded and unable to engage.

Staff in drug treatment and sexual health services are ‘increasingly encountering complex chemsex-related needs, but often lack the capacity and coordination required to respond effectively’ the report says, with the findings highlighting a need for more ‘coordinated, culturally competent responses’ that are mental-health focused, peer-led and ‘reflect the realities of LGBTQ+ lives’. Mental health support needs to be integrated into all chemsex interventions, it adds, while mainstream services should invest in training to ensure they are ‘LGBTQ+ competent’. Coordination between sexual health, mental health and substance services also needs to be strengthened, and awareness and visibility levels improved.

‘People we spoke to expressed a need to have access to a wide range of intervention types including harm reduction, out of hours support, and more holistic opportunities to address their substance use issues,’ the document states. ‘They were especially clear about their desire for support to be LGBTQ+ specific and for the delivery of this to be by their LGBTQ+ peers, including those with lived experience of substance use issues.’

The survey of healthcare professionals found ‘a significant number’ of drug treatment staff reporting that they’d like additional training on chemsex substances. More than 40 per cent said they wanted more training on methamphetamine and GHB/GBL, while almost 50 per cent wanted more mephedrone training.

Monty Moncrieff: ‘It’s clear that chemsex is often related to a range of complex issues, and that services need to do more to meet these holistically’

‘It’s clear that chemsex is often related to a range of complex issues, and that services need to do more to meet these holistically, especially through improved mental health support,’ said London Friend chief executive Monty Moncrieff. ‘Queer people are really clear in telling us they want to have better access to services run by and for their LGBTQ+ peers so there’s a real need to rethink how and where support is provided.’

Examining the drug, alcohol and chemsex experiences of LGBTQ+ people and the healthcare staff supporting them available here

Beyond the stereotypes

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Surviving Earth is a new film that rejects stereotypes and easy explanations to shine a light on the complexities of substance use and family, says Sophie Wilsdon.

This week, I sat in a steering group with BDP Creative Communities members, staff and volunteers, thinking about how best to celebrate BDP’s 40th birthday in a concert later this year.

The group felt strongly that although there’s so much to celebrate, it’s also vital we take time to recognise what and who has been lost in those many years – and what the reality of drug use can be for individuals and their families.

It’s this reality – the messy plurality of drug use – that is captured in Surviving Earth, the debut feature film by writer/director Thea Gajić. Themes of relationships, parenting, drug use, relapse, resilience after trauma and survival through music are delicately and accurately played out through Thea’s own lived experience. 

Surviving Earth is based on the true story of her father, Vladimir Gajić, and centres on his life after arriving in the UK in the 1990s, having fled the conflict in the former Yugoslavia. Set in Bristol in 2015, the story focuses on Vlad’s life post-rehab, his relationship with his daughter, and his role as a drugs worker while also pursuing success with his Balkan band, Fuzia.

The film has a particular resonance to BDP in that its lead characters, Vlad, Duncan and Misko, were group workers here for many years and formed Fuzia with other colleagues including myself. Misko sadly passed away before the film went into production, bringing an additional poignancy.

Personal and professional 

The film touches so many intersections of drugs work and recovery that cross between the personal and professional, and it will have a particular resonance for anyone whose life has been touched by addiction in some way. Our field is full of people with lived experience, which brings invaluable insight, knowledge and understanding. But it can also make it hard for people to ask for help when struggling with their own triggers while maintaining a job in the drugs field, on top of other responsibilities. 

Thea wanted to touch on this directly in the film. ‘I’m very keen to break the negative stereotypes around addiction and see how highly functioning people can be even when they need help to get clean,’ she says. ‘If we break those taboos, more people would feel safe to speak about it, and ultimately more lives would be saved.’

The film’s story is told from the daughter’s perspective, and tenderly explores the ways children navigate living alongside parental substance use. ‘One of the most challenging things was deciding whose point of view to tell the story from,’ she says. ‘It’s written from my point of view, but I had to figure out whose is the most interesting perspective to tell it from because if it was the daughter’s, it would’ve missed a lot of Vlad’s story.’ 

The reality of drug use is rarely portrayed well on the big screen, it being much easier to resort to stereotypes and black and white thinking. Slavko Sobin’s portrayal of Vlad is a welcome respite from this – he manages to capture the charm of someone who inspires love and loyalty despite repeatedly inflicting damage on those closest to him. 

‘It’s a full-bodied role with this amazing range of things that you need to show and live through,’ he says. ‘And it’s an important story because it talks about healing and friendship and humanity. I play a recovering drug addict at a point in his life where it’s really hard to remain strong and not go back to using. So it’s a challenge on its own to have to play that duality, someone who wants to be strong but isn’t.’

surviving earth trailer
Watch the trailer online

Passion and drive

What Slavko, and the film, also brilliantly portray is the passion and drive that music and creativity can inspire in someone in the shadow of trauma. Vlad lives out his dreams of playing music from his homeland with his friends, pushing them to take bigger financial and personal risks to achieve it. Music brought and bound the friends together, tumbling through gigs and parties and fall-outs and reunions. 

One of Thea’s key collabora­tors was composer and musical director Hugo Brijs, who brought the sound of Fuzia to life. The soundtrack is inspired by original Fuzia songs and some of us from the original band worked on the soundtrack and as musical consultants.

Shared experience

Alex, a musician with years of gigging experience, says that ‘for someone like me with a lived experience of drug abuse, mental illness and trauma, working with an orchestra whose members share similar lived experiences gives us a great camaraderie in our process of growth and understanding of music and recovery.’

For others, it’s a new experience that gently nudges people out of their comfort zone to create an incredible shared experience – something that’s also passed onto our audiences. 

Risk of relapse 

As in real life, the film music also created situations where risk of relapse was present – working in a night-time economy and a culture infused with alcohol and drugs. Many musicians come into recovery unsure if they can, or even want to, carry on playing music. 

It’s in this context that we created Bristol Recovery Orchestra in 2019, as part of BDP Creative Communities. Creative Communities began in 2014, in the group work team where Vlad, Misko and Duncan spent many an afternoon jamming with clients in post-group sessions. 

While Rising Voices Choir is our longest standing group, and the only one Vlad was witness to, it’s the orchestra that particularly resonates with Surviving Earth. Although we’re partnered with Bournemouth Symphony Orchestra, we’re an orchestra in the loosest sense of the word. We welcome musicians of any background and instrument, and the only criteria is to play your instrument well enough to be able to follow a structure – and to have lived experience.

There are many reasons it exists, and people get many different things from it – confidence, fun, recovery support, new skills, and performance opportunities. Added to this, it’s a space where people can experience the healing power of music away from the triggering settings where it’s often created and performed. Some of our members have come into music after becoming drug free, while others are seeking a space where they can come back to their instruments and perform in a structured and drug-free environment.

Surviving Earth is well worth an hour and a half of your time – go see it, support independent film, and help shine a light on the complexities that lie behind every drug-related death. And when we get together on stage later on in the year to celebrate 40 years of BDP, we’ll also play music that reflects those who aren’t with us any more – but whose creativity lives on through us.

Surviving Earth is released in UK cinemas on 24 April
@survivingearthfilm @bdpcreativecommunities
@bristoldrugsproject @metisfilmsuk

Sophie Wilsdon is creative communities team leader at BDP
Sophie Wilsdon is creative communities team leader at BDP

Wastewater analysis shows estimated £9.8bn cocaine consumption in England alone

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Analysis of wastewater samples by the Home Office shows that an estimated 123,000kg of cocaine was consumed in England in the year to July 2025, equating to a £9.8bn market value. Ketamine consumption, meanwhile, was estimated at more than 30,000kg, with a market value of just under £1bn.

The Home Office’s Wastewater Analysis for Narcotics Detection (WAND) programme has been taking samples from wastewater treatment plants since 2021, and now covers just under a third of England’s residential population. The analysis shows that cocaine has by far the largest estimated consumption levels and market value of the six drug types measured – cocaine, ketamine, heroin, amphetamine, MDMA and methamphetamine. The programme does not currently test for cannabis because of the ‘complexities of the sampling method’, the Home Office states.

The analysis shows that cocaine has by far the largest estimated consumption levels and market value of the six drug types measured

Heroin consumption was estimated at almost 7,000kg with a £0.3bn market value; amphetamine at nearly 47,000kg, with a £0.5bn market value, and MDMA at just under 10,000kg, equating to a £0.3bn market value. Unsurprisingly most drugs show higher concentrations in urban areas – with London, Manchester, Liverpool and Brighton ‘notable hotspots’ – while drugs such as MDMA and cocaine showed high levels of weekend usage and low weekday usage. Ketamine, amphetamine and methamphetamine, however, showed consistent consumption throughout the week, ‘indicating more regular and potentially problematic use’.

The WAND programme provides ‘robust and timely estimates of drug consumption’ via an internationally used method, the Home Office states. Previous estimates of drug use had been reliant on Crime Survey England and Wales statistics, which are likely to be less accurate as they are based on self-reporting methods – ‘where respondents may not feel comfortable reporting their illicit drug use’.

Consumption estimates for MDMA and ketamine in England have shown increases of 232 per cent for MDMA and 229 per cent for ketamine since 2021, as well as more than 60 per cent for methamphetamine and 26 per cent for cocaine. Estimates for heroin showed a 40 per cent drop, however, alongside a 27 per cent drop for amphetamine. The most recent EU-wide waste water analysis figures from SCORE and EUDA also showed a surge in cocaine and ketamine detections compared to the previous year.

Wastewater Analysis: Estimating drug consumption available here

Launch of new service to help recovery in North Northamptonshire

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James Parker, Forward Trust’s Head of community services substance misuse, describes their involvement in new community drug and alcohol services in North Northamptonshire.

northamptonshireI am delighted to confirm that Forward has been commissioned by North Northamptonshire Council to deliver a community rehab programme and build a brand new Lived Experience Recovery Organisation [LERO] in the area.

We will be delivering drug and alcohol support services for adults in partnership with Change Grow Live, Family Support Link and Release.

We will be bringing our successful day rehab programme to North Northampton as part of the new treatment system, meaning more individuals will have access to the transformational change that intensive treatment programmes can bring.

James Parker, Forward Trust Head of Community Services Substance Misuse
James Parker, Forward Trust Head of Community Services Substance Misuse

The new LERO will be built by people in recovery, for people in recovery. It’ll be a space to connect, grow, and support one another in recovery from addiction — creating a real sense of belonging in the community.

Today is a landmark for Forward in that this is the first time that we will be delivering services in the North Northamptonshire area and the LERO will be the second one that we have helped to create in the UK.

Find out more

DDN magazine is a free publication self-funded through advertising.

ddn magazine partnersWe are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of The Forward Trust

Early start

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Ketamine use is rising exponentially among young adults. That means early awareness and support are vital, says Dr Martyn Hull.

Ketamine, once a niche anaesthetic used primarily in medical and veterinary settings, has rapidly evolved into a widely used recreational drug – particularly among young adults. New research commissioned by Turning Point reveals just how embedded ketamine has become in youth culture, and why improving awareness, early identification, and access to specialist support is now a public health priority.

A recent YouGov survey of more than 1,000 people aged 18–30 found that one in three young adults believe ketamine use is common among their peers. This perception was even more pronounced among women, with 37 per cent reporting its widespread use compared to 28 per cent of men. While perceptions alone are worrying, reported behaviours are equally concerning – 7 per cent of respondents said they’d used ketamine in the past but had since stopped, 3 per cent currently use it, and 1 per cent use it daily. Extrapolated across the UK population, this suggests that more than 100,000 young people may be using ketamine every single day.

These figures align with national trends. Data from the Crime Survey for England and Wales shows that ketamine use has more than doubled over the past decade, rising from 117,000 users in 2013 to nearly 300,000 in 2023.

Among 16 to 24-year-olds, the increase has been even more stark – from 52,000 to 222,000 during the same period. At Turning Point, every one of our substance use services across the country has seen a corresponding rise in the number of people seeking help for ketamine-related problems. In areas such as Bristol, Lincolnshire, Suffolk and Wakefield, referrals have grown more than sevenfold since 2020.

Despite this escalating pattern of use, the harms associated with ketamine remain poorly understood. Our survey found that while 65 per cent of respondents recognised ketamine as dangerous, this awareness was lowest among 25 to 30-year-olds. Worryingly, only half of young adults in London – where ketamine is particularly prevalent – believed it posed risks to physical and mental health.

When we talk to people about their reasons for using ketamine, a familiar set of themes emerges. Many report taking it to enhance social experiences such as parties and festivals (52 per cent), out of curiosity (50 per cent), or simply because their friends are using it (49 per cent). A significant proportion – 35 per cent overall and nearly 40 per cent of 18 to 24-year-olds – believe people also turn to ketamine to cope with stress or mental health difficulties. This combination of social normalisation and emotional coping creates a dangerous environment in which troubled young adults may escalate their use quickly and without recognising the risks.

And those risks are serious. Symptoms such as abdominal pain, urinary retention and incontinence are now common presentations in our services. For some individuals, the urinary tract damage is so substantial that surgery becomes unavoidable.

Emily’s experience is a powerful reminder of how quickly ketamine can take over a person’s life. She began using ketamine in her teens after becoming part of the rave scene, where the drug was widespread. Although she initially used other substances, ketamine soon became her primary drug due to its low cost and intense effects. Within a year, she developed crippling bladder issues and severe abdominal cramps. At one point, she was told she might need her bladder removed. Ultimately, Emily underwent a bladder augmentation procedure which improved her symptoms, but some of the damage is permanent. Today, she is three years abstinent and works as a peer support worker at Turning Point – helping others find a way out of the same cycle.

Stories like Emily’s highlight the urgent need for better awareness, earlier intervention, and more consistent identifi­cation of ketamine-related harms by healthcare professionals.

Turning Point is responding to this need through our new national ketamine awareness campaign, which aims to improve public understanding, strengthen referral pathways, and support systemic change. As part of the campaign, more than 1,000 healthcare professionals are expected to attend our webinar on ketamine use and harm reduction, created in response to evidence that GPs and pharmacists are not always recognising ketamine-related symptoms at an early stage.

Dr Martyn Hull is clinical director at Turning Point
Dr Martyn Hull is clinical director at Turning Point

Across the country, we’ve developed specialist ketamine treatment pathways led by multidisciplinary teams of clinicians, therapists, recovery workers and peer mentors. These services ensure that people receive tailored, evidence-based support – whether they are simply seeking advice, wanting to cut down, or hoping to stop using ketamine entirely.

My message to anyone concerned about their own use – or the use of someone they know – is simple: don’t wait. Seek support early. The sooner ketamine dependency is recognised and addressed, the greater the chance of preventing long-term and possibly irreversible harm.

You can download Turning Point’s ‘Know.Your.K’ – Communications toolkit here

Veteran who survived domestic abuse and drugs walks 15 miles for charities

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Arron Henery is walking 15 miles from Staithes to WithYou in Redcar and Cleveland to mark one year of sobriety, raise money, and challenge stigma around mental health, substance use, and domestic abuse – particularly for men, who are too often overlooked or disbelieved.

The 34 year old Royal Navy veteran and former prison officer is now an ambassador for the THRIVE recovery partnership, which combines drug and alcohol charity WithYou, domestic abuse charity Harbour – one of only two male refuges in the UK, and education and behavioural change provider, Intuitive Thinking Skills.

Arron served for eight years in the Royal Navy as a weapons engineer working on submarines, where resilience and emotional suppression were part of the culture.

The transition into civilian life brought uncertainty, anxiety, and unresolved mental health struggles. Arron joined the prison service but the initial sense of belonging disappeared and he began using cocaine heavily.

When his mum was diagnosed with cancer in 2022, he says he used cocaine to cope with the stress, ‘My drug use spiralled. The whole world felt fuzzy. My mum had always been my rock. I even lied to my sister about not seeing my mum in the hospice because I wanted to get some cocaine. I’m not proud of any of this — it was an everyday life, it was with me everywhere.

‘I was still able to find excuses to continue using, that it wasn’t my fault, that I was normal. I upped my use, and myself and my partner were spending £100-£200 per day. I felt that I had lost everything, family, friends. I didn’t understand how or what was going on.’

Arron felt that his relationship with his partner was unhealthy after noticing subtle behaviours which left him scared, anxious and in an unsafe environment with his son.

He explains, ‘Around Christmas time in 2024 thanks to family and friends I finally started to see that my marriage wasn’t quite right, I didn’t know who I was anymore when I looked in the mirror. I didn’t see me, I didn’t see the proud respectful man that joined the armed forces all those years ago. And it was also confirmed by a family member who  intervened and asked me if I was being abused. The question threw me, and my response was to say, ‘Don’t be stupid, I’m a bloke — I can’t be abused.’ I was blind to it.’

With support from family and friends, Arron sought support from the THRIVE partnership in Redcar and Cleveland.

THRIVE is England’s first Integrated Domestic Abuse and Substance Use partnership, bringing together three specialist charities to address complex, overlapping needs in Redcar & Cleveland – WithYou, lead partner, Harbour, domestic abuse charity offering advice, advocacy and safe accommodation for survivors and perpetrators, and Intuitive Thinking Skills, peer-led education and behavioural change provider.

Find out more about Arron’s journey and support his walk here.

DDN magazine is a free publication self-funded through advertising.

ddn magazine partnersWe are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of WithYou

Consumption rooms should be rolled out across the country, says SDF

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A network of mobile and fixed-site consumption rooms should be established nationwide, SDF chief executive officer Kirsten Horsburgh told Abbeycare’s Listen Up podcast.

The facilities should be rolled out in any area where the alternative for people was injecting ‘somewhere extremely unsafe’, she said. Edinburgh council recently launched a consultation process to hear the views of local residents on a proposed consumption room, which would be the UK’s second following the opening of Glasgow’s The Thistle last year.

The Thistle’s value was that it was ‘completely non-judgemental’, Horsburgh said. ‘People don’t necessarily for the first time go in and inject drugs – people have been going in to use the showers, or to use the clothing facility, or to just have a chat with staff to suss out what the staff are like and how they’ll be treated. To have that space is invaluable.’

SDF strategy co-ordinator for drug death prevention, Kirsten Horsburgh
Kirsten Horsburgh: ‘the evidence will speak for itself’

Acknowledging the controversy around the issue and the concerns of local communities, she said she believed that ‘the evidence will speak for itself as the service begins to embed itself more thoroughly – this has been the case internationally, that originally you get a lot of public discontent’.

‘To reduce drug-related deaths, we must continue to focus on harm reduction and also on services that are actively helping people overcome and recover from addiction,’ said Listen Up host and Abbeycare outreach manager Eddie Clarke. ‘At Abbeycare, we fully endorse the necessity of harm reduction interventions as a vital component of care, and use these tools within our own programmes when needed. However, we maintain that abstinence-based recovery is the most robust and safest form of harm reduction available. By providing a clear pathway away from substance use altogether, we empower individuals to eliminate the risks of toxicity and overdose, ultimately fostering the most secure environment for lasting health and personal transformation.’

Listen Up podcast available here

See May’s DDN for a feature on the lessons from consumption room initiatives across Europe

Where do we go from here?

