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Turning the page, WithYou: Steven’s Story

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DDN
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Steven shares the story of his journey to recovery with support from WithYou.

‘Recovery isn’t just about stopping, it’s also about what comes after stopping.’

Raised by his dad and granddad after his mother left at age five, Steven had a challenging childhood. He began drinking at a young age, and this escalated during his teenage years and into adulthood. Around a year ago, Steven decided he wanted to break the cycle and make a change. He came to WithYou with this as his goal, and today, he’s been without a drink since March last year.

‘At senior school, I got in with the wrong crowd of boys and was always getting up to mischief, causing trouble, pinching from the shops. I started drinking around this age.

‘I was rejected to play for a football club when I was a teenager, and I turned to drinking to forget about it. I could’ve tried it again, but instead, I chose to drink. Before I turned 18, I got an apprenticeship. I remember constantly thinking that the money I earned could be used as “beer tokens” – I could drink as often as I wanted.’

It was around this time that things took a turn for Steven. He began visiting the local workman’s club, and from then on, his alcohol consumption increased dramatically. This took a toll on his professional life, causing frequent absences and discussions with his employer about his drinking habits. His own business suffered as well.

‘I would be out on Fridays in the club, Saturdays would be match day drinking, and then on Sundays, I’d be back in the club telling stories about football – drinking again. Eventually, I ended up at the club every day.

‘I’d be having a lot of time off work because of alcohol use. My employer had several talks with me about my drinking. I also owned my own business, but it all dwindled away because I wasn’t showing up and spending all my money on drink.’

Despite previous attempts at rehab, Steven recognised the need for a different approach. He really wanted to make a change. From this, he found WithYou, and together we helped him to set goals and make slow reductions.

‘Deep down, I knew I needed help. I’d paid for rehab in the past, but I’d just discharge myself and be back onto drinking again. I needed to try something different. I thought, at my age, if I don’t stop now I’ll never stop. It’ll be a continuous cycle. This was my last chance to save myself.

‘I really wanted to do it. Just coming into WithYou every week to have a chat and do a breathalyser meant a lot to me, because I could challenge myself to get a lower reading each week. Doing the drinks diary alongside this really helped. I’ve never praised myself for anything before. But hearing that my readings were getting lower each week was like hearing “Steven you’re doing brilliant”.’

With the guidance of his recovery worker, Steven began to see noticeable changes. The encouragement and positive affirmations only fuelled his determination, and before long, Steven looked forward to the weekly meetings.

‘A lot of the support WithYou gave me was around setting goals and slow reductions. As hard as it was, I stuck to it. They helped me understand how much to reduce safely. My recovery worker’s face was always over the moon when I’d give him my weekly diary and update – I was proud as punch. Coming down to WithYou each week, I could see I could get there, bit by bit.’

Reflecting on his journey, Steven acknowledges how far he’s come. Now, he enjoys looking after himself and this is reflected in how he goes about his life. This positive shift in his daily routine motivates him to continue leading a life that is truly his own, independent from his past challenges with alcohol.

‘I think of who I am now and how happy I am compared to who I was before, and it spurs me on. I have a laugh, I talk to people. I enjoy life. I thought I had no hope, that my life was going to continue in a cycle of drink until I was dead. But I changed it around. I’m learning how to cook now, I’m making lasagne from scratch. I’m learning how to look after myself, and enjoying being social again.’

With the right support, Steven was able to make a change and live a life he didn’t think was possible. It’s proof that, with determination and by taking it one step at a time, anyone can reshape their life.

If you or someone you know is seeking support on the path to recovery, With You is here to help. Wherever you are in your recovery journey, we’re here to work alongside you.

This blog was originally published by WithYou. You can read the original post here.

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 WithYou

The Forward Trust marks LGBT+ History Month

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DDN
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The theme for LGBT+ History Month 2024 is medicine, celebrating LGBT+ peoples’ contribution to the field of medicine and healthcare both historically and today. Here’s how Forward will be marking this year.
Photo by Steve Johnson on Unsplash

 

For our staff, clients and wider networks, LGBT+ History Month is an opportunity to share the rich and diverse history of the LGBT+ community and is a chance for everyone, no matter their identity, to learn more.

At The Forward Trust, we are celebrating LGBT+ History Month in our services and across the organisation, showcasing the amazing work of our staff providing care for the LGBT+ community in our services. From running LGBT+ recovery groups to wearing Pride lanyards, our teams are working towards making The Forward Trust an inclusive, welcoming and caring place where anyone can access support.

Internally, our employee resource group are sharing recommendations for books and podcasts to encourage staff to take time to listen to LGBT+ peoples’ stories and learn about the history of LGBT+ people’s rights in the UK. Forward staff will also be taking part in a film club, watching and discussing the 2014 film Pride later in the month.

Most importantly, whilst we take time to recognise the achievements of the people who have helped fight for LGBT+ rights in the past, we are also having conversations about how we can make our services and workplaces more inclusive going forward. This February, staff will be taking part in LGBT+ training, running workshops in prisons and taking time to learn from our clients and colleagues in the LGBT+ community.

Here at Forward we are proud to provide a dedicated, year-round service for anyone.

You are free to be yourself, without fear of judgement or stigma.

Forward is a safe place for everyone.

This blog was originally published by The Forward Trust. You can read the original post here.

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

DDN Conference 2024

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DDN
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The DDN Conference 2024

Stronger Together

11 July – National Motorcycle Museum, Birmingham

Credit Card Bookings available here If you need to be invoiced please contact ian@cjwellings.com

Group bookings, exhibition stands and sponsorship options are available now! Space is limited! Contact ian@cjwellings.com or call 07711 950 300 today!

We have negotiated a conference rate of £99 at the Arden Hotel which is 5 minutes from the venue. To secure this rate call Jennifer Hancox on 01675 445605, quoting Reference GA002977

Never been to a DDN event and want to see what it is all about, or just want a reminder? Read reports and watch highlights from last year’s event here

Release to open Harm Reduction Hub in London

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DDN
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Release is opening a Harm Reduction Hub in London – here the charity explains how you can help.

Why we need a Harm Reduction Hub in London

The spread of synthetic opioids and their contamination of multiple drug supplies across the UK means they are here to stay. The UK is the deadliest country in Europe for people who use drugs, and this is only set to get worse. We are not prepared: we do not have a structure to test drugs before consumption and drug services aren’t adapting to truly meet people where they are at – we know this because they are ringing our helpline instead. We are at a point where we need to intensify our struggle for real harm reduction, and fight against the forces preventing change around us to truly bring change.

We have tried to do what we can with our current resources:

  • We’ve created harm reduction advice on nitazenes, partnering with organisations to increase their reach
  • We’ve spoken on national media to raise awareness on the dangers of synthetic opioids and what needs to be done to reduce their harms
  • We’ve written to public health professionals on how to improve health system resilience to new psychoactive substances
  • We offer free training to workers in our local homelessness partner services to ensure workers can double as drug treatment advocates – as we know that OST greatly reduces the likelihood of experiencing a fatal opioid overdose.

We are tired of begging people for piecemeal changes – and seeing our people die while the Government refuses to take action. We have reached a point where we want to take control and fight against the forces preventing change with our own model of action and community care. Along the way, we hope to build evidence of good harm reduction practices which can be implemented across the country.

For that reason, we are repurposing a part of our building into a harm reduction centre – and we need your help.

What the Hub will contain

We need 7,500 GBP as quickly as we can gather it in order to turn our ground floor meeting room into a public-facing drop-in space. This money would be used to:

  • Rebuild the room, including expanding the walls to increase its capacity
  • Refit the space with new electrical wiring and fire detection system
  • Furnish the space
  • Paint a shopfront externally so that we can be found easily on the street.

Any additional funds would be used to print harm reduction literature, as well as ordering harm reduction materials such as nitazene and xylazine strips, and/or drug testing kits for consumer purchase. The literature would include our new advocacy guide to help people who do want to go to drug services to access the treatment that works for them, as well as leaflets on nitazenes and sample testing forms for people to send drug samples to WEDINOS for analysis.

Once open, the space will offer:

  • A warming space for anyone, with access to tea, coffee, and phone chargers
  • Signposting to relevant health and social services
  • Legal referrals
  • Basic legal one-off advice (similar to our National Helpline)
  • Public health literature available for takeaway (such as info on BBV prevention and treatment, support with GP registering, and drug alerts)
  • ‘Know your rights’ literature, as well as work from other allies
  • Merchandise and harm reduction materials for sale
  • A welcoming local community space to have a friendly conversation.

We’re getting closer to our goal – help us get over the line! Donate here.

This blog was originally published by Release. You can read the original post here.

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 Release

A tribute to the late Erwin James, Forward patron (1957 – 2024)

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DDN
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The Forward Trust pays tribute to its remarkable patron, Erwin James.

Erwin was a remarkable man who inspired so many through his journalistic achievements, but also his story of recovery and transformation.

When Erwin spent time in prison, he discovered his love for writing and combined it with his newfound desire to help others, including writing letters for fellow inmates. Through his writing, Erwin was able to channel his passion for reform in thought-provoking and groundbreaking opinion pieces on the UK criminal justice system. It has been credited as having helped change public attitudes towards prison reform and prison life. This amazing work led to a regular column in The Guardian called A Life Inside – credited by many as being a catalyst for others to start campaigning on prison reform more actively.

A successful career followed as a writer, editor-in-chief of the prisoners’ newspaper Inside Time, and an author.

“I didn’t believe I was lovable” Erwin once said – but we can see from the outpouring of tributes since his sad passing that he was indeed very much loved.

RIP Erwin James Monahan

This tribute was originally published by The Forward Trust. You can read the original post here.

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

Turning Point celebrates 60 years of transformational support for mental health, substance use, and learning disabilities

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DDN
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Close up of holding hands
Photo by Joey Yu on Unsplash

On Turning Point’s 60th year providing support for people with drug, alcohol or mental health issues and people with a learning disability, Chief Executive Julie Bass takes a look back at where it all started.

This year, Turning Point will celebrate its 60th year providing support for people with drug and alcohol or mental health issues and people with a learning disability.

Back in 1964, London philanthropist Barry Richards first established the ‘Helping Hand Organisation’, with its first service being the Camberwell Alcohol Project. This eventually took the name Turning Point in 1979 and has grown into the multi-sector service provider we know today, supporting over 171,000 people each year in over 280 sites across the country.

The past few years have seen the organisation go from strength to strength – with our turnover increasing steadily and enabling us to support nearly 40,000 more people each year.

We are proud to be delivering high quality care and support and this is reflected in our CQC rating which has increased from 91 per cent to 96 per cent in the past few years.

The health and social care landscape

Due to the uncertainty which defines the health and care landscape in which we operate, 60 years on, it is vital that Turning Point continues to achieve and deliver more high-quality support for people in need, preventing vulnerable groups from falling through the cracks in the system.

Many people’s situations are increasingly precarious as a result of the cost-of-living crisis, placing huge pressure on households and particularly groups we support, including people with a learning disability, those struggling with mental health and substance use, people experiencing homelessness and young care leavers.

High inflation has eaten into NHS and social care budgets and financial problems are compounded by record waiting lists, workforce pressures, and a lack of available beds. Issues surrounding workforce were brought to the fore last year with regular strike action, which became a significant feature of health and wider public services.

Local authorities in England continue to face a funding gap of £4 billion across this year and the recent settlement does not change the funding gap facing councils.

Improving and expanding our services

Despite the challenges we face as a sector, in its 60th year, Turning Point continues to extend out work in new areas, to develop innovative new approaches, and adapt and improve our services and the lives of those we support.

In Stafford, we are working in partnership with people with lived experience of homelessness to develop new high-level supported accommodation for people with multiple and complex needs at risk of rough sleeping.

In London, we are expanding our sexual health services. A new young people’s sexual health outreach service opened in Hounslow last year and we are about to launch a new service in Southwark.

In our learning disability services, the introduction of Nourish (a leading digital social care records platform) has enabled us to spend less time updating paper records, and spend more time with the people we support. Nourish is not just about making our records accessible electronically – it helps us to record information at the point of support, involving the person and facilitating truly personalised support planning.

To better support the experiences of those with mental health and substance use issues, Turning Point launched a new training resource last year to increase the awareness and understanding of substance use and mental health. The free online course has been designed by experienced specialists and is available for anyone to access for free, regardless of level of knowledge. It has information and guidance on how to recognise and support people who have a co-existing or a co-occurring condition.

Turning Point’s longevity speaks volumes about the level of support our services provide across the country. This milestone provides a great opportunity to look ahead to the next 60 years, building upon our experience delivering quality care, our partnerships within local communities, and utilising lived experience throughout to improve the lives of people with a learning disability and people struggling with substance use and mental health.

This blog was originally published by Turning Point. You can read the original post here.

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 Turning Point

Language Barriers

By
DDN
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language barriers ddn article

‘Living the stigma: understanding addiction and overcoming prejudice’ was the theme of this year’s NHS Addictions Provider Alliance (APA) conference. DDN reports.

‘We’re making progress – people are talking about this more,’ NHS APA chair Danny Hames told delegates at the organisation’s Living the stigma conference. Stigma was now being considered in terms of how policy was written and services developed, but ‘there’s still a job to be done’, he said. 

Chair of the Drugs, Alcohol and Justice APPG, Dan Carden MP – who shared his personal story of recovery in the House of Commons (DDN, June 2022, p10) – said he’d chosen to talk about his experience partly to challenge the stigma. ‘Having overcome the grip of alcoholism, keeping my recovery hidden was never going to be an option for me. I wish I could tell you that the political will to prioritise addiction has been found, and attitudes towards those living with substance use disorders is changing – but that wouldn’t be true.’ 

This meant it was now vital to reach parity between addiction and other chronic mental health conditions, he said. ‘Addiction thrives on isolation, and the remedy is human connection. Reconnecting with my family and friends and community is what keeps addiction at bay’, with stigma undoubtedly the biggest barrier to recovery. ‘Intolerance towards addiction is well-known, well-researched and often denied by those setting policies’, with many still seeing substance issues as a moral affliction. ‘We’re fed an unhealthy diet of stereotypes. It’s not all – or even mostly – about the substance. It’s about reconnecting people to the world around them, treating trauma, and providing hope.’ 

On the question of how to go about influencing organisations, a significant misconception was that addiction was a choice, said clinical director at South London and Maudsley NHS Foundation Trust, Dr Emily Finch. ‘One of the best ways we can answer that is to educate people on what we know works.’ For people who had already developed a problem this was about making sure they had truly effective treatment, she said – ‘in the same way as someone with diabetes getting treatment that works. I think that’s the route to genuine understanding, rather than the moral weakness argument.’ 

DDN Coverage of the NHS APA Event 2023‘Challenging at every point,’ was vital, said programme manager at North East Lincolnshire Public Health, Mike Hardy. ‘I’ll be in meetings and the language that’s used is not just old and antiquated, it’s offensive – but there’s no awareness of that. It’s also about making sure that everything we put out uses language that people with lived experience – or who are currently using – are comfortable with.’ 

It was also important to challenge definitions of recovery that had been externally imposed, said Jon Findlay, harm reduction lead at Humankind. ‘If I don’t stop using drugs, I’m not a successful treatment outcome – I’m not a success until I can tick a box on the NDTMS form. I’m measured on that, and I can’t volunteer or work for an organisation because of somebody else’s version of recovery. From a stigma point of view, we set the bar really high.’ 

It was also important for people in the sector to challenge themselves, however. ‘To a certain degree we’ve created this closed community,’ he continued. ‘Drug and alcohol treatment services are very confidential spaces. They’re a bit mystical – unless you’ve got a reason to, you’d never go in. It creates a kind of “it’s just for those people” attitude, whereas a GP’s surgery is for everyone.’ While it was clearly crucial to maintain confidentiality and dignity, it was also important to be more open and honest, he said. 

Join the Anti Stigma Network and help improve understanding of the stigma and discrimination experienced by all people harmed by drug and alcohol use
Join the Anti Stigma Network and help improve understanding of the stigma and discrimination experienced by all people harmed by drug and alcohol use

Language was undoubtedly important, but it was also vital not to let it get in the way of other things, said Hames. ‘I think sometimes we can get so consumed with this, we miss the point of moving forward and doing something positive.’ 

‘I would always use “alcohol use disorder” or “substance use disorder”, but I recognise that for some individuals the words “alcoholic” or “alcoholism” can be useful and have a meaning for them,’ Finch stated. ‘For some people understanding that they are an “alcoholic” can be a pivotal moment of change, so I would listen to the individual. We don’t have one person with one problem – individuals are individuals, and they have different needs. And once you recognise that you get rid of some of the stigma, because it becomes more about the person.’  DDN

NHS APA is a founding member of the Anti Stigma Network (ASN) – find out more at www.antistigmanetwork.org.uk

 

Government to ban disposable vapes

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DDN
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The government intends to ban disposable vapes in a move to ‘protect children’s health’, the Department of Health and Social Care (DHSC) has announced. 

Disposable vapes are a ‘key driver’ in the rise in the number of young people vaping, DHSC states, with the proportion of under-17s using vapes increasing almost ninefold over the last two years. There will also be new restrictions on flavours specifically aimed at children and a move towards ‘plainer, less visually appealing’ packaging. Vapes will also have to be displayed away from products like confectionary, and the sale of nicotine pouches to children will also be banned. 

The announcements form part of the government’s response to its eight-week consultation on smoking and vaping, which received more than 25,000 responses. The government has also re-stated its intention to create a ‘smoke-free generation’ by preventing anyone currently aged 15 or under from ever being able to legally buy tobacco (https://www.drinkanddrugsnews.com/government-plans-smoke-free-generation/). 

health secretary Victoria Atkins
Health secretary Victoria Atkins

‘The health advice is clear – vapes should only ever be used as a tool to quit smoking,’ said health secretary Victoria Atkins. ‘But we are committed to doing more to protect our children from illicit underage vaping, and by banning disposable vapes we’re preventing children from becoming hooked for life.’

Banning disposable vapes when they were ‘so widely used’, however, would require strict enforcement to be effective, warned ASH chief executive Deborah Arnott. Illegal vapes were already ‘flooding the market’, even before a ban, she stated. ‘At the turn of the last century illegal tobacco was out of control, just as illegal vapes are now, but the number of illegal cigarettes on sale in the UK fell by 80 per cent between 2000 and 2021 after a comprehensive cross-government strategy was implemented. It’s excellent news that the government has updated its strategy for tackling illicit tobacco, but we are yet to see the same strategic approach applied to vapes.’

ASH chief executive Deborah Arnott
ASH chief executive Deborah Arnott

The ban on single-use vapes and restrictions on flavouring would make it harder for people to quit smoking and push those who had ‘back into smoking’, said chair of the Independent British Vape Trade Association, Marcus Saxton. ‘Big tobacco will be rubbing its hands with glee in anticipation of possible vape bans. Further, with an estimated third of the UK vape market comprising illicit products, any ban will simply benefit those pushing illegal and unregulated product as people seek out single-use and flavoured products from illicit sources.’

‘While banning disposables might seem like a straightforward solution to reduce youth vaping, it could have substantial unintended consequences for people who smoke,’ added Dr Sarah Jackson of UCL’s Institute of Epidemiology and Health Care. ‘In the event of a ban, it would be important to encourage current and ex-smokers who use disposables to switch to other types of e-cigarettes rather than going back to just smoking tobacco.’

See tobacco harm reduction feature in the February issue of DDN 

New report shows Phoenix’s residential family service creates up to £23.5 million of social value

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DDN
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Phoenix’s National Specialist Family Service in England is one of only two residential treatment services in England that enable parents to benefit from residential drug and alcohol treatment whilst caring for their children.

Both Phoenix’s service, and the similar service run by Trevi, Jasmine Mothers Recovery are long established with a track record for enabling families to stay together safely in treatment and to maintain care of their children safely in the long term.

Phoenix latest Social Return on Investment (SROI) report finds that by helping families stay together safely these services help make huge savings for the state, up to £23.5 million over the last 3 years alone. The service creates savings for the NHS, Local Authorities and the Criminal Justice system.

Karen Biggs, Phoenix Chief Executive
Karen Biggs, Phoenix Chief Executive

In a period of time when NHS and Local Authority funds are stretched it clearly makes sense to invest in safe and effective interventions that save money for the state’ Karen Biggs, Phoenix Chief Executive

Treatment completion rates for these services are excellent at between 80% and 90%, and our 2013 SROI report found that 70% of families were still together after up to 4 years post treatment. The 2013 report and the update 2024 report show consistent and similar rates of return on investment.

Over and above the savings to the state identified in these report, services may be having an in impact on future generations by breaking the intergenerational transfer of trauma and addiction. Scientific studies confirm that alcohol and drug problems can be and often are transmitted across generations, supporting parents with addiction needs is an effective means of preventing harm to future generations.

What’s more there is significant need, the 2022/23 national drug treatment statistics show that 20% (26,924) of people starting treatment were living with children, either their own or someone else’s. A further 14% (18,853) were parents who were not living with their children.

But behind these statistics there are compelling life stories and Phoenix’s resident’s experiences have featured in a 2017 BBC documentary, the service has also hosted a visit from BBC Radio 5’s Adrian Chiles and you can read Connie and her daughter Ruby’s story in The Times here. 

‘The Scottish Government have recently funded a national specialist service for Scotland and we’re seeking to establish a more stable score of funding for our English service. Trevi and Phoenix have supported hundreds of families over the years and it’s imperative we can continue to do so for many more years to come.’

This blog was originally published by Phoenix Futures. You can read the original post here.

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 Phoenix Futures

Number of young people in treatment up by 10 per cent

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DDN
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There were just under 12,500 young people in contact with drug and alcohol services in the year ending March 2023, according to the latest figures from OHID, a ten per cent increase on the previous year. 

young person joint
Cannabis is still the most common substance that young people access treatment for.

However the number is still 13 per cent lower than the pre-COVID figure of 14,291 in 2019-20. While around half of under-18s in treatment reported problems with alcohol, cannabis is still the most common substance that young people access treatment for – at 87 per cent. 

Fewer young people reported problems with benzodiazepines – down to 2 per cent from 3.7 per cent the previous year – but 9 per cent said they had problems with powder cocaine and 7 per cent with ecstasy. The number reporting problems with ketamine was up from 4.5 per cent to 5.8 per cent, and the number saying they had issues with solvent misuse increased from just under 3 per cent to more than 5 per cent. More than half reported polydrug use. 

The median age of young people in treatment was just under 16, with a ratio of roughly two thirds boys to one third girls. Almost a third were referred by education services, and just over a fifth by social care, with more than 80 per cent successfully completing treatment. Twelve per cent dropped out, and 3 per cent transferred to a different provider – similar proportions to the previous year. 

The number of young people with a mental health treatment need stands at 48 per cent – up from 32 per cent three years previously – with 65 per cent of girls reporting a mental health need compared to 39 per cent of boys. More than half of girls also reported self-harming behaviour, and five per cent of young people entering treatment reported some form of child sexual exploitation. 

Meanwhile the Alcohol Health Alliance (AHA) is calling on the government to increase alcohol duty by 2 per cent above inflation in the spring budget to ‘curb the mounting death toll’. Deaths from alcohol-related liver disease fell when an alcohol duty escalator – an annual 2 per cent increase above inflation – was in place between 2008 to 2012-13, the alliance states.  

