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Anonymous tip

By
DDN
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drama therapy for substance misuseOur ‘anonymous drama’ (AD) programme has been supporting people in recovery, both in residential settings and community groups, for several years now – with spectacular results.

When I’m describing it to someone who has never heard of it, I usually say it’s like ‘drama therapy’ for people who often have no interest in either drama or therapy. 

The unique elements include:

1. Anonymity – Participants are working with fictional characters so no one in the session knows the difference between what’s real and what’s fiction.
2. Programming – The programme has been broken down into session plans with safeguarding guides so that they don’t need to be delivered by drama or therapy-type professionals – they can be delivered locally by support staff or volunteers.
3. Opportunity – Giving non-creative ‘civilians’ the opportunity to take part in things like improvisation and role play.

We also deliver sessions across the UK using our own experienced delivery teams – some of whom are drama or therapy type professionals, while some are support staff or volunteers. Some residential or community groups don’t have the available budget to bring in our delivery teams, so the remote session plan model was developed to extend the reach of the work and ensure that lack of budget and resources wouldn’t be a barrier.

If we need advice or interventions for our physical health of course we all know we can engage with medical professionals like GPs. We can also do our own research and seek to improve our physical health via things like diet and exercise.

drama therapy workshopI believe the same applies to our mental health. Yes, we can engage with mental health professionals and without a doubt they provide a valuable service. However, the ethos of AD is that we’re capable of exploring our own mental health and emotional wellbeing, without depending on professionals.

Glasgow University recently completed an impact study on AD and the results reaffirmed what we already knew from the feedback of thousands of participants. Taking part in the AD programme has a positive impact on the mental health and emotional wellbeing of participants, and ultimately supports them on their recovery journey.

I have been writing, directing and producing for film and theatre for 15 years, and my introduction to the concept of using creative practices for therapeutic gains was seven years ago. I was invited into a maximum-security prison to work with a group of ten inmates on a new theatre programme. We started with a blank page and with our support they devised their own group script which they went on to perform for fellow inmates, family and staff. The project had a huge impact on the participants, but it was also life changing for me.

Since that day I’ve become obsessed with the concept of using creative practices to help people achieve more positive outcomes. I still work periodically on mainstream projects, but I have become more focussed on ‘socially aware’ work and aligned myself with partners who are motivated to help individuals and their communities who are marginalised or vulnerable in some way.

As I explored areas like drama therapy one of the first things I did was anonymise our sessions. It felt potentially problematic to have creative professionals like myself – however well intentioned – exploring participants’ lived experience and unresolved trauma, and periodically this created emotionally charged or even triggering environments.

Of course, we can’t completely remove the possibility of someone being triggered. That could happen at any time, but the anonymity and safeguarding protocols built into our session plans keep the possibility to a minimum. For example, if a participant wants to share details relating to an adverse childhood experience (ACE), our session plans support them to explore the ACE of a group fictional character. A subtle shift, but a powerful one, and in our experience it adds more value from a self-awareness perspective. The opportunity is to drill deeper using fiction by proxy as a safety net.

AD is most definitely not a drama group. It’s not about people who are interested in writing or acting (though some participants are and that’s great). The focus is people who have an open mind and are up for trying something different. The work in the sessions around self-awareness and mental health and emotional well-being is the focus. 

That said, usually a group script starts to emerge over the weeks/months of sessions – mixture of very personal and insightful monologues, sketches and spoken word. Some groups decide they want to share these scripts with their family, friends, staff, and these events are incredible. Nothing fancy, no stage or lights, just a group of volunteers from the group, and a celebration of their hard work and effort. In some cases, participants are reunited with family members with whom they have completely fractured relationships.

My parents were both alcoholics and my younger brother spent most of his adult life in the justice  system before dying of a heroin overdose. I doubt very much I will ever be involved in any future project  professionally that will be more important or personal to me. Everything I do in this field is motivated by the trauma that I experienced as a family member of people who struggled with alcohol and drug addiction. It killed my brother and my father. My mother has been sober for 25 years, but even she  knows that she can’t take her sobriety for granted and lives one day at a time. 

Mark MacNicol, 4Um Theatre’s playwright and director

I thought it might be useful to take a snapshot of some recurring impact areas/quotes that came back from just a small random selection of participant evaluations and the Glasgow University study:

‘Boosted my general mood levels and state of mind.’ ‘Confidence growing with each session.’ ‘I’m a different person.’ ‘Even in early detox and lacking focus I was benefiting.’ ‘I work on things in character I’ve never shared with anyone.’ ‘I never knew I was capable of this.’ ‘They recommended we use a journal outside of sessions and I have it with me all the time.’ ‘My anxiety and depression more impacted by this than any medication I’ve taken.’ ‘I do the breathing exercise every day.’ ‘I rearranged other commitments, and refused to miss a session.’ ‘I could pass on any activities, never felt pressured.’ ‘My literacy wasn’t great, the script work has been a big help.’ ‘The thing I remember most about the sessions is the laughter.’ ‘After this I know there is an inner strength inside me, I never knew was there.’ ‘These sessions make me more likely to speak to a therapist.’ ‘After this programme I find eye contact easier.’ ‘I felt like all the people I’ve lost to addiction were in the audience at the reading.’ ‘I find the sharing bit in fellowship meets problematic but in character it’s so much easier.’ ‘These sessions helped me look into the mirror for the first time in my life.’

Liam Mehigan, director at Abbeycare Clinics
Liam Mehigan, director at Abbeycare Clinics

The service provider response to AD is equally positive. ‘The recovering voices sessions and performance have been a great addition to our programme at Abbeycare by using creative expression to aid people’s recovery process,’ said Liam Mehigan, director at Abbeycare Clinics. ‘The sessions culminating in the performance have given participants an opportunity to creatively express themselves. Participants have been able to build confidence and develop trust and their relationships with one another as they support each other whilst participating. 

‘The sessions have also enabled participants to have fun whilst at the same time challenge themselves,’ he added. ‘It’s beautiful to witness people grow and develop through the process.’ 

If anyone is interested in possibly hosting an AD programme either via an existing delivery team or your own volunteers/support staff, please email info@4umtheatre.org 

 

 

 

 

Most of Northern Ireland’s drug deaths among young people 

By
DDN
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People aged between 25 and 34 account for the highest number of drug-related deaths in Northern Ireland, according to research by the country’s drug deaths taskforce. 

Professor Anne Campbell of Queen’s University
Professor Anne Campbell of Queen’s University

The proportion of 25 to 34-year-olds dying a drug-related death rose from 13 per 100,000 in 2011 to 27 per 100,000 in 2021, says the report. 

The findings are in contrast to data on drug deaths in England and Wales, where the highest rate is among 45 to 49-year-olds, and Scotland, where people aged between 35 and 54 are most likely to die from drug misuse. The average age of drug misuse deaths in Scotland has risen from 32 to 44 over the past 20 years. Northern Ireland currently has the second highest rate of drug-related deaths in the UK after Scotland, at 11.5 per 100,000 population.  

The research is the first to look at data from across a range of services in Northern Ireland, including the ambulance service, the National Programme on Substance Misuse Deaths, the Northern Ireland Statistics and Research Agency (NISRA) and emergency admissions from the country’s health and social care trusts. It was carried out in collaboration with Queen’s University Belfast, the Northern Ireland Alcohol and Drugs Alliance (NIADA), South Eastern Health and Social Care Trust, Ulster University, and the University of St Andrews.  

Northern Ireland’s health agencies need to closely monitor the emergence of synthetic opioids, the report warns, and improve drug testing of samples submitted by community and voluntary sector organisations. The country’s drug landscape is changing and ‘we are beginning to see evidence of nitazenes in recent drug deaths’, the document states. More resources, including staff, also need to be allocated to outreach work targeting younger people, it adds, along with enhanced peer naloxone training. 

‘The prevention of each of these deaths is possible, making it essential for the Department of Health, the NI Executive, and society to prioritise this issue,’ said Professor Anne Campbell of Queen’s University, who led the research. ‘This work will provide the evidence base for the nature and type of drug related deaths in Northern Ireland, the numbers admitted to hospital for overdose, the number of deaths that could have been avoided, and the number of young people and young adults who are being admitted with overdoses. This report will inform the work undertaken by the drug deaths taskforce, which has recently been implemented.’ 

Drug overdoses and drug related deaths in northern ireland report

 

Drug overdoses and drug-related deaths in NI is available here

Missed opportunities to create a world class treatment system

By
DDN
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Karen Biggs

Opportunities are being missed to create a treatment system accessible to all, writes Karen Biggs, Chief Executive at Phoenix Futures.

Under cover of the dramatic reshuffle, the Government has announced additional funding for drug and alcohol treatment of £267m from April 2024. This is the third year of additional monies committed to support the Government’s 10-year Drug Strategy.

The National Audit Office recently reported on the progress of the strategy. They found that the delay in funding announcements in previous years had made progress difficult, so this very timely announcement will be welcomed by the sector.

Those of us working in the sector all agree the way to achieve a ‘world class treatment system’ and stem the increase in drug related deaths is to ensure that all treatment options are open to people across the country.

As the charity providing the largest number of residential treatment services in the UK, we have a particular focus on how residential treatment is supported through the drug strategy implementation. Sadly, the news is not positive.

Despite the additional £250m additional funding over the last two years, we have seen a reduction in the number of people accessing residential treatment to below 1% of all people in treatment. That compares to 7% in Portugal (a country known for its funding of a wide range of treatment options) and an average across Europe as a whole of 11%.

We will be publishing a report later this week that sets out the raft of missed opportunities created by the lack of strategic support for residential treatment, including a gap in treatment options for women and families and those whose multiple needs would be best met by this intensive form of treatment.

The UK Government’s 10 Year Drug Strategy, published in 2021, recognised that intensive treatment options, such as residential treatment, weren’t available across the country in line with clinical guidance. The strategy committed to developing mechanisms to address this and ensure equal access to inpatient detox and residential rehabilitation treatment in all areas of the country.

A 2% benchmark was set for each local authority area, setting an expectation that 2% of people in treatment accessed residential treatment each year. Local authorities were expected to consider this as a ‘floor’ and not a ‘ceiling’ but the aim was to ensure that pathways into residential treatment were created in every part of the country.

Some local authorities have been able to increase access to residential treatment, showing good practice in relation to targeted funding and appropriate trauma informed pathways.

However, in 2022/23 there were still areas in the country in which state funded residential treatment was denied to people unless they had the means to pay for it privately.

  • There are still areas of the country that create punitive and unrealistic hurdles for people to navigate before they get to residential treatment, despite NICE guidance which recommends residential treatment as an appropriate form of treatment for people who ‘have not benefited from previous community based psychosocial treatment’.
  • Pathways from prison to residential treatment are still not created despite NICE guidance stating residential treatment should be considered within care plans of people who want to be abstinent from drugs following their release.
  • Some local authority areas who have yet to achieve the 2 per cent benchmark are freezing residential treatment budgets until April next year.

By comparison, inpatient detox funding has been ringfenced for the last three years and the ringfence has been confirmed again for a further year.

The lack of comparative strategic support for residential treatment means it isn’t universally available in line with NICE guidance across the country, and it is being denied to people who would benefit from it as a critical part of their drug treatment care plan.

So once again we will be asking the new relevant ministers (once we are clear who they are after the reshuffle) to give the Drug Strategy their full focus and ensure that all treatment options are available to all parts of the country. Only then will we have a chance of reducing the number of people who needlessly die of drug related issues.

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

Average potency of cannabis resin in Europe up by 200 per cent in a decade

By
DDN
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The new report examines the illicit market for cannabis products – the largest drug market in Europe.

The average potency of cannabis resin in the EU increased by almost 200 per cent between 2011 and 2021, according to new analysis by EMCDDA and Europol. The average potency of herbal cannabis rose by almost 60 per cent over the same period.

The EU cannabis market is estimated to worth at least EUR 11bn annually, says the report, and remains the biggest drug market in Europe. Cannabis products are becoming increasingly diverse – as well as potent – the document states, with a ‘range of natural semi-synthetic and synthetic cannabinoids available in many different forms’ including edibles, vaping products, oils and ‘concentrates’.

Cannabis represents an ‘attractive market’ for serious and organised crime, the report says. While criminal networks involved in the cannabis market tend to be ‘highly cooperative’ at the wholesale level, sharing resources and building partnerships, the profitability and wide geographic span of the market also make it ‘highly volatile and dynamic’, with frequent violence as a result of disputes over the control of territories, as well as ‘debt recovery and revenge’ and ‘attempts to defraud business partners or remove competitors’.

Catherine De Bolle: Cannabis trade yields are ‘staggering’

‘Despite the cooperation that occurs between networks, much of the violence among criminals reported to Europol in past years has been connected to illicit cannabis markets’, the document states, with violence involving street gangs involved in cannabis trafficking a serious problem in parts of France and Sweden. Although most cannabis resin in Europe is still smuggled from Morocco, more cannabis products are being smuggled from North America and there are also ‘signs that resin production within the EU may be on the rise’. Meanwhile, five EU member states – Czechia, Germany, Luxembourg, Malta and the Netherlands – have introduced or are planning to introduce approaches for regulating the supply of cannabis for recreational use, the report points out.

‘Cocaine seizures might be grabbing the headlines, but trafficking of cannabis is just as important a threat,’ said Europol executive director Catherine De Bolle. ‘The cannabis trade yields a staggering EUR 11.4bn annually, which is still a minimum estimated value of the market. In addition to the impact on public health, the substantial illegal proceeds criminal networks obtain from trafficking cannabis fuel dire consequences — criminals increasingly veer into extreme violence to further their criminal goals.’

EU drug market: cannabis at https://www.emcdda.europa.eu/publications/eu-drug-markets/cannabis_en

 

Government already delivering ‘balanced public health approach’ to drugs

By
DDN
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The current legislative framework and strategy are ‘already delivering a balanced approach which combines a range of public health and criminal justice approaches’, the government has stated in its official response to the Home Affairs Committee’s report on drugs. 

The Loop
The report concluded that there should be ‘greater use of public health-based drug interventions’, and called for a new legislative framework to include drug testing at festivals and consumption room pilots

The committee’s report, published this summer, concluded that the 1971 Misuse of Drugs Act was outdated and should be reformed to support ‘greater use of public health-based drug interventions’, and called for a new legislative framework to include drug testing at festivals and consumption room pilots. The government was unlikely to achieve its drug strategy aims without ‘significant expansion in the range and availability of health-based interventions’, it warned. 

The cross-governmental Joint Combating Drugs Unit is already driving coordinated activity across health, criminal justice, education, employment and housing to support the drug strategy’s priorities, the government states in its response, adding that it does not accept the recommendation to reform of the Misuse of Drugs Act. 

‘A balanced public health and law enforcement response to drugs is compatible with both the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001,’ it says. It also has no plans to review the classification and scheduling of drugs under the act, it states. 

The Home Affairs Committee report also highlighted that the Home Office appeared ‘more likely’ to adopt the ACMD’s advice to increase the classification of a drug than reduce it, citing the examples of MDMA, cannabis, khat and, most recently, nitrous oxide.

While advice from the ACMD formed ‘an essential part’ of decision making and the government had ‘complete faith in its quality and rigour’, the government could however ‘decide to progress alternative action that it deems necessary, taking into account other relevant factors, and in some cases arriving at different conclusions’ the response states. The government would also not be issuing the ACMD’s unpublished 2016 report, it adds, and ‘respectfully declines to provide the committee with a confidential copy’. 

On the question of the long-term sustainability and security of funding for treatment – also highlighted in a recent report from the National Audit Office – the government states that it is ‘not possible to commit to providing funding for any longer than the current spending review period’.

£267m treatment funding to be rolled out next April

By
DDN
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Almost £267m of funding to improve drug and alcohol treatment and recovery services will be rolled out to local authorities next April, the government has announced. 

Professor Dame Carol Black.
‘A key aim of my report was to make sure vulnerable people with substance misuse problems can access the support and tools needed’, Professor Dame Carol Black.

The money is part of the ten-year strategy to improve the quality of – and access to – treatment, and follows the £95m made available in 2022-23 and £154m this year. Funding is prioritised for the areas with the highest need, the government states, based on drug death rates, opiate and crack prevalence, the size of the treatment population, and crime and deprivation levels. 

A report by the National Audit Office (NAO) last month, however, found that while government departments had made some progress towards meeting the objectives of the drug strategy, delays in distributing funding and implementing new projects – as well as lack of funding certainty post-2025, gaps in the evidence base and a lack of focus on prevention – were among the significant challenges still remaining (https://www.drinkanddrugsnews.com/significant-challenges-to-meeting-governments-drug-strategy-ambitions-warns-national-audit-office/). 

‘A key aim of my report was to make sure vulnerable people with substance misuse problems can access the support and tools needed to recover and lead full lives,’ said independent adviser to the government, Professor Dame Carol Black. ‘Today’s allocations of almost £267m will go directly to local authorities and their partners, meaning they can deliver treatment that is tailored to meet local needs. The end goal is to get many people into world-class recovery and treatment system, reduce drug use and drug related crime – and ultimately save lives.’

Meanwhile, Ireland’s Health Service Executive (HSE) has issued a warning about nitazene-type substances in Dublin’s heroin supply. More than 50 overdoses have been reported in the city since late last week. 

‘We are urging extreme caution following a sharp rise in the number of overdoses related to a powder being sold as heroin in the Dublin region,’ said HSE’s national clinical lead for addiction services, Professor Eamon Keenan. ‘Preliminary laboratory analysis has confirmed that recent overdoses may be caused by heroin mixed with nitazene, a potent and dangerous synthetic opioid. These pose a substantial risk of overdose, hospitalisation and death.’

Nitrous oxide ban comes into force

By
DDN
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Possession of nitrous oxide, ‘where a person intends to wrongfully inhale it for a psychoactive effect’, is now illegal.

The substance is now a class C drug, which means possession could result in an ‘unlimited fine, a visible community punishment, a caution (which would appear on their criminal record) and for repeat serious offenders, a prison sentence’, the Home Office states. The maximum sentence for ‘production, supply importation or exportation of the drug for unlawful purposes’, meanwhile, has doubled – from seven to 14 years in prison.

Nitrous oxide possession will still be permitted for ‘legitimate reasons’ including catering, but individuals need to demonstrate they are not ‘intending to wrongfully inhale it’

The ban – which forms part of the government’s Anti-Social Behaviour Action Plan – has been enacted despite the ACMD advising against it, as the harms associated with nitrous oxide were ‘not commensurate with control under the Misuse of Drugs Act 1971 (DDN, November, page 4). Possession of nitrous oxide will still be permitted for those with a legitimate reason, such as maternity wards – where it is used for pain relief –or the catering and industrial sectors, the government states. While licences will not be required for legitimate use, individual users will need to demonstrate they are lawfully in possession of nitrous oxide and not ‘intending to wrongfully inhale it’, it says.

Chris Philp: ‘Sending a clear signal’

‘Today we are sending a clear signal to people, especially young people, that not only is abuse of nitrous oxide dangerous to their health, but it is also illegal and those caught possessing it will face consequences,’ said crime and policing minister Chris Philp. ‘For too long the use of this drug in public spaces has contributed to anti-social behaviour which is a blight on communities. We will not accept it. This law gives the police the powers they need to take a zero-tolerance approach to this crime.’

The ban was ‘another sign of the ever-increasing punitive and carceral approach to drug policy that characterises the UK government,’ said Release. ‘Not only is there no political opposition, there is complicity from Labour and industry with this ridiculous decision.’

Consumption rooms among ‘key interventions’ to prevent infections, says EMCDDA

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DDN
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Drug consumption rooms feature in the new guidance

Drug consumption rooms are among the six key interventions to prevent and control infections among people who inject drugs, according to new public health guidance published jointly by EMCDDA and the European Centre for Disease Prevention and Control (ECDC).

While there has been a ‘steady reduction’ in the number of HIV diagnoses over the last decade among people in the EU/EEA who inject drugs, very few countries have seen a significant reduction in hepatitis C infections, says the document.

Alongside the still-controversial consumption rooms, the other five key interventions are listed as sterile injecting equipment, voluntary and confidential infectious disease testing, infectious disease treatment, opioid agonist treatment – including in prisons – and finally, vaccinations against hep A and B, respiratory infections, tetanus, and the pneumococcal and the human papillomavirus vaccines for people living with HIV who inject drugs. The interventions should be delivered in ‘combination with each other and with health promotion activities that target structural and individual factors that promote healthier and/or safer behaviours’, the guidance states.

Andrea Ammon: Services are hindered by stigma

‘There are better and more effective tools than ever before to prevent, detect and treat infections associated with injecting drug use,’ said ECDC’s director, Andrea Ammon. ‘However, access to these services is often hindered by barriers like stigma, discrimination, or legal concerns. When designing strategies, policies, and programmes to address infectious diseases among people who inject drugs, policy makers and public health planners should consider approaches that limit and overcome these barriers and that promote service accessibility, uptake and coverage through the combined provision of interventions.’

Alexis Goosdeel: ‘We have the knowledge’ for harm reduction interventions

The guidance reiterates the need for countries to ‘expand their coverage of a number of life-saving harm-reduction and treatment services which have proven to be effective in preventing and controlling infectious diseases among people who inject drugs’, added EMCDDA director Alexis Goosdeel. ‘We have the knowledge. We now need to ensure that these interventions are delivered at optimal scale.’

Prevention and control of infectious diseases among people who inject drugs — 2023 update available here

Grimsby man joined charity that helped ‘save his life’

By
DDN
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‘I have recovered my old self. That’s what I see recovery as – recovering yourself before addiction took over.’

