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 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.
As Overdose Awareness Day approached, the millionth kit of injectable naloxone was distributed. DDN looks back at the story of this lifesaving intervention.
Naloxone 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.’
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.
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(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.
(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
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.
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
‘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.’
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.’
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.
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.
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.
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 beprepared 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.
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.
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).
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.’
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)
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.’
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.
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.
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.
‘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.’
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.
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.
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.
DDN 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).
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
‘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 – 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.
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.
Our 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.
With over 500 delegates and more than 40 exhibitors the DDN conference this year provided an opportunity to share ideas, get inspired and work together.
The first session focused on stigma, with Karen Biggs, CEO of Phoenix Futures outlining the aims of the Anti Stigma Network and inviting delegates and organisations to join.
April Wareham of Working with Everyone and Hannah Shead, CEO of Trevi looked at the specific challenges faced by women who use drugs and the need for more specialist support.
Callie Davidson of the Safe Ground project talked about how they are working with serving prisoners to challenge stigma and thrive.
The second session focused on peer power. Alistair Bryant and Luke O’Neil from Cranstoun shared genuine examples of co-production to develop their dynamic harm reduction initiatives including peer led naloxone distribution and innovative tech to create the BuddyUp app.
Laura Pechey from the government’s Office for Health Improvement and Disparities (OHID) and Lanre Babalola and Ade from BUBIC along with Ged Pickersgill from The Well Community discussed their shared determination to embed lived experience in the treatment system.
Marcus Johnson, Christiane Jenkins, and Karolina Sowinska from SUIT shared innovative ways they’re engaging with the wider community, including challenging specific issues around stigma faced by people in Asian and East European communities.
The afternoon session centred on THE BIG CONVERSATION – a chance for delegates to contribute to the debate, let people know what’s working, what needs to be done and ideas for how it should happen. Topics ranged from personal experience of treatment, how peer involvement can save lives, challenging stigma and looking at ways we can organise, mobilise and influence.
We would like to thank all of our sponsors, exhibitors, magazine supporters who made this event possible and whose continued support allows us to keep providing a free publication.
Supported by:
If you attended this year’s event we would be grateful for your feedback which will help shape next year’s conference. All contributions will be entered into a draw for a £50 Amazon voucher!
At-a-glance Information
Timings and venue: 13 July, The National Motorcycle Museum, Birmingham. The closest train station is Birmingham International and there is free parking available onsite.
Delegate registration from 9am, First Session 10am, Lunch 1-2pm, Afternoon Session 2-3.30pm Conference close 3.45pm
Delegate information: Tickets include refreshments and a cooked lunch with vegan and gluten free options available. The venue has free wifi. Tickets include access to all sessions, the exhibition area and free access to the motorbike museum from 3.45pm.
Exhibitors and Group Bookings: If you have booked an exhibition stand all of the information you require is here.
Programme/Times
The programme will run from 10am–4pm including a lunch hour and tea and coffee breaks.
Sessions will focus on tackling stigma with direct action and a new campaign, demonstrating how we can all create strong and effective partnerships between people with lived experience, commissioners and services, practical advice and support around overdose prevention, BBVs, family support, brief interventions and personalised treatment, and pathways to and from treatment.
The vibrant exhibition area will be at the heart of the event. It features community groups, treatment providers and support services, to share ideas and inspiration, offer information and support and give practical training and demonstrations. Refreshments will be on hand while you enjoy networking!
If you have a stand booked all the details you need are here.
Delegate Places
Tickets are £145 + vat for professional places and £95 + vat for volunteers and people with lived experience/people who use services
Tickets include full access to the presentations and exhibition, tea, coffee and refreshments, a full cooked lunch and access to the National Motorcycle Museum in the afternoon!
Venue Access and Accommodation
Situated on junction six of the M42 and providing free parking for cars, buses and coaches, as well as being just five minutes away from Birmingham International Train Station and Birmingham Airport, the National Conference Centre at the National Motorcycle Museum provides easy access for all delegates attending for the day.
The DDN Team are staying in the Arden Hotel which is close to the conference venue. You can book online or on 01675 445605.
There are other hotels close by in the NEC or Birmingham city centre is only 20 minutes away.
If you have any questions or would like to discuss the event please contact ian@cjwellings.com
Working together, we will challenge stigma and build better fairer treatment systems for everyone – systems that are responsive and work for every single person, no matter what stage they are at.
The event is welcoming, inclusive, optimistic and inspiring – but at the same time we are not afraid to challenge what’s not working. By learning from each other we create an experience that goes beyond the event.
Over the past 15 years of this conference you – the participants – have helped to change the treatment landscape and started conversations that have led to truly innovative partnerships. The networking throughout the conference, exhibition (and frequent refreshment breaks!) has resulted in new peer groups and initiatives that have galvanised peer power and representation in many areas and recognised the value of lived experience.
We have challenges ahead, but also many opportunities to directly shape our treatment services. This year’s theme, Many Roads, recognises there are many directions, individual needs and preferences involved in treatment, which we will look at together. But there are also certain elements that we must all move in the right direction with – tackling stigma and seeking out positive partnerships.
If this chimes with you, we want to see you and hear you at the best networking event you can circle on your calendar! Last year it was amazing to be able to get together in person after so long. This year we are action-driven and determined to make this the most dynamic – and enjoyable! – conference ever.
Naloxone is safe and easy to use. So let’s get lots more people trained up and carrying it, says Deb Hussey.
Part of my role as Turning Point’s safer lives lead is expanding naloxone provision, and as an organisation we’re committed to ensuring that naloxone is available to anyone who may need to use it.
I’m passionate about service user involvement, so the DDN conference is always a highlight in my calendar. For this year’s conference I was delighted to showcase our Carry Naloxone co-production campaign alongside providing naloxone training to almost a hundred attendees.
Our Carry Naloxone campaign started back in 2021 after an international review highlighted the low numbers of people carrying a naloxone kit on a daily basis. Most overdoses are thought to occur with someone else in the room or nearby, making early intervention possible – but that person needs to have a naloxone kit. Alongside colleagues Jennifer Scott and Jo Kesten from the University of Bristol – and funded by Somerset Council – we aimed to develop a project to increase awareness and carriage of naloxone.
We started by running a short survey with people who use Turning Point services in Somerset, to see if the numbers reported in the 2021 study were borne out locally. The results were sobering – 87 per cent who responded said they had a naloxone kit but only 26 per cent carried one. Forty-six per cent had experienced an overdose, with more than half having overdosed between two and five times.
User Involvement
For this project to be a success we knew that we needed to actively involve the people we wanted to reach, and we recruited five people who were using our services to work alongside us as part of a co-production team.
We held our first focus group last summer. Recruitment had initially been challenging – people thought it was a tick-box exercise, that their opinions wouldn’t be listened to, and it probably wasn’t until the second group meeting that they began to see their ideas were being taken seriously.
That’s my favourite part of co-producing projects – the moment when you see people start to understand that their contribution has meaning. Entering this project, I fully expected that our focus would be on making naloxone easier to carry. That’s why it’s so important to come to the table with a willingness to adapt, and why people with lived experience should always be consulted in projects that affect them.
Stigma
Ease of carriage was raised as an issue, but as the consultation progressed a larger issue emerged – stigma. The co-designers felt that carrying a naloxone kit identified them as someone who uses drugs, so the need to challenge public perceptions and normalise naloxone as a first aid medication became our primary objective.
Working with artist Michael Linnell, the co-designers’ ideas were developed into three posters – there’s also an app to direct you to the nearest naloxone supplier that can be accessed via a QR code on the posters, an idea from one of the co-designers. The app is currently only available in Somerset but we have a set of posters without the QR code that can be used nationally. Getting to showcase the posters at DDN’s conference was a great opportunity to introduce them to a wider audience.
At a concerning time for the sector with the increased overdose risk from synthetic opioids, this Carry Naloxone campaign is part of Turning Point’s wider commitment to increase naloxone training and carriage rates among family members, friends, people who inject drugs (whether they’re in treatment or not), and people working in services and across key parts of the public sector including health, housing and criminal justice.
At present, under the Human Medicines Act 2015, only those ‘employed or engaged in the provision of drug treatment services’ are able to issue the medication without prescription. While we wait for policy to shift, we’re doing all we can to develop more joined-up approaches and increase training and carriage rates across all groups.
Click and deliver
A new naloxone click and deliver service available through the Turning Point website launched on International Overdose Awareness Day in Somerset. This allows people to order naloxone kits online and have them delivered straight to their homes, and will be particularly beneficial for those who may be reluctant to collect a kit from the pharmacy. Following a trial period, we hope to roll the scheme out across Turning Point services nationally.
Prison training
At one of our services, HMP Thameside in south-east London, as well as running drug and alcohol rehabilitation programmes, we train prisoners and prison officers in how to use naloxone. Seamus Tobin, Turning Point’s senior operations manager at the service, has been stressing the need for naloxone for prison leavers for almost a decade. Even if someone leaves prison and dies within six weeks, it’s still classed as a death in custody. After securing a six-month naloxone pilot through NHS England in 2020, the Turning Point team at HMP Thameside trained and handed out around 450 naloxone packs in that period.
The programme at HMP Thameside is now permanent thanks to funding from NHS England. ‘The people carrying the naloxone packs – it’s not their lives they’re going to be saving, it’s someone who’s using in their community and overdoses,’ said Seamus.
(The DDN Conference 2023): Cranstoun’s Worcestershire service talk about their peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.
Medication that can save the lives of people who are overdosing on opioids has recently been used by staff at Wicker Pharmacy following training by Humankind’s service Likewise.
Following timely training by our new local drug and alcohol service, Likewise, pharmacy staff used naloxone to revive two people. Naloxone is a medication that temporarily reverses the effects of an overdose from opioids like heroin. When administered, it buys crucial time while waiting for the emergency services to arrive.
Our new community service recently launched in Sheffield on 1 August offering support to people experiencing issues around drug and alcohol use. Likewise is a partnership between national charity Humankind and Project 6.
One aspect of this support is harm reduction, which includes equipping people who use drugs, their friends, loved ones and professionals with naloxone kits and training them to use the medication effectively in an emergency.
Staff at Wicker Pharmacy undertook training sessions with Likewise during August to ensure they were able to respond should someone near their premises accidentally overdose.
Within one week of completing this training, staff members were called upon to apply their learning in real-life situations where people had overdosed. Without hesitation, they stepped up to save their lives.
One of these staff members was Joseph Ridge, a trainee pharmacy technician at Wicker.
“A member of the public came into the pharmacy reception and said that someone had collapsed nearby,” Joseph said. “As soon as I could, I went down the street and saw three other members of the public stood around the person collapsed on the floor. The members of the public were already on the phone to the ambulance service.”
Joseph realised the person’s condition was extremely serious, so he called his colleague and asked them to bring the pharmacy’s defibrillator and their naloxone kits.
As soon as his colleague arrived, he administered the naloxone to the person in need. There was unfortunately no response at this point.
Joseph remembered from his training that further doses of naloxone can be administered if someone experiencing an overdose remains unresponsive after a short amount of time has passed. After a couple of minutes, he decided to try again and administered a second dose of naloxone.
“Thankfully, the person did then come around,” Joseph said. “They still weren’t fully with us, but they were now moving on the floor. Quite quickly after that, the emergency services arrived and continued to tend to them.”
In no uncertain terms, Joseph’s ability to effectively apply the learning from his naloxone training saved the person’s life.
A similar situation occurred the same week as this incident on Wicker Pharmacy’s premises, which also led to another member of their team administering naloxone to someone they suspected was experiencing an opioid overdose. Their life was also saved by this team member’s action.
“The naloxone training was really useful,” Joseph continued. “There wasn’t anything I felt unsure about. It was obvious the person was unconscious and the ambulance service on the phone was also very supportive. They said if there was naloxone available, I should definitely use it. There was no hesitation from anyone involved.”
All staff at Wicker Pharmacy who may find themselves in a similar situation have now been fully trained by Likewise and equipped to use it in an emergency, like Joseph and his colleague.
Jon Findlay, National Harm Reduction Lead at Humankind who led the naloxone training with Wicker Pharmacy staff, said: “Knowing people have directly saved someone’s life after engaging with your training offer is one of the most rewarding feelings I can imagine. Joseph and his colleagues are nothing short of heroes and I’m so thankful to them for carrying naloxone. It cannot be said enough: naloxone saves lives.”
Ellie Bennett, Managing Director at Wicker Pharmacy, said: “When we organised the training, I wasn’t expecting it to be put it into practice so quickly, but thanks to Jon from Likewise our staff felt confident enough to administer the naloxone when it was needed. I am really proud of the way they responded.”
Graham Parsons, Pharmacy Director at Humankind, said: “Forging strong partnerships with people and organisations in local communities is at the heart of what we do. Without those partnerships, our work to support people with their drug and alcohol use, and ultimately reverse the trend of increasing deaths due to drugs, would be far less effective.
“We want to thank Wicker Pharmacy staff for their dedication to this cause and encourage anyone who wants to engage with our harm reduction training to contact us.”
Greg Fell, Director of Public Health at Sheffield City Council, said: “The prompt actions of Joseph and his colleagues at the Wicker Pharmacy are recognised and applauded. The fact that they had been trained and were in possession of naloxone at the times of these events undoubtedly saved the lives of two people.
“Naloxone is a game-changer, it is effective and very simple to use. Training can be provided.
“Sheffield City Council, in collaboration with Humankind and Likewise, is currently reviewing and expanding the provision of naloxone across the city and together we hope to save many more lives”
International Overdose Awareness Day takes place on 31 August every year. People who use drugs, their friends, loved ones, professionals, and even members of the public who may encounter someone they suspect could have overdosed are being encouraged by the new Likewise service to engage with their free naloxone training, get a kit, and save a life.
Harm reduction is seen as one of several key tools in plans to reduce drug related deaths across England and Wales, which hit their highest levels on record in 2021 according to ONS data.
Visit www.likewisesheffield.org.uk to learn more about the services Likewise provide and contact them for more information.
This blog was originally published by Humankind. You can read the original post here.
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.
(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
Release, alongside EuroNPUD and other drug treatment service colleagues in the UK, have produced harm reduction advice on nitazenes.
There has been an increase of nitazenes detected across the UK drug supply. These substances are a class of synthetic opioids that are believed to be as strong (or stronger) than fentanyl.
The 2022 Afghan ban on heroin production, jointly with a spike in heroin price and availability across Europe, may have triggered its appearance in the market.
And while the drug has circulated around the UK for a while, it’s been connected to a spike in deaths in 2023.
Nitazenes don’t have a particular look, and can be bought as a powder or pressed into pills.
WEDINOS, a drug testing lab in Wales, has detected nitazenes in:
Diazepams/Flubromazolam/Valium/Xanax
Opioids (Oxycodone/oxycontin)
Cannabis
Illegal vapes (unclear if for cannabis or nicotine)
We’ve produced alongside EuroNPUD and other drug treatment service colleagues in the UK some harm reduction tips on staying safe. These are available to print and hand out to people using drugs or know someone that could be exposed to nitazenes.
You can send anonymous drug samples to WEDINOS (wedinos.org) and get test results in a couple of days. Fentanyl test strips don’t work with nitazenes.
2. Start low, go slow / Don’t use alone
Start with low doses and wait for peak effects to pass before redosing. Consider staggering doses with a friend to ensure you can help each other if needed.
3. Carry naloxone
A no brainer! Especially because nitazenes are showing up in all supply, not just opioids. Get it from your local drug service. Learn how to detect an overdose and what to do. Multiple doses may be needed.