Professor Sir Ian Gilmore
Alcohol Health Alliance chair Professor Sir Ian Gilmore

‘Alcohol harm levels are directly linked to its affordability – the cheaper alcohol is, the more alcohol is consumed, and therefore the more harm caused,’ said AHA chair Sir Ian Gilmore. ‘That’s why the Alcohol Health Alliance is urging the chancellor to take action on cheap, harmful alcohol. Recent inflation coupled with years of cuts or freezes to alcohol duty has left alcohol relatively cheap compared to other drinks. Currently, a 2-litre bottle of cider is sometimes cheaper than orange juice supermarkets. How, in good conscious, can government allow this to continue? With deaths from alcohol at an all-time high, and sadly no sign of it slowing down, the government cannot afford to miss the opportunity presented at the spring budget to save lives, reduce pressure on the NHS and boost the economy.’

AHA letter at https://dmscdn.vuelio.co.uk/publicitem/e1c35028-927a-4bef-8ec3-5ecf90f8584a

UK’s first regular drug testing facility launches in Bristol 

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DDN
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The country’s first regular drug checking service has been launched in Bristol. Operated by harm reduction organisation The Loop in partnership with Bristol City Council, Bristol Drugs Project (BDP), and the universities of Bath and Liverpool, the free, confidential service will operate once a month.

Bristol drug testing
The service will operate once a month in Bristol

Licensed by the Home Office, it will allow people to submit substances for testing with results available after an hour, along with ‘personalised, non-judgemental’ health advice. The council-funded service will also increase understanding of local drug markets for health services and the police, says The Loop, and will focus on ‘dependent, frequent and problematic use’ with the aim of reducing consumption of contaminated or adulterated drugs. Users of the service will be able to drop a small amount of drugs in an amnesty bin at BDP’s premises, and will also be signposted to other support services. 

Professor Fiona Measham
Professor Fiona Measham

‘This is a landmark moment for harm reduction – after 12 years of preparations, evaluations and negotiations, it is fantastic news that The Loop can start the UK’s first regular drug checking service,’ said the charity’s founder and chair, Professor Fiona Measham. ‘With more cities due to follow soon, this launch represents the start of a new era for drug checking and it could not come at a more important time. The risks from adulteration of the illegal drug market have never been greater.’

Bristol Council public health lead, Ellie King
Bristol Council public health lead, Ellie King

‘I am proud that Bristol is the first city in the UK to have a regular drug checking service,’ added the council’s public health lead, Ellie King. ‘This new initiative is ultimately going to save lives. It also means our communities will be able to access scientific and evidence-based information about the drugs that they may consume and that are in circulation. This is about working in partnership to help reduce harm to our communities and empowering people to make safer, more informed choices, with access to drug treatment and further support.’

European heroin market worth EUR 5bn a year

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DDN
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The EU heroin market is estimated to be worth ‘at least’ EUR 5.2bn annually, says a new report from EMCDDA and Europol. 

While the Taliban’s opium ban has led to a 95 per cent fall in poppy cultivation in Afghanistan according to the latest UNODC analysis (https://www.drinkanddrugsnews.com/afghan-opium-cultivation-drops-by-95-per-cent/), there are as yet no signs of any heroin shortages in Europe, states EU drug market: heroin and other opioids. 

EU Map
The amount of heroin seized by EU member states more than doubled in 2021

The amount of heroin seized by EU member states more than doubled in 2021, to 9.5 tonnes, the highest level recorded for two decades. There are an estimated 1m high-risk opioid users in the EU, the report says, with opioids responsible for three quarters of 2021’s 6,000 drug-related deaths across the continent. Many drugs organisations are concerned that any decrease in heroin availability caused by the situation in Afghanistan could lead to highly potent synthetic opioids like nitazenes filling the gap in the market, with consequent increases in overdose deaths. 

‘Compared to North America, the EU has been impacted to a much lesser extent by synthetic opioids,’ EMCDDA states. ‘This can be attributed to protective factors such as strict prescribing practices, social healthcare provisions in most countries, and well-developed treatment and harm reduction services for existing opioid users.’ However, they are increasingly being detected in places like Latvia, Lithuania and Sweden, and urgent action is needed to ‘increase preparedness’, the report says. ‘Concerningly, over the past five years, most of the newly identified opioid substances reported to the EU early warning system on new psychoactive substances have been highly potent benzimidazole (nitazene) opioids, rather than fentanyl derivatives as in previous years,’ it says. 

‘Although we are seeing a decline in opium poppy cultivation in Afghanistan, close monitoring of the supply chain and the diversification of the market is paramount, as criminal networks are known to be business-oriented, flexible and always on the lookout for new opportunities,’ said Europol’s executive director Catherine De Bolle.

‘Europe’s opioid problem is fast-evolving and increasing in complexity, shaped by global developments that may have far-reaching implications for our preparedness and response,’ added EMCDDA director Alexis Goosdeel. ‘It is imperative that we strengthen our capacity to rapidly detect and counter health and security threats emerging from a changing opioid market. At the same time, maintaining and developing further an integrated and evidence-based portfolio of health and social responses is more important than ever. For this purpose, we need to build on the results and the lessons learned from 30 years of European drug policy, based on the fundamental rights and the active participation of all stakeholders, including people who use drugs.’

Document at https://www.emcdda.europa.eu/publications/eu-drug-markets/heroin-and-other-opioids_en

Drug deaths are everyone’s business

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Turning point drug related death conferenceTurning Point’s latest Safer Lives Conference took place at a time of worrying changes in the UK drug market. The way we work will need to change too, says Deb Hussey.

Deb Hussey safer lives lead at Turning Point
Deb Hussey, safer lives lead at Turning Point

November saw us return to Birmingham for our second Turning Point Safer Lives Conference. A bigger event this year, with 200 delegates from across England, Scotland and Wales including colleagues from Humankind, With You, Change Grow Live, Cranstoun, BDP, Barod, Kaleidoscope and the Scottish Drugs Forum, as well as representatives from the police, NHS providers and public health. 

The theme was ‘Drug deaths are all of our business’ and my hope was for us to come together and explore the role we all have to play in reducing the number of drug deaths, in a context of changing drug markets and increasing evidence of synthetic opioids entering the drug supply. It felt appropriate that we were in Birmingham, a city that saw an increase in overdose deaths across the summer.

With this year’s ONS data delayed, OHID’s Steve Taylor reviewed what we already know – drug poisoning deaths have doubled since 2012, with older age ranges increasingly affected and deaths of women rising. Recent overdose death numbers saw concentrations in certain areas and involvement of nitazenes, which is unusual. OHID’s action plan to reduce drug and alcohol deaths addresses five priority areas – within these there is a focus on improving treatment quality, expanding naloxone provision, improving toxicology, coroner reporting and information sharing, and the reduction of stigma in healthcare services.

There were presentations from the police, services that support family members, and the most moving presentation of the day from Pat Hudson. Pat told the story of her son Kevin, who tragically died of a heroin overdose in 2017. ‘Kevin was a sensible boy,’ she said. ‘If there was an overdose prevention centre in the town, I believe he would have used it and I believe he probably would be alive today’. 

Jenny Scott from the University of Bristol asked us to raise our naloxone in the air, reminding us of the importance of carrying a kit. Jenny presented her work on co-designing solutions to promote naloxone carriage with people who use drugs, including the innovations that came from this project – a poster campaign to raise awareness and challenge stigma and the Carry Naloxone app that tells people where they can pick up a kit. 

Chris Rintoul, head of harm reduction at Cranstoun, explored what more we can do to reduce overdose deaths. He reflected on the resistance in his native Northern Ireland towards the shift to more of an abstinence focus over the past ten years – the result of strong memories of life without harm reduction services, which were introduced much later than in England. Chris stressed the importance of making treatment more attractive, ‘a lot of those most in need of treatment often aren’t in it’. 

This was echoed by Daniel Ahmed, clinical director at Cranstoun and clinical partner at Foundations. Daniel presented on the experiences of staff and service users at the pioneering Middlesborough diamorphine-assisted treatment clinic, which closed in 2022. In an area with some of the highest drug death rates in England, independent evaluation showed that in the clinic’s first year, there was a 60 per cent reduction in service users’ criminality, a significant reduction in their use of street heroin and other drugs, reduced homelessness, and improved wellbeing.

For those of us working in the substance use field, it’s a worrying time. The drugs we’re seeing in the UK are changing, and the way we work will need to change too. We need to make services that fit the people they’re aimed at, not the other way round, but the conversations I had throughout the day fill me with hope. Although we don’t know what’s ahead, we will work together to meet the challenges to come. When Pat Hudson spoke about the death of her son Kevin, we were all reminded of why we’d chosen to come together. Drug deaths are all of our business. 

Turning Point would like to give special thanks to their sponsors Ethypharm, who made this event possible.

THE ROLE OF THE POLICE  

Chief inspector Jason Meecham
Chief inspector Jason Meecham

Chief inspector Jason Meecham shared developments since he presented at last year’s event, including that Durham has expanded the availability of naloxone to any officer who wishes to carry it. Officers have the choice to carry injectable or nasal, and Durham is unique in that it also issues naloxone kits to people who use opiates on release from custody. This is made possible through a collaboration with local treatment providers, councils and public health teams – in the last year there were 44 uses of naloxone to reverse opiate overdose by police in Durham and Darlington, an increase of 47 per cent. Jason has also been busy promoting naloxone through appearances on local and national media, and since our conference last year has had many conversations with other police forces around the country with a goal to support them in rolling out naloxone in their area.

Inspector Tom Gent, lead for naloxone with Avon and Somerset Police, spoke about how Turning Point’s work with Somerset Police in 2021 has led the roll out of naloxone across all five areas covered by the force, with 500 officers currently trained. As well as being able to save more lives, Tom discussed the wider benefits including improved partnerships with drug treatment providers, opportunities to reduce stigma, increased referrals into treatment and the opportunity to demonstrate to other forces that this can be done with no issues.  It also meant that they were better prepared when Bristol, like some other areas, saw a spike in overdoses over the summer due to synthetic opioids.

ENGAGING FAMILIES TO REDUCE DRUG- RELATED DEATHS  

Justina Murray
Justina Murray, CEO of SFAD

A number of speakers discussed the family perspective and how families can be supported. Justina Murray and Gill Harmon from Scottish Families Affected by Alcohol and Drugs (SFAD) talked about the fact that an average 11 family members are negatively affected by a person’s problematic drug or alcohol use and that it takes, on average, eight years before family members access support in their own right. 

SFAD use an evidence-based approach which supports affected family members to help move their loved one towards treatment, to reduce their drug or alcohol use and simultaneously improve their own lives. They talked about the heightened responsibility that affected family members feel to keep their own family member alive and the importance of recognising this when engaging families in initiatives aimed at reducing drug-related deaths. 

Jan Larkin, head of psychology at Turning Point spoke about the Family 5-Step approach. Turning Point has developed a digital version of the programme in response to the fact that often affected family members don’t know about drug and alcohol services, and if they do know about them they would still rather access support anonymously. Pat Hudson, who works with the Anyone’s Child campaign, spoke very movingly about the death of her son Kevin from opiates when he was 32 and the measures she feels could have prevented his death – namely heroin-assisted treatment and an overdose prevention centre.

For more information about Scottish Families Affected by Drugs and Alcohol visit www.sfad.org.uk . For more information about Anyone’s Child visit www.anyoneschild.org 

 

Humankind celebrates its work at London Regional Roadshow

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Humankind’s London workforce came together to celebrate their work at the charity’s London Regional Roadshow this month.

The first of the 2024 series of Humankind Being Human Regional Roadshows took place in London on Tuesday 16 January and was attended by 90 per cent of the organisation’s workforce from across the capital.

The day featured a series of speakers, including Humankind CEO Paul Townsley, who looked ahead to the future of the organisation, as well as executive medical director Roya Vaziri, who spoke about some of the great work happening across Humankind nationally.

There was also a focus on regional excellence and pride as the director of London and South, Lyndsey Morris, celebrated some of the fantastic work in the region and individuals shared their proudest moments from the previous year.

The purpose of the event was to bring together professionals from the region to share ideas, celebrate the successes and look forward to the future. Tom Colley from the Pier Road Project spoke about his experiences working with the innovative Ketamine Project in Bexley. There were other presentations from Liz Legge and Anita Leslie about the work of Primary Care Recovery Service (PCRS) and Alison Beeton-Hilder who talked about some of the work which is taking place in Humankind’s Better Lives Family Service in Islington.

As part of the celebrations, Lee Wilson, regional director, and Roya Vaziri gave out individual awards to the staff who received the most recognition over the last year. In addition, there were collective awards for team performances in the region.

The day featured a number of interactive sessions for people to meet their colleagues and understand the way in which other Humankind services work.

Director for London and South, Lyndsey Morris, said, ‘It was great to see our staff from across the region come together to receive recognition and celebrate the great work that we do. Having some of the services showcase what they do reminds us of our impact on those accessing our services and how we help people have better chances.’

This blog was originally published by Humankind. You can read the original post here.

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 Humankind

Forward chosen as charity of the year by Midlands conveyancing firm

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Aconveyancing, a law firm that specialises in conveyancing and property law, have recently selected The Forward Trust as their charity of the year for 2024.

Aconvenancy Ltd provide legal services in all aspects of residential property transactions, providing conveyancing services and legal advice. They have offices based throughout the Midlands in Tamworth, Sollihull and Leicester.

The Forward Trust was selected as their chosen charity after tragically losing a previous colleague and friend to alcoholism. Aconveyancing are keen to do all they can to help people living with addiction – and help challenge the stigma that often prevents people getting the support they need.

Aconveyancing’s founder and director, Natalie Moore said, ‘It’s widely known that there is a strong association between the legal profession and addiction issues. It’s a challenge to avoid alcohol in the job we do – whether that be work nights out, networking and events. Just last year, we were devastated to lose a great conveyancer to the effects of addiction.

‘The Forward Trust say that “everybody knows somebody” and I believe that we can do more to raise awareness of addiction within our industry, work hard to stop the stigma surrounding addiction and amplify conversations around the support available to those who might need help.

‘Watch this space for more to come from us this year.’

The Forward Trust will work closely with Aconveyancing on many different company-led initiatives, including the highly anticipated Networking and Fundraising day – Chrystal Maze Challenge – which is due to take place on 26 June 2024.

This blog was originally published by The Forward Trust. You can read the original post here.

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

Drug seizures at highest ever level

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The Border Force made the highest number of drug seizures on record in the year 2022-23, according to the latest Home Office figures. 

Antwerp Docks
Most cocaine enters the continent via ports such as Antwerp and Rotterdam. 

There were almost 26,000 seizures made, an increase of almost a quarter on the previous year, involving more than 90 tonnes of illegal drugs – including more than 15 tonnes of cocaine. Almost 3.5 tonnes of cocaine were also seized separately by the police. 

Border Force officials have seized more than 9 tonnes of cocaine every year for the last three years, the Home Office states, the result of ‘bigger intelligence-led seizures’. Cocaine seizures across Europe are now at record levels, with more than 300 tonnes seized in EU member states in 2021, according to last year’s EMCDDA figures (https://www.drinkanddrugsnews.com/record-cocaine-seizures-across-europe/). Most cocaine enters the continent via ports such as Antwerp and Rotterdam. 

Global production of the drug has surged in the post-COVID years, with the most recent analysis by UNODC finding a 35 per cent increase in coca cultivation between 2020 and 2021 (https://www.drinkanddrugsnews.com/global-cocaine-production-sees-dramatic-increase-says-unodc/). 

border minister Tom Pursglove MP
Border minister Tom Pursglove

‘We are committed to stopping dangerous drugs from coming into the country, where they fuel violence and exploitation and cause significant harm to our communities,’ said border minister Tom Pursglove MP. ‘Today we’ve seen a record level of seizures demonstrating that police and Border Force are working relentlessly to stop illegal drugs from coming into the country and keep them off our streets.’ 

Via to provide new drug and alcohol recovery service in Gloucestershire

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Gloucestershire County Council will fund leading charity Via with £5.8 million per year to provide drug and alcohol treatment services for the county.

The new service will start on 1 April 2024 and run for an initial 5 years, with the option to extend the contract up to a further 4 years, which would bring the total amount of funding to £52.2 million.

Cheltenham high street
The service will be delivered from hubs in Cheltenham, Gloucester, and Stroud

Via will provide free, confidential treatment and support to adults who live in Gloucestershire who need help with alcohol and drug issues. The service will be delivered from hubs in Cheltenham, Gloucester, and Stroud, as well as across an extensive network of community partnerships throughout the county.

Research shows for every £1 spent on drug treatment, there is a social and economic benefit of £4. This includes reductions in health, social care, and offending costs.

Mark Hawthorne, leader of Gloucester county council
Mark Hawthorne

Mark Hawthorne, leader of the county council and cabinet member for public health and communities, said: ‘I’m really pleased to welcome Via as Gloucestershire’s new community drug and alcohol treatment provider. As well as helping some of our most vulnerable residents to turn their lives around, these services help to improve our communities. Housing, health, and social care services all benefit when drug and alcohol treatments are working effectively.’

Yasmin Batliwala, Chair of VIA
Yasmin Batliwala

Yasmin Batliwala, Chair of Via said: ‘We are looking forward to working in close collaboration with our partners and serving the needs of our clients and their families within the local communities across Gloucestershire to deliver high quality services from April 2024.’

VIA have experience of working with partners in Gloucestershire and are already working in collaboration with The Nelson Trust on the UK’s first women’s only detox which will also be based in Gloucestershire.

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

Overdose prevention centres could save ‘thousands’ of lives, says major evidence review

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A German overdose prevention centre – one of more than 200 worldwide

Overdose prevention centres have the potential to ‘prevent thousands of deaths’ and reduce the spread of disease, with no increase in drug-related crime, according to what is believed to the largest evidence review on the subject.

The report, which was led by Queen’s University Belfast in partnership with the National Institute for Health and Care Research (NIHR), Release, Drug Science and the universities of Oxford, Kent and East Anglia, looked at almost 600 items of peer-reviewed research, guidance and other documents from around the world.

The study cites examples where staff in overdose prevention centres – also known as consumption rooms – have reportedly safely managed ‘hundreds, in some cases, thousands’ of overdoses, ‘saving many lives’. Researchers also found evidence of prevention of HIV and hepatitis transmission through reduced sharing of injecting equipment, as well as referrals to drug treatment and other support and collection of valuable data for health services. The centres also reduced drug litter in neighbourhoods, the report states, as well as saving public money through fewer ambulance call-outs and hospital admissions.

There are now more than 200 overdose prevention centres worldwide, including in Canada, France, Germany, Spain and the US, with plans to establish a pilot facility in Scotland after the country’s lord advocate said it would not be in the public interest to prosecute people for possession offences in one (https://www.drinkanddrugsnews.com/glasgow-consumption-room-gets-go-ahead/).

Recent public health guidance from EMCDDA and the European Centre for Disease Prevention and Control listed consumption rooms as one of the six key interventions to prevent and control infections among people who inject drugs (https://www.drinkanddrugsnews.com/consumption-rooms-among-key-interventions-to-prevent-infections-says-emcdda/), although some commentators have questioned how many people are likely to use the facilities in the UK (https://www.drinkanddrugsnews.com/the-right-fix/).

Dr Gillian Shorter: ‘These spaces aim to meet people where they’re at.’

‘These are harm-reduction spaces which aim to meet people where they are at, provide health support and basic facilities, and keep people alive,’ said the study’s lead author, Dr Gillian Shorter. ‘They are places of safety and inclusion, often for those who do not have other places to go. The evidence shows OPCs don’t just improve multiple outcomes for people who use drugs – they reduce drug litter, and lead to less visible drug use on our streets which is good for businesses and communities. Ultimately, they save money through reduced emergency-service use and drug-related deaths.

‘We hope our report will improve the public perception of OPCs by demystifying what they do. What our review showed is that OPCs can help save lives in an urgent and growing drug-death crisis in the UK. Alongside other essential public-health strategies such as naloxone availability and real-time drug testing, the adoption of OPCs in areas of need will help reduce the enormous costs facing our communities.’

Overdose prevention centres, safe consumption sites, and drug consumption rooms: a rapid evidence review available here

Sharp rise in clinicians seeking poisoning information about nitrous oxide and ketamine

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There has been a 175 per cent increase in clinicians consulting the National Poisons Information Service (NPIS) about nitrous oxide in a year, says the latest NPIS report, with a 25 per cent increase related to ketamine over the same period. 

nitrous oxide users with balloons
There have been reports of increasing levels of neurological harms associated with heavy nitrous oxide use. 

NPIS is an expert toxicology advice service with 24-hour telephone support commissioned by the UK Health Security Agency (UKHSA), as most UK hospitals do not have specialist clinical toxicology services in-house. Its annual report sets out how often it was consulted by clinicians, and for what reason. NPIS also operates an online database and app for healthcare professionals called TOXBASE, providing general information and advice, enquiries to which are included in the figures.  

There have been reports of increasing levels of neurological harms – including nerve and spinal cord damage – associated with heavy nitrous oxide use. The government’s controversial ban on the substance came into force late last year (https://www.drinkanddrugsnews.com/nitrous-oxide-ban-comes-into-force/), despite the ACMD advising not to schedule it under the Misuse of Drugs Act. 

According to the latest treatment figures from OHID, more than 2,000 people entered treatment for problems with ketamine in 2022-23, five times the total from less than a decade ago (https://www.drinkanddrugsnews.com/ten-per-cent-increase-in-people-entering-treatment-for-cocaine/). 

‘The NPIS annual report serves as a comprehensive statement of NPIS’s activities, emphasising its pivotal role in managing poisoning cases, offering expert advice, and contributing to public health efforts,’ said Professor Raquel Duarte-Davidson of UKHSA’s Radiation, Chemicals and Environmental Hazards Directorate. ‘The rise in nitrous oxide and ketamine-related activities underscores the need for targeted interventions to protect public health and prevent further harm.’

Meanwhile, a YouGov survey commissioned by alcohol industry-funded body the Portman Group found that almost half of 18 to 24-year-olds now considered themselves occasional or regular drinkers of low- or no-alcohol alternatives, up from a third on the previous year. Almost 40 per cent drink no alcohol at all, making them ‘the most sober age group overall’, the Portman Group states. 

National Poisons Information Service – report 2022 to 2023 at https://www.npis.org/Annual%20reports.html

Ofsted recognises Forward’s service delivery of adult education and apprenticeships

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Following a recent inspection, The Forward Trust has been awarded a ‘Good’ rating by Ofsted, acknowledging achievements made in its adult education and apprenticeship schemes.
Photo by Dylan Gillis on Unsplash

 

The government’s regulatory body for services providing education and skills for learners of all ages assessed Forward’s Adult Education Budget (AEB) and apprenticeships provision (24-26 October 2023).

Rated ‘Good’ across all judgements, this was Ofsted’s first ever full inspection of The Forward Trust following its reasonable progress judgement of the organisation after the new provider monitoring visit in 2022.

Read the Ofsted inspection report here.

Asi Panditharatna MBE, executive director of employment services, said, ‘We are absolutely delighted to have received this very positive judgement from Ofsted and it is testament to the hard work and commitment of our staff, advisory group, trustee board, our employers and partners.

Asi Panditharatna MBE
Asi Panditharatna MBE

‘We have spent four years developing an exciting carers advice, skills, education, employability, and self-employment offer for individuals from very disadvantaged backgrounds. This judgement demonstrates that we are able to walk the walk in providing good quality services.

‘This judgement will give us the confidence to build upon this work and progress our learners and clients into rewarding careers in the future.’

This blog was originally published by The Forward Trust. You can read the original post here.

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

Recovery lounge and warm space in memory of Somerset Drug and Alcohol Service (SDAS) peer mentor

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Turning Point’s Somerset Drug and Alcohol Service (SDAS) Yeovil hub recently celebrated the opening of its newly refurbished Recovery Lounge, a warm and welcoming space for those in the community who are struggling, not only during the holiday season, but all year round.

The lounge has been named ‘Matt’s Recovery Lounge’ in memory of a peer mentor Matt, whose parents, Sue and Peter Ricketts, generously provided funding for its refurbishment alongside additional support from Somerset Council.