Shaun from Grimsby was first introduced to drugs at the age of just nine. By the age of 12, he was using several different types of drugs, but alcohol quickly took over – and nearly ended – his life.

After alcohol and drug use spanning 20 years, Shaun describes how it severely impacted all aspects of his life including personal, work and health. Having replaced alcohol with cocaine after ten years of drinking, he was using four to five grams every night. After his divorce in 2020, Shaun was using both alcohol and cocaine and sadly, he made an attempt to end his life.

Thankfully, Shaun pulled through – despite a further lapse in recovery in 2021 – and determined to get help, he got in touch with alcohol, drug and mental health charity WithYou in North East Lincolnshire.

Recovery helped Shaun find himself and happiness again and he is now able to, in his own words, ‘give back’ to the alcohol and drug charity which helped save his life.

Shaun says: ‘I was introduced to drugs at a very early age. I advanced quickly to using things like glue, lighter fuel, petrol and by the age of 12 I was using amphetamines as well as LSD and other recreational drugs. It became a big problem. It stunts your maturity – it’s not good for a youngster to use drugs at that age.

‘Alcohol quickly became my drug of choice. I enjoyed alcohol. It gave me a sense of confidence. I was using it alongside amphetamines for about 20 years. It played a big part in lost jobs and failed marriages.

‘In 2020 I reached a massive cross-point in my life. I was ten years abstinent from alcohol but replaced it with cocaine. I was working in Belgium in a high-paid job as a supervisor but was using four to five grams every night. After another failed marriage I reverted back to alcohol. I attempted suicide as I had become so low – luckily it wasn’t successful. I was drinking three litres of Bacardi a day and any cocaine I could get my hands on.

‘Something had to give and it was my liver and my kidneys – they completely failed. I was admitted to hospital and given 48 hours to live. Thankfully I pulled. through – but even that never stopped me.

‘I relapsed in April 2021. I got support from WithYou and they massively helped me. I had to change my whole environment so I got employed in a local homeless night shelter which I really enjoyed. I was working with clients – many had a lot of trauma and mental health issues. I had to find ‘positive addictions’ — which I found through exercise. It’s been a massive part of my recovery.

‘If it wasn’t for WithYou and my partner, Vanessa who helped direct me to the right support, I wouldn’t be here today. Now I’ve come full circle as I am working full-time as a recovery worker in Grimsby; I’m able to give back and I understand the clients as I have lived experience. It’s something I’ve always wanted to do but never been in a good place before. It’s so supportive with such good staff. It’s my dream job – I absolutely love it.

‘I’ve found my love of training again as well as the gym and martial arts. I want to promote it, set up my own gym or group where I can promote sessions or boot camps. I just want to give other people that structure again – put their mind into other things.

‘It [exercise] releases endorphins, giving you confidence and self-esteem. It has a holistic effect on your wellbeing. Even if it’s getting out for a walk with nature – we have the beach here, you can do it. Exercise can benefit everybody.

‘Addiction took everything away from me. Not just material things but it took ‘me’ away. I have recovered my old self. That’s what I see recovery as – recovering yourself before addiction took over.’

Leah Briggs, Head of Service Delivery at WithYou in North East Lincolnshire, says: ‘Shaun is a core member of our Grimsby team and we’re so proud of what he’s achieved. He’s so passionate about recovery and goes over and above to give clients the very best chance of achieving their own dreams.

‘We’re so proud of the team here and encourage others to reach out to the WithYou service. We offer facts and options so you can make safer choices for yourself and support you to meet your goals in recovery, at your own pace. If you need a safe space to talk, we are with you. No judgement, no lectures, no nonsense. Just compassion and a friendly face.’

Shaun adds: ‘If clients want to listen to me, I will tell them my story. It shows them you’ve been there and you have that empathy with them – you get that connection. Please get in contact. Just engage – come through that door. It will change your life, it really will.’

If you or someone you know is struggling with alcohol or drugs in North East Lincolnshire contact call 01472 806890 or visit the website wearewithyou.org.uk for more information or to use our free, confidential webchat service.

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

Afghan opium cultivation drops by 95 per cent

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DDN
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Opium poppy cultivation in Afghanistan has fallen by 95 per cent following the Taliban’s opium ban last year, says UNODC, further fuelling fears that highly potent synthetic opioids will now fill the gap.

Poppy cultivation fell in all parts of the country, according to UNODC’s latest analysis, from 233,000 hectares to less than 11,000. As a result, opium supply has fallen from 6,200 tons last year to just 333 tons in 2023. ‘The near-total contraction of the opiate economy is expected to have far-reaching consequences,’ the agency states, warning that it ‘could spur the emergence of harmful alternatives, such as fentanyl and other synthetic opioids’.

The experience of the US demonstrates how easily cheaper and readily available alternatives can displace heroin, the report states. ‘The emergence of fentanyl and other potent synthetic opioids has shown that markets can transform; heroin shortages could lead to increased infiltration of established heroin markets with synthetic opioids, possibly increasing potency and bringing a heightened risk of overdoses.’

Opium traders are now selling off their stored opium from the record harvests in previous years, says UNODC, with heroin processing falling as a result. There has also been a surge in methamphetamine production and trafficking in the region, it adds (https://www.drinkanddrugsnews.com/afghanistan-sees-shift-from-opium-to-methamphetamine-production/).

‘As Afghanistan has long been the leading global producer of opium poppy for illegal opiate markets, there is considerable interest in possible downstream effects in the availability of heroin and opium related to a sharp contraction in opium production,’ says the document. ‘An examination of seizures recorded in and around Afghanistan shows that opium seizures are increasing while heroin seizures are declining. Continued opium seizures throughout 2022 and well into 2023 suggest existing opium stocks built up from recent productive years’ harvests are being liquidated.’

UNOCD is also calling for urgent humanitarian assistance, with farmers’ income falling by more than 90 per cent and more than 80 per cent of the population depending on agriculture for their livelihoods. ‘This presents a real opportunity to build towards long-term results against the illicit opium market and the damage it causes both locally and globally,’ said UNODC executive director Ghada Waly. ‘At the same time, there are important consequences and risks that need to be addressed for an outcome that is ultimately positive and sustainable, especially for the people of Afghanistan.’

 Afghanistan opium survey 2023 available here

Related articles:

(Features, November 2023): Stayin’ Alive, Clear messaging on the new family of synthetic opioids, known as nitazenes.

(News, September 2023): Significant shift in Afghanistan’s drug market, with ‘surging’ levels of methamphetamine production, according to a new UNODC report.

(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 opium production, nitazenes, fentanyl and synthetic opioids.

Home truths

By
DDN
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Lack of stable accommodation makes it almost impossible to recover from substance issues. In the third of our latest commissioning series, we look at strong partnerships across the homelessness and substance misuse sectors.

If it’s possible to draw any positives at all from the COVID pandemic, one might be that it demonstrated what proper joined-up action can do when it comes to tackling homelessness. 

In 2020, the ‘Everyone In’ scheme saw 37,000 people who were either sleeping rough or at risk of sleeping rough moved into emergency accommodation, showing ‘just how much can be achieved with the right political will and investment’, said Shelter. 

However, a letter to the prime minister signed by 30 homelessness organisations in June this year pointed out that rough sleeping rates since then have actually gone up, rising by 26 per cent between 2021 and 2022 – the biggest year-on-year percentage rise in nearly a decade (DDN, July/August, page 5). 

As the letter pointed out, the average age of death for someone experiencing homelessness is 43 for women and 45 for men. What’s more, according to ONS, almost two in five of these deaths are related to drug poisoning (DDN, December 2022/January 2023, page 4). Homelessness and unstable housing also ‘substantially’ increase the risk of acquiring hepatitis C and HIV among people who inject drugs (DDN, April 2021, page 5), and according to Crisis, two thirds of homeless people cite drug or alcohol use as a reason for first becoming homeless in the first place. 

These are clearly people who desperately need support, and that support hasn’t always been available. A report from St Mungo’s found that in 2018-19, 12,000 people who were either sleeping rough or at risk of doing so missed out on the drug and alcohol treatment they needed. 

Joint working

All of which clearly reinforces the need for effective joint working between the drug treatment and homelessness sectors, something that’s often been patchy, to say the least. ‘I think it’s not unlike trying to square the circle of dual diagnosis,’ says director of recovery and resettlement at Ara in Bristol, Robbie Thornhill. ‘There’s the historical idea that we have to fix one before we fix the other.’

Things seem to be changing, however. ‘I do think now, with Dame Carol Black particularly, there’s more understanding about how vital stable and secure housing is to drug and alcohol treatment. We’ve been working at the nexus of homelessness and drug and alcohol treatment since 1987 and I really feel there’s a momentum behind looking at the two together.’

Housing shortage

Bristol is a magnet for people from across the South West and South Wales, and as a result is an expensive city to live in. ‘According to the Shelter stats, we have 19,000 people on the social housing waiting list,’ says Thornhill. ‘So if you’re a single male between the ages of 18 and 35 you won’t get housing – they’re advising people to look at private rented options.’

These are also very thin on the ground, however. Properties at the Local Housing Allowance rate – used to calculate housing benefit for tenants in the private rented sector – are in incredibly short supply, and ‘obviously you have everyone going for those’, says Thornhill. ‘So if you don’t have the social housing option, and people aren’t able to access private rented, it’s really difficult – some of my staff can’t get rental properties. And the vulnerable and disadvantaged people we look after aren’t at the same starting line as everyone else – they’re way back.’ 

Homelessness pathways

Bristol City Council commissions four homelessness pathways – men’s, women’s, mixed and substance use – with the latter run by Ara. It also commissions ROADS – the Recovery Oriented Alcohol and Drug Service. ‘We sit in the middle of the Venn diagram between the two,’ says Thornhill. ‘We support people who are homeless or at risk of homelessness and looking to recover from drug or alcohol misuse.’

There are 6,500 dependent drinkers in Bristol and 5,000 opiate users, and like elsewhere that opiate population is aging one. Ara provides a range of housing options – for people who are abstinent, stable on prescriptions or simply motivated to address their drug and alcohol issues. ‘We have different levels, and we also have different sub-contractors,’ he says. Of 140 units, 76 are administered directly by Ara, 54 with one contractor, and ten with another.

Offering choice

Partners include the Junction Project and The Bridge Project, and the strength of the partnership is that ‘we each offer slightly different things’, he says. ‘When someone comes in, there isn’t a template offering of “this is what you must do”. Some people are more likely to benefit from a mutual aid and fellowship approach, while with others it might be more about motivational interviewing. It’s about making sure that we orientate the service to what they need.’

The partners connect every three or four weeks for operational management group meetings, as well as every six weeks to two months for strategic management group meetings. There are also regular meetings with the council, which are led by Ara with other partners attending when they need to. 

One recent innovation has been to use funding from the Housing Support Grant for a service that’s able to work with people in hostels, emergency accommodation, supported accommodation and the private rented sector, as well as those being discharged from residential rehab, prison or hospital. 

‘The council approached a few different providers and talked about how best to use the money,’ he says. ‘We have some challenges in Bristol around access to treatment and continuity of care, and housing definitely exacerbates some of the wider issues that people have.’ 

The council was looking for a way to provide treatment for those unable to access current services, underpinned by the need to help sustain tenancies. ‘So where people are in private rented, helping them to maintain that if things like anti-social behaviour have become a problem with their drinking or drug use. Or if they’re in temporary accommodation, supporting the council to look for ways to get them into other offerings – the homelessness pathways or non-commissioned services where we can make sure they have the stable and secure housing they need to engage in treatment.’

Service Launch

The service launched in July, and is contracted until March 2025. ‘Some of the money we get through the rough sleeper initiative is year-on-year, so having the opportunity to do it for that length of time is fantastic. As well as the increase in the NDTMS numbers we’re going to see because of the group work and one to one, we’ve also worked the current ROADS providers to make sure that people are engaged with treatment – and we’re going after their drop-offs. Where people are falling out of treatment we’re saying, “What’s your need, how can we support you back into treatment – and is housing a part of this?”. 

The new service has a team of ten, all with different specialisms. ‘We have two dual diagnosis workers, and they’re doing one-to-ones with people. A lot of people who are dropping out aren’t able to engage in groups because of their experience or type of trauma. We also have two community engagement brokers – if you’re entrenched quite often your social networks have changed or atrophied entirely so these guys are out there working with people at the drop-ins and giving people some of the resilience they need to maintain their recovery.’

Key messages

So for areas still trying to develop strong partnerships across the treatment and homelessness sectors, what are some of the key lessons? ‘Firstly, we’ve been lucky enough to develop the KPIs with the commissioners,’ he says. ‘There’s a quantitative element to that – they need to see the numbers go up – but what we’ve done is some sophisticated work looking at strategic outcomes for the housing support grant and saying, “How can we fill in the gaps and do something that hasn’t been done before – and doesn’t overlap with services – to improve the stats?”’ 

The other essential is to make full use of partnerships, he stresses. ‘We’ve engaged One25 – a specialist charity that works with sex workers and vulnerable women – and subcontracted one of their team. I could have maybe recruited someone from one of the specialist women’s organisations – leaving them with a gap – but the idea of that rainbow team approach is that they have reach-back into the wider knowledge of that service. Where there are partners who know more than you, embrace that.’

One key gap is community detox, he states. ‘If you live alone you can’t do community detox because people worry about the effects in the first week. We’ve set something up whereby our workers are able to provide that check-in, and it means that people who weren’t able to access community detox now can because our workers can go and see them once or twice a day – it seems odd to me that stuff like that isn’t already in place.’ 

director of recovery and resettlement at Ara in Bristol, Robbie Thornhill
Director of recovery and resettlement at Ara in Bristol, Robbie Thornhill

Ultimately, it’s about innovation, he states. ‘Using the housing support grant in innovative ways to solve the problems that people know exist, but haven’t addressed. I’d be really keen if people in other areas wanted to come and talk to us about this – it’s early days but the stats are fantastic. I’d be happy to talk to anyone.’  DDN

Bristol City Council and its partner organisations, including Ara, have received a range of support from national charity Homeless Link, including training and consultancy. 

This series has been produced with support from an educational grant provided by Camurus, which has not influenced the content in any way. See the July/August and September issues for parts one and two.

 

 

 

 

 

Stayin’ alive

By
DDN
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Nitrazenes and synthetic opioid campaignA new family of synthetic opioids, known as nitazenes, have adulterated a number of illicit drugs in the UK.

It’s not clear exactly when this began, but evidence of them being present in cocaine and heroin was detected in 2021.  

Nitazenes are broadly equipotent to the fentanyls – or in layman’s terms, they’re many times stronger than heroin and morphine. Unknowingly taking a drug containing nitazenes represents a severe risk of overdose. By the summer of 2023 there was sufficient evidence of them contaminating other drugs for OHID to provide a patient safety alert for all of the UK, based on an increase in both fatal and non-fatal overdoses (NFOs).

Nitazenes have been found in contaminated heroin, fake OxyContin (oxycodone) and fake Xanax (usually bromazolam rather than alprazolam), meaning the risk was extending to young people who don’t use heroin but buy what they think is OxyContin from the dark web or a few bars of Xanax from their mate. This group would have no or a very low baseline opioid tolerance to withstand the effects of a nitazene and would be unlikely to have naloxone, putting them at yet further risk. Deaths have escalated throughout 2023, most notably in the Birmingham area in July.

Still recovering from a decade of budget cuts to drug treatment and the unintended adverse impacts of the recovery agenda moving the focus away from harm reduction – and with drug-related deaths escalating every year since 2011 – treatment services were not ready for the severe overdose risk posed by nitazenes. Many of the people most at risk are no longer engaged with services, do not have or carry naloxone, use multiple drugs in combination and are also getting older.

Posters as part of an awareness campaign for nitazenes and synthetic opioidsFirst things first

After communicating the alert the first challenge was to engage with people at risk and offer a form of treatment they would want – whether reluctant returners or newcomers. We need to be more attractive to those people we really should be better at engaging, treating and retaining. In Dr Steve Brinksman’s words: ‘Treatment (OST) protects, you’re less likely to overdose, and if you do overdose you’re less likely to die.’

Many drug treatment services have national leads for harm reduction, and we know, trust and respect each other. We decided that because of the severe threat of overdose we should work together to provide clear advice on how to reduce the risk. A little discussion on X/Twitter with Stephen Malloy of Ethypharm and Dr Judith Yates came about one evening, sharing our concerns as the deaths and NFOs rose and rose.

The plan was simple enough – provide useful advice to people at risk. This came from a genuine place of care and concern. We would all say exactly the same things, and launch on our websites and social media feeds at the same time. The lovely Dr Yates joined in and supported our efforts, and we felt a common responsibility as those with expertise in harm reduction and overdose that we should be the people to lead our organisations and the wider sector through this storm. The unified message we released in mid-July had the advantage that we all had to agree to it before going public, reducing the likelihood of providing poor information. In hindsight we realised that although the advice itself was sound, there was too much of it, meaning it could be overwhelming – or ignored. 

nitazenes posters as part of an awareness campaign

Up and running

The situation developed quickly and in the run up to International Overdose Awareness Day we planned an update, based on the excellent work of Lynn Jefferys of EuroNPUD. We contextualised the work to the UK, resulting in a total of six short messages released on successive days. By then our small group had expanded as more treatment services and organisations like Release wanted to support. Release kindly helped this larger flock to keep together by providing secretariat support. Given the numbers now involved, consensus on the messages was a little slower, but getting it at all is credit to everyone involved. The harms of nitazenes galvanised us.

We arrived at the idea for an individualised overdose plan because we felt too much of the advice given by staff (well-meaning as it is) doesn’t engage people as well as asking them to come up with a plan to account for the circumstances they’re in, the drugs they’re using and the resources available. Ultimately they’re the only ones who know all the detail, the where and when, and – crucially – how they could be found if they did overdose. Our intention is that by asking them to complete a plan it’s far more likely to take account of all the things unknown to us, such as where the spare key to someone’s flat is. It’s also more likely that in making a plan, that person will consider and decide to do the very things we’ve been rattling on about for years – carry naloxone, test dose, go slow and so on. Ironic, isn’t it?

We’re learning all the time about how best to respond to nitazenes – this story is about how our thinking has evolved to counter the threat, especially ‘what works’, and to ensure that the people who are exposed to it make their own plan that keeps them alive throughout it. We’re committed to continue to produce information and advice around these potent synthetic opioids that’s helpful to those using drugs, and that centres around the statement and our shared belief that ‘You are important’. 

The bigger ask of people is to treat any drug as if it’s something else, something they’re not expecting to take – and be aware of the greater need for universal precautions and looking after each other.

Simple Messaging

Information on nitazenesMuch as the intention was always to provide useful information to PWUD so that they could manage the risk, we knew that people reading the advice on our websites or social media accounts were more likely to be those working in the sector. It made sense to recalibrate and look at how we could influence them to influence the people they work with.

In October we evolved again with this in mind and went to HIT with the idea of keeping the messaging simple, empowering workers to have conversations with PWUD about the nitazenes threat and to discuss a plan for overdose with them. We call it a ‘Stayin’ Alive’ plan rather than an overdose plan. 

HIT kindly developed some simple posters on our behalf, which could be downloaded and printed in any service, anywhere.

Download resources here: hit.org.uk/stayin-alive

In memory of the many lost, unnecessarily.

Deb Hussey is national safer lives lead at Turning Point; Jon Findlay is national harm reduction lead at Humankind; Peter Furlong is national harm reduction lead at Change Grow Live; Chris Rintoul is innovation and harm reduction lead at Cranstoun; Maddie O’Hare is deputy director of HIT

Related articles:

(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.

DDN November 2023

By
DDN
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‘A unified message cuts through the noise’

November 2023 DDN MagazineThe campaign to inform people about potentially deadly nitazenes is an essential one (p6). But as well as vital information, we also want to share the efforts to work together across service boundaries to engage with people at risk. This ‘common responsibility’ led to a unified message by cutting through the noise of poor information. It’s so logical to involve people in making a plan that’s directly relevant to them; how often do we throw the information out there and assume that it’s hitting the target? 

This consultative approach is also seen to great effect in our latest commissioning article (p8) and through community work in Leicester with people from a south Asian background (p14).

We have two perspectives on drama in this issue, because both have exciting potential. Anonymous drama (p12) is the opposite of anything ‘stagey’ but it gives permission to examine the hidden depths of our minds and personalities, offering life-changing possibilities for dealing with unresolved trauma. 

Meanwhile sociodrama (p24) can be a useful tool for stepping into the lives of others and exploring the situations they face. Both methods can enhance our understanding if we approach them with an open mind.

Read the November issue as an online magazine or download the PDF here

Claire Brown Editor of DDN Magazine

Claire Brown, editor

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

Scotland expands naloxone provision to community pharmacies 

By
DDN
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Naloxone will now be available in community pharmacies across Scotland, the Scottish Government has announced.

prenoxad
Community pharmacies will hold ‘at least two’ naloxone kits – either nasal or injectable.

The £300,000 Emergency Access Naloxone Scheme will see all community pharmacies holding ‘at least two’ naloxone kits – either nasal or injectable. 

‘Through our national mission to reduce drug deaths and harms, we have invested more than £3m in widening access to naloxone, including through our emergency services,’ said drugs minister Elena Whitham. ‘Police Scotland recently completed a force-wide rollout to 12,500 officers who have used the kits more than 300 times and, according to the most recent statistics, 70 per cent of those who are at risk of opioid overdose are being provided with a lifesaving kit.’

The new scheme service would be a ‘welcome addition’ to existing services, she said. ‘It provides a substantial increase in life-saving emergency access and I’m grateful to all those in community pharmacies who are supporting our £250m national mission to reduce drug deaths. We’ll also continue to focus on getting more people into the form of treatment and support they need, expand access to residential rehabilitation and drive the rollout of life-saving medication assisted treatment (MAT) standards where we are making significant progress.’