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Ketamine was derived from phencyclidine to be used for surgical anaesthesia. The first instances of the illicit use of ketamine were reported in the 1960s, with its popularity surging in the 1990s. Crime Survey for England and Wales data has shown a rapid growth in reported use of ketamine.

Mat Southwell, Coact M.D.
Mat Southwell, Coact M.D.

Use in young people has increased by more than 200 per cent since 2013, and by 2010 26 per cent of surveyed people who used ketamine already reported urinary symptoms such as irritation and bleeding. Case reports from urology services also paint a worrying picture. 

The UK government’s focus on reclassification in 2006 and 2014 without a clear commitment to public health measures has coincided with a massive increase in ketamine use in those aged 16-24. Thankfully the ACMD has recommended that the government does not reclassify ketamine as a class A drug, and we await the government’s response. 

Generation K

Beccy Rawnsley, Coact operations manager
Beccy Rawnsley, Coact Operations Manager

Coact has worked with the peer pioneers from ‘Generation K’ and other experts to gather learning on ketamine, and with HIT have developed a strategic training response to ketamine dependence and bladder syndromes. There has been a remarkable range of peer responses from Generation K around the UK – Coact has now gathered these peer pioneers into a ketamine peer advisory group (K-PAG), which will be a reference point for the development and delivery of this training model. K-PAG will also support advocacy for an enhanced policy and practice response to ketamine. 

‘I have worked with the amazing peer pioneers from Generation K to gather peer stories and photos that help explain the realities of the ketamine crisis to drugs and health workers,’ says Amy Massey. ‘I’m proud to carry this community learning into the ketamine course.’ 

Amy Massey is a ketamine peer trainer.
Amy Massey is a ketamine peer trainer

A generation of young people using ketamine has been more heavily criminalised, not provided with known harm reduction advice, and left to approach drug and health services where they must often teach practitioners about their health conditions to receive help. 

People with ketamine bladder syndrome are left with a life-limiting condition that can leave them locked at home close to the toilet and/or requiring surgery. The inability to manage severe chronic pain is a key barrier to securing and sustaining positive change, while peers who have achieved abstinence feel abandoned by the system and left with such limited and pain-filled lives that some commit suicide.

    SO WHAT’S GOING WRONG?

Ketamine's reputation began as a horse tranquiliser. Peer pioneers have steered a campaign - and imagery - to give technical knowledge alongside essential harm reduction advice
Ketamine’s reputation began as a horse tranquiliser. Peer pioneers have steered a campaign – and imagery – to give technical knowledge alongside essential harm reduction advice
  • The very low cost of a complex drug with significant risks linked to regular use.
  • Lack of technical understanding of ketamine and its risks among Generation K.
  • The switch from liquid to crystal ketamine, and the introduction of the practice of dissolving ketamine crystal in water and heating it to dry it into a powder.
  • The lack of transfer of knowledge between generations of people who use ketamine about the importance of episodic using and hydration.
  • Applying more general stimulant harm reduction or recovery models to ketamine – an atypical drug requiring highly tailored harm reduction and treatment responses.
  • Lack of integration between general practice, urology services, pain clinics and drug services.
  • Once ‘ketamine bladder’ and dependence syndromes have become established, peers report a rapid return of symptoms and fast-rising tolerance even after several years of abstinence.
  • A lack of aftercare for people who achieve abstinence but still live with chronic pain leaves them unsupported and hopeless.
  • Ketamine is also increasingly cut with other substances, which can include much stronger ketamine-like synthetics.
  • Increased criminalisation and lack of legal regulation of ketamine.

Knowledge sharing 

Coact has developed a one-day course that brings together different stakeholders from places with significant patterns of ketamine use. The course supports practitioners, local leaders and decision-makers to gather technical knowledge, hear testimonies from Generation K, and explore these issues through evolving case studies.

Participants will learn specialist harm reduc­tion advice, strengthen practice skills and learn strategies that support positive change with ketamine. The event will conclude with partners discussing how to strengthen their local system and response. 

Ketamine is causing devastating harms, and requires specialist harm reduction and drug treatment responses. Coact has developed a course model that allows stakeholders from the same system to learn and plan together and agree on how to develop partnerships, protocols and care pathways that address the problem.

    WHAT DO WE KNOW?

  • Ketamine was historically a relatively safe drug, that was usually high purity and had a low overdose risk.
  • The previous generation of people who used ketamine naturally used episodically and hydrated well, given their connections to MDMA culture.
  • Ketamine is a complex drug that behaves differently at different doses, and different people require different doses to achieve the same desired effect.
  • There are setting risks associated with taking ketamine in baths or showers, while driving, and there are risks of falling with high doses.
  • ‘K-holing’ – a desired state for some, and an accidental state of losing control for others – can leave people vulnerable to robbery, sexual assault or rape in the wrong setting or company.
  • Hydration is key while using ketamine, and for several days afterwards. This helps the ketamine residue be carried safely past the bladder and connected systems without irritating or sticking to the bladder lining – which causes ketamine-induced cystitis and longer-term bladder hardening and shrinkage.
  • Ketamine tolerance rises fast within a using session. Using ketamine regularly and without breaks leads to escalating tolerance, which does not drop back without respecting the need to take tolerance breaks after sessions. People who use ketamine take a break to let tolerance drop back to base, which is part of the protective rhythm of optimum ketamine use.
  • People who use ketamine heavily also experience ‘drip back’ which is the acid-based residue inside the nose falling into the stomach upsetting the balance of the stomach and being another source of pain.
  • Some people with ketamine bladder and dependence syndrome have learnt how to manage their acid balance in their stomachs and to cope with bladder and stomach pain through a mix of cessation and a tailored diet.
  • Psychological retraining can be required to overcome the urge to go to the toilet, which may continue beyond the resolution of the physical urological condition.
  • Ketamine disconnects the conscious brain, throwing you back onto your unconscious mind which is dominated by repeating established patterns and habits. Disconnecting your conscious mind as a temporary break from reality can support exploration of consciousness and spirit – doing it on a sustained basis turns off the part of the brain that is responsible for critical thinking, which hampers discussions around positive change.

Mat Southwell is managing and technical director at Coact. Beccy Rawnsley is operations manager. Amy Massey is ketamine peer trainer.

Coact and HIT offer a one-day learning and development event bringing together 30-50 practitioners, local leaders, and decision-makers. Find out more here.

Edinburgh consults local residents on consumption room plans

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The City of Edinburgh Council has launched a consultation to let local residents share their views on a proposed drug consumption room for the city. The facility would be the first to launch in the UK since Glasgow’s The Thistle opened in January last year.  

The 13-week consultation process will allow people who live or work in the city’s Old Town area to have their say on the plans, via an online hub or city-centre drop-in sessions. People with lived experience and families affected by drug use will also be consulted, the Edinburgh Health and Social Care Partnership states. The outcome of the consultation will then help determine whether to develop a formal business case to be presented to the Scottish Government.

The facility would be the first to launch in the UK since The Thistle opened in January 2025

Around 10 per cent of Edinburgh’s drug-related deaths are the result public injection incidents in the Old Town, according to a report from the Edinburgh Integration Joint Board (EIJB) last year. Two potential city centre sites for the facility were identified last summer, in Cowgate and Spittal Street.

‘There has long been calls for a safer drug consumption facility in Edinburgh,’ said Edinburgh Health and Social Care Partnership chief officer Christine Laverty. ‘Research suggests that this type of facility would reduce drug-related harm and, crucially, reduce the number of fatal overdoses. This will allow the public to give their views on a safer drug consumption room, and we are keen to hear from a wide range of people which will help us to shape any business case for a safer drug consumption facility in Edinburgh.’

Consultation available here until 1 July

Poor relations

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When someone in England presents to drug treatment, that individual is categorised based on what drug(s) they are experiencing difficulties with, in one of four categories: opiates, non-opiates, non-opiate and alcohol, or alcohol-only. Where poly-drug use is present – for instance, if a person uses both crack and heroin – they would be labelled as an opiate user by this system.

‘Non-opiate’ users are defined as ‘people who have problems with non-opiate drugs only, such as cannabis, crack and ecstasy’. Of course, these drugs are all very different and may require different specialist interventions to help an individual meet their goals. Nonetheless, in many services we’ve found that people classed as ‘non-opiate’ users are more likely to be sidelined from receiving ‘structured treatment’. 

This is defined as a ‘package of concurrent or sequential specialist drug- and alcohol-focused interventions… [which] requires a comprehensive assessment of need, and is delivered according to a recovery care plan, which is regularly reviewed with the client’. Structured treatment is meant to be one or more psychosocial interventions and one or more pharmacological ones, not one or the other – and all groups should be receiving a health assessment at the start of treat­ment regard­less of if there’s expectation of prescribing in the service.

Previously in this series, we’ve highlighted that some drug users do not receive an offer of structured treatment despite a clear need, as in the case of those with benzodiazepine dependences. Today we have another non-opiate group who we’d like to draw attention to – ketamine users.

In recent months, the Release helpline has received a noticeable increase in the number of calls from people using ketamine who are asking for advocacy, often seeking to access residential rehabilitation.

Residential rehabilitation support is a tricky topic for our advocacy – these programmes are very diverse and the evidence supporting them in different cases is quite mixed. In a 2020 study by Wakeman et al, outcomes for more than 40,000 people with opioid use disorder were compared based on form of treatment received against a baseline of no treatment at all. Treatment with ‘buprenorphine or methadone was associated with a 32 per cent relative rate of reduction in serious opioid-related acute care use at three months and a 26 per cent relative rate of reduction at 12 months compared with no treatment’. Meanwhile, individuals who went the detoxification and residential rehab route, and those who received psychosocial treatment only, did not experience either ‘reduced overdose or serious opioid-related acute care use at three or 12 months’. 

We do not oppose access to residential rehabilitation nor refuse advocacy support to those who seek it, although we are realistic with people that the guidelines do not offer clear support for this form of treatment. Rather, we take seriously the fact that if the people contacting us – who are very often more knowledgeable than us on these matters – are unified in this desire, then likely something is seriously amiss in their community services.

Castel’s case is one example. Castel has been using ketamine daily for around two years and had been with her local service for a year when she contacted Release. She reported being told by multiple workers in her service that, due to funding restrictions, it was ‘almost impossible’ to access rehabilitation for ketamine use. Castel also said that she’s had to be the one to initiate all her key-working sessions, and when she asked about harm reduction was told that ‘there isn’t really much harm reduction for ketamine’. She also had to educate her keyworker on the risk of bladder damage from regular ketamine use. 

Her situation is unfortunately not unique – ketamine users are telling us they don’t feel welcome in drug treatment, nor do they feel any benefit from being there. At the same time, keyworkers at treatment services are often faced with unmanageable caseloads, and little to no time for specialist training. Less experienced or less specialist workers may feel just as lost at sea as the service user when tackling ketamine use in treatment, especially if they’re accustomed to working with people who are also receiving pharmacological treatments, which helps give a structure to the overall treatment plan. 

Still, in the ‘Orange Book’ it states that keyworkers need to be able to support ketamine using patients and even identifies ‘ketamine-related urological damage’ at the top of the list of ‘recent areas of developing knowledge’. It has now been nearly a decade since this guidance was published, and given that the number of people entering treatment for ketamine use is now over 12 times higher than it was in 2014-15 we cannot continue to make excuses for the sector when it comes to supporting people struggling with ketamine use.

Through the Release helpline, we’ve heard similar accounts from people using many different ‘non-opiate’ drugs. Of those callers, many are not accessing treatment because they feel there’s nothing available for them. When they do seek help in reducing their use, support is almost always limited to attending recovery groups – rarely does one get an offer of ‘structured treatment’, an option which is seen as reserved for those in the opiate category. 

There are, however, many recognised pharmacological interventions for non-opioid users in drug treatment, re­flected in the NDTMS adult drug and alcohol treatment definitions – these include different manners of benzodiazepine prescribing (as benzodiazepine dependence maintenance treatment, for stimulant withdrawal and for G withdrawal), carbamazepine for acute alcohol withdrawal, dexamphetamine for stimulant withdrawal, and a general ‘other’ category for otherwise unlisted uses of medication as treatment of drug misuse/dependence/withdrawal and associated symptoms.   

Ketamine, when used often and for long periods, has been seen to cause users to experience withdrawal, so why not consider what forms of clinical support might make ketamine cessation more comfortable and achievable for those asking for treatment? It seems ironic that ketamine might sooner be a recognised pharmacological intervention for people in treatment for other drugs than the reverse, when most of the drugs that ketamine has been trialled as a treatment for already have existing pharmacological interventions established.   

Of course, there will be no miracle medication that will universally resolve the problems of ketamine users in treatment, as different individuals require different interventions tailored to meet their needs. We also know that ultra-bespoke specialist treatment won’t be available to everyone, because of financial and workforce constraints.

We’re not demanding either a perfect pharmacological or psychotherapeutic response to problematic ketamine use – we’re simply demanding that ketamine users and other non-opiate users have the same opportunity to access a treatment plan at all. None of us should be satisfied with a one-size-fits-all approach that flattens so many different drugs into the ‘non-opiate’ category, and gives so few tools to people who are junior in the sector. As such, we echo recommendation 12 from the ACMD’s latest ketamine review, that:

‘Integrated harm reduction approaches should be developed and delivered, combining education, professional training, access to drug checking and safer use practices. Delivery should be through a range of community-based services and incorporate outreach activities to reach the diverse groups who use ketamine.’

We also demand that resources be committed to improved research and innovation in treatment modalities for different drug users, and that those in treatment be proactively provided with information on what recourse is available to them if their treatment needs aren’t met. This is crucial for people coming into treatment without many peers in that environment, who will be less likely to know what ought to be on offer or where to turn if falling through cracks in the service. 

This is the case for ketamine users up and down the country today. But if the sector can get treatment working right for this group, then those users will become tomorrow’s ambassadors – and harm reduction conduits for huge numbers of ketamine users who are not in touch with services.

Riley Johnson is a research assistant and Shayla Schlossenberg is head of drugs service at Release.

Choices Rehabs meet at the House of Lords

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DDN
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Choices Rehabs is a group of independent residential rehab providers working in partnership to share best practice, offer a treatment loop and be a voice for the residential rehab sector.

They meet every ten weeks and one of the strengths of the network is the ability to adapt quickly.

The recent surge in ketamine use is a stark example: many of the members are now supporting a much younger cohort of people who have found themselves addicted far faster than expected, often with devastating consequences such as bladder damage and, in the most extreme cases, permanent loss of bladder control. These are life‑altering harms, and underline why residential treatment must remain accessible, flexible and properly supported.

Because of the growing challenges, raising the profile of the sector’s work has become more important than ever, so when Lord Brooke of Alverthorpe offered to host one of the network’s face‑to‑face Choices meetings at the House of Lords in March, it was welcomed. Being present in the same room to share practice and tackle emerging issues provides a value that cannot be replicated remotely.

Lord Brooke has long been a dedicated advocate for residential rehab, and his presence brought both warmth and insight to the discussion. He spoke candidly about his lived experience and the need for equal access to treatment, challenging the sector to think differently about pathways into rehab and how earlier intervention might prevent irreversible harm.

The meeting reaffirmed that collaboration remains the sector’s most powerful tool. Providers across the country continue to face rising complexity, inconsistent commissioning and the ongoing pressure to deliver high‑quality support with limited resources. Yet the room was filled with energy, innovation and collective determination to improve outcomes for the people they serve – something the Choices Rehabs group have become known for.

Shortly after the meeting, Lord Brooke agreed to become a patron of one of the members, Kenward Trust — a gesture of great significance to the organisation. His support is active and informed, rooted in decades of advocacy for individuals affected by addiction. He has already offered thoughtful reflections on strengthening partnerships, widening access and building resilience into services for the future.

When his patronage was announced, Lord Brooke remarked: ‘It’ll be good for me – service – that’s what keeps me getting up and going!’ That spirit of service is exactly what communities need.

Penny Williams
Penny Williams

Across the Choices network, the commitment to providing residential rehabilitation, supported housing, prevention work and life‑changing therapy, remains unwavering. The House of Lords meeting was more than just an event; it served as a powerful reminder that residential rehab is a vital lifeline — and that through collective effort, stronger, fairer and more accessible routes to recovery can be created for everyone who needs them.

By Penny Williams, Chair of Choices Rehabs and CEO of Kenward Trust

Find out more about Choices Rehabs: choicesrehabs.com

Picture this

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DDN
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Rhea Mehmet is digital strategy and marketing lead at PORe
Rhea Mehmet is digital strategy and marketing lead at PORe

A groundbreaking Manchester exhibition is hoping to give people a new perspective on both art and recovery, says Rhea Mehmet.

Recoverist Curators: Reimagining the World We Live In is an exhibition at the Whitworth Gallery in Manchester, where six people in recovery from substance use took the lead. Given free rein to select works from the gallery’s collection, their choices proved unexpectedly radical – not for including provocative artists like Francis Bacon and Tracey Emin, but for being filtered through the lens of lived experience.

The show caps a year of workshopping and research. And for Dominic Pillai, curator of social engagement at Portraits of Recovery (PORe), it’s deeply personal. I sat down with him to discuss the exhibition.

You came into this role with a background in filmmaking and community arts. What specifically drew you to Portraits of Recovery?

Dominic Pillai, Curator of Social Engagement
Dominic Pillai, Curator of Social Engagement

I started as a workshop facilitator on projects like the BFI Film Academy, and through working with charities as a project manager. I moved into community arts, creatively facilitating various marginalised groups – particularly people with disabilities, neurodivergence and mental health issues. Curation has always been a prominent aspect of my own creative practice, so moving into this area professionally felt like a natural progression. But there’s something else. As a neurodivergent person with South Asian heritage, a long-term mental health condition and lived experience of recovery, I am acutely aware that many areas of the community are often excluded from the recovery narrative. Portraits of Recovery aims to readdress that through its intersectional work, and it was this approach that drew me.

You’ve spoken about the decision to be open about your own recovery journey – was that a difficult choice?

In 12-step programmes, anonymity is fundamentally important because of the stigma of addiction. Although Portraits of Recovery’s ethos is around visibility we also want to respect people’s choices, which can at times be a tightrope act. When I started in this role, I had to come to terms with the fact that my being in recovery would be out in the open. There was no external pressure to ‘out’ myself, but I felt it was important that the people we work with know I’m part of their community. A critical part of facilitating a group is building trust, and being open about my lived experience supports this. 

The Recoverist Curators project placed six people in recovery with no prior curatorial experience centre stage, in selecting and re-interpreting artworks. What did the process feel and look like in practice?

The project was led by Portraits of Recovery in partnership with the Whitworth, tasking six curators – Anastasia, Annie, Chanje, Paul, Penny and myself – with reinterpreting the gallery’s collection through the lens of recovery. Meeting bi-weekly for a year, they began by reflecting on themes like ‘self-care’, ‘pride’, and ‘journeying’, using these to guide archive dives and discussions until a resonant set of works emerged.

The gallery sector is start­ing to acknowledge the lack of representation within their institutions. Through a socially engaged, collaborative approach to curation it provides an oppor­tunity to address this issue but also provide space for these miss­ing voices to be heard. I’m interested in the idea of disrupting traditional art spaces because they can often feel inaccessible and non-inclusive, which is very much in line with Portraits of Recovery’s activist approach. 