The event was attended by the SDAS team, peer mentors, and Alison Bell, consultant in public health (strategic manager) at Somerset Council. The lounge was renovated and refurbished by the peer mentors with the addition of some bespoke artwork by one of our very talented SDAS clients.

Joseph, peer mentors and volunteers team leader, expressed his excitement about the newly renovated lounge,

‘We are thrilled to be able to offer this greatly improved space to the community in memory of Matt. Matt’s Recovery Lounge is designed to provide a warm and inclusive atmosphere for individuals from Yeovil and nearby communities.

‘It is a place where everyone is welcome to come and have a warm drink, play a game, read a book or engage in friendly conversations with our SDAS key workers or peer mentors. We will strive to make this a space where everyone feels safe, valued and respected.”

This blog was originally published by Turning Point. You can read the original post here.

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 Turning Point

Vital Link – Forward Trust, The Bridges

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Forward Trust The Bridges Rehab Hull

The Bridges – Hull, Forward Trust’s residential treatment centre, has been successfully supporting people on their drug and alcohol recovery journeys since 2004

Bridges Hull forward trust rehab
‘The Bridges, and its staff are on a different level… exceptional.’ a graduate

THE BRIDGES – HULL offering support to people aged 18 and over, who have completed detox and want to make positive changes in their lives. We’re experts in helping people to address, and recover from, their addictions.We work to establish a lifelong framework through which they can rehabilitate and blossom to reach their fullest potential in life.

This starts with nurturing self-care skills and the journey of self-discovery.Our evidence-based treatment programme uses the Minnesota model and is highly effective in supporting our clients into recovery.

We offer both 12- and 24-week full treatment programmes.

OUR SERVICES INCLUDE • a treatment programme delivered as a mixture of one-to-one and group sessions• a range of activities including therapy, counselling,meditation, study groups, and outdoor and social events• friendly, non-judgemental,professional support from people who understand addiction and recovery

THE IMPACT OF OUR WORK Over the last three years, 81 percent of the individuals staying at The Bridges – Hull completed our programme of support, remarkable 32 per cent above the national average of people who complete rehabilitation support.

MOVING FORWARD Our support doesn’t end when a client leaves The Bridges. We understand how important stable accommodation is to maintaining recovery. As clients prepare to leave, they work with our resettlement worker to develop a plan to ensure they have a secure place to live when they complete treatment.The Forward Trust also offers ongoing recovery support and aftercare.‘The treatment at the Bridges has been challenging,insightful,enlightening, fun and peaceful.

Find out more at www.forwardtrust.org.uk/service/the-bridges-hull

Unlocking the path to recovery with Ark House

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ark house a bridge to recovery

Ark House – Scarborough – arkhouserehab.co.uk – 01723 371 869

For three decades, Ark residential drug treatment service in Scarborough has been a beacon of hope for individuals seeking to overcome addiction and reclaim their lives.

A legacy of success

Ark has become a trusted name in addiction recovery. Since our establishment 30 years ago, we have garnered a reputation for excellence and innovation. Our long-standing commitment to helping individuals break free from addiction has given back hope to countless families and individuals.

The power 12-Steps

CEO Maximilian Von Habsburg
CEO Maximilian Von Habsburg

At the heart of Ark’s success is its unwavering dedication to the 12-step programme. This time-tested approach has helped people find their way to recovery through a structured and supportive framework for healing. 

CEO Maximilian Von Habsburg and the whole team at Ark House have created an environment where everyone can flourish. Whatever their background or personal circumstances, clients at Ark can embark on a transformative journey toward sobriety, self-discovery, and personal growth.

Our 12-step programme goes beyond simply treating addiction; it addresses the root causes, helps individuals build resilience, and fosters a sense of community. The programme encourages self-reflection, accountability, and spiritual growth, providing a holistic path to recovery. Clients at Ark not only break free from the chains of addiction but also emerge stronger and better equipped to face life’s challenges.

Aftercare lifeline

Raff Latiff
Outreach Directory Raff Latiff enjoying a moment with a resident

Recovery doesn’t end when treatment does; it’s a lifelong journey. At Ark we understand the importance of ongoing support in maintaining sobriety. That’s why we’ve cultivated a vast network of graduates who serve as mentors for those still on their path to recovery.

Our network of graduates is a testament to the enduring success of Ark’s programme. These individuals have not only conquered their own battles with addiction but have also become dedicated advocates for others seeking recovery. They offer invaluable insights, guidance, and mentorship to current clients, providing a lifeline of support during the early stages of sobriety and beyond.

The bond between our graduates and current clients is a testament to the strength of the Ark community. It’s a network built on shared experiences, understanding, and the belief that recovery is possible for everyone. Whether it’s a late-night phone call, a coffee meet-up, or simply a reassuring message, our graduates are always there to lend a helping hand.

Join our recovery pathway

Ark is more than just a treatment centre – it’s a place where transformation happens. Our legacy of success, commitment to the 12-step programme, and extensive network of graduates set us apart as a trusted and proven partner in the journey to sobriety.

If you or a loved one is struggling with addiction, don’t wait to take the first step toward a brighter future. Reach out to us today and unlock the path to recovery. You don’t have to face addiction alone – Ark is here to guide you toward a life of sobriety, purpose, and fulfilment.

Join us on this journey of hope, healing, and transformation. Together, we can build a brighter future, one step at a time.

Ark House Kitchen
Food is prepared fresh on site each day

WHY CHOOSE ARK RESIDENTIAL DRUG TREATMENT SERVICE?

  • Proven track record: With 30 years’ experience, Ark has a long history of successfully helping individuals achieve lasting recovery.
  • Comprehensive 12-Step programme: Our structured programme offers a holistic approach to addiction recovery, addressing the mind, body, and spirit.
  • Extensive aftercare support: Our network of graduates is here to provide ongoing support and encouragement on your journey to sobriety.
  • Community and connection: At Ark, you’ll find a welcoming and compassionate community of individuals who understand what you’re going through and are ready to support you every step of the way.

ark house rehab banner

Making the right choices 

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Choices Rehab Group

Choices represent a number of independent treatment centres across the country offering; ethical, affordable and effective treatment from a wide range of options.

Choices promotes excellence in addiction treatment through collective action.

In the ever-evolving landscape of residential treatment, Choices is a beacon of collaboration, resilience, and excellence. Established in 2013, this charitable group is composed of independent residential treatment services, each with unique models and specialisms, dedicated to enhancing the quality of addiction care in the UK. 

As we extend an invitation to new members, here’s an overview of the ethos, benefits and initiatives that define our group, with its focus on a person-centric and trauma-informed approach.

A diverse group

Choices is not just a consortium – it’s a commitment to individualised and compassionate care, recognising the diverse needs of individuals on their journey through addiction and recovery. 

This includes services catering to mothers and babies, medically managed inpatient detoxification, stabilisation and assessment, and a range of psycho-social treatment models, some incorporating medically monitored detox to support entry into rehab for those who need it. These services reflect a dedication to addressing the multifaceted challenges that individuals may face.

Our philosophy

At its core, Choices is founded on a simple yet profound philosophy – by uniting independent and unique residential treatment providers, the group can collectively thrive, survive, and compete. The emphasis on collaboration is coupled with a commitment to environments that consider the impact of trauma while respecting each member’s individuality.

Bridge to treatment

Choices was conceived with the primary goal of allowing renowned independent residential treatment providers to share experiences, influence best practice, and inform policymakers. The group serves as a bridge to treatment by offering an informed choice of ethical and effective options to suit a range of budgets. 

Regular online meetings provide members with a forum to share policy and procedural experiences, discuss tendering and funding opportunities, tackle topical issues, engage in shared problem-solving, and network with other professionals in the field. This collaborative environment supports trauma-informed practices, allowing members to share insights and strategies to improve outcomes for individuals.

Choices also facilitates reciprocal visits among its members, fostering the exchange of ideas and examples of good practice and creating a vibrant community of practitioners dedicated to continuous improvement.

One of our standout initiatives is the Treatment Loop service – an alternative to withdrawing treatment when clients breach core boundaries. Members work together to offer places to clients who need to leave their current treatment – benchmarking quality, matching fees, and sharing the costs of relocating the client. 

This initiative, recognised as best practice by NTA/OHID and aligning with trauma-informed care principles, currently involves around 20 organisations across the UK and operates at no cost. The service saves lives and upholds the integrity of treatment boundaries, maintaining a keen understanding of the potential impact on individuals with trauma histories.

Choices rehabs servicesOpening doors

Traditionally comprising independents, we are now opening our doors to new members, extending our reach beyond charities or not-for-profits to those with a CQC assessment of ‘good’ or above.

This expansion aligns with the launch of the new Choices website and a social media campaign, aiming to offer potential service users a centralised and unbiased platform for informed choices about available treatment options. It also provides local and national government authorities with a single point of contact, streamlining communication and ensuring that the collective views and experiences of our members are effectively communicated and heard.

The future

As we welcome new members, Choices is poised to play a pivotal role in shaping the future of addiction treatment in the UK. By fostering collaboration, sharing best practices, and providing a unified voice for its members, the group stands as a testament to the power of collective action in the pursuit of excellence in addiction care.

Choices embodies a commitment to ethical and effective addiction treatment. As the group continues to grow and evolve, its impact on the residential addiction treatment landscape will be both enduring and transformative. If you share the vision of elevating residential addiction treatment standards, consider exploring the collaborative opportunities offered by Choices – where collective action paves the way for a brighter future in residential addiction care.

Find out more at choicesrehabs.com

Welcome to Esh Community

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DDN
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Esh community DDN magazine feature

Esh Community: www.eshcommunity.org

Our approach

ESH Community is a fully residential CQC inspected and rated detox and rehab treatment facility for people over the age of 18 whose lives have been adversely affected by alcohol, drugs and other addictions.

The facility was purposely established as a small recovery community with treatment and accommodation in the same location.

Located in the Heart of England’s Warwickshire countryside our centre is a safe and supported environment with a relaxed family feel where residents can enjoy regular country walks supported by staff members.

‘ESH changed my life. One of the best things I’ve ever done, the staff and support workers were all amazing. The best possible set up for the rest of my life.’ ~ Resident

We are an organisational member of British Association of Counselling Professionals (BACP) and our specialist addiction counsellors are Accredited Members MBACP (Accred)

The centre is operated and managed by experienced professional staff who have all had their own personal experience of addiction and more importantly sustained recovery.

We are a not for profit organisation so our pricing fits within most local authority budgets. The accommodation is for a maximum of eleven residents to ensure we provide the best possible support with the right amount of personal dedicated time from our staff.

We recognise that addiction is influenced by people’s life experiences and the treatment we offer is personalised to each individual’s circumstances, recovery plans are jointly reviewed to meet the differing needs.

Our goal is to encourage psychological changes to enable people to deal with their feelings and emotions so they can maintain a drug and alcohol free lifestyle with meaning and purpose.

Esh video about the rehab
Hear more from the team and see what makes Esh different

Dual Diagnosis

Potential Dual Diagnosis residents are considered on an individual basis. The initial pre-assessment will consider the severity and stability of the co-occurring mental illness.

In general, mental health disorders can dramatically improve when the drug/alcohol misuse is treated.

Detox and Treatment

Residents are medically assisted through detox and then encouraged to explore and understand the underlying causes of their addictive behaviour away from everyday distractions.

Twice weekly 1-2-1 professional counselling, daily group therapy sessions along with peer support helps to develop our resident’s confidence, regain self esteem and self-belief.

  • Residents eat, sleep and undertake all the core activities of the programme either at the centre or within the grounds
  • Meals are freshly prepared and cooked on site by our dedicated catering staff
  • On-site professionally managed activities include Yoga, TaiChi, cardio exercise, meditation and acupuncture sessions
  • The location is supported onsite 24/7
  • The rooms are all single, except for one twin room if additional support is required.
  • The accommodation is currently male only
Esh community house and gardens
Located in the Heart of the Warwickshire countryside our centre is a safe and supported environment with a relaxed family feel

Aftercare

There is a comprehensive aftercare programme included with all rehab placements which incorporates follow-up counselling sessions, telephone support and regular on-going aftercare groups supported by professional staff and other ex-residents.

Family support

Our family support can address any questions about addiction, addictive behaviours and also suggest ways to approach their loved ones aftercare and sustained recovery. This is beneficial for both the family members and the person in recovery.

Phone: 01926 811702

Web: www.eshcommunity.org Email: community@eshworks.org

Nitazenes detected in 25 Scottish drug deaths

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DDN
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Highly potent nitazenes have now been detected in 25 Scottish drug-related deaths since last year, according to data from Public Health Scotland’s (PHS) latest Rapid Action Drug Alerts and Response (RADAR) early warning system. 

scottish ambulance
PHS first warned about the presence of nitazenes in Scotland’s drug supply at the start of the year

The figures, which are based on post-mortem toxicology testing through to the end of September, mean there ‘can be little doubt’ that nitazenes are now circulating in Scotland’s drug supply, says PHS, posing a ‘serious harm to health’. 

The RADAR system allows national data to be combined with information from healthcare, criminal justice and toxicology services. PHS first warned about the presence of nitazenes in Scotland’s drug supply at the start of the year, and recently collaborated with SDF on a nitazene resource pack for people at risk of overdose, as well as their families, friends and treatment services (https://www.drinkanddrugsnews.com/sdf-launches-nitazenes-resource-pack/).  

‘Because nitazenes have been found in various street drugs like benzodiazepines and fake pharmaceuticals, people may not be aware they are taking nitazenes or the increased risk,’ said consultant in public health medicine at PHS, Dr Tara Shivaji. The amount present could vary widely, even within the same batch, he pointed out, meaning that people needed to be more vigilant. They could reduce risks by ‘dosing low, going slow, avoiding mixing drugs and ensuring naloxone is to hand’, he added, as well as making sure there are people around who could respond in an emergency. 

Meanwhile, the latest drug and alcohol treatment waiting time figures from PHS show that almost 11,500 referrals were made during the third quarter of 2023, more than half of which were for alcohol, 36 per cent for drugs and 12 per cent for both. While overall more than 90 per cent of people who started treatment had to wait three weeks or less, five NHS boards failed to meet the government’s 90 per cent standard – Lanarkshire, Forth Valley, Lothian, Fife and Western Isles. 

National drug and alcohol treatment waiting times, 1 July 2023 to 30 September 2023

Related articles

(Features, November 2023) Stayin’ Alive, A new family of synthetic opioids, known as nitazenes, have adulterated a number of illicit drugs in the UK. Information and downloadable resources.

(Features, June 2017): Meet the Fentanyls, a guide to the fentanyl family by Kevin Flemen.

(News, August 2023): Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK

(Partner Updates, September 2023): Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.

(News, January 2023): Fentanyl behind 80% increase in New York’s overdose deaths

Search the DDN archive for more on nitazenes, fentanyl and synthetic opioids.

Voluntary gambling sponsorship ban on Premier League shirts will have little effect, say MPs

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DDN
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The voluntary withdrawal of gambling sponsorship from the front of Premier League players’ shirts will have little effect on the volume of betting ads visible during a match, according to a report from the Culture, Media and Sport Committee.

online football gambling
A new gambling code of conduct should include both fewer gambling ads in stadia

The voluntary agreement is set to begin at the end of the 2025-26 season (https://www.drinkanddrugsnews.com/premier-league-clubs-to-voluntarily-withdraw-shirt-front-gambling-ads/).

The government needs to take a ‘more precautionary’ approach to advertising than was included in this year’s gambling white paper, which faced widespread criticism for not doing enough to address the issue (https://www.drinkanddrugsnews.com/lukewarm-response-to-gambling-white-paper/), the report states. 

The document cites studies claiming that front-of-shirt branding accounts for less than 10 per cent of gambling advertising seen during broadcast matches, with almost 7,000 gambling messages visible during six matches surveyed on the season’s opening weekend. A new gambling code of conduct should include both fewer gambling ads in stadia and a higher proportion dedicated to safer gambling messages, it recommends. The government also needs to set out a detailed timetable for the delivery of the measures contained in the white paper, it states, many of which are still subject to further consultation

Dame Caroline Dinenage MP
Dame Caroline Dinenage MP

‘While gambling regulation should not overly impinge on the freedom to enjoy what is a problem-free pastime for the majority, more should be done to shield both children and people who have experienced problem gambling from what often seems like a bombardment of advertising branding at football and other sporting events,’ said committee chair Dame Caroline Dinenage MP. ‘The government needs to go further than the proposals in the white paper and work with sports governing bodies on cutting the sheer volume of betting adverts people are being exposed to.’

Gambling regulation report at https://publications.parliament.uk/pa/cm5804/cmselect/cmcumeds/176/report.html

DDN publication dates 2024

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DDN
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DRINK AND DRUGS NEWS (DDN) is the monthly magazine for everyone working with substance use issues. Since 2004 it has become established as the authoritative voice of the sector, the place for in-depth news and features and the forum for debate.

Scroll down for advertising information, issue dates and the 2024 features schedule.

Published independently by CJ Wellings, DDN is distributed through a printed circulation that has a readership of more than 25,000. The website, receives more than 21,000 visitors a month and the DDN Bitesize weekly email alerts go to 7,000 subscribers. It’s the place to find all the latest news, comment, information, resources and jobs. With its thriving comment and letters pages, the magazine is the must-read forum, linking to the DDN Facebook page and over 10,000 Twitter followers.

The DDN community links people working with drug and alcohol problems with the wider health and social care field. Through fair and balanced journalism the magazine has become valued as the regular read for a discerning and interactive community that includes treatment agencies, commissioners, medical professionals including GPs and nurses, those working in the criminal justice service, housing professionals, social workers, politicians and policy-makers, service users, advocates and people working in education, prevention and all areas of public health.

Advertising to DDN’s targeted readership represents excellent value for money. With our design team offering a first-class layout service at no extra charge, we make the advertising process as seamless as possible, and the testimonials speak for themselves in showing that DDN always reaches a captive audience and gives a direct route to the right candidates. 

To find out more about advertising please contact

e: ian@cjwellings.com t: 07711 950 300

Articles and feature contributions need to be emailed to claire@cjwellings.com by the 15th of the month before the press date. (News items can be sent up to the last minute!) The deadline for letters and comment is the Wednesday before publication. Please get in touch to discuss features so they can be scheduled in advance.

The advertising print deadline for each issue is 5pm on the Thursday before publication. Please email ian@cjwellings.com for details

The mechanical information and sizes for print adverts is available here.

We publish ten issues a year, the issue dates for 2024 are:

  • February issue: Monday 5 February
  • March issue: Monday 4 March 
  • April issue: Monday 1 April 
  • May issue: Monday 6 May
  • June issue: Monday 3 June
  • July/August issue: Monday 1 July
  • September issue: Monday 2 Sept
  • October issue: Monday 7 October
  • November issue: Monday 4 November
  • December/January 2024 issue: Monday 2 December

DDN Conference: Thursday 11 July

Articles and feature contributions need to be emailed to claire@cjwellings.com by the 15th of the month before the press date. (News items can be sent up to the last minute!) The deadline for letters and comment is the Wednesday before publication. Please get in touch to discuss features so they can be scheduled in advance – and please see the scheduled themes for each month, below.

The advertising print deadline for each issue is 5pm on the Thursday before publication. Please email ian@cjwellings.com for details

The mechanical information and sizes for print adverts is available here.

————

Editorial features schedule 2024

February: Fitness & wellbeing, Mental health

March: Alcohol, Training & careers

April: Criminal justice, Veteran support

May: Housing and resettlement, Women’s services

June: Early trauma, Volunteering 

July/August: Gambling, Family & carers

September: DDN Conference Special issue

October: Homelessness, Mental health 

November: Alcohol (Alcohol Awareness Week, 18-25 November), Lung health/smoking 

December/Jan: Early trauma, Gambling

Throughout the year: ideas and innovations for the ‘best practice exchange’; career stories for the ‘I am a…’ series; interviews, Q&As, profiles, professional ‘clinics’, and advice pages. Articles on tackling stigma are always welcome.

WithYou: Home Support

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DDN
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‘We don’t let people walk through darkness alone’: improving drug, alcohol and housing access across Bournemouth, Christchurch and Poole.

Drugs controlled Bel’s life for 27 years. They were her escape from reality and took her to a place where she felt safe and comfortable – where she felt like she belonged. A self-described ‘functioning addict’, drugs were the only thing that got Bel through each day. But then the unthinkable happened and Bel’s world fell apart. 

Now, four years later, Bel’s life couldn’t be more different. Working at WithYou, a national drug and alcohol treatment charity, Bel leads a new team who are reaching some of Bournemouth, Christchurch and Poole’s (BCP’s) most vulnerable communities. 

WITHYOU worker Bel
Bel says that her passion for supporting people with drugs and alcohol challenges is driven by her own experiences.

Bel’s team, which was created following the national housing support grant, works with local housing providers to identify people who are experiencing challenges with drugs or alcohol and are at risk of losing their homes. 

In collaboration with a number of different organisations, including social services, hospital care teams and other support services, WithYou’s new housing support team is preventing evictions, rough sleeping and homelessness. 

Explaining why it’s important to support people struggling with drugs and alcohol who face eviction, Bel added:

‘Preventing people from being evicted from their homes plays a really important part in someone’s drug and alcohol recovery. We know that one of the main issues facing those sleeping rough is drug or alcohol misuse and that it’s much harder to address these challenges when they are homeless; the work we do enables us to better support people before it gets to that point.’

‘We build trust with vulnerable people, bring them into our service, and support them to feel empowered enough to begin their recovery journeys. We stand with people when they’re at rock bottom: we don’t let people walk through darkness alone.’

Bel says that her passion for supporting people with drugs and alcohol challenges is driven by her own experiences. 

‘Because of how much I was using, I couldn’t see my kids, and I felt like I didn’t have anything to live for anymore. I’d always used drugs to numb the pain, but all of a sudden, I had so much pain and the drugs stopped working. My world became nothing but sadness and darkness. I had absolutely nothing left and I felt like I didn’t deserve a second chance.

‘But then I was introduced to this amazing recovery worker at a drug and alcohol service. Her belief in me gave me the confidence to believe in myself, and I started to think that maybe I did have a right to be okay. With a lot of support from my recovery worker, I started to address my trauma, build my self-esteem, and rebuild my relationship with my children. It didn’t happen overnight and it was a lot of work, but I finally started to feel self-worth.

‘Somewhere along the way, I decided that I wanted to work for a drug and alcohol charity. I’ve been at WithYou for two years now – I feel like my life has gone full circle. A recovery worker saved my life, and now I have the opportunity to support people who are going through similar things that I experienced.

‘I’m proud to be a survivor of the traumas I’ve experienced in my life. I’m proud to be a recovering addict. But most of all? I’m so proud of the team we’ve built here and the difference that we’re making to people’s lives. So if you, or someone you know, needs us, we’re WithYou – and if you don’t feel able to come to us, know that we’re always ready to come to you.’

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 WithYou

Highest ever drug death total for England and Wales

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DDN
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There were 4,907 deaths related to drug poisoning recorded in England and Wales last year, according to the latest figures from the Office for National Statistics (ONS).

The figure is 1 per cent up on 2021’s total of 4,859 and the highest number since records began 30 years ago. 

DRD ONS Stats 2023The age-standardised mortality rate for deaths related to drug poisoning has risen every year for a decade, says ONS, with the rate of drug-poisoning deaths now more than 80 per cent higher than in 2012 – at 84.4 deaths per million people compared to 46.5 per million. 

At least 3,100 of the 4,907 deaths in 2022 were the result of drug misuse, with the highest rate among 40 to 49-year-olds. Two thirds of the deaths were among men and a third among women, with just under half of all drug-poisoning deaths involving an opiate. The number of deaths involving cocaine, meanwhile, was 2 per cent more than in 2021 and represents the 11th consecutive annual rise.