Scotland introduced a national naloxone programme in 2011, the first country to do so. However, while the country’s drug death figure fell by more than 20 per cent last year – to its lowest level since 2017  – it remains almost four times higher than two decades ago and is still the highest in Europe (https://www.drinkanddrugsnews.com/scottish-drug-deaths-down-by-a-fifth/).  

Scottish Drugs Forum CEO Kirsten Horsburgh
Scottish Drugs Forum CEO Kirsten Horsburgh

Many people in the sector have also warned about the risks associated with powerful synthetic opioids such as nitazenes and fentanyls entering the country’s drug supply. ‘Everyone seems to know that Scotland has an astonishing rate of drug-related deaths and that was before we saw this emerging trend of new synthetic opioids within the heroin supply,’ said Scottish Drugs Forum CEO Kirsten Horsburgh in August. ‘Alarm bells should be ringing all over government and all through the treatment and support services because we are not prepared.’

Related articles

(Features September 2023) This year the millionth kit of injectable naloxone was distributed. DDN looks back at the story of this lifesaving intervention.

(Features September 2023): Naloxone is safe and easy to use. So let’s get lots more people trained up and carrying it, says Deb Hussey.

(Features February 2023): Turning Point hosted its first Safer Lives conference in Birmingham making a commitment to addressing the drug death crisis.

(News August 2023): An app to highlight places such as pharmacies and needle exchanges that offer free naloxone has been launched by Turning Point and Somerset Council.

(The DDN Conference 2023): Cranstoun’s Worcestershire service talk about their peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.

(News March 2023): Peer-to-peer naloxone programmes can help to reduce stigma and boost confidence, says a new report from the Scottish Drugs Forum

Search for naloxone distribution, pharmacy roles and harm reduction vacancies on DDN jobs

Read more on harm reduction, and naloxone distribution in our archive.

Webchat ‘first port of call’ for people struggling with drugs, alcohol or mental health

By
DDN
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Photo by Sergey Zolkin on Unsplash

A webchat run by WithYou is breaking down barriers for groups less likely to seek traditional support – with more than two-thirds of all users never before accessing professional help.

In a new report, WithYou has analysed seven years of data from its webchat – a virtual service where people can speak to a trained professional about struggles with drugs, alcohol or mental health.

The charity says its webchat has become an important ‘first port of call’ for thousands of people who might be less likely to approach an in-person drug or alcohol service – more than two thirds (67%) of users haven’t previously accessed professional help.

The webchat provides brief interventions, advice, referrals and emotional support, with 20 per cent of sessions provided outside ‘regular’ working hours when in-person services are not available. This allows working professionals, primary caregivers and other groups who can’t or don’t want to use an in-person service the opportunity to get help.

The service also breaks down barriers by offering help to people hindered by stigma, geography or work-life patterns, whilst acting as a pathfinder signposting people to additional programmes and treatment options.

Commenting on the new report, Robin Pollard, head of policy at WithYou, said, “Our webchat service has become a first port of call for thousands of people across the UK who want help with issues relating to drugs, alcohol or mental health.

“More than two-thirds of people accessing our webchat service haven’t previously reached out for support. Whether this is because of geography, stigma, work schedules, or due to a fear of the unknown, we found this virtual service breaks down many of the barriers people face when seeking support.

“The anonymous, confidential, and instant support we can provide plays a vital role in getting people the support they need, and which they often wouldn’t get anywhere else. However, this work is far from over and we know there is so much more we can do with this service. We look forward to using our insights from this report to expand and refine our offer so that we can reach even more people in the future.”

Abby Bradshaw, a virtual support worker who supports people across the UK from her home in Kent, added, “Whether it’s helping a woman detox from methadone, finding treatment options for someone facing eviction from a residential rehabilitation centre or helping young people with high levels of anxiety after a night out, webchat is a safe space where people can seek help anonymously – either for themselves or to get advice about someone they are worried about, without judgement. Chats come in on a one-to-one basis, allowing our support workers to give that person our full support and attention.

“I have supported people seeking help for struggles with drugs, alcohol and mental health since 2016, working in the webchat since 2020. Knowing that the service has had an incredible impact on people’s ability to make positive changes to their lives, I couldn’t imagine working anywhere else. Hopefully, this is just the beginning, we want to expand the webchat service so that we can help more people access support in their own time and in a place where they feel safe.”

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

Humankind opens its first employment focussed drug and alcohol support service in South London

By
DDN
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Humankind has launched its first-ever London employment-focused drug and alcohol support service in the boroughs of Lambeth, Lewisham, and Southwark.

Photo by Clem Onojeghuo on Unsplash

Individual Placement and Support (IPS) services work with people recovering from drug or alcohol dependence and local employers to help those in need of support back into work at the start of their recovery. In addition to a wage, work can support recovery and can give people purpose and the opportunity to build new friendships and connections that can help them move away from drug and alcohol use.

IPS provides intensive, personalised support, starting with a rapid job search to help people find and choose the right job for them and stay in the role. By using a personalised approach to support, IPS helps people find paid jobs that suit their skills and interests within just weeks of being referred to the service. A key component of Humankind’s IPS model is the ongoing support provided to ensure that once a service user enters the workforce, they are supported to stay in their role and build a life around it. Humankind IPS staff also work alongside employers, helping them to meet their recruitment needs and offering ongoing support throughout the employment period.

Cllr Jim Dickson and Cllr Marcia Cameron, Lambeth’s Cabinet Members for Healthier Communities, said, “We are pleased to welcome the Individual Placement Support initiative to Lambeth. It is an important investment in our communities and we believe is the right way to make a real difference in the lives of those suffering the often hugely damaging impacts of addiction.

“Substance abuse not only damages individuals’ lives but also harms families and our wider communities. With specialist and trained workers in place, we will be able to now support some of our most vulnerable residents into employment which will help sustain their recovery and make positive change in their lives.”

Christine, one of Humankind’s service users who was supported through the IPS scheme, said of her experience, “All of this has changed my life for the better. I’m busy now and I’m making my own money and learning new skills. I love interacting with the residents in the care home and I feel good knowing that I’m helping others. The support I received once I started work was really useful as without it, I may have ended up quitting because of any small stress factor. I’d definitely tell anyone to get help from IPS as the support is ongoing and so you’ll be more likely to get and keep a job.”

Now district councils from Southwark, Lambeth and Lewisham have all teamed up to tackle drug use and alcoholism in South London by commissioning us to provide a new service. Humankind has an extensive experience and a track record of producing excellent long-term results through other IPS schemes in various areas of the country including Leeds, Gateshead, and Cumbria.

Humankind Director of Operations for London, Lyndsey Morris, added, “This is an exciting new opportunity for people that use our services in Lambeth, Lewisham and Southwark. Having employment can be a key part of the recovery process, providing a reason to get out of bed in the morning and boosting confidence, motivation, and financial independence.

“We have seen the transformative effect that IPS has had in other areas and our own fantastic team of trained employment specialists are looking forward to delivering this programme as part of an integrated approach to people’s recovery journey.”

Seamus Costello, the Borough Lead for Lambeth Addictions Consortium for South London and Maudsley NHS Foundation Trust said, “As part of our Consortium’s ongoing commitment to deliver excellent treatment and support for our clients, we are delighted to share Humankind’s ambition to ensure all service users have the opportunity to flourish in their communities, with help from Humankind’s introduction of an exciting new IPS programme across three South London boroughs.”

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

Over-supervised, Under-dosed

By
DDN
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supervised OST

This is the second column from the drugs team at Release, where every other month we are putting forward a new case study from our advocacy work to share with others in the sector. Our hope is to spotlight some of the difficulties people face in treatment and shine a light on how people might advocate, both for each other and themselves. 

This time we are writing with Allie, a patient who reached out to Release for support with her pick-ups and under-dosing. Allie has been on the same dose of OST for about ten months. However, her current dose doesn’t hold her, with severe effects from the under-dosing – daily insomnia, trembling, sickness, headaches, anxiety, diarrhoea, nervousness, and dizziness. In short, Allie has a textbook list of withdrawal symptoms, which she could reel off to any doctor if they asked. 

Because of the withdrawal symptoms, Allie was buying heroin to manage. This was neither what Allie wanted to be doing nor was it financially sustainable. To make matters worse, drug alerts for nitazenes, as well as confirmed reports of xylazine in Allie’s local area, meant her heroin was coming from an increasingly unsafe supply. 

So, Allie approached her service to discuss a possible increase to her medication. Release supported Allie in the subsequent review. Though she is formidable at self-advocating in her own right, she feels more confident with an advocate there. 

For a number of reasons, Allie was put onto daily pick-up of her medication during the review, having previously been on a weekly script. During Allie’s appointment, we advocated for a timely review of the pick-up situation, stating clearly that continual daily pick-up would not be feasible in the context of her health and disabilities. 

Regular pharmacy attendance, for some patients, increases their risk of harm rather than reduces it – these patients shoulder the financial and physical burden of attendance, and the practice reinforces stigma and a feeling of being untrustworthy. Allie has several disabilities, which make going outside regularly very difficult, whether it is to get food, go to the GP, or see loved ones. When on daily pick-up, what energy Allie does have is expended on pharmacy attendance. 

Still, Allie negotiated and met the service in the middle, agreeing to supervision on the promise that it wouldn’t become over-supervision, meaning without purpose and with no end-date in sight. We asked for a timely medical review for Allie, but what Allie got was new barriers. The service told Allie that she would need to present ‘clean’ urine screens before any medical review, which was needed both to re-evaluate pick-ups and to discuss Allie’s dose. Imagine an equivalent – once you’ve got yourself better the doctor will see you. 

Such a barrier felt contrary to the basic premise of OST, which is to prescribe in place of street opioids at an adequate dose to alleviate all withdrawal symptoms, as well as the basic premise of harm reduction, which is to meet people where they are at. 

More concretely, the barrier is also contrary to the guidance of the ‘orange book’, which advises in chapter 4 that, for patients on OST who are having to buy street opioids, prescribers could ‘increase dose, if inadequate’ – something that can only be arranged in a medical review. 

What Allie was thus left revolving in was a chicken-and-egg situation. She couldn’t reduce her heroin use without an optimised OST dose, but she couldn’t get that optimised OST dose without reducing her heroin use. 

Over the last few weeks, Allie did reduce her heroin use to nothing, without any support and in a way that she fears is not sustainable. She is struggling and very sick, but her need for her pick-ups to be reviewed and reduced is so great that she is simply pushing through. Allie cannot pay for regular travel, has caring responsibilities, and does not have the energy to walk every day. She is hoping for a medical review soon. But it doesn’t change the fact that she is being asked to do things in the wrong order – sort things out before getting support. 

Fenella Sentance drugs adviser and advocate at Release
Fenella Sentance is a drugs adviser and advocate at Release

In Allie’s words, which put it best, ‘I always think after these decisions, have I done something wrong? Am I doing something wrong? Is there something I should be doing that I’m not? Maybe I’m approaching the service wrong. But I feel like I’m always pleasant to them – I’m not rude. It’s just that the more honest I am, the more I feel I get punished.’

 

‘Significant challenges’ to meeting government’s drug strategy ambitions, warns National Audit Office

By
DDN
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The government will need to address gaps in the evidence base, a lack of focus on prevention and uncertainties about future funding in order to meet the objectives of its 2021 drugs strategy, according to a report from the National Audit Office (NAO).

While the strategy has provided ‘fresh impetus’ there are still ‘significant challenges to address barriers to achieving a long-term reduction in drug use, deaths and related crime’ says NAO, which is responsible for auditing the work of government departments. The report assesses progress so far against the ten-year strategy, publication of which came in the wake of a decade-long ‘surge in drug-related crime and deaths’, it says.

Delays in distributing funding has resulted in underspend, and there has been slow progress in recruiting key medical staff.

Departments have made progress in some areas, the report states, with more than 1,200 new drug and alcohol workers already recruited by local government against a target of 950 by 2024-25, and more than 100 new partnerships established with local areas and representatives from the health and criminal justice sectors. However, delays in distributing drug strategy funding and implementing new projects resulted in a 14 per cent underspend in 2022-23, and there has also been ‘slower progress in recruiting medical, mental health and other professionals.’

Lack of certainty post-2025 is also restricting the ability of local areas to recruit and plan, the document warns, with some ‘already asking service providers to plan to reduce services beyond 2025’. The Joint Combating Drugs Unit has begun to prepare for the 2025 spending review, but it has not ‘developed a plan beyond that date’ the report says. It has also not developed sufficient capacity to ‘draw departmental evaluations together to understand the type of interventions that are effective’, it adds, or the local impact of projects.

While the government has committed almost £30m to reducing long-term demand for drugs, this represents just 3 per cent of drugs strategy funding to 2025, compared to more than £100m for disrupting supply. ‘The UK does not have an effective drug prevention system’, says the report, nor does it yet have ‘the evidence it needs to understand how to change behaviours’.

Gareth Davies: Government needs to develop a longer-term funded plan.

‘The government has shown a clear commitment to reducing the harm caused by illegal drugs by establishing a cross departmental drugs strategy and committing £900m in the first three years,’ said NAO head Gareth Davies. ‘But much work needs to be done ahead of the next spending review to ensure it understands how to develop its approach and achieve its long-term aims. Significant challenges remain, and the current lack of emphasis on preventing illegal drug use means that departments risk only addressing the consequences, rather than the causes, of harm. Government will only achieve value for money if it builds on the initial momentum of the new strategy and develops a longer-term, funded plan that delivers a joined-up, holistic response.’

Nic Adamson: Issues run deep and cannot be solved overnight.

‘The headline facts presented in today’s report speak for themselves,’ added Change Grow Live deputy chief executive Nic Adamson. ‘People and communities are suffering, and whilst we have made some progress with achieving the ambition of the national drug strategy, there is still more to do. We need to create lasting change and welcome the NAO’s call for a long-term implementation plan. Sustained, long term funding and commitment is critical. We have made a start, but the issues the sector faces run deep and cannot be solved overnight or in isolation. Local partnership collaboration is key, only by working together can we address the root causes of suffering and ensure that support is accessible and attractive.

Reducing the harm from illegal drugs at https://www.nao.org.uk/reports/reducing-the-harm-from-illegal-drugs/

National award nomination for member of Forward’s Restart team

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Forward Trust is celebrating a colleague being shortlisted for a national award.

Kirsty Langely, ReStart Scheme Employment Advisor, has been announced as a finalist for Frontline Advisor of the Year award at the Employment Related Services Association (ERSA) Awards 2023.

The category recognises staff and trainers who have shown exceptional commitment working with their caseload in terms of moving people into jobs with opportunities and career prospects and providing in-work support.

Kirsty came to Forward’s employability team having started out as an administrator when she was joined the newly mobilised ReStart team and associated contract Forward holds in partnership with Reed in the Home Counties.

Kirsty’s personal development has been acknowledged by all those around her – where since starting (in 2021) Kirsty supported 136 people into work – with 94% of those supported still in the same job after four months.

At the same time, she has helped settle in new Employment Advisors, providing them with training to familiarise themselves with contract quality and compliance.

The Restart Scheme helps people claiming Universal Credit who have been out of work for at least 12 months to find jobs in their local area.

People that present to Restart may have had previous history of recovering from addiction, those escaping domestic abuse, cycles of crime and risk of cross county lines.

Access to this service if you:

• Are claiming Universal Credit; and
• Have been out of work for 12 months; and
• Live in Thanet, Kent.

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

Change Grow Live backs NAO report

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Nic Adamson, Change Grow Live’s Deputy Chief Executive, responds to the National Audit Office report on the drug strategy.

Photo by Marcin Nowak on Unsplash

The headline facts presented in today’s report speak for themselves, people and communities are suffering, and whilst we have made some progress with achieving the ambition of the national drug strategy, there is still more to do.

We need to create lasting change and welcome the NAO’s call for a long-term implementation plan. Sustained, long term funding and commitment is critical. We have made a start, but the issues the sector faces run deep and cannot be solved overnight or in isolation. Local partnership collaboration is key, only by working together can we address the root causes of suffering and ensure that support is accessible and attractive.

Now is the moment to press forward and address the fundamental challenges drug treatment services have faced for the past decade. We back the NAO’s call for:

  • A long-term evaluation plan, that takes account of service quality, local innovation and meaningful recovery. Measuring the things that demonstrate the overall impact of services, without creating perverse incentives.
  • An end to the funding delays experienced in 22-23, and 23-24, which will ease the pressure on already strained local authorities and services, and give the time needed to plan quality service delivery and recruit new staff.
  • A new, long term implementation plan for the drug strategy, with indicative future funding agreed between departments and the Treasury, enabling sector organisations to agree on the range and nature of services needed over the next 10 years.

The sector is committed to the ambitions of the drug strategy, acting on these recommendations will help us deliver them, and allow services to focus on high quality treatment and sustainable recovery for the people who need.

This blog was originally published by Change Grow Live. 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 Change Grow Live

New EU ‘roadmap’ to address drug trafficking and violence

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A new EU-wide ‘roadmap’ has been adopted to tackle drug trafficking and criminal networks, the European Commission has announced.

Seizures of cocaine in the EU are at an all-time high, with more than 300 tonnes seized in 2021 (https://www.drinkanddrugsnews.com/record-cocaine-seizures-across-europe/), the most recent year for which figures are available. More and more cocaine is also being manufactured in the EU itself, with Europe overtaking the saturated US market as the largest single cocaine market in the world.

Europol’s 2021 European Union serious and organised crime assessment stated that the European drug trade was more violent than it had ever been (https://www.drinkanddrugsnews.com/europes-drug-trade-more-violent-than-ever-says-europol/), with an increase in the number of ‘killings, shootings, bombings, arsons, kidnappings, torture and intimidation’. Last year a Dutch court sentenced 11 men after the discovery of a soundproofed torture chamber hidden in shipping containers.

‘The scale, sophistication and violent consequences of organised crime have become a serious threat to the EU’s security,’ the roadmap document states. ‘As criminal networks’ methods become more sophisticated, so should the EU’s: the response to dismantle these networks needs to be stepped up urgently.’

The roadmap sets out four priority areas, the first of which is a new European Ports Alliance. Almost three quarters of the cocaine seized in 2021 was in Belgium, the Netherlands and Spain, with the trafficking of extremely high volumes through ports like Antwerp and Rotterdam driving the high availability of the drug. The alliance will aim to increase the resilience of ports against criminal infiltration – where port workers are either bribed or intimidated into helping the trafficking gangs – by reinforcing the work of customs, law authorities and others with ‘state-of-the-art scanning and equipment’.

Other priority areas are using financial and digital investigations to dismantle criminal networks, preventing them from recruiting young people, and working with international partners to strengthen law enforcement and judicial cooperation with non-EU countries.

Ylva Johansson: Many innocent people are being caught in the crossfire of trafficking.

‘The threat of organised crime and drug trafficking is worsening,’ said commissioner for home affairs, Ylva Johansson. ‘It is not only affecting rival gang members, but also innocent people, including children, who find themselves in the crossfire. I have said that we need a network to fight a network. This new roadmap, which will scale up our response, is a significant step in building that network.’

‘Customs are on the front line in our common EU fight against drug-trafficking – a phenomenon which causes untold violence, crime and suffering,’ added commissioner for economy, Paolo Gentiloni. ‘This year we have already put forward proposals for a robust, data-driven reform of the EU Customs Union so that, managed by a future customs authority, it can more easily control imports and stop risky goods, such as illegal drugs. In the meantime, we need to ramp up cooperation and information sharing between officials on the ground at entry points to the EU – a proven driver of success in stemming the tide. That’s where the European Ports Alliance can have real added value.’

Communication on the EU roadmap to fight drug trafficking and organised crime at https://home-affairs.ec.europa.eu/communication-eu-roadmap-fight-drug-trafficking-and-organised-crime_en

Possession of nitrous oxide to be illegal from next month

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Possession of nitrous oxide will be illegal from 8 November, the Home Office has announced.

It will become a class C substance, which means that ‘repeat serious users’ could face up to two years in prison, the government states, while dealers could be jailed for up to 14 years. 

nitrous oxide balloons and litter in a park
Use of nitrous oxide is linked to ‘intimidating gatherings on high streets and in children’s parks, often leaving empty canisters scattered across public spaces’, the government states

The secondary legislation also means that anyone in possession of nitrous oxide for the intention of inhaling it could face an unlimited fine, a caution – which would appear on their criminal record – or a ‘visible’ community punishment. 

The ban was first proposed in the government’s Anti-social behaviour action plan, published in March (https://www.drinkanddrugsnews.com/government-bans-nitrous-oxide/), and is part of a ‘zero tolerance approach’ to anti-social behaviour. The move comes despite the ACMD advising the government not to implement a ban, as the harms associated with nitrous oxide are ‘not commensurate with control under the Misuse of Drugs Act 1971’ (https://www.drinkanddrugsnews.com/acmd-advises-government-not-to-ban-nitrous-oxide/). 

The ACMD’s report recommended that nitrous oxide remain under the Psychoactive Substances Act 2016, but warned that regulating it under the Misuse of Drugs Act would put ‘disproportionate burdens’ on its legitimate use across a range of industries and sectors. 

Anyone with a legitimate reason for possessing nitrous oxide – such as catering businesses or maternity wards – will be exempt from the ban, the government stresses. However, there is also a responsibility on legitimate producers and suppliers to ‘not be reckless’ and make sure people have a legitimate reason to buy it, it adds. ‘Turning a blind eye will be committing an offence.’