Find out where you can get naloxone or needles/syringes posted straight to your home here.
Better utilisation of data and data sharing, including early warning systems, is needed to address the escalating drug crisis in the UK, says a report from Cranstoun.
The document has been published in response to the increasing number of accounts of parts of the UK’s heroin supply being contaminating by highly potent nitazenes.
Among the report’s other recommendations are the scaling up of properly funded drug checking services and testing kits, increasing naloxone supply, scaling up provision of diamorphine-assisted treatment, the implementation of overdose prevention centres and increasing the number of people accessing substitute medication and opioid treatment. The report has been backed by 35 parliamentarians from across the political spectrum.
Nitazenes can be anything up to 500 times more potent than heroin and the Taliban’s ban on opium cultivation could mean more synthetic opioids in circulation in the UK, the report warns, a situation the charity calls a ‘rapidly developing public health emergency’ that could mirror the ongoing crisis in North America.
‘Our report calls on the UK government to get ahead of the curve on this rapidly escalating public health emergency.’ – Cranstoun director Megan Jones.
‘We are seeing substances mis-sold as heroin or heroin and other drugs mixed with high-strength synthetic opioids right across the country,’ said Cranstoun director Megan Jones. ‘Our report calls on the UK government to get ahead of the curve on this rapidly escalating public health emergency. The window of opportunity to reduce deaths and suffering, prevent nitazenes becoming ubiquitous in the drug supply, and prevent an unmanageable crisis for emergency responders is closing. Without immediate action encompassing a whole system approach, we will be wholly unprepared for what lies around the corner. We cannot afford to sleepwalk into a public health emergency. We fear that now these types of opioids are becoming widely available, that pandora’s box has been opened and these much more potent types of drugs will remain mainstream in the UK’s drug supply.’
After a turbulent upbringing filled with grief, Phil Hetherington from Darlington shares his story of recovery with With You.
For too long, alcohol had taken control of all aspects of Phil’s life: consuming jobs, relationships, and his sense of self.
“Substance only takes, it never gives. One by one it will take jobs, relationships, your licence. It might make you happy when you’re under the influence, but ultimately, you’ve got to wake up.”
Like many, he believed that it was just a normal part of life, one that he could handle. But he soon realised that whilst drinking offered him fleeting moments of happiness, the cost to himself and his loved ones was too high. Leaving school without qualifications, Phil found himself stuck in unsatisfying jobs just to fund his nights out.
“I just thought I was one of the lads thinking; it’s ok, it’s acceptable, it’s what we all do. But I would always go that one step further. I just thought I could handle more – but clearly not.”
Phil’s partner, Anne-Marie
Through all this, his partner Anne-Marie stood by his side through both the highs and lows of their relationship. She shared how she often felt stuck in the middle, without knowing which way to go:
“Our relationship has been up and down. The sober part is a kind heart. But as soon as he has a can in his hand, that’s it. You don’t exist anymore. It’s him and the can. I’ve managed to get through it. I don’t know how, but I have.”
Phil’s path to recovery began when he was introduced to the With You service at STRIDE in Darlington and joined a 12 Steps to Recovery programme. During the programme, every week marked one step. The final week asked each person to give a presentation to reflect on and share their story. Step by step and week by week, Phil and his fellow participants formed a close bond, supporting each other through the ups and downs of recovery.
“Steps 1, 2, and 3 of the programme encourage you to find your higher power – something bigger than yourself. I chose Jesus. Then we got to step 4 and that’s when you have to delve into your life – secrets etc. This loneliness from my childhood that had continued to adulthood; it had all been lifted.”
Phil (left) and Gary Besterfield, Contracts Manager, STRIDE
Today, having graduated from the programme, Phil stands proud – he hasn’t had a drink for over 200 days. His journey has instilled in him a desire to give back, to share the message of hope with others struggling with alcohol dependence.
“Now I’m looking to start volunteering to give the message of hope, that alcohol dependence and drinking isn’t the be-all and end-all. If you can do it socially, then great. But no need to go over the top. It’s not going to achieve anything.”
With You’s Service Manager at STRIDE, Kayleigh Gamblin, celebrates Phil’s inspiring story and reminds us that every milestone in the recovery journey is worth celebrating. She said:
“The team is delighted with Phil’s progress. Through willingness to engage, and commitment to attendance, it shows what can be achieved with the support of an experienced team. Our staff continue to work hard to deliver a service we are proud of and to help improve the lives of more people like Phil.”
Phil and his partner, Anne-Marie
If you or someone you know is seeking support on the path to recovery, With You is here to help. Wherever you are in your recovery journey, we’re here to work alongside you.
Visit the With You website for information and advice, chat with a trained advisor, find your local service or find out how you can support other people on their recovery journeys.
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.
An app that uses Google Maps to highlight places such as pharmacies and needle exchanges that offer free naloxone has been launched by Turning Point and Somerset Council on International Overdose Awareness Day.
The Carry Naloxone app, which was launched in partnership with Bristol University, also provides short videos on how to recognise an overdose. The scheme, which is being piloted in Somerset and will be rolled out nationally if successful, is being launched at the same time as on online click-and-deliver scheme to people unable to collect a kit. The campaign will also feature posters that include a QR code to help people find the nearest place stocking naloxone.
Dr Jennifer Scott: No one can predict when naloxone may be needed
‘Carrying naloxone is really important, not keeping it in a cupboard,’ said senior lecturer at Bristol University Dr Jennifer Scott, who developed the app. ‘No one can predict when the medication might be needed and the quicker it is given, the more likely it is to save someone’s life. The training is simple, and the ambition of this campaign is to support International Overdose Awareness Day in its mission to end overdose.’
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.
(The DDN Conference 2023): Cranstoun’s Worcestershire service talk about their peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’.
The 1971 Misuse of Drugs Act is outdated and should be reformed to support ‘greater use of public health-based drug interventions’, says a report from the House of Commons Home Affairs Committee.
The Committee wants a new legislative framework bolstered by public health. This includes testing at festivals.
The committee wants to see a new legislative framework that includes consumption room pilots and drug testing at festivals, with better joint working between health, social services and police. However, there should also be an ‘appropriate’ criminal justice response, it states, with law enforcement doing all it can to ’stamp out the illicit trade of controlled drugs’ –bolstered by a stronger public health framework that keeps people out of addiction and the criminal justice sector.
While the government’s drug strategy helped to shift the focus towards public health, it is unlikely to achieve its aims without a ‘significant expansion in the range and availability of health-based interventions’, the report warns. The government should learn from locally developed schemes that are having a positive impact, it adds. However, the document also expresses concern about the long-term sustainability of funding for the drug sector, questioning whether the two-year period of the latest funding allocation is enough for service providers to ‘embed change’.
The drugs classifications system should be reviewed by ACMD to make sure it accurately reflects the risk of harm – with additional reviews carried out every ten years – the document states, with psychedelic drugs reclassified to support research into their therapeutic use. However, the committee does not believe that cannabis should be legalised or regulated for non-medical use.
Among the report’s other recommendations are a UK-wide, postal-based anonymous drug checking service, centralised funding for diamorphine-assisted treatment, a national naloxone programme for England, and more use of schemes to divert people away from the criminal justice system. Trauma-informed practices should be used by all police forces when dealing with drug offending, it adds, with more done to ensure that vulnerable young people exploited by county lines gangs are kept out of the criminal justice system.
Dame Diana Johnson: Drug strategy requires ‘much more meaningful action’
‘Whilst the drug strategy is moving in the right direction, it requires much more meaningful action to tackle the broad range of drug-related problems,’ said committee chair Dame Diana Johnson.
‘The criminal justice system will need to continue to do all it can to break up the criminal gangs that drive the trade in illicit drugs. However, it must also recognise that many children and young people involved need to be supported to escape, not punished for their involvement. Fundamentally, we need to have the right interventions in place to help people break free from the terrible cycles of addiction and criminality that drug addiction can cause. Simply attempting to remove drugs from people’s lives hasn’t worked. They need the right support to let them deal with addiction, but also psychosocial support and interventions that deal with the underlying trauma that may have led them to drugs in the first place.’
Projects using technology such as AI or drones to help prevent fatal overdoses have been awarded a share of £5m funding from the Department of Health and Social Care and Department for Science, Innovation and Technology.
The projects will explore how AI wearable technologies can detect overdoses and alert healthcare professionals or family members to provide lifesaving care, or how naloxone can be dispersed via drone. Twelve projects will receive funding from the Office for Life Sciences, as part of the Reducing Drug Deaths Innovation Challenge. The projects will operate across the whole of the UK.
Eleven of the projects have been awarded up to £100,000 each to develop prototypes, with grants of up to £500,000 available for 12-month follow-on demonstration projects to collate real-world evidence. Among the projects are a chest-worn biosensor that can detect the onset of life-threatening respiratory depression and which alerts emergency services and nearby carriers of naloxone, a controlled-release patch for naloxone and flumazenil delivery, and a handheld device for self-monitoring benzo use.
Anna Dominiczak: Innovative solutions are ‘truly inspiring’
‘It is truly inspiring to see some of the innovative solutions that are being supported through the Reducing Drug Deaths Innovation Challenge and the partnership between the chief scientist’s office in the Scottish Government and the UK government’s Office for Life Sciences’ said the Scottish Government’s chief scientific advisor for health Professor Dame Anna Dominiczak. ‘Utilising the expertise in Scotland and across the rest of the UK we can continue to deliver results in harm reduction, developing truly impactful innovations and driving prevention initiatives, having a hugely positive impact both across the UK and globally.’
The number of alcohol-specific deaths in Scotland rose by just over 30 to 1,276 between 2021 and 2022, according to the latest figures from Public Health Scotland – an increase of 2 per cent. The figure represents the highest number since 2008.
There were four times as many alcohol-specific deaths in deprived areas, compared to the least deprived.
While the number of deaths among men remained unchanged – and men continue to account for two thirds of all alcohol-specific deaths – the number of deaths among women increased by 31 to 440. As with drug deaths, people in the country’s most deprived areas are more likely to die an alcohol-specific death. There were more than four times as many deaths in the most deprived communities compared to the least deprived.
‘Looking at the long-term trend, the number of deaths from alcohol-specific causes fell between 2006 and 2012 but has risen since and is now about the same as 2010 levels,’ said head of vital events statistics at Public Health Scotland, Daniel Burns. ‘In 2022, the average age at death for females from an alcohol-specific cause was 58.7 years and for males it was 60.0 years.’
While Scotland continues to have the highest alcohol-specific death rate of any UK country, the gap has been narrowing over the last 20 years. Figures for alcohol-specific deaths in 2022 for the rest of the UK are due to be published soon.
Humankind’s REACH service has been successful in winning the contract to provide Dorset Council’s alcohol and drug support service for another eight years.
REACH has been delivering excellent care and support for the people of Dorset since 2017. This announcement means that they can continue to embed themselves in local communities and provide a bespoke drug and alcohol service to people when and where they most need it. The recommissioning announcement is a validation of the high regard with which the service is held and all the hard work, professionalism and expertise of staff and volunteers.
This is the best outcome for the people who need support for their drug and alcohol use in Dorset. Recommissioning REACH gives people who use Humankind’s services much needed stability of treatment and continuity of care.
Cllr Jane Somper, Dorset Council Adult Social Care and Health Portfolio Holder said, “We are delighted to be able to award REACH the contract to deliver drugs and alcohol support services in the Dorset Council area.
“We have had a great partnership so far and we look forward to continuing to deliver services together to help those residents who need support with substance misuse.
“It is also great news that those residents in our treatment services already will see no difference in their current recovery journeys with having REACH continue their fantastic work in the county.”
The new contract starts on 1 November 2023, and remains a fully integrated service for young people, adults and families. The service for young people under the age of 25 is run in partnership with Essential Drug and Alcohol Service (EDAS) and clinical delivery is led by Avon and Wiltshire Partnership Trust (AWP).
There is a specialist family team within REACH that works with the whole family. In addition, the service works in harmony with Dorset Social Care and NHS England through the Safeguarding Families Together team and the Mental Health Treatment Requirement service.
Ted Haughey, Executive Director of Operations at Humankind, added, “This is great news for Dorset. REACH is a service that is genuinely embedded in and part of its local community. In March, Humankind launched an ambitious five year strategy, Being Human, which contains the three key themes of people, partnerships and place. REACH embodies our commitment to the provision of bespoke services woven into Dorset’s community fabric and shaped around the needs of local people. There is rightly a genuine hope, optimism and excitement about REACH’s future.”
Humankind is a national charity which supports over 90,000 people every year. Its services stretch from Dorchester to Durham, supporting people’s complex health and social needs. As part of a larger organisation, REACH now benefits from connection, innovation and learning from Newton Aycliffe to Newton Abbot.
REACH has developed a close partnership with Dorset Council over the past six years and prior to that, 10 years becoming embedded in the local community through innovative projects such as the first peer mentor programme in the South in 2009. This project became an accredited programme in 2011, as well as becoming the second service in England to offer postal naloxone through the web based NSPDirect service.
REACH was also the first service to offer postal Dry Blood Spot Testing (DBST) in partnership with the NHSAlliance and Hep C U Later Campaign which was just one small part of REACH’s exceptional covid response plans.
“REACH has an ambitious vision of continuous improvement for the communities of Dorset in the coming years,” said Beth Davies, who leads the REACH service in Dorset. “We will maintain excellence in all our contractual and Office for Health Improvement and Disparities (OHID) targets. REACH’s end of year performance report reflects a picture of exceptional outcomes. We have met and exceeded all our contractual targets within the Humankind quality and performance framework, reaching the highest level of performance across all key indicators. We will be building upon these solid foundations, developing accessibility to services and innovative partnerships.”
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.
There were 1,051 deaths as a result of drug misuse in Scotland last year, according to statistics released by National Records of Scotland. This represents a reduction of 21 per cent from the previous year.
The fall by almost 280 deaths from 2021 means 2022’s figure is the lowest since 2017. The number is still almost four times higher than in 2000, however.
Glasgow had the highest death rates alongside Dundee
Opiates and opioids – including methadone – were implicated in more than eight out of ten deaths, with the highest death rates in the Glasgow City and Dundee City areas. People in the country’s most deprived areas were almost 16 times more likely to die from drug misuse compared to people in the least deprived areas. The majority of deaths were classed as accidental poisonings, although seven per cent were recorded as intentional poisonings. While men were still twice as likely to die a drug-related death than women, the fall in deaths in 2022 was much larger for men than women.
‘While drug misuse deaths have been rising over the last two decades, with a particularly sharp increase after 2013, today’s statistics show the biggest year-on-year decrease since the series began,’ said head of demographic statistics at National Records of Scotland, Julie Ramsay. ‘The statistics provide some insight into the people who are most likely to die from drug misuse. The age profile of drug misuse deaths has become older over time – the average age of people who died from drug misuse deaths has increased from 32 in 2000 to 45 in 2022.’
Elena Whitham: Not underestimating scale of the challenge
‘While I am pleased to see that hundreds of families have been spared this agony and lives have been saved, every life lost is a tragedy and the number of deaths is still too high,’ said Scottish drugs minister Elena Whitham. ‘I will never underestimate the scale of the challenge we continue to face, including responding to new threats such as synthetic opioids and stimulant use.’
Kisten Horsburgh: ‘Alarm bells should be ringing… we are not prepared.’