The most recent treatment statistics from OHID showed a 10 per cent increase in people seeking treatment for cocaine in 2022-23 (https://www.drinkanddrugsnews.com/ten-per-cent-increase-in-people-entering-treatment-for-cocaine/). 

DRD ONS stats breakdown by sexThere has also been an increase in polydrug use, with substances such as benzodiazepines and gabapentinoids increasingly seen alongside opiates. ‘For each year from 1993 to 2011, the average had been either 1.4 or 1.5 drugs per death – for deaths registered in 2022, the average had risen to 2.0 drugs mentioned per death,’ ONS states. As in previous years, the highest death rates for both drug poisoning overall and drug misuse were in the North East. 

The continuing high level of deaths was a ‘tragedy’, said Turning Point’s chief operating officer Clare Taylor. ‘Drug-related deaths are preventable, and the right treatment and support for anyone at risk, in any community, remains the key protective factor.’ While the investment in the wake of the drug strategy had helped to increase the number of treatment places, it would take time to ‘build up the workforce including training additional specialist doctors, nurses, pharmacists and psychologists to deliver world-class drug and alcohol treatment services’, she said, with future funding remaining uncertain.

‘If the government continues to invest in building up skills and capacity in the sector, we can turn the tide. The threat posed by the emergence of cheap, synthetic opioids, that are many times more potent than heroin, means we are facing an uncertain future and therefore the continued investment beyond March 2025 to enable higher quality support to more people is now more important than ever.’

Services and support needed to be ‘more empathetic, easily and immediately accessible, and provided free from stigma’, added WithYou’s interim chief executive Hayley Savage.

‘Cocaine deaths continue to rise and polydrug use is increasing. Nitazenes and other synthetic opioids are also being increasingly identified in drugs like heroin and illicit benzodiazepines. With the majority of drug-related deaths connected to opiates and benzodiazepines, we need to do everything we can to further scale up our access to opioid overdose reversal medicine naloxone as well as increase access to testing of drug samples to avert a worsening of this crisis. It’s vital the political and financial investment for our sector continues over the coming years if we are to reduce the number of drug-related deaths.’

‘Recent increased funding is welcomed, but honestly it is too little too late,’ said Release’s executive director Niamh Eastwood. ‘The figures this year are once again record breaking, and with the arrival of synthetic opioids in the drug supply chain this crisis is set to become catastrophic. This is a public health emergency and we need action now or more needless and preventable deaths will occur.’

The Salvation Army also issued a call for a government-funded naloxone programme for England, with all frontline police trained and equipped to administer and distribute it and take-home kits issued by emergency departments, ambulance services and mental health trusts.

‘We know from our work that the use of drugs is often a way to cope with despair and distress due to trauma, poverty, and a sense of hopelessness,’ said director of addictions Lee Ball. ‘Every death that results from this is a tragedy, even more so when that life could have been saved.’

Deaths related to drug poisoning in England and Wales: 2022 registrations at https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2022registrations

(Features, November 2023) Stayin’ Alive, A new family of synthetic opioids, known as nitazenes, have adulterated a number of illicit drugs in the UK. Information and downloadable resources.

(Features, June 2017): Meet the Fentanyls, a guide to the fentanyl family by Kevin Flemen.

(News, August 2023): Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK

(Partner Updates, September 2023): Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.

(News, January 2023): Fentanyl behind 80% increase in New York’s overdose deaths

Search the DDN archive for more on nitazenes, fentanyl and synthetic opioids.

Smoking-related hospital admissions up 5 per cent in a year

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DDN
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Hospital admissions as a result of smoking increased by almost 5 per cent in 2022-23, according to the latest figures from NHS England, although they remain lower than before the COVID pandemic. 

woman smoking to illustrate an article on hospital admissions for smoking
Around one in six of all admissions for respiratory diseases were estimated to be smoking-related.

There were an estimated 408,700 smoking-related hospital admissions in England in 2022-23, up from 389,900 in 2021-22. Around one in six of all admissions for respiratory diseases were estimated to be smoking-related, along with 8 per cent of cancer admissions and 7 per cent of cardiovascular disease admissions. According to the latest OHID statistics, almost half of the people in treatment for drug or alcohol issues are smokers, with less than 5 per cent reporting having been offered a referral for smoking cessation services (https://www.drinkanddrugsnews.com/ten-per-cent-increase-in-people-entering-treatment-for-cocaine/). 

‘No other consumer product kills up to two-thirds of its users, which is why we have set out plans to stop children who turn 14 this year and younger from ever legally being sold cigarettes – the most significant public health intervention in a generation,’ said public health minister Andrea Leadsom. ‘We are doubling funding for stop smoking services, helping 360,000 people quit, and providing local authorities with one million free vapes via our world-first “swap to stop” programme.’

Delegates at this year’s Global Forum on Nicotine, however, heard how the last decade had been a challenging one for tobacco harm reduction, with ‘regulators, parliamentarians and legislators changing the pace of progress’ according to Prof Gerry Stimson, and the WHO remaining largely opposed to products like e-cigarettes (https://www.drinkanddrugsnews.com/igniting-the-debate/). 

According to a recent survey of almost 12,300 adults commissioned by ASH, nearly 40 per cent of UK smokers think vaping is ‘as or more risky’ compared to smoking, an increase from just 27 per cent a year ago (https://www.drinkanddrugsnews.com/four-in-ten-smokers-believe-vaping-is-as-harmful/).

SDF launches nitazenes resource pack

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DDN
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The Scottish Drugs Forum has launched a nitazenes resource pack for people at risk of overdose, their families and friends, and service staff. The resources include booklets and posters, and will be accompanied by social media posts.

The resources were produced in partnership with service providers and other organisations, and are endorsed by the Scottish Government, Public Health Scotland, Change Grow Live, Turning Point, Scottish Families Affected by Drugs and Alcohol and homelessness charity Simon Community Scotland.

Public Health Scotland first warned about the presence of nitazenes in the country’s drug supply at the start of the year, with their continuing presence suggesting they have ‘become an established part of supply and may prefigure the introduction of similar drugs including fentanyls which have caused many deaths in the United States and elsewhere’, SDF states.

Although Scotland’s drug death total fell by 21 per cent last year, the number is still almost four times higher than from two decades ago (https://www.drinkanddrugsnews.com/scottish-drug-deaths-down-by-a-fifth/), with many agencies issuing stark warnings of the increased overdose risk associated with nitazenes and fentanyls. The delayed drug death figures for England and Wales are scheduled to be published next week.

SDF strategy co-ordinator for drug death prevention, Kirsten Horsburgh
Kirsten Horsburgh: We need to act now on the challenge of nitazenes

‘It is clear that, as anticipated, synthetic opioids have become involved in the drug supply in Scotland,’ said SDF CEO Kirsten Horsburgh. ‘Nitazenes have been found in heroin and benzos but may be in supplies of other drugs. There is always risk so long as drug supply is unregulated. But the core message is to try and reduce risk as far as people can and to carry and use naloxone if someone overdoses. We have an imperfect picture of what is happening in Scotland. This is because we’ve been slow to heed warnings and adequately prepare. We need to act now in the face of the threat posed by these drugs being in the supply. The challenge of nitazenes and other drugs in the supply makes more urgent broader measures to prevent deaths.’

Resources available at https://www.stopthedeaths.com/resources-1

Reconnected to Health awarded Best Use of Workplace Technology category at Nursing Times Awards

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DDN
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Humankind’s Reconnected to Health Team has recently won the Best Use of Workplace Technology award at the Nursing Times Awards.

The Nursing Times Workforce Awards is an event that recognises and rewards the outstanding work that is being done by staff and employers to support the nursing and midwifery workforce.

Co-located with the Nursing Times Workforce Summit, the event inspires and rewards organisations for excellence in supporting the future of the health and care workforce.

Humankind and partner Spectrum were shortlisted with His Majesty’s Prison and Probation Service (HMPPS) and Lifeworks for the Best Use of Workplace Technology category.

Their partnership was recognised for working to roll out Breaking Free Online, a confidential treatment and recovery programme developed to support people through their recovery from drugs or alcohol.

Robyn Taylor, a service manager at HMP Durham, attended the Nursing Times Awards on 21 November and received the award on behalf of the team.

Jas Holburn, area manager for North East Prisons at Humankind, said, ‘We are very proud to be part of this partnership, and this award reflects the power of collaboration between HMPPS, Spectrum, Breaking Free Online and Humankind to offer innovative digital solutions to people in our care in North East prisons.’

This blog was originally published by Humankind. You can read the original post here.

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 Humankind

Ten per cent increase in people entering treatment for cocaine

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DDN
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The number of people starting treatment for powder cocaine issues increased by 10 per cent in 2022-23, from 21,298 to 23,529, according to the latest treatment statistics from OHID. The previous peak number was 21,396 in 2019-20.

The headline figure is for powder cocaine use, but there are also increases in treatment for crack cocaine and ketamine.

There has also been rise in the number of people entering treatment for crack – both those using crack with opiates (from 18,832 to 20,158) and without opiates (4,711 to 5,444). The increase comes after two years of declining figures.

Overall there were 290,635 adults in contact with drug and alcohol treatment services in 2022-23, slightly up from the previous year’s figure of 289,215. However the number of people entering treatment was higher than for the last two years, at 137,749 compared to 130,490 and 133,704. As in previous years, almost half of people in treatment were there for problems with opiates, with those in treatment for alcohol alone making up the next largest group, at 30 per cent.

The number of people entering treatment for problems with benzodiazepines dropped by 6 per cent to 3,620, after increasing every year since 2018-19. The number entering treatment for cannabis was up by 2 per cent, however, to 28,845, and more than 2,000 entered treatment for problems with ketamine – five times the total from less than a decade ago.

Just over 127,000 people exited the treatment system in 2022-23, with almost half having successfully completed their treatment. However, the number of people who died while in contact with treatment services was 4,166, up more than 10 per cent on the previous year.

Just under 68 per cent of people in treatment overall were male and just over 32 per cent female. Sixty per cent were over 40, an almost 10 per cent increase since 2016-17, with the number of under-30-year-olds in treatment for opiates standing at just 5 per cent.

Homelessness looms large, especially for the opiate treatment group.

More than two thirds of people in treatment reported having a mental health treatment need, which is broadly similar to last year but a substantial increase from 2018-19 when the figure was just over half. A fifth of people starting treatment said they had no home of their own – with the highest proportion among the opiate treatment group, at 37 per cent –while just under ten per cent said they were at risk of homelessness in the next eight weeks.

More than 40,000 people said they’d smoked tobacco in the month before starting treatment – 49 per cent, compared to smoking rates in the general population of 14 per cent for men and ten per cent for women. However less than 5 per cent said they’d been offered a referral for smoking cessation.

Very few treatment clients are being offered smoking cessation, despite the high number of smokers.

The latest drug misuse statistics from the Crime Survey for England and Wales have also been published, showing that around 9.5 per cent of 16 to 59-year-olds used an illicit drug in 2022-23. While there was no statistically significant change compared to the figures for the year ending March 2020, levels of use were up by 8 per cent on a decade ago, including more than 6 per cent for cannabis and 2.5 per cent for class A drugs.

Around 770,000 people said they’d taken drugs more than once a month during the last year. The number of 16 to 24-year-olds who reported any drug use was down by more than 20 per cent on the year ending March 2020, however – largely the result of falls in cannabis use – although this age group still had the highest prevalence of drug use overall.

Adult substance misuse treatment statistics 2022 to 2023: report here

Drug misuse in England and Wales: year ending March 2023 here

 

Review of the year – 2023

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DDN
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ddn magazine review of the drug treatment system in the uk 2023

While the money promised in the wake of the drug strategy continued to flow into the treatment system, there were disturbing shifts in the country’s constantly changing drug supply – with more highly potent synthetic opioids being entering the market than ever before.

JANUARY

In what could be an ominous sign of things to come on this side of the Atlantic, New York City’s health department attributes an almost 80 per cent increase in overdose deaths since 2019 largely to fentanyl. More than a million Americans have now died from a drug overdose since 2000, says the US Centers for Disease Control and Prevention. Meanwhile, the number of people being treated for alcohol issues in the UK is up by 10 per cent in a year, to almost 85,000, according to the latest OHID figures. 

FEBRUARY

ddn magazine february 2023More than £420m funding is confirmed for local authorities to provide drug and alcohol treatment through to 2025, part of the government’s commitment to significantly increase treatment capacity. The number of drug-free wings in prisons doubles to 45, with up to 100 special blocks planned by 2025, and DDN is devastated to hear of the death of harm reduction activist and long-time DDN conference team member Si Parry. 

MARCH 

ddn magazine may 2023The government announces that it intends to ban nitrous oxide, despite the ACMD advising that the harms associated with the substance are ‘not commensurate with control under the Misuse of Drugs Act’ and a ban would put ‘disproportionate burdens’ on its legitimate use. Meanwhile, global cocaine production increases by 35 per cent in just two years following a COVID-related slowdown, says UNODC. ‘The surge in the global cocaine supply should put all of us on high alert,’ says the agency’s executive director, Ghada Waly.

APRIL

ddn magazine april 2023The much-delayed gambling white paper is finally published, with proposals including a mandatory levy on the industry to fund treatment and new stake limits for online slot games, although many are disappointed with the lack of action on advertising. 

A statement from 30 health organisations warns that Scotland could be ‘sleepwalking’ back to record levels of alcohol-related deaths, while the latest Home Office figures reveal that seizures of cocaine and ketamine are at their highest ever levels. 

Meanwhile, the first comprehensive census of the drug sector’s workforce shows there are now almost 11,500 ‘whole time equivalent’ treatment provider staff working alongside nearly 400 commissioning staff.

MAY

ddn magazine may 2023The government is ‘complacent’ about the scale of alcohol-related harm in the country, warns the House of Commons Public Accounts Committee, with a ‘staggering’ 82 per cent of dependent drinkers not receiving treatment. ‘The government has had no alcohol strategy in place since 2012 and abandoned its latest effort in 2020 – just as deaths from alcohol began to rise sharply over the terrible, unacceptable toll it was already taking,’ states committee chair Meg Hillier. 

JUNE

ddn magazine june 2023Global drug markets are being transformed by ‘cheap and easy’ synthetic drugs, warns UNODC’s latest World drug report – with ‘lethal’ results. Synthetic opiates mean lower costs and fewer risks for traffickers, the report points out, with more and more now likely to enter the market as a result of the Taliban’s opium ban in Afghanistan. 

Some good news, however, in an update to the HIV action plan for England, which states that new HIV transmissions have fallen by a third since 2019. This means the country is on course to meet the target of an 80 per cent reduction in new transmissions by 2025, and an end to them by 2030. 

JULY

ddn july 2023Treatment agencies begin issuing warnings about unusually strong opioids, with clusters of fatal overdoses around the country. Drugs sold as heroin, oxycodone and ‘street benzos’ are being found to contain fentanyls and nitazenes, the organisations point out. 

DDN heads to Birmingham for its 15th annual service user conference, Many Roads. While it’s no longer socially acceptable to stigmatise people with mental health issues, Phoenix Futures chief executive Karen Biggs tells delegates, attitudes to people who use drugs still haven’t changed. 

AUGUST

OHID issues updated guidance for commissioners and services on preparing for incidents involving fentanyl and nitazenes, telling local areas that they need to plan how to ‘rapidly understand and assess’ the risks and minimise the impact – including by improving drug information systems and naloxone supply. Scotland’s latest drug death figures show a 21 per cent reduction, however, although the figure is still almost quadruple the level of 20 years ago. 

A report from the House of Commons Home Affairs Committee, meanwhile, says the 1971 Misuse of Drugs Act is outdated and in need of reform. ‘Whilst the drug strategy is moving in the right direction, it requires much more meaningful action to tackle the broad range of drug-related problems,’ says committee chair Dame Diana Johnson.

SEPTEMBER

ddn september 2023Scotland’s lord advocate says it would ‘not be in the public interest’ to prosecute people for possession offences committed in a pilot drugs consumption room, opening the door for the introduction of legal pilot schemes. Two weeks later Glasgow approves the plan for a facility in the city’s east end, while Scotland also consults on raising the minimum unit price for alcohol to 65p – despite ongoing controversy over how effective the intervention has been so far.

OCTOBER

ddn oct 2023The National Audit Office warns that the government will need to address a lack of focus on intervention, uncertainties around future funding, and gaps in the evidence base if it is to achieve its drug strategy ambitions. While more than 1,200 new drug and alcohol workers have already been recruited against a target of 950 by 2024-25, there are still delays in distributing drug strategy funding and implementing new projects. 

The government also announces ‘the most significant public health intervention in a decade’, with plans to raise the smoking age year-by-year to prevent anyone now younger than 14 from ever being able to legally buy cigarettes. 

NOVEMBER 

ddn november 2023Opium poppy cultivation in Afghanistan has plummeted by 95 per cent since the Taliban’s opium ban, says the latest analysis by UNODC, fuelling fears of yet more fentanyl and nitazenes entering the drug market, while the Metropolitan Police recovers 150,000 nitazene tablets – the UK’s largest ever seizure of synthetic opioids – that are destined for sale on the dark web. 

The government’s controversial nitrous dioxide ban comes into force, while New Zealand’s plan to ban smoking for future generations – the model for the UK’s projected legislation – is promptly scrapped by the country’s new government. 

Meanwhile, new public health guidance from the European Centre for Disease Prevention and Control (ECDC) and EMCDDA classifies consumption rooms as one of the six key interventions to prevent infections among people who inject drugs. 

And finally, with a general election once again looming, Change Grow Live share their asks of a new government, including committing to sustainable three-year funding cycles, recognising the role of third-sector providers and publishing a comprehensive substance misuse workforce strategy. 

DECEMBER

ddn december 2023At the turn of the year we hope for continued investment alongside stability and progress in the sector – and look forward to its favourite magazine turning 20 years old!

 

Working at WithYou: Emma and Jade’s pharmacy technician journeys

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DDN
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Ever wondered what it’s like to be a pharmacy technician at WithYou? We hear from Emma and Jade who help WithYou clients throughout their treatment journeys at the charity’s drug and alcohol services.

Emma (left) and Jade (right)

What does a typical day look like?

Emma: ‘There is no typical day for me. One day I can be training people on naloxone use, promoting world health awareness days, attending incident review meetings, liaising with pharmacies or preparing for audits – the list is endless and exciting.’

Jade: ‘It’s exciting and interesting. Every day is different! My role varies from assessing medication in residential rehab, conducting medicine management audits across the service, communicating between local pharmacies, offering medicine training to recovery workers or pharmacies and so much more. I see myself as a vital ‘middle person’, connecting the pharmacies and the WithYou service to achieve the best treatment for our clients.’

What’s the best thing about being a pharmacy technician?

Emma: ‘There’s no better feeling than knowing you are helping clients by offering harm reduction advice and getting the knowledge out there that overdoses can be prevented. Building relationships with people, like local pharmacies, and bridging the gap to help make the whole process smoother for everyone.’

Jade: ‘I love being able to support clients in their recovery and offer my pharmaceutical knowledge. The priority is always the client, and I am passionate about assisting in the treatment journey.’

What personal qualities do you think make an excellent pharmacy technician?

Emma: ‘Being compassionate, empathetic, organised, methodical, having a fine eye for detail, being a people person and having a desire to help people, a problem solver.’

Jade: ‘An excellent pharmacy technician requires dedication and passion, both to the job and the clients. Having efficient organisation skills, communication and empathy are also really important.’

What role do you feel pharmacy technicians play in helping people to live healthier, happier lives?

Emma: ‘We’re like approachable signposters. People feel they can ask for advice without feeling embarrassed or that they’re wasting your time. Often, people will ask me things that they don’t want to trouble a doctor with.’

Jade: ‘The client receiving the best possible care and treatment is always the main goal. It’s not just about prescriptions; it’s about personalised care, clinical advice, and solid support.’

What made WithYou stand out?

Emma: ‘I read an article about the peer on peer distribution of naloxone and I just thought wow! Such a simple thing of supplying people with a little piece of kit to help prevent deaths blew me away! And it made me want to be part of this amazing work. The more I looked into WithYou, the more I wanted to be part of it. I also loved the non-judgmental ethos and the person-centred approach.’

Jade: ‘From only having community pharmacy experience, I had no idea that a role like this could exist in a service like WithYou. I was immediately drawn to the idea of being a Pharmacy Technician in a passionate, dedicated and unique setting.’

What advice would you give someone who is considering starting their journey at WithYou as a pharmacy technician?

Emma: ‘Before I started with WithYou, I was on the brink of giving up my registration and considering a job at a local farm shop. With eight years in dispensing doctors, 11 in hospital pharmacy, and a stint in retail, the pressures on pharmacies and the NHS had worn me down. I felt defeated, unable to give patients the attention and care they deserved.

Working for WithYou has brought back my passion and my zest for learning. I can feel that I’m making a difference. I have the freedom to work in areas that I feel passionate about, like harm reduction and providing needle syringe provision. I remember early on I was told “The role can be whatever you want it to be” and that is so true. I’ve never had a job as a pharmacy technician where I’ve felt so supported and valued, and recognised for the work I do.’

Jade: ‘Absolutely go for it! Although the workday here is very different to a typical day in a community pharmacy, it’s hands down the best job I’ve ever had. Your skills and experiences will be widely developed, and it’s exciting getting stuck into something new each day.’

This blog was originally published by WithYou. You can read the original post here.

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 WithYou

Street Benzos: Clinical Management That’s Fit for Purpose 

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DDN
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header for an article in DDN Magazine on Street Benzos

For its latest column, Release teams up with national charity WithYou to discuss how to better support people in treatment for so-called ‘street benzos’.

It’s time for a new approach, say Dr Kate Blazey and Shayla Schlossenberg.

This is what we know from a clinical perspective. Drugs and alcohol charity WithYou is seeing people in treatment services with unexpectedly high levels of benzodiazepine dependence, rendering this group more vulnerable to, among other harms, overdosing. The high levels of dependence have also created uncertainty amongst clinicians about how to respond.

It’s believed that these high levels of dependence are caused by street benzos; pills sold illicitly under names such as Valium or Xanax but often containing other – often more potent – substances. In this article, a ‘novel benzo’ refers to a completely new benzo that has entered the illicit supply. ‘Street benzo’ is used for benzos that have been in the supply for a while, and are more established.

To provide better treatment to people who detox from street benzos as well as reduce the risk of overdoses and deaths, WithYou’s clinical team has discussed how benzodiazepine can be prescribed during street benzo detoxification. 

image used as a sub header - Nick's story of street benzo useRelease initially shared Nick’s* story (DDN, July/August, page 18) to raise awareness about the need to adapt the clinical treatment offered to people detoxing from street benzos. Nick approached Release while dependent on street benzos, mainly diazepam. On at least one occasion, he had taken the street benzo bromazolam (thinking he had bought diazepam). While less is known about street benzos, many are more potent, which can increase the risk of overdose and death. 

Later in treatment, Nick was only offered a diazepam prescription for a short time — at a dose much lower than the amount which would be equivalent to his daily benzodiazepine use at the time — affecting his ability to detox in a meaningful way. Unable to convince his clinician to prescribe him the dose that he would have needed to stabilise, Nick instead turned to his illicit supply. He shared his story with Release in the hope of raising awareness about the need for more flexibility when detoxing from street benzos.

Finding a way to better support people like Nick – WithYou’s approach

According to the ‘Orange Book’, diazepam can, under certain circumstances, be part of a benzo detox programme, while not specifying for how long the drug can be prescribed.  