Use of nitrous oxide is linked to ‘intimidating gatherings on high streets and in children’s parks, often leaving empty canisters scattered across public spaces’, the government states, while heavy regular use carries health risks including nerve damage and paralysis. 

‘We are delivering on the promise we made to take a zero-tolerance approach towards antisocial behaviour and flagrant drug taking in our public spaces,’ said crime and policing minister Chris Philp.

‘Abuse of nitrous oxide is also dangerous to people’s health and today we are sending a clear signal to young people that there are consequences for misusing drugs. Both users and dealers will face the full force of the law for their actions.’ 

DDN Conference 2023

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DDN Magazine Conference 2023

The DDN Conference 2024

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Liverpool – 10 November

Harm Reduction Event – sharing innovation and best practice from across the globe.

2023.hit.org.uk

Gambling levy to raise £100m a year for treatment

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The NHS becomes the main commissioner for gambling services.

The mandatory levy on gambling firms set out in the gambling white paper earlier this year (https://www.drinkanddrugsnews.com/government-plans-mandatory-levy-on-gambling-firms/) will raise £100m in new funding for treatment, research and prevention, the government states. It means the NHS will become the main commissioner of gambling treatment services.

Following publication of the much-delayed white paper, the government is now taking the ‘next step in mandating payments from the sector’ by launching a consultation on the design of the levy. The government is ‘minded to’ set the levy as a 1 per cent fee on gross yield for online gambling operators, and 0.4 per cent for betting shops and casinos, which have higher fixed costs, it states. At the moment the levy is voluntary which means that not all gambling companies contribute equally, with some paying as little as £1. ‘The government is therefore acting to ensure all operators contribute their fair share,’ it says.

A consultation has been launched to gather views, including from those who have experienced harmful gambling.

Under the proposed levy, the industry will also no longer have a say in how the money is spent, with the funding instead being distributed by the Gambling Commission directly to the NHS and UK Research and Innovation (UKRI). The levy will be ‘underpinned by legislation, meaning firms will be required to pay’.

The consultation – which will be open until 8 December – is being launched to ‘gather views from industry, clinicians, practitioners, academics, those who have experienced harmful gambling and the wider public’ the government adds.

‘We know that gambling addiction can devastate lives, which is why we are working quickly to implement our bold plans for reform,’ said gambling minister Stuart Andrew. ‘This consultation brings us a step closer to being able to provide £100m of new funding for research, prevention and treatment, including ring fenced investment for the NHS to help gambling addicts. Gambling firms should always pay their fair share and this new statutory levy will ensure that they are legally required to do just that.’

OHID is consulting on its first ever set of clinical guidelines for alcohol treatment.

Meanwhile, OHID is consulting on the UK’s first ever set of clinical guidelines for alcohol treatment. The guidelines are split into two documents, with the first covering the core elements of alcohol treatment and the second looking at specific sectors and populations.

Gambling levy consultation at https://www.gov.uk/government/consultations/consultation-on-the-statutory-levy-on-gambling-operators

UK clinical guidelines for alcohol treatment at https://www.gov.uk/government/consultations/uk-clinical-guidelines-for-alcohol-treatment/uk-clinical-guidelines-for-alcohol-treatment-consultation-document until 8 December

Breaking the cycle: How employment support enables drug and alcohol recovery

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Photo by Dylan Gillis on Unsplash

WithYou’s Individual Placement and Support (IPS) programme helps people recovering from issues with drugs and alcohol to find employment. John’s story illustrates how the programme can help break the cycle and support recovery.

WithYou’s Individual Placement and Support (IPS) programme offers intensive, individually tailored support to help people recovering from issues with drugs and alcohol to find a job. Employers and employees also receive support together to help ensure that the person keeps and develops in their job.

Access to the right job, with the right support, plays a key role in drug and alcohol recovery. John*, who lives in Cornwall, understands this more than most people. From a young age, John started taking amphetamines, and as he got older, he became addicted to heroin. John has spent much of his life in prison;  since the age of 14, he’s served 15 sentences, including dealing drugs to help fund his drug dependency.

John describes being stuck in a cycle that felt impossible to break: “After finishing one prison sentence, he’d look for work but would be unable to find an employer who’d take on someone with a criminal record. To pay for his drug use, he’d return to dealing, and would then end up back in prison.”

It wasn’t until John found WithYou that the cycle was broken. John was put onto a buprenorphine script and WithYou’s IPS team supported him to find a job. Because of the stability that employment bought John, he’s been able to rebuild a relationship with his family, including with his children.

“The IPS team has helped me break the cycle.
They’ve filled the gap. They find ways around
the barriers so that people like me can
get a chance in life.” – John

John explains, “I started getting in trouble with the police when I was 14. Since then, I’ve been in and out of prison 15 times. I was also using drugs. It started with amphetamines and then I started taking heroin when I got older.

“I made contact with WithYou and they helped me really quickly. They got me onto a buprenorphine script and put me in touch with their IPS team. Vicki, from the IPS team, talks to potential employers to see if they’d be willing to bring on a new employee through the IPS service. She helped me to get a coat and some work boots so that I could do some casual work while I found something more permanent.

“One day, Vicki called me to tell me about a vacancy for a Lived Experience Support Worker and asked if I was interested in applying. I said I was, and she helped me to fill out an application form and prepare for my interview.

“I’ve been working alongside Cornwall Council for a year now. My role involves using my lived experience to support people with a similar background – I’m really enjoying it. I also recently went with Vicki to HMP Exeter Prison and spoke to some of the prisoners about what the IPS service is and how it can help them after they finish their sentence.

“Life is so much better now. When I was in and out of prison, even though I was trying to get help, I was stuck on benefits because I couldn’t find anyone who would employ me. So I’d go out and deal drugs because it was the only way I could make enough money to survive. But now I have a job, I don’t need to go out and sell drugs – and nor do I want to. I also now have a relationship with my dad, and my son actually lives with me, which is really fantastic.”

Vicki Eslick, Senior IPS Employment Specialist at WithYou in Cornwall, said, “In Cornwall, over the last year, our IPS service has supported 185 clients. Of these, 45 individuals have moved into paid work. We’ve matched these 45 clients with employers who we know will treat them with respect, and in return, they’ve gained a new team member who’s motivated and dedicated, and who brings with them diversity and experiences which enrich their current organisation.

“As John’s story shows, as well as the financial benefits, IPS helps our clients to realise their potential, develop a new sense of purpose and gain a sense of belonging – and all of these things play a massive part in someone’s drug and alcohol recovery journey.

“We would strongly encourage any employer who is interested in being a part of our IPS programme – gaining a hardworking and productive team member, while also giving someone an opportunity to change their life – to get in touch with us.”

Kim Hager, Joint Commissioning Manager and Drugs Partnership Lead at Cornwall Council, said, “IPS is a really important initiative for challenging perceptions and stigma around people with drug and alcohol misuse issues. We also know that for many people like John, IPS plays a really important part in how we can empower people to sustain their recovery journeys. Without employment, it can sometimes be really difficult for people to live the life they hope for. I am particularly proud that Cornwall Council have chosen to be one the Employers for this scheme and lead by example.”

John added, “If I hadn’t met Vicki and the IPS team, I’d still be going round in circles. The IPS team has helped me break the cycle. They’ve filled the gap. They find ways around the barriers so that people like me can get a chance in life. I am so grateful to Vicki and the team, and when I think about it, I can’t put my thanks into words.”

*John’s name has been changed to protect his identity 

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

Government consults on wide-ranging vape restrictions 

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The government has launched a public consultation on youth vaping in what it calls its ‘next steps to create a smokefree generation’.

The move follows the recent announcement of its intention to raise the legal smoking age by a year each year, until it applies to the entire population.

disposable vapes
‘Vapes are too often targeted at children, with the promotion of cheap, colourful and sweet flavours commonplace.’

The government is committed to ‘clamping down on vapes being promoted to children while ensuring adults who want to quit smoking remain supported’, it states. The consultation document includes proposals to restrict bright coloured packaging and ‘child-friendly’ flavours for vapes, as well as restricting the sale of disposable vapes which are ‘clearly linked’ to the rise in vaping in children. It also includes plans to regulate point-of-sale displays so that vapes are kept out of sight of children and away from sweets or other products likely to appeal to them. 

The consultation also explores whether increasing the price of vapes will reduce the number of young people using them, as well as considering further restrictions for non-nicotine vapes and other nicotine products such as pouches. 

While it is already illegal to sell vapes to children, it is ‘clear from recent statistics that vapes are too often targeted at children, with the promotion of cheap, colourful and sweet flavours commonplace’ the government states. Rates of youth vaping have tripled over the  last three years, and one in five children has now used a vape, it says. A report from ASH in June this year found that more than half of children had reported seeing e-cigarettes being promoted in shops, and almost a third online. Among children who had vaped, almost 70 per cent said the most frequently used device was a disposable vape – up from 7 per cent in 2021 – with the most popular flavours fruit (60 per cent) followed by ‘sweet or soft drink’ (25 per cent).

The government consultation will run for eight weeks, with views sought from ‘the public, the retail sector, clinicians and medical professionals, public health stakeholders, academic experts, employers and trade unions’. 

‘There has been a surge in vaping amongst children, which is why we’re taking action to reduce the appeal and availability of vapes,’ said health secretary Steve Barclay. ‘Vapes should never be used by children and we’re committed to reversing this trend. We also need to take bold action to protect future generations from the harms of smoking addiction, which damages health at every stage of life and costs the economy billions.’

‘Vaping is less dangerous than smoking but still has risks and can cause addiction,’ added chief medical officer Chris Whitty. ‘Vaping can be useful for smokers to quit, but should not be marketed to non-smokers and marketing them to children is utterly unacceptable.’

Use of e-cigarettes among young people in Great Britain report at ash.org.uk

Day in the life of Mickey Hickman

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Mickey Hickman

Mickey Hickman is the Young Persons & Family Team Manager at Turning Point and has a passion for helping young people which is clear in her daily routine.

No one day is ever really the same, but her boundless energy and desire to help young people and young adults in Somerset means she is ready to take on whatever each day may bring.

Her role takes her all over Somerset to ensure that young people who are struggling with their own or a family members alcohol or drug use get the support they need. Travelling to meet young people in their own home, a YMCA drop-in, or wherever they will feel most comfortable.

Mickey’s dedication has played a significant role in the growth and success of the team of recovery workers at Somerset Drug and Alcohol Service (SDAS) and she was recently promoted to the YP and Family Team Manager. She is an inspiration to many, and her work serves as a reminder that we can all make a positive impact in the lives of others.

Having personal experience of how substance use can affect a family. After losing her sister to addiction, this first-hand knowledge has given her a real desire to help others. She started her career as a primary teacher, where she worked for 17 years, and has gone on to get a master’s in education and management and has recently been promoted to Team Manager, which is a testament to her ability to adapt to new challenges.

Mickey understands that her job comes with its own unique challenges. She said, “You want to save the world, but we aren’t an emergency service. You sometimes need to take a step back, respect the young person’s space, their lifestyle and what they perceive as normal in their world. You need to guide them, give them advice and support so they can make their own decisions”.

If you, a family member or someone else you care about would like to speak to someone at SDAS, please contact Turning Point 0300 303 8788 (24/7 helpline).

Or maybe you have lived experience of the skills and would like to join our team to help others? We have volunteering, peer mentoring, part-time and full-time roles available. We would be happy to hear from you and welcome people from all backgrounds.

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

Breakfast at The Brink – stories of hope and inspiration from the UK’s first dry bar

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Sally Benton, Executive Director of Fundraising and Communications, provides a review of The Forward Trust’s recent event from the Labour Party Conference (Fringe).

On 9th October, The Forward Trust hosted a special event at The Brink, Liverpool. It’s a unique place that offers the friendly, warm welcome you would expect from your local café – but one that goes way beyond expectations to provide an ‘award winning’ recovery hub that provides specialist support to people working through addiction.

In the spirit of its setting, our Breakfast at the Brink event provided a fantastic showcase of the transformative work that is delivered here – day in, day out.

It was a privilege to open the event, a room of staff, supporters and advocates alongside delegates from the Labour Party Conference – who wanted to experience something beyond the political bubble at this unique fringe event.

Next up, we heard from Mike Trace – CEO of The Forward Trust – who explained the reason why addiction services are so integral to thriving societies, but also their worth as community hubs.

We were incredibly grateful to hear from Dan Carden MP (Liverpool Walton) who reflected on the impact of addiction in the UK, the growing and tragic death rates and how policy should respond.

The real unsung heroes of the event were Andy, James and Cath – all taking to the stage to reveal their journey to recovery. The common theme throughout? Community, connection, and hope. The Brink and our day recovery programme SHARP, creates a sense of community, so that anyone, wherever they are on a journey can connect, initiate or continue a journey of recovery. A safe place to share, a dry place, a truly life changing space.

If you haven’t already, I strongly encourage you to watch the full event video below:

Play full video recording below (duration 60 mins)

Thank you to everyone who shared, who prepared the amazing food and joined us to create addiction awareness at the heart of the Labour Party Conference.

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

Free learning event on criminal prosecution diversion for young people

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The free online event is being hosted by WithYou and the University of Kent on 6 November at 10.30 am.

WithYou and the University of Kent are coming together to deliver a free, online learning event.

The session will examine criminal prosecution diversion for young people and the impact of the charity’s Re-Frame programme.

Re-Frame is a pre-arrest diversion which aims to divert children from the criminal justice system when they come to the attention of the police for possession of a class B or C substance. It is delivered by WithYou in Kent, Cornwall, Sefton, and Wigan, thanks to funding from the Youth Endowment Fund. The University of Kent is the chosen evaluation partner for the programme. 

Jake Sinetos, Service Manager at Re-Frame
Jake Sinetos, Service Manager at Re-Frame

Jake Sinetos, Service Manager at Re-Frame, says: ‘I look forward to explaining how our Re-Frame programme works – and how we’re helping to divert children and young people from criminal prosecution.

I will be joined by Nadine Hendrie, trail manager from the University of Kent, who will discuss the randomised control trial and the pilot report evaluation.’

Nadine Hendrie, trail manager from the University of Kent
Nadine Hendrie, trail manager from the University of Kent

‘This is bound to be a really interesting session – book your free place now!’

The event will take place on Monday, 6 November from 10.30am via Google Meet.

It is free to attend. To register, please visit Eventbrite now. 

For further information contact Jo Hamilton, Head of Communications at WithYou on jo.hamilton@wearewithyou.org.uk or 07974883432.

About WithYou

WithYou is a leading UK drug, alcohol and mental health charity. Each year it works with more than 100,000 people in over 120 locations across Scotland and England, providing a free and confidential service without judgement to people experiencing issues with drugs, alcohol or mental health. To find out more, please visit wearewithyou.org.uk

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

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

This content was created by WithYou

A proud tradition

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The Kaleidoscope team in the early daysProud Tradition - Kaleidoscope look back on 20 years of harm reduction

Founded in 1968 by my father Rev Eric Blakebrough, Kaleidoscope’s name comes from the idea of making beautiful patterns from a diversity of people. Kaleidoscope grew from the acorn of a nightclub in the late 1960s that was used as a vehicle for community outreach – the club responded to the needs of those who came through its doors, including around drug use and, in particular, heroin. From the outset Kaleidoscope’s focus was very much about harm reduction and it pioneered needle and syringe exchange and substitute medication. 

Kaleidoscope’s innovative approaches led Newport City Council, the police and the health board to ask Kaleidoscope to set up a service in the city, supporting residents throughout Gwent. The offer was made with no buildings or staff, and with the key stipulation that Kaleidoscope would treat 100 people in the first three months. 

When Newport made their proposal, it was clear that Kaleidoscope could not simply be a London organisation providing services in Wales – there was a need to become Welsh. So in 2003, following a five-year apprenticeship with my sister Adele, who ran the organisation after our father’s retirement in 1993 – I relocated the head office to Wales.

Reverend Blakebrough receiving an award for his services to drug treatment and harm reductionThe team

The first tasks, documented by the BBC, were recruiting a team to establish services in Newport and securing a building. Kaleidoscope set up the services in St Pauls Church, Newport – the congregation and church were incredibly supportive of our work. Some of those initially recruited are still with Kaleidoscope today, including Veronica Snowball, Paul Perry and Sian Chicken. 

The need for our help was clear and many who came through our doors had waited for years to get into treatment. What was particularly special was how grateful people were – it was amazing how service users were towards staff, with real patience shown to us. 

The support of other local agencies helping people with drug and alcohol issues was great including from Drugaid (now Barod) and GAP (Gwent Alcohol Project). The collaborative approach had been missing in England, and it was inspiring to see how agencies worked together. This partnership approach led to us establishing Drug and Alcohol Charities Wales (DACW), now renamed Developing a Caring Wales. Critically, services were no longer in competition with one another.

Team members and clients from Kaleidoscope's harm reduction services

Substitute drugs

Kaleidoscope soon ran out of space and after a few years of working with King’s Church in Newport we took over their building, an old primary school called Powells Place. This building is still the largest dispenser of substitute drugs in Wales. Need then drew us to expand into the Salvation Army Citadel in Tredegar. Initially there was real community hostility, but once they understood what we were doing – notably helping people in their own families and communities – we found we’d moved to an amazingly supportive environment. 

There were difficult days. We initially had a problematic relationship with the statutory NHS service but through partnership working the relationship has gone from strength to strength. Then, and after five years of success, a tender process was put in place and despite exceeding all our targets we lost our Gwent contract. Newport City Council didn’t accept the decision and decided to leave the Gwent consortia, contracting all its services to Kaleidoscope. We only survived because of some real champions and the initial shock turned out to be a blessing as we became contracted to not only treat people medically, but to support care planning. 

We continued to recruit amazing staff and won a wide range of contracts across Wales. The Powys and North Wales services are run in partnership with CAIS (now Adferiad) and, together with Barod, they’re our two most important partners in Wales. Powys is the most complete service as it is both treatment and social support – an innovative and dynamic community service, as well as a criminal justice service. In North Wales we are linked with the North Wales police and crime commissioners, which has been vital in making sure those in the criminal justice system are properly supported. 

Kaleidoscope harm reduction service team membersCriminal Justice

In Kaleidoscope’s early days we existed despite the police. We avoided criminal justice contracts but were approached in 2005 to set up a DTTO and prescribe to people in the criminal justice system. This was a very difficult decision to make, as we were rooted in community services where people chose to use us. Nevertheless, we were persuaded to work in this strange environment, and by doing so we have come across many inspiring people who have been the biggest champions of change. 

We’ve worked together in Wales with third sector agencies with a focus on making real change for some very vulnerable people – most notably, in South Wales through Dyfodol and in Gwent, where we work with G4S and Barod. 

Kaleidoscope harm reduction service clientsPositive futures

Kaleidoscope’s belief is that supporting people with drug and alcohol issues must be about positive futures, not just treatment. The establishment of our peer ‘out of work’ service allowed us to do this. Today this is funded by the Welsh Government, but for most of its 15-year existence it was funded by the EU. The service helps people to gain confidence, training and experience, creating pathways to employment. 

Martin Blakebrough is chief executive of Kaleidoscope

As Kaleidoscope plans the next chapter co-production is a cornerstone of our plans.  The Kaleidoscope board has committed £100,000 per year from investments to develop a team with lived experience to ensure we not only listen to people who take drugs, but that they are shaping our services. We want to amplify the voices of people who use drugs, and this investment is the next step in our co-production journey. This fresh focus will also see the creation of a shadow board comprising peers. 

We always seek to work on an evidenced-based approach, and this drives our innovations. Thus, we’ve always gathered evidence to inform policy. The Senedd Cross-Party Group on Substance Use and Addiction, chaired by Peredur Owen-Griffiths MS, drives an ongoing debate on policy which we facilitate, while the Welsh Council (WCAD) – led by Professor Wulf Livingston and supported by Kaleidoscope – is another way of ensuring research continues to guide the future in Wales.

Find out more at: kaleidoscope68.org

Related Articles

Partnership working – the DDN Conference 2023: Cranstoun’s Worcestershire service’s peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.

Nitazines – harm reduction information: Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.

The Global Forum on Nicotine in Warsaw: The challenges of mainstreaming tobacco harm reduction.

Looking to work in harm reduction? See DDN jobs for the latest vacancies for harm reduction working

More harm reduction articles in the DDN archive.

 

Galloping Gallaghers raise £3,000 for The Greens

By
DDN
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The Galloping Gallaghers have raised £3,000 for The Greens in Sheffield, Humankind’s recovery-focused accommodation.

In line with the third year of Humankind’s United for Fair Chances (UFFC) – the chance for individuals and groups to raise money for many aspects of our work, including our vital Service User Fund – we’re sharing the incredible story of The Galloping Gallaghers. 

Friends of beloved Stefan Gallagher ran 24km up and down the hills of Sheffield to raise an incredible £3,000 for The Greens in Sheffield, our recovery-focused accommodation. 

Recently, the group who call themselves The Galloping Gallaghers challenged themselves to complete the Round Sheffield Run and raise money for The Greens in memory of their friend, Stefan Gallagher. 

The service previously supported Stefan, and in return, the group have been fundraising to show their thanks and help them to keep supporting many other people.  

The team were also joined by team members from The Greens Sheffield who also completed the Round Sheffield Run.  

The Galloping Gallaghers raised a total of £3,000 which has all been dedicated to the service. The staff members and residents have been talking about the use of the money raised, including talks of a defibrillator on site and some adventures to the beach and Peak District. 

Alongside the many donations were some heartfelt messages, including one from Stefan’s dad, Sean Gallagher, “Good luck guys and thanks so much for keeping Stef’s positive spirit and memory alive and helping to raise money for a great cause. He would be proud of you all, just as I am.” 