The exhibition pairs major artworks alongside deeply personal interpretation panels. You, for instance, see your former self in a Tillmans photograph of friends outside a Berlin club. Anastasia finds the joy of her recovery in a Hockney still life. How do you navigate sharing these personal testimonies and exploring such vulnerability?

It’s about doing things ‘with’ people in recovery, not ‘about’ them. Being trained in visual anthropology taught me the importance of communities using creative practice to tell their own stories. The project sparked fascinating discussions around how substance use is often problematically represented in culture – and how we could rewrite that stigmatised narrative. What excited me most was that the curators didn’t just select work; they wrote interpretations examining each piece through the lens of their own lived experience.

Recovery is vast and can be explored in many ways. Those interpretation panels aren’t just labels – they’re an interventionist reframing. You may have seen that Bacon before, but you haven’t seen it through these eyes.

The Whitworth has committed to preserving the curators’ interpretations in their database and hosting AA meetings in the gallery. That feels like more than just an exhibition – it’s an institutional change. 

Exactly. A lasting legacy of this exhibition is giving the recovery community a permanent voice at the Whitworth. Each curator’s interpretations will live in the collection’s database, so anyone searching for these artworks will encounter what it means to be a ‘recoverist’. Long-term, we want the Whitworth to host regular fellowship meetings, which usually happen in hidden, uninspiring spaces. Holding one in a temple of art is nationally groundbreaking, but it aligns with our belief that art is critically essential to recovery. The project challenged the Whitworth to rethink how it listens and shares power. Rather than leading from the top, they embraced our expertise and we shaped the exhibition together.

You use the words ‘recoverist’ and ‘recoverism’ – can you explain what they mean?

Recoverism is a form of cultural activism that uses art to challenge how we think and live. Rooted in Manchester’s history of social movements, it’s about making recovery from substance use visible and valued. We call those we work with ‘recoverists’ (recovery + activist), not ‘participants’ or ‘service users’. The term reflects self-empowerment and the drive to be the change. For a hyper-marginalised community facing deep stigma, visibility is everything. Portraits of Recovery creates platforms for these voices, breaking down barriers to cultural inclusion.

You’ve spoken elsewhere about art being an alternative addiction. What do you mean by that?

There are a lot of artists in recovery, and for them creativity is an essential part of their recovery journey. Art provides meaning and purpose to their lives. Putting down a substance is only the first step. It’s where you choose to channel addictive behaviour that is key. Creativity is a more positive, less destructive activity to be addicted to.

The exhibition runs until July – what do you hope audiences take away from it?

I hope audiences come expecting one thing but leave with an entirely new perspective. Perhaps they’ll be attracted by a famous name – Hockney, Tillmans, Bacon, but stay for Anastasia, Penny, Chanje, Annie, Paul and Dom. By coming to understand that addiction is a response to the consequential pain of being alive, they might better see what it means to be a person in recovery. As Anastasia puts it, ‘To me, recovery is at the bottom of the washing up bowl. It’s a beautiful place to start.’

Photography by Joe Fildes from the Whitworth collection through a Recoverist Lens. Featuring curators Chanje, Anastasia, Paul, Annie and Penny.

Find out more at portraitsofrecovery.org.uk

All by myself

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DDN
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all by myself ddn feature on isolation

An epidemic of solitary use is helping to drive Britain’s drug deaths crisis, says Dr David Patton.

Across the UK, drug-related deaths continue to rise, driven not only by increasingly potent substances but by something far simpler and far more human – many people are using drugs completely alone. From bedrooms to hostels to temporary accommodation, solitary use has quietly become one of the most dangerous and least discussed patterns in the country’s drug landscape.

Dr David Patton is associate professor in criminology at the University of Derby
Dr David Patton is associate professor in criminology at the University of Derby

As part of a recent UKRI-funded partnership with Derbyshire Healthcare NHS Foundation Trust, we listened to frontline workers and people currently using drugs across the county. Their message was clear. People are not dying because they don’t understand the risks – they’re dying because they have no one with them when something goes wrong.

For many participants, using alone was not a rare occurrence but the norm. Some described practical reasons, such as wanting control over their dose, avoiding pressure to share, or using in spaces where visitors weren’t allowed. Others spoke about shame, fear of judgement, or a desire to avoid chaotic environments. A few said they used alone most of the time because it simply felt safer than being around anyone else.

Shrinking networks

Frontline staff echoed these stories. They described older men with deteriorating health and shrinking social networks, women drinking in private due to stigma or fear of family consequences, people in hostels who hide their use because of rules, and individuals newly released from prison with nowhere safe to go. What connects these situations is not drug choice but disconnection. People’s social worlds have collapsed, and solitude has become a survival strategy long before it becomes a risk behaviour.

Stigma plays a central role in this. Many people avoid GPs, pharmacies and emergency departments because they fear being judged. Some go to great lengths to remain unseen when collecting equipment or medication, while others have withdrawn from services entirely because the shame feels too heavy to carry. When stigma becomes embedded in healthcare, housing, criminal justice and community settings, it creates the conditions where solitary use takes hold.

This is why solitary use needs to be understood not as a personal choice but as the end point of a broader crisis of loneliness, shame and invisibility. And it’s why reducing deaths requires more than advising people not to use alone – it requires building the kinds of relationships, environments and safety nets that make connection possible again.

Naloxone remains essential, but not only as an emergency intervention. It works best when it’s everywhere, carried by neighbours, family members, housing staff and members of the public. A kit in every home and workplace is less about equipment and more about creating a culture where people look out for one another.

Stigma-free access to injecting or smoking equipment is equally important. When people can obtain what they need through quiet, anonymous routes, they remain linked to services rather than pushed into hiding. Vending machines, discreet pharmacy collection and postal supply aren’t luxuries, they’re forms of connection that meet people where they are.

Communities matter

Community spaces matter too. Not treatment centres, but everyday places such as libraries, warm hubs, cafes and church halls where people can exist without labels. Many of the staff we spoke to described how small, ordinary interactions – a greeting, a familiar face, a place to sit – can be profoundly protective for someone who spends most of their life alone. People with lived experience also have a crucial role and, when properly paid and supported, bring trust and continuity into the system. They reach those who avoid formal services and often understand the emotional and relational realities of solitary use in ways that others cannot.

Housing policy must also reflect the importance of connection. Rules that force people into secrecy increase risk, while safer policies allow visits, check-ins and simple human presence. A place to live isn’t just shelter – it’s a container for relationships. Finally, people leaving prison need support that begins before release and continues afterwards. This includes safe accommodation, medication continuity and a named person who maintains contact. The first days after release are among the most dangerous in a person’s life, so connection during this period can be lifesaving.

The rise in drug deaths linked to solitary use tells us something important. People do not survive because they have the strongest willpower, or the deepest knowledge of risk. They survive because someone is close enough to notice when they need help. Solitary use removes that possibility.

If we want to save lives, we need to redesign our systems around connection, not surveillance, not punishment, not shame. Most of the answers already exist in the everyday practices of harm reduction, lived experience and community work. The task now is to centre them. People aren’t dying because they use drugs. They’re dying because they’re alone. Changing that reality begins with bringing people back into view.

UNDERSTANDING ‘MISSINGNESS’

Many people avoid GPs and healthcare for fear of being judged – some go to great lengths to remain unseen, Prof Andrea Williamson told the RCGP/Addiction Professionals conference. So how can we address this?

Prof Andrea Williamson
Prof Andrea Williamson

As a professor of general practice and inclusion health, Prof Andrea Williamson had studied nearly half a million GP records and more than 9m appointments to build up a picture of people who ‘tend to have a pattern of enduring missingness’. ‘Missingness’, she said, was defined as ‘the repeated tendency not to take up opportunities for care – such that it has a negative impact on the person and their outcomes’.

What the study team found was that ‘patients are not missing appointments because they’re no longer sick or they don’t need care. They’re missing appointments because they’ve got lots of challenges going on… really complex social circumstances.’ The data also showed an association with higher premature mortality.

The patterns of missingness continued through secondary care – missed outpatient appointments, a likelihood to discharge themselves from hospital, and a continued unwillingness to engage.

The NHS was under enormous pressure – austerity measures had seen a melting away of third sector and voluntary sector organisations and demanded the NHS be more flexible in meeting people’s needs. But people weren’t engaging with the NHS when they had the perception that it wasn’t helpful, and many had negative associations from being mistreated or feeling stigmatised. 

We had to flip that into a positive by realising that every contact is important – from the reception staff, to the call handler talking about the next appointment, to the work in clinical care. Accessing care felt difficult when there was gatekeeping in place and a ‘sense of inflexibility’. We also needed to appreciate that people lived with competing demands – the need to prioritise other things above attending health appointments. ‘We tend to make the assumption in the NHS that people can just get time off to attend appointments,’ she said. 

But looming large was the theme of mistrust and distrust – people experienced stigma, discrimination and being misunderstood. ‘A really important message that came across from our lived experience participants was that the NHS loves easy patients – it literally can’t cope with people when they’re more complicated,’ she said. ‘And that’s not a great thing to hear.’

Trying to understand what drives missingness – including thinking about social determinants, poverty and marginalisation – was the route to a much more person-centred approach, said Williamson. But we needed to go beyond reading the literature on good practice and ‘be really disruptive’, thinking about how we could bring this to the mainstream as a suite of interventions. DDN

Prof Andrea Williamson teaches and trains about the social determinants of health, inclusion health practice and trauma-informed care. She leads on research about ‘missingness’ in healthcare and is involved in wider research and policy work to improve care for people experiencing severe and multiple disadvantage. 

From www.gla.ac.uk

DDN April 2026

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DDN
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How do we address this invisibility?

ddn magazine april 2026Our cover story this month challenges a familiar narrative – that knowledge and willpower are enough to keep people alive. They’re not. Too many drug deaths are happening because people are alone.

Looking at why people might take drugs in isolation, I was struck by how relatable these reasons are – wanting control over the situation, avoiding judgment, not wanting to be seen, as well as the more obvious one of having nowhere else to go. But the problem with drugs is that when no one’s around to notice something going wrong, survival becomes a matter of chance.

So how do we address this invisibility? ‘Connection’ isn’t a quick policy fix – it requires culture change that should touch each one of us. It’s about running services and healthcare in the right way, yes, but it’s also about how we treat each other in everyday moments, and about building love, support and empathy into the fabric of our communities.

It’s with this in mind that we’ve decided to theme our DDN Conference this year ‘Me, Myself… Us’. True support is not about telling people to try harder – it’s about saying ‘let’s do this’. We  hope you’ll join us on 9 July.

Read the April issue as an online magazine (you can also download it as a PDF from the online magazine)

Please send your letters and comment to claire@cjwellings.com

Claire Brown Editor of DDN Magazine

Claire Brown, editor

The best laid plans

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DDN
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With Scotland in the grip of a drug deaths crisis for well over a decade, not to mention the ongoing impact of high rates of alcohol harm, how effective will its latest government strategy be?

In late February, as the Scottish Government announced the final round of funding for its five-year national drugs mission, drug and alcohol policy minister Maree Todd said that the government would soon be announcing its new alcohol and drugs strategic plan. That came less than two weeks later, with the publication of Preventing harm, promoting recovery. 

Backed by £160m of funding for this financial year, the new plan aims to improve collaboration between the government and grassroots delivery, with a ‘locally led, accountable system, guided by clear national direction and support’. 

According to previous reports by Audit Scotland, that improvement in accountability is something that’s sorely needed, with a 2022 document stating that the country’s complex delivery system for drug and alcohol services made it hard to properly track either spending or the value it was providing. A follow-up report said while there had been progress in boosting residential capacity and implementing treatment standards, Scotland’s ongoing drug death crisis had led to attention shifting away from the country’s serious levels of alcohol harm. 

Although Scotland saw a 7 per cent fall in alcohol-specific deaths in 2024, this was from the previous year’s record high of 1,277 – the highest figure since 2008. Meanwhile, the most recent Police Scotland figures show there were 1,146 suspected drug deaths in 2025 – 8 per cent up on the previous year (see news, page 4). 

Cautious optimism

Responses to the new plan have been cautiously optimistic, with more than one organisation stressing the importance of not overlooking alcohol. ‘Back in 2024, Audit Scotland called out the Scottish Government for shifting focus away from alcohol harm,’ said SHAAP chair Dr Alastair MacGilchrist, who welcomed the document but said the government needed to ‘act with urgency’ to address the country’s alcohol problem – as the scale of the challenge demanded action ‘that matches the rhetoric’. 

Alcohol Focus Scotland (AFS), meanwhile, said it was pleased to see a commitment to ‘whole population, preventative action’ on alcohol harm – around price, marketing and availability – and also welcomed the plan’s commitment to expanding early detection of liver disease, including increased use of non-invasive mobile liver scanning. A report from Public Health Scotland last year warned that the number of people living with chronic liver disease – the majority of which cases are alcohol-related – was projected to increase by more than 50 per cent by 2044. 

Industry opposition

‘Scotland was, not so very long ago, a pioneer on the prevention and reduction of alcohol harm – the first country in the world to introduce minimum unit pricing, a real David versus Goliath victory in the face of massive industry opposition,’ said AFS chief executive Carolyn Lochhead. ‘Sadly, recent years have seen us overtaken by other countries – with the likes of the Republic of Ireland striding confidently ahead with restrictions on marketing and the introduction (albeit delayed by industry lobbying) of health warning labels.’ The Scottish Parliamentary elections are being held next month, and whoever wins had the opportunity to ‘once again lead the way on tackling alcohol harm’, she said. 

Human rights approach

The Scottish Government says that delivery of the plan will be underpinned by a human rights-based approach, something that WithYou’s director for Scotland, Louise Stewart, called ‘vitally important’ – but with the caveat that unless the next government ensured the plan was backed by ringfenced, inflation-proof funding, the sector risked losing not only the momentum but its workforce. 

The plan’s commitment to residential rehab, meanwhile – and reducing the myriad barriers to accessing it – has been welcomed by organisations like Phoenix Futures and Abbeycare, with Phoenix Futures chief executive Karen Biggs calling it ‘well informed, honest and ambitious – some might say too ambitious in the range and depth of the challenges it has set. 

‘I won’t be criticising anyone for having ambition for the people the strategy aims to support,’ she stated. ‘That for me is well overdue.’  DDN

Preventing harm, promoting recovery: Scotland’s alcohol & drugs strategic plan 2026–2035 is available at www.gov.scot

Heated tobacco products a ‘highly effective’ tobacco harm reduction tool

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DDN
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Heated tobacco products have proved to be highly effective at replacing cigarette smoking in countries with vaping restrictions, such as Japan, says a new briefing paper from the Global State of Tobacco Harm Reduction (GSTHR).

The paper is intended as a primer on heated tobacco products, providing an overview of how they work and their reduced risk profile. Heated tobacco products (HTP) – also known as ‘heat-not-burn’ products – are non-combustible safer nicotine devices that use an electronic heating element to heat sticks of tobacco, producing a nicotine vapour for inhalation in a manner similar to vaping.

Unlike cigarettes, which burn tobacco to produce more than 4,000 chemical products, HTP heat the tobacco below its combustion point

While tobacco is burned in cigarettes – producing more than 4,000 chemical products, at least 70 of which are known carcinogens – HTP use a battery and heating element to heat the tobacco below its combustion point. Just under 70 countries currently allow the sale of HTP, the leading brands of which include Ploom, IQOS and glo, with one in three users reporting that they buy the products to help reduce or quit smoking.

‘Key market data sheds some important light on the impact HTP are having on the sale of cigarettes,’ the document says, with ‘a clear substitution effect’ taking place in some European markets – driven in part by high rates of tax on cigarettes. In Japan, however – where vapes are banned unless licensed as a medical product – research by GSTHR shows that cigarette sales have fallen by more than 50 per cent since the introduction of HTP just over a decade ago.

The regulatory framework for HTP varies widely, from full-scale bans – in countries including Australia, Brazil and China – through strict regulation to open availability. While the World Health Organization has taken a hardline stance on HTP – classing them as ‘inherently toxic’ products alongside cigarettes and cigars – and the EU’s tobacco products directive has banned all flavoured HTP, a 2018 Public Health England evidence review concluded that HTP were likely to be significantly safer than cigarettes. ‘Compared with cigarette smoke, HTP are likely to expose users and bystanders to lower levels of particulate matter and harmful and potentially harmful compounds,’ it said.

‘Heated tobacco products have proved to be highly effective in replacing cigarette smoking in countries such as Japan, where vaping restrictions have helped to boost their appeal to consumers – so much so that heated tobacco products have now become the dominant safer nicotine product by market share,’ the GSTHR briefing paper states. ‘Their steady rise in popularity has helped shift people who smoke onto these less-harmful alternatives, with national public health bodies citing these products as playing a role to help reduce smoking rates. Influential public health research such as the Cochrane Review 2022 have widely agreed that heated tobacco products expose users to lower levels of key toxins and carcinogens than are otherwise found in combustible tobacco smoke.’

However, the relative lack of independent research into their safety means there is still significant opposition, it continues, with a consequent difficulty in ‘separating these products from the devastating impact of combustible tobacco use. With some regulators looking to tighten restrictions on the sale of these products, their future – as with some other safer nicotine products – is uncertain. But the real-world impact of these products in helping reduce cigarette consumption highlights their potential to play a key role in tobacco harm reduction efforts across the globe.’

In countries where vapes are banned, such as Japan, HTP have proved to be ‘highly effective in replacing cigarette smoking’

Meanwhile, a new study suggests there may be a ‘tipping point’ at which smoking-related lung damage becomes more likely to be irreversible. Taking a measure of a ‘pack year’ as equating to 20 cigarettes a day for a year, the study – by TidalSense – indicated a potential tipping point of 25 years, after which ‘the likelihood of retaining normal lung function decreases significantly’. The study used capnography data, which measures the concentration of carbon dioxide over time, and found ‘markedly worse’ airway disease indicators after 40 pack years.

According to figures published earlier this month by UCL, more than a million people in the UK quit smoking last year, while research by ASH shows that more than half of current smokers would like to stop. The number of vapers in the UK has now overtaken the number of smokers for the first time. The Tobacco and Vapes Bill – which aims to create a ‘smokefree generation’ by phasing out the legal sale of tobacco to anyone born after January 2009, as well as tightening the regulations around vape flavours and packaging – has passed its final stage in the House of Lords and is expected to be passed into law in the coming weeks.

This year’s Global Forum on Nicotine takes place in Warsaw on 3-5 June 2026. Full details available here

What are heated tobacco products is available here

Quantification of smoking-related airway remodelling in COPD, using N-Tidal is available here

DDN Conference 2026 exhibition details

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DDN
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Thank you to everyone who has booked an exhibition space at the DDN Conference! The details for exhibitors are below.

If you have not yet confirmed your booking it’s not too late! Please contact ian@cjwellings.com today.

QUICK LINKS:

Timings, venue details, accommodation and set up

Information for stand deliveries 

Delegate names 

Invoicing

Contact for questions: Ian Ralph: ian@cjwellings.com – 07711 950 300

Timings, venue details, accommodation and set up

Date and timings
The conference is on Thursday 9 July. The conference programme will run from 10am – 4pm with breaks for refreshments and lunch. Registration will be from 9am.