Separate from Nick’s experience, WithYou noticed an increase in the number of clients using street benzos such as flualprazolam and flubromazolam, thinking they were taking regular benzos – this meant clients were often in the dark about increased potency and risk. In addition, WithYou noticed an increase in people with severe dependence to what was believed to be diazepam but turned out to be street benzos after testing. Having made these observations, the clinical team decided to review WithYou’s approach.

Firstly, the clients were encouraged to test their samples using the WEDINOS external testing facility and harm reduction project. In some instances, flubromazolam was identified and it was possible to screen for it as part of the treatment programme.

Dr Rachel Britton guidance of diazepam dose for street benzo users

New Guidance

Following this — working with Dr Rachel Britton (formerly clinical director at WithYou, now clinical lead at Via) and other senior clinicians — WithYou adapted its benzodiazepine guidance. The new guidance allows a slightly higher starting dose of diazepam for clients who would struggle with unpleasant and potentially risky withdrawal symptoms under the regular regime (and therefore be more inclined to top up with benzos obtained illicitly). 

In addition, the level of support for those replacing high-strength benzodiazepines with the reduction regime was increased, including more frequent check-ins. Once stabilised, the gradual reduction could proceed regularly. The revised approach meant that clients suffered less unpleasant withdrawal symptoms and were less likely to turn to an illicit supply to cope with these during their initial detoxing journey.

image used as sub header on identifying risk of street benzo useThis is one example of how to better cater to the clinical needs of people like Nick. However, it’s important to remember that not all people who use street benzos will require this approach, many can withdraw safely themselves, supported by treatment services or primary care. The challenge from a clinical perspective is to identify those more at risk and be prepared to be flexible, within a safe, clinical framework.

A revised approach to supporting people dependent on street benzos – Release

Having initially shared Nick’s story to raise awareness about the need to adapt clinical treatment offered to people detoxing from street benzos, it’s important to remember that there are several under-addressed dangers for people who use illicit benzodiazepines. Firstly, the increased presence of novel benzos in the illicit benzo supply. For instance, in Scotland, where benzodiazepines were implicated in more than half of 2022’s drug-related deaths, Public Health Scotland notes an ‘increase in harms related to the use of new benzodiazepines such as bromazolam’. 

In October alone, WEDINOS received more than 20 samples from around the UK containing new benzodiazepines largely from samples believed to be either diazepam or alprazolam when purchased. The consumers of these benzodiazepines often lack access to a steady supply at a known and controlled dose, with these substances also often significantly stronger than legally prescribed ones.

Additionally, there have been many recent instances of drugs purported to be benzodiazepines turning out to contain nitazenes. Nitazenes are potent and high-risk synthetic opiates, posing great danger to people who use them. This is especially true for people who use benzodiazepines and don’t regularly use opiates.

sub header - revised approach to street benzo useGiven the risks above, including the likelihood of new, unregulated substances emerging around the country, we need a revised approach to supporting people dependent on benzodiazepines across the sector. 

This approach must include promoting drug testing to all people who use drugs, as well as greater access to naloxone. Additionally, we must improve screening tests to have an understanding of what benzodiazepines – and potentially other substances such as nitazenes – the person has used in order to respond appropriately.

As drug supplies evolve, the sector must stay current to be relevant to people who are using drugs and are at risk of drug-related harms. Updating how we collectively work with people who use benzodiazepines is paramount to the greater mission of keeping people who use drugs alive.

*not his real name

Kate Blazey and Shayla Schlossenberg

 

Dr Kate Blazey is medical director at WithYou. Shayla Schlossenberg is drugs service coordinator at Release

 

 

Related articles

(Features, August 2023) Rough Treatment – Release share a case study demonstrating the effects of inflexible and ineffective treatment for benzos.

(Features, June 2020) The benzo trap – Improving our understanding of benzodiazepines would save many lives, says Kevin Flemen.

Read more on benzos in our archive

Myanmar overtakes Afghanistan as largest opium source

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DDN
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Opium cultivation in Myanmar has increased by almost 20 per cent in the last year, according to the latest UNODC survey, with the country now the world’s largest source of opium.

The Golden Triangle Opium
Cultivation has continued to expand in the ‘Golden Triangle’ countries of Southeast Asia

While cultivation has continued to expand in the ‘Golden Triangle’ countries of Southeast Asia, the Taliban’s opium ban in Afghanistan has led to a 95 per cent drop in cultivation since last year, fuelling fears that highly potent synthetic opioids will fill the gaps in supply (https://www.drinkanddrugsnews.com/afghan-opium-cultivation-drops-by-95-per-cent/).

Economic and security disruptions in Myanmar since the military takeover in the country last year are driving more farmers in remote areas to opium cultivation to make a living, says the UNODC report. ‘While it is too early to draw conclusions on the impact the opium ban in Afghanistan has had on the situation in Southeast Asia, a protracted ban is expected to translate into continued high prices and further increases in cultivation,’ UNODC states. 

‘In the current situation, farming communities are caught between insecurity and economic hardships,’ said the agency’s deputy regional representative Benedikt Hofmann. ‘Even more people will look at opium as a viable crop if there are no alternatives, especially in the absence of the rule of law.’

Meanwhile, Public Health Wales is the latest UK agency to issue a warning about highly potent synthetic opioids. WEDINOS, the drug testing service operated by the agency, has received more than 20 samples of benzodiazepines that were found to contain nitazenes since September. The samples included substances being sold as diazepam and alprazolam – both ‘street benzos’ and drugs bought online by people ‘likely believing them to be genuine pharmaceutical products’. 

head of substance misuse at Public Health Wales and WEDINOS, Rick Lines
Head of substance misuse at Public Health Wales and WEDINOS, Rick Lines

‘We’re concerned that people taking these substances could quickly find themselves in a life-threatening situation,’ said head of substance misuse at Public Health Wales and WEDINOS, Rick Lines. ‘For individuals experiencing negative effects from taking what they believe are benzodiazepines, they may in fact be experiencing a more serious opioid overdose that should be treated with naloxone. We want to raise awareness of the dangers and make sure that people know that naloxone is a lifesaving medicine available free of charge in Wales to reverse the effects of an opioid overdose.’

The National Crime Agency recently told the BBC that nitazenes had now been linked to at least 54 deaths in the UK in the last six months, with 40 more cases awaiting further testing. The delayed drug death figures for England and Wales from the Office for National Statistics are due to be published next week.

Related articles:

(Features, November 2023) Stayin’ Alive, information and downloadable resources on nitaznes.

(News, September 2023) Afghanistan sees shift from opium to methamphetamine production

(News, January 2023) Myanmar opium poppy cultivation up by a third

(News, August 2023): Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK

(Partner Updates, September 2023): Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.

(News, January 2023): Fentanyl behind 80% increase in New York’s overdose deaths

Search the DDN archive for more on opium, nitazenes, fentanyl and synthetic opioids.

The impact of gender based violence on mothers

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DDN
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Michaela Dean, registered manager, National Specialist Family Service England at Phoenix Futures, shares how services that support mothers and their children to stay together can help break down barriers to treatment.

We know that women, but especially mothers who use drugs, continue to face stigma when reporting their experiences of violence against them. This has been apparent in many stories we have heard from the mothers who access our service.

Whilst fighting to care for their children and facing their recovery, the question remains, ‘why did you not report this at the time?’ Fear, lack of hope, trust, and belief they will be judged and not believed are just a few thoughts going through a woman’s head when experiencing violence against them.

Due to the structures, decision making and assessment for children in our court systems surrounding a family, evidence is required to be able to confirm on the balance of probability if violence and/or abuse has been experienced when it has not been reported to the Police.

A story that is prominent in my mind, and one of many who have experienced similar situations, is of India, a mother who became pregnant after experiencing violence and assault in the throes of her addiction. As part of the court proceedings, the judge wanted to determine whether the father should have access and be allowed parental responsibility for the child.

This meant that this mother had to give a detailed account of her experience, as she was unable to report it to the police at the time. Her traumatic experiences were then discussed for hours by professionals in the court arena whilst she had to sit and listen. The language was cold, and she felt that the consideration of the trauma she experienced was secondary in their minds.

India had recently given birth, navigating a postpartum body and early motherhood, she was also at the end of her detox from substances. Despite these challenges she was engaged and keen to work on her recovery.

The support that we were able to give her from the service allowed her to face these challenges, whilst caring for her newborn. She knew that if the father became involved, he posed a very real risk to both her own and her child’s life.

Our service enabled and supported India to use her voice, to feel strong and confident enough to speak of her experience in an intimidating environment to professionals who were assessing her life and whether she could safely care for her child in the future. She felt judged.

India knew she was a good mother, and her child gave her focus; she had hope for the future she wanted for herself and her child.

Thankfully the female judge recognised the risk – she made the decision that including the father in the child’s life would be detrimental not only to India’s mental wellbeing and her recovery but also to the child’s wellbeing. India went on to graduate from our service and has stayed together with her child.

Whilst many families come to us during care proceedings, in a study across our family service following 41 parents and 42 children, 70 per cent of families were still together up to four years after completing treatment.

We have an average completion rate of 86% across all our family services.

Providing a treatment approach that supports mothers and their children to stay together and keeps children safely outside of the care system breaks down barriers for women to accessing treatment, knowing that they will not have to be separated from their children to get help for substance use and related issues.

This approach also supports children’s development and helps them to overcome some of the negative consequences of being part of a family experiencing addiction. And it provides long term sustainable recovery for the mother and her children.

We believe that whole family approach should be available to all families experiencing addiction and should be considered before the decision is made to remove children into the care system and separate families.

This blog was originally published by Phoenix Futures. You can read the original post here.

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 Phoenix Futures

Navigating the festive season for those in recovery, sober or abstinent

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DDN
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Photo by Chad Madden on Unsplash Go to Chad Madden’s profile Chad

In this blog, the team from Turning Point’s Drug and Alcohol Wellbeing Service explores the topic of sobriety during Christmas, focusing on those who are in recovery, sober, or abstinent.

While there may be some overlapping tips for anyone looking to cut down on alcohol or drug use, we believe it is essential to provide a separate guide specifically tailored to those navigating the challenges of maintaining sobriety during this festive season.

So, whether you’re newly in recovery or have been on this journey for a while, join us as we discuss practical strategies to help you navigate the holiday season. Additionally, for those who drink alcohol or use drugs and are simply looking to practice safe and responsible consumption during this time, we have a separate guide available.

Here are some tips on looking after yourself this festive season

Make a plan and stick to it

Before the holidays start, take some time to think about your triggers and develop a plan for how you will avoid them. This may include avoiding certain people, places, or activities, or having a plan for what you will do if you feel tempted to drink.

Communicate your commitment to sobriety to your loved ones

Let your friends and family know that you are not drinking and ask for their support. This will help you to stay accountable and avoid situations where you might be tempted to drink.

Attend recovery meetings or support groups

Remember, you are not alone. Many people in recovery find the holidays to be a challenging time. But with planning, preparation, and support, you can stay sober and enjoy the holidays.

Recovery meetings or support groups are a great way to connect with other people who are in recovery and get support and encouragement.

Take care of yourself and practice relaxation techniques

Make sure you are getting enough sleep, eating healthy foods, and exercising regularly. These activities can help you to feel your best and reduce stress, which can trigger cravings for alcohol. When you feel stressed or anxious, try relaxation techniques such as yoga, meditation, or deep breathing. These techniques can help you to calm down and avoid cravings for alcohol. Take breaks from social situations if you need to.

Reward yourself for staying sober

Set small goals for yourself and reward yourself when you reach them. This will help you to stay motivated and on track.

Remind yourself of the benefits and the reasons why you are sober

Embracing a life free from drugs and alcohol can benefit your physical, mental, and emotional well-being. This decision can significantly reduce your risk of developing chronic health conditions like heart disease, stroke, liver disease, and cancer. Additionally, you may experience improved sleep quality, increased energy levels, and a stronger immune system.

Don’t be afraid to ask for help

Reach out to Turning Point for support if you’re struggling, we understand what you’re going through. We also offer boost programme for people who have finished their treatment.

Bring your own non-alcoholic drinks to parties and gatherings

Try to avoid situations where alcohol is heavily served, or offer to help with hosting or cooking, so you are busy and have less time to focus on drinking.

Need more help?

Turning Point offer recovery coaching, confidential one-to-one support online, in person and by phone, as well as access to social groups, fitness and outdoors activities and much more.

Remember, seeking help is a sign of strength, and there are numerous resources available to support individuals in making positive changes in their lives. If you or someone you know is struggling, reaching out to us can be a crucial step to supporting your recovery and wellbeing.

Turning Point Drug and Alcohol Wellbeing Service Festive Opening Times

Our hubs will not be open on the following days: Monday 25th December, Tuesday 26th December, and Monday 1st January.

Our partners Build on Belief will have a social club open at Acorn Hall, 1 East Row, W10 5ar every Saturday and Sunday in December and January from 12-5pm. Build on Belief will also have a special Christmas event and raffle on Sunday 17th December, open to anyone who is struggling with drugs and alcohol.

We will also be supporting Crisis at Christmas from 27th December – 4th January.

This blog was originally published by Turning Point. You can read the original post here.

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 Turning Point

Staff awards light up Forward’s winter season

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DDN
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The Forward Trust’s Staff Awards (Winter) 2023 event once again highlighted incredible individual, team and cross-organisation achievements from this year.

With over 65 nominations received, this year’s event on Monday 20th November at The Brink, Liverpool, provided a welcome opportunity for staff across the organisation to get together, enjoy a tasty lunch and get to know/reacquaint with colleagues from all parts of the country.

This year’s awards recognised both individuals and teams for their innovation, service delivery, personifying Forward’s values, volunteers’ efforts, and personal achievements.

The winners on the day were;

Forward People Award for Individuals
Winner: Katy McGrath, safeguarding manager within GQA Team

Since joining the charity last year, among many other things, Katy has implemented a comprehensive and preventative safeguarding strategy, working with others to produce and implement new policies and launching related training that saw 60 of our staff receive accredited L3 safeguarding training in quarter three of 2022.

Katy has gone above and beyond, conducting welfare checks on staff to assist in making decisions on their wellbeing in the support of staff, managers and the safety of others.

Honourable mention: Darren Lacey, inclusion co-ordinator/drug and alcohol practitioner/LGBTQ+ lead

Forward Thinking Award for Innovation

Winner: Heidi Hart, gov admin 

Heidi was instrumental in updating and designing the Governance Info site on the staff intranet, ensuring staff have access to documents, governance guidance, and training, making the pages a much more interactive and useful space for staff to access all sorts of information and develop more understanding about governance.

The site now includes pre-recorded workshops that staff can access at any time and covers a broad range of topics. This page is also used to alert clinical staff to NHS safety alerts, and much more.

Honourable mentions: Karen Lord, service manager at HMP Downview and Rhianne Graham, regional manager, Surrey & London

Forward Champion Award - for volunteers & peer supporters 

Winner: Gillian Blogg, ReNew Hull volunteer

Gillian graduated from support within our Independent Family Service and has continued to share her story, providing hope to others and their family members who have been impacted by a loved one’s addiction.

A volunteer for around five years, Gillian provides a weekly support group, Recovering Families, where she shares her own lived experience, she also runs peer support groups for people in our family service who leave treatment and has been described by her nominator as a ‘beacon of visible recovery for family members, who is invaluable to us and whose work does not go unnoticed’

Honourable mention: William Garnier, Vision Housing volunteer mentor

Dream Team Award for an Inspiring Team
Winner: The Regional Programmes Team for the Surrey region

This team, made up of Leah Roberts, Daniel George, Daisy Halll, Charlote Bleackley, Anahita Razavi, and Sharon Hill have gone ‘above and beyond’ in their flexible working to support the Surrey prisons programmes and case management. In particular, the Bridge programme at Highdown where the team liaised with safer custody and violence reduction teams to implement a plan allowing a client to attend the programme despite non-associates being located in the houseblock where the programme was due to take place, going so far as to arrange glasses for the client so he could complete assignments. They also introduced family graduations, allowing family to attend graduations and they facilitated the Bridge, the first programme to be delivered at HMP Coldingley in five years.

Honourable mention: The Bridges – Hull Team

Richard Stephenson Award for Forward Values
Winner: Ilo Edwin, head of custodial services 

Edwin has been with Forward for 17 years, starting out as a practitioner and working his way up. He’s been described by colleagues as brave, innovative, adaptive, inspiring and kind. Most recently he has developed supporting opportunities for trainee counsellor volunteering roles which will increase the therapeutic capacity of our prison services.

Honourable mention: Gee Punia, head of employability & skills

This event included a number of hosts from across Forward, including CEO Mike Trace, executive director of substance misuse services, Jason Moore, and two trustees, Louise Gibbings and Benita Rayne.

Guests were also treated to refreshments, afternoon tea style platters and a live musical opening by a Liverpool-based ukulele band.

The awards also provided a new opportunity to show a recent film launched by Taking Action on Addiction (led by The Forward Trust) as part of the national campaign, Addiction Awareness Week. Over 40 participants featured in this groundbreaking film, each telling their own story or journey through addiction and recovery.

One of the most poignant moments from the awards was the remarkable introductory speech by Louise Gibbins (a Forward trustee), highlighting the namesake of the award, the late Richard Stephenson, or ‘Steff’ as he was affectionately known – a Forward Trust graduate who had a remarkable story of recovery. Richard was a client of Forward more than 20 years ago and recovered from his own addiction going on to provide support, help and inspiration to others during his life, until passing away later this year.

The late, great Richard ‘Steff’ Stephenson

Read Louise’s tribute to Richard:

‘I first met Richard 22 years ago when he was at Wandsworth prison. He, like many of our clients, had many difficult problems and he had already served a number of sentences, but he was determined to turn his life around. And I had the privilege of watching him do just that.

When he left (prison) he wanted to help other graduates going through what he had been through. I really believe he was the first of our volunteers who started the meet and greet. He was committed to it, and it’s been one of the important things that we (Forward) do.

He lived a remarkable life, from that change in him. He took two degrees, although he was very dyslexic, and he was a trained therapist, and he also worked, not only for us, but another number of other organisations – but he always kept in in touch with Forward.

In fact, we asked him to set up the Advisory Committee for our service users and he was a wonderful voice for us, as trustees, to listen to and understand.

Very sadly he was diagnosed with cancer and he survived another two years – the greatest man I have ever seen.

I was so glad to be able to tell him before he (passed), and his two daughters and wife, that there was going to be award for him. As you can imagine he was very touched. It is wonderful for us here to be celebrating a remarkable life.’

The event ended with a chance for colleagues to chat, take photographs and reminisce about their achievements over the last year, and this special ceremony provided a welcome occasion for celebration for all nominees.

This blog was originally published by The Forward Trust. You can read the original post here.

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 Harrow achieves micro-elimination of Hepatitis C

By
DDN
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VIA Harrow celebrate successfully reaching the impressive milestone of Hepatitis C micro-elimination in their service.

Anna Whitton CEO Via
Anna Whitton, CEO at Via said: ‘This is a really positive and important outcome, which has made a tangible difference to many people.’

NHS England has a target to eliminate the virus by 2025 and Via services are aiming to do this in their local areas by the end of 2023.

Hep C is a blood borne virus which, left untreated, can cause liver cancer and liver failure. It usually displays no symptoms until the virus damages the liver enough to cause liver disease. People who inject drugs are at the highest risk of becoming infected.

As of November 2023, our team in Harrow has reached the following targets with the people who use their service:

  • 100% of those in treatment have been offered a Hep C test.
  • 100% of people who currently inject or have previously injected have been tested for Hep C.
  • 90% of individuals who currently inject or have previously injected have been tested in the last 12 months.
  • 90% of people who were diagnosed with Hep C at the service have started treatment.

By meeting these targets, we’re proud to report that Via Harrow has formally achieved Hep C micro-elimination! This is Via’s first service to reach micro-elimination, and the third West London service and the sixth London borough to reach this incredible milestone.

In partnership with Gilead Sciences, staff and volunteers at all our Via services have been working tirelessly to promote testing and treatment with the people they work with, on their journey to micro-eliminate Hep C, and we hope to be able to announce more micro-elimination wins soon!

Oasis Azeez-Harris, Senior Public Health Commissioner for Sexual Health and Substance Misuse from Harrow Council said: ‘Congratulations to the Via Harrow staff team for working hard to achieve the micro-elimination of the Hep C Virus through a substance misuse service, this is a huge achievement to be celebrated as we, as a system work towards World Health Organisation’s (WHO) ambition to eliminate viral Hepatitis by 2030. It is wonderful to see Via Harrow leading the way, being a beacon for others to learn from. This would not be possible without Via Harrow’s close working arrangements with other stakeholders, for example the Hep C Trust amongst others – this shows that joint work leads to better outcomes of people using services on their recovery journey. Well done Via Harrow staff team – keep up the fantastic work to maintain and exceed this success for Harrow residents using your services!’

Prof Ashley Brown, Clinical Lead at West London HCV Operational Delivery Network said: ‘Another milestone has been reached I our aim to eliminate Hepatitis C with the announcement that Harrow Drug services have achieved their micro-elimination targets. Huge congratulations and thanks go to the team at Via working in collaboration with the clinical nurse specialists from Northwick Park Hospital, peers from the Hep C Trust and the clients within the service, in bringing this about.’

Anna Whitton, CEO at Via said: ‘This is a really positive and important outcome, which has made a tangible difference to many people. Our team has worked hard to make Hep C information, testing and treatment as easy to access as possible and we are really proud of this achievement.’

Vanessa Duke, Area Director at Via said: ‘Access to testing, treatment and ongoing recovery focused care is so important to our service users and everyone in the Via Harrow service is 100% committed to providing that! I am so proud of the team in Harrow for all of their hard work in achieving Hep C micro-elimination, this is a great outcome for our service users and for the community as a whole. 

The success we have seen in Harrow is not wholly down to Via, we are so thankful to the local ODN (operational delivery network) and our colleagues from Northwick Park Hospital who deliver clinics from our service, providing access to Hep C treatment in a place where our service users feel safe.  Breaking down the barrier of having to attend another clinic or the local hospital has been key to supporting people to commence and complete Hep C treatment.’

Allen Quine, Service Manager at Via Harrow said: ‘We’re really proud to have achieved micro-elimination in Harrow; the team have worked hard for this and excellent communication has helped us hit our goal. We’ve worked closely with our local Infectious Diseases Team for a long time and this was a great starting point for us. Adding in very proactive input and support from the Hep C Trust, our data team and Marlon (our Hep C Lead) has been fantastic.

Communication and co-ordination have been absolutely key – from identifying where (and who) to focus and following this through with that larger team’s involvement up to and including outreach. I like to see the public health implications in a simplistic way. The health impacts of Hep C can be terrible with a big social impact. If no one had Hep C, there wouldn’t be anyone who can pass it on. I am pleased to say that by achieving micro-elimination, this multi-disciplinary team have brought Harrow closer to that new reality.’

Dr. Vivienne Gosnell, Clinical Lead at Via Harrow said: ‘Achieving micro-elimination in Harrow has very much been a joint effort. The crux was having reliable, up-to-date data, shared regularly with our team, so that opportunities to test wouldn’t be missed. We worked closely with Northwick Park Hospital infectious diseases unit and The Hepatitis C Trust to host in-service Hep C clinics. Our infectious diseases nurse worked flexibly with those service users who were reluctant to engage, and our Hepatitis C Trust mentors provided fantastic support, taking medication to service users, and providing testing at home.

In addition, we co-ordinated testing drives in the service and in partnership with University College London Find & Treat Community Van, where incentives like vouchers, Via’s Capital Card reward scheme and pop-up shop events were used. Successful Hepatitis C treatment not only prevents long term health complications such as cirrhosis and even liver cancer for those affected, but also stops transmission to others. We want to thank everybody involved for their hard work and dedication in achieving this goal.’