Thank you to The Galloping Gallaghers for your hard work and dedication. All funds raised will be a huge help to the service and Stefan’s spirit will live on.  

The Galloping Gallaghers are:  

  • Julie Bicknell
  • Tristan Clarke
  • Garan Comley
  • James Coulson
  • Jim Danson
  • Katja Danson
  • Andy Dixon
  • Fran Garretty
  • Jaime Gray
  • Dave Hollinshead
  • Clare Kendall
  • Anthony Major
  • Ben Mooney
  • Sally Mooney
  • Ben Morton
  • Christina Shipley
  • Graham Wilkinson
  • Bill Young
  • Georgia Young

During United for Fair Chances, we have members of the Humankind team completing numerous fundraisers which we will continue to share. If you would like more information on fundraising activities or how to donate, please visit our  fundraising events and initiatives at Humankind.

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

Women being put at risk in ‘intimidating’ treatment services

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DDN
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Women can be at risk of being targeted by abusers in ‘chaotic, intimidating or unsafe’ drug and alcohol treatment services, according to a report from the Centre for Justice Innovation and Staffordshire University. 

Some women were forced to attend mixed-gender treatment groups, which could make it difficult for them to talk about issues associated with their substance use, such as sexual abuse or sexual violence. Others said they felt vulnerable to ‘predatory males’ in mixed-sex treatment spaces, the report states. 

Barriers to accessing treatment were found to be ‘more pronounced’ for members of some minority communities, such as South Asian women
Barriers to accessing treatment were found to be ‘more pronounced’ for members of some minority communities, such as South Asian women

The findings are based on interviews at community treatment services – including one women’s centre – across three local authority areas in the West Midlands. Participants included almost 30 women in treatment along with 20 practitioners, all of whom had experience of both mixed-sex and women-only provision. Treatment workers described women being groomed into sex work after being targeted by male service users, with one practitioner stating that, ‘My experience of women coming in to services is that you do tend to get a lot of predatory males attending services as well. I know over the years it was sort of like a hunting ground.’

Women entering treatment for substance issues have different needs to men, including childcare responsibilities, a more acute sense of stigma and higher incidences of trauma and abusive relationships, the document states. It calls for specialist approaches to women’s treatment that are designed to keep them safe – including spaces appropriate for those with children – and that recognise the ‘strong link’ between substance use and domestic abuse or childhood sexual abuse.

Barriers to accessing treatment were found to be ‘more pronounced’ for members of some minority communities, such as South Asian women or women with an Eastern European background, it adds. Services also still tended to work in silos rather than in partnership with other sources of support such as women’s centres, mental health or domestic abuse organisations, with many of these not offering support to women using substances.

At the DDN Conference in July director of Working With Everyone, April Wareham, told delegates how women at her organisation’s workshops had reported that they’re weren’t offered the choice of a male or female key worker, with female attendees at fellowship meetings often the only woman in the group (DDN, September, page 7). ‘I still go to events now where I’m asked to write my name, phone number and email address on a piece of paper that will then be passed around the room,’ she said.  

‘The government’s From harm to hope drugs strategy recognises that many women are not receiving effective drug treatment, and that changes are needed,’ said deputy director at the Centre for Justice Innovation Vicki Morris. ‘Our research paints a clear picture of how current services run the risk of making women unsafe or failing to give them the support they need. We must take advantage of the government’s investment in new treatment places to provide safer, more effective services for women.’ 

‘Overcoming addiction to alcohol or drugs is an immensely difficult challenge – and this is made even harder for women, who face wider issues which can prevent their ability to engage with treatment services,’ added West Midlands police and crime commissioner Simon Foster. ‘By understanding the unique challenges faced by women and implementing evidence-based practices, we can take the necessary action to ensure a more inclusive and effective treatment system, that supports the recovery and well-being of all people in our community.’

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

Read reports and watch video from the DDN Conference session looking at challenges faced by women who use drugs and the need for more specialist support. 

Government plans ‘smoke-free generation’ 

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DDN
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The government has announced its intention to introduce an ‘historic new law to protect future generations of young people from the harms of smoking’. 

In what would be ‘the most significant public health intervention in a decade’, the legislation would prevent any young people who turn 14 this year – or are younger – from ever being able to legally buy cigarettes in England, effectively raising the smoking age ‘by a year each year until it applies to the whole population’. If passed, the legislation would apply from 2027 – a similar law was brought into force in New Zealand last year. 

disposable vapes
The government will also consult on restricting disposable vapes and regulating both flavours and packaging to reduce their appeal to children.

The government is also more than doubling funding for stop smoking services, it says, with an extra £70m a year to expand local provision. Smoking remains the UK’s biggest ‘preventable killer’, responsible for 64,000 deaths a year in England and ‘almost one hospital admission every minute’. 

‘I want to build a better and brighter future for our children, so that’s why I want to stamp out smoking for good,’ said prime minster Rishi Sunak. ‘These changes will mean our kids will never be able to buy a cigarette, preventing them getting hooked and protecting their health both now and in the future.’

‘Becoming addicted to cigarettes in early life is one of the worst things that can happen for future health,’ added chief medical officer Chris Whitty. ‘Preventing people becoming addicted to smoking, and helping those who smoke to quit are two of the most important measures we can take to improve health.’

The proposal has been criticised as unworkable by some commentators, however, with the Institute of Economic Affairs (IEA) calling it ‘hideously illiberal’ and ‘ full of holes’. It would create a ‘two-tier society in which adults buy cigarettes informally from slightly older adults, and will inflate the black market in general,’ said its head of lifestyle economics, Christopher Snowdon. ‘It may well breach equalities legislation and will very likely be challenged in the courts. It will certainly create huge problems for retailers and may ultimately require a system of national ID cards.’

The government will also consult on restricting disposable vapes and regulating both flavours and packaging to reduce their appeal to children. Alongside restricting the flavours and descriptions of vapes to ensure they’re not targeted at young people, the consultation will cover regulating packaging and point-of-sale displays in shops to keep vapes out of sight from children and away from sweets and other products that appeal to them, as well as restricting the sale of disposable vapes which are ‘clearly linked to the rise in vaping in children’. 

‘Vaping is rightly used by adults as a tool to quit smoking, but the health advice is clear – if you don’t smoke, don’t vape, and children should never vape,’ said health and social care secretary Steve Barclay. ‘It is already illegal for children to vape but in a worrying trend, youth vaping has tripled in the last three years, and more children now vape than smoke.’

E-cigarettes: a double-edged sword in the battle to stop smoking

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DDN
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Photo by CDC on Unsplash

Turning Point Hammersmith & Fulham’s Stop Smoking service lead Stephen Adeniyi discusses the ongoing debate surrounding electronic cigarettes, which has polarised opinions of their use to stop smoking over the last decade.

While e-cigarettes have been embraced as a less harmful alternative to traditional cigarette smoking by some, others raise concerns about their potential to create new addictions and the long-term health effects.  
 
The blog explores the key differences between e-cigarettes and traditional cigarettes, the benefits they offer in helping smokers quit, and the concerning rise of e-cigarette use among young people.  

The difference between e-cigarettes and traditional cigarettes 

Traditional cigarettes are notorious for containing over 5000 ingredients, 63 of which are linked to various types of cancers. Interestingly, nicotine, the addictive component, is not among these harmful ingredients. It’s the combustion of these substances that releases toxins, causing severe health effects. As the late Michael Russell (Scottish Politician) famously said, “People smoke for the nicotine, but they die from the tar.” 

In contrast, e-cigarettes do not contain tar. Most e-cigarettes consist of nicotine, various flavourings, sweeteners, vegetable glycerin, and propylene glycol. Instead of combustion, e-cigarettes function by heating the device, releasing nicotine and other components in the vapour. This heat-based mechanism is considered a healthier option, though not entirely risk-free. The World Health Organization (WHO) has warned about the unknown long-term impact of e-cigarettes on health, especially for those who have never smoked. 

Are e-cigarettes stopping people smoke traditional cigarettes? 

One of the most compelling arguments in favour of e-cigarettes is their potential to aid smokers in quitting. In the year 2020-2021, e-cigarette use was associated with the highest success rates (64.9%) in smoking cessation services, compared to attempts made without vaping devices (58.6%). A noteworthy clinical trial led by Peter Hajek from Queen Mary University of London found that e-cigarettes doubled the success rate of quitting compared to gum or other aids. 

Is vaping creating new addictions? 

Concerns are mounting regarding the increasing popularity of e-cigarettes among young people. In the UK, the percentage of young people using e-cigarettes has risen by 50% year over year, from one in 13 to one in nine, according to a recent report by Action on Smoking and Health UK (ASH). In 2023, 20.5% of adolescents aged 11 to 17 have tried e-cigarettes, up from 13.9% in 2020 and 15.8% in 2022. This upward trend is likely influenced by heightened e-cigarette awareness campaigns both in retail establishments and online. 

Among adults, the prevalence of e-cigarette use in 2023 is at its highest ever, with 9.1% of adults, totalling 4.7 million users. ASH’s August 2023 report indicates that 56% (2.7 million) of e-cigarette users are ex-smokers, 37% (1.7 million) are current smokers, and 320,000 people have never smoked before. 

Are e-cigarettes useful to help people stop smoking? 

E-cigarettes can serve as a valuable harm reduction tool to help individuals quit smoking traditional cigarettes. However, it is crucial not to promote them to people, especially young individuals, who have never smoked conventional cigarettes. Recent data highlights the concern that some current smokers and ex-smokers may have developed a new addiction to e-cigarettes.  

Whilst we support people to stop smoking this Stoptober, it is essential to strike a balance between recognising the potential benefits of e-cigarettes for smokers and addressing the growing issue of e-cigarette addiction among the youth. 

Want to learn more? 

Join our free webinar on Tuesday 17th October 2023 for Stoptober to hear from Turning Point’s Hammersmith & Fulham stop smoking experts and Liam Humberstone, Technical Director for Totally Wicked, the World’s Premier Vaping Retailer. 

Register here.

Need help to stop smoking? 

If you live in Hammersmith & Fulham, our stop smoking support workers are here to provide you free, confidential and non-judgemental support to help you quit smoking.  

Refer yourself today, by following this link.

 

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

For Black History Month we are ‘Saluting our Sisters’ – but equality, diversity and inclusion must also be year-round goals

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DDN
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Simone James, Change Grow Live’s director of inclusion, explains how the organisation is marking Black History Month, and why equality, diversity and inclusion should form a golden thread throughout everything we do.

Photo by Ian Kiragu on Unsplash

As we step into October, we embrace an important annual event: Black History Month. It’s a time to honour the achievements of black individuals, recognise the challenges we still face in dismantling racism, and aspire towards a fair and equal society.

This year, the theme for Black History Month is ‘Saluting Our Sisters’, a tribute to the remarkable work of black women and their place in our collective history.

Throughout this month, we’ll be sharing stories and experiences on our national social media accounts, encouraging everyone to reflect on the inspiring black women who have made an impact.

These stories exemplify why it’s crucial to salute our sisters and celebrate black history. However, let’s acknowledge that championing equality, diversity, and inclusion (EDI) should not be confined to just one month of the year; it should be a constant and integral part of everything we do.

EDI – a golden thread throughout our work

At Change Grow Live, we work closely with some of the most marginalised and stigmatised individuals in society. The people we work with are disproportionately affected by health and social inequalities – so every prejudice or stigma we challenge breaks down a barrier that might otherwise deter someone from reaching out and seeking help.

As an organisation we can help to drive this change by making sure the principles of equality, diversity and inclusion run through everything we do. EDI shouldn’t stand alone; it should permeate every part of our work. It should be a golden thread that runs through all our actions, policies, and processes. Our vision is to be an EDI leader in our sector, fostering an inclusive environment where every individual’s voice is valued – and this vision can begin with making sure our own organisation is living up to its values.

Reporting on our Ethnicity Pay Gap

To help This year, we will be publishing our first ever Ethnicity Pay Gap Report. Reporting on our ethnicity pay data is not a statutory requirement – instead, we believe it’s an opportunity to understand where we can make improvements that live up to our values. It is one of the ways we can identify and investigate disparities in the average pay between white employees and black, Asian, mixed race and other ethnic minority groups in our workforce.

The report will be published later this year, and will come with an action plan to address any areas of improvement that are identified. At the same time, we are also working with an external agency to assess our sustainability as an organisation, including our approach to EDI and race quality.

The aim of projects such as these is to ensure that everyone at Change Grow Live already considers EDI in everything they do. By making these principles a golden thread through all of our work, we can ensure that we are welcoming, inclusive champions for the people we support.

Building a culture of inclusion

In line with our commitment to EDI, Black History Month holds a special place. However, it’s essential to go beyond just the month and celebrate black women throughout the year. Intersectionality comes into play here, reminding us that our celebrations and efforts should encompass and uplift all women, recognising the unique challenges they face.

Our staff, volunteers and the people who use our services can all play a part in helping us achieve these goals. Together, we can continue to promote an open and considerate culture where people feel able to express themselves freely, and to act against prejudice wherever they encounter it.

This blog was originally published by Change Grow Live. 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 Change Grow Live

Half of people living with HIV are over 50

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DDN
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Half of people living with diagnosed HIV are now aged 50 or over, according to the latest figures from the UK Health Security Agency (UKHSA).

This reflects the ‘success of HIV treatment in enabling people with HIV to live long, healthy lives’, the agency states.  

HIV Infection graph

There were 3,805 HIV diagnoses in England in 2022, a rise of more than 20 per cent compared to the previous year. This is ‘likely due to lower testing rates during the COVID-19 pandemic’, says UKHSA. While 36 per cent of the diagnoses were among people previously diagnosed abroad, of the 2,444 diagnoses first made in England just 1.7 per cent were of people first exposed by injecting drug use. 

Lower testing rates as a result of COVID were also likely to be a key reason for the rise in the number of late diagnoses, UKHSA states, which were up from 812 to 865. Among those diagnosed late, the highest death rates were among people exposed by injecting drug use (125 deaths per 1,000) and people aged 65 and over (91 deaths per 1,000). Treatment coverage was consistently high across all exposure groups, with the lowest treatment coverage among those exposed by injecting drug use – although this was still 97 per cent. 

Professor Kevin Fenton
Professor Kevin Fenton

‘The latest data shows the positive results of our ongoing efforts to end new HIV transmissions within England by 2030,’ said chief advisor on HIV to the government, Professor Kevin Fenton. ‘Through our HIV prevention programme and the fantastic work of our local authority and NHS colleagues, we are making positive progress to boost testing uptake and improve timely access to effective treatment.

However, we’re not yet seeing progress across the board and there remain some concerning trends around low testing and PrEP uptake in certain groups, particularly in women and those from ethnic minority backgrounds. Our priorities for HIV control remain the same and must now be accelerated to respond to the emerging trends; scaling up HIV testing, expanding access to HIV PrEP, linking and maintaining patients in high quality HIV care, and tackling HIV stigma.’

HIV testing, PrEP, new HIV diagnoses and care outcomes for people accessing HIV services: 2022 report at https://www.gov.uk/government/statistics/hiv-annual-data-tables/hiv-testing-prep-new-hiv-diagnoses-and-care-outcomes-for-people-accessing-hiv-services-2023-report

In-cell videos to inform and inspire prison clients

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DDN
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Forward is working with HMPPS to produce videos and podcasts that prisoners can listen to and watch in their cells.

Featuring the voice of ‘lived experience’, the content ranges from information to raise awareness of the dangers of misusing substances, to inspirational stories of recovery and rehabilitation.

We have been collaborating with His Majesty’s Prison and Probation Service (HMPPS) to share and develop content for ‘Launchpad’, a digital content hub that is currently available in 15 prisons through in-cell technology, with plans for further expansion in due course.

Inspiration & motivation

We started our collaboration with HMPPS by sharing More Than My Past ‘life stories’ of men and women with lived experience of prison and addiction. The aim was to reach offenders affected by substance misuse and to inspire and motivate them to step forward for help.

Advice & information

Since then, we have also made videos to make prisoners aware of the harm caused by substances. For example, we produced a video on fentanyl (a synthetic opioid up to 50 times stronger than heroin), presenting the facts about the psychological and physical impact of the substance, and how to help people who have overdosed (e.g. through the ‘recovery position’).

We train and support members of our recovery community, Forward Connect, to present the videos, as they are people with lived experience who prison viewers can relate to (e.g. pictured below).


We also use subtitles and graphics to emphasise key information and make it easy to understand and remember.

Mental health

Most recently, we have worked with HMPPS to produce ‘audio workbooks’ to help prisoners manage stress, anxiety and other mental health problems. These feature exercises and activities (such as guided meditations, spoken aloud) that we have used in prison over many years.

We look forward to continuing this innovative work with HMPPS, developing new content in response to need, and to involving current and former service users in the process, bringing the value of their ‘lived experience’.

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

Northumberland Recovery Partnership joins Humankind

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DDN
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The Northumberland Recovery Partnership (NRP) service will join Humankind from 1 October 2023.

Northumberland Recovery Partnership is a dedicated service for anyone in Northumberland aged 18+ who is experiencing problems with drugs and/or alcohol.

The service offers a range of support provided by medical staff, nurses, and dedicated Recovery Navigators. This includes community-based recovery programmes, help to stay physically healthy, and support with people’s next steps into employment, housing and better health. Twenty three staff and four volunteers are transferring to Humankind.

The lead provider for the Northumberland Recovery Partnership continues to be the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) which, from October onwards will be working in partnership with Humankind.

Christine Hutchinson, director of community substance misuse services with Humankind said, “We are really looking forward to working with CNTW to deliver high quality services to the people of Northumberland.”

The service will continue to provide the same range of effective, evidence-based support and wherever possible, people will continue to be supported by the same staff. The main change is to the non-residential rehabilitation service, currently the Oaktrees programme/building. Going forward, this will be delivered using Humankind’s Recovery Academy, a bespoke recovery programme tailored to offer a range of recovery options. This will build on the existing recovery services, ensuring recovery is open and accessible to all from the start of peoples’ recovery journey.

Find out more about the Northumberland Recovery Partnership.

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

Ground Support

By
DDN
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There is increasing recognition of the impact of moral injury - the psychological harm caused by experiences that violate someone’s moral or ethical code. Those affected by it need appropriate and effective treatment, say Amanda Bonson, Gavin Campbell and Dominic Murphy.
There is increasing recognition of the impact of moral injury – the psychological harm caused by experiences that violate someone’s moral or ethical code. Those affected by it need appropriate and effective treatment, say Amanda Bonson, Gavin Campbell and Dominic Murphy.

The concept of PTSD arising from traumatic experiences is widely understood. Accidents, conflict exposure, and violence can, for some, result in lingering psychological difficulties. But what about those experiences which don’t impact a person’s sense of safety, but instead threaten their deeply held moral beliefs about themselves and the world? For those people, we talk not of PTSD, but of moral injury.  

While the exact definition and application of moral injury is still being discussed by researchers and healthcare professionals, the central features of lasting feelings of guilt, shame and anger differentiate moral injury from the classic symptoms of PTSD. Crucially, moral injury results in a breakdown in the relationship the morally injured person has with themselves, their loved ones and the world around them. This contrasts with those with PTSD who often describe a loss of feeling safe as central to their difficulties.

Military veterans in the UK and around the world have described exposure to morally injurious events during their military service, and experiencing mental health difficulties as a result. These potentially morally injurious events may include situations where a veteran is unable to prevent harm, may bring harm to others or feel deeply betrayed by a trusted authority. For example, a soldier may be unable to intervene when a child is suffering or harmed due to their rules of engagement, a drone operator may take the lives of innocent civilians when dropping a bomb to take out an insurgent, or a medic treating casualties may be left with insufficient information or equipment to treat gravely injured patients safely or effectively.   

Mental Health

The impact of exposure to these events on the lives of veterans is significant. They are more likely to experience other mental health disorders such as PTSD and depression, have strained relationships with others and experience suicidal thoughts – they are also more likely to behave in a way that is self-destructive or self-sabotaging. These veterans also tend to have poorer treatment outcomes when accessing therapy services and often feel undeserving of support or recovery, preventing them from accessing support in the first place. 

Increasingly, research is also finding that it isn’t just military veterans who are at risk of moral injury. Journalists, firefighters, police, and veterinarians have also described similar struggles with their mental health following exposure to potentially morally injurious events. In particular, the COVID-19 pandemic shone a light on moral injury among healthcare workers. Frontline workers across roles and specialisms demonstrated being particularly susceptible to moral injury when faced with the death of vulnerable people and when they felt unsupported and unprepared for the moral load of the work they were undertaking. 

Currently there isn’t a specialist treatment approach that therapists can draw on to target moral injury symptoms. Instead, clinicians have told us that they rely on combining a number of different approaches in an attempt to best meet the needs of their patients. Clear clinical guidance on best treatment approaches and how to ensure confidence in what is being provided is also currently lacking. As previously mentioned, research has demonstrated that existing treatments may not fully address the needs of those with moral injury and the barrier to positive changes that such strong feelings of guilt and shame can create. With a significant numbers of people reporting being exposed to potentially morally injurious events, there is a clear need for effective treatments to be developed.

New Treatment

Alongside our colleagues at King’s College London, the research department at Combat Stress – the UK’s leading veterans’ mental health charity – have developed a new treatment for moral injury to meet this need. We’ve collaborated with leading clinical, pastoral and research professionals across the globe to better understand the needs of those with moral injury, and the most effective treatment approaches. From this we have developed a moral injury treatment plan which was then refined in partnership with veterans who had experienced moral injury or exposure to morally injurious events. 