Venue
The event will be held at the National Conference Centre (The National Motorcycle Museum), Birmingham, B92 0EJ. The venue is easy to reach by both car and public transport and offers free parking. Full details on location, accessibility and other information on the venue can be found here.

Accommodation

The DDN team will be staying at The Arden Hotel, which is five minutes from the venue and close to the train station and airport. The conference room rate is £99 which can be booked by calling (0)1675 443221 and quoting reference GA003325.

It is worth checking on booking.com as prices can change and sometimes there are better deals available here and at other local hotels.

 

Exhibitor set up
Exhibitors will have access to set up stands from 8:30am on the morning of the conference. There will be limited availability to drop stands and materials off at the venue between 2-4pm the afternoon before (Wednesday 8 July) but you will not be able to set your stand up until the morning of the event. Please let Ian know if you are dropping off material the day before.

Exhibition space
You have an exhibition stand which will be a tabletop and chairs with space for pop up banners and stands. Please email if you have specific requests such as power or need extra space for stands etc.

As those of you who have attended before will know, this is a vibrant area at the heart of the event and interactive stands and giveaways are incredibly popular.

Information for stand deliveries 

Delegate bag inserts and information for couriers
The deadline for sending inserts for delegate bags will be aproximately 10 days before the event and we will supply details for the delivery address nearer the time

We are expecting over 500 delegates. 

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If you are sending your stand via courier a day or two before the event, please send it to the details below.

If you are popping it in the day before, please go to reception and ask for Michelle Cruise. She will store your materials and it will be waiting for you in the exhibition area on the day of the event. Please note, you will not be able to access the venue itself the day before as another event is taking place.

Stand delivery/drop off
Attention Michelle Cruise, Events Planner, MichelleC@nationalconferencecentre.co.uk, 01675 444149.

The National Conference Centre (at the National Motorcycle Museum)
Coventry Rd
Bickenhill
Hampton in Arden
Solihull
B92 0EJ

Please ensure all stands are clearly marked DDN Conference 9 July.

Please email Michelle in advance and copy in ian@cjwellings.com.

DDN cannot take responsibility for delivery or pick up of stands from the venue.

Delegate names

We will be issuing delegate badges at the event in the same customisable format as last year, so there is no need to supply a list of names! We just need the number of people attending.

Invoicing

You will be emailed an invoice for your booking to be paid in advance of the event by either BACS or credit card. If you have any questions regarding the invoicing, please contact accounts@cjwellings.com.

We hope this helps you prepare for what should be a fantastic, interactive, energetic and inspiring event. If you have any questions or would like to discuss the event or DDN magazine, please contact ian@cjwellings.com – 07711 950 300.

 

Details of the event, speakers and programme coming soon.

Make sure you subscribe to our email newsletter for updates on the event and more from DDN

Drug harm costing Scotland £6bn a year, says think tank

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DDN
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Scotland’s drug harm is losing the country up to £6bn a year, according to a report from the Social Market Foundation (SMF) think tank. The cost to the country’s public sector is estimated at around £1bn per year, with the wider social and economic harms increasing the figure to as much as £5.7bn, says Harm, hardship and the price of inaction.

Although Scotland’s ongoing drug death crisis is a ‘well-documented’ problem, it has now taken on ‘new dimensions’, the report says – including the emergence of powerful synthetic opioids, the rise in polydrug fatalities, and the ageing of people who started using drugs decades ago and are now facing more serious health risks.

Powerful synthetic opioids and increasing polydrug use represent stark new dangers, the report warns

The document is based on both economic modelling and focus group interviews with current and former drug users in Edinburgh and Glasgow. The £1bn cost to the country’s public sector – including around £222m on healthcare and drug services, and £320m criminal justice costs – would cover two thirds of the entire mental health budget, it says, with the impact on GDP estimated at a further £1.2bn through unemployment and reduced productivity.

‘Not only do these figures represent clear economic damage, but they showcase the extent to which Scotland’s drug crisis affects so many lives and livelihoods across the country,’ says SMF. The focus group interviews, meanwhile, ‘confirmed an increasingly pervasive drugs market alongside worries that drugs services can be difficult to access’.

The most recent set of official drug death figures, for 2024, showed a 13 per cent decrease on the previous year. While this could ‘signal that the country is starting to get to grips with the crisis’ it could also prove to be ‘nothing more than a blip’, the document warns, with powerful synthetic opioids and increasing polydrug use representing stark new dangers. ‘The drug market is increasingly volatile and fast-moving,’ it states. ‘New substances emerge quickly, potency varies unpredictably, and drug consumption behaviours continue to change over time. This makes it difficult for services and policymakers to keep pace, and there is a risk that headline declines in overall drug-death figures obscure the underlying trends shaping future harm.’ Last month Public Health Scotland warned anyone taking illicit drugs that they should assume they were contaminated with other substances.

With the Scottish Parliament elections taking place in May, the report sets out a ‘clear

The £1bn cost to the country’s public sector includes around £222m on healthcare and drug services, and £320m in criminal justice costs

roadmap’ for tackling the drugs crisis, including expansion of naloxone provision, needle and syringe programmes and drug checking services, as well as a shift towards a ‘primarily public health approach’. Data collection also needs to be improved, it says, alongside enhanced detox capacity.

‘For years, Scotland has recorded the highest drug death rate in Europe, with thousands of lives lost,’ said senior researcher at SMF, Jake Shepherd. ‘Scotland’s drug crisis is nothing short of a tragedy, and no argument for change is more compelling than the human cost. Our research shows the issue is also economically unsustainable. While the Scottish Government has made meaningful attempts to address the crisis in recent years, it must go further and faster. Drug harms are avoidable, and a more effective response could reduce these impacts. The price of inaction is too high to ignore. We hope that policymakers across the UK, and the incoming Scottish Government, act on these findings to reduce harm, reverse drug deaths, and improve the wellbeing of future generations, while supporting people who use drugs to live healthy and meaningful lives.’

Harm, hardship and the price of inaction is available here

Charities call for action on alcohol harm ahead of Welsh elections

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DDN
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Five charities have issued a joint call to action urging the next Welsh government to prioritise policies that address alcohol-related harm. The call, by Adfam, Adferiad, Alcohol Change UK, Barod and Kaleidoscope, comes six weeks ahead of the Welsh Senedd elections in May.

The most recent official figures, for 2023, saw the highest number of alcohol-specific deaths ever recorded in Wales, at 562, with almost 700 more deaths classed as alcohol-related. Alcohol-specific deaths in Wales have doubled in the space of two decades, including an ‘unprecedented’ 28 per cent increase during the COVID years of 2020 and 2021. Whatever the outcome of the May elections, Wales ‘needs a renewed focus on reducing alcohol harm’, the charities state.

Alcohol-specific hospital admissions are also increasing, with more than 12,000 in 2023

Alcohol-specific hospital admissions are also increasing, with more than 12,000 in 2023, involving more than 8,000 people. Those in the country’s most deprived areas are almost three times more likely to be admitted for alcohol-specific conditions than people from the least deprived. Wales also recorded its highest ever level of drug misuse deaths in 2024.

The statement calls for eight key changes, including an updated substance use strategy focused on both prevention and treatment to provide ‘clear direction’, consistent support for families affected by alcohol use, and outreach work to identify and support vulnerable people with alcohol dependence. It also wants to see better joint working between treatment and domestic abuse services, access to safe detox for alcohol-dependent people, and an end to the requirement for sobriety before people are eligible for mental health support. Trauma-informed approaches are also vital, it says, as is consistent identification and treatment of people with alcohol-related brain damage (ARBD).

Andrew Misell: ‘The next Senedd has a real opportunity to reduce alcohol harm in communities across Wales’

‘Charities are working hard to help people live happier, healthier lives, free from alcohol harm – delivering support when and where it’s needed,’ said Alcohol Change UK’s director for Wales, Andrew Misell. ‘Yet, as the figures show, there is still much more to do and the next Senedd has a real opportunity to reduce alcohol harm in communities across Wales. No single policy will solve every problem. That’s why our five charities have come together to set out some practical steps the next Welsh Government can take to prevent harm, support those who need help, and ensure momentum is not lost. Whichever way the May election goes, we stand ready to work with members of the next Senedd to turn these priorities into action across Wales.’ 

The Welsh Senedd voted earlier this year to retain minimum unit pricing and increase it to 65p per unit from October, bringing it in line with Scotland.

Action on alcohol during the next Senedd 2026-2030 is available here

The Art of Lived Experience Storytelling

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DDN
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What makes a good story? Libby Chandler gives thoughts from working with Voices Support CIC.

A descriptive setting that sets the mood, the main protagonist suffering with inner conflict, the triumph or shattering of character development, a plot twist to throw the audience into a state of shock, emotional relatability and everything and anything to increase the heart rate. We know what makes a good story. We all enjoy a good story.

But what makes a valuable story? Is it the story that provides the lens for us to see through another’s eyes? One that allows us to truly understand and empathise with another’s experience, so we can learn how to help others and do better. A new perspective, profound enough to encourage positive change. A story that sticks with us long after we close the book for the final time.

You could say that lived experience is an accumulation of stories. Stories that might be brief, others lengthy; some turbulent or plain sailing, all with their lessons and insights.

From these tales, we can highlight mistakes and successes and, with these learnings, contribute to the design and delivery of services that are fit for purpose. An individual’s encounters enable decision-makers to understand the real-world impact of their decisions. False and dominant narratives can be challenged, and equitable solutions can be sought moving forward.

On 5th February 2026, Changing Futures held an event at The Bond in Birmingham, focused on storytelling as a tool for systems change.

VOICES Support CIC, a Lived Experience Recovery Organisation (LERO), is proud to be a part of Changing Futures Surrey, and their team joined the event to learn how storytelling is vital in our work.

Read the full report here

The original feature was written by Libby Chandler on behalf of Changing Futures Surrey. 

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created on behalf of Changing Futures Surrey

Via strengthens recovery with Mind Body Balance Academy

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DDN
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VIA is pleased to announce this partnership with Mind Body Balance Academy (MBBA), based in Northwich, to offer innovative fitness and wellbeing experiences to people accessing our Cheshire West & Chester service hubs through the Capital Card.

Mind Body Balance Academy studio
Mind Body Balance Academy studio

Via’s Capital Card is an award-winning reward card scheme which empowers and rewards people for engaging in recovery-focused activities. Using a simple earn-and-spend model, people earn points through attending appointments, participating in groups, and working towards their recovery goals. They can then exchange their points for positive, community-based activities that support their wellbeing.

Mind Body Balance Academy has joined the scheme as a Capital Card spend partner, offering people the opportunity to redeem their points for group padel sessions, as well as yoga, Pilates and holistic wellbeing pathway sessions.

Megan Hallahan, Senior Capital Card Officer at Via, said: ‘We’re delighted to partner with Mind Body Balance Academy because it brings together structured physical wellbeing and community connection in a way that directly supports sustained recovery.’ 

Find out more at viaorg.uk

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by VIA

Street support 

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DDN
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Mark Hindwell - DDN article

 

Sally Higgins is a mental health nurse with Forward Leeds. Her pioneering role is at the intersection of addiction, trauma, safeguarding and outreach work with women involved in street-based sex work.

In a new and almost unique post, Sally provides dedicated mental health support to women alongside the sex worker outreach team at Forward Leeds, offering a level of consistency, advocacy, and accessibility that many UK services cannot reach.

Sally has worked at the city’s alcohol and drug support service since 2022 in the co-occurring mental health, alcohol and drugs (COMHAD) team, where she’s employed by Leeds and York Partnership NHS Foundation Trust (LYPFT) as part of the Forward Leeds partnership.

It was there that Sally, along with colleagues in the sex worker outreach team, noticed a persistent problem. The women they supported had extremely high levels of unmet need, but current mental health services struggled to meet them where they were. Missed appointments, lack of fixed address, chaotic life circumstances, and trauma-related avoidance frequently resulted in women not being able to get the support they needed.

Her role, launched in September 2025, was created to solve that problem. It allows Sally to carry her COMHAD expertise directly into the outreach environment, without waiting for formal assessments or appointments in one of the Forward Leeds hubs.

Sally Higgins
Sally Higgins’ work is almost entirely street- based. Roles like this barely exist in the UK, yet the impact is unmistakable.

Sally’s work is almost entirely street based. Most days begin at a Forward Leeds hub, planning the day with recovery coordinators in the sex worker outreach team. Then she’s out in Holbeck, Beeston, Armley, or Harehills – wherever she thinks the women are likely to be that day. 

Her support isn’t delivered in therapy rooms or offices, but on pavements, in parks, in cars, and sometimes outside houses known for drug activity. The approach is flexible, patient, and rooted in consistency.

‘It’s just sort of showing face and being consistent, and showing them that I’m someone that’s going to keep turning up,’ says Sally. ‘And then once we’ve built that little bit of rapport and trust, we have some conversations about their mental health, what they’re concerned about, what type of support they think they need.’

One of the people Sally is working with told her, ‘I’m not ready for therapy, but I need someone to help me understand what I’m going through. People think drugs cause my mental health to be bad, but I use drugs because of what I’ve been through.’

Too often women find that mental health support services say ‘come back when the chaos is sorted’ – when housing, safety, sobriety, and stability are in place. As Sally points out, some of the women she helps have been in the same circumstances for a decade or more. Waiting for ‘stability first’ can mean they never receive mental health support at all.

Sally’s presence means women who would normally fall out of community services get another chance. She attends meetings, advocates for women who struggle to speak for themselves, and personally brings people to assessments if that’s what it takes. The difference is profound – without her, many would simply be discharged for non-attendance.

The nature of the work is emotionally heavy. Sex worker outreach staff witness relentless sexual violence, exploitation, deprivation, and harm. Winter brings particular strain – cold, dark nights spent driving around searching for women shivering on the roadside with nowhere safe to go. Sally offers reflective sessions and day-to-day emotional support to her colleagues, something that would be impossible without her dedicated role.

Roles like Sally’s barely exist in the UK. Within the NHS this level of specialist, embedded mental health support for sex workers is virtually unheard of. Yet the impact is unmistakable. Colleagues describe her role as ‘exceptional’, and the value has already become clear to the outreach team, Forward Leeds leadership, and external partners.

As Sally puts it, ‘It is niche but I’m really proud of what I do. And I hope to stick around and keep doing this for some time to come.’

Mark Hindwell is marketing and communications officer at Forward Leeds

Europe-wide surge in wastewater detections of cocaine and ketamine

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DDN
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There have been ‘strong increases’ in cocaine and ketamine detections in European wastewater analysis, according to the latest report from the Europe-wide SCORE group in association with EUDA.

The project, which analysed wastewater in 115 cities across 25 countries, also found a ‘marked decline’ in MDMA residues. Samples from a population of 72m people were analysed for traces of amphetamine, cannabis, cocaine, ketamine, MDMA and methamphetamine between March and May last year. Despite varying results it is ‘noteworthy that all six drugs investigated were found in almost every participating city’, the researchers state.

Alexis Goosdeel: ‘Cocaine is more accessible, more affordable and more potent than ever before’

Cocaine loads in wastewater increased by 22 per cent between 2024 and 2025 across the cities that reported data for both years, with detections highest in western and southern Europe – particularly Belgium, the Netherlands and Spain. Ketamine loads, meanwhile, increased by more than 40 per cent in cities reporting data for both years – predominantly in Belgium, Germany and the Netherlands.

Late last year outgoing EUDA executive director Alexis Goosdeel said the exponential increase in cocaine production and trafficking had developed into ‘an unprecedented phenomenon’, with the drug ‘more accessible, more affordable and more potent’ across Europe than ever before. Most cocaine shipments have traditionally arrived via Antwerp and Rotterdam, although more traffickers are now using Spain as an entry point.

MDMA loads fell by 16 per cent – a sharper decline than in 2020, when nightlife venues were closed because of COVID – with the fall most noticeable in Germany, Austria and Slovenia. Amphetamine residues were highest in northern and central Europe, and lowest in the south. Methamphetamine, meanwhile, which was once concentrated in central Europe is now being found in Germany, Spain, the Netherlands, Norway and elsewhere.

Although wastewater analysis is an established method for monitoring quantities of illicit drugs use at population level, it cannot provide information on prevalence and frequency of use, or the purity of the drugs, the researchers point out.

‘Europe’s wastewater tells the story of a drug phenomenon that is widespread, varied and in constant flux,’ said EUDA’s new executive director Dr Lorraine Nolan. ‘This year’s study, covering 115 European cities, reveals a marked decline in traces of MDMA, alongside continued signs that cocaine and ketamine detections are on the rise. Wastewater analysis helps us track these shifts early to better understand where attention and resources are needed and to inform evidence-based public health and policy responses across Europe’.

Wastewater analysis and drugs — a European multi-city study available here

Scottish suspected drug deaths up almost 10 per cent

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DDN
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There were 1,146 suspected drug deaths in Scotland last year, according to the latest Police Scotland statistics – 8 per cent up on 2024’s figure of 1,065.

Men accounted for two thirds of the suspected drug deaths, with the highest number of deaths in the Greater Glasgow, Ayrshire and Lanarkshire police divisions.

Men accounted for two thirds of the suspected drug deaths, with the majority of fatalities among people aged between 35 and 54. The highest number of deaths were in the Greater Glasgow, Ayrshire and Lanarkshire police divisions. Although the number of suspected drug deaths in the final quarter of 2025 was 15 per cent down on the previous quarter, it was an increase of 7 per cent on the corresponding period for the previous year.

The figures are based on reports from officers attending scenes of death, which means they are not subject to the same level of validation as the official figures published each year by National Records of Scotland. The most recent set of official statistics, for 2024, recorded 1,107 drug misuse deaths.

Public Health Scotland recently warned that the ‘highly toxic and unpredictable’ drug supply across the country meant that anyone using street drugs should now assume they were contaminated with other substances. The Scottish Government published its new ten-year drug and alcohol plan last week, replacing its national mission on drugs.

Suspected drug deaths in Scotland: October to December 2025 available here

‘No evidence’ that medicinal cannabis works for common mental health conditions

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DDN
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There is no evidence that medicinal cannabis is an effective treatment for conditions like depression, anxiety or PTSD, according to a major new review by researchers at the universities of Sydney, Melbourne, Brisbane and Bath.

The study, which is published in Lancet Psychiatry, is the largest ever to look at the safety and effectiveness of medicinal cannabis for mental health and substance use disorders.

Mental Health
‘The routine use of these medicines for mental disorders and substance use disorders is rarely justified’

Anxiety, depression, PTSD, ADHD, insomnia and sleep disorders account for six of the top ten reasons cannabis is prescribed, the researchers state. However, they found ‘little evidence’ that medicinal cannabis is an effective treatment for these conditions, and while most side effects were mild to moderate, ‘some serious questions about safety remain’.

The researchers studied more than 50 randomised control trials involving almost 2,500 participants over a 35-year period, looking at whether medical cannabis reduced or effectively treated a range of mental health disorders, as well as substance use disorders including cocaine and opioids. The most common cannabinoid being evaluated was CBD, followed by THC or a combination of both.