Scotland had made an ‘inadequate response to the ongoing public health emergency’ and now faced the emerging threat of a drug supply containing dangerous new synthetic opioids, said a statement from the Scottish Drugs Forum (SDF). ‘This situation demands the urgent implementation of the full range of evidence-based practice and policy now,’ including monitoring changes in drug supply, including via drug checking services, maximising Scotland’s naloxone programme, implementing safer drug use facilities, widening access to treatment, and decriminalising possession.
‘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 CEO Kirsten Horsburgh. ‘Alarm bells should be ringing all over government and all through the treatment and support services because we are not prepared.’
Drug-related Deaths in Scotland in 2022, report and statistics here
ReNew, the Change Grow Live service in Hull, is looking forward to the UK National Recovery Walk coming to the city and urges you to get involved!
The UK Recovery Walk is a national event of great significance, gathering individuals, families, and communities to raise awareness about addiction recovery.
The walk will start from Zebedee’s Yard, 23 Posterngate, Hull HU1 2JN
It is a day of unity, hope, and compassion, aiming to reduce the stigma surrounding addiction and highlighting the incredible transformations that can be achieved through recovery.
All are invited to take part in the walk, regardless of personal experiences with addiction. Whether you have directly faced the challenges of recovery or not, your presence and support will be invaluable. The event is an opportunity for us to come together as a society, supporting those who have overcome addiction while fostering an understanding and accepting environment for those still on their journey to recovery.
This year’s UK Recovery Walk is particularly special, as it is not only the first time the event will grace the streets of Hull, but it may also be the last. Previously held in cities like Newcastle and Blackpool, this powerful gathering has left an indelible mark, drawing thousands of participants. Now, Hull has the chance to create its own legacy of unity and hope.
The organisers are aiming high, hoping to welcome over 1,000 attendees from Hull and beyond to this extraordinary occasion. By uniting in such numbers, we can showcase our collective support and demonstrate our commitment to the recovery community.
Following the walk, the festivities will continue at the Recovery Village event. Taking place at Zebedee’s Yard, the village promises to be a vibrant hub of art, culture, and wellbeing. Attendees will have the chance to indulge in live music performances on a dedicated stage, admire thought-provoking art exhibitions, and explore various health and wellbeing stalls. The Recovery Village presents a golden opportunity to engage with local support services, discover valuable resources for recovery, and connect with a community that wholeheartedly believes in the power of healing and transformation. ‘We are really excited to bring the UK Recovery Walk to Hull,’ said Matthew Butler, host of the Believe in People podcast, a series that highlights stories of recovery over addiction.
‘This is an occasion of hope and celebration, where we stand together, showing that recovery is not only possible but worthy of recognition and support. The incredible backing from the public and the local community in the voting process to have the Recovery Walk here in Hull means the world to us, and we are eagerly anticipating the positive impact an event like this can have on our community.’
The organisers encourage the public to seize this chance to participate in the walk and bask in the uplifting atmosphere of the Recovery Village. By doing so, we can witness the strength and resilience of individuals who have triumphed over addiction while collectively embracing the message of hope and recovery.
So, let’s unite as one community, celebrating the victories of those who have overcome addiction, and displaying our unwavering support for those currently on their journey to recovery. Join us at the UK Recovery Walk in Hull on September 23rd, where we will redefine the power of compassion and unity, and create a lasting impact on countless lives.
Event Details:
Date: Saturday, September 23rd, 2023
Time: Walk starts promptly at 12:00pm, with an 11:00am meet.
For more information and to get involved, visit the FAVOR UK website at 2023 Recovery Walk | Favor (facesandvoicesofrecoveryuk.org) or find the hosts on social media (@CGLHull). Let’s come together as a community, celebrate recovery, and spread the message of hope and resilience.
See you all at the UK Recovery Walk in Hull on September 23rd!
NHS England recently announced that the country is on track to eliminate hepatitis C by 2025, five years ahead of the World Health Organization 2030 target. It also said that the country’s ‘pioneering’ elimination programme has helped find and cure more than 70,000 people of this potentially fatal virus.
This means that England could become one of the first countries to eliminate the virus – a real example for the rest of the world and for other areas of public health. But with 74,000 people in England still believed to have the virus and current funding for the programme requiring renewal in April 2024, it also means we must not rest on our laurels in these crucial two years.
Earlier this year HCV Action – a network coordinated by The Hepatitis C Trust – released Taking the initiative: how England is eliminating hepatitis C, a report exploring the elimination programme and some of the main initiatives that have been developed under it. These have included efforts by NHS bodies, voluntary sector organisations and pharmaceutical industry partners to find, test and treat people in community settings, the criminal justice system, primary care, drug services, emergency departments and more.
A key finding has been the widespread value of peer-to-peer workers and volunteers with lived experience of hepatitis C or substance use in finding and supporting people with hepatitis C. Figures from The Hepatitis C Trust show that since the current programme started in 2019, 29,000 people at risk of hepatitis C were tested and 3,800 were supported into treatment thanks to this kind of work. In recognition, health minister Lord Markham recently commented that, ‘Almost every [hepatitis C] elimination initiative that NHS England manages and commissions…has peer involvement. NHS England consistently finds that people with lived experience are excellent advocates and are crucial in developing therapeutic alliances to support people into testing and treatment who may have felt excluded from traditional healthcare and other settings.’
The UK Health Security Agency (UKHSA) cites injecting drug use as a risk factor in most hepatitis C cases. This is why collaboration in drug treatment services has been developed under the programme to help cut across commissioning boundaries, simplify pathways and bring together service providers that often find themselves in competition. A Hepatitis C drug treatment services provider forum was established to strengthen data sharing across organisations, improving access to treatment for people using services. Initiatives during the COVID-19 pandemic saw drug treatment services adapt to include home testing, remote monitoring and targeted testing of homeless populations, and these types of efforts recently saw the provider forum receive a Health Service Journal award for its ‘outstanding dedication to improving healthcare and effective collaboration’.
However, with the programme having found many of the more reachable cases, in the final stretch we’re now seeing additional work to find outlying cases. The HCV Action report touched on NHS England plans for an online portal where people can order a discrete and remote home testing kit. This scheme – aiming to broaden access to treatment for people neglected by, or physically further from, services – has since been launched and is accessible at hepctest.nhs.uk/.
With funding for the elimination programme coming to an end at the end of March 2024, a new strategy will be needed to ensure that the work so far doesn’t go to waste, and that elimination is achieved by 2025. This is why The Hepatitis C Trust’s message for World Hepatitis Day 2023 on 18 July will be ‘don’t miss the target’, to keep up momentum and to ensure that years of work and £1bn of investment are built upon.
Even beyond this, we’ll need strong and vigilant harm reduction measures – such as needle and syringe exchange programmes and regular testing of people from higher-risk backgrounds – to prevent new infections, alongside continued commitment to testing and treating those at risk. This will safeguard the legacy of England’s hepatitis C programme, ensuring that we achieve elimination and sustain it for everyone thereafter.
Elliot Bidgood is policy and parliamentary adviser for The Hepatitis C Trust and Coordinator for HCV Action.
(July 2023): Turning Point’s Drug and Alcohol Wellbeing Service (DAWS) highlights the five key steps you can take to protect yourself and reduce your risk of hepatitis B and C.
Last year we ran a three-part series looking at what’s next for commissioning in the wake of Dame Carol Black’s Independent review of drugs, the drugs strategy and the new money that followed it (DDN, October 2022, p12; November, p12, and December-January, p14).
Commissioning had become fragmented, said the Black review, with deteriorating partnerships between local authorities, housing and criminal justice agencies, among others. The government’s Commissioning Quality Standard (CQS) then set out what it thinks good commissioning should look like, with a vision of a person-centred treatment system and integrated approach – a document that was broadly welcomed by commissioning staff. So when it comes to commissioning, what does a strong partnership look like?
Connect Wiltshire
Connect Wiltshire is a new service that integrates drug and alcohol treatment from Turning Point and the Nelson Trust with homelessness charity Julian House and DHI (Developing Health and Independence). The latter, which was originally set up to help bridge the gap between substance misuse and housing services, operates its own social lettings agency, as well as offering supported housing, while the Nelson Trust has a strong focus on women’s services.
The service launched on 1 April this year, so it’s ‘still in its infancy’, public health principal for building resilience at Wiltshire Council, Kelly Fry, tells DDN. ‘There’s been a lot of scoping, a lot of stakeholder engagement. We’ve co-produced the specification based on local need and prevalence, but also being mindful of the Dame Carol Black review recommendations, so for us it’s been an amalgamation of various different strands that have come together into that one specification.’
Inclusive service
Turning Point is lead provider, and has sub-contracted arrangements with Julian House, DHI and Nelson Trust. ‘That was because we felt there would be better collaboration, better resilience, better working practice, and we’re already seeing evidence of that even though we’re in those early stages,’ says Fry. ‘We wanted more of an inclusive life-course model rather than having silos for young people and adult services.’ One key aim was to address the potential for people to fall through the cracks when they turned 18, she says, ‘so we’ve factored in an 18-25 service as well which should help keep people in treatment and support when they need it. The idea is that it’s based on need, so they’d move with their key worker throughout their journey.’
‘I’m pleased with how the service is working,’ adds senior operations manager at Turning Point, Tina Roberts. ‘We’ve worked previously with our partner agencies Julian House, DHI and Nelson Trust but now we’re working as an integrated, collaborative service. Even though it’s only been a few months, I would encourage other commissioned services to combine and work together. We’re taking a holistic life-course model where there’s support for adults, young people, and supported housing to ensure continuation of care – the clients don’t have to retell their story by going from one service to another.’
Vital Links
When it comes to those vital housing links, Julian House has a wide client base after working in Wiltshire for a number of years, so there’s a full journey ‘in terms of early intervention, support, prevention, harm reduction advice, right the way through to supported accommodation and recovery’, says Fry. ‘We’ve also given Connect our prescribing, supervised consumption and pharmacy elements as well – again, we just felt that it made sense as they’re the clinical leads. We can oversee it as commissioners, but they know what’s working well and what isn’t.’
Forward Momentum
At the moment the partners are still meeting every two weeks, which is a ‘really important as part of mobilisation’, Fry stresses. ‘We’re really keen to keep the momentum going, making sure we’re all on the same page.’ There will be at least monthly meetings, as well as the regular meetings around grants, meaning ‘constant discussion with the key partners’, she says.
One concern about re-commissioning was the potential for a dip in service provision, Fry says, ‘so we really want people to invest in Connect.’ This has meant a keen focus on getting the message out about new identity and culture, and so far the partnership arrangements have been bedding in well, she says. One example is the supported accommodation element from Julian House – while previously there were voids, since the organisation has been a sub-contractor for Turning Point ‘we’ve been full, which is phenomenal. It just shows that developing those relationships has really paid off.’
Although it’s still early days for the service itself, what’s in place is the result of an intense 18-month period of work and planning. Aside from the usual processes and legalities of a project like this, it was also about ‘collating evidence, hearing from service users about what’s working, what isn’t, how we can improve local delivery,’ Fry stresses. ‘We co-produced specifications, so while public health are the lead commissioner we co-commission it alongside the Office of the Police and Crime Commissioner (OPCC) and we also sought support from internal services’ including children’s services, adult social care and housing. So it really did feel very collaborative.’
Outreach
Wiltshire is a rural county, making travel to community hubs difficult for some people – how much of an influence did this have on shaping the service? ‘It’s something that we’re really mindful of,’ says Fry. Money from the supplementary substance misuse grant and rough sleeper drug and alcohol treatment grant enabled the service to provide outreach buses, and Connect is also looking at much more collaborative working with GPs. This additional funding for rough sleepers ‘enables us to have a team of people that are able to go out and access a different cohort of clients that may struggle to access treatment’, says Roberts. ‘We’re able to take treatment to them.’
Criminal Justice
There’s also a strong criminal justice element to the service, with workers funded through the supplementary substance misuse treatment and recovery grant. ‘We also have the money through from the OPCC so we’ve got really good continuity of care from the prisons – we really hone in on that pathway,’ says Fry.
A clear outcomes framework has been developed for the joint combating drugs partnership, meanwhile, as ‘it’s an area that touches on so many different organisations as well as our lead providers – it’s about what data can you bring,’ Fry continues. ‘What’s happening with county lines, drug arrests, A&E admissions – are those pathways working? We’re very data-driven, and everything’s shared at the combating drugs partnerships so we’re clear about whether we’re doing well or if we have to potentially support to improve that performance – or just hold partners to account.’
Peer mentors and service user reps also attend the joint combating drugs partnership meetings, while commissioners attend the service user council, so there’s constant feedback. ‘The service users are very frank, they’re very open – if it’s not working they’ll say,’ she states.
Service levels
While there were some initial worries around what would change and if people would keep the same keyworker, the service was determined to communicate clearly from the start. ‘What we didn’t want to do was start losing people from treatment,’ says Fry. ‘It’s just having that continuity and discussions with service users and staff and partner agencies. The feedback is we’re getting more referrals from the 18-25s which we really wanted to see, and just the fact that we’ve got more people going through that supported accommodation pathway is testament to the fact that service users are feeling happy, feeling supported.’ To ensure that clients were aware they’d ‘still be receiving the same level of service under the Connect Wiltshire umbrella, we sent out information via email, letters, leaflets as well as speaking to clients face-to-face and updating our stakeholders in strategic meetings,’ adds Roberts.
One holistic model
So in the time since the Carol Black report said that partnerships were deteriorating, is there a sense that things are improving on a national level? ‘I think so,’ Fry says. ‘There’s a lot more governance, a lot more scrutiny, a lot more accountability now. There are national commissioners’ calls, regional commissioner meetings, SRA (senior responsible officer) meetings and more to share learning. A great deal has been put into it.’
And when it comes to lessons learned, what advice would she have for other areas trying to do similar things? ‘I think the lead-in time is really important, but now it’s about making sure that we have that life-course approach and one joined up, holistic model. I think that takes time to embed, and it can be a culture change from the way partners may have worked in the past. For example, we’re now calling them Connect rather than Turning Point and DHI. So while you’re employed by that agency, the service is called Connect. They’re their own providers with their own cultures, but for us it was about joining up so we really did create that ethos of that one service approach. It’s about letting people we know that we haven’t removed a service, we’re creating a more inclusive service for everyone – a new service based on real need.’
This series has been produced with support from an educational grant provided by Camurus, which has not influenced the content in any way.
The Gambling Commission has become ‘very concerned’ at what it sees as a significant increase in the misuse of statistics, as ‘different parties seek to make persuasive arguments’, according to an open letter from its chief executive Andrew Rhodes.
There is currently no recognised measure of gambling-related harms, which refers to the adverse impact of gambling on individuals, families, communities and wider society.
Various groups and individuals have been seeking to influence opinion during the development of the government’s gambling white paper, the letter states, adding that it is not the commission’s place to ‘referee’ the debate. ‘However, much as everyone is entitled to present their arguments, what is wholly unacceptable is the misuse of statistics to support that argument.’
The commission had seen misuse of statistics ‘from gambling operators, trade bodies, charities, media outlets, sporting venue owners and others’, the letter says. ‘The commission has even received (or has been copied into) complaints about the misuse of statistics by another party, where the complainant themselves has misused statistics in order to press their complaint. Others have sought to rely on data which the authors have said is not reliable enough to draw those conclusions. This is unacceptable. All parties seeking to rely on statistics to advance their arguments must do so accurately and in the correct context.’