Faye Martin, Peer Lead, The Hepatitis C Trust said: ‘Collaborating closely with Marlon, the Hep C Coordinator at Via, has significantly enhanced my effectiveness in my role as the West London Peer Lead. Together, we’ve successfully conducted joint training sessions on Hep C awareness and skilfully guided Via Recovery Practitioners in performing dry blood spot tests (DBST) for service users.

Our partnership has not only contributed to the positive well-being of Harrow service users but also played a crucial role in supporting them throughout their treatment journey. As a testament to our joint efforts, we’ve successfully achieved micro-elimination of Hepatitis C in Harrow, marking a milestone in our commitment to improving healthcare outcomes.’

Marlon Freeman, Hepatitis C Coordinator at Via said: ‘Via Harrow through a remarkable journey has reached Hepatitis C micro-elimination and is Via’s first service to do so. This success story is a testament to the unwavering commitment to improving health in our boroughs, particularly among a community battling substance misuse.

Via Harrow’s achievements stand as a symbol of transformation, proving that through compassion, resilience, and innovative solutions, we can pave the way for a healthier and more equitable future for all free of Hepatitis C.’

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

Majority of public behind ‘smokefree generation’ plans, says government

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DDN
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Around 25,000 people have responded to the government’s consultation on creating a ‘smokefree generation’, with the majority of the public backing the plans, according to the Department of Health and Social Care (DHSC).

The smoking age would be raised year by year in an attempt to phase it out altogether.

In what the government describes as the ‘most significant public health intervention in a generation’, the sale of tobacco would be gradually phased out by raising the legal smoking age year-by-year until it applies to the whole population. It would mean that anyone aged 14 or younger this year would be unable to ever legally buy cigarettes in England (https://www.drinkanddrugsnews.com/government-plans-smoke-free-generation/).

The consultation, which closes today, has seen responses from public health experts, healthcare professionals, teachers and young people, the government says, with the official response to be published ahead of the forthcoming tobacco and vapes bill’s introduction to Parliament. The plans are based on similar legislation in New Zealand, which was due to be introduced next July but was scrapped last month by the country’s new government.

Smoking remains the UK’s biggest preventable killer, causing around 64,000 deaths a year in England alone. ‘No other consumer product kills up to two-thirds of its users and the plans will save tens of thousands of lives and save the NHS billions of pounds,’ DHSC states. Critics of the plan, however, have argued that it is ‘unworkable’ and would boost the black market, while the Express reports that ‘as many as 50’ Conservative MPs are planning to vote against it.

The government is also introducing measures to make vapes less easily available – and appealing – to children, while ‘ensuring they remain available as a quit tool for smokers’ (https://www.drinkanddrugsnews.com/government-consults-on-wide-ranging-vape-restrictions/). Shadow health secretary Wes Streeting told the Telegraph that vapes could be prescription-only under a Labour government.

‘Smoking is the biggest preventable killer in the UK, and that’s why we need to push ahead at pace with our plans to protect today’s children, and create the first smokefree generation while cracking down on youth vaping,’ said public health minister Andrea Leadsom. ‘We are taking the long-term health decisions needed to safeguard the next generation from the harms of smoking and risk of addiction.’

‘With the overwhelming support of the public the UK has picked up the baton to become the first country in the world to create a smokefree generation,’ added ASH chief executive Deborah Arnott. ‘This will herald the start of a new era in tobacco control, where the end of the smoking is finally in sight.’

Turning the Page, WithYou: Dave’s Story

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DDN
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WithYou volunteer Dave shares the story of his struggle with alcohol, and his journey to recovery.

‘I was holding down a good job, nice house, wife, family. But alcohol took all of that away from me. It’s not just health issues – it’s the wider picture and the ripple effect. Alcohol affects every single part of your life and body.’

Dave from Grimsby started drinking alcohol aged just 14. Despite having a seemingly stable life from the outside – a good job, a nice house, and a loving family – Dave found himself facing challenges with alcohol dependence. Over the years, what started as social weekend drinking at pubs escalated to drinking every day. His story is a reminder that challenges with alcohol, drugs or mental health can impact anyone, regardless of their circumstances.

After trying to give up alcohol without support, Dave was rushed to hospital with organ failure. He spent three and a half days in an induced coma, facing a stark reality when he woke up:

‘I was told if I didn’t safely reduce my alcohol intake, I would die. It should have been enough, but it wasn’t. Six months later I was back in hospital again. To me, that was more frightening than actually being told I was going to die – because the relapse made me realise how fragile I was. After that, I went to my GP and he said I needed some support.’

Thankfully, Dave made contact with drug and alcohol services available at the time and that marked the beginning of his recovery journey. It’s now been nearly eight and a half years since he’s had an alcoholic drink. Today, Dave embraces his new way of living and has a completely different outlook on life.

‘You have to learn a totally new way of life. I thought I could handle a couple of drinks. Now I know I can’t. It’s taken a long time for me to develop the mindset to allow me to do that.’

When Dave felt ready, he decided to give back. He began volunteering at WithYou, supporting other clients on their own recovery journeys. All these years later, he’s still there – sharing his lived experience and offering hope and advice.

‘I wanted to keep involved to enhance my own recovery – it keeps me on track. I can use my experience of recovery to hopefully help others. I’m still learning. From every session I have with a client, whether that’s group sessions, face-to-face or over the phone – every bit I learn makes me stronger.

‘I just find WithYou amazing. They allow me to continue my recovery – because it’s a life-long thing. They keep me grounded, focussed.’

Dave’s dedication extends beyond WithYou, too. He volunteers for several recovery community groups, including Great Escape and The Comeback. He’s even started his own not-for-profit company called ‘Angle for the Community’, which aims to help young people find new paths through therapeutic activities like fishing.

‘I’m trying to give people an interest and understanding of the environment – fishing is therapeutic. WithYou have been looking at getting their own fishing equipment and hopefully, we can get a new group going in the new year.’

People like Dave are invaluable to our organisation. His story teaches us that with the right support and determination, overcoming challenges with alcohol, drugs, or mental health is possible. Dave’s journey shows us that it’s never too late to turn the page and start a new chapter.

Dave (left) and ‘Angle for the Community’ business partner Ken (right)

If you or someone you know is seeking support on the path to recovery, With You is here to help. Wherever you are in your recovery journey, we’re here to work alongside you.

This blog was originally published by WithYou. You can read the original post here.

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 WithYou

Services designed by women for women – Taking a gender transformative approach

By
DDN
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Phoenix Futures’ Lucie Mauger, senior marketing manager, speaks to Helen Brewin, innovations and improvement manager, about taking a gender transformative approach to the design and delivery at Ophelia House.

As a woman with lived experience, a graduate of Phoenix’s residential rehab and a former residential service manager, I am highly aware of the need for a more gendered response to substance use treatment.

We have very recently opened an important new service, Ophelia House. This is a new residential rehab only for women. We knew from the outset that getting this service right demanded a gender transformative approach to service design, development, implementation, and delivery. The core principle of Ophelia House is that it is designed by women, for women. We worked with women with lived experience, female friends, family and loved ones and experts from across the sector to better understand the needs of the women that we will serve.

Why is it important?

Despite widespread acceptance of the need for a gendered approach to substance use treatment, many local authorities in England do not deliver gender-specific support.

Trauma is often a factor in substance use for both men and women, however women frequently experience additional gender based-traumas that impact their substance use and have devastating short and long-term effects – domestic violence, coercive and controlling behaviour and being forced into sex work are common experiences for many women that use substances; the perpetrators of these crimes are most often men.

Substance use treatment services are male-dominated environments; only 32% of people in drug and alcohol treatment in England are women. These services have usually been designed by men and consequently are more catered towards meeting the needs of men. This means that the specific gendered needs of women are often overlooked. Consequently, women who have been abused by men can find it difficult to maintain treatment in mixed-gender settings.

‘Female-only environments can help to create a sense of safety and address the specific treatment needs of women. These environments can help foster healthy attachments, provide positive peer reinforcement, strengthen self-expression, and support with developing skills.’ – Abigail Jones, Psychologist Phoenix Futures

What do the statistics say?

Gender based violence (GBV) is disproportionately experienced by women who use substances. Women who experience domestic abuse are eight times more likely to have a substance use need compared to those who have not and twice as likely to have an alcohol use need.

The rate of alcohol-related hospital admissions made by women to NHS hospitals has risen by over 30% since 2008/09 to 2014/15. 2,851 women died of alcohol-related causes in the UK in 2013, a mortality rate of 9.1 per 100,000 population; this increased to 9.6 in 2014 (IAS 2015).

Understanding barriers to accessing help

When developing Ophelia House, our research helped us better understand the barriers that women are facing when accessing a residential rehab placement. This has led us to create an internal ED&I women’s working group and will inform our policy and campaigning approaches calling for equity of access and a gender transformative approach to substance use treatment.

Our consultation group confirmed that women require a coordinated approach to drug and alcohol treatment with intensive support across a range of different needs. Therefore, Ophelia House offers a safe and therapeutic environment, with trauma-responsive delivery, onsite counselling, and mental health support. As well as specialist interventions for women who have experienced domestic violence, housing, health and family support.

The consultation group also felt that the group programme needed to be gender specific and responsive to the needs of women. The Ophelia House programme aims to create a safe and empathic therapeutic environment to address gender-specific needs in a strength-based approach developing social skills such as validation, empowerment, and empathy, which have been considered critical for attachment and recovery in groups of women.

The programme at Ophelia House is delivered by a multi-disciplinary, all female staff team which over 70 per cent of the women that we consulted at the outset said was important. At Ophelia House, women live together and learn from each other. The community of women offers emotional support and the development of healthy boundaries, behaviours, and values.

In addition to the broader consultation group, we created a smaller focus group of women with living and lived experience to advise in more depth on service design and delivery, they helped inform the physical environment, choosing colour schemes and layouts deciding the look and feel of Ophelia House, they advised on the group programme and feedback on policy and processes.

What’s in-store for Ophelia House?

I was glad to be asked to lead on the consultation of the development of Ophelia House and witness it take shape from the initial concept to CQC registration. As we look forward to welcoming our first community members, we stand in the knowledge that we have created a well-informed start point for a much-needed service that I hope will provide many women with a safe, nurturing environment for healing and growth.

As we take our learning forwards and use it to inform delivery across our other specialist services, we will work together with commissioners and key stakeholders to consider how to overcome the significant barriers to accessing residential treatment for women with multiple support needs so that they can experience the benefits of an environment designed by women for women.

This blog was originally published by Phoenix Futures. You can read the original post here.

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 Phoenix Futures

Crisis talks

By
DDN
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crisis talks on drug servicesFor people who inject drugs, needle and syringe programmes (NSP) are a life-changing – and even life-saving – intervention.

Being able to access clean injecting equipment, advice, and harm reduction interventions massively reduces people’s vulnerability to hepatitis C, HIV, bacterial infections and a range of other harms. 

While we know that NSPs are an effective way to reduce harm to people who inject drugs, we also know there are factors that are holding these programmes back from their full potential. In particular, we face a crisis in coverage that is preventing people from accessing the support that they need to stay safe.

Here at Change Grow Live, we’ve been exploring new ways to break down these barriers and ensure that NSP is available to the people who need it, whenever they need it – and we want to bring voices from across the sector together to achieve this. 

Coverage crisis

In 2014, the National Institute for Health and Care Excellence (NICE) retained its target of achieving 100 per cent NSP coverage (see box, below) for the UK. Their evidence showed that even if we achieve 100 per cent coverage for 60 per cent of the population, this would be enough to dramatically slow the spread of blood-borne-viruses and infections among people who inject. 

Unfortunately, the UK is falling far behind these targets. There is currently no national approach to measuring the UK’s level of NSP coverage, but informed estimates place it at around just 30-35 per cent. The government’s most recent Shooting up report suggests that the number of people sharing and reusing injecting equipment is still high, with a third of people who inject drugs saying they don’t have enough clean equipment.

Every increase we can make to the UK’s coverage rate can reduce people’s risk of harm and help to save lives – and Change Grow Live is working with the UK Health Security Agency (UKHSA) as part of a national working group to develop a standardised approach to measuring NSP coverage.

Safer injecting 

There’s no single, catch-all solution to this issue, but there are ways we can begin to tackle the challenge of expanding our NSP coverage – and at Change Grow Live we’ve already begun to explore what those responses might look like.

One of the major challenges is the question of how we reach people who are not in regular contact with drug and alcohol services, or face difficulty in – or have reluctance to – accessing a service in person. The introduction of integrated recovery services, replacing the tiered models of care approach, has made many people reluctant to engage with NSP services. The one-stop shop approach of integrated care is welcome in many ways, but feedback shows that many people who inject drugs miss the discreet, anonymous approach to NSP provided by open-access tier 2 services. 

People want to access NSP in a way that is simple and discreet, and with a degree of separation from conversations they may be having around their substitute prescribing treatment. To support with this, we’re working with the harm reduction social enterprise Exchange Supplies to provide people with the service NSP Direct – an online ordering system that allows people to have safer injecting supplies delivered to their home address.

Our NSP Direct offer began as a way of helping people maintain their safer injecting supply during the pandemic, but it’s proven to be a well-received intervention that we believe has a role to play in expanding NSP coverage more broadly. By supporting people to access NSP in a simple, discreet way that works for them, we can help to break down barriers and reduce harm. 

Model for success 

We also need to ensure that the issue remains at the forefront of debate and of performance targets for the drug and alcohol sector. If we recognise the crisis, we can plan the response accordingly. This response will be strongest if we work together, as demonstrated by the successful achievements already made as part of the UK’s hepatitis C elimination strategy.  

Hepatitis C is the most common bloodborne virus affecting people who inject drugs, so we’ve welcomed the massive investment in testing and treatment the strategy has ushered in. We’ve also welcomed the commitment to partnership working that we’ve seen, as providers come together to share learnings, resources, and expertise. 

Nowhere is this commitment better demonstrated than in the award-winning work of the Hep C Provider Forum, of which Change Grow Live is proud to be a member. Together, the forum shares knowledge, expertise and resources to collectively work towards the NHS’s hepatitis elimination goals.

Never before have providers worked so well together to get this far, and the results are clear to see. Between April 2022 and March 2023, more than 35,000 people were tested in our services for hepatitis C and other blood-borne viruses, with more than 1,400 of those people going on to access treatment. In that same period, six of our services and two of our hubs achieved the milestone of hepatitis C micro-elimination. This is a major achievement, but we can only maintain this success with improved, robust harm reduction provision for people who inject drugs. 

We want to build on these successes, to ensure that the gains we have made are sustainable, and that more people than ever are able to reduce their risk of harm via NSP. Crucially, we want to do this with your support.  

Stronger together

The time is right for a renewed focus on improving our coverage rate. We are at a crossroads moment for our sector, with major changes already underway and a general election on the horizon. This gives us the opportunity to reimagine the future and plan our new direction. 

Peter Furlong, national harm reduction lead at Change Grow Live
Peter Furlong, national harm reduction lead at Change Grow Live

The sector must come together to tackle the NSP coverage crisis, taking inspiration from the success of the Hep C Provider Forum. We can look to how different voices came together and galvanised change, and use this example to make sure that safer injecting equipment and harm reduction guidance are available to everyone who needs them. 

If you’d like to work with us to ensure more people can access the life-saving interventions they need, we’d love to hear from you – please get in touch at Peter.Furlong@cgl.org.uk to find out more about what we can achieve together. 

 

 

Female Focus

By
DDN
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Female Focus on women's drug and alcohol services

Trevi chief executive Hannah Shead
Trevi chief executive Hannah Shead

‘As 52 per cent of the population, sometimes our needs aren’t thought about in a specialised, specific way,’ Trevi chief executive Hannah Shead told this year’s DDN conference session on stigma and women’s services. ‘We can sit and talk about this stuff for ever, but we need to see things change.’ 

According to OHID’s Adult substance misuse treatment statistics 2020 to 2021, around two thirds of people in drug treatment are men and one third women, while in alcohol treatment it’s roughly 60/40. As the Women’s Treatment Working Group points out, although the number of women dying a drug-related death has risen by almost 80 per cent over the last decade, the figures for women seeking treatment have remained mostly unchanged (www.drinkanddrugsnews.com/new-group-champions-womens-right-to-high-quality-services/). So what’s deterring them – is it still the stigma?

Chaotic services

Sophie Carter, head of the family justice team at the Centre for Justice Innovation
Sophie Carter, head of the family justice team at the Centre for Justice Innovation.

‘It’s an uncomfortable conversation for many people to have, but the stigma is huge,’ says Sophie Carter, head of the family justice team at the Centre for Justice Innovation – an organisation that recently published a report warning that many women were experiencing ‘chaotic’ and ‘intimidating’ treatment services (DDN, November, page 5). ‘Whether we like it or not, it’s perfectly acceptable in society for a father to not be the primary carer for their child, but for a mother to not be the primary carer – or not be seen as a fit parent – is much more significant.’ 

It’s long been pointed out that services are still not set up for women with caring responsibilities, and while individual practitioners are ‘committed to getting it right, the reality of how it’s set up doesn’t always allow that,’ says Carter. So is it the case that, as so with many things, treatment services have basically been designed with men in mind? ‘I think it is, and I know practitioners recognise that, but the reality of what steps you can take – from a day-to-day point of view all the way through to changing your strategies and partnerships – is not always easy.’ Things have been improving in recent years, and there are some excellent women’s services, but it does remain very much a postcode lottery. ‘Not just that, but a transport and accessibility lottery alongside it,’ she points out. 

Trauma responses

Closely connected to questions of stigma are women’s responses to trauma, and the behaviours that can often result from that. These can be difficult to manage, and many services still aren’t set up in a way that allows the building of the relationships needed to do that, and with women ‘stigmatised again for not fitting into the processes’ as a result. 

People frequently talk about a trauma-informed approach, but how many services are genuinely geared up to deliver that – with staff who are properly trained and capable? ‘That’s a good question, because it can be a bit of a buzzword. How you translate that into day-to-day practice is the most important part. The realities of commissioning – access to resources, being able to signpost to relevant services, non-attendance and outreach policies – are not always designed to match the knowledge that practitioners have. So there’s still a lot of work to be done around how you can upskill organisations as a whole to have that trauma awareness, and understand those interlinking factors for women coming into services.’

One of the report’s recommendations is training all key workers to recognise and respond appropriately to signs of domestic abuse and sexual violence – how far along that road are we at the moment? ‘Probably not as far as we’d like. With the increased funding coming in, the whole point was to try to reduce practitioner caseloads, and increase access to the most appropriate psychosocial interventions. That’s where you’d hope to see changes, but we’re only really at the beginning of that.’

Women are clearly very unlikely to talk about trauma or abuse in mixed-sex groups, or to male drug workers, and yet frequently that’s all that’s on offer – apart from perhaps a token women’s group for an hour a week. ‘There’s a lot of recognition that you’d like to be able to offer a female key worker, but again you’re looking at recruitment, staff, those retention issues – it comes back to individual services’ resources,’ she says.  

But it remains the case that, even for people without those underlying trauma issues, there’s the inescapable fact that overwhelmingly male settings – particularly group work or fellowship meetings – can be intimidating spaces for women. Is this taken into account enough? ‘Probably not – it’s difficult because of the actual buildings to set up women-only spaces, but you can have things like women-only days – there are ways around those barriers.’  

Uncomfortable truths

Worryingly, the report also highlighted something that’s discussed anecdotally but not often officially acknowledged – that, as one drug worker told the authors, ‘You do tend to get a lot of predatory males attending services as well – over the years it was sort of like a hunting ground.’ Why isn’t there more acknowledgement of this? 

‘I think a lot of the research on women’s services is often carried out in silos as well, looking at one particular area, whereas I think this piece of research has been able to really pull together all of the different factors. But it is a reality, sadly, in the same way that dealers will wait for people leaving prison.’ 

Again these can be very uncomfortable conversations, she acknowledges. ‘There can be a sense of helplessness around it. As practitioners, what can we realistically do when managing caseloads and we only have one building with one entrance – you can’t always walk a woman into to her session if your clinic is back-to-back and overrunning, and you don’t always know who’s a risk because they probably haven’t told you the names of the people who’ve harmed or abused them.’ And none of this is new, she points out. ‘Fifteen years ago as a member of staff in treatment services I’d have cars pull up next to me, either dealing or expecting to pick me up for sex work – the look of panic when they realised I had a badge on, or I knew their name and could flag it to the police.’

Reality and risk

All of this means that it’s still not uncommon for women to only manage a couple of appointments before being reported as having ‘disengaged’, she says. ‘But I do think now we’re better able to discuss these experiences because we’re seeing people accessing recovery services as more than an “addict” or “criminal” or “problem”, or someone who’s just not motivated or presenting with “challenging behaviour”. The benefit of the growing awareness around trauma and adverse experiences is we’re much more open to understanding the reality and risks women face, the systemic factors in a woman’s life, and to seeing behaviours and choices through the lens of trauma.’

The centre is now pulling together some wider policy and practice recommendations for commissioning teams that can be translated into action, with a view to publication next year. ‘It’s about really being able to see women in the context of their family, their community, their environment, and those influences. So it’s not just about silos in terms of access to treatment, but the risk of just seeing a woman only as someone who uses substances – without all the other influences. That feels like a really important message for practitioners to start with straight away.’

Joined-up approach

The report points out that even where there is good support available in the local area, drug services often still don’t have those links with other organisations like women’s centres and mental health charities, again something that can come down to commissioning pathways and funding streams. And while it’s not the case across the board, for many services it’s ‘still very much “you come to us for drug and alcohol, you go to them for mental health, you go up the road if you want to look at accessing domestic abuse support”,’ she says. ‘If we’re saying it’s already difficult for a woman to access one treatment service, we’re now expecting her to overcome the barriers to get through the door of three of them – and that just doesn’t work.’  DDN

Exploring women’s experience of drug and alcohol treatment in the West Midlands at justiceinnovation.org/publications/exploring-womens-experience-drug-and-alcohol-treatment-west-midlands

 

DDN December/January 2023

By
DDN
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‘It’s our job to override debilitating stigma’

DDN Magazine December 2023The number of women dying a drug-related death has risen by almost 80 per cent in a decade – yet the number of women seeking treatment has remained about the same (p6). If you need any more reasons to challenge stigma, read on through this month’s issue. 

‘Addiction thrives on isolation, and the remedy is human connection,’ said Dan Carden MP at the NHS APA conference (p8). This connection is equally important to families trying to support their loved ones, who describe the stigma towards them as ‘like being labelled with a big invisible sign’ (p12).

It’s our job to override debilitating circumstances that are fuelled by stigma. The pragmatic response to the shortage of needle and syringe programmes (p20) shows that swift and certain collaborative action is effective in carving a path to harm reduction. So let’s be just as clear about our one-to-one treatment obligations, including challenging any suggestion of coercive control (p10).

When there’s a crisis headlined by an increase in drug-related deaths, we’re capable of collaboration to rise to the challenge (p22) – let’s be equally proactive across the board. Season’s greetings to you all, and here’s to 2024.

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

Claire Brown Editor of DDN Magazine

Claire Brown, editor

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

 

Hear My Truth!

By
DDN
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Hit Hot topics conference 2023

‘Women and non-binary people are often excluded from services,’ said Aura Roig Forteza. ‘When they go to other services, such as mental health, they’re not allowed in because they’re using drugs.’

She went on to describe her experience in her home country, Spain. In the late ’80s, Spain had the highest rates of HIV in Europe. Her service, Metzineres, was responsive – an innovative, daring, non-profit cooperative, providing a sheltered environment exclusively for women. ‘It covers the full spectrum of harm reduction approaches,’ she said.