‘We found cannabis medicines were no more effective than a placebo at treating symptoms of psychotic disorders such as schizophrenia, anxiety, PTSD, anorexia or opioid use disorder,’ said Jack Wilson and Emily Stockings of the University of Sydney. There were however ‘promising findings’ that medicinal cannabis could be effective in reducing cannabis use among people with a cannabis use disorder. ‘While this may sound strange, the medicines largely consisted of an oil-based combination of CBD and THC that was taken orally. As these medicines reduce craving, patients may use less of their usual cannabis. So for people who regularly smoke high-THC cannabis, using medicinal cannabis instead may reduce their risk of related health problems, such as lung conditions,’ they say.

They urged caution, however, when interpreting the ‘positive’ findings. There was a high risk of bias in the studies as the intoxicating effects of THC could mean participants being aware they hadn’t been given a placebo. As well as being psychoactive, THC is also linked to short- and long-term harms, so while the ‘data alone seems to suggest cannabis medicines are relatively safe’, this may not be reflected in ‘real-world use.’ Although the average length of treatment in the studies was just five weeks, one review from 2024 found that a quarter of people prescribed medicinal cannabis went on to develop a cannabis use disorder – a similar rate to that for non-medical use.

While it ‘may sound strange’ that medicinal cannabis could be effective for people struggling with a cannabis use disorder, the oral medicines reduce cravings and lessen the risk of lung conditions and other health issues, researchers say.

‘We need more research on cannabis medicines, particularly for conditions with limited alternative treatments, and monitoring over longer periods,’ the researchers say, adding that for people who believe their medicinal cannabis is beneficial ‘our review does not mean to contradict your experience. However, we encourage you to regularly discuss your circumstances with a doctor, and if possible, consider alternative evidence-based treatments.’ Doctors in the UK have been able to prescribe medicinal cannabis since 2018.

‘It is concerning that the use of these treatments could delay or replace the use of more effective therapies,’ the review states. ‘Overall, given the scarcity of evidence for efficacy and greater risk of all-cause adverse outcomes, the routine use of these medicines for mental disorders and [substance use disorders] is rarely justified.’

The efficacy and safety of cannabinoids for the treatment of mental disorders and substance use disorders: a systematic review and meta-analysis is published in Lancet Psychiatry, available here

Safe haven

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DDN
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The Nest Essex An Essex service is offering integrated and genuinely trauma-informed recovery from both domestic abuse and substance issues, says Sally Harrington.

The landscape of addiction and recovery services is increasingly recognising the need to address so much more than substance use alone. Nowhere is this more acute than at the intersection of domestic abuse and substance use. 

For countless women, sub­stances are not a recreational choice but a desperate, self-medicating strategy to manage overwhelming multiple traumas. Traditional, siloed services – where a survivor is told to achieve sobriety before receiving trauma counselling, or vice versa – have historically failed this complex cohort. This structural divide leads to cycles of relapse, homelessness, and re-victimisation.

In Essex, a pioneering residential service is closing that gap and leading the way for integrated care. The Nest, a collaborative project by the county-commissioned domestic abuse support service Next Chapter and leading substance use support provider Open Road, has established itself as a secure, trauma-informed haven. It provides the critical time, space, and specialist skills needed for women to address both their safety and their substance dependency simultaneously, fundamentally aligning with DHSC’s commitment to integrated service delivery.

Unique model

The Nest
The Nest provides a holistic, person-centred approach to healing – focusing on mind, body, and emotional wellbeing.

The foundational philosophy of The Nest is built on the principle that recovery cannot begin until physical and psychological safety are established, and that trauma must be addressed alongside substance dependency. This mandates a departure from traditional community-based programmes, which often cannot provide the necessary level of isolation from risk. 

The service is explicitly tailored for women who have fled severe domestic abuse and require both secure, safe accommodation away from their risk area and expert support to manage trauma-induced substance use. The residential nature of The Nest provides an essential buffer, allowing the resident to begin processing their trauma without the constant vigilance and threat associated with remaining in their home environment or being street homeless.

The model is defined by several critical, interlocking features that create a holistic pathway:

Secure, residential safety

Providing immediate, 24/7 safe supported accommodation. This allows residents to de-escalate their crisis response, stabilise, and begin processing trauma in a consistent, controlled, and protected environment. This is vital, as the acute stress of fleeing domestic abuse often exacerbates substance misuse behaviours.

Trauma-informed integration Next Chapter provides the foundational trauma-specific care and safety planning, while Open Road delivers in-house, evidence-based addiction recovery support alongside Essex STaRS prescribing service. This eliminates the fragmentation, delays, and re-traumatisation often experienced when women are forced to navigate two separate, uncoordinated systems.

Person-centred healing Recognising that substance use in this context is a survival mechanism, the environment is intentionally compassion\ate, non-judgemental, and therapeutic. Recovery programmes are highly customised to the unique needs of each woman, incorporating a range of therapeutic modalities to build resilience, develop healthy coping mechanisms, and prepare for sustainable independence. The round-the-clock key worker support ensures consistency and crisis management, building the crucial element of trust that trauma survivors often lack.

National blueprint 

By formally uniting the expertise of a commissioned domestic abuse service with a leading drug and alcohol recovery charity, The Nest has created an entity that addresses the whole person, not just the symptoms. For commissioning bodies, public health teams, and providers looking for robust, effective delivery models that fully align with the renewed national focus on addressing co-occurring mental health and substance use conditions, The Nest provides a compelling blueprint. It demonstrates that collaboration is not just beneficial – it’s cost-effective and clinically necessary for achieving lasting change. 

Furthermore, it directly tackles the issue of stigma and judgement – creating an environment where women feel safe to disclose the full extent of their challenges without fear of immediate censure or service rejection. The ability of the two expert organisations to share best practice, pooled resources, and a single governance structure is what underpins the model’s efficacy.

Integrated outcomes

The success metrics reported by The Nest are a powerful affirmation of the integrated, residential approach for this highly vulnerable group. We’re proud to report that 75 per cent of residents successfully complete their comprehensive programme of support, safely transitioning into long-term recovery and stable independent living. The model proves that when care is provided in a dedicated, secure setting by integrated specialists, the likelihood of sustained recovery increases dramatically.

The Nest demonstrates that for women whose substance use is inextricably linked to the trauma of domestic abuse, specialist, holistic care is not merely an option – it’s the vital engine for breaking deeply entrenched cycles of addiction and domestic abuse, allowing survivors to truly reclaim their narratives and choose a brighter future.

Sally Harrington
Sally Harrington is director of adult services and deputy CEO at Next Chapter

We’re proud at Next Chapter to have built a legacy of providing rapid, free, and confidential support across Essex, and we’ve recently been recommissioned for a further five years. This is testament to the charity’s exceptional service delivery and provides the long-term foundation necessary to undertake innovative, high-impact projects like The Nest. 

Sally Harrington is director of adult services and deputy CEO at Next Chapter

More information at nest.thenextchapter.org.uk

Sarah’s Story: ‘I Would Have Died Without This Place’

Sarah's story ddn‘I can honestly say that coming to Essex has been a life-changer. Before I walked through the doors of The Nest, I wasn’t sure I would make it at all. My life had spiralled into a dark place defined by addiction and abuse. Looking back now, I know the reality was stark: I would have died without this place – either from the drugs, the alcohol, or at the hands of a man. The Nest literally saved my life. I had hit rock bottom. I turned up with absolutely nothing to my name, stripped of my dignity and my hope.

But more than the lack of possessions, it was the shame that weighed me down. I was so worried about being truthful, for fear of being judged for what I had done and what ‘It was the shame had happened to me. Instead of judgment, that weighed me down. I was so worried about being truthful, for fear of being judged for what I had done and what had happened to me.’ found a sanctuary. I was given clothes, food, and a place of safety immediately. That basic security meant I could finally stop running and start to sort myself out and recover. 

Before I knew it, I had told them everything. Next Chapter didn’t just give me a bed; they gave me a future. They provided therapy and, perhaps most importantly, they really believed in me when I didn’t believe in myself. They gave me the courage to be who I am. With their help, I began to address the painful situation with my daughter. I had been so ashamed of what my life had become that I avoided meeting my family because I felt I had let everyone down. 

The team at The Nest gave me the stepping stone I needed to bridge that gap. Standing tall today I never imagined I could get to where I am now. I’ve realised I am worth more than what I had settled for previously. Being here has given me my life back and provided me with the life skills to keep it. Today, I have amazing people around me who provide constant support. I can now meet my family and feel like I’m ten feet tall because I am actually proud of myself. I would not be standing here today if I had not turned up there. My life is pretty amazing.

Let’s get real

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DDN
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Lets get real russell booth cgl

The root of the word communications comes from the Latin ‘communicare’ – ‘to share’. In the corporate world, however, sharing became more about manicuring our reputations than genuine connection, with the purpose of comms teams often defaulting to ‘making us look good’.

Charities looked at the corporate world with their high-end production values and silky smooth messaging, and professionalised their communications to compete in a crowded attention economy. But in doing so, have we lost some of the heart and soul that makes the work that charities do so unique and the stories so powerful? With information overload, AI slop, and all-time-low trust in institutions, we may be at an inflection point. People are craving more ‘show don’t tell’, more unvarnished truths. 

The fact that grant funding awarded through the drug strategy is being consolidated into the public health grant and maintained at roughly current levels is a mixed outcome – the total funding originally committed to in the drug strategy is unlikely to arrive, and an alcohol strategy also looks unlikely under this government’s term. It could have been better, but in a climate of economic turmoil where political appetite to publicly champion drug treatment remains frustratingly scarce, it could have been worse.

As we encountered various politicians, two pieces of feedback have emerged, both uncomfortable: First, that the sector doesn’t speak with a united voice; second, that it hasn’t done enough to justify further investment. So why is there a perception that the sector hasn’t done enough?

The sector emerged from a global pandemic straight into implementation of an ambitious drug strategy, while managing the fastest-evolving substance landscape in decades and helping more people than ever before. What more could we have done? Well, we could have communicated differently. Drug and alcohol services are full of people doing difficult work under pressure, helping people at crucial moments in their lives. Progress and setbacks, passion and frustration, elation and sadness. Our communications have rarely shown the full picture. 

Instead, we’ve hosted VIP visits from politicians, triumphantly promoted our achievements, published annual reports cataloguing our incredible work, all of it presenting a successful story. There’s obviously a reason for this – demonstrating impact is essential. Commissioners and stakeholders funding our work need to see outcomes, delivery, value for money. 

The bind is that we also need to show what’s not working, what’s overwhelming services, what’s getting worse despite our best efforts. Communicating success and struggle simultaneously is a tricky brief. But I think we’ve defaulted to the easier option – showing only half the picture. Professional, appropriate, reassuring. Dangerously reassuring. So at Change Grow Live we’re going to change our approach. 

After five months working through this with colleagues, our executive team and board of trustees, we’re committed to something different – communications that show the work as it happens. Problems as we’re solving them. Things we didn’t achieve alongside those we did. This started with our new strategy launch, which we announced through a brief 500-word website story. No diagrams, awkward jargon or ambiguous vision statements. Just what we’re trying to do and why it’s difficult. People using services emailed me and, to my surprise, had both read it and had thoughts. A career first for me. 

Last month, Tracey Kemp, our director of criminal justice wrote about how many people in the prison system were neurodivergent but our staff weren’t trained for it. We built a toolkit and shared it – it’s been accessed hundreds of times since. And when our executive director, Vicki Markiewicz, spoke to the Sun about a number of tragic cychlorphine deaths, we told them that our services don’t feel prepared.

How could any already stretched team prepare for novel substances that appear without warning, with unknown effects? We have training, and processes in place to respond as best we can, but saying ‘we’ve got this covered’ would have been both reassuring and dishonest. That’s the change. Fewer polished narratives. More messy present tense – what we’re trying, what’s failing, what we’re learning.

Transparency builds trust. Not polish. Not perfection. The sector’s been told it hasn’t demonstrated enough change. Maybe that’s because our communications have been demonstrating competence instead of actual adaptation – the difficult, incremental reality of trying to help people live better lives. And maybe we can change that. 

Russell Booth is head of strategic communications and external affairs at Change Grow Live

 

 

A Deep Breath

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DDN
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Deep breath tobacco harm reduction

There’s no excuse for ignoring tobacco harm reduction, hears DDN.

There’s tension between tobacco harm reduction (THR) and ‘traditional’ harm reduction, said Tony Duffin, introducing a dialogue hosted by Knowledge Action Change. ‘But harm reduction is about active intervention and not standing about waiting for something to happen.’ So what’s going on, and what should we be doing?

Firstly, we had to understand the pressing need, said Professor Gerry Stimson. Twenty per cent of the world’s population now smoked and it killed more than malaria, AIDS, TB and illicit drugs combined. Cigarettes were a convenient but very dirty delivery system; furthermore they were highly reinforcing, providing a big spike in nicotine that quickly made smokers want another.

THR had mainly been about making it difficult to smoke and was also one of the only public health areas to use stigma – the deliberate stigmatisation of smokers. Harm reduction had lagged behind as nicotine replacement therapy was ‘boring’ – there was no hit. Then e-cigarettes came along in the 2000s and were a consumer-led intervention that changed all that, said Prof Stimson. But a lot of misinformation – and silence from key organisations that could have furthered the dialogue – had stalled progress.

The fact remained that most drug users smoked and smoking-related deaths were the biggest health risk they face, he said. So it made no sense that smoking was still ignored by many services.

‘Tobacco harm reduction is even more contentious than drug harm reduction,’ said Dr Garrett McGovern of Priority Medical Clinic in Ireland. ‘The field hasn’t embraced it at all and there’s a disinterest in getting involved.’ Vaping was revolutionary but was ‘often thrown under the bus’ along with smoking. ‘It’s hard to believe that tobacco harm reduction is so controversial,’ he said. ‘It should be an easy sell.’

Wider smoking harms

Dee Cunniffe
Dee Cunniffe, lead of the SWERVE harm reduction hub

The risks of smoking were not limited to cigarettes, emphasised Dee Cunniffe, lead of the SWERVE harm reduction hub in London. Safer inhalation and pipe provision could make a significant difference to the health of people using crack – many homemade pipes used steel wool that resulted in people ingesting metal. Yet it was currently illegal to give out pipes and gauze. 

‘People think smoking is safer than injecting, but with new synthetic drugs that’s not always the case,’ she added. ‘It’s just as risky as injecting.’ She called for more harm reduction hubs – places like SWERVE, which was unusual as it wasn’t part of the drug and alcohol service. ‘It works better as people don’t fear their prescription will be changed,’ she said.

Mobile Outreach

Dr Al Story, professor of inclusion health at University College London, is involved in running a pioneering ‘electric tricycle clinic’ outreach service that’s equipped for scanning, testing and treatment. The initiative is part of Find & Treat, in partnership with Central and North West London NHS Foundation Trust, whose focus is on early detection and treatment of tuberculosis. London was ‘the TB capital of Western Europe’, he said. 

‘We talk about harm reduction but not harm diversion,’ he said. Seeing inside people’s lungs on a day-to-day basis showed the damage inhaling could cause, and there were significant risks of TB from smoking crack – ‘It hits your airway like a volcano exploding, but it completely numbs your lung. It anaesthetises you, so you carry on. It’s a superhighway to becoming a respiratory cripple.’

His colleague at UCL, Robert West, had carried out a ‘willingness to quit’ survey. Pre-radiology the results were the same as for the general population, but post-radiology the scale of willingness ‘went through the roof’ as people were conscious of the harms. ‘We don’t use any of these opportunities in the NHS,’ he said, and so remained very poor at promoting any kind of harm reduction.

Dr Al Story
Dr Al Story rides an electric tricycle fitted to function as a health clinic as part of UCLH’s Find & Treat service. The mobile clinic has been designed to allow access to London’s hard-to-reach homeless population and screen for blood borne viruses, TB and much more. Credit: uclh.nhs.uk

Misconceptions

Martin Cullip of the Taxpayers’ Protection Alliance underlined a fundamental problem – that people routinely believed that nicotine caused the harm rather than the combustion. ‘It’s a simple concept, but consumers need to have accurate information – 63 per cent of people who smoke think vapes are at least as harmful as cigarettes.’ 

The Tobacco and Vapes Bill was a ‘despicable policy’ in terms of its vape regulations, and would cause harm, he said. ‘Access, affordability and choice are what you need, and it limits those.’ We were turning a blind eye to the evidence on every level, he said – in Sweden people used snus as an alternative to smoking and the country had one of the lowest cancer rates in Europe. ‘But its sale is banned here, and that’s crazy.’

‘We now have a hysteria around e-cigarettes and youth,’ added Garrett McGovern. ‘It’s far from an epidemic – it’s rights of passage stuff. You don’t see kids smoking in the media, just vaping – but that’s far better than smoking.’

Challenging environments

Mick Stoney, governor of HMP Barlinnie, described the challenges of introducing harm reduction to the prison estate. Prison not only took away freedom, it also took away freedom to make choice, so with any health intervention (such as hepatitis C testing and treatment) it was hard to gain trust. In 2018 smoking was banned from prisons – for reasons of prison officers inhaling second-hand smoke – and vapes were introduced, which turned out to be a successful transition.

People often left prison in much better health than when they went in, he said, but if there were no plans in place when they came out the improvement was doomed to failure. We had to take into consideration that the vast majority of people in prison had experienced a range of adverse childhood experiences (ACES) and needed support at all levels.

For Adriana Curado of the harm reduction network GAT in Portugal, harm reduction was ‘a way of thinking, dignity and social justice… but if it is inclusive, it must include tobacco.’ Dialogue was ‘prohibitionist, driven by fear’ and the other barrier was cost – safer nicotine options were more expensive than cigarettes. But people needed choices about their own health. Two nicotine harm reduction projects in Portugal offered access to free products and a space without pressure or moral messaging. The conversion rates were good, she said: ‘People were tired of smoking and aware of the harms.’

Reducing Harm

Paul Townsley is CEO of Humankind
Paul Townsley is CEO of Humankind

‘To help people reduce harm we need to have an honest conversation – the most vulnerable people aren’t engaging,’ said Alex Boyt. Misplaced focus in our drug strategy had seen deaths rising every year, and services weren’t attractive to people who needed harm reduction the most. Services had never cared about tobacco harm reduction – ‘I smoked for 30 years and no service addressed that.’

‘It’s appalling what services don’t do – including ours – around smoking,’ said Paul Townsley, CEO of Waythrough. ‘It’s a whole area that’s not seen as relevant to treatment services. We can improve massively.’

We needed to go back to the evidence base – what works for people, he said. Despite being much better resourced than we were 20 or 30 years ago, we were also now working in a ‘policy vacuum’ – ‘the government is not interested in the people we’re working with’. We had to have more buy-in from politicians and local areas on every level, he added. And for tobacco harm reduction? ‘It’s about looking forward, notwithstanding the challenges we’re up against,’ he said. DDN

 

More than a million people quit smoking last year

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More than a million people in the UK quit smoking in 2025, according to figures from UCL’s smoking toolkit study released to mark yesterday’s National No Smoking Day. Thirty-five per cent of current smokers had tried to stop, with 29 per cent quitting successfully. A separate poll by ASH, meanwhile, shows that more than half of smokers would like to stop.