These veterans provided a valuable insight into their experiences of moral injury and how to improve upon the treatments currently provided. From this we developed Restore and Rebuild (R&R), a novel treatment for moral injury. This 20-session treatment was piloted at Combat Stress between 2021 and 2022, with 20 military veterans struggling with conflict-related moral injury. The one-to-one treatment with a therapist aims to provide veterans with an opportunity to share their morally injurious experiences, with a specific focus on understanding and overcoming guilt and shame-based thought patterns and beliefs. R&R also supports veterans in overcoming some barriers and problems in relationships with others following their moral injury, and helps them shape future goals and directions that are meaningful to them. 

Early assessment

The results of the early assessment of this R&R treatment are promising. Veterans demonstrated a significant reduction in symptoms of moral injury related distress, as well as associated symptoms of PTSD, depression and alcohol misuse. There were no drop-outs in treatment, which can often be a particular difficulty when working with veterans who’ve experienced military trauma. When interviewed, veterans who received the treatment described a ‘light bulb’ moment when moral injury was explained to them, finally having a name for the difficulties with which they had been battling. They reflected on improved self-care and relationships with others, as well as being more in touch with the personal values of importance to them. Veterans described an improved quality of life as a result of treatment and, despite the pain of talking through such distressing events, the treatment was seen to be well tolerated. 

So what next? While these results are encouraging, our R&R treatment still needs further rigorous assessment before it can be rolled out to other clinical settings and populations. The next stage of this assessment process is a stringent randomised control trial, which will again be running at Combat Stress starting in 2023 for three years. In this stage, R&R will be compared with the standard combination treatments currently provided to veterans with moral injury, and we hope to be able to report on the findings in 2026. 

Moral injury is a novel term to many people, and it is still finding its place in academia, diagnostic tools and clinical settings. Although research into the field has grown exponentially in recent years, this isn’t a novel experience or type of trauma. It is increasingly clear that there are a significant number of people who struggle with symptoms of moral injury as a result of often impossible moral situations encountered as part of their profession, including professions centred around protecting, caring for and serving those most in need. We hope that R&R offers a treatment option that meets the needs of this population, in a way which current treatments may not. In doing so, we aim to provide effective relief from the heavy weight of moral injury which encourages compassion, understanding and hope for the future. 

Amanda Bonson is a research therapist, Gavin Campbell is a research assistant and Dominic Murphy is head of research at Combat Stress 

John’s Story

‘I joined the Royal Engineers in 1984 when I was 16 and straight out of school. I served in Germany, Northern Ireland, Canada and served in the first Gulf War.

‘I left the army after 14 years as I felt I’d reached the end of my time – I’d done and seen everything I needed to, been to war, got the T shirt and wore medals. I got a civilian job working as a development analyst for an airline and had a successful career in project management, but I knew inside I was an angry man. I didn’t realise I had mental health issues, although I guess everyone  around me soon realised.

‘I had no patience and it wouldn’t take me long to go from calm to taking the world on – it didn’t matter what the consequences would be, in my mind it wasn’t me who had the issue, everyone else had the problem.

‘By 2015 everything was going wrong around me and my relationships were rubbish, I was alienating people who cared about me. In my mind I had a deep, dark secret stemming from my time in the army and I thought if people knew what it was, they wouldn’t like me. I hated myself so how could anyone like me, let alone love me? So, I did all I could to make people dislike me first, no matter who it was – parents, partners, whoever.

‘I finally went to the doctor in 2016 on the ‘advice’ of my family – it was to get help or get out. The doctor suggested I needed help. He had a friend who had served and who had suffered, so I called Combat Stress and within 90 minutes I was talking to a nurse.’

Related Articles

Features/June 2023 – Change Grow Live’s services support an increasing number of veterans who’ve been affected by their service and the return to civilian life. Since signing the Armed Forces Covenant – which aims to ensure veterans are treated fairly – in 2021, they have been committed to making sure that veterans can access support that understands their needs.

Features/December 2020 – Despite high levels of problematic substance use among ex-services personnel, the ingrained forces mentality can mean a reluctance to seek help – something that also extends to their families, says Robert Stebbings.

Addiction Treatment – Tom Harrison House is a specialist facility providing an addiction recovery programme exclusively to military veterans, reservists, serving personnel, and their families.

Read more in our archive.

DDN October 2023

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DDN
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The more we understand, the better we can help

DDN Magazine October 2023With Mental Health Awareness Day this month, we’re looking at some key areas of support. Our cover story explores  moral injury (p6) – an area we haven’t talked about directly  before, but which traces a clear path from combat-related experiences to escaping trauma through substances. Veterans make up a significant part of our DDN community and we hope that this will open up more dialogue with Combat Stress and the other support charities who are ready with highly skilled interventions. 

Meanwhile, the more we understand the reasons for young people’s substance use, the better equipped we are to help them cope with the effects of adversity, abuse and exploitation and can aim for the essential ‘whole school’ approach (p12).

We’re keen to help sustain momentum of your Recovery Month activities, so are sharing forward-looking ideas on recovery protection (p16). And have you heard about Recoverist Month (p10)? The founder began his journey in a homelessness hostel but is now working with inspiring visual artists who hope to be regulars on the cultural calendar. For further inspiration, travel 20 years with Kaleidoscope (p20), trailblazing harm reduction in the community.

Read the October issue as an online magazine or download the PDF here

Claire Brown Editor of DDN Magazine

Claire Brown, editor

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

Blank Canvas

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DDN
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A group of recoverists on their way to see Melanie Manchot’s film Stephen. Portraits of Recovery’s Mark Prest is crouching front centre, with artist and film maker Melanie Manchot to his right.
A group of recoverists on their way to see Melanie Manchot’s film Stephen. Portraits of Recovery’s Mark Prest is crouching front centre, with artist and film maker Melanie Manchot to his right.

From director of an art gallery to living in a homelessness hostel, Portraits of Recovery founder Mark Prest’s own lived experience led him to launch Greater Manchester’s first Recoverist Month.

It was December 2007, almost Christmas, and I was in my dream job. A northern working-class boy had shaken up the status quo and risen from exhibitions officer to director of the City Gallery in Leicester. Until my world came crashing down.

The launch of the Annual Open, our most popular show of the year – more than 100 guests including arts professionals and local government – were invited to view works by amateur and professional artists from across the region. It was a big night. And the gallery director, man of the moment, was inebriated, slurring his way around the show, making barbed comments.

When squeamishly reading the incident report, my crashing into an exhibiting artist’s sculpture leapt off the page. Thankfully no damage was done – the damage was all to my reputation. I ended up suspended, narrowly avoiding dismissal for gross misconduct.

By that point, I had been struggling with alcohol use for seven years. The doctor’s response? Simply ‘don’t drink’. I eventually engaged with drug and alcohol services, but nothing stuck. I was in denial. Time off work meant more drinking time, and things got worse.

Crossing the line

I can pinpoint exactly when I crossed the line from social to problematic drinker. It was after a night out on ecstasy with friends whilst on holiday in South Africa in 2000. I suffered a panic attack. A friend suggested a glass of wine to calm my nerves. It worked. From then on, I self-medicated my acute anxiety issues with alcohol.

The period between Christmas 2007 and April 2008 was a blur. My drinking was out of control, and I rarely went out unless it was for further supplies. Just before Easter, the telephone rang, and I answered – a rare occurrence at this point, as I neither opened the curtains or the mail.

It was a friend from home, and he said he was coming to fetch me. An intervention I now know, as he hadn’t heard from me in ages and feared the worst. I’ve no recollection of him arriving or the 120-mile drive to Oldham, my hometown. I was – I was later told – deposited, a stinking, shaking wreck, at my mother’s house. What I do remember is waking up the next day without booze, suffering two withdrawal seizures, being hospitalised, and having psychosis.

After a spell in rehab, during which I lost my job, I left and quickly relapsed. Worse was to follow.

My poor old mum was due to go into hospital for a long-awaited hip replacement. I was drinking again, and she was rightly fearful of leaving me in the house. So, she called my brother for help.

He arranged for me to stay at a homelessness hostel. I remember waking up the next morning with no clue where I was or how I had got there. I had hit rock bottom. Somehow, I got sober. All that I had learned fell into place, and after getting myself back to AA, I started working a programme.

Arts in recovery

During my time in rehab, I had begun to think about the value and role of the arts within recovery. Undoubtedly the arts were in my blood. Prior to gallery work, I studied for a degree in contemporary glass. From 1991-95 I set up my own studio, selling my work internationally, including to Liberty in London.

The only exposure I had to creativity in rehab was some time-filling, pedestrian colouring in. The arts were only seen as diversionary activity rather than a parallel tool for recovery itself. A seed of thought, planted by a therapist, started my musing on how exploring self through self-portraiture might help socially reintegrate recovering people by redefining their relationship with themselves and their place within the world.

Out of rehab, feeling more stable, and having permanently relocated to Oldham, an opportunity presented itself. I approached the director of Gallery Oldham with a proposal. He was an arts colleague who I knew very well. I was honest about what had happened and explained that if he gave me desk space, I would deliver two arts recovery projects. 

To my amazement, he agreed, getting on board with a series of artist-led self-portraiture workshops by painter David Hancock alongside an exhibition of artworks for and by people in recovery. Called Portraits of Recovery, the title later became the name of the arts organisation I now run.

My second proposal was for an R&D project called Addict, with artist Melanie Manchot. The central premise was an art dialogue in recovery exploring descents into and out of addiction, and for mapping journeys of recovery. This took some six years to realise, later becoming the multi-channel video installation Twelve, which toured nationally.

Lived experience

The Portraits of Recovery pilot was a success. Participant outcomes included enrolment on local arts courses and increased confidence for volunteering. Local drug and alcohol services’ ears pricked up and gallery audiences responded positively to the authenticity of the works on show. What I also realised was that new life opportunities had opened up for me through combining my cultural assets with my lived experience. If it could work for me then why not for others?

In 2011, I founded the visual arts charity Portraits of Recovery (PORe) – an organisation that works with contemporary art, artists and people and communities in recovery to create inspirational art for reimagining the world we live in. It was a slog working from home with little funding. PORe was just me, but I had done it. A raft of projects followed, in a range of art forms, and working with multiple partners. A 2015 project called Typecast saw people in recovery work with clay, to create an exhibition at Manchester School of Art. In 2017, young Asian men in recovery took part in workshops with artist Sutapa Biswas. The work resulted in a bold, neon artwork at Rochdale bus station, now in the permanent collection of Touchstones Rochdale.

In late 2022, I had some incredible news. After a lengthy process, PORe had secured Arts Council England’s National Portfolio Organisation (NPO) status. Alongside securing three years’ regular funding, it also meant national recognition for changing the conversation around addiction and recovery through art. We were now able to run regular programmes throughout the year.

A long-time ambition was to mark International Recovery Month, and PORe’s Recoverist Month launched this year – an annual programme of cultural events for celebrating the aspirational hopes, fears, and dreams of Greater Manchester’s recovery communities. In case you’re not familiar with the term, recoverist = recovery + activist. The programme’s aim is to put recovery communities centre stage by increased visibility and directly supporting the voice of lived experience.

Flagship event

PORe’s aim is to establish Recoverist Month as a yearly flagship cultural event, as a parallel to Black History Month and Pride. As the UK’s only contemporary visual arts organisation working in recovery, we take our mission seriously.

This November, we host a post-Recoverist Month stakeholders’ event at The Whitworth gallery with speakers including mayor of Greater Manchester, Andy Burnham. Sharing our success, we hope to garner support from decision makers for embedding Recoverist Month within Greater Manchester’s annual cultural calendar. No mean feat but after that, who knows: the world is our oyster!

Mark Prest is the founder and director of Portraits of Recovery

 

DELIVERED OVER MANCHESTER PRIDE WEEKEND, artist Harold Offeh set up a vintage radio show-themed art installation in city’s the gay village to explore conversations on chemsex. A packed-out panel discussion featuring high profile figures from Manchester’s queer community followed at Manchester Art Gallery

Coronation Street actor Sue Devaney’s premiere of Didn’t You Used to be Somebody? sold out at HOME arts centre and music producer Quieting recorded thoughts and stories on recovery and homelessness for a musical sound experience at The Stoller Hall.

Melanie Manchot’s first feature film, Stephen (2023), blurs the lines between fact and fiction to examine addiction and recovery. The preview sold out quickly and was moved to a larger screen.

Finally, To the Sun, Moon and Stars saw textile artist Lois Blackburn deliver a series of arts and recovery workshops at Gallery Oldham (back where it all started), commissioned by Oldham Council’s substance misuse team.

 

Early Intervention

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DDN
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Young people mental health issues

Despite what tabloid headline writers may think, the majority of young people in the UK are not perpetual or problematic users of alcohol and illegal drugs – although a significant proportion have tried alcohol or drugs during their lifetime. However, for those who find themselves in difficulties, whether as a result of experimenting with risk-taking behaviours (part of growing up) or something more sinister – such as exploitation at the hands of county lines gangs – the support available needs to be joined-up, effective and well resourced. 

Those young people for whom alcohol or drugs become a serious problem are likely to have been exposed to risk factors such as abuse and neglect, parental substance use, chaotic environments, social exclusion or poor mental health. The single strongest predictor of the severity of a young person’s substance misuse problems is the age at which they start using substances. According to Lankelly Chase’s Women and girls at risk report, responses to adversity, including abuse, tend to be different according to gender. Boys are more likely to externalise problems and to act out anger and distress through antisocial behaviour, and girls to internalise their responses in the form of depression and self-harm. Substance misuse services for young people may need to consider these gender issues. 

The toll of trauma

The impact of such adverse experiences can be profound. According to an article in the Lancet, four per cent of 10 to 19-year-olds experience an emergency admission to hospital due to an injury that is self-inflicted, drug or alcohol-related or due to violence. Of these, 7.3 per 1,000 girls and 15.6 per 1,000 boys died within ten years of their first such hospital admission, with suicide, drug- or alcohol-related deaths, and homicides accounting for 64 per cent of these fatalities. The toll that childhood trauma is taking on young people’s lives is shocking. 

The public health response, quite rightly, has a focus on prevention and early intervention. At a universal level, evidence suggests that prevention approaches that set out to reduce risk and increase resilience are most effective. These approaches focus on such factors as family stability, improving educational attainment, training and employment, and promoting positive health and wellbeing, positive relationships and meaningful extra-curricular activities. Opportunities presented through personal, social, health and economic education (PSHE) and relationships and sex education (RSE) allow for a ‘whole-school’ approach that includes engagement with parents and families. This approach aims to equip young people with the skills and resilience they need to make healthy choices. 

Intervening with addiction at an early stage can help keep a young person out of the criminal justice system and minimise the harm that more long-term drug and alcohol misuse causes to health, social functioning, family life, work prospects and overall quality of life.

In addition, though, as eloquently pointed out by Westminster City Council in their Children and young people drugs strategy 2023-2026, ‘We need to challenge the acceptability and glamourisation of drugs and the “lifestyle” of being involved with dealing drugs’. In 2020 alone, referrals of children suspected to be victims of county lines increased by 31 per cent – not a lifestyle choice that is desirable, and one that’s often made through coercion and that exposes young people to high levels of risk. 

Essential capacity 

The complex nature of mental health presentations means that specialist young people’s services must have the capacity to work hand in glove with children and adolescent mental health services, as well as with troubled family teams, social workers and sexual health services. They also need to have the knowledge to understand, identify and respond to child sexual exploitation and abuse, because of the links to the use of alcohol and drugs. 

There were 11,013 young people in contact with tier 2 and 3 (non-residential) alcohol and drug services between April 2020 and March 2021. Cannabis remains the most common substance (89 per cent) for which young people seek treatment. 

Around four in ten young people in treatment said they had problems with alcohol. Meanwhile, among 17-year-olds in the UK, one in 10 will have used harder drugs such as ketamine and cocaine, according to University College London research.  

Fundamental determinants

Wider determinants of health – such as housing, education and employment opportunities, social support, and personal resilience – are likely to have a fundamental effect on both the risk of drug misuse and the effectiveness of interventions to prevent drug misuse.

The Royal College of Psychiatrists reported that the impact of the COVID pandemic, together with ‘drastic’ historical funding cuts, had prevented young people from accessing the drug and alcohol treatment they need. It said spending on youth addiction services in England had been cut by 41 per cent in real terms since 2013-14, a fact that Dame Carol Black acknowledged in her independent review.  There has been a 55 per cent reduction of the numbers of young people in treatment since the peak in 2008-09. However, the government’s ten-year drug strategy brings with it the prospect of extensive reinvestment in drug and alcohol treatment, and promises early intervention for young people and families at the greatest risk, including through the Supporting Families Programme. 

It sets a target of delivering 5,000 additional treatment places for young people. The government’s mental health recovery plan earmarks funding for children’s mental health services with the aim that an additional 345,000 children and young people in England will have access to mental health services each year by 2023-24. In addition, The Youth Investment Fund will be targeted at areas most in need and will provide investment in new safe spaces for young people, so they can access support from youth workers, and enjoy beneficial activities including sports and culture.

Working with younger alcohol and substance users, whether it be in preventative or specialist services can be challenging but extremely rewarding and, as the figures show, there is no shortage of young people out there needing our help. There is no better feeling than seeing a young person successfully complete treatment and go on to flourish in recovery, with the prospect of building an amazing life for themselves. 

Stuart Croft is manager of Gladstones Clinic

Connecting to flourish

At Gladstones Clinic, a residential detoxification and rehabilitation service in Gloucestershire, where we work with 16- and 17-year-olds alongside the adult cohort, we’ve seen a predominance of ketamine use with all of its associated and very painful health issues. We’ve also seen a proliferation of young people with very problematic relationships with food. We see, as you would expect, a range of co-morbid mental health conditions, care leavers, those who’ve been victims of sexual exploitation and those who are not in education, employment or training (NEET). 

Young people we’ve worked with have been neurodiverse, have had a history of self-harm and suicidal thoughts, have had difficult parental relationships and low self-esteem. Some have a history of offending. We place a great emphasis on addressing behavioural factors and understanding that a pain management personality has developed, and the young person needs support in developing new strategies.  

We’ve also, thankfully, seen some outstanding outcomes and many young people have gone on to build very successful recovery for themselves. Often, they leave rehab to go into well-selected housing where they become connected to a recovery community and begin to flourish. We find that working with them alongside the adult cohort produces some fantastic intergenerational interactions and far from being a problem, it’s a real positive.

 

Inclusion at Forward Trust

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DDN
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Darren Lacey, Inclusion Co-Ordinator at Forward Trust, discusses attending Pride marches, LGBTQ+ staff training and always learning.

For the past 10 months, I have been working as the Inclusion Co-ordinator at Forward, supporting LGBTQ+ clients and staff. The role has helped Forward provide a supportive, non-judgmental service to everyone who needs it. It’s important that we show we are open to everyone, and part of that is making sure that we can provide dedicated support to the LGBTQ+ community.

A few ways I have been able to support the organisation in this goal are; running training sessions about the LGBTQ+ community, attending Pride events under The Forward Trust banner and setting up social events for our clients who are part of the LGBTQ+ community.

This year, I’ve written and delivered training/information sessions to over 300 members of staff explaining the unique needs of the community and how we can all be better allies. One of the fundamental areas of the training is around pronouns and identities, which some people have been worried about due to fear of offending someone by using wrong language/terminology.

We talk about how important it is to speak with people and ask them how they want to be referred to, rather than avoiding the matter for the sake of your own embarrassment. Staff have been incredibly supportive and receptive to the sessions and often bring their own questions to ask me, which is fantastic. We also cover topics more specifically about addiction, substnace use and recovery, such as chemsex which is a growing concern for many in our local communities.

This summer Forward has been attending various Pride events across the country – nine in my last count! These are important to show we are here for support, year-round, not just for Pride Month. We also have one-to-one LGBTQ+ meetings in a few locations and are looking at getting more set up in the coming months. In East Kent we also have a monthly LGBTQ+ social event where we go for a walk and have a picnic, this is proving to be extremely popular with our clients who enjoy meeting each other and are building a real sense of belonging.

We are determined to show that we are a place for everyone and no matter who you are, how you identify, or who you love, you can come to us for the support you need and deserve.

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

Turning Point’s response to the Government’s naloxone recommendations and overdose prevention centre

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DDN
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Photo by Marcin Nowak on Unsplash

Clare Taylor, Chief Operating Officer at Turning Point, responds to the publication of the Government response to the ACMD’s recommendations on naloxone and the news that the UK’s first overdose prevention centre has had the green light in Glasgow.

“Last year, drug related deaths reached the highest on record. We are pleased to see the government has accepted the AMCD’s recommendations and is actively exploring policy changes towards removing barriers in the distribution of naloxone, a lifesaving drug that can reverse an opioid overdose and save lives.  

We also welcome the decision to move forward with the UK’s first overdose prevention centre in Glasgow. There is good evidence from elsewhere that drug consumption rooms can help bring down drug related deaths particularly among individuals experiencing homelessness and ensure that help and support is even more readily available within the community. It will be good to see if this is also the case within a UK context.”  

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

Glasgow consumption room gets go-ahead

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DDN
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The UK’s first official consumption room has been approved by Glasgow’s Integration Joint Board. The facility will be based in a clinic on Hunter Street in the city’s east end. 

A staff member at an Australian DCR - Photo by Nigel Brunsden
A staff member at an Australian DCR – Photo by Nigel Brunsdon, nigelbrunsdon.com

Earlier this month Scotland’s chief law officer – the lord advocate, Dorothy Bain KC – said she would be prepared to publish a prosecution policy stating that ‘it would not be in the public interest to prosecute drug users for simple possession offences committed within a pilot safer drugs consumption facility’, providing a legal basis for the establishment of a consumption room pilot. The Scottish secretary, Alister Jack, subsequently confirmed that the UK government would not block the plans. 