Being effective meant breaking protocols. The Metzineres model provided consistency while being reliable, pragmatic and cost effective. Above all, it welcomed all women with compassionate responses. ‘We try to empower the women and respect their goal,’ she said.

Hit Hot topics conference 2023

Flip the narrative

‘I used drugs since I was 13 and was only ever treated punitively,’ said Anna Millington, explaining why she set up the support group, Mother2Mother. When her daughter was taken off her for two years, she realised how hard it was to move on from a negative stance.

‘We’re told “don’t fear us, you can come into services” – but it’s a lie,’ she said. ‘Mothers are told they have choices and options – but they haven’t.’ Experiencing attitudes that they shouldn’t be taking drugs, mothers were hiding from treatment services and afraid of social services. ‘But they’re not the expert – you are,’ she would tell them. Generational trauma was all too frequent, but ‘if you’ve been taken off your mother, you’re even less likely to trust services.’ Her mission was ‘changing things from hidden and seedy to public and positive’, as ‘if people feel so badly about it, they don’t want to talk about it.’ 

‘Do you consider mothers who use drugs in your service?’ she would ask services, But she soon realised that acknowledging the question implied having to do something about it – a slow process. So she launched a campaign to collect positive and negative stories and create materials for mothers, based on what they actually wanted. 

‘I’m angry that I’m watching mothers and children being ripped apart,’ she said. ‘It’s time to flip the narrative.’

Hit Hot topics conference 2023Expert opinion

‘Drug use doesn’t happen in a vacuum – the lives we live impact on how we use drugs,’ said Ailish Brennan of the Women and Harm Reduction International Network. Her journey as a transwoman had combined joy and acceptance with traumatising experiences, and as a result she was passionate about designing gender-sensitive services.

‘Self-medicating was the only outlet I had,’ she said. ‘Trans people are generally very demotivated to access services – it’s very low down on the list of things we want to do.’ However, accessing treatment had changed the way she used drugs and enabled her to enhance her health and wellbeing, so she wanted services to be more accessible and approachable. Above all, they had to be consultative: ‘We are all experts on our own existence,’ she said. ‘We need to be respected and included.’ 

Hit Hot topics conference 2023Overdose risk

Working at the Academy of Perinatal Harm Reduction had led Joelle Puccio to become passionate about reproductive justice and ‘the right to control our bodies’. The argument had come about barriers and oppression, rather than the drugs. In the US, overdose was more common during the year following birth. The body was changing during pregnancy and afterwards, so women needed to know what drugs they were taking and what the likely effects would be. ‘We need to make the healthy choices the easy choices,’ she said.

Criminalisation was ‘ineffective’ and she was involved in developing a harm reduction toolkit – ‘thoroughly researched and referenced’ and ‘available to anyone who needs it, anywhere in the world’. She hoped to adapt the toolkit for the UK, free to access.

Hit Hot topics conference 2023Challenging culture

The need to challenge the narrative was demonstrated to great effect by Katrina Ffrench of Unjust CIC. ‘Young black men are in gangs to push drugs – that’s the narrative,’ she said. Her organisation was based in London but with a national focus to bring people together and hold flawed practices of drug law enforcement up to the light.

‘Black people are four times more likely to be stop-searched and five times more likely to have force used against them than white people,’ she said. ‘But behind the statistics are people. The perception is that every black person does drugs.’ 

The narrative persisted – in County Lines scenarios, young black boys were seen as perpetrators not victims. Police officers were able to ‘smell drugs in your car from theirs’ – as shown by a recent case of car search of a young black couple with their baby, with no grounds for suspicion. ‘Child Q’, a 15-year-old schoolgirl had been subjected to an unlawful search in school.

‘We have to end the racist war on drugs,’ said Ffrench. ‘And we have to stop criminalising mental health. Life is fucking tough sometimes and it’s your body, your choice.’ So how could we encourage the whole criminal justice system ‘to de-escalate stuff’? It was imperative to work together and engage with young people by acknowledging them, she said. ‘We isolate them.’ 

‘We don’t have enough of us infiltrating the system,’ she told the audience. ‘Go into these spaces, we need you. Are you working with marginalised groups – or just people who look like you?’

Hit Hot topics conference 2023Lies, dammed, lies…

Beccy Henderson talked about ‘lies, damned lies and statistics’ from her work as a consultant. Drug strategy focused on repeat offenders without considering the reasons why. 

The reputation of drug testing on arrest had been tarnished by the private sector scandal of manipulated results. But headlines did not necessarily tell us the truth – we needed to check the methodology and sample size. Furthermore, there were stats ‘they don’t want you to think about’, she said, relating to childhood trauma and to deindustrialisation – the massive increase in opiate use coupled with the ‘decimated communities’ of the Thatcher years, which ‘took away cohesion. It destroyed everything and people ended up taking heroin.’

‘The barrier to any harm reduction is stigma,’ said Henderson, refocusing on the here and now. ‘We need to make it safe to say “I use drugs, I want help”. If we can remove stigma we can start to help. Stigma creates silence – and it’s silence that kills people.’

Youth focus

‘Are the key principles of harm reduction different for young people?’ asked Stuart Haste of Compass’s free and confidential young people’s drug and alcohol service, as he looked at reframing the conversation to be relevant to the younger age group. Age 18-24 was a high target group for drugs education – ‘but what about the age before that?’ he asked. ‘I have seven-year-olds in services using class C drugs.’

The ‘near misses’ were a lot higher than the deaths, and for young people it was often about trauma and mental health. Because it was ‘so slow’ to get a diagnosis through child and adolescent mental health services (CAMHS), drug and alcohol services found themselves on the frontline.

‘We won’t tell them off, we’re inclusive, we will talk to the individual about trauma,’ he explained. But we needed to stop splitting services and bring them back together so the person had a continuous experience.

Flexibility

Natalie Broughton brought her perspective from Matrix young people’s service, a partnership formed of the local authority, Turning Point and local services. ‘We want young people to know what support could look like,’ she said. ‘We start by meeting the young person where they’re at on that day. We give them that space and someone to listen to them.’ They were guided by an informal and compassionate approach. Flexibility was equally important, with no ‘two strikes and you’re out’ policy.

Alongside forming multi-agency partnerships, they worked with schools, reminding them of guidelines and evidence to reduce exclusions – and she acknowledged that this wasn’t always easy: ‘We have teachers who have their own ideas on what drugs education should be. It’s about breaking down barriers.’

Last chance to listen

End-of-life care was one of the most important opportunities to listen and respond, said Sarah Galvani as she shared research from conversations with people in hospitals and hospices.

Her project at Manchester Metropolitan University aimed to find out about responses to people who use drugs, when they were at the end of their lives. The conversations included people with experience (with an age range of 38-71) and their families, friends, and carers.

Firstly, it was found that while hospices’ knowledge around alcohol was good they were ‘a bit at sea’ with other drugs. Then it became clear that there was a general lack of end-of-life communication – some wouldn’t talk about it; others struggled to understand. Hospice staff often assumed that somebody else would have already told the person they were dying. 

The person concerned often anticipated discrimination, and assumed they would be treated differently. But they were likely to be afraid and need support, and often had a sense of being somewhere that was not age-appropriate and not set up for younger people. Hospices were a real comfort and relieved loneliness, but there needed to be more understanding of self-stigma and the accompanying defensiveness that were so often present.

New Models

Research colleague Sam gave the views of carers and families – a snapshot of ‘the chronic strain of caring’. People didn’t know what to do for the best and there was often no one around to advise. The impact of chronic strain could reveal emotional limitations – ‘I despised him’ – and there was a lack of support and communication, often accompanied by the social isolation that came with the burden of care. People had a fear of opening up about this, and a lack of trust in the response they would get.

The result of the project was an objective – to develop a new model of care, with short, medium and long-term outcomes. It was also important to consider the impact on the professional, added Galvani, both from personal grieving and from it being an ‘unsuccessful completion’. ‘Talking about death and dying in our services is so important,’ she said.

Information and resources at endoflifecaresubstanceuse.com

Photography by Nigel Brunsdon

 

Power in Practice

By
DDN
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power in practiceService users are accustomed to professionals exerting power over them. Nowhere is this more true than in drug and alcohol services, says Tom Zagoria.

I work in a service where the power we exert frequently occurs at the overlap between ‘risk management’ and ‘medication control’. 

We prescribe people with ‘opiate substitution’ treatments, providing buprenorphine or methadone to reduce their physical need for heroin or other opiates. However, if a service user is not engaging with support and regular risk reviews, I will be asked to put their script ‘on hold’ in the pharmacy, requiring that they attend an appointment prior to accessing their medication. For service users who are living in chaotic circumstances, I’m doing this regularly.

This is considered an important part of risk management, as if I were unable to properly assess a service user it would limit the support I could offer. If a service user never engaged with the service, we could not continue to prescribe opiates for them as it could pose risks to themselves and others in the community.

However, feedback from service users has been clear that this feels like a coercive imposition on their lives. While some have thanked me for putting their scripts on hold – forcing them to come into the service to ask for help – and others simply recognise it as a ‘normal’ part of how services operate, I’ve had service users arrive in tears because I’ve put their scripts on hold. Sometimes service users have shared that they missed appointments due to crippling anxiety, and by putting their script on hold I’ve made them the centre of attention in the pharmacy and forced them to attend the service on a ‘bad mental health day’.

Service users have shared similar feedback around being forced to collect daily supervised medication, rather than being provided with a week’s medication at once. These decisions do not fall under my power – they’re clinical decisions – however as the keyworker I’m the face of the organisation. One service user in particular spoke about our control over collections as a method of social control, utilised to reward or punish people.

Incorporating this feedback into risk management has triggered the question of whose risks are we managing. There’s a tension between managing and mitigating risks for the service user, and mitigating and managing risks for us as an organisation.

One example – we were concerned that one service user was using heroin on top of her prescription. We followed normal procedure and changed her collections to daily supervised in the pharmacy. Her feedback was that because of her severe anxiety – for which she was on long waiting lists for secondary mental health support – she began missing doses and buying more heroin, because, as she put it, heroin from her dealer is ‘home delivery’. We had effectively mitigated our own organisational risks, as the medication we prescribed was now less likely to be misused – however, had we really mitigated the risks to the service user, who was now saying plausibly that as a result of our decision she was using street heroin more regularly than before?

This dilemma of risk management has an enormous impact on service users’ lives on a regular basis. By providing a high-strength opiate to someone physically and psychologically dependant on that drug – and who could be placed in severe distress by its withdrawal – and then imposing conditions on continuing to prescribe it, we must recognise the power of coercive impact, and threat of real harm, that we hold over service users. I’m not a clinician and I make no final clinical decisions, but as a recovery worker (and in particular as a qualified social worker trained in safeguarding) my assessment of the risks present carries weight. That creates a power imbalance and an implicit threat between myself and the service user.

Questions of power imbalance and coercion become even more relevant when service users are also engaging with other state agencies that are more openly coercive than drug/alcohol addiction services. There are countless examples of service users trapped in cycles of coercive control by the criminal justice system, often for drug-related offences. This raises for me the dichotomy of multi-agency working between different agencies (criminal justice and addiction/social work) that have a different relationship with service users, and which treat drugs in such a different way.

Service users imprisoned for drug-related offences or missed probation appointments have told me the criminal justice system makes them feel their personal circumstances were rendered irrelevant, their essential recovery connections cut short and their lives reduced to a box-ticking exercise. Service users from migrant backgrounds face additional barriers, such as fears of services sharing information with the Home Office and the ‘hostile environment’, making many reluctant to seek help.

Addiction support, medication control (under the Misuse of Drugs Act 1973), and multi-agency working must be placed in the context of the ongoing ‘war on drugs’, which many people argue has had the impact of exacerbating structural inequalities, traumas and the health and social damage of drug use.

Working in drug and alcohol services has made me more aware as a practitioner of the power contained in my professional role. While in practice my job role involves exercising power, as part of safeguarding, risk management, medication control and multi-agency working, what I’ve tried to do is have more open conversations with service users about the nature of the systems they’re engaging with. 

Tom Zagoria
Tom Zagoria

My aim is to position myself not as a ‘gatekeeper opposite’ but rather an ‘advocate alongside’, who will explain every process and seek to help them navigate systems and legal frameworks which may in many circumstances be unjust. 

Tom Zagoria is a recovery worker and social worker at Change Grow Live

——–

POSITIVE COERCION

There’s a consensus in many treatment services that coercion to require compliance with treatment is necessary in the long run. There are arguments that even in circumstances where a mental capacity assessment would judge an individual to have capacity, their independent agency is impaired over the long term through the impact of addiction on their brain. Many in recovery have emphasised that they found being pushed into engaging with services beneficial at certain points.

The impact of addiction on the brain is agreed both from biological neuroscience-focused perspectives on addiction, and alternative perspectives such as Gabor Maté’s ‘biopsychosocial’ paradigm of addiction. Maté argues that a continuum of addiction runs throughout our society, with more extreme forms of addiction developing in the early childhood environment when the ‘neurobiology of the brain’s reward pathways’ develop. Continuing and ongoing stress – which can be related both to ongoing traumas, as well as service failures – continues to create and renew predispositions to addiction over the course of life.

Nevertheless the service user remains the person with the most expertise regarding their own life, and it’s the responsibility of the practitioner to respect this and support the service user to make their own choices as safely as possible. This can be done using tools of motivational interviewing and other social work techniques.

 

Body language

By
DDN
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Language matters when it comes to describing people with substance issues, hear delegates at this year’s NHS APA conference 

‘People with eating-related conditions are always referred to as having an eating disorder, never as “food abusers”,’ professor of psychiatry in addiction medicine at Harvard Medical School, Dr John Kelly, told the NHS APA’s Living the stigma: understanding addiction and overcoming prejudice conference. ‘So why are people with substance-related conditions referred to as “drug abusers” or “alcohol abusers”, and not as having a substance use disorder?’

Dr John Kelly
Dr John Kelly

When it came to substance use problems, this ‘abuse’ terminology had been adopted across scientific and clinical literature in countries around the world, he said. Describing a substance use disorder instead as something that was treatable and from which people did recover, however, undoubtedly helped to reduce the stigma. 

Our understanding and conceptualisation of these conditions and what underlies them inevitably affected our approaches, he said. ‘Should we appropriate more funding for prevention, treatment and recovery support services – or should we build more prisons?’ While those kind of decisions at a policy level were all inevitably affected by stigma, language also evolved over time. ‘We don’t talk about lunatic asylums or dipsomania today. Language changes, and it should change when we understand it may be stigmatising and affecting different populations.’ 

Many people would argue that this was ‘all just political correctness’ and didn’t really matter very much, he said. ‘We mean well, even though we may not use the most optimal language. But we tested this in experimental studies, and found it does make a difference – even among expert clinicians.’ 

More than 500 doctoral-level clinicians were exposed at random to vignette scenarios with descriptions of people either as having a substance use disorder or as substance abusers, and were asked to rate whether the person was to blame in the scenario and whether they should receive treatment or punishment. ‘We found that even among experts, at random, they were susceptible to more stigmatising beliefs and attitudes towards the exact same person if they were described as an abuser as opposed to having a substance use disorder.’ The same experiment carried out among members of the public had even more pronounced differences in results, he pointed out. 

NHS England’s national mental health director, Claire Murdoch
NHS England’s national mental health director, Claire Murdoch

One definition of stigma was ‘an indelible stain or mark’, NHS England’s national mental health director, Claire Murdoch, told the conference. ‘What a dreadful thing for any human being to carry. We also know that can easily be internalised and turned into a sense of worthlessness, a lack of hope, and a difficulty in asking for help.’ 

When it came to accessing help, it was vital to address the ongoing gaps between mental health and substance services, she stressed. The best services thought long and hard about ‘no wrong front door’, so that no matter where someone presented ‘such will be the extent of join-up and the clarity of the patient pathway that people don’t feel bounced around.’ 

Part of the NHS long term plan for mental health was to see a roll out of gambling addiction clinics, she said. ‘There’s a growing concern that there’s a clear link between those most severely addicted and suicide, but also a whole array of other challenges and problems.’ 

Until around ten years there hadn’t been a single NHS-funded gambling clinic in the country, she pointed out. ‘I was sure that in a matter of two or three years we’d see the roll-out of those clinics everywhere. It’s taken longer than that, but we will very soon be at 15 new NHS specialist gambling addiction clinics, and I feel really proud that we’ve worked so hard between us all to have this addiction recognised alongside the seriousness of other addictions.’ 

language barriers ddn magazine coverage of the nhs apa event 2023Responsibility was still far too often focused on individuals, however, as if it was merely ‘lack of willpower’ that led to someone experiencing gambling addiction. ‘I’m really aware that this applies to all addictions, and it’s really important that we do take a really comprehensive public health approach – proper education, early intervention, and no-blame approaches with compassion.’ 

On the question of why mental health services were still so reluctant to work with people who had substance issues, the restructuring in the wake of the 2012 Health and Care Act had led to local authorities delivering a ‘tremendous amount’ in terms of drug and alcohol services, but had also coincided with ongoing national economic challenges and huge financial pressures, she said. ‘What we saw was a kind of separation among commissioners around addiction and NHS services,’ and a move away from addiction psychiatrists and ‘expensive staff’ in the NHS towards different models – all of which had driven ‘quite a big divide into what was already quite a fragile set of pathways’, she stated. 

‘All of these hand-offs that we do in the NHS cost us money,’ she continued. ‘Even to assess someone and say no takes time and money, and to do that multiple times takes more time and money. But doing it right once – together, or in a single service – really helps.’ Clearly not everyone with a substance problem had a mental health problem and vice versa, but where someone did have co-occurring conditions ‘why would you make a human being already juggling with so much go through different pathways?’ The frequent re-tendering of addiction services also hadn’t helped, she added. ‘I’m hoping we can get more stability so people can concentrate on what really matters – which is making silos a thing of the past.’ 

Anti Stigma Network
Join the Anti Stigma Network and help improve understanding of the stigma and discrimination experienced by all people harmed by drug and alcohol use

There were now real opportunities for genuinely good quality system design, however, said clinical lead for the NHS Northern Gambling Service, Dr Matt Gaskell. ‘You can’t disentangle the two, and we’ve got the opportunity with the NHS specialist clinics, and working closely with third sector partners, to accurately understand the nature of those co-morbidities and work on the sequence of interventions in a really thoughtful way.’  

A lot of racially diverse communities had issues accessing treatment services because of ‘not just societal stigma but challenges within their own culture and potentially with regards to religion,’ said operational and development lead for the West Midlands Gambling Harms Clinic, Paul Evans. ‘And that’s especially acute with gambling. I’d ask colleagues to consider that and try to understand how we can reduce barriers overall.’ 

But it was also firmly about core education and attitudes, stressed Murdoch. ‘Just because you work in mental health services you assume you’re always going to be fighting stigma, that you understand it, that you chose mental health to work in because you have a fire in your belly about the rights of individuals. But be aware, because we’re just as susceptible to pigeon-holing people as anyone else. So for me it’s about awareness-raising, education, and designing services differently from the very outset.’ 

Find out more and watch sessions from the NHS APA 2023 Anti-Stigma Conference 

Back to Work scheme extension: Learning from our DWP Restart delivery experience

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DDN
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Emma Woodward, operational manager, DWP Restart shares how The Forward Trust’s Back to Work scheme has been a success.

The Forward Trust has been delivering DWP Restart for 27 months as part of Reed Partnership’s supply chain in the Home Counties Contract Package Area.

Working closely with other specialist intervention partners across Thanet, The Forward Trust has supported high volumes of unemployed people with complex barriers including:

• Those in drug recovery
• Facing homelessness
• In debt
• Living with disabilities and suffering long term health conditions
• Ex offenders.

We have reflected upon how we have effectively supported cohorts of individuals with complex barriers, and critical to our success has been:

• Ongoing staff training and development, including regular opportunities for CPD. We ensure staff who are new to the sector receive on the job mentoring from more experienced staff as well as bringing their own insights and life experiences to effectively supporting participants into work. This is complemented by The Forward Trust’s mandatory training and access to the employability practitioner apprenticeship delivered by the organisation.
• Building rapport and developing respectful relationships with participants is important. When our advisors first meet a participant, we co-produce a plan that they can own and we can support as part our commitment to them. We help with CV preparation, job applications, interview techniques, better off calculations and identify suitable specialist intervention when needed – such as mental health support or substance misuse recovery support . We ensure every participant leaves each appointment with the objective and commitment to find sustainable work.
• Hosting monthly job fairs with our employer partners, offering a community food bank and progressions into our skills contracts including adult education budget and multiply provision based in the same offices.
• The Forward Trust also hosts monthly job fairs and sector tasters with actively recruiting employers in addition to offering a community food bank whilst delivering back-to-back adult skills training through our adult education budget and multiply provision based at the Margate hub. Recently our skills trainer introduced our new four day ‘Back to Work’ course – all focused on supporting those who have been unemployed for over 50 months or have significant gaps in their CVs.

Our efforts, staff training and commitment to delivering the Restart Scheme has also led to The Forward Trust being nominated for an Employment Related Services Association (ERSA) Award 2023.

Kirsty Langley, front line advisor of the Year Finalist, joined the Restart Scheme in 2021 to try something new and different.

‘When I joined The Forward Trust as employment advisor, I was anxious about what challenges the role may bring – but after receiving three weeks of intensive employability training – my confidence grew,’ she said.

‘I began to put all my training into action and soon realised what an impact good employability support can do! I was not only helping look for jobs for my participants but supporting them with their confidence, self-esteem and getting participants to believe in their capabilities to try new things. Alongside this, I’ve been privileged to meet some fantastic people and be part of a great team who care about every single person that walks through our door.

‘As a team, we’ve helped people get support for their mental health, tackle crippling debt and even escape domestic violence for instance. After taking a gamble and changing career I’ve never looked back. I love what I do, I enjoy working towards challenging targets and seeing the reaction from my participants when they get to tell me, “I got the job!” We’re not just finding people sustainable jobs – but every day we feel like we’re changing lives and that is the most rewarding feeling.’

The Forward Trust is a growing employability provider delivering DWP Restart and the JCP DPS programme as well as other education and skills programmes. The Forward Trust is a finalist in the ERSA Frontline Advisor of the Year award at the Employment Related Services Association (ERSA) Awards 2023.

This blog was originally published by The Forward Trust. You can read the original post here.

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

Social Interest Group Christmas Campaign

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DDN
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Social Interest Group (SIG) is a leading UK charity providing bespoke person-centred health and social care services.

Through SIG Penrose, SIG Equinox, SIG Pathways to Independence, SIG Safe Ground, and SIG Housing Trust. Across SIG, we have some fantastic services that enable meaningful change in the lives of some of our society’s most vulnerable and marginalised people. 