The gambling white paper was published in April, nearly two and a half years after the government first launched its review of the 2005 Gambling Act, which was designed to update legislation for the ‘smartphone era’. The white paper’s proposals – which are subject to further consultation – include a mandatory levy on gambling firms, revised stake limits for online slots games and improved player protection. Controversially, however, it contained little on tightening restrictions around advertising and marketing.
The most common misuse of statistics has been around conflating problem gambling and gambling-related harm, Rhodes’ open letter states – ‘two separate, but linked, experiences’. While problem gambling – which means gambling that damages family or personal life – can be measured by a range of screening tools, there is currently no recognised measure of gambling-related harms, which refers to the adverse impact of gambling on individuals, families, communities and wider society. The commission will assume any misuse of official statistics to be accidental, it adds, and offer the chance to correct the record, after which it will consider referring the matter to the government’s Office for Statistics Regulation.
The DDN guide on gambling addiction helps identify problems and the available treatment options.
The commission is funded by fees paid by gambling businesses, which are set by the Department for Digital, Culture, Media & Sport (DCMS).
‘The debate around gambling is often a fierce one, but nobody is well-served by statistics being misused to further an argument,’ the letter states. ‘I therefore ask anyone commenting on this area to take a greater degree of care to ensure they are using evidence and statistics correctly, accurately and in the proper context and with any necessary caveats applied.’
In this blog post, Turning Point’s Safer Lives Lead, Deb, sheds light on the emergence of a concerning new class of opioids known as “nitazenes” and the risks they present.
We recently shared a joint statement addressing the evolving nature of drugs available in the UK. As an organisation dedicated to supporting individuals facing substance use challenges, we recognise the importance of providing clarification and guidance on these new drugs.
Deb offers some advice for people using drugs on how they can reduce their risk of overdose and support each other to take charge of their safety.
Find out more by watching our video below:
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.
Representatives of leading health organisations have written an open letter to The Lancet challenging assertions by Scottish Conservative health spokesperson Dr Sandesh Gulhane that the impact of MUP in Scotland has been overstated.
Dr Gulhane had written to the UK Statistics Authority to say that that the findings in Public Health Scotland’s (PHS) evaluation report had overstated MUP’s impact.
The signatories – who include representatives from the BMA, the London School of Hygiene and Tropical Medicine, and the European Alcohol Policy Alliance – express concern that support for MUP could be weakened, despite ‘high-quality’ evidence that it had reduced alcohol-specific deaths in Scotland by 13 per cent. The policy is subject to a ‘sunset clause’ which means that it will lapse next year unless the Scottish Parliament renews it.
Dr Gulhane had written to the UK Statistics Authority to say that the findings in Public Health Scotland’s (PHS) evaluation report had overstated MUP’s impact, and called for a review of the report to be carried out. Of the 40 independent studies cited by the document, just eight mentioned MUP’s health implications, he said, with seven ‘inconclusive’ and the remaining study conducted by a PHS adviser.
The PHS report stated that there was ‘quantitative evidence that MUP was associated with a reduction in deaths wholly attributable to alcohol consumption, relative to England where MUP was not implemented’. Comparing trends in Scotland and England, ‘including during the pandemic when alcohol deaths were increasing in many countries, is an entirely appropriate approach,’ the open letter states. ‘This summary of MUP research is comprehensive, including interviews with individuals who fear the policy will be detrimental to them personally and or financially. The Public Health Scotland approach of emphasising population level findings is the right one for assessing population level interventions like minimum unit price. The alternatives proposed by the Scottish Conservatives are neither feasible or appropriate.’
Policy makers could be confident that there are ‘several hundred low-income people in Scotland who would have died from alcohol, who are alive today as a result of minimum unit pricing’, the letter concludes.
The PHS Scotland report did acknowledge, however, that for people with alcohol dependence there was ‘limited evidence of any reduction in consumption’, and some evidence that people with alcohol dependence on low incomes prioritised spending on alcohol over food and other essentials. Despite the introduction of MUP, Scotland’s alcohol death rate in 2021 was 1,245, the highest for almost 15 years.
The afternoon at Many Roads was a lively interactive session, where delegates explored a range of key themes and topics.
Experiences of treatment
How do we challenge ‘one size fits all’ treatment? In London, for example, there had been entire boroughs with just a single treatment modality – and a lot of this simply came down to poor commissioning. Services had been declining over the course of the last decade across every indicator, resulting in a severe lack of choice. The funding system after drug treatment’s move to public health also meant that more money was being spent on bureaucracy, with many projects abandoned simply because they weren’t big enough.
‘It’s the abandonment of empathy,’ said one delegate. In some areas, people were required to do around nine weeks of group work prior to a detox – ‘they’d lost interest by then’. Another thought that the drugs issue had been framed in a way – ‘as is often the case with politicians – that we need to make people jump through hoops to solve it’, ignoring the fundamental truth that it should be about choice. ‘You can’t let service providers off the hook, either’, another delegate stated. ‘There’s often an attitude of “this is what we do here”.’ People who were using on top of their prescriptions could be thrown off a service despite the fact that ‘these are exactly the people you want in here.’
Words from the floor:
‘Ketamine use is on the rise and cystitis, or “K bladder” is something that’s not addressed. So development of a specialist treatment pathway for that, for example, would be one way to challenge one size fits all.’
‘If you’re a menopausal woman living in temporary accommodation on your own, or an 18-year-old person surrounded by a supportive family, one size fits all won’t work – it just doesn’t. There’s a lack of engagement with the individual, and far too much ticking boxes.’
‘Out of hours provision is important. We’ve bought into this idea from social services, education, GP surgeries, where it’s 9 to 5, Monday to Friday. And if you are doing out of hours provision it’s about advertising that, and making sure people know where to go at those times.’
‘I’m wondering what’s happened to outreach services. During the pandemic it was exciting that we could go out and find people and do testing on the street, or at least be talking to them. It seems that these days most of the outreach is run by homeless services. I think more drug services should be proactive in getting out there.’
Peers save lives!
The drugs sector in the 1990s had ‘more of a wild west feel, an energy’. Ten years later it had obviously become more professional but had also lost some of the initiative – a lot of outreach work had disappeared with recommissioning and the later move to public health. ‘In the pandemic there was lots of great outreach work – including giving out naloxone – but it was being done by homelessness and housing charities,’ one delegate stated.
Words from the floor:
‘I’m five and a half years clean. Through Turning Point I was introduced to a peer-led recovery community called Dear Albert, and my whole journey from there to now has been in that recovery community. We have a list of all the mutual aid available in the services, in GP surgeries; we do outreach on a daily basis, we work with the drug services, criminal justice, we go into prisons, work with the homeless services. If it wasn’t for people with lived experience I wouldn’t be here today.’
‘It’s about trusting people who take drugs. In Wales we have peer-to-peer naloxone, which means making sure that people who are taking drugs – and so are more likely to be there when someone overdoses – are given the tools and training to deliver naloxone. It’s not that useful me having naloxone – there aren’t that many people overdosing in Waitrose. And give the drug dealers as many needles as you can, to keep people safe.’
‘I’ve been impressed with what happened in Birmingham in the COVID year. Our drug-related death rate was 20 per cent lower than in 2019 – and that’s because we had the outreach. Go to people where they are, and help them to get whatever they need. We used to have excellent outreach teams, but they disappeared when the money went. They’ve been reinvented because of COVID, so let’s not lose that.’
‘Peers do amazing work in accessing our communities, but let’s start paying them.’
Let’s talk about stigmaMore and more jobs at drug services were now requiring DBS (disclosure and barring service), one participant explained, as they involved access to vulnerable people. ‘There’s this attitude of “you can’t trust people”. People who just want to do their jobs are being prevented from doing it – attitudes haven’t changed’.
Words from the floor:
‘Every time someone writes some bullshit about us, get on social media and respond to it. We need positive depictions of people who use drugs.’
‘Stigma has affected me throughout my life. Services are trying to put a plaster on a gaping wound and it isn’t going to work. We need to educate from the bottom up to eradicate stigma – we’ve done this already for mental health. We need to do the same thing for addiction, because it is a mental health matter.’
‘We’re all here for a reason, because we believe in this. But when we go back to our workplaces we probably all work with people who see their job as transactional. We are all social changemakers – it’s about having the conversations. Use the communities, be that online or in person to replenish your energy. Because one of the risks we all have is burnout.’
Me, myself, I… where do we go from here?
Drug treatment hadn’t been a political priority for a long time, but services still needed to interact with politicians, one delegate stressed. ‘Get the MPs and local councillors out to talk to service users.’ Human stories were powerful, as had been seen with medicinal cannabis and the Anyone’s Child campaign. ‘It all comes down to the way things are framed, and in the grand scheme of things it’s pennies so it’s worth getting it in front of them. There’s an election coming up so they want to be everyone’s friend. It’s worth a try.’
Words from the floor:
‘People’s personal stories are what changes people’s minds, never mind the evidence.’
‘We need to be radical and transformative in who we network with, whether that’s on social media or in person.’
‘Every year we have Anyone’s Child, and I think it would be good if more users could come along and speak there – because that’s lobbying Parliament.’
‘We’ve got these lines of communication. Let’s use them, let’s network more beyond this room, let’s keep in touch, let’s keep the great work going.’
Acorn/Delph – Residential treatment, detox and community support in the North West, using lived experience to inspire and motivate change: acornrecovery.org.uk
Aquarius – Midlands-based charity helping people and communities overcome the harms caused by alcohol, drugs and gambling: aquarius.org.uk
B3 – Providing peer support and advocacy to drug and alcohol service users in Brent: www.b-3.org.uk
Ban the Box – a campaign to increase opportunities for people with convictions to compete for jobs: unlock.org.uk/project/ban-the-box
BDP – Bristol Drugs Project is a charity providing harm reduction and treatment services for people who are experiencing a negative relationship with drugs and/or alcohol: www.bdp.org.uk
Bill Nellis – Drug user activist and founder of the Methadone Alliance, now living in Canada: www.facebook.com/IlanBoy2
Broadway Lodge – One of the leading and most respected abstinence-based residential addiction treatment centres in the UK: www.broadwaylodge.org.uk
Change Grow Live – National health and social care charity supporting people with challenges including drugs and alcohol, housing, justice, health and wellbeing: www.changegrowlive.org
Dear Albert – Is based in Leicester and helps individuals to stop taking alcohol and drugs while specialising in working directly with providers of substance misuse services and other to achieve better outcomes including successful completions: www.dearalbert.co.uk
Forward Trust: A national charity delivering a range of services and interventions in both communities and prisons aimed at helping people to move forward with their lives: www.forwardtrust.org.uk
George Charlton – An award winning trainer and consultant renowned for developing and co-producing innovative and dynamic user led projects which put people with lived and living experience at the heart of everything: georgecharlton.com
Hep C U Later – Helping people get tested and treated for Hep C: www.hepculater.com
Kenda Reiki – Teaching and offering private Reiki healing, Crystal Healing, Chakra Balancing, Aura Cleansing as well as addiction recovery affirmation cards with in-depth understanding and a guidebooks: www.kendareiki.com
Lynette Fryer – Following a career as a drug and alcohol professional Lynette now offers massage, therapy, healing and wellbeing support sessions aimed at individuals, professionals and organisations: www.lynettefryer.co.uk
Nal Von Minden – Market leader in rapid drug testing, offering the widest range of parameters and test formats for customers including doctors, drug services, police, customs and prisons: nal-vonminden.com/eng
NHS Inclusion – Provide services that include advice, information, harm reduction interventions, recovery planning in conjunction with a range of pharmacological, psychosocial and structured treatment programs: www.inclusion.org
Recovery Cymru – A peer-led, mutual-aid, recovery community in Cardiff and the Vale of Glamorgan that empowers people to achieve and maintain recovery: www.recoverycymru.org.uk
Recovery Street Film Festival – A film festival celebrating people with lived experience of recovery from drug and alcohol use: rsff.co.uk
Spectrum CIC – Delivering services in partnership, with multi-disciplinary teams renowned for excellence in care with clinics across County Durham, South Tyneside, York and North Yorkshire. As well as supporting patients with substance misuse in secure environments: spectrum-cic.org.uk
With You – National charity that offers free confidential support to people who have issues with drugs, alcohol or mental health: www.wearewithyou.org.uk
The day’s second session explored the countless benefits and opportunities of partnership working.
‘I’ve lost a lot of people who drug treatment doesn’t work for,’ harm reduction content creator at Cranstoun, Alistair Bryant, told delegates. ‘If you can get to any of our doors, you’re already halfway through what you need to do. I think it’s time to work with that community who can’t come to us, or who are just happy where they are – it’s not on us to tell them what to do. So how do we do that, and how do we embrace harm reduction as a whole?’
Cranstoun’s Worcestershire service had developed a peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’, he said (DDN, April, page 16). ‘They have keys to the community that we don’t have. I can now take harm reduction and support to people who need it the most – that’s why we all need to start working with the people on the other side of our door.’
Cranstoun had recently launched a pouch containing two naloxone injections, and designed to be visible. The commissioners had been impressed and provided further funding, and the PACKS team then packed ‘an entire room’ of the pouches. ‘We probably packed 500 pouches, and we got them out there. It was amazing to see the potential of a group of people who treatment, volunteering and peer mentoring has ignored for the last ten years. There are damn good people with skill sets who treatment haven’t embraced because they “might be too risky”.’
PACKS videos on social media had now had more than 1.5m views, he told the conference, with the content most popular among 18 to 35-year-olds. ‘In Worcester, that’s the age range who don’t stay in treatment because they don’t find it meaningful. Yet the appetite for being safe is very much there.’ It was also vital to pay people, however. ‘If you want people to do something, pay them to do it. Pay peers, rep the underdog, and change the system.’
Turning Point provided naloxone training, giving kits to nearly 100 delegates on the day. Plus there was a surprise appearance from Naloxone Man!
Cranstoun was also piloting a new app-based service to reach those people ‘not inside the treatment doors, and behind their own closed doors when they use drugs’, said his colleague, assistant director for business development, Luke O’Neill.
More than half of people who died a drug-related death died alone, he said. ‘We looked beyond our shores and took inspiration from safer injecting services, from the ‘Never Use Alone’ helpline in Australia, and the software developer in Canada who first designed the digital solution called Brave.’ Cranstoun asked if they’d work with them to develop a UK version of an app they’d first developed in Vancouver, he said – the result was Cranstoun’s Buddy Up (DDN, May, page 5).
Buddy Up was a low-threshold harm reduction app that had been created specifically for people using drugs alone, to put them in touch with someone who could send help in case of a suspected overdose. The service was anonymous and private, with callers able to create multiple rescue plans if they used drugs in different locations. While the pilot currently used paid staff, volunteers and peers would have a role to play in scaling up and improving it, he said.
Discussions with the organisation’s insurance broker about ‘what is essentially a digital safer injecting service was an interesting one to navigate’, he told delegates, and there had also been ethical considerations. ‘At the moment our supporters will send an emergency ambulance response in the case of an overdose but in North America people can nominate a rescuer’ – such as a next-of-kin.
‘There’s scope to do that here, but we need to think carefully about how we get opt-in and consent, and make sure they feel supported and safe if we’re informing them of an overdose and potentially sending them to an address they might not know much about, and where they may be risk factors that we’re not aware of.’
Cranstoun was also putting in an application to a mobile network for 500 SIMs loaded with 40G of data per month for six months to support and encourage people to use the app. Sharing and promoting it would now be the focus, he stressed, and there was potential for building in other elements like naloxone ordering and access to drug checking services. ‘We’ve all got an ambition to reduce drug-related deaths, so work with us to promote this service and make it available in your area,’ he asked delegates. ‘Too many people are dying behind closed doors, and no one needs to die alone.’