Although the latest Scottish drug death figures showed a 21 per cent reduction on the previous year, the rate is still higher than anywhere in Europe.  

Pride and Prejudice

By
DDN
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As Overdose Awareness Day approached, the millionth kit of injectable naloxone was distributed. DDN looks back at the story of this lifesaving intervention.

naloxoneNaloxone was first developed in the 1960s and used by the emergency services to reverse opioid overdose. It wasn’t until 2005 that it was made available under UK law to be administered by anyone for the purpose of saving a life – but it would be another ten years before drug services could supply naloxone without a prescription.

Evidence swiftly mounted on the success of pilot programmes, showing overdoses were reversed each time it was used. By 2008 we were hearing from groups of clinicians and user groups who were championing the cause with tangible results – but without national guidance or support. The Scottish Government, in recognition of ever-escalating drug-related death statistics, recommended the provision of take-home naloxone (THN). But there were still concerns about legislation and the practicalities of obtaining a ‘prescription-only medicine’ and anxiety around using it. 

At this point naloxone didn’t feature in National Treatment Agency (NTA) targets, but the following year the NTA announced that families and carers of injecting drug users would be trained to administer naloxone in 16 sites across England. There were calls for the pilot to be extended to drug users and their peers – those most likely to be present at the time of an overdose. By 2012 a ruling in Scotland allowed homeless hostel staff to hold naloxone ready for emergency use without prescription; there was optimism that a wider rollout could be getting closer for the whole of the UK.

The first licensed THN product, launched in 2013, pushed open the gate to widening access. Its distribution was still a postcode lottery and there would still be many hurdles to overcome, but pressure was building on commissioners, clinicians, treatment services and prisons to take naloxone seriously and to incorporate it as essential harm reduction.

You Need To Get Angry

By 2014 Scotland, Wales and Ireland each had national programmes of naloxone distribution in place, but in England it had been left up to localism. Activism was audible – ‘you need to get angry. You should all be persuading your commissioners that we need naloxone.’ Some prisons took the initiative on naloxone, but many didn’t. Those which introduced a THN programme to equip prisoners on release took a massive step towards protecting those vulnerable to overdose.

GPs joined the call for everyone to spread the word on naloxone. ‘We need those of you who work with clinicians, those who commission services and those who provide education to recommend the prescribing of naloxone,’ said our regular GP columnist Dr Steve Brinksman, while Dr Judith Yates told us: ‘I believe that it may come to be seen as negligent to prescribe methadone without also prescribing a take-home naloxone kit.’ 

The Naloxone Action Group (NAG), a group of service users, treatment workers and medical professionals, examined the ‘postcode lottery’ through a survey and vowed to challenge every area of the country that was slow or reluctant to roll out distribution or training. 

Release were ready to challenge non-provision through legal action, with ‘very strong right-to-life and human rights arguments,’ said Niamh Eastwood. Outreach worker and activist Philippe Bonnet, who delivered naloxone training at the 2015 DDN Conference, urged: ‘Identify champions and knock down doors, and make use of the service user groups and advocacy groups that can do that on your behalf. But don’t take no for an answer.’

But there was still no national programme or requirement to provide naloxone in England, and the postcode lottery continued. Chris Rintoul, then lead trainer for Street Rx in Northern Ireland, was in no doubt that the Scottish Drugs Forum (SDF) had ‘watered the seeds of take-home naloxone’ and allowed them to kick-start the programme in NI. ‘Before that we had no naloxone, and no sight of it,’ he said. ‘Some of the action involved aggressive campaigning’, developing partnerships with all stakeholders.

Drop in Overdoses

When a change in the law in England allowed outreach services and hostels to give out naloxone, as well as pharmacies, a significant drop in overdoses seemed like no coincidence. Meanwhile on the international stage, the EMCDDA published a Europe-wide review of the case for distributing naloxone, which included good practice and training examples, as well as looking at the legal barriers to distribution.

As the record number of drug-related deaths dominated DDN conference debate in 2017, Alex Boyt drew attention to the fact that ‘people who are dying are not in service, while the naloxone doses are being given to those who are in service. But we’re in a situation where the budgets are being cut so severely that people are just clinging on to what they do and not trying anything new. We need to be saturating the drug-using community with naloxone.’ A few months later Alex Stevens, professor of criminology at the University of Kent said he was ‘saddened and angry’ that commissioners hadn’t got the message that naloxone should be provided to anyone who comes into contact with a person who could be at risk of overdose.

The Local Government Association (LGA)’s Naloxone survey 2017 showed that 90 per cent of English local authorities were making THN available, through treatment services, hostels and outreach workers. But Release examined the THN statistics through freedom of information requests and found that just 12 take-home kits were being given out for every 100 people using opiates. Levels of naloxone provision by local authorities were ‘chronically inadequate’ they stated, as statistics showed opiate-related overdose deaths to be the highest since records began.

Concern was not limited to the sector. Calls for change were being heard from senior police and crime commissioners, who said a ‘grown-up conversation about drugs’ needed to involve equipping the police with naloxone. And while we found some examples of highly effective prison healthcare, treatment providers were finding it rare for any of their service users to have been provided with naloxone on release from prison. The government confirmed in 2018 that there were no plans to make this a mandatory requirement for prisons.

Upward Trends

Activism scaled up further in response to diminishing treatment budgets. ‘Imagine what the drug-related death figure would be if naloxone wasn’t about,’ said Mick Webb, while George Charlton – whose alter ego Naloxone Man would become a regular sight – said: ‘If we’re not giving out naloxone, we’re giving the message that it doesn’t matter if you die. Overdose is reversable, death is not.’ 

In examining the ‘substantial upward trend’ in drug-related deaths, the Drug, Alcohol and Justice Cross-Party Parliamentary Group concluded that naloxone was ‘simply not reaching the people who need it the most’.

The COVID-19 pandemic brought new fears – lockdown measures were compromising the purity of many drugs and dwindling budgets were having an impact on naloxone provision. As 2021 dawned, the government announced an £80m investment in drug treatment in England. Targeted at reducing crime, its ‘system-wide approach’ would include funding naloxone provision for ‘every heroin user in the country that needs it’. Partnerships with police teams and custody suites were encouraging police officers to carry kits. 

Scotland swiftly followed with a pledge of £250m to tackle its record high rates of drug-related deaths and would use some of the money to widen naloxone distribution. A Stop the Deaths campaign included a dedicated website where people could order kits, and Police Scotland confirmed that officers right across Scotland would be equipped with naloxone.

Further Provision

Alongside the government’s announcement that 50 of England’s most deprived areas would receive significantly more funding came the opportunity to further widen naloxone provision in 2022, and the ACMD identified a key role for community pharmacies. Scotland’s Drugs Death Taskforce said developing the world’s most extensive naloxone network was still a key aim in a very necessary public health approach.

As we entered 2023 the SDF shared evaluation of pilot peer-to-peer naloxone programmes in three settings – one urban, one rural and one in prison – which showed the power of peer involvement in saving lives with naloxone. Reporting on initiatives from across the UK in DDN has confirmed the essential role of peers, right up to inspirational presentations at the DDN conference. 

As we commemorate another Overdose Awareness Day there is much to acknowledge – the millionth injectable naloxone kit being distributed to save yet another life – yet still much to do. There are still too many people who have never heard of naloxone, let alone been trained in what to do with it. Do you carry a kit? DDN

This article has been produced with support from an educational grant provided by Ethypharm, which has not influenced the content in any way.

Related articles

(Features September 2023): Naloxone is safe and easy to use. So let’s get lots more people trained up and carrying it, says Deb Hussey.

(Features February 2023): Turning Point hosted its first Safer Lives conference in Birmingham making a commitment to addressing the drug death crisis.

(News August 2023): An app to highlight places such as pharmacies and needle exchanges that offer free naloxone has been launched by Turning Point and Somerset Council.

(The DDN Conference 2023): Cranstoun’s Worcestershire service talk about their peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.

(News March 2023): Peer-to-peer naloxone programmes can help to reduce stigma and boost confidence, says a new report from the Scottish Drugs Forum

Search for naloxone distribution and harm reduction vacancies on DDN jobs

Read more on harm reduction and naloxone distribution in our archive.

 

Scotland consults on raising minimum unit price to 65p

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The Scottish Government has launched a consultation on raising the minimum unit price of alcohol to 65p.

‘Views are being sought on whether to continue minimum unit pricing (MUP) legislation beyond the current term which ends next April, and the level at which it should be set,’ the government states.

Scottish parliament
Legislation is subject to a ‘sunset clause’, meaning that it will expire in April 2024 unless the Scottish Parliament votes for it to continue

MUP legislation is subject to a ‘sunset clause’, meaning that it will expire in April 2024 unless the Scottish Parliament votes for it to continue. The level has been set at 50p per unit since MUP was implemented in 2018, with campaigners arguing that it has failed to keep pace with inflation. There were 1,276 alcohol specific deaths in Scotland last year, the highest number since 2008 (www.drinkanddrugsnews.com/small-increase-in-scottish-alcohol-deaths/). 

A new report from the Sheffield Alcohol Research Group states that ‘even under the most optimistic assumptions’ about how quickly alcohol consumption among the heaviest drinkers is likely to return to pre-pandemic levels – if at all – there is likely to be a ‘marked increase ‘in alcohol harms. High inflation has also ‘eroded the real-terms value’ of the 50p MUP level it adds. 

drug and alcohol policy minister Elena Whitham
Drug and alcohol policy minister Elena Whitham

‘The recent rise in alcohol-specific deaths highlights the need for more to be done to tackle alcohol-related harm,’ said drug and alcohol policy minister Elena Whitham. ‘We believe the proposals set out in this consultation strike a reasonable balance between public health benefits and any effects on the alcoholic drinks market and subsequent impact on consumers, but we want to hear from all sides and urge everyone to take the time to respond.’ 

The minimum unit price should be increased to 65p to ‘match inflation and ensure that this continues to be an effective measure in tackling our nation’s complex relationship with alcohol,’ said policy lead at With You, Graeme Callander. ‘But minimum unit pricing cannot be delivered in isolation. The Scottish Government also needs to commit to the provision of well-funded and readily available support and treatment services for people with alcohol dependence.’

Alcohol – minimum unit pricing – continuation and future pricing: consultation at www.gov.scot/publications/alcohol-minimum-unit-pricing-mup-continuation-future-pricing-consultation/

New modelling of alcohol pricing policies, alcohol consumption and harm in Scotland at https://sarg-sheffield.ac.uk/new-modelling-of-alcohol-harms-in-scotland/

 

 

 

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Turning Point’s Oxfordshire & Slough services achieve micro-elimination

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Photo by Rémi Walle on Unsplash

Two Turning Point treatment services – Oxfordshire Roads to Recovery and Slough Treatment, Advice & Recovery Team (START) – have achieved micro-elimination of hepatitis C.

To achieve micro-elimination status, the services had to meet three criteria set out by the NHS. Every person accessing the services had to have been offered a hepatitis C test; 90 per cent of those had to be tested within the last 12 months; and of those diagnosed with hep C, 90 per cent had to have started treatment.

NHS England has set targets for micro-elimination as part of its goal to eliminate hep C as a major public health threat in the UK by 2025 – five years ahead of the World Health Organization’s global goal of 2030.

The strategy aims to tackle hep C on a national level through local initiatives, ensuring people are diagnosed and given access to treatment. Injecting drug use continues to be the leading risk factor for hep C infection in the UK.

Andy Symons, senior operations manager at Turning Point’s Oxfordshire Roads to Recovery service, said, ‘We are incredibly proud to achieve hep C micro-elimination in Oxfordshire ahead of the NHS England target of 2025.

‘Our wonderful collaboration with the John Radcliffe Hepatology Department and the Hepatitis C Trust has successfully treated over 250 people within drug treatment services, enabling life extending treatment, saving lives and protecting communities in Oxfordshire.’

START nurse Kirsty Sachs played a key role in achieving micro-elimination in Slough. She worked closely with teams from the Hepatitis C Trust, Berkshire Healthcare NHS Foundation Trust and Surrey and Sussex Healthcare NHS Trust to both increase testing and help those who tested positive to engage with treatment. Sachs was recognised for her work at Turning Point’s national Nursing Awards earlier this year.

START’s senior operations manager Alison Finlay said of Sachs, ‘I am so proud of the team for this achievement and, in particular, of Kirsty who has been instrumental to this success. I am also delighted for all our clients who are now successfully clear of hep C.’

Tim, a service user from Oxfordshire who recently found out he was clear of hep C, said of his experience, ‘I have cleared my hep C after being positive for the last 10 years, which is great.

‘My Turning Point worker Michael has been fantastic. I was given hep C meds twice before, but was too scared to take them. Michael gave me the confidence to take them; he came to my house every day to encourage me to stick at it and I am so pleased to be given the all the clear – it has changed my life.’

Forward Trust Patron HRH The Princess of Wales meets families impacted by addiction at HMP High Down event

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Image: The Forward Trust

The Forward Trust was delighted to welcome its Royal Patron, HRH The Princess of Wales, to HMP High Down in Surrey on Tuesday 12th September.

Her Royal Highness met families impacted by addiction to learn about how we are supporting those in the criminal justice system to manage and recover from their addictions.

Her Royal Highness shadowed the experience of a family during a normal visit, starting with the security procedures visitors are required to go through. The Princess heard about the impact that this has on families and the work that HMP High Down has put into making the experience a more positive one for children in particular. Her Royal Highness then sat down with serving prisoners working with Forward whose journey into prison started with an addiction, to hear about the current programmes provided by both the charity and the prison, and support they are receiving for their addiction.

Forward delivers a range of services at HMP High Down, tailored to meet the needs of the men who reside there. These include The Bridge, an intensive abstinence-based programme, Stepping Stones, a low- to medium-intensity intervention for those whose alcohol or drug consumption is at harmful or dependent levels, and Relationships Matter, a series of workshops designed to improve interpersonal relationships and restore healthy communication.

Finally, The Princess visited The Clink, an on-site restaurant which trains prisoners in hospitality, where she met with former prisoners and Forward Trust alumni. Her Royal Highness spoke to those who have worked with and volunteered for the charity in prison and the community and learned how they have been supported to recover from and manage their addictions. Guests in attendance were celebrating recovery by taking part in the first of a series of ‘Let’s Talk About Addiction’ events, in preparation for Addiction Awareness Week, which this year takes place from 28th October to 4th November.

The theme of this year’s Addiction Awareness Week is “Everyone Knows Someone”, which aims to highlight the vast array of people across society who are affected by addiction. During the week families, friends and individuals will be encouraged to join a national conversation, lifting the barriers that prevent sharing the widespread experiences of addiction in society.

Speaking after the event, Mike Trace, CEO of The Forward Trust, said: “The visit today was an emotional testimony of how recovery from addiction not only turns individual lives around but it ripples across families, children and communities. Everyone knows someone who has been impacted by addiction, and we hope that greater awareness means people can start to talk about it more. Forward Trust are privileged that our Patron HRH The Princess of Wales takes the time to listen to the human stories behind addiction. By doing so, more people will feel able to reach out for the support that’s available to help turn their lives around.”

You can support Addiction Awareness Week (#AAW2023) by following The Forward Trust and Taking Action on Addiction social media channels.

To find out more about Forward’s work, email communications@forwardtrust.org.uk.

Watch the short video of the Princess of Wales visiting HMP High Down, Surrey
Narrated by Mike Trace, CEO of The Forward Trust
Video by the Household of The Prince and Princess of Wales

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

Suspected Scottish drug death figures up again

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There were 600 suspected drug deaths in Scotland in the first six months of this year, according to provisional figures from Police Scotland – a 7 per cent increase on the same period in 2022. 

Police Scotland
The data is based on reports from police officers attending scenes of death.

The data is based on reports from police officers attending scenes of death and is not subject to the same level of validation as the official statistics from National Records of Scotland, which are compiled from death certificates and pathologist reports. The most recent official set of annual figures – for 2022 – saw a 21 per cent fall compared to the previous year (www.drinkanddrugsnews.com/scottish-drug-deaths-down-by-a-fifth/). 

After following a downward trend, the rolling total number of suspected drug deaths has ‘increased slightly in recent quarters’, says the Scottish Government. Men accounted for 72 per cent of suspected drug deaths, with 67 per cent of all fatalities occurring among people aged between 35 and 54. The police divisions with highest number of suspected drug deaths were Greater Glasgow, Lanarkshire and Edinburgh City.

Despite last year’s fall in the total number of deaths, Scotland continues to have the highest drug-related death rate in Europe. Scotland’s lord advocate recently potentially paved the way for the introduction of legal drug consumption rooms in the country by saying that she would be prepared to publish a prosecution policy stating that it would not be ‘in the public interest’ to prosecute people for possession offences related to a pilot consumption facility. 

The lord advocate’s statement ‘removes an obstacle’ to establishing the UK’s first official consumption room, says the Scottish Government. A proposal for a pilot consumption room scheme by Glasgow City Health and Social Care Partnership is scheduled to be presented to the city’s integrated joint board of council and health officials at the end of this month, and if approved will then be put out to consultation. ‘Glasgow authorities may now progress their proposal to set up a facility which can operate within the existing legal framework,’ said drugs minister Elena Whitham. 

WithYou announce the appointment of Simon Phillips as Chief Executive Officer (CEO).

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Simon will join WithYou from Macmillan Cancer Support, where most recently he has been Chief Operating Officer, with responsibility for strategy and performance alongside cancer support operations.

Prior to this, Simon was Macmillan’s Executive Director of Strategy and Performance, having been with the team since 2005.   

Simon will replace Belinda Phipps who has been interim CEO for the last three years and leaves the organisation in a strong position and with secure finances. 

Simon brings extensive charity leadership experience, having been an executive leader for over a decade, including organisational strategic development, broad operational expertise, and leadership of setting up specialist services such as the Macmillan Support Line.

Simon will join WithYou starting January 2024.

Simon, commented: ‘I am delighted to have been appointed to lead WithYou from January 2024. I’m incredibly passionate about giving people the support they need to live a happy and healthy life, no matter their background or current situation – WithYou does this without question.

‘I can already see the passion that comes from the staff delivering life-changing services at WithYou, alongside the breadth of specialist expertise delivered to support those most in need of support.’

Anne Chapman, With You’s Chair of Trustees, commented: ‘Simon’s experience means he is the ideal person to lead WithYou on the next phase of our journey as a provider of expert drug, alcohol and mental health recovery services. He has a considerable breadth and depth of charity experience in health and social care, supporting people in what could be the most challenging chapter of their lives.

‘Under Simon’s leadership I am confident that WithYou will continue to thrive and ultimately realise our vision of a future free from harm, suffering or deaths caused by poor mental health, drug and alcohol use, where anyone seeking help feels welcomed, not judged.’

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

International aid money being spent on punitive drug control, says HRI report 

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Almost $1bn from aid budgets intended to help end poverty was spent on the global ‘war on drugs’ over the last decade, according to a report by Harm Reduction International (HRI). 

Cocaine crop
The report is calling for governments and donors to divest from ‘punitive and prohibitionist drug control regimes’ and instead invest in evidence-based programmes such as harm reduction. 

Beneficiaries of the donor funding included police and prosecutors’ offices and projects that increased surveillance and arrests, says Aid for the war on drugs, with at least $70m of overseas development aid going to countries that retain the death penalty for drugs, including Iran and Indonesia. More than 90 developing countries were recipients of aid funding for drug control, the report states, with Colombia receiving $109m and Afghanistan $37m. More than half of the funding for drug control since 2012 has come from the US, at $550m, followed by EU institutions ($282m), Japan ($78m) and the UK ($22m). 

HRI analysed reports of donor spending that are submitted to the OECD each year. ‘Though data availability and transparency vary across projects and donors, this analysis reveals how aid money has supported approaches that undermine global development goals and “do no harm” principles,’ the report states. ‘Put simply: aid funding is supposed to help poor and marginalised communities, while punitive drug control regimes have been shown to disproportionately negatively affect them.’

The report is calling for governments and donors to divest from ‘punitive and prohibitionist drug control regimes’ and instead invest in evidence-based programmes such as harm reduction. 

‘International aid is supposed to help end poverty and support development, not fuel human rights violations,” said HRI executive director Naomi Burke-Shyne. ‘Using aid budgets for drug control doesn’t help meet development goals. These funds are being used to increase policing, surveillance, and arrests of vulnerable people and communities. Drug control must have no place in the future of aid.’ 

‘Governments need to ensure that development assistance budgets are used to promote people’s health and human rights, and not to fund repressive drug control policies which have proven to be harmful and ineffective,’ added chair of the Global Commission on Drug Policy and former New Zealand prime minister Helen Clark. ‘It is particularly abhorrent that development assistance is applied to so-called narcotics control activities in countries which continue to execute people for drug-related offences.’

Aid for the war on drugs at hri.global/publications/aid-for-the-war-on-drugs/

‘Not in the public interest’ to prosecute users of consumption rooms, says Scotland’s lord advocate

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Scotland’s lord advocate, Dorothy Bain KC, has said she would be prepared to publish a prosecution policy stating that ‘it would not be in the public interest to prosecute drug users for simple possession offences committed within a pilot safer drugs consumption facility’.

The move by Scotland’s chief law officer could potentially pave the way for consumption rooms to be legally piloted in Scotland. 