According to the most recent ONS statistics, around 5.4m UK adults had used e-cigarettes in the previous year, with the number of vapers overtaking the number of smokers for the first time. The proportion of current smokers fell to 10.6 per cent of the population in 2024, the lowest since records began.

The proportion of current smokers fell to 10.6 per cent of the population in 2024, the lowest since records began

The Tobacco and Vapes Bill – which aims to create a ‘smokefree generation’ by phasing out the legal sale of tobacco to anyone born after January 2009, as well as tightening the regulations around vape flavours and packaging – has now passed its final stage in the House of Lords. Although the bill still has to return to the commons for consideration of amendments, it is expected to become law by the end of next month.

However, health charities including ASH are urging the government to maximise the impact of the legislation by pairing it with a ‘national quit push’, including ‘properly funded’ smoking cessation services, a high-profile public health campaign, and targeted help for the groups with the highest smoking rates – such as people in manual jobs and people with mental health needs.

A report last year from the University of York called for urgent action to address the ‘unseen epidemic’ of smoking-related deaths among people with mental health issues, as those with conditions like depression, bipolar disorder or schizophrenia were around three times more likely to smoke than the general population. According to the most recent NDTMS figures, almost half of people in drug and alcohol treatment were also smokers.

‘The smokefree generation policy is a vital step forward, but it will not on its own address the harm caused by smoking among the millions of people who already smoke,’ said Sarah Jackson of UCL. ‘To prevent avoidable illness and premature deaths on a large scale, we must ensure that existing generations of smokers are supported to quit. Making effective treatments accessible, affordable, and proactively offered through healthcare services will be critical if we are to translate motivation into long-term success and reduce the massive burden of smoking-related disease.’

Hazel Cheeseman: ‘History shows that big, high-profile policies create a real ripple effect’

‘History shows that big, high-profile policies create a real ripple effect,’ added ASH chief executive Hazel Cheeseman. ‘When smokefree laws banning smoking in public places were introduced in 2007, almost one in five people who tried to quit said the new law helped motivate them. Now we have the chance to do that again, inspiring the 5.3m people still smoking to join the smokefree generation and take a step towards ending the harm caused by tobacco.’

This year’s Global Forum on Nicotine will explore why prohibition of safer nicotine products such as vapes, pouches and snus in some countries risks rather than protects public health, and look at the emerging ‘deep structural contradiction’ between science and global public health policy from organisations such as WHO. Full details available here.

Drug executions hit highest ever level

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At least 1,212 people were executed for drug-related offences last year, according to the latest analysis by Harm Reduction International (HRI) – a ‘catastrophic’ 97 per cent increase on 2024’s total of 615 and the highest number since monitoring began two decades ago. More than 950 of the executions were carried out in Iran, an average of almost three per day.

Punitive drug control is now a ‘primary driver’ of the death penalty worldwide, says The death penalty for drug offences: global overview 2025, with drug-related executions now accounting for almost half of all confirmed worldwide executions. However, levels of state secrecy in countries like China and North Korea mean the true scale is likely ‘far greater’, the agency stresses.

Almost 2,500 people are currently on death row for drug offences, with many facing ‘imminent’ execution.

Almost 2,500 people across 22 countries are currently on death row for drug offences, the report states, with many facing ‘imminent’ execution. The number of countries retaining the death penalty for drug offences now stands at 36, its highest level, after Algeria and the Maldives amended their laws to introduce it.

‘The application of the death penalty for drug offences frequently targets the most vulnerable members of society,’ the document says, with the majority occupying ‘peripheral roles’ in the drug trade. Among those executed last year, more than 270 were foreign nationals and almost 340 were from ethnic minorities. At least 23 were women, many of whom were arrested either as couriers or accomplices to their partners.

‘Iran’s intensified war on drugs has disproportionately impacted marginalised groups, including ethnic minorities, people from disadvantaged backgrounds and foreign nationals,’ the report states, with many enduring trials ‘riddled with severe rights violations.’ Most drug-related executions in Iran are not officially announced, it says, with many carried out in secret.

‘Iran’s Islamic Penal Code allows elm-e-qazi (knowledge of the judge) as an admissible basis for establishing guilt in the absence of a confession or witness testimonies, based on other available evidence – including circumstantial evidence,’ the report continues. Human rights organisations have reported instances where this has been ‘arbitrarily applied’, such as when three men were executed on 9 September last year ‘in a joint case where no drugs or other evidence were found’. Other documented human rights violations include ‘systematic’ denial of effective legal counsel and confessions extracted through torture.

While the world had been generally trending towards abolition, last year saw ‘significant setbacks’, says HRI. ‘The 2025 spike was driven largely by a small group of countries that have intensified their punitive measures’ while ‘for the first time in over a decade, two countries – Algeria and the Maldives – introduced the death penalty for certain drug offences.’

‘The year 2025 was an exceptionally brutal one for global drug control,’ said HRI’s acting executive director Catherine Cook. ‘We are witnessing a sharp escalation in the use of the death penalty by a small but resolute group of countries. The international community’s long-standing failure to hold executing states accountable has moved beyond negligence and now borders complicity. By maintaining “business as usual” – and in the case of the UNODC, continuing to fund enforcement in countries like Iran – global institutions are effectively subsidising a record-breaking surge in state-sanctioned killing.’

The death penalty for drug offences: global overview 2025 available here

New ten-year drug and alcohol plan for Scotland

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A new ten-year plan to reduce drug and alcohol harm and deaths has been jointly published by the Scottish Government and the Convention of Scottish Local Authorities (COSLA).

Preventing harm, promoting recovery: Scotland’s alcohol & drugs strategic plan 2026-2035 replaces the five-year national mission on drugs, the final funding for which was announced late last month.

The plan, which is backed by £160m funding for 2026-27, aims to ‘improve collaboration between government and grassroots delivery with a locally-led, accountable system, guided by clear national direction and support’. A damning 2022 report from Audit Scotland said that delivery of drug and alcohol services in the country was overly complex, with lines of accountability ‘not always clear’ – making spending and value for money difficult to track. A subsequent Audit Scotland report said that while some headway had since been made, the country’s ongoing drugs death crisis had led to the government shifting attention away from alcohol harm.

‘As we respond to new challenges – including an increasingly toxic drugs supply – this plan refocuses our efforts in a more co-ordinated and sustainable way,’ said drugs minister Maree Todd

One key priority for the new plan is to expand treatment standards to include alcohol and all drugs, the Scottish Government states, while there will also be a ‘renewed focus’ on prevention, and support for residential rehab – especially ‘improving pathways through detox, crisis care and stabilisation’. The plan is ‘underpinned by a human-rights approach’, it adds.

Although the most recent figures for drug and alcohol deaths in Scotland both showed decreases from previously record highs, the drug death rate remains the highest in Europe – with the most deprived communities bearing the brunt.

WithYou recently published its manifesto for drug and alcohol services ahead of this May’s parliamentary elections, calling for a dedicated alcohol strategy, expansion of harm reduction, and ‘clear outcomes and accountability’ across all services.

The fact the new plan was a joint government-COSLA initiative would ‘strengthen national and local partnership working so that people can receive the right help when and where they need it’, said drug and alcohol policy minister Maree Todd. ‘The last five years have seen record investment in alcohol and drugs services, with significant progress, but we want to do more. This plan marks the next phase in our response to tackling alcohol and drug harms. We are already widening access to treatment, residential rehabilitation and life-saving naloxone, and Glasgow hosts the UK’s first safer drug consumption facility. As we respond to new challenges – including an increasingly toxic drugs supply – this plan refocuses our efforts in a more co-ordinated and sustainable way.’

‘Back in 2024, Audit Scotland called out the Scottish Government for shifting focus away from alcohol harm and made a strong recommendation that by mid-2025, the Scottish Government must “agree actions to increase focus and funding for tackling alcohol-related harm, while continuing to tackle drug-related harm”,’ said SHAAP chair Dr Alastair MacGilchrist. ‘Today’s plan is welcome but we have been pressing the Scottish Government for some time to act with urgency to address Scotland’s alcohol problem. With almost one in five Scottish adults showing signs of hazardous or harmful drinking, around 30,000 alcohol-attributable hospital admissions every year, and more than three people dying an avoidable alcohol death every day, the scale of the challenge demands action that matches the rhetoric.’

Abbeycare’s Billy Henderson: ‘We welcome the focus on bridging the gap between detox and rehabilitation’

His organisation would ‘now advocate for accountability – and funding’, he added, ‘so that today’s plan is not forgotten about after May’s elections, but forms the basis of meaningful and sustained action to address the treatment gap for people struggling with alcohol problems across Scotland.’

‘Scotland’s drug-related death toll is still tragically high, so it is crucial that the Scottish Government continues to take action,’ said service engagement manager at AbbeyCare, Billy Henderson. ‘We welcome the commitment to maintaining a minimum of 1,000 rehab beds annually, and the focus on bridging the gap between detox and rehabilitation. By strengthening the links between statutory services, recovery communities, and mutual aid groups, this plan addresses the critical aspects needed to save lives and support long-term recovery.’

‘The strategy provides the long-term framework we’ve been calling for,’ added director of Scotland at WithYou, Louise Stewart. ‘We particularly welcome the commitment to expand safer drug consumption facilities beyond Glasgow, explore drug checking through mobile and postal services, develop overarching treatment standards covering all substances with clear accountability for delivering them, and commission a national needs assessment for alcohol treatment. The strategy’s human rights-based approach is also vitally important, and embedding the Charter of Rights across all services will be critical. But the next government must guarantee that this strategy is backed by protected, multi-year funding that rises with inflation. Without that, we risk losing the workforce, the momentum and the progress that’s been built.

Although alcohol deaths outnumbered drug deaths in 2024, alcohol has ‘consistently received less policy focus and funding,’ she continued. ‘The strategy commits to a national needs assessment for alcohol treatment, considers expanding alcohol care teams in hospitals, and promises an action plan later in 2026. These are important steps. But we are calling for a dedicated alcohol strategy with ring-fenced resources. That action plan must be published swiftly with clear timelines. Alcohol cannot be overshadowed again.’

Preventing harm, promoting recovery: Scotland’s alcohol & drugs strategic plan 2026 – 2035 is available here

The Loop launches London drug checking service

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The first drug checking service in London has been launched by The Loop, the charity has announced. The initiative, which is funded by Camden and Hackney councils and supported by the Metropolitan Police, will offer ‘rapid chemical analysis of substances of concern’ alongside personalised health advice.

The service will also be able to collect information on drug market trends to share with local communities, the police, health services and the hospitality and events industries. The Loop, which has been carrying out drug testing at festivals and events for more than a decade, launched the UK’s first regular drug checking service in Bristol in early 2024. Both the Bristol and London services are licensed by the Home Office.

Fiona Measham: ‘Drug markets are more dangerous than ever’

The new London service will ‘aim to reach and work with people at all stages of dependency’, the charity states, offering non-judgmental support from health professionals. ‘The organisation is clear that no drug use is without risk, but that better understanding of substances of concern in circulation benefits individuals, communities and emergency services by reducing the harm caused by potentially dangerous drugs,’ it says.

A report published last month by researchers at King’s College London stated that limitations in postmortem toxicology testing meant that the official number of deaths related to nitazenes in the drug supply had likely been underestimated by ‘up to a third’, while Public Health Scotland also recently warned anyone using street drugs to assume they are contaminated with other substances.

‘Drug markets are more dangerous than ever, with increasing numbers of potent synthetic drugs in circulation across the UK,’ said The Loop’s founder and chair of trustees, Professor Fiona Measham. ‘Drug checking can play a unique role in countering these threats, acting as the “canary in the coalmine”. It tests, identifies and communicates these risks rapidly and directly to local services and local communities. Drug checking reduces drug-related harm, which reduces the burden on emergency services and the NHS.’

The project marked a ‘major step for harm reduction in the UK’ added the charity’s CEO, Katy Porter. ‘Hackney and Camden are the first of several London boroughs we are working with, alongside further cities. This launch represents another important shift toward evidence-based health interventions at a time when drug deaths in England are at an all-time high.’

WithYou publishes Scottish drug and alcohol manifesto

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WithYou has published a manifesto setting out six key priorities for drug and alcohol treatment ahead of the Scottish Parliament elections in May.

The next Scottish Government must agree on a long-term plan beyond the national mission on drugs, which ends this month, as well as ‘put people first by embedding rights and challenging stigma’, the charity states.

The next Scottish Government must agree on a long-term plan beyond the national mission on drugs, WithYou states

It is also vital that the government deliver a dedicated alcohol strategy for the country, establish ‘clear outcomes and accountability’ across all services, expand harm reduction, and ensure that services are ‘accessible and consistently available’. The final funding for the five-year national mission was announced by the government last month. ‘With elections in May, every party must commit to evidence-based policy, sustained investment, and the courage to close the gap between policy and practice,’ says WithYou.

A 2024 report from Audit Scotland found that while the Scottish Government had ‘made headway’ in implementing treatment standards and increasing residential capacity it had been ‘slow to progress’ key national strategies like a workforce plan or reforming alcohol marketing, adding that the country’s ongoing drug death crisis had shifted attention away from alcohol harm. A previous report from the auditing body found that delivery of drug and alcohol services in the country was overly complex, with lines of accountability ‘not always clear’.

Drug deaths are up to 12 times higher in Scotland’s most deprived communities, WithYou points out, with alcohol deaths more than four times higher –  inequalities that would not be solved by ‘treatment alone’. The next government needs to ‘invest in prevention, addressing poverty, trauma and exclusion before they drive harmful use’, it says.

The charity supports more than 14,000 people across the country with drug and alcohol issues. ‘We see their courage. We see what’s possible when the right support is there. And we see what happens when it isn’t,’ said the charity’s director for Scotland, Louise Stewart.

Priorities for the next Scottish Government available here

Is this a record? Ruth celebrates 35 years at Mount Carmel

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We’re delighted to share with all our friends and partners that Ruth Allonby has just celebrated 35 years here at Mount Carmel – including the last 30 as CEO – and still counting.

Ruth Allonby
Ruth Allonby, CEO Mount Carmel

Is this a record, we wonder?

Thirty-five years is a long time in any organisation, but especially in the rehab world, where the pressures and emotional demands can so easily lead to burnout. Over all those years, Ruth has steered Mount Carmel through challenges and changes that everyone in Choices will know well.

Some of these changes have been brought about by our drive for continuous improvement of our services.

But the greatest impacts have come from three external factors:

  • the problems around the relentless reductions in public funding for our treatment services
  • the ever more detailed scrutiny from the CQC – beneficial of course, but demanding too
  • and finally, Covid. Like all residential rehabs, we, and Ruth in particular, were faced daily with the responsibility of keeping staff and clients safe and healthy, and maintaining morale.

Ruth’s leadership in dealing successfully with all these issues – especially the Covid threat, existential in every sense – has been outstanding.

We asked Ruth how she’d summarise her 35 years:

‘Looking back, it’s amazing how quickly the time has passed. In some ways it feels as though day one was yesterday. But when I compare where we are now with the late ’80s, we really have achieved a huge amount.

‘And I say “we” because none of it would have been possible without our staff team. Their dedication to Mount Carmel and to our clients underpins everything we do. Also vital are our partnerships with local authorities and the social care charities, CGL, Via, and similar – we couldn’t do our work without having these close working relationships. There are so many committed, compassionate people across the addiction field, and I’m very lucky to have worked alongside so many of them.

‘But what still gets me up early to face the South London rush hour is the chance to help people into recovery. As we all know, recovery transforms not just our clients’ lives, but the lives of their families too. Knowing we play a part in that, again and again, is a huge motivation. And when I meet graduates at our annual BBQ – including people who began their recovery in Mount Carmel years ago in my early days – and hear how their lives have prospered, I feel privileged.

‘Long may it continue!’

Find out more about the work of Ruth and the Team: mountcarmel.org.uk

Beachfront Addiction Recovery Facility in Thailand with Holina Rehab

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Holina Rehab ThailandResidential addiction treatment overseas remains a truly viable consideration for some UK clients and families, particularly where privacy, rapid access to support or alternative therapeutic environments are priorities.

One service positioning itself within this international recovery landscape is Holina Rehab, a licensed residential addiction and trauma treatment centre located on the Thai island of Koh Phangan.

Licensed by the Thai Ministry of Health, Holina offers structured residential programmes combining traditional addiction treatment approaches with holistic therapies and emerging complementary interventions, including hyperbaric oxygen therapy (HBOT).

Why some UK clients consider overseas rehab

While most treatment in the UK continues to be delivered through NHS or commissioned third-sector services, private overseas rehabilitation has become a niche option for certain groups. Some of the reasons cited by providers and families include confidentiality, shorter waiting times and the perceived benefits of a physically separate recovery environment.

Holina highlights the privacy of its island location alongside accessibility for international clients. Koh Phangan has a well-established wellness and therapeutic community, which allows the service to draw on a diverse range of therapists and recovery specialists. The tropical setting can support recovery by reducing external stressors – a tranquil space away from the hustle and bustle of life – and offers opportunities for many outdoor therapeutic activities.

Cost is also a factor mentioned by families exploring overseas care. Depending on the length of stay and package options, residential treatment abroad can, in some cases, compare favourably with UK private rehab pricing – although travel, insurance and aftercare continuity all need careful consideration.

Koh Phangan’s tropical paradise island is the perfect setting for drug detox programs and holistic addiction treatment in Thailand.
Koh Phangan’s tropical paradise island is the perfect setting for drug detox programmes and holistic addiction treatment in Thailand.

A structured residential recovery model

Holina describes its core approach as a combination of a Western 12-step framework with psychotherapy, trauma-informed work and a range of holistic interventions. These include somatic therapies, breathwork, mindfulness practices, physical wellness activities, creative therapies and structured group work.

The programme is designed to address substance addictions alongside behavioural or process addictions and co-occurring mental health challenges such as anxiety, trauma and depression. Treatment typically begins on arrival rather than fixed cohort start dates, allowing flexibility for international admissions.

A typical weekday schedule includes morning meditation or physical activity, therapeutic group work, individual sessions, educational groups and evening recovery activities. Nutrition, physical wellbeing and peer support groups form part of the daily routine.

Holina also emphasises continuing support after residential treatment, with ongoing support groups helping to sustain recovery once clients leave the programme.

Holina Thailand offers a range of holistic therapies – daily Yoga, Yoga Nidra, Breathwork, Mindfulness exercises, and our renowned Inner Walking meditation.
Holina Thailand offers a range of holistic therapies – daily yoga, yoga nidra, breathwork, mindfulness exercises, and inner walking meditation.

Integrating hyperbaric oxygen therapy into recovery support

One of the more distinctive aspects of Holina’s offer is the inclusion of hyperbaric oxygen therapy within its broader wellness programme. HBOT involves breathing oxygen in a pressurised chamber and has established medical uses in areas such as wound healing and certain neurological conditions.

Within addiction treatment settings, interest in HBOT has been growing internationally and research is emerging. Some providers are exploring its potential role in supporting neurological recovery, stress reduction and general wellbeing during early recovery, though it is not currently a standard addiction treatment intervention in the UK.

Holina positions HBOT as a complementary element rather than a standalone treatment, integrated alongside psychotherapy, trauma therapy, physical wellness and peer support. As with any adjunctive therapy, prospective clients are advised to consider the evidence base, clinical oversight and suitability for their individual health needs.