People with lived experience had been central to setting up treatment services, from the 12-step fellowships onwards, said programme manager for alcohol and drug treatment and recovery at the Office for Health Improvement and Disparities (OHID), Laura Pechey. ‘The key is relationships, authenticity, and honesty.’ The government was committed to supporting thriving recovery communities and networks of recovery organisations, she said, along with more peer support workers.
Lanre and Adé from BUBIC discuss the best ways to engage Lived Experience Organisations with Ged Pickersgill from The Well Communities and Laura Pechey from OHID
Last year OHID had commissioned a national workforce census (DDN, April, page 6) and had asked treatment providers, local authority commissioners and lived experience recovery organisations (LEROs) about their workforce – there were 640 peer support roles in treatment services, four out of five of which were volunteers, she said. This compared to one in three of the lived experience workforce being volunteers. ‘Volunteering can be amazing – it can help the person who’s volunteering and certainly the people they’re working with – but when we did a consultation last year we did hear reports of people in peer support roles who didn’t have the right support and training to do that role and to benefit from it themselves.’
The team from Archer Resourcing had been busy baking!
OHID had also developed guidance with recovery champion Dr Ed Day and the CLERO to try to give this part of the sector ‘its moment in the sun’, she said, and demonstrate the value of working together to develop these initiatives. The final section of the document would set out how local areas can do this – ‘getting those assets and building them, making sure things are safe and effective and supporting the funding growth.’ Another section was how to contract lived experience organisations, including minimum standards. ‘For commissioners, I imagine if they’ve never commissioned a lived experience organisation there’s a nervousness about that.’
Sometimes that was inevitably the result of stigma, she said. ‘It’s worth noting that contracting isn’t the only way to do this – we’ve heard a lot about building reciprocal relationships, working together to a shared purpose, and supporting each other.’
Ged had plenty of support from his colleagues at The Well Communities
On the subject of asset-based community development, Ged Pickersgill from the Well Communities told delegates that it came down to ‘being given a handful of corn and being expected to feed 25,000 chickens with it – the very nature of where our organisation stems from means we have to use an asset-based approach.’ This meant focusing on operational delivery – service user feedback showed that a good quality service was more about treating people with honesty and integrity than having top-quality facilities. ‘Asset-based development is something we do with our community and for our community – everything we do is done with, not to. We’re led by the very people we serve.’
The commissioning process needed to take account of the feedback that organisations like his were getting from the ground, he stressed. ‘We know our community. We’re professional people, with lived experience. There needs to be a wider acknowledgement that we need to listen to what people need, not purport to know what they need.’
‘The community knows what the community needs,’ agreed Lanre Babalola, chief executive of BUBIC (Bringing Unity Back Into The Community). ‘We’re able to be creative.’ His organisation had built a strong relationship with commissioners and treatment providers, he added. ‘It’s not us and them – it’s us together – because the most important person is the client.’ In the early days of the organisation it had been challenging, however, said his colleague Adé. ‘The clients told us more than they told anyone else, but when we’d go meetings there’d be no data sharing.’ When his 81-year-old neighbour asked him to take the lid off a jar, said Ged Pickersgill, he didn’t say ‘where’s your risk assessment? I just take the top off the jar. We could learn from that.’
Sanjeev Kumar, Marcus Johnson Christiane Jenkins and Karolina Sowinska share the story of SUIT and some laughs!
‘Eight years ago I was in a rehab thinking my life was over – I’m managing SUIT today,’ said Marcus Johnson of Wolverhampton-based SUIT (Service User Involvement Team). He’d started as a volunteer himself, and in the last 18 months or so his organisation had managed to get 30 of its volunteers into paid employment – something that was achieved through partnership working with local clinical organisation Recovery Near You. ‘We’re into our sixth year of working with them. Sometimes the partnership’s a bit like the Conservatives and the Lib Dems, but it’s getting better. And for organisations like ours to continue to exist, it’s all about funding.’
Everybody at SUIT had lived experience, he stressed. ‘They all bring something you can identify with. For me, the power of identification and lived experience saved my life. To be working with these people on a day-to-day basis is unbelievable.’ Staff with lived experience were able to be understand and be patient and get the best from each individual, added his colleague Sanjiv Kumar. ‘I’d really like to emphasise the opportunities that SUIT volunteers get – the opportunity to be innovative, be creative, and put your own personal touch into projects. It’s what I believe keeps organisations and their staff from becoming stagnant.’
Exhibitors offering tailored support for individuals.
Alcohol use in the South Asian community was a ‘massive’ problem, he said, and it could be hard to engage with this population group. Issues facing the community included older generations not understanding addiction, pressure to succeed in academia and pressure to enter arranged marriages. ‘People do turn to drink and drugs to relieve this pressure, and the language barrier is a big problem. I can speak Punjabi – having an understanding of where they’ve come from and being able to speak the language helps.’
SUIT volunteer Karolina Sowinska was able to use her lived experience to engage with the Polish and Eastern European community, she told the conference. ‘And I never thought I’d be able to make use of my lived experience.’ According to the 2021 census, 1.3 per cent of Wolverhampton’s population had Poland as their country of birth – ‘we’re immigrants, we’re parents, we’re people, we’re drug and alcohol addicts. But communication is a big problem.’
Overall, there were 10,000 people in Wolverhampton whose access to services was limited by a language barrier, she pointed out – ‘Punjabi, Polish, Czech, Slovakian, Lithuanian.’ While previously, there were just two Polish people – from a local population of more than 3,400 – in local services, since SUIT’s outreach work with Karolina, four had been registered in June alone. ‘The Ethnic Community Project has given us the chance not only to get more people assigned to services, we’ve created much more – we’re giving hope. And I hope in the future I can make those numbers much bigger.’
The team from Changes UK who provided fantastic support to make the event possible.
Recovery through creative and collective processes was also encouraged and celebrated at SUIT, said volunteer and PhD student Christiane Jenkins. ‘Lived experience is a source of inspiration and proof of successful recovery. We can all be described as recovery carriers, enabled and empowered to share our wisdom and inspire others.’
Peer-led support could show that transformation was possible, she said. ‘Unlocking people’s talents and providing opportunity through positive change in a social group will profoundly develop success in recovery. Recovery is contagious.’ SUIT had now also developed a creative arts collective, she said. ‘Exploring the arts can mean discovering lost skills, identifying emotions and communicating our feelings – especially for people coming from multiple disadvantage.’ It was the ‘outreach of opportunity’ to those who would otherwise be excluded, she stated.
‘SUIT’s creative space is DIY, it’s grassroots, and it’s co-produced. It provides creative freedom and a sense of place. It’s through individual support and collective action that we can push through to policy development and contribute to challenging and transforming dominant modes of policy intervention and care.’
Cranstoun presentations by Alistair Bryant (Packs Team) and Luke O’Neil (Buddy Up). More information: cranstoun.org
Partnership working Dr Laura Pechey, OHID in conversation with Ged Pickersgill, The Well Communities and Lanre and Adé from BUBIC.
BUBIC: Bringing Unity Back Into the Community – Breaking cycles of habitual behaviours through peer support and engaging with communities to create inclusion and cohesion: www.bubic.org.uk
SUIT – Wolverhampton’s drug and alcohol service user involvement team has supported vulnerable adults in the city for over 15 years: www.wvca.org.uk/suit
The Well Communities – Lancashire based Lived Experience Organisation supporting people in recovery through therapy, counselling, peer mentoring, employment training and social activities: www.thewellcommunities.co.uk
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Other useful links:
Abbey Care – Offering detoxification and residential treatment services in Scotland and Gloucestershire: www.abbeycarefoundation.com
Archer Resourcing – Providing staffing solutions to the criminal justice, nursing, substance misuse, social care and housing sectors: www.archerresourcing.co.uk
Changes UK – Birmingham based Lived Experience Recovery Organisation that supports people in both residential and community settings: changesuk.org
Druglink – Substance misuse charity based in Hertfordshire whose objective is to change the future for people affected by substance misuse through treatment, housing solutions, education and training: www.druglink.co.uk
Exchange Supplies – A social enterprise working to improve the harm reduction response to drug use by developing products and information for injecting drug users, drug services, and needle exchanges: www.exchangesupplies.org
Generis (ADS) – The Alcohol & Drug Service works in partnership to support people affected by substance misuse to make positive change: ads-uk.org
Naloxone Man – Who knows who he is and when he may appear? But you may be able to contact him via the award winning trainer and consultant George Charlton: georgecharlton.com
Rite to Freedom – From their Devon base they offer opportunities for creativity, nature connection and meditation, supporting a thriving addiction recovery community to live with meaning, purpose and joy: ritetofreedom.org.uk
Steps Together Group – A collection of addiction treatment services, providing a combination of residential and outpatient addiction treatment & therapy services for individuals and their families: stepstogether.co.uk
Turning Point – Social enterprise, delivering health and social care services in the fields of substance use, mental health, learning disability, autism, acquired brain injury, sexual health, homelessness, healthy lifestyles, and employment: www.turning-point.co.uk
The 15th DDN conference, Many Roads, kicked off with a powerful session on challenging stigma.
‘We’re making the statement that whatever our background, our beliefs, our lifestyle, the stage we are each at – we’re here because we value the dialogue between us all,’ DDN editor Claire Brown told delegates, as she explained the theme of this year’s conference – Many Roads.
For decades, organisations and initiatives had been working to tackle the stigma directed at people who used drugs and some who used alcohol, said chief executive of Phoenix Futures and co-chair of the Anti-Stigma Network, Karen Biggs. ‘It’s no longer socially acceptable to stigmatise people with mental health conditions or people who’ve experienced domestic violence, even though we know that still happens.’ Attitudes to people who used drugs, however, hadn’t changed.
Karen Biggs, CEO of Phoenix Futures Launches the Anti-Stigma Network. Click to view Karen’s presentation
There were constant examples of overtly stigmatising language across the media, health and social care, and policy domains – almost all of which went unchallenged, she stated. ‘If we’re to make real progress in helping people whose lives are impacted by addiction, we need our governments, our media and our public servants to understand stigma, how it’s created, and the pernicious effect it has on so many people’s lives.
Join the Ant-Stigma Network
It was a process that would take time and commitment, she said. ‘We all need to act against stigma and ensure that our work doesn’t inadvertently or purposefully perpetuate it.’ Establishing the Anti-Stigma Network had involved talking to people with direct experience of stigma, service providers, academics and others. ‘Our mission is to end stigma,’ she stated. ‘Some people say that can’t be done, but our view is that our ambition can’t be anything else but to end the discrimination that limits the opportunity to thrive in life, that creates inequality, and takes away people’s basic human rights. We’ll do it by collaboration and co-production – we won’t always be right, we’ll make mistakes, and we hope to be able to learn together.’
Follow Via to help smash stigma
The approach was rooted in lived experience, she said. ‘We’ve worked with people with different life experiences of stigma to help us create the network, from the initial idea to the aims and the branding.’ The stories on the network’s website were about people, she stressed – ‘drugs and alcohol are a feature, but they’re not the story.’ Instead they were about lives, experiences, journeys and barriers faced. ‘We believe this is a powerful way to educate people about what stigma is. It’s the shaming, the prejudice, the discrimination people face in accessing health, housing and employment, and it’s the policies and procedures that make it difficult for people to create the life they want.’
Membership of the network currently stood at around 400 individual members from a wide range of sectors, she said, with an organisational membership due to launch soon. ‘We started with a personal membership because – as with any anti-discrimination initiative – this takes a personal motivation and an individual set of values to truly commit to.’
The Team from Tom Harrison House were highlighting the challenges and stigma faced by ex service personnel.
In establishing the network she’d frequently been asked, ‘what makes you think this will make a difference?’ she said. ‘The question for me is bigger than that – it’s why this, why us and why now? Well of course the answer is that the right time to do this was a long time ago. Maybe we wouldn’t be in the situation we are now, with the highest ever number of people dying from a preventable condition.’ In some parts of the UK, even with the new drug strategy, this showed no signs of improving, she pointed out. ‘But we know more now about what approaches work. The next level of progress will be when we create something bigger together than we can do on our own. We’ll learn how to do this as we go, and we’re a broad church – with different life experiences and values. There are indeed many roads that have brought us together, and that gives us a massive canvas to address the many forces that create stigma. It’s about our personal openness and commitment to our anti-stigma role.’
Hannah Shead CEO of women and children’s charity Trevi, with her colleague Faye.
The network’s starting point for naming, understanding and calling out stigma was the health and social care sector, she told delegates – including drug and alcohol treatment. ‘We all have examples of how services and pathways stigmatise people.’ Alongside structural stigma, this was also down to individual assumptions and actions, she stressed. A recent report into women’s experiences in the North East of England found that 64 per cent of women looking for help for domestic violence, substance use or homelessness had experienced discrimination from practitioners, she pointed out – ‘the very people they were looking to for help. So we’re calling on all of us to get our own house in order, which will give us the strength to tackle the wider societal and structural stigma which will be critical to our success.’
When it came to women’s treatment, the Dame Carol Black review – while a welcome and valuable document – didn’t focus enough on the specific needs of women, said Hannah Shead, chief executive of Trevi, a partner in Collective Voice’s Women’s Treatment Working Group. ‘As 52 per cent of the population, sometimes our needs aren’t thought about in a specialised, specific way. We can sit and talk about this stuff for ever, but we need to see things change.’
April Wareham from Working with Everyone highlighted the specific stigma women face (April asked not to be pictured)
The working group was interested in the views of both women who used services and those ‘who don’t come to our services, because they don’t feel it’s safe’, she said. ‘Women who won’t reach out for help because of the stigma, and because of the way our services work.’
‘Society judges women who use drugs more harshly than it judges men, and it judges them pretty harshly,’ April Wareham, director of Working With Everyone, told delegates. ‘Even among people who use drugs, women are judged more harshly. Women who use drugs feel that men see them as sexually available, just because they happen to use drugs. Women have told me that there was an assumption that they were sex workers even when they weren’t.’ And mothers who used drugs were subject to particularly harsh judgement, she added. ‘I’ve heard of women being told by hospital staff just after having a miscarriage that “it was probably for the best, wasn’t it?” For most mothers who use drugs that I speak to there’s a massive fear of getting help because they’re scared they’ll lose their children’ –and of course mothers who lost custody of their children were judged more harshly still.
Exhibitors showcased the work they do supporting individuals and challenging stigma
At a recent women-only workshop she’d been involved in, all ten participants reported being survivors of domestic abuse, physical abuse and emotional abuse – ‘with a side order of gaslighting’, she said. Eight out of ten reported financial abuse, sexual abuse or sexual assault from an intimate partner. ‘You talk to women and they’ll say, “I thought this was normal”.’ Women were reluctant to ask for help for domestic abuse, fearing they’d be blamed because they used drugs, she stated.
Anna Millington works to support mothers who use drugs and to challenge the stigma they face.
‘Back when I was using treatment services I saw a guy outside. The last time I’d seen him he’d been holding my sister-in-law by the throat, so I didn’t go in. I speak to women all the time who are told to go to a treatment service or they’ll have their kids taken away. So the choice is to go to a service where you don’t feel safe or to have your children taken. You’re damned if you do, and you’re damned if you don’t.’