This Christmas, we are working to raise some much-needed funds for five of our community-based and residential services so they can provide additional support for participants and residents throughout 2024. We have included more information below about each of these campaigns: 

Penrose: Bridge House – Based in Luton, Bridge House is a women-only temporary housing service for mothers with young children fleeing crisis and experiencing homelessness. This Christmas, we are raising money to improve Bridge House’s Garden to transform the space into somewhere for the women and children to enjoy. We are also raising money to fund family days out for the residents in 2024. To find out more and make a donation, visit Penrose: Bridge House Christmas Appeal 2023 – JustGiving

Equinox: The Solace Centre – The Solace Centre is an out-of-hours mental health service that supports people with long and enduring mental illness, combats loneliness and isolation through social inclusion, and maintains wellness and healthy lifestyles in Ealing. This Christmas, we are raising funds to transform a room at The Solace Centre to create a private and peaceful space to enable members to receive 1:1 support for their mental health and wellbeing. To find out more and make a donation, visit Equinox: The Solace Centre Christmas Appeal 2023 – JustGiving

Pathways to Independence – Pathways provides supported housing for vulnerable, single homeless people with additional support needs in Kent and Medway. This Christmas, we are raising funds to provide art activities and equipment for the residents of Pathways to help build their confidence and sense of self, helping them to move forward in their recovery journey. To find out more and make a donation, visit Pathways to Independence Christmas Appeal 2023 – JustGiving

Equinox: Brighton Women’s Service – Brighton Women’s Service is a women-only residential project providing assistance for women who have experienced homelessness, domestic violence, physical and emotional abuse, and have support needs around mental health, drugs and alcohol and offending behaviours. This Christmas, we are raising funds to provide Pamper Packs for the women of our Brighton Service to help them rest and relax and improve their confidence, self-esteem, and mental and physical health. To find out more and make a donation, visit Equinox: Brighton Women’s Service Christmas Appeal 2023 – JustGiving

Penrose: Roots to Recovery – Roots to Recovery (R2R) is our award-winning garden-based project providing a therapeutic growing space to reduce social isolation and increase physical and emotional wellbeing for the most vulnerable people in Luton. This Christmas, we are raising funds to help people struggling with their mental health and social isolation access Roots’ recovery garden and benefit from the community activities that will take place throughout 2024. To find out more and make a donation, visit Penrose: Roots to Recovery Christmas Appeal 2023 – JustGiving

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 Social Interest Group

Becoming Culturally Competent

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DDN
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Culturally appropriate drugs servicesMore than half of the population of Leicester is from a non-white background – something that hasn’t always been reflected in services, says Dilesh Popat.

Turning Point’s drug and alcohol service in Leicester has been working with the local community to support clients from a south Asian background who are often reluctant to seek specialist help. The 2019 rapid evidence review (bit.ly/3FFdk77) conducted for Alcohol Change UK found that people belonging to ethnic minority groups are less likely to access services and may be less likely to seek help for alcohol use until they have experienced serious health consequences.

Leicester is one of the most diverse cities in the country. The 2021 census showed that 51.9 per cent of the population are from a non-white background, with the largest single ethnic group being Asian at 43.4 per cent. However, Turning Point services in Leicester noticed that the ethnicity of the city didn’t reflect that of the clients seen at the service.

Five years ago, only seven per cent of the people we support were from a diverse background. When it comes to south Asian communities, a UKDPC survey (bit.ly/40kpkEx) found that a reluctance to seek help due to stigma and a lack of knowledge about services are reasons why these groups are underrepresented. A perceived lack of understanding of their culture and, occasionally, racism within services were also reported as barriers to treatment.

Fear and Shame

From our work with south Asian communities in Leicester, we’ve found that people are afraid to ask for help from their GPs or their local drug and alcohol services because of the perceived shame it will bring upon their families. 

We’ve noticed that families often have their own ideas on how to help their loved ones overcome alcohol and substance use – one is to send the client to the sub-continent in the belief that they might not be able to get hold of the drugs or alcohol. Even if this succeeds there’s clearly a risk of relapse when they return home. 

At Turning Point we not only want to raise awareness of drug and alcohol services that are available, but also remove the stigma associated with accessing these services – we’ve taken the approach to work with the community, in the community, for the community. 

If you look at south Asian communities, one thing Muslims, Hindus and Sikhs all have in common is they meet in large gatherings – at the temples, gurdwaras or mosques.

We work with these organisations who are already established within the community. We work with community leaders, spiritual leaders, educational leaders and offer them support, training and education. 

Spinney Hill Recovery

Spinney Hill Recovery was created by two imams to help address the growing number of people from the Muslim community in Leicester that had developed an addiction to drugs and/or alcohol.

Mushtaq Dakri, one of the founders of Spinney Hill Recovery, said he created the group as Muslim clients felt mainstream services weren’t aware of the specific needs of different cultures. 

‘There’s always been drugs consumed in the area,’ he says. ‘But there was a change we noticed in the type of drugs that were being consumed. We went from cannabis and class B drugs to class A drugs, synthetic drugs and alcohol. People were becoming addicted and they were asking us for help. Initially we referred them to commissioned services. However, over a period of time, the feedback we were getting was that they didn’t feel like it was meeting their needs. They didn’t feel like the services understood them culturally. They didn’t like having to go to town and be seen by members of the community.’

They decided to establish something for themselves that would meet the needs of the community. ‘When we first looked at this around 15 years ago, there was very little interest from the community because it was thought drug addiction was something that happened to other people,’ he states. ‘But as time went on, people have realised that this was now on our doorstep and we can’t ignore this anymore. There was a realisation that something had to be done.’

When Spinney Hill Recovery approached Turning Point six years ago, things were starting to get out of control in their community with substances like heroin, crack and alcohol. It now refers clients to Turning Point, which aims to get the client assessed and into treatment within 24 hours. 

One thing they found was that people were relapsing because there wasn’t anything for them to do when they came back from rehab, so Spinney Hill put together a package of activities for every day to keep them engaged and to reduce the rates of relapse. 

Spinney Hill and Turning Point have developed their working relationship further and Spinney Hill now receives funding from Turning Point and has its own facilities – a large area with a gym, pool table, kitchen, group room and room for one-to-one counselling.

The service is open to everyone, not just Muslims. But the goal is to use spirituality as a tool to recovery, and it has imams come to deliver spiritual classes and work with the clients.

Drinking is a major issue in the Sikh community, with a BBC investigation finding that although drinking alcohol is technically forbidden in Sikhism 27 per cent of British Sikhs report having someone in their family with an alcohol problem. A parliamentary early day motion in July 2022 called on government to acknowledge the prevalence of alcohol addiction within the South Asian community and to tailor appropriate outreach and services through overdue alcohol strategy.

Sikh Recovery Network

Jaz Rai founder and chairperson of the Sikh Recovery Network
Jaz Rai, founder and chairperson of the Sikh Recovery Network

The Sikh Recovery Network is a national organisation that helps support people with drug and alcohol recovery, running online and face-to-face groups around the country, including a Leicester-based group.

Jaz Rai is founder and chairperson of the Sikh Recovery Network, and regularly talks about his own addiction and recovery journey. I approached him and we started working together. 

In Leicester, we have drop-in sessions for clients at the local gurdwara. If anyone Leicester-based contacts Jaz he will refer them to us, and we get them into treatment and start supporting them straight away. We have a number of volunteers and peer mentors who have come through recovery via the Spinney Hill Recovery and the Sikh Recovery Network and are now working for Turning Point as peer mentors and volunteers. 

Something we’re trying to do at Turning Point is ask if we’re culturally competent as a service. Do we have enough people of colour within our staff? Do we have a variety of different languages spoken by support workers? Do we provide information in different languages? We celebrate Christmas, but do we celebrate Eid or Diwali or Vaisakhi? 

We’re sharing the work we’re doing with south Asian communities in Leicester with our services across the country to help them meet the needs of different communities. It’s all about spreading awareness to the people we support and our colleagues.

Dilesh Popat is diverse communities team leader at Turning Point

Met seizes 150,000 nitazene tablets

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The Metropolitan Police has made what it says is the largest ever seizure of synthetic opioids in the UK.

Around 150,000 nitazene tablets were recovered by officers working with UK Border Agency staff at addresses in the London boroughs of Waltham Forest and Enfield. 

dark web
‘It is suspected the drugs were sold via the dark web, using encrypted chat applications and social media’

The tablets were recovered in a ‘sophisticated factory set up’, say the police, alongside other class A and B drugs, a pill pressing machine, more than £60,000 in cash and a firearm. 

The drugs were seized on 24 October, with 11 people arrested as of 21 November. ‘It is suspected the drugs were sold via the dark web, using encrypted chat applications and social media’, the police state. Around £8,000 in cryptocurrency stored on hard drives was also seized. 

Nitazenes are extremely potent synthetic opioids that are increasingly being found in the UK drug supply, including in heroin batches and pills sold as oxycodone or benzodiazepines. They are associated with high levels of sedation and respiratory depression, with overdoses often requiring multiple doses of naloxone. 

Many in the treatment sector are concerned that the UK drug market may be flooded with synthetic opioids like nitazenes and fentanyl as a result of the Taliban’s opium ban in Afghanistan. Opium poppy cultivation in the country has fallen by 95 per cent since last year, according to the latest UNODC analysis (https://www.drinkanddrugsnews.com/afghan-opium-cultivation-drops-by-95-per-cent/). 

Nitazenes were linked to a number of fatal overdoses in the Birmingham area earlier this year. Their presence in fake Xanax or OxyContin pills purchased from the dark web also means that they’re more likely to be used by people with very low levels of opioid tolerance, and without access to naloxone (https://www.drinkanddrugsnews.com/stayin-alive/). 

‘Synthetic opioids have been detected in batches of heroin found in London and across the UK,’ said Detective Superintendent Helen Rance. ‘They substantially raise the risk of incredibly serious harm to the user and are believed to be linked to a number of deaths. We are working closely with partners to monitor and proactively tackle this issue, provide advice and remove the availability of these dangerous drugs from our streets.’

Related articles:

(Features, November 2023) Stayin’ Alive, information and downloadable resources on nitaznes.

(Features, June 2017): Meet the Fentanyls, a guide to the fentanyl family by Kevin Flemen.

(News, August 2023): Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK

(Partner Updates, September 2023): Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.

(News, January 2023): Fentanyl behind 80% increase in New York’s overdose deaths

Search the DDN archive for more on nitazenes, fentanyl and synthetic opioids.

The Big Ask

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Russell Booth CGLThe government’s drug strategy brought increased investment, fresh ideas and a renewed focus on the importance of drug treatment services in local communities.

We’ll be about three years into this ten-year strategy when parliament is dissolved, government offices are cleared out and we march to the polls to pick our representatives for the coming years. 

It’s a big moment in a painfully busy political landscape. As with any change, there’s a chance that priorities will shift and it’s our responsibility to make sure we do everything we can to prevent the vital work of drug treatment services from slipping down the political agenda.

That’s why this year, for the first time, Change Grow Live hosted events at both the Conservative and Labour party conferences. We talked about the importance of the drug strategy and shared five asks for the next government: 

1. Back the vision behind the national ten-year drug strategy

The drug strategy provides a vision for the transformation of drug treatment services. It recommends new partnerships between the NHS, the third sector and other public health services to create system stability, and also recognises that drug and alcohol dependency is a health condition. We want to see a new government back this vision and commit to building on the progress made over the past two years. We also want to see the success of the drug strategy measured through a broader variety of qualitative metrics. moving away from a focus on narrow data points.

2. Commit to sustainable three-year funding cycles

Change is needed but yearly funding cycles make long-term change to service delivery challenging. It’s hard to plan and deliver long-term ideas if you don’t know how much funding will be available. 

To ensure that additional funding can deliver genuine, sustainable benefits in local communities, we want to see the introduction of funding cycles of at least three years. For every £1 spent on drug treatment, £4 is saved, and demands on health, prison, law enforcement and emergency services are reduced. Stable funding will mean that improvements delivered through the drug strategy are long-lasting and that cost savings are realised.

3. Recognise the role of third sector service providers in delivering high quality drug and alcohol treatment as part of the wider public health system

Third sector providers of drug and alcohol services are part of the wider public health system, but this is not always recognised or acknowledged. The third sector offers innovation and flexibility, and often has strong roots in local communities. It plays a crucial role in delivering high quality treatment for people who use drugs and alcohol, which helps to tackle health inequalities and reduce pressures on the NHS. 

To maximise the value of the third sector, our treatment services need to be a fully integrated public health system and contribute to decisions about service design and delivery. As a minimum, drug and alcohol treatment services should be represented and given equal voice at all Combating Drugs Partnerships across the country.

4. Work with us to beat stigma

People who use drugs and alcohol deal with prejudice, ignorance, and misconceptions, which makes it harder for them to access the services they need. When people are seen as individuals instead of defined by their drug or alcohol use, their treatment and recovery journey becomes less challenging. 

As with campaigns to tackle the stigma around mental health, we want to work with the incoming government to run national awareness campaigns and local training to help professionals and the public understand the needs and lives of people who use drugs and alcohol.

5. Publish and implement a comprehensive substance misuse workforce strategy

We are calling on the next government to publish a workforce strategy in line with the drug strategy’s ambition to encourage more people to work in the sector, and to provide high-quality training and development for them. A comprehensive strategy to rebuild the substance misuse workforce is critical to increasing the capacity and improving the quality of services, and to realising the benefits of the national drug strategy.

We believe that change is possible, and we believe the time is right to make it happen. The changes we have already seen within the sector, coupled with prospect of a looming general election, have created an opportunity for us to reimagine the future. Our asks for the next government have a crucial part to play in turning our ideas and principles into reality, and to help more people change their lives for the better.

If anything I’ve written here chimes with your thinking and your ambitions for the future, then let’s work together. We have a much greater chance of cutting through the noise if we act as a single voice. Contact me at Russell.Booth@cgl.org.uk

Russell Booth is national communications advisor at Change Grow Live

 

Alcohol duty frozen until August 2024

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Alcohol duty will be frozen until next August, chancellor Jeremy Hunt has announced in his autumn statement. 

man buying wine
Alcohol is 14 per cent more affordable than in 2010

Almost 50 health campaigners including representatives from the British Liver Trust, Humankind and Nacoa earlier this year urged him to increase the duty rate, as alcohol was now 14 per cent more affordable than it had been in 2010 (https://www.drinkanddrugsnews.com/campaigners-urge-chancellor-to-increase-alcohol-duty/).

The autumn statement also saw tobacco duty rise by 2 per cent above the RPI inflation rate, with the duty on hand-rolling tobacco increasing by 12 per cent above RPI. The government recently announced plans to create a ‘smoke-free generation’ by increasing the legal smoking age by one year each year, until it applies to the entire population (https://www.drinkanddrugsnews.com/government-plans-smoke-free-generation/). 

Dr Richard Piper
Dr Richard Piper

Alcohol Change UK Dr Richard Piper said it was ‘astonishing’ that the government had frozen alcohol duty again, calling it ‘a tax cut for wealthy alcohol producers’. The decision to ‘subsidise’ producers was ‘disgraceful’, he stated. ‘Alcohol harm costs all of us taxpayers around £21bn per year and it’s not acceptable that the government is failing to recoup this cost from those who profit from alcohol harm. We need the government to urgently reconsider this decision and remove the freeze on alcohol duty. With alcohol liver deaths rapidly rising, with no signs of that falling back, we desperately need bold action from the government to stop more lives being needlessly lost.’ 

Alcohol Health Alliance chair Professor Sir Ian Gilmore
Alcohol Health Alliance chair Professor Sir Ian Gilmore

The freeze was ‘utterly frustrating news’ added Alcohol Health Alliance chair Professor Sir Ian Gilmore. ‘Freezing duty makes alcohol cheaper to buy in real terms. We know that the cheaper alcohol is, the more is consumed, and the more damage done. Cheap alcohol has unquestionably played a part in the record number of alcohol-related deaths and hospital admissions we are now experiencing. Reintroducing the alcohol duty escalator from 2008 to 2014 – which increased duty by 2 per cent above inflation each year – would save lives, help hospitality, and contribute to Treasury revenue.’

WithYou declares hep c micro-elimination at North Lincolnshire service

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WithYou has achieved micro-elimination of hepatitis C at its North Lincolnshire service, taking a step towards NHS England’s target to eliminate the virus by 2025.

Photo by lilartsy on Unsplash

The service has achieved micro-elimination by meeting a set of criteria, including: offering 100% of clients in structured treatment a hepatitis C test; testing 100% of those with a history of injecting; ensuring 90% of current and previous injectors (at risk) have a hepatitis C test date within the last 12 months; and ensuring 90% of clients who have tested positive for hepatitis have commenced or completed treatment.

NHS England has set a target to eliminate hepatitis C by 2025. As part of a partnership with Gilead Sciences, WithYou committed to micro-eliminate hepatitis C in 12 of their blood-borne virus commissioned services.

‘As an organisation, we are committed to and passionate about eliminating hepatitis C and supporting NHS England and partners to achieve and sustain our shared ambition. We recognise that clients may not always disclose their past injecting history or other risk factors; that’s why we want to challenge the stigma that surrounds hepatitis. Through these interventions, we have an opportunity to bust those myths, raise awareness, and empower people to stay safe and make informed decisions’, said Emma Lamond, Director of Integrated Treatment at WithYou.

‘I would like to thank the North Lincolnshire team who have achieved micro-elimination; the impact they’ve had is extraordinary. Their hard work means our service users have a greater chance of receiving timely, appropriate treatment and ultimately have the opportunity to get better.’

WithYou services are actively raising awareness and enhancing testing and treatment processes. Whilst the micro-elimination approach enables services to focus efforts on high-risk areas, the priority has been to normalise testing and embed it as part of core services. For this reason, WithYou launched their ‘Test, Treat, Repeat’ campaign to encourage services to test every client whether or not they inject drugs.

Jimmy, a client from WithYou in North Lincolnshire treated for hepatitis C, said of his experience, ‘I got hep C in the early 90s and there was no cure. I first heard there was a cure about 15 years later, but the rumour was the treatment was nasty, painful and complicated. But roll on 10 years, my WithYou recovery worker told me the new treatment was a lot better with hardly any side effects. It was one tablet a day for about three months I think so I decided to get treated and just three months later I got tested it was all clear. I had no side effects and I went around town with The Hep C Trust to pass the word to other people and urged them to get treated.’

‘This has been a real team effort, everyone in the service has been involved in achieving this and actively encouraging clients to get tested and treated,’ added Kate House, Head of Service Delivery for WithYou in North Lincolnshire. ‘We have also worked closely with The Hep C Trust and Northern Lincolnshire and Goole Hospitals NHS Foundation Trust; we wouldn’t have achieved this without these partnerships. I’m also really proud of the clients for their bravery in coming forward for testing and working with us when treatment has been recommended.’

Emma concluded, ‘On behalf of WithYou I would also like to share our appreciation for all our BBV-commissioned service staff for their ongoing dedication, and to partners for their continued collaboration. We could not have reached this milestone without the joint working partnership and the dedicated and passionate teams involved.

‘There is of course still work to be done – we must continue our comprehensive testing programme to sustain micro-elimination status and strive towards complete elimination of hepatitis C going forward which includes strengthening our harm reduction provision and reaching more people .’

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 WithYou

Abbeycare appoints service engagement manager with over 20 years’ experience

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A residential rehab centre has appointed a new member of its leadership team to strengthen its engagement with partners and clients.

Billy Henderson has joined Abbeycare after a career spanning more than two decades in the addiction recovery sector and brings invaluable experience to his post as service engagement manager.

In his new role, Billy will develop Abbeycare’s existing relationships with alcohol and drug partnerships and care managers to ensure quality of service and ongoing engagement.

He will also work closely with the facility’s admissions and outreach teams to ensure clients are fully prepared and supported in the days and weeks leading up to the start of their recovery journey.

Billy spent the last two years as manager of Calderglen House in High Blantyre, Lanarkshire, and previously worked at The Priory in Glasgow for almost two decades, where he was initially a senior addictions therapist before going on to manage the hospital’s Addictions Service.

Abbeycare provides residential drug and alcohol rehabilitation and detoxification services at its clinics in Erskine, Renfrewshire, and in Minsterworth, Gloucestershire.

It also offers extensive aftercare, recovery care planning, harm reduction interventions, support for families, and counselling to help people address the issues behind their substance use disorders.

Paul Bowley, chief executive of Abbeycare, said: ‘We are incredibly excited to welcome Billy to our dedicated multi-disciplinary team and are pleased that he has chosen to bring his expertise to Abbeycare.

‘He brings a wide range of expertise and more than two decades of experience in addictions services and residential support.

‘His appointment will help to strengthen our engagement with external partners and clients as he works closely with our admissions and outreach teams.’

Billy Henderson said: ‘Abbeycare have been a leading provider of residential alcohol and drug rehabilitation services for approaching 20 years and I have engaged with them several times during my own career.

‘I am therefore delighted to be able to join their team and look forward to building on my existing good relationships with alcohol and drug partnerships and playing my part in ensuring clients are best prepared to start their recovery journey.’

For more information, please visit www.abbeycarefoundation.com

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, whose support makes the free publication possible.

This content was created by Abbey Care

Thousands raised at Forward’s annual London quiz 2023 event

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Over £18,000 was raised by supporters and donors at Forward Trust’s recent quiz event to generate funds for frontline services.

The Annual London Quiz 2023, hosted by comedian Jimmy Mulville, welcomed over 130 guest to a fun-filled evening at The Tabernacle, London.

This special event is hosted by Forward to spend time with our supporter community in a relaxed, friendly atmosphere whilst being able to raise funds towards our projects that help people to break the cycles of addiction or crime and move forward with their lives

For over 30 years, the charity has been fulfilling it’s longstanding mission to successfully help people break the vicious cycles of addiction and crime so that they can lead positive and fulfilling lives.

During the evening, guests enjoyed a relaxed two-course meal and heard many inspiring stories of recovery and transformation, followed by a thoroughly enjoyably silent auction.

There were many excellent, unique and memorable prizes kindly gifted to the raffle, including signed Downton Abbey books (by Julian Fellowes, creator, writer and executive producer of Downton Abbey), a free reflexology session and a White Company advent calendar.

One of the highlights of the evening was a testimonial by Leon Rowe, a Forward alumni, with an incredible story to tell.

In Leon’s words, ‘I used to work for Brent council and Westminster council – I was a youth worker, I used to run after school clubs. Then my best friend passed away; he was a drug dealer, they found traces of drugs in his system. He died in my block of flats; I was in disbelief. I gave up my work and started using – I didn’t know it would take control of me. I ended up carrying out crime and I was in and out of prisons. My son’s mother, my family – no one believed me because of the job I had done so it was only in 2020 that I asked for help, all those years I was pretending I was alright.

‘After around 18 years I decided I wanted to make a change. Whilst in prison I got in touch with The Forward Trust where I did some cell packs on relapse prevention and awareness with Naz. I got my certificates for these. I knew if I was homeless after prison, I would end up back on drugs.

‘So after I got support from Forward in prison, I asked if they could help me because I didn’t have a home to go to. They offered me to get involved in the Nehemiah Project – I’ve been here since 14th April 2021. I’m still here – thank you to Forward Trust. Through Forward I was put in touch with Josh (the Forward Connect Coordinator). With Josh I’ve completed some training and e-learning – and now a volunteer.

‘As a volunteer I support Forward reunions, I facilitate Forward Connect meetings and share my story. The team have been really supportive, it’s like a family – Delroy (Forward Connect Practitioner) has helped me to prepare for a job interview for a role at The Forward Trust.

‘The Forward Trust have done a lot for me, I’m so happy to be a part of it because I have a lot to give and a lot to share. Forward have helped me change, and a lot of people look up to me. I can now show that change is possible, which is why I like to visit the prisons, so they can visibly see how change is possible.’

Stories like Leon’s help to showcase the amazing work that takes place within Forward to help support people into moving away from a life of crime and overcoming addiction.

Today The Forward Trust supports the recovery and rehabilitation of individuals through a broad range of services, both in prison and in the community, including employment support, housing provision and interventions to support affected families, including children and young people living with parental addiction.

All of this work is only possible thanks to fundraising, and the Annual London Quiz 2023 enables our generous supporters to help us in our mission to achieve our annual fundraising target of £3 million.

On behalf of everyone at The Forward Trust, and all the individuals we will be working with, we would like to thank you for your generosity – undoubtedly helping us to change lives.

Shera Bledisloe, Marianne Hinton, Isabelle Laurent, Annabel Portsmouth and Cosima Somerset represent Forward’s London Quiz Committee.

This blog was originally published by The Forward Trust. You can read the original post here.

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

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