The dedicated team of professionals at our Thailand rehab centre ensures each person receives comprehensive treatment tailored to their needs
The dedicated team of professionals at Holina Rehab Thailand ensures each person receives comprehensive treatment tailored to their needs

Environment and therapeutic setting

Holina’s facilities are located close to the coast, with accommodation, therapy spaces, fitness facilities and communal areas designed to support residential recovery. Residents have access to private rooms, outdoor therapy options, yoga, mindfulness sessions and wellness amenities such as pools, sauna and fitness areas.

The environment is designed to be part of the therapeutic approach, emphasising calm surroundings, structured daily routine and opportunities for reflection away from usual triggers.

A supportive option for international clients

For some UK clients and families, overseas residential treatment offers a combination of privacy, focused therapeutic time and a change of environment that can help support engagement with recovery. Services such as Holina aim to provide structured care alongside a calm, wellness-focused setting, with programmes designed to support both immediate stabilisation and longer-term personal development.

The emphasis on community living, daily therapeutic structure and holistic wellbeing reflects a broader trend within private residential care towards treating addiction in the context of overall physical and emotional health.

To explore how Holina Rehab Thailand could support you on your recovery journey, visit: www.holinarehab.com

The Forward Trust’s Annual Review and Impact Report

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The Forward Trust reached over 35,000 people in 2024-2025, making this a record-breaking year with a 9% increase in the number of individuals supported compared to the previous year. 

Forward Trust Impact report This growth was fuelled by the expansion of our services – we now have 74 contracted programmes across England and Wales, in prisons and the community.

This report, which formed part of our wider ‘Annual Review, Impact Report and Accounts for the year ending 31st March 2025‘, showcases a range of service developments and interesting case studies that show why Forward has been able to support more people than ever before.

Context for the importance of our work is evidenced in the ‘Who we work with’ section: one in four clients in the community are in need of housing (or already homeless), and one in ten people have never been employed.

As a social justice charity, we reach some of society’s most marginalised and disadvantaged groups – the individuals we support are often homeless, out of work, and in poor mental or physical health. Most will have been let down by schools or the care system, and many will have been traumatised by adverse childhood experiences.

This is why our research and evidence-based treatment approach is fundamental to our work, including the Theory of Change, which is a foundational element to all of our service support pathways.

The report also provides a meaningful explanation for the service categories – Substance Misuse and Mental Health, Criminal Justice, Employment, and our range of smaller services within Recovery and Belonging.

Find out more

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by The Forward Trust

 

Via strengthens residential rehab provision at Passmores House

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Via has strengthened its residential detox and rehabilitation provision at Passmores House, increasing capacity to meet sustained demand while maintaining the quality, consistency and clinical oversight the service is recognised for.

Passmores House is an established residential substance misuse service supporting adults with alcohol and drug dependence, including people with co-existing mental and physical health needs.

Based in Essex, just outside London, the service accepts referrals from across England and works closely with community treatment teams, commissioners and partner agencies to support planned admissions into detox and rehabilitation.

Passmores House video
See what it’s like inside Passmores House residential rehab and detox centre

Supporting access to residential treatment

The increase in capacity enables the service to support more people through medically managed detoxification and structured rehabilitation, helping to reduce delays and improve continuity between community and residential care. Quality and responsiveness recognised by CQC. In its most recent inspection, Care Quality Commission rated Passmores House Good overall, with the service rated Outstanding for responsiveness. Inspectors highlighted the service’s ability to tailor care to individual need, its flexibility in supporting complex presentations, and its strong focus on continuity of care.

The inspection also found the service to be Good across safety, effectiveness, caring  and leadership, noting that people felt safe, well supported and treated with dignity and respect. Feedback from people using the service and their families was consistently positive, with many describing Passmores House as highly supportive and therapeutic.

‘The CQC findings reflect what referrers already know about Passmores House,’ said Paul Mubu, Area Director. ‘This is a service with strong clinical leadership, skilled multidisciplinary staff and a clear focus on individualised, recovery-oriented care.’

Passmores house
Passmores’ grade II listed building offers first-class facilities and serene surroundings.

An established, clinically led residential service

Passmores House offers integrated detoxification and rehabilitation programmes, typically over 12 or 24 weeks, delivered by a multidisciplinary team including doctors, nurses, recovery practitioners and psychological specialists. The service supports adults with a broad range of needs, including people accessing planned detox and rehabilitation as well as those who have more complex presentations and require additional clinical or psychological support.

‘Strengthening capacity at Passmores House allows us to respond to ongoing demand for residential detox and rehab while preserving the therapeutic environment and level of individual attention that we are known for,’ added service manager Darren O’Meara.

The expanded provision at Passmores House forms part of Via’s wider commitment to improving access to high-quality residential treatment and supporting effective, joined-up pathways between community and inpatient services.

Find out more at viaorg.uk

Passmores House rated Good overall and Outstanding for responsiveness by CQC

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Passmores House, Via’s residential detox and rehabilitation service in Essex, has been rated Good overall and Outstanding for responsiveness by the Care Quality Commission (CQC).

The inspection recognised the service’s person-centred approach, clinical quality and ability to respond flexibly to people with complex needs.

The inspection praised Passmores House for tailoring care to individual need, supporting people with co-existing mental and physical health conditions, and maintaining continuity between detoxification, rehabilitation and discharge planning. The service was also recognised for strong leadership, a positive learning culture and skilled, compassionate staff.

CQC rated the service Outstanding for responsiveness, highlighting its flexibility in meeting complex presentations, including chemsex and ketamine use, and its commitment to ensuring people feel safe, respected and involved in their care.

Read the full report

Beyond Custody

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Beyond Custody DDN article

Women in custody are some of the most marginalised in our communities. It’s time to put some real alternatives and genuine recovery pathways in place, says Rachael Clegg.

International Women’s Day this month is a time to celebrate progress, but also to face hard truths. One of those truths is this – some of the most vulnerable women in our society are still more likely to go to prison than into treatment. More likely to be separated from their children than supported to recover alongside them. More likely to experience systems as punitive rather than protective.

Women in custody are among the most marginalised in our communities. Many live with trauma, poor mental health, poverty, homelessness and substance use. Many have experienced domestic abuse or sexual violence. Many are primary caregivers. Almost all have faced significant adversity long before they enter the criminal justice system. And yet, for some women, prison is the first place they experience stability, the first time substance use stops, the first time there’s routine, the first time there’s a bed of their own.

Prison should not be the safest place a woman knows. If we’re serious about fairness and prevention, we must strengthen real alternatives to custody and create clear, gender-specific pathways from custody into residential rehabilitation. Treatment should not be a last-minute option at crisis point. It should be considered early – before custody, instead of custody, and directly from custody when appropriate.

Women leaving prison or facing court are often trying to navigate probation, social care, housing, safeguarding and mental health services all at once. These systems are complicated even for professionals. For women with histories of trauma – especially those who’ve felt judged or harmed before – they can feel overwhelming and unsafe.

If we want women to engage, we have to do more than offer a placement. We must walk alongside them. That means making safeguarding processes transparent, ensuring agencies communicate clearly with one another, providing practical support to attend appointments and hearings, and building trust through consistent, relational approaches rather than reinforcing fear.

Real alternatives 

Alternatives to custody are not about avoiding accountability. They are about responding to the realities of women’s lives – trauma, motherhood, coercion and poverty – with structured, intensive, trauma-informed treatment options that include residential services and protect both women and their children.

Gender-specific residential services, such as Phoenix’s National Specialist Family Service based in Sheffield and Ophelia House in Oxford, provide psychologically and physically safe environments where women can begin to recover. They offer structured therapeutic programmes and trauma-responsive care, alongside parenting support delivered within treatment rather than separately from it. Safeguarding processes are transparent and proportionate, helping women understand what’s happening and why. Support is integrated across housing, domestic abuse services, healthcare and the criminal justice system so women are not left trying to coordinate everything alone.

Our recent internal review of family-centred residential provision showed measurable improvements in women’s recovery outcomes alongside significant gains in children’s safety, stability and wellbeing. This is whole-family recovery in practice.

Importantly, these services are not soft options. They are structured, accountable and risk aware. They give courts and probation confidence that women are engaging in intensive interventions designed to reduce harm and reoffending.

The right pathway DDN article on women and prisonsTreatment is not enough

Many women involved in the criminal justice system have experienced services as fragmented or frightening. Safeguarding can feel threatening. Court can feel overwhelming. Housing systems can feel impossible to navigate. Disclosure can feel unsafe.

We cannot simply expect traumatised women to ‘engage better’. Advocacy and coordination are essential. Women need support to understand processes, prepare for meetings, attend appointments and rebuild trust in systems that may have previously let them down. This relational work is not an optional extra – it’s central to sustainable recovery and reduced reoffending.

To make real alternatives standard practice, women who would benefit from residential rehabilitation treatment need to be identified earlier. Funding pathways must be clear and accessible. Referral routes between courts, prisons, probation and treatment providers need to be strong and straightforward. Cross-agency women’s panels can support timely, informed decision-making. Sentencers need confidence that residential rehabilitation is a credible and effective alternative to custody. And recovery cannot end at dis­charge – long-term aftercare planning must be built in from the start.

Rehabilitation should not feel like a ‘golden ticket’ available only when risk escalates to crisis. It should be part of a clear continuum of care that prevents harm rather than simply responding to it.

Call for change 

As a society, we often expect the most from the women who have the least support. We ask them to stop using substances, comply with probation, attend court, secure housing, engage with safeguarding and parent under scrutiny, all while managing trauma and fear.

phoenix women prison service detailsWomen in custody do not lack resilience. What they need are accessible, gender-specific, trauma-informed alternatives that recognise both risk and potential. When we create real alternatives to custody and clear pathways into residential rehabilitation, we do more than reduce reoffending. We prevent babies being born into instability. We keep families safely together. We interrupt cycles of trauma.

Rachael Clegg
Rachael Clegg

Recovery for women, whether alone or alongside their children, should not be rare. It should be expected. And together, across justice, health and social care, we can build a system where that expectation becomes reality.

Rachael Clegg is head of operations for women and families at Phoenix Futures

 

 

At their service 

By
DDN
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WithYou’s groundbreaking Rebuild Project is providing much-needed dedicated support for female veterans struggling with trauma and substance use. DDN reports.

Read it in DDN Magazine

Female soldiers of 7th Battalion, The Rifles at the Lord Mayor’s Show parade 2024 in the City of London. Avpics / Alamy
Female soldiers of 7th Battalion, The Rifles at the Lord Mayor’s Show parade 2024 in the City of London. Avpics / Alamy

‘Women have served within the armed forces for over 100 years,’ says the 2021 We also served: the health and wellbeing of female veterans in the UK report. But while their contribution has been ‘extraordinary’, it states, the prevailing military culture had left its ‘mark on the health and wellbeing of many’.

Women veterans remain ‘very much a hidden population’, states the No man’s land report from veterans’ charity Forward Assist. The authors spoke to 100 women veterans, with the findings giving ‘real cause for concern’. Fifty-eight per cent reported having mental health issues, with ‘little support’ provided to help prepare them for the transition to civilian life, and adding that the civilian community often had difficulty even recognising women as veterans – something that could lead to women becoming ‘depressed, isolated, disconnected from services, and angry that their personal service goes unrecognised’.

Unique needs

Late last year, however, WithYou launched a new pilot substance use support service tailored to the unique needs of this group, and recognising the ‘intersections of military culture, gender-based experiences, and the stigma that surrounds both trauma and substance use within veteran communities’. With funding from the Armed Forces Covenant Trust, WithYou’s Rebuild Project offers specialist trauma-focused psychological therapy and forms part of its wider Armed Forces Community Programme – the charity was already the first drug and alcohol service provider to receive a gold award in the Ministry of Defence’s employer recognition scheme (DDN, November 2025, page 14). 

WithYou CBT and EMDR therapist, Simran Jassal
WithYou CBT and EMDR therapist, Simran Jassal

The free services on offer during the Rebuild Project’s 16-week course of specialist one-to-one therapy include CBT and EMDR (eye movement desensitisation and reprocessing), and the project is the ‘first of its kind in terms of having that in-house recovery worker engagement, plus the evidence-based support’ says the service’s high intensity CBT and EMDR therapist, Simran Jassal.

Positive outcomes

A 2021 study published in the journal Addiction found that almost half of women veterans in the UK were drinking at hazardous levels, and the available literature tends to suggest that among female veterans with substance issues, the problems are predominantly with alcohol rather than drugs. Among the Rebuild Project’s clients, it’s ‘usually co-morbid, but is often more alcohol,’ says Jassal – ‘although ketamine is a frequent one, along with cannabis.’ Clients find the EMDR process particularly helpful, she says, with ‘very positive outcomes – including reductions in alcohol use and overall mental health’. 

So do her clients feel there’s traditionally been little support available for them? ‘Definitely,’ she says. ‘A lot of the support organisations that are out there are very male-centric – in the advertising the pictures are always of men and the services are run by men, so it doesn’t seem very welcoming for a lot of females.’ 

Gaining trust

Given the sense of isolation and disconnection that some women veterans can feel, does it often take a long time to gain their trust? ‘It really depends on the client and their needs, and also the experiences they’ve gone through,’ Jassal says. ‘It depends on the trauma. I think they find it easier to open up because I’m female myself – they would have found it a lot harder if I was male – but with some clients, especially with the alcohol use being so substantial, there’s often more self-care work that needs to be done. So that can kind of put the therapy aside to some degree.’ 

Women now comprise just over 10 per cent of UK armed forces personnel – although the MoD is aiming for 30 per cent by 2030 – and their role has changed substantially over the last century. Whereas during the First World War they were likely to be confined to nursing or domestic roles, they’re now able to serve in close combat – with all the attendant dangers of injury and PTSD.  

Worryingly, however, the risks of trauma aren’t just limited to the battlefield. Military sexual trauma (MST) is defined as harassment, bullying or assault that occurs during military service, and according to a survey by Combat Stress one in five women veterans reported being the victim of sexual harassment and one in 20 of a sexual assault during their time in the military – this is alongside a fifth who’d experienced emotional bullying. The No man’s land report, meanwhile, estimated that more than three quarters had either witnessed – or sustained – a physical or sexual assault, with less than a quarter of those who experienced inappropriate or criminal behaviour feeling able to report it.  

Trauma familiarity 

Added to this, some female veterans will have experienced sexual abuse even before entering the military, and perhaps joined at a young age as an escape from their home environment. The ‘likelihood of experiencing childhood abuse, especially physical and sexual abuse, is higher for individuals with military service compared with the general population’, another Combat Stress report points out. 

How many of the Project Rebuild clients have experienced sexual abuse? ‘The majority,’ Jassal states. ‘But in a lot of cases it’s childhood sexual abuse. A lot of the women actually don’t experience trauma in the military, but it’s often what’s led them to the military. As there’s a lot of childhood sexual abuse, there’s that trauma familiarity that they’ve gone on to navigate their life with to some degree.’ The women will then ‘re-experience mistreatment from men around verbal abuse and harassment’, she says. ‘I’ve found more that women have been sexualised through verbal abuse from males, rather than rape, within the military. The sexual assaults have usually happened prior to joining the military.’

This existing trauma can be compounded by ‘going into the military and not having that strong sense of self’, she says, ‘and then coming out in a vulnerable state’. Even with one client who had served in combat situations, ‘her trauma isn’t about the combat,’ she states.

In terms of female veterans being voiceless and disenfranchised, however, things may be slowly starting to change. The project has built strong links to other organisations, and there’s a great deal of effective partnership working, Jassal says. ‘There’s other charities such as Salute Her and Tom Harrison House, and there’s also the Female Veterans’ Transformation Programme, which has been developed by women with lived experience. We work quite closely with them, and they’ve put together a package that includes housing support, mental health support, physical health support, all for women. That’s a great toolkit.’ 

‘Female veterans are not a homogenous group – they are a diverse group of women of different ages, experiences, ethnicities and backgrounds, who often go unrecognised,’ the toolkit says. While most female veterans won’t necessarily need additional support in transitioning to civilian life, ‘for those that do, all organisations need to do more to make sure they get the right support at the right time and in the right way.’

So is Rebuild likely to become a permanent service? ‘We’ve proposed 12 months, but we’re looking at potentially expanding and extending that, depending on the results,’ she says. ‘But it’s looking really good so far, so I don’t think that will be an issue.’  DDN

DDN March 2026

By
DDN
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Trauma isn’t incidental – it’s the central thread

DDN march 2026Our spotlight on women’s treatment in this issue makes it uncomfortably clear that women’s needs are being recognised too late. Whether we’re talking about female veterans experiencing the shock of civilian life, women navigating custody, survivors of domestic abuse, or those trying to engage with community treatment, the same pattern emerges. 

Trauma isn’t incidental, it’s the central thread – yet too often services remain shaped around a crisis response, with models originally designed for men. But it’s encouraging to hear from services that are listening and redesigning around what women actually need, and we have to make sure this practice is built into the culture of our services. Gender-responsive care shouldn’t be something women are lucky to find — it should be something they can count on.

In the same spirit of responsiveness, Digital Lifelines Scotland shows how embracing technology can add superpowers to harm reduction, particularly when co-production is involved. What better way to strengthen engagement – particularly at key transition points such as prison release and homelessness – and find people when they need us the most?

Read the March issue as an online magazine(you can also download it as a PDF from the online magazine)

Please send your letters and comment to claire@cjwellings.com

Claire Brown Editor of DDN Magazine

Claire Brown, editor

The right connections

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DDN
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Digital exclusion DHI

Since its launch in April 2021, Digital Lifelines Scotland (DLS) has evolved into one of Scotland’s most significant digital inclusion initiatives, with a primary aim to reduce drug‑related harm. 

The ambition of DLS (DDN, Dec 2025/Jan 2026, page 19) – which is underpinned by Scottish Government Drugs Policy Division funding and delivered by the Digital Health & Care Innovation Centre (DHI) in partnership with the Scottish Council for Voluntary Organisations (SCVO) and others – is to facilitate digital inclusion and design digital solutions that better meet people’s needs, to improve healthy outcomes for people who use drugs, and reduce the risk of harm and death.

The programme has demonstrated measurable and system‑level impact through increased digital access, improved wellbeing and strengthened service collaboration – with more than 5,500 people supported, more than 3,000 devices provided and almost 4,000 connectivity packages delivered. Nearly 520 staff and volunteers have also been trained in digital inclusion. 

Sustained delivery

These figures represent sustained delivery over four years and six funding rounds, and in partnership with 35 organisations – enabling access to services and support for communities that faced digital exclusion.

Through collaboration and partnership with experienced addiction service organisations, DLS identified three tiers where the programme needed to make an impact:

  1. People have greater access to the digital solutions that keep them safe and enable them to remain connected to family, friends and services, and the confidence, skills and motivation that provides.
  1. The services that support these people have the digital means to develop and strengthen the support they provide, and staff that are skilful in using and developing digital solutions to enable those they support.
  1. The sector is connected and collaborating, developing joined-up services and exploring digital solutions together.