Most women reported that they’re weren’t offered the choice of a male or female key worker, she continued, and would not talk about issues like abuse to a man. Many areas also didn’t have women-only fellowship meetings, and any female attendees could often be the only woman in the group. ‘I hear from women who are terrified that there won’t be a woman available to sponsor them.’
Women felt that there were defined gender roles in the drug world, all the way through to recovery, she said. ‘I remember user involvement groups in the NTA days – when I agreed with the men I was a princess, and when I disagreed I was a bitch. 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. I’ve experience misogyny in the addictions field, and been told that I hadn’t. Part of me is back there picking myself up off the floor from where a man who told me he loved me had knocked me down, being told it wasn’t domestic abuse and besides it was all my fault. Women’s lived reality and lived experiences are still being minimised and denied. It doesn’t go away.’
Society was structurally and institutionally sexist, so it was little surprise that treatment services had been designed around the needs of men, she said. ‘Whether they meet men’s needs or not is a discussion for another day, but time and time again I hear women telling me that this one size doesn’t fit anyone.’
Sometimes doing the smaller things could be the beginning of significant changes, said Hannah Shead – ‘creating women-only spaces in your services will start to show to women that there’s somewhere safe. Think of those small changes you can make, and have the courage to make them. And when we’re delivering, designing, planning, let’s think about the women in our services – and think about the women who perhaps aren’t coming to our services because of the way we design and plan them.’
Callie Davidson, programmes coordinator at Safe Ground, shared the experience of stigma people working with the programme faced.
Callie Davidson, programmes coordinator at Safe Ground – a national organisation that delivers arts-based group work to people in prison and community settings – then shared the experiences of stigma among people the organisation works with. ‘We know that are participants are capable of far more than they’re given credit for,’ she said.
Her organisation was concerned with ‘the stories we tell ourselves, the stories we tell one another and the stories that are told about us,’ she said. Concepts of identity and relationships were central, and participants were encouraged to reflect on, and learn from, their own lives.
‘We work hard to create a space in which biases and preconceptions are acknowledged and interrogated. But the goal of our methodology and the way we approach our work is to make room for participants to be themselves. So I want to encourage you all not to wait for an annual conference to invite people’s stories. Every day we’re presented with the opportunity to hear people’s stories and discover the wealth of experience, creativity, reflections and ideas they have to offer. When we give people the time and space to tell their own stories on their own terms, we can begin to deconstruct the stigma they encounter.’
Emerging Futures, cup cake makers extraordinaire! Also a charity working to support people affected by homelessness, drug and alcohol problems and physical and mental health needs: www.emergingfutures.org.uk
neo360 provide comprehensive harm reduction monitoring and reporting solutions: neo360.co
The Hepatitis C Trust is a charity dedicated to eliminating hepatitis C in the UK by 2030. Find information and support about the virus here: www.hepctrust.org.uk
Intuitive Thinking Skills: Empower individuals and build personal resilience via mentoring, accredited programmes and through highly innovative IPS services in communities, prisons, schools and via our digital services: www.intuitivethinkingskills.co.uk
Phoenix Futures is a national charity providing both community and residential services: www.phoenix-futures.org.uk
Red Rose Recovery: Lancashire based peer-led organisation supporting individuals and creating opportunities for people affected by substance misuse, mental health and offending behaviours: redroserecovery.org.uk
Tom Harrison House, specialist addiction recovery programme for UK Armed Forces veterans and emergency services personnel: tomharrisonhouse.org.uk
Yeldall Manor is a residential drug and alcohol recovery centre near Reading offering a healing community with a holistic approach for men struggling with addiction: yeldall.org.uk
Release is the national centre of expertise in drugs and drug laws. We were founded in 1967 – potentially making us the world’s oldest drugs charity – and we provide free, non-judgmental, specialist advice and information to the public and professionals on issues related to drug use and drug laws. We also fight for drug policy reform, so that in the future people who use drugs are treated based on principles of human rights, dignity and equality. To achieve this, we advocate for evidence-based drug policies that are founded on principles of public health rather than a criminal justice approach.
We provide frontline services via our legal clinics around the country. We also provide direct advocacy support to people who use drugs, to ensure that those in drug treatment are receiving person-centred care. Over the years, we’ve advocated for the rights of many different groups of drug-using people. In some cases, matters are swiftly and positively resolved for all involved – with others, issues can sadly drag on for years at the expense of the service user, who is subjected to inadequate or ill-fitting treatment plans throughout this lengthy process.
The Orange Book details how clinicians should treat people with drug misuse and drug dependence problems. The Ashton Manual contains protocols for tapering safely.
Release actively works towards a world where our drugs advocacy service becomes obsolete, and where people who use drugs are heard when they need changes to their treatment plans – not because they’ve brought in ‘a national expert’ to sit in on their medical review, but because their needs are respected. To make this vision a reality, we’ve embarked upon a mission to create, publish and widely distribute our own advocacy toolkit, so that people can more readily advocate for themselves and their communities.
Of course, our toolkit won’t account for everything, and we still find ourselves regularly stumped on advocacy cases. Much of what we’ve achieved would not be possible without help from others in the harm reduction world, who have generously shared examples of good practice, specialist resources, and strategy ideas for our advocacy cases. We want to return that kindness by sharing with our community what we have been through and learnt, in the hopes that future services can improve their practices and people can more easily access high quality treatment.
For this reason, every other month, Release will publish a case study in DDN from our advocacy work, including relevant guidelines and pieces of evidence we used. Our aim is to promote better practices for DDN readers who work in services, and to give people tools to challenge their own treatment decisions, if they find themselves in similar circumstances.
Nick’s Case
For our first case study, I’d like to introduce ‘Nick’ – not his real name, but a very much real and recent situation. Nick is a 42-year-old man who was dependent on street benzos, mainly diazepam, when he contacted Release. His benzo supply has not been regular, and when he has accessed drug testing via WEDINOS he has seen that at least on one occasion his supply was bromazolam as opposed to diazepam, which is what it supposedly was when purchased.
Nick has used benzos for six to seven years, on and off for the first few years. He is not sure how long he has been ‘dependent’, although he believes this has been since around lockdown. During lockdown, Nick’s overall quality of life deteriorated, and his drug use increased. In 2021, he admitted himself into a private rehab clinic, staying there for two months. He was consulted by a virtual clinician for 20 minutes who was based abroad, then immediately put on only 30mg of diazepam when he was previously on a much higher dose of street benzos. The withdrawal was difficult to manage, impacting his sleep and his ability to take part in psychosocial interventions, causing him eventually to leave the rehab.
Nick has been in drug treatment twice, not counting his time in private rehab. His first time was around 2019. During lockdown, he returned to drug treatment and has been there since. However, since the end of lockdown, Nick’s service has been recommissioned, causing significant staff turnover. Nick was assigned a new key worker every few weeks, negatively impacting his ability to build a therapeutic relationship and make progress in his treatment plan. At this point, Nick reached out to Release, with the goal of safely working towards becoming abstinent from benzos. However, his treatment service says they won’t prescribe benzos to him to use for this reduction as it is against the service’s policy.
What do the guidelines say about Nick’s case?
Regarding the care Nick received at his private rehab, the Drug misuse and dependence: UK guidelines on clinical management, otherwise known as the Orange Book, states that: ‘For those who are benzodiazepine dependent, sudden cessation in their use can lead to a recognised withdrawal state. Good assessment and care planning – and adherence to local protocols – are prerequisites for considering prescribing benzodiazepines. Prescribing benzodiazepines to drug misusers requires competencies in this form of treatment and appropriate supervision.’
As for the commissioned drug treatment provider, the same guidelines say that to ‘prevent symptoms of benzodiazepine withdrawal, the clinician should continue a current prescription but the dose should be gradually reduced to zero… The aim should normally be to prescribe a reducing regimen for a limited period of time.’
When Nick contacted us, he was already quite knowledgeable about the Orange Book and other resources such as the Ashton Manual, which contains protocols for tapering safely off different benzodiazepines. We obtained permission from Nick to contact his treatment provider and request their benzodiazepine treatment policy. They then produced a policy which allowed for prescribing, but only for a very short period of time – there was little room for flexibility in how a person can detox safely and comfortably.
Once again, the Orange Book states that: ‘While full detoxification can proceed without difficulty within weeks or within 2-3 months for some patients, NICE expert review has noted that withdrawal may take three months to a year or longer in some cases. An optimal speed or duration of dose reduction is not known.’
Ultimately, Nick ended up doing the taper himself with his illicit supply rather than continuing to battle his service to access care. His goal now is to share his story and influence treatment systems to better support people who use benzodiazepines. Nick worked with Release to turn his story into a case study to share with attendees of the Managing Drug And Alcohol Problems In Primary Care Conference, to promote more understanding amongst prescribers, and has given permission for its use here.
Shayla Schlossenberg is drugs service coordinator at Release.
Just under 40 per cent of smokers in the UK think that vaping is ‘as or more risky’ compared to smoking, according to a YouGov survey of almost 12,300 adults commissioned by ASH.
ASH has published a ‘myth buster’ to challenge ‘common misrepresentations of the evidence’ on vaping.
Last year, just 27 per cent of smokers believed this to be the case.
Almost two million people who smoke have never tried vaping, says ASH, despite it being a ‘very effective quitting aid’, while nearly three million have tried vaping and since stopped. A government ‘swap to stop’ campaign earlier this year offered a million smokers a free vaping starter kit alongside behavioural support, with the success of the scheme threatened by growing concerns that vaping is riskier than smoking, ASH states.
ASH has published a ‘myth buster’ to challenge ‘common misrepresentations of the evidence’ on vaping. Professor Sir Chris Whitty, the chief medical officer, puts the case ‘succinctly’, the document states: ‘The key points about vaping can be easily summarised. If you smoke, vaping is much safer; if you don’t smoke, don’t vape.’
‘The government has backed a vaping strategy as its path to reduce rates of smoking, but this approach will be undermined if smokers don’t try vapes due to safety fears or stop vaping too soon and revert to smoking,’ said ASH’s deputy chief executive Hazel Cheeseman. ‘The government must act quickly to improve public understanding that vaping poses a fraction of the risk of smoking.’
The most recent NHS Digital Smoking, drinking and drug use among young people in England report found that while the number of secondary school pupils who took drugs had dropped from 24 to 18 per cent since 2018 the number vaping had increased from 6 to 9 per cent.
‘Anxiety over youth vaping is obscuring the fact that switching from smoking to vaping will be much better for an individual’s health,’ added Professor Ann McNeill of King’s College London. ‘ It is wrong to say we have no idea what the future risks from vaping will be. On the contrary levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke, which indicates that any risks to health are likely to be a fraction of those posed by smoking.’
Updated guidance for commissioners and local services on preparing for, and responding to, incidents involving fentanyl and nitazenes has been issued by OHID.
Fentanyls are still causing ‘significant issues’
Fentanyls are still causing ‘significant issues’ in the US and Canada, and there are signs that they are being seen more often in local drug markets in the UK, the agency states. Local areas need to plan for how they will ‘rapidly understand and assess’ the risk of any future threats, as well as do everything they can to review their arrangements to minimise the potential impact. This includes improving local drug information systems and naloxone supply.
‘Areas should work through existing mechanisms for emergency preparation, response and recovery to develop a plan that can be enacted quickly in the event of an incident,’ the guidance states. ‘This may benefit from working with or through the local resilience forum and local health resilience partnership.’
Synthetic opioids can be found in different formats including fake oxycodone tablets
Synthetic opioids are both actively sought by people buying drugs and added to street heroin without buyers’ knowledge. They can also be found in fake oxycodone tablets or occasionally in other drugs. In the event of any threat, local areas need to rapidly understand how many people are affected and in which neighbourhoods – including those in neighbouring council areas –along with the numbers of overdoses or deaths. This information can come from police, emergency departments, drug services and the local drug information system (LDIS) or professional information network (PIN), as well as testing.
The information will then need to be shared with ambulance trusts as well as treatment, harm reduction and outreach services, and people who use drugs. ‘You should target messages at the audiences most likely to be at risk and the places you are most likely to reach them, the guidance says. ‘In most cases, it will be people who use drugs and are not in treatment who are at most risk, and you will need to make greater efforts to reach them,’ including enhanced targeted outreach.
Areas also need to implement a clear incident response plan that incorporates business continuity and risk assessment, it adds. ‘Your OHID regional team can provide advice and expertise in preparing for, or activating, a response to an incident caused by potent synthetic opioids.’
Guidance for local areas on planning to deal with potent synthetic opioids available here
A new service launched by Humankind and Project 6 will open its doors on 1 August 2023, aiming to support people who have issues with alcohol and other drugs across the city of Sheffield.
Likewise, which has been commissioned by Sheffield City Council, is a partnership between national charity Humankind and Project 6. The service will provide free, confidential, and non-judgemental support to people who need it.
Likewise is the second service Humankind has launched in partnership with Project 6, after New Vision Bradford opened its doors across the Bradford District in April 2023. Project 6 has been providing support to individuals and families affected by substance use and experiencing multiple disadvantage in Sheffield for over 40 years.
The newly established Likewise and New Vision Bradford represent a significant extension to the support Humankind has been providing to people across Yorkshire for many years, through other services like Barnsley Recovery Steps, Calderdale Recovery Steps, Forward Leeds, North Yorkshire Horizons and The Greens.
Every Humankind service across the country that has been inspected by the Care Quality Commission (CQC) has been rated either ‘Outstanding’ or ‘Good’, including its services across Yorkshire.
Greg Fell, Director of Public Health, Sheffield City Council said, “Sheffield City Council are delighted to be working alongside Humankind to deliver the new service Likewise, which will play a vital role in supporting individuals and communities in Sheffield impacted by drug and alcohol use.
“We have seen the impact Humankind have had regionally and nationally and are very excited to be in partnership with them to deliver the goals set out in the National Drug Strategy ‘From Harm to Hope’.”
Emily Todd, Humankind Regional Director, added, “We are proud to be increasing the support Humankind offers to people across the country and in Yorkshire.
“With the local expertise of Project 6, feedback received from people we will be supporting and our workforce, and the extensive preparation that has been put in to launching the new service, we know we are in a strong position to make an incredibly positive impact on the overall health, wellbeing and safety of the Sheffield community.”
Vicki Beere, Project 6 CEO, also commented, “We are very pleased to be working alongside a partner in Humankind, with a track record of delivering exceptional services across our region. We look forward to this opportunity to build upon our years of experience developing community-rooted projects to ensure more people across our city have access to support and recovery services when they need them.”
Likewise will offer a range of support including harm reduction, recovery navigation, clinical and therapeutic interventions. The service will also provide support for family members and continue to work with people in longer term recovery to help them create a healthy and meaningful life.
From 1 August, you can contact Likewise for free and confidential support or advice about your drug or alcohol use, call 0114 308 7000, email info@likewisesheffield.org.uk or visit www.likewisesheffield.org.uk
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.
Access to alcohol treatment in Scotland has declined by 40 per cent in ten years, according to analysis by Alcohol Focus Scotland.
The number of people starting specialist alcohol treatment fell from more than 32,500 in 2013-14 to just over 19,600 in 2021-22, according to analysis of data published by Public Health Scotland. Funding to alcohol and drugs partnerships was cut by 20 per cent – from £69.2 to £53.8m – over the same period. The drop in provision also predates any impact from COVID-19, Alcohol Focus Scotland states, as provision had already fallen by 30 per cent before the pandemic.
Laura Mahon: The drop in treatment level is shocking
Alcohol Focus Scotland is calling for more investment in alcohol services and recovery support, alongside an uprating of MUP and more action to restrict alcohol marketing.