Staff at the MSIC in Sydney Australia observe people while they use their drugs, and provide medical assistance or advice if needed. Photo by Nigel Brunsdon (nigelbrunsdon.com)
Staff at the MSIC in Sydney Australia observe people while they use their drugs, and provide medical assistance or advice if needed. Photo by Nigel Brunsdon (nigelbrunsdon.com)

While she has not been asked to sign-off or approve any facility, ‘prosecution policy is for me alone to set’, states Bain. Scotland’s drug-related death figure has now fallen to its lowest level since 2017, but the country’s drug death rate remains the highest in Europe and the Scottish Government has long been at loggerheads with Westminster over its policy on consumption rooms. The Home Affairs Committee recently recommended the use of consumption room pilots as part of a shift towards ‘public health based interventions’.

The lord advocate’s statement would not cover any offences other than possession, Bain stated: ‘It does not amount to an exclusion zone whereby a range of criminality is tolerated. Police Scotland have operational independence and it has been of the utmost importance to me to ensure that Police Scotland retain the ability to effectively police the facility and ensure that the wider community, those operating the site, and those using the facility can be kept safe.’ 

The Scottish Government welcomed the announcement, stating that it ‘removes an obstacle’ to establishing the first official consumption room facility in the UK. Bain had previously considered a proposal for a pilot scheme by Glasgow City Health and Social Care Partnership. 

‘Glasgow authorities may now progress their proposal to set up a facility which can operate within the existing legal framework,’ said drugs minister Elena Whitham. ‘While the service would still be limited to some extent, due to the reserved Misuse of Drugs Act, we are confident it would save lives. This is not a silver bullet. But we know from evidence from more than 100 facilities worldwide that safer drug consumption facilities work. It is now time to see this approach piloted in Scotland.’

‘We hope the lord advocate’s decision will move Scotland closer to introducing overdose prevention centres in areas where people are most vulnerable,’ added policy lead for With You in Scotland, Graeme Callander. ‘Evidence shows that overdose prevention centres can reduce deaths, encourage safer injecting practices, prevent infections, and increase engagement with treatment and support services. Although some progress has been made in reducing drug-related deaths in Scotland, it simply isn’t enough. As a nation, we need to embrace innovative approaches and commit to making real change in order to save lives.’

Statement on pilot safer drug consumption facility at www.copfs.gov.uk/about-copfs/news/lord-advocate-s-statement-on-pilot-safer-drug-consumption-facility/

Afghanistan sees shift from opium to methamphetamine production 

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There is already a ‘significant shift’ in Afghanistan’s drug market, with ‘surging’ levels of methamphetamine production, according to a new UNODC report.

Methamphetamine trafficking saw a ‘drastic’ twelvefold increase in the five years to 2021, it says, from 2.5 tons to just under 30 tons. 

opium field
The Taliban introduced its opium ban in 2022.

The UNODC found that heroin trafficking had continued, but at a lower rate, since the Taliban returned to power in 2021 and introduced its opium ban a year later. Many people fear that the opium ban – if sustained and successful – will see heroin replaced by far more potent fentanyls and nitazenes in the drug market, with significantly higher risks of overdose. There have already been several reports of nitazenes entering the UK’s drug supply, with agencies warning that increasing levels of synthetic opioids in the UK market could lead to an escalating overdose crisis that mirrors the situation in the US.

OHID recently issued updated guidance on preparing for, and responding to, synthetic opioid threats. 

The levels of methamphetamine trafficking in Afghanistan detected since the opium ban indicate a ‘possible reshaping of illicit drug markets long dominated by Afghan opiates’, says UNODC, with seizures of suspected Afghan methamphetamine reported across the globe. The agency will publish its annual survey of Afghan opium cultivation next month. 

UNODC executive director Ghada Waly
UNODC executive director Ghada Waly.

‘The surge in methamphetamine trafficking in Afghanistan and the region suggests a significant shift in the illicit drug market and demands our immediate attention,’ said UNODC executive director Ghada Waly. ‘This new UNODC report aims to provide the international community with vital information to tackle the growing synthetic drug threat.’ 

‘Shocking as the spectre of further encroachment of fentanyl into UK illicit opioid supply chains may be, the landscape is already more troubling,’ stated a recent analysis by Transform. ‘Fentanyl is just the first of a new wave of synthetic opioids, notably including nitazenes – a family of compounds that include isotonitazene, some 40-50 times more potent than morphine’. Nitazenes were already associated with hundreds of deaths in the US – and 24 in UK in 2021 – it said, with WEDINOS analysis detecting them in substances sold as heroin, diazepam, oxycodone, Xanax and more.

‘There is also growing concern about the use of illegal benzodiazepines – implicated in hundreds of drug-related deaths in Scotland (often when used with heroin) every year, and growing numbers across the UK. Again, if heroin becomes less available, the incentive to use “street benzos” as well will increase.’

Understanding illegal methamphetamine manufacture in Afghanistan.

Taliban opium ban: what the future holds at https://transformdrugs.org/blog/taliban-opium-ban

Celebrating recovery with Peer Mentor graduates in Somerset

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As we celebrate Recovery Month, a graduation ceremony took place in Taunton, Somerset for those that have completed Turning Point’s Somerset Drug and Alcohol Service’s (SDAS) ‘Peer Mentor’ training programme.

The group of graduates are all people who have successfully completed treatment through SDAS and will now be able to support others suffering with addiction.
 
The programme is a 10-week, level 2 accredited training course which will enable them to support SDAS service users, co-facilitate groups and work with the relatives of service users.
 
The new group of Peer Mentors will now be able to use their own experience of treatment and recovery to support other service users to achieve recovery too.  
 
Alice, SDAS Peer Mentor said,  “I lost my child through alcohol addiction. I gave up my job as a mental health nurse. I lost my whole life and ended up remanded to prison… I am very passionate about recovery. About women in recovery, about Mums and Dads in recovery. Let’s remove the stigma that goes with that. We want to shout at the top of our lungs that we’re people. We are very capable and proud to have done this course.”
 
National Recovery Month (September) promotes awareness and understanding of substance use and encourages individuals in need of treatment and recovery services.  The month is an opportunity to celebrate individuals living lives in recovery and to recognise the dedicated workers who provide the prevention, treatment and recovery support services that help make recovery possible.
 
Professor Trudi Grant, Director of Public Health at Somerset Council said,
“The Peer Mentor training programme is so important as it is exactly these people who are best placed to help others living lives so familiar to them.  
 
“Their lived experience will be a vital tool in helping to provide the essential non-judgemental support that others living with addiction so truly need.
 
“This group of new Peer Mentors have been on an incredibly inspiring journey and it is a remarkable achievement to have completed the course and now be able to make recovery a possibility for others.”
 
Joseph Olubodun, Peer Mentors and Volunteers Team Leader at SDAS added, “Money cannot buy all the knowledge and experience of the lived experience that our mentors will now bring to enhance our service delivery for those clients still in treatment.  
 
“We salute them all and celebrate their wonderful achievement.”
 

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

With You: Building brighter futures for children in East Dunbartonshire

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The team from With You’s East Dunbartonshire Service, Scotland

The team behind With You’s service for young people in East Dunbartonshire may be small, but it’s certainly having an impact.

Referrals to the service have increased by nearly 40% since January, highlighting the urgent need for support tailored to those under the age of 25.

“Children as young as 11 years old come to us for help,” says service manager Christine McCauley. “The support they need is completely different to what would be provided by an adult service. We have a great reputation with partner agencies in our area, because they know that we are helping young people at a really critical point in their lives.”

Christine’s team of two substance misuse workers, Aaron and Hannah, meet the young people they support several times a week in order to form a relationship and build up trust. As well as holding one-to-one sessions, they support young people to attend meetings with other organisations, such as their school and social work.

The service is able to make direct referrals to With You’s CBT and trauma therapists, meaning its clients can access this support without having to join the long waiting list for CALMS.

Christine explains: “Some of the young people we support are using substances because of trauma, they are looking for a way to numb painful feelings. Others have started using substances because they want to have a good time and it gets out of hand.

“I really worry about the mental health of the younger generation. We meet so many young people who have anxiety, they feel like they don’t fit in. So they turn to substances for a feeling of confidence.”

With You has been proudly supporting the people of Scotland for almost two decades. Our person-centred drug and alcohol services are deep-rooted in communities across 12 local authority areas, from the busy streets of Glasgow to the rural pockets of Dumfries and Galloway.

“A 14-year-old boy came to us because he was using cannabis. It was affecting all areas of his life — from his relationship with his parents, to his learning at school.
Just three years later, his head teacher describes him as a ‘model pupil’. He got great results in all his exams and he is a keen sportsman! He’s 17 and the world is his oyster.”
-Christine McCauley, service manager at With You in East Dunbartonshire

Dedicated to reaching as many people as possible, we also provide national support online via our webchat service and on the phone, offering free, confidential advice on drugs, alcohol, and mental health.

If you’re worried about your own drug or alcohol use, or if you want advice for someone you know, please get in touch with us via our webchat service or by contacting one of our local services — we offer free, non-judgemental advice to whoever needs it: https://www.wearewithyou.org.uk/help-and-advice/find-service/

This blog was originally published by With You. 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 With You

Ophelia House – A place for women

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Photo by Becca Tapert on Unsplash

Carly Dawson, Head of Quality and Performance, gives some insight into Phoenix Futures’ Ophelia House, a Trauma Responsive Therapeutic Community developed to meet the needs of women who require abstinence-based residential treatment in a safe and therapeutic environment.

The differences between women and men who use substances and access treatment are widely documented. We know that women are more likely to be involved in sex work, have more extensive histories of trauma and abuse and have greater caregiving responsibilities.

Women are more likely to encounter additional barriers such as stigma, housing instability, lack of childcare and fear of losing custody of children. It is thought that when women access services, their needs are greater than men’s. Women present with higher levels of distress, mental health needs, and complex inter-related family issues.

There is a direct correlation between early trauma and drug misuse, with women often using substances to self-medicate mental health issues stemming from early life experiences and trauma. Research has found that women who experience domestic abuse are eight times more likely to have substance use needs compared to those who have not.

Traditional treatment services tend to be male-dominated environments that cater for the majority and overlook the specific gendered needs of women. Despite widespread acceptance of the need for women-only treatment services, there is a distinct lack. Women’s only environments can help foster healthy attachments, provide positive peer reinforcement through shared life experiences, strengthen self-expression, and help individuals develop skills.

Ophelia House, delivered by Phoenix Futures, is a Trauma Responsive Therapeutic Community developed to meet the needs of women who require abstinence-based residential treatment in a safe and therapeutic environment.

The programme, delivered by an all-female staff team, is based on the Therapeutic Community model where social relationships, daily structures and various activities are deliberately designed to support health and well-being. Women live together and learn from each other. The community helps individuals emotionally and supports the development of behaviours, attitudes, and values of healthy living.

The structure supports the whole person and acknowledges that substance misuse is not an issue that can be addressed in isolation from many other factors impacting mental, physical and emotional well-being. Our treatment service provides ‘psychosocial support’, which refers to the actions that address both psychological and social needs of individuals, families and communities.

We have worked with partners across the substance use sector and alongside women with lived experience to develop the service, creating an environment to serve better those who have experienced trauma. For those women we spoke to, the majority felt there needed to be onsite counsellors and mental health support. They also felt the group programme needed to be gender specific and responsive to the needs of women in treatment.

The Ophelia House programme seeks to provide a safe and empathic therapeutic environment to address gender-specific needs and develop social skills such as validation, empowerment, and empathy, which have been considered critical for attachment and recovery in groups of women.

Our model has been developed using evidence and best practice around trauma-informed approaches to care, with staff trained to recognise and respond sensitively to the effects of trauma. Being trauma-responsive, we have carefully considered the layering of a holistic group programming, the needs of the physical environment, our use of language and our values.

Our history of providing gender-specific residential treatment has shown us that women-only services, characterised by all-female residents and staff teams, can provide a specially designed environment and programme delivered by an appropriately trained staff team to help women feel safe. This sense of safety and trustworthiness enables honest and open discussions about shared women-specific issues, creating an improved community of support and empowerment between residents and a focus on building individualised and highly personalised skills and resources to aid long-term recovery.

We created our treatment programme to be reflective if this. Offering a minimum three-month programme incorporating a range of sessions aimed at supporting recovery from trauma as well as accredited workshops, and therapeutic activities, including the Freedom Programme.

The structured group programme enables people to share and learn together in groups facilitated by expert staff. We take a holistic, trauma-informed approach, addressing physical and mental wellbeing through a range of health and wellbeing activities, including regular yoga and gym sessions and regular participation in Recovery Through Nature.

Our Recovery through Nature programme enables people to come together with a common purpose to complete conservation projects. Being with others, exercising together and working to create a positive environmental impact is proven to aid a sense of belonging and in turn, mental well-being. We bring together these core interventions and other specialist interventions, such as 1:1 counselling to support trauma, mental health and substance use so that they fit together in a blended approach to care.

The Ophelia House team comprises a Psychologist, Counsellor, Registered Nurse and Therapeutic Workers in a multidisciplinary team. They work together across different care disciplines to create a safe therapeutic environment to deliver coordinated and personalised trauma-responsive care bolstered by the peer support of a Therapeutic Community.

Ophelia House offers 26 single en-suite bedrooms, including those adapted for women with mobility needs. We listened to those with lived experience who expressed that the physical environment can impact an individual’s sense of identity, worth and dignity and its role in individual mood and well-being. We mobilised the design concept to ensure the physical space promotes a sense of safety and is calming for people accessing treatment and those who work there.

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

Igniting the debate

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GFNDDN visited the Global Forum on Nicotine in Warsaw to hear about the challenges of mainstreaming tobacco harm reduction.

Earlier this year we looked at tobacco harm reduction and observed that smoking still causes 8m deaths a year. Why had there been so many false starts on finding safer ways to use nicotine? Despite brilliant innovations and the launch of safer products – thanks to consumer-driven breakthroughs in tobacco harm reduction (THR) – we learned about inertia in public health, varying resistance through global politics, conflicts within the tobacco industry, and confusion surrounding tobacco control organisations, who resisted the notion that safer nicotine products could be used recreationally (DDN, February 2023).

Paddy Costall
Event co-founder Paddy Costall

So when DDN was invited to the tenth Global Forum on Nicotine (GFN), it seemed like an interesting opportunity to see key players in active debate. As the event’s co-founder Paddy Costall said, ‘Ours is the only conference in the smoking, tobacco and nicotine arena that welcomes all the players involved in tobacco harm reduction – consumers, regulators, parliamentarians, manufacturers and scientists – with no bans on who can attend or who can speak.’

A Sense of Optimism

Gerry Stimson at the GFN
‘The event was born from a sense of optimism’, said co-founder Prof Gerry Stimson

The event was born from a sense of optimism, said co-founder Prof Gerry Stimson. ‘We thought we were on the cusp of a breakthrough, and that with safer nicotine products, millions of premature deaths from smoking could be avoided. If played right, we felt sure that harm reduction for tobacco could be a huge individual and public health success.’ The last ten years had been a challenge, with regulators, parliamentarians and legislators changing the pace of progress. But he still remained confident that ‘it’s not a matter of whether tobacco harm reduction will happen, but when’.

Fifty ‘thought leaders’ from the field were invited to speak. They looked at the milestones of the last ten years, assessed a complex political, regulatory and scientific environment, and debated the challenges of the future. The flavour of the event was energetic and respectful, and characterised by a willingness to listen. Despite the great divide between countries that were being constrained by poor policy and regulatory obstacles and those buoyed by a wave of progress and consumer interest, there was a sense that sharing the science could translate into helpful take-home messages.

There were bound to be more questions than answers. A session called ‘The Big THR Conversation’, chaired by UK public health expert Clive Bates, asked: How can the last decade influence and inform the next?’ What are the dynamics? What causes success or failure? Why does the World Health Organization (WHO) do what it does? Why is the science a mess? Why is there such indifference to that? What role should the industry play? How do we see the world of nicotine in 15-20 years?

Entrenched Positions

As delegates from different countries gave their thoughts, we heard about narratives changing – or positions becoming more entrenched. In some countries there were very active communities of users, linked by social media; in others, vaping was still new to politicians accompanied by ‘a lag in public health awareness and understanding’.

Snus
Snus – a smokeless tobacco pouch, placed under the top lip

Comments from a Swedish delegate illustrated this. He had been in the Court of Justice when consumers challenged a ban on snus and said, ‘What happened in court made me decide the ban on snus [a smokeless tobacco pouch, placed under the top lip] was 100 per cent political. A hundred pages of scientific evidence were ignored.’

There was discussion about the reasons for banning THR products. Bans made good headlines (delegate from the US); bans make politicians look like they have potency (Clive Bates, session chair); prohibition and a ban is a much easier sell to the public (Fiona Patten, former politician from Australia). There were different routes to prohibition, from changing the law to making the products as unappealing as possible.

The Tobacco Industry

The involvement of the tobacco industry in THR, primarily vaping, had been a double-edged sword. Alongside their innovations, they ‘brought their reputational baggage into the room’, which hardened attitudes towards vaping products. The Foundation for a Smoke Free World, set up to ‘end smoking within a generation’, belonged to Phillip Morris and was launched at a tobacco industry event. No wonder there was cynicism.

But in this forum, the industry was a welcome contributor to the debate – a partner in driving up product standards and keeping illicit (and possibly dangerous) products outside of the marketplace. New products to emerge included nicotine vapes, Swedish-style snus, and nicotine pouches – none of which burned tobacco, and all of which had been shown to be significantly safer than combustible cigarettes. An estimated 112m people used these products worldwide.

Success Stories

In some countries, ‘amazing progress’ had translated into public health success stories; for instance in New Zealand Maori smoking had plummeted after introducing vaping. The Philippines had ‘got over the line’ with vaping because of consumer advocacy, and a turning of the tide meant it would soon be legal to vape in Malaysia and Thailand. 

For others, progress was being frustrated. Last year Mexico banned vapes on World No Tobacco Day – a decision that was ‘science-free and a political gesture’, according to Bates – while in South Africa a new tax on vaping was likely to push people back to cheaper tobacco and Australia was also cracking down on vaping. In England there were positive signs of free vaping kits being distributed – but also a media-driven narrative about young people becoming addicted. 

The WHO continued to oppose safer nicotine products for smoking cessation and to publicly deride tobacco harm reduction. All eyes were on the WHO Framework Convention on Tobacco Control Tenth Conference of the Parties (COP10) in Panama this November, which GFN feared could have ‘grave implications for global public health’.

We needed to be mindful that ‘science has become subordinate to the political argument,’ said Bates. But the endgame was that the THR debate was very useful – it could solve COPD, cardiovascular disease and cancer while involving a stimulant that people enjoyed using.

For many, the debate served to re-energise efforts to take THR to the next level. ‘We need to keep kicking those doors,’ commented a delegate. ‘It’s easy to be negative, but we’ve done incredible work.’

‘Nicotine doesn’t cause cancer and when we make people realise this then we can discuss lower levels of harm of the products,’ said another. ‘There is not one single golden bullet.’  DDN

Headline Ruse

Don’t believe everything badged as research, said Roberto Sussman.

‘I understood indoor smoking bans’  – that people needed to be protected from my smoke. But not outside bans. Bullshit alert!’ Dr Roberto A Sussman waved his arms around theatrically and the audience responded to his lively presentation. A full-time senior researcher and lecturer at the Institute of Nuclear Sciences at the National University of Mexico, Sussman had nipped across from the world of cosmology to write peer-reviewed research on e-cigarette aerosols.

There’s a nasty short circuit in tobacco science that would never have happened in physics,’ he said. ‘Outdoor smoking bans are social engineering, and their goal is not health driven. It’s about eradication of conduct.’ The question was – could this be justified for vaping? Are we going to allow denormalising of vaping as was done on smoking?’

Tobacco harm reduction was seen as a Trojan Horse of the tobacco industry, he said, a way of bringing in young people, young addicts.’ There was a toxic academic environment in which technically sloppy papers were published to support policy.

‘Research ignores that most usage is experimental,’ he said. ‘Frequent vapers tend to be those who have tried tobacco and/ or smoking. The vaping youth epidemic is a political construct.

Dr. Roberto A Sussman is a lecturer at the Institute of Nuclear Sciences, National Autonomous University of Mexico. He is also the director of the non-profit association Pro Vapeo Mexico.

 

 

 

Related articles

(News, August 2023): 40 per cent of smokers in the UK think that vaping is ‘as or more risky’ compared to smoking up from 27% last year.

(News, June 2021): Health professionals can recommend e-cigarettes as tools to help stop smoking, according to new draft guidance from NICE and PHE.

(Features, February 2023): The genie’s out of the bottle – embracing tobacco harm reduction could end smoking within a generation, says Knowledge Action Change.

Read more articles on tobacco harm reduction, vaping and smoking cessation in the DDN archive.

DDN September 2023

By
DDN
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Remember how much impact we can have.

As we go to press on this issue it’s International Overdose Awareness Day and we’re never far from thinking about everyone we’ve lost.

DDN Magazine September 2023Our collective efforts on harm reduction will make the world a safer place – from collaborative commissioning (p18) to distributing naloxone (p14 and 24). This issue’s articles remind us of the struggles, but demonstrate how much impact we can have. 

The conference coverage – and pics! – are not just a souvenir of a grand day out in Birmingham, although it was wonderful to see everyone. The level of engagement and participation was extraordinary, even with such exceptional speakers. The Big  Conversation (p20) not only gave us a snapshot of experiences across the country but also many thoughtful and constructive ideas. 

It absolutely confirmed that there are many roads to  doing things – in the way that matters to each of us. Putting on an event of this nature is hard work for all involved  and we would like to thank everybody who gave their time to be a part of it, from the consultation on the programme to support and participation on the day.

Please help us to strive for more by giving us feedback on your experience.

Read the September issue as an online magazine or download the PDF here

Claire Brown Editor of DDN Magazine

Claire Brown, editor

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

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