Co-designing with partners identified key transition points where people were most vulnerable, such as experiencing or being at risk of homelessness, being released from custody or being discharged from hospital or residential services. DLS ensures that time is taken to fully understand the needs of affected people before co-designing appropriate solutions with them. By asking questions, listening to the answers and acting on these insights, a shared set of values has evolved:

» A culture of kindness, compassion and hope which is stigma-free and developed in an equal partnership with those who use services

» Support which adopts the principles of harm reduction in ‘meeting people where they are’

» Integrated case management, which involves the person in decision-making and a shared assessment of risk

» Practice which addresses more than just drug use, and is person-centred and trauma informed.

digital exclusionPositive Impact

Independent evaluations of DLS found the programme delivered ‘significant results’, including improved digital inclusion and digital literacy, better access to health and support services, reductions in social isolation, improved wellbeing and enhanced harm‑reduction outcomes.

Service users reported that digital connectivity made them feel safer, more valued, and better able to maintain contact with supportive networks. Evaluators also noted strong evidence of improved person‑centred service delivery, with individuals expressing a strengthened sense of connection, belonging and personal responsibility, facilitated by digital tools. This feedback reinforces Digital Lifelines’ core premise – that meaningful digital access is now inseparable from effective harm‑reduction activities in Scotland.

Workforce skills

A further sign of success lies in how DLS has equipped frontline workers and organisations – more than 500 staff and volunteers have received digital inclusion training, helping practitioners integrate digital tools confidently into support provision. This capacity‑building element has enhanced service responsiveness and the ability to maintain contact with individuals at risk, as well as sector‑wide collaboration on digital approaches.

Digital solutions developed through the programme have enabled organisations to deliver safer, more flexible support, particularly important for people who face stigma or life circumstances that can hinder traditional service access. The programme’s wider system impact is evidenced through:

» Joined‑up digital approaches across sectors, supporting cross‑organisational learning

» Significant contributions to national harm‑reduction priorities

» The embedding of digital practice into health and social care pathways

Strong outcomes

Comprehensive evaluations, such as the Digital Lifelines Scotland Evaluation 2025 by Figure 8 Consultancy, and Drugs Research Network Scotland’s assessment of the first two years, have shaped the design of the current phase 3 of the programme. These consistently emphasised the programme’s strong outcomes and its potential for scalable, long‑term impact. Ongoing impact reports produced by SCVO also show that DLS has been effective at reaching groups and areas previously underserved by digital inclusion initiatives.

A pivot towards system and sector level impact has been adopted for phase 3, working with some of Scotland’s alcohol and drug partnerships (ADPs) to help facilitate change. DLS continues to explore opportunities with suppliers and developers who are innovating in this still somewhat immature marketplace – alongside addiction-specific and overdose detection products is an enthusiasm to introduce people to the advantages of the digital world, reducing their fears and increasing their skills and confidence. 

Continued funding 

The Scottish Government’s decision to allocate funding for 2025-26 demonstrates strong confidence in the programme’s achievements and future direc­tion. After a competitive application process, funds were awarded to East Ayrshire and Angus ADPs – both have been exploring how digital zones and ‘Well-Bean’ recovery cafes hosted and developed by trusted community partners can improve access to digital support. In both locations the intention is to improve communications and collaboration between the many services supporting people who use drugs to better integrate services. 

It’s anticipated that further funding for 2026-27 will be confirmed this month, and senior government and sector leaders have publicly affirmed the programme’s life‑saving potential, describing DLS as ‘a powerful example of how innovation and compassion can come together to save lives’. The programme has also been recognised nationally, winning at the Holyrood Connect Digital Health and Care Awards in the digital Inclusion category, as well as being shortlisted for several other awards.

Across its first five years, Digital Lifelines Scotland has established itself as a transformative programme with demonstrable impact at personal, service, and system levels. Through improved digital access, stronger support networks, enhanced workforce capability, and evidence‑driven innovation, DLS has contributed meaningfully to Scotland’s efforts to reduce drug‑related harm and death. 

The programme’s expanding reach, strong evaluations and ongoing government investment position it as a vital component of Scotland’s national digital inclusion and public health landscape.

Alan Connor is portfolio lead at the Digital Health & Care Innovation Centre (DHI)

DHI conference

Scottish Government announces final national drugs mission funding

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DDN
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The Scottish Government has announced the final funding from its five-year national mission on drugs. Twenty-eight projects across the country will share £1m administered by grant-making charity the Corra Foundation, it states.

The projects include treatment and health support in Edinburgh and West Dunbartonshire, recovery hubs in Kilmarnock and Forth Valley, homelessness outreach services in Aberdeen, family liaison in the Highlands, a Forth Valley peer harm reduction project, and recovery workshops in Glasgow and Dundee.

Maree Todd: the Scottish Government will shortly announce its new alcohol and drugs strategic plan

‘As the national mission ends next month, we will shortly announce our new alcohol and drugs strategic plan and new support for the third sector,’ said drugs minister Maree Todd. ‘This funding provides a vital bridge to that – where we will again focus on sustained, need-based investment.’

Meanwhile a new briefing on substance misuse in prisons has been published by Scottish Health Action on Alcohol Problems (SHAAP). With more than 60 per cent of people in Scottish prisons having an alcohol use disorder, alcohol is ‘the forgotten crisis for those in the justice system’, it says.

An estimated 5,000 prisoners with alcohol dependence are entering custody each year, the briefing states, with the treatment gap now ‘massive’. Although 40 per cent of prisoners were drunk at the time of their arrest and 41 per cent said they would accept help if it was offered, just one per cent of the prison population were referred to specialist alcohol services in 2024-25. Continuity of care is also inconsistent, it adds, with the risk of death from alcohol-related causes three times higher for men – and nine times higher for women – who have been in prison than for the general population.

‘Alcohol is used as a coping strategy for unresolved trauma and mental ill-health, yet access to talking therapies, peer support and evidence-based treatments remains patchy,’ the report states, with overcrowding, lack of purposeful activity and long periods of lock-up increasing distress and driving substance use. ‘Alcohol harm in Scotland’s prisons is widespread, and people are not receiving enough of the support they need.’

Criminal justice committee inquiry into substance misuse in prisons available here

Health campaigners call for introduction of MUP in Northern Ireland after record alcohol deaths

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DDN
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Health leaders have signed an open letter to the first and deputy ministers of Northern Ireland calling for ‘urgent action’ after figures released last week showed an 80 per cent increase in alcohol-specific deaths in the space of a decade.

The Alcohol Health Alliance (AHA), which includes more than 60 charities, medical royal colleges and treatment providers, expressed ‘deep concern’ at the at the almost 400 alcohol-specific deaths registered in 2024 – the highest number ever recorded. ‘Decisive, evidence-based action’ was now needed to prevent more avoidable deaths, it said.

Professor Sir Ian Gilmore: ‘The need for decisive action has never been more urgent.’

The figures highlight ‘stark inequalities’, the letter states, with deaths in the most deprived areas almost four times higher than in the least deprived, and nearly two thirds of deaths registered among men. ‘We believe the publication of these latest figures underlines the growing urgency of effective, decisive policy action to prevent avoidable deaths and reduce alcohol-related harm,’ the letter states.

Scotland and Wales have both voted to continue with MUP and increase it to 65p per unit, while MUP has also been in place in the Republic of Ireland since 2022.

‘It’s Northern Ireland’s shame that alcohol deaths are at an all-time high,’ said chair of the Royal College of Psychiatrists NI’s addictions faculty Dr Joy Watson. ‘The fact that MUP could reduce deaths is an obvious public health measure that should not be delayed. We seem to be way behind when it comes to adopting a sensible policy to cut alcohol-related harm in NI, and it’s about time we kept up pace. The government need to listen to medical experts as MUP could save lives and cut NHS costs. There is no hidden agenda – only public health gain.’

‘The evidence is clear that minimum unit pricing reduces consumption and saves lives, particularly in the communities that suffer the greatest levels of alcohol harm,’ added AHA chair Professor Sir Ian Gilmore. ‘With deaths rising and inequalities widening, the need for decisive action has never been more urgent.’

Pharmacies in Worcestershire to offer access to lifesaving medication in charity pilot scheme

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DDN
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The lifesaving drug naloxone will be more widely available in Worcestershire thanks to a partnership between Cranstoun and local pharmacies.

Lisa Wootton from Spring Gardens Pharmacy, Worcester with Laura Finnegan, Primary Care and Governance Lead at Cranstoun
Lisa Wootton from Spring Gardens Pharmacy, Worcester with Laura Finnegan, Primary Care and Governance Lead at Cranstoun

Naloxone will be available at three pharmacies in the county during a trial to widen access to this lifesaving tool.

Social justice and harm reduction charity Cranstoun is leading the pharmacy naloxone take-home project, which will run as a pilot for six to nine months.

The aim is to broaden access across Worcestershire to naloxone and raise awareness of overdose symptoms, as well as create valuable opportunities to support people who may not be in contact with specialist substance use services.

Three pharmacies are currently involved in the pilot scheme, with the potential for more to join as the trial progresses.

Find out more

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Cranstoun

Prolonged-release buprenorphine injections can offer stability and boost treatment retention, researchers say

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DDN
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Prolonged release buprenorphine injections can offer much-needed stability to clients and help to improve retention in services, says a new report from researchers at the University of South Wales (USW).

The document, which was commissioned by the Welsh Government, looks at how the prolonged release injections have been implemented in Wales, and whether they live up to initial claims of being a ‘game changer’ in terms of transforming treatment for opioid dependence.

The injections removed both the need for regular medication collection and reduced the stigma that can ‘come with visible treatment routines’, the report says

This form of buprenorphine was first recommended for use by NICE in 2019, but rolled out more widely during the COVID epidemic as it only requires weekly or monthly injections instead of daily oral dosing. For many people the prolonged release nature can be ‘life changing’, the researchers say, removing both the need for regular medication collection and reducing the stigma that can ‘come with visible treatment routines’.

The evidence points to lower healthcare costs, good treatment retention, reduced use of opioids, and ‘positive patient experiences’, the document states – particularly among people who had been struggling with daily dosing routines. However, the report is clear that the medication should be offered as part of a ‘wider, person-centred treatment system’ integrated with proper psychological support and meaningful social activity, rather than as a stand-alone solution. Although there were ‘clear benefits’, the overall picture was more complex, the report continues, with some people experiencing challenges during induction and others continuing to use other substances to deal with ‘boredom, isolation or resurfacing trauma’.

While the urgency of COVID had created a ‘unique’ opportunity for the rapid roll out across Wales, the speed of implementation had inevitably resulted in significant variations in terms of funding and delivery, the report states. Availability of resources, staff training and clinical confidence all play a ‘crucial role’ in users’ experiences of the medication, it stresses. Over time prolonged release injections have ‘become recognised not as a cure-all or silver bullet, but as one important element of a broader treatment framework’, it says.

The Welsh Government has ringfenced £3m a year to continue the injections alongside a longer-term full evaluation, with adoption  now ‘significantly higher’ in Wales than England. In Finland between 60 and 65 per cent of OST patients are now prescribed prolonged-release injections, the report adds.

Patients tended to use healthcare services ‘less often’ than those on methadone and oral buprenorphine, with the difference ‘most marked in relation to use of the ambulance service’

‘What comes through very strongly’ is that the injections can offer ‘a sense of stability and breathing space that daily treatments don’t always allow’, said Professor Katy Holloway of USW. ‘For some, it reduces the constant pressure of managing withdrawal and appointments, making it easier to focus on work, relationships, and recovery. But it’s not a silver bullet. The context around the substance use really matters.’

The evaluation ‘reminds us that effective treatment isn’t just about medication’, she continued. ‘It’s about dignity, giving people real options, and addressing the root cause of substance use’, but ‘must be embedded in compassionate, well-resourced, wrapround care, and patient networks and forums.’

Patients tended to use healthcare services ‘less often than those on methadone and oral buprenorphine, which translates into lower healthcare utilisation costs to the NHS,’ added professor of clinical pharmacology at the University of Hertfordshire, Fabrizio Schifano. ‘Indeed, the difference was most marked in relation to use of the ambulance service.’

Report available here

Holina Village Cyprus, Addiction and Trauma Recovery for Ages 16-25

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DDN
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Waiting times for specialist addiction and mental health support remain a concern across many services, particularly for younger people whose needs can change quickly.

For families seeking alternatives outside statutory provision, residential therapeutic settings can offer a more immediate option. One service doing this very effectively is Holina Village in Cyprus, which provides therapeutic support to overcome addiction in a wonderful residential setting, specifically for young people aged 16 to 25.

Holina Village is a rehabilitation centre that focuses on addiction recovery, behavioural challenges, trauma support and all-round health and wellbeing for adolescents and young adults. The service emphasises a holistic approach, combining individualised care, group connection and a therapeutic community model intended to support longer-term personal development and recovery.

Holina Village Cyprus - young peoples treatment for addiction
Holina Village has helped countless teens and young adults overcome challenges such as addiction, behavioural and mental health struggles, and trauma.

A focus on an under-served age group

The service was developed specifically for the 16–25 age range, because of the lack of alternative treatment options for this group across the UK, Europe and parts of the Middle East. Waiting times for a statutory appointment were just too long and opportunities were being lost – young people need to feel supported and confident to grasp the life ahead of them. The experienced staff team knows that working with younger clients can present distinct challenges, including motivation for change and engagement with treatment, particularly where substance use or mental health issues haven’t yet reached ‘rock bottom’ for them personally.

The service provision for this ‘transitional’ age group means that the only support on offer can fall between child and adult treatment. Holina’s programmes take a different view, being designed to promote healing, personal growth and rebuilding of daily functioning within a structured therapeutic community environment.

Therapeutic community and holistic approach

Holina Village is a safe and contained space, operating as a farm with bothanimals and orchards designed for young people aged 16 to 25
Holina Village is a safe and contained space, operating as a farm with both animals and orchards designed for young people aged 16 to 25.

Central to the model is a therapeutic community framework in which residents support each other while taking responsibility for their own recovery. This peer-based environment has shown to be highly effective in establishing a path to emotional healing, personal growth and social connection.

Treatment approaches at Holina include a mix of traditional psychological therapies such as cognitive behavioural therapy, alongside innovative approaches including dialectical behaviour therapy, acceptance and commitment therapy, and motivational interviewing. Creative and experiential elements, such as equine therapy, art therapy, music therapy and adventure-based activities, ensure everyone can savour and enjoy each stage of their experience.

Alongside therapeutic work, residents are offered educational opportunities and structured activities designed to build confidence, resilience and life skills. The service has a memorandum of understanding with UCLan Cyprus that supports teaching, research collaboration and developing employability skills for Holina residents.

Environment and residential support

Holina supports young people on their journey
We ensure that every young person’s journey is unique and tailored to their specific needs.

Holina Village operates as a fully residential setting, with residents typically staying for several months. The minimum stay is four weeks, with longer programmes often recommended for sustained change.

The setting at Holina has everything needed for a contained therapeutic environment, with accommodation, activities and therapy delivered onsite. The high-grade facilities have en-suite bedrooms, and the outdoor spaces include orchards and animals – a popular feature of therapeutic programmes.

Family involvement is a key component, with family therapy offered to support relationships and recovery outcomes. Visits are generally encouraged from the second month onwards, alongside structured therapeutic family sessions.

Range of needs addressed

The service works with young people experiencing substance misuse, depression, anxiety, trauma, behavioural difficulties, stress and related emotional challenges. It also provides support for issues such as self-harm, isolation and motivational difficulties.

English-speaking services are offered for young people from the UK, Europe and other regions, and the service’s location makes it accessible for families seeking residential treatment outside their home country.

Continuing support and recovery focus

Importantly, Holina’s ongoing support lasts beyond the residential treatment programme. It includes post-rehab programmes and support groups, aimed at sustaining recovery and maintaining connections formed during treatment. The structured environment at Holina makes sure peer relationships and therapeutic engagement play a key role in supporting long-term behavioural change among younger people facing addiction or mental health challenges.

An alternative pathway

For professionals, families and commissioners exploring options outside statutory provision, residential therapeutic communities represent one possible pathway alongside outpatient and community-based support. Services such as Holina Village can provide more immediate access to structured treatment environments, particularly where delays or disengagement risk worsening outcomes.

As with any residential service, suitability will depend on individual need, clinical assessment and ongoing support arrangements after treatment. However, the development of specialised provision for younger adults reflects a growing recognition that age-specific approaches may improve engagement and recovery outcomes.

Holina Village offers flexible pricing options to meet the unique needs of each family. Find out more on holinacyprus.com

 

Government providing £20m grant funding for addiction tech

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DDN
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The government is making £20m of grant funding available for new tech projects to reduce harm from drugs and alcohol, the Department of Health and Social Care (DHSC) has announced.

The grants will support the development of wearable tech, AI, virtual reality, treatment apps and other projects designed to ‘improve treatment, strengthen recovery, and reduce harm’, the department states. The funding is being delivered by Innovate UK as part of the Office for Life Sciences’ Addiction Healthcare Goals programme.

A recent EUDA webinar heard that the drug and alcohol field had been slow to keep up with advances in digital technology

Grants of up to £1.5m will be available for early-stage innovations to help ‘promising technologies’ demonstrate effectiveness and strengthen their business planning, while awards of up to £10m will support later-stage ‘high impact’ projects that are already close to deployment and can demonstrate ‘real-world effectiveness, UK market readiness and progress towards regulatory approval’.

Previous projects to receive funding from the Office for Life Sciences include a chest-worn biosensor to detect the onset of life-threatening respiratory depression and alert emergency services and nearby naloxone carriers, a controlled-release patch for naloxone delivery and a handheld device for self-monitoring benzodiazepine use. A recent EUDA webinar heard that the drug and alcohol field had been slow to keep up with advances in digital technology, with the potential for innovation to improve service provision encompassing the behavioural, psychosocial, pharmacological and more.

‘Cutting-edge medicines and technologies could save thousands of lives lost to alcohol and drug addiction while improving outcomes for hundreds of thousands more,’ said science minister Lord Vallance. ‘Backing both late‑stage technologies and earlier‑stage innovations means we are creating a clear and rapid route from breakthrough ideas to real‑world impact. This is about using the UK’s scientific excellence to prevent avoidable deaths and support recovery, while helping innovative companies to grow and thrive in the UK at the same time.’

Applications are open at Innovate UK until 6 May.

More Accessible and Inclusive Services for LGBTQ+ Clients

By
DDN
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I was saddened to read last week that new data from the Office for National Statistics (ONS) reveals stark disparities in causes of death among lesbian, gay, and bisexual (LGB+) adults.

By linking 2021 Census data with death registrations between March 2021 and November 2024, the analysis shows significantly higher rates of suicide, drug poisoning, and alcohol-related deaths among sexual minority adults compared with their heterosexual peers.

Ketiwe Anjorin
By Ketiwe Anjorin, Head of EDI at The Forward Trust

As we mark LGBTQ+ History Month, these findings are a powerful reminder of the ongoing challenges faced by LGBTQ+ communities and why organisations like ours must remain responsive, supportive and inclusive.

At Forward, ensuring our services are accessible to a broad range of minoritised groups is a key strategic priority, and this data reinforces the importance of continuing and strengthening that work.

Read more

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We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Forward Trust

 

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