‘The drop in the level of treatment in Scotland over the last ten years is shocking and deeply concerning,’ said the charity’s deputy chief executive, Laura Mahon. ‘Alcohol harm has remained high in Scotland over this time period, so this is not a question of whether people’s need for support has reduced, but rather that they are finding it more difficult to access the support they need. This drop in treatment coincides with a period when budgets for alcohol and drug partnerships were cut. At the time, many of us feared that those cuts would affect service provision and it now appears that is the case. The fact that this drop in support is only now coming to light is also of real concern. The Scottish Government urgently needs to invest in alcohol treatment – as they have in drug services – and to monitor provision to ensure these vital services are maintained.’
Turning Point’s Drug and Alcohol Wellbeing Service (DAWS) highlights the five key steps you can take to protect yourself and reduce your risk of hepatitis B and C.
An estimated 60,000 people in London have been infected with hepatitis C (they are hepatitis C antibody positive), of these, 69% have not cleared the infection. This highlights the impact of hepatitis C locally, and millions of people are affected worldwide. For World Hepatitis Day on Friday 28th July, we want to raise awareness of the risks of hepatitis to promote prevention, early detection, and effective treatment.
There are five main types of hepatitis, each caused by a different virus, and they vary in terms of how serious they are and how they can be passed on. Hepatitis A and E are usually transmitted through contaminated food or water and are not common un the UK. Hepatitis D only affects individuals already infected with hepatitis B. It tends to worsen the outcomes of hepatitis B infection.
The two main hepatitis viruses that effect people in the UK are:
Hepatitis B spreads through infected body fluids, such as blood and sexual contact. If left untreated, hepatitis B can lead to severe liver damage, including liver disease and liver cancer.
Hepatitis C is primarily transmitted through contact with infected blood, often linked to sharing needles or receiving blood transfusions. Many people who use drugs are at risk and can be effected by it. Like hepatitis B, it can also cause chronic liver disease. Hepatitis C is treatable although no vaccine for hepatitis C is available. Medicines can cure most cases of hepatitis C.
Five things you can do to lower your risk of getting seriously ill from hepatitis B and C
You can get vaccinated for Hepatitis A and B to prevent infection. We provide hepatitis B vaccinations in our hubs.
Get tested for Hepatitis C at one of our hubs in Hammersmith & Fulham, Kensington & Chelsea and Westminster. Find your nearest hub or give us a call 0330 303 8080
Use condoms to reduce the risk of contracting hepatitis B and other sexually transmitted infections.
People who share needles or drug equipment are at a higher risk of contracting hepatitis B and C as these viruses can be transmitted through infected blood. If you use needles for medical or recreational purposes, make sure they are new, sterile and not shared with others. You can use our free needle exchange services to ensure you have safe and sterile equipment. We even provide injecting advice and harm reduction techniques.
Try to be more aware of how much alcohol you’re drinking and stay within the recommended 14 units of alcohol per week. Alcohol abuse can take a toll on the liver, making you more vulnerable to hepatitis related damage. Combining alcohol with certain medications for hepatitis treatment can be dangerous too.
How do I know if I might have hepatitis and what should I look out for?
Common symptoms are:
Fatigue
Abdominal pain
Jaundice (yellowing of the skin and eyes)
Nausea, and loss of appetite
In some cases, hepatitis may present without any symptoms, making it crucial to get tested, especially if you are at risk due to potential exposure. i.e use of needles, sex working etc
Get access to testing and advice
All of our hubs offer testing for hepatitis and other blood borne viruses. If you receive support from us, we offer a £5 voucher as an incentive for you supporting us to eradicate hepatitis C by 2030. Don’t wait. Give us a call or visit our hub today. Get tested and access lifesaving treatment. It could save your life and others.
Get access to testing and advice this week at one of our drop in testing events from 10am – 3pm. See details below for dates and locations.
Wednesday 26th July – 209a Harrow Road, W2 5EH
Thursday 27th July – Acorn Hall, 1 East Row, W10 5AW
Friday 28th July – New Coach House, 370-376 Uxbridge Road, London, W12 7LL
Friday 28th July – 32a Wardour Street, W1D 6QT
On the Right Track (August 2023): Elliot Bidgood from the Hepatitis C Trust talks about the importance of key targets in the campaign to eliminate hepatitis c.
The average weekly number of drug-related attendances at Scottish A&E departments between March and May this year increased by 13 per cent compared to the same period last year – to more than 1,080 attendances.
The A&E entrance at Ayrshire’s Crosshouse Hospital, located between Kilmarnock and Irvine. (Stock image copyright Mary and Angus Hogg)
However, the average weekly number of drug-related acute admissions was down by 23 per cent between January and March compared to last year, and by almost 50 per cent compared to 2021.
The figures are included in Public Health Scotland’s (PHS) latest RADAR (Rapid Action Drug Alerts and Response) quarterly report. The number of suspected drugs was ‘broadly stable’ at around 100 per month between March and May, the report adds, a similar figure to last year.
The drug death figures in RADAR documents, however, are based on the reports of police officers attending scenes of death and do not provide a ‘robust indication of the numbers of drug-related deaths occurring each year’, PHS states. The official statistics from National Records of Scotland, which are based on death certificates and pathologist reports, are due to be published in August. RADAR has two current alerts for drugs that pose a high risk of overdose – nitazene-type opioids and bromazolam, the most commonly detected ‘street benzo’.
Rapid Action Drug Alerts and Response (RADAR) quarterly report: July 2023 here.
Hepatitis C (hep C) is spread through exposure to infected blood and can cause serious damage to the liver without someone knowing.1
If left untreated hep C may cause scarring to the liver, cancer and even death.1
In England, there are currently 74,600 people living with chronic hep c, with almost 75% of those infected unaware that they have this disease. An important at-risk group are those who inject drugs, where the prevalence is estimated to be 56%.2
The good news is that advancements in testing and treatment mean health service providers have the tools to combat hep C, which was once a challenge. However, continued collaboration is required to achieve the NHS England (NHSE) target of hep C elimination in advance of the World Health Organisation goal of 2030, which would make England one of the first countries in the world to do so.3
Mark Gillyon-Powell, Head of Programme for Hep C Elimination in England, NHS England, states:
“Seeing the likes of drug and alcohol support services, NHS organisations, charities and the pharmaceutical industry coming together to tackle this challenge, is great. We’re achieving big milestones at national, regional and local levels towards elimination. The fact our initiative is not overly reliant on just one group is a real strength and is achievable by this cross-functional collaboration. Our ambition is to bring about an end to hepatitis C infection in this country, and making sure we don’t leave anyone behind along the way.”
In order to reach this target, we need the support of drug support service workers, like you, who can play a vital role in providing information and resources about hep C testing and treatment to people who currently or have previously injected drugs. Below are a few ways you can get involved:
1. Learn more about hep C elimination
The Be Free Of Hep C Elimination Series offers you the opportunity to share and learn from elimination peers involved in the identification, diagnosis and/or treatment of hepatitis C. Watch the highlights from our 2022 workshop and hear why this is the time to get involved.
We’ve never been so close to our shared goal of elimination. So far, more than 16 drug services have achieved micro-elimination status in England.4 This means that they have completed these milestones for the testing and treatment of hep C:5
100% of those in treatment have been offered a test
100% of those that have a history of injecting drugs have been tested
90% of those currently using injected drugs, or at continued risk of infection, have been tested within the last year
90% of people who test positive for hep C, have started treatment.
The definition and criteria for micro-elimination was created and agreed through a collaboration between WithYou, Change Grow Live (CGL), Westminster Drug Project (WDP), Humankind, Turning Point, NHS Addictions provider alliance (NHS APA) and Gilead Sciences.
To learn more about the changes that can be made, however small, that will make a huge difference, visit befreeofhepc.co.uk/elimination to watch the latest videos in this series. Or sign-up to our Gilead mailing list here, to receive updates when new resources become available.
2. Download helpful resources
Discussion guides, leaflets, posters, and stickers are available to download and print.
To support you with highlighting the risk factors for hep C to your clients, we have created tools, such as discussion guides, leaflets, posters, and stickers to use in your centres and when engaging those at-risk. Visit befreeofhepc.co.uk/providers to download and print these materials.
3. Raise awareness about testing options
Approximately 50% of people living with hep C do not know that they have the virus, therefore, it is important to get all those at-risk a test.6 Since 2019, through joint efforts with elimination partners, there has been over 300,000 hep C tests conducted.5 This is despite a drop in testing of over 65% in the first 6-months of the COVID-19 pandemic.7
With the aim of increase testing accessibility, NHS England has now launched a free, at-home blood test, that is delivered confidentially through the post. This additional testing offering supplements the existing approach of using medical appointments to take a blood sample.
At Gilead, we are working toward elimination targets by actively supporting the efforts of governments, patient organisations, payers and healthcare providers to increase awareness, drive screening and facilitate linkage to care. Collaborating with the aforementioned organisations we are empowering community-based testing of those at risk and getting those with hep C into the appropriate treatment pathways. We are proud of the work done so far by our partners whilst we make steps toward elimination.
The Be Free Of Hep C and Hep C, Ki? campaigns are disease awareness programmes that have been developed and funded by Gilead Sciences Ltd, a science-based pharmaceutical company. Gilead Sciences are proud to be working in partnership with NHSE, Hepatitis C Trust and drug treatment services to help reach the hep C elimination target.
UK Health Security Agency. Hepatitis C in the UK 2023. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1133731/hepatitis-c-in-the-UK-2023.pdfLast accessed: June 2023.
Two Humankind services, Calderdale Recovery Steps and Staffordshire Integrated Co-occurring Needs (ICoN), have been featured in the first annual national drug strategy report for their innovative approaches to supporting people with a drug related support need.
Photo by Rémi Walle on Unsplash
The annual report is the first collection of evidence and case studies published relating to progress towards achieving the aims outlined in the Government’s 10-year drug strategy, ‘From harm to hope’.
Calderdale’s approach to drug-related offending
Calderdale Recovery Steps, a CQC-rated ‘Outstanding’ service which supports people who have issues with drugs and alcohol in the West Yorkshire borough, has been recognised for its innovative approach to supporting people arrested for drug-related offences.
Since September 2022, the Calderdale community has benefited from ‘Fine Line’. The programme offers a bespoke support pathway for people arrested for offences related to cocaine. Anyone who has a positive test is directed to a required assessment with Calderdale Recovery Steps. The support service then determines the most appropriate support for that person, including flexible group sessions and individual check-ups with professional staff facilitated jointly by Humankind and our partners at The Basement Project.
79% of people eligible to access support from the programme did so, with over three quarters of those not re-offending over an average period of six months.
ICoN
Funded by Staffordshire County Council and the NHS, Staffordshire ICoN, a partnership between Humankind and Midlands Partnership University NHS Foundation Trust (MPFT) has also been spotlighted. The new initiative supports people in the county with both mental health and drug and alcohol issues.
Dame Carol Black recently attended an event to mark the launch of ICoN, commenting on her hope that “other areas will now find out more about ICoN and think about how they could borrow it, follow it or perhaps adjust it to best meet the needs of their local communities and the people who need their support.”
The power of partnerships
Both innovations highlight the significance of collaboration across criminal justice, health, and community organisations. The government’s drug strategy guidance for local delivery partners on participating in Combating Drugs Partnerships underscores the importance of this collaborative approach. Humankind is proud to identify ‘partnerships’ as one of the three key themes in our strategy Being Human. We are proud to see these innovations helping to build healthier and happier communities in the places we work.
The drug and alcohol treatment workforce has grown by 1,670 staff in the first year of funding following the government’s drug strategy, the Home Office has announced. This includes more than 1,250 new drug and alcohol workers, almost 480 of whom are focused on criminal justice.
According to the first ever national drug and alcohol treatment and recovery workforce census, published earlier this year, in 2022 there were almost 11,500 ‘wholetime equivalent’ treatment provider staff, almost half of whom were drug and alcohol workers (DDN, April, page 6).
The number of people having an inpatient stay in a specialist detox unit is also up by more than 25 per cent, while the number going to a residential rehab has increased by just under 5 per cent, says the Home Office document From harm to hope: first annual report 2022 to 2023. In terms of the criminal justice response, more than 1,300 county lines have been closed, it states, with almost 26,000 arrests across 13 project ADDER sites since 2021 – including more than 12,000 in the last year.
‘Our ambition is to support an additional 54,500 people into treatment by March 2025, focusing on the areas hardest hit by drug misuse first, with other areas following in years two and three,’ says the report. The overall number of adult treatment places has remained relatively stable in the year to March 2023, however, with local authorities focusing on recruiting new staff and building up local partnerships.
‘Local authorities have recently reviewed and updated their local annual treatment and recovery plans which must be in place before they can access the additional investment provided through the drugs strategy,’ the document states. ‘They have been encouraged to develop their plans against a menu of evidence-based interventions including recovery services and to be clear about where investments are focused. No two areas are alike, and this includes setting local ambitions to increase treatment capacity, which would deliver our national ambitions.’
Dame Carol Black: This journey requires ‘considerable cultural and operational change’
‘Although encouraged by the progress made so far, I would like us to be more agile in the years ahead,’ said Dame Carol Black in her foreword to the report. ‘We are on a unique and transformative journey, requiring considerable cultural and operational change. I have, without exception, seen examples everywhere I have been of people doing their absolute best to help turn people’s lives around. Those who work in addiction need to be given appropriate resources and tools, and leaders who can bring about whole-system change. I have seen some excellent practice but also practice that needs to improve – this requires integration into the recovery process of mental health and trauma support, housing support, and training and work opportunities.’
While the sector had ‘come a very long way’ since 2021, there was more to do, she stated – ‘we must be bold, determined and innovative, working around or through barriers, making our case for further support so that we realise our ambitions for the world-class system we can and should deliver.’
A team of nurses at Turning Point’s Rochdale and Oldham Active Recovery (ROAR) service has been nominated for a national award for their inspirational work.
As an important part of Turning Point’s ROAR service, the nursing team have led service improvement, ensuring quality, compassion and care for very vulnerable people.
The team have been recognised for their work by being shortlisted in the Public Health Nursing category for the Nursing Times Awards 2023.
The award recognises the important role that the nursing profession plays in promoting and protecting the public’s health.
Nurses at ROAR not only provide day-to-day support to service users, they also find innovative ways to reach people struggling with drug and alcohol use.
Within the service they have increased access to screening for blood borne viruses (BBV) and deliver Hepatitis B vaccinations and Hepatitis C treatment.
Some of their out-of-service work includes, piloting outreach into homeless hostels, delivering mobile Hepatitis C testing and treatment in the community, introducing novel opiate substitute therapies, and providing system leadership on services for people with complex needs.
A recent audit of randomised cases identified that over 90 per cent of ROAR’s clients had either current or past suicidal thoughts. Over 80 per cent of these clients had an unmet mental health need.
As a result, a new specialist nurse post was created to foster closer links with local mental health providers. The specialist nurse works with Turning Point clients providing mental health interventions. As well as creating a team around a client approach and providing a system leadership role, driving through quality improvements.
The team’s ambitions for the future include: achieving micro-elimination of Hepatitis C, extending the hostel outreach programme in order to increase the numbers in treatment and expanding their health screening, such as fibroscan for liver ailments, in order to reduce the pressure on primary care.
David (not real name), a male 58-year-old client at ROAR said the nurses had helped him accept help for his substance use.
“I have had substance use issues for over 15 years. I’ve used illicit substances like heroin, crack cocaine, diazepam and pregabalin. I am currently homeless after being evicted from my previous residence,” said David.
“I haven’t liked engaging with services in the past. I have seen the nurses at Turning Point for reviews of my medicine and health check. I’ve seen them both in the service and hostels as well.
“Their mental health nurse also completed a safety plan with me because I was having suicidal thoughts. They have puta plan in place for ongoing support and will talk to my GP if my mood deteriorates.
“The relationship I have with the nurses means I will go and talk to them about any physical health concerns. They talk to my GP and come with me to appointments when I need them.”
In April, the team received the Public Health Nursing Team of The Year in Turning Point’s national nursing awards.
Karen Penswick, clinical services manager at ROAR, said, “We know that the staff and service users at Turning Point are really appreciative of the work that the nursing team does which gives us more motivation to do more innovative work.
“I manage a really focused group of nurses who are dedicated to working with this client group. Some of them are quite new to this field but are really passionate about working with the clients whilst others have worked in this field for quite a while.
“I feel very proud of being able to manage this team because they are solution focused. They want what’s best for the client so if a client won’t come and see us, they’ll go out to their house or they’ll go and see them in a hospital or in a hostel.
“Our nurses recognise that some of our clients don’t go and see the GP or they don’t attend hospital appointments. We need to reach these clients and give them harm reduction advice and make it easier for them to access services.”
Annie Lynn, senior operations manager at ROAR added, “Some of the people we work with have a multitude of issues that they may need support with. We work with people with complex needs, we work with people who have been through trauma. Having that clinical capacity to be able to support people and ensure they’re on the right medications, can mean that they can travel through that recovery journey a little easier. Whether it’s for stabilisation, whether it’s harm reduction, whether it’s recovery, the clinical team are integral to everything we do.”
Julie Bass, Turning Point CEO, said, “My congratulations to the team at ROAR. Being shortlisted for a national nursing award is no small achievement. I am immensely proud of their hard work, their professionalism and their commitment to the people of Rochdale and Oldham.”
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.
The Federation of Independent Retailers, which represents more than 10,000 retailers and small businesses across the UK and Ireland, is calling on the Scottish Government not to impose too steep a rise in the minimum unit price of alcohol.
The government is currently consulting the industry on its views on a range of MUP rates – 50p per unit, the current level, as well as 60p, 70p and 80p or more. Health campaigners have long argued that the impact of the 50p level has been significantly eroded by inflation, and a recent statement signed by more than 30 health organisations and charities called for MUP to be increased to at least 65p, among other measures.
Scotland’s MUP legislation is subject to a ‘sunset clause’, which means that the Scottish Parliament needs to vote before May next year on whether or not to keep it in place. Legal challenges by the alcohol industry delayed the implementation of MUP in Scotland by several years after the legislation had been passed, and the Scottish Government is currently reviewing the evidence and considering whether to recommend to MSPs that MUP continues and what the new level should be.
Public Health Scotland’s final report on MUP, published in June, claimed that MUP had reduced alcohol deaths by 13 per cent and hospital admissions by 4 per cent, with the most impact felt in the country’s most deprived areas. However, it also acknowledged that there was little evidence of any impact on people with alcohol dependence, with many prioritising spending on alcohol over food and other essentials.
Scotland’s first minister, Humza Yousaf, told BBC Scotland that it was vital to ‘make sure, from a government perspective, that we have a robust evidence base and that we have done the consultation with stakeholders as necessary’, and would not be drawn on any potential future rate.
‘We can see the argument for increasing the price which has been in place for five years, a time of inflation,’ said president of the Federation of Independent Retailers, Hussan Lal. ‘However over 80p is over the top. We welcome any reduction in harmful levels of drinking. It undoubtedly blights many lives. However we feel that, as Public Health Scotland has suggested, this scheme can only be part of the solution. Our members feel there needs to be highly effective campaigning to help change Scotland’s attitude towards drink, and therapy for problem drinking needs to be much more widely available.’
We really want to hear what you thought about this year’s DDN Conference – what you enjoyed, parts you found interesting, anything that worked well and anything you think that could be improved. We are planning lots of online coverage of the event and a special issue of the magazine, so we would also be really grateful for any pictures or video you may have taken and any comments you would like to share. If you booked on behalf of a group, please forward this to everyone who attended as part of your party.
Anti-stigma campaigns in prison settings can have a huge impact, says Lashandra.
My name is Lashandra, and I work for an addiction treatment charity inside a prison. Working in this setting I often witness stigma against people who use substances – it’s so commonplace that you could easily become resigned to it. I often hear people who use drugs being referred to in demeaning, labelling, and dehumanising terms. Words can hurt and they can poison, or they can empower and build people up.
‘I was in the meds queue one morning to get my methadone,’ says a member of the prison stigma forum. ‘An officer was manning the queue and as “banter” said to me, “yeah, but you’re just a crackhead”. He laughed, and I laughed along with him. This really hurt me, and I went back to my cell and it went round and round in my mind. In that moment I felt like I wasn’t worth anything. The officer thought he was being funny, and he didn’t realise how it made me feel. Since being part of the Stigma committee and attending our meetings, I feel like I would be able to challenge him in an appropriate way.’
The people we support generally tend to agree that it’s ok for them to self-identify as something – an ‘addict’, for example – but that doesn’t mean it’s okay for someone else to use that term to describe them. In order to create behaviour change, stigmatising language needs to be called out and challenged. Many people who use substances, however, don’t challenge it because they’ve internalised these labels throughout their lives, and their confidence and self-esteem are so low that they start to believe that is all they are.
Whether I’m talking to someone using our services, a prison officer, another colleague, a family member, or the public, I’ll educate them as to why the terminology used isn’t respectful or inclusive. I explain the impact of stigma, offer insight into how it makes people feel, and suggest alternative terms.
I started to have conversations in the prison with the people that we support to better understand how stigma impacts them, and through these I understood there was a definite need to act. We created a stigma committee made up of people with lived experience, and it meets regularly to discuss ideas and feedback. We’ve also implemented stigma forums which are used as safe spaces to discuss issues relating to stigma and substance use – it’s a place where people can come and talk about their issues openly. Through these forums we’ve found that many people have been in denial about their substance use, or kept it a secret because they don’t want to be treated differently. We’ve also learnt that some people on scripts will collect their meds late because they don’t want others to look down on them for being on medication.
We’ve seen a great response to the stigma forums from both people who use substances and the wider prison population. It’s been impactful to see the benefits for those who are gaining support, self-esteem and confidence, and I’ve also noticed a move away from the acceptance of certain words and behaviours. The committee is currently working on co-producing our own anti-stigma campaign, and we’re also developing awareness-raising leaflets, posters and an educational video that shares lived experience.
We’re also delivering training to staff and the wider prison community. To make anti-stigma education as accessible and inclusive as possible, the committee has developed an approach that suits different learning styles – as part of that we’re putting on a play for the prison staff and governors. It will then be put onto a digital platform for the wider prison community to watch.
Reaching out far and wide, breaking down barriers to accessing support, and offering education to those who don’t fully understand stigma are important tools in facilitating change. We must speak up on behalf of the people we support. Even when they have the confidence and self-belief to advocate for change themselves, it’s all of our responsibilities to find innovative and inclusive ways of amplifying their voices and making sure they get heard.
Lashandra works for a treatment charity in a UK prison. Join the Anti Stigma Network at www.antistigmanetwork.org.uk
The government’s Medicines and Healthcare products Regulatory Agency (MHRA) has launched a consultation on reclassifying opioid-containing cough medicines as prescription-only.
Codeine linctus is used to treat a dry cough.
There have been ‘multiple’ reports to the Yellow Card reporting site for the side effects of medicines about recreational use of codeine linctus for its opioid effects, the government states.
Codeine linctus, which is used to treat dry coughs, is currently available over-the-counter in pharmacies. If reclassified, however, it would be unavailable to buy without presentation of a prescription.
‘Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences,’ said the MHRA’s chief safety officer, Dr Alison Cave. ‘Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status. We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered decision for the benefit of patients, carers, and healthcare professionals across the UK.’
‘We believe there is insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately,’ added president of the Royal Pharmaceutical Society, Professor Claire Anderson. ‘We also have significant concerns about its misuse and addictive potential, as well as the risk of overdose. There are many non-codeine based products available for the treatment of dry cough. With studies showing up to 60 per cent of people are genetically predisposed to opioid dependence, the role of codeine linctus in treating what is ultimately a self-limiting condition is questionable.’
Three quarters of adults believe that the number of units in an alcohol product should be included in the labelling, while just over half want to see nutritional information like calories and sugar content, according to a survey commissioned by the Alcohol Health Alliance (AHA).
The survey of 12,000 people by YouGov also found that 70 per cent wanted to see government policy protected ‘from the influence of the alcohol industry and its representatives’. More than half supported a ban on alcohol advertising on TV, online and in public, while 60 per cent thought that alcohol promotions in shops should only be visible to people browsing for alcohol.
Alcohol is currently exempt from the requirement for food and drink products to display nutritional information – alcohol products only need to state the alcohol volume and strength (as ABV) and list common allergens. The government has previously said it would launch a consultation on alcohol labelling, but the plans have subsequently been delayed. However Ireland became the first country to introduce mandatory health labelling for alcohol – including calories, grams of alcohol contained and warnings about liver disease and cancer – earlier this year (https://www.drinkanddrugsnews.com/ireland-becomes-first-country-to-introduce-mandatory-comprehensive-alcohol-labelling/).
Prof Sir Ian Gilmore: ‘People want the opportunity to make healthy choices.’
The AHA has launched a manifesto, Pouring over public opinion, calling for commitments from all political parties for a ‘comprehensive evidence-based strategy, free from alcohol industry influence’. The UK is at ‘a tipping point, and the public knows it’, it states. ‘Whilst the government continually delays its promised public consultation on alcohol labelling, our report found that 76 per cent of those surveyed supported a legal requirement for alcohol labels to display the number of units in alcohol products. One of the major barriers to progress is the influence of the alcohol industry.’
‘The results of the YouGov survey clearly show that people in the UK want to see politicians doing more to protect their health and that of their families and their communities,’ said AHA chair Professor Sir Ian Gilmore. ‘People want the opportunity to lead healthy lives and make healthy choices but current legislation, or lack of, makes this difficult when important health information is being withheld from labels and children are being bombarded by alcohol adverts. Deaths from alcohol have reached a record high and every week that the government fails to act on this issue, another 490 people die.’
I noticed a deep sense of calm in myself on the morning of our cross-sector event, Social Work in a Changing World. The event was a collaboration between Change Grow Live, Adfam, Addiction Professionals, Collective Voice and The British Association of Social Workers, bringing people together to explore the possibilities of social work, and have conversations on how best to respond to the drug strategy. I had a sense that I was walking into a collective of people who all wanted the same thing – to be able to offer the best social work for people who use services.
Dame Carol Black’s recommendation to increase the number of social workers in drug and alcohol services is clear, and the drug strategy also provides fresh possibilities around the impact of social workers.
We created the space to have the conversations that mattered – to explore the role of social work, learn, and hear new ideas and diverse perspectives.
We wanted diversity of thought – we wanted to hear the ideas and questions that hadn’t been heard before. The invitation for this event went out far and wide, and we gathered as a diverse group – not just social workers but people with lived experience, social work students, policy makers, strategists, regulators, educators and academics. Yet our job titles weren’t important – we were there as people who wanted to explore the role of social work in the drug and alcohol sector.
As a collective we crafted questions that were taken into open space discussion groups. Some strong themes were shining through – purpose and professional identity, involving people with lived experience, and offering the best support so that people are truly empowered to make the changes they want.
As we were nearing the end of the day, we spoke about what we wanted to do next. People wanted more connection and conversation, more in-depth exploration of what we’d started, sharing of ideas and insights, creating a movement, making a difference, and celebrating social work.
Together we are energised to influence social work developments and changes, to improve what we do, to respond to the changing contexts and to be alongside people. We can share stories of good practice, celebrating the impact the profession has, and promoting a shared understanding of the role for effective collaboration.
We can help to define the social work role in the sector to maximise positive impact for people who use services and wider teams, contributing to the delivery of the drug strategy and Dame Carol Black’s recommendations. We want to share our learning and experience, as well explore our way forward, so that we create a social work role that is fit for purpose in our ever-changing landscape.
We reflected on the importance of social work values, skills and knowledge at this time where health and economic inequalities are creating layers of complexity and compounding social exclusion of the poorest people in society. People need us to be alongside them, to listen to their experiences, to be flexible to respond, and most importantly to create meaningful relationships.
There are multiple factors that are shifting the foundations of how we live. People are facing extraordinary challenges. The economic and health inequalities that we see in society now bring a level of complexity that calls for social work values, knowledge, and skills.
I’ve met many wonderful new people as a result of arranging this event; I’ve created new relationships and we’re having fresh conversations. We are forming a new Social Work Community of Practice, across the sectors, and I’m really excited to see where this will lead us – great things can happen.
Thanks to everyone who supported the event: Jennifer Condron at Warm Data Wandering, Bec Davison at Rippleshift, Kate Halliday at Addiction Professionals, Viv Evans and Rob Stebbings at Adfam, Luke Geoghegan at BASW, Oliver Standing at Collective Voice, Tom Bailey, and Zac McMaster, Helen Thompson, Danielle Hickey, Rebecca Pettifort and Peter Furlong at Change Grow Live.
If you’d like more information on the new Social Work Community of Practice please contact Ellie.Reed@cgl.org.uk
Ellie Reed is head of social work – principal social worker at Change Grow Live.
The number of hospital admissions where the primary diagnosis was liver disease rose by 22 per cent in the year to March 2022, according to the latest figures from the Office for Health Improvement and Disparities (OHID) – from 67,458 to 82,290. The number of admissions where the primary diagnosis was specifically alcoholic liver disease was up by almost 12 per cent over the same period, to 27,419.
‘Liver disease is almost entirely preventable,’ says OHID
As is the case with alcohol-related deaths and hospital admissions, the highest rate was in the North East of England, while the rate of hospital admissions for alcoholic liver disease was twice as high in men than women. There was a more than ten-fold difference in admission rates for alcoholic liver disease between the counties and unitary authorities with the highest rates and those with the lowest, OHID points out. ‘Liver disease is almost entirely preventable, with the major risk factors – alcohol, obesity and hepatitis B and C –accounting for up to 90 per cent of cases’ it states.
Liver disease admissions are up by 47 per cent compared to a decade ago, and the British Liver Trust is calling on the government to prioritise investment in prevention and early diagnosis – especially as the disease often has no symptoms in its early stages. ‘These figures once again demonstrate how action is needed,’ said the charity’s director of policy, Vanessa Hebditch. ‘The British Liver Trust is calling for a prompt and comprehensive review of adult liver services to address the huge variation and inequalities in liver disease treatment outcomes and care. The surge in hospital admissions emphasises the urgent need for immediate action to tackle the growing burden of liver disease on the NHS and society as a whole. By allocating resources to education, raising awareness, and promoting healthier lifestyles, we can collectively work towards reducing the burden of liver disease and improving the wellbeing of individuals across the country.’
The charity’s submission to the parliamentary health and social care committee inquiry into cancer care also points out that liver cancer is the fastest rising cause of cancer death in the UK, with liver disease the biggest factor for developing it. The document adds the charity’s voice to the call for a new and comprehensive alcohol strategy that ‘addresses the affordability, promotion and availability of alcohol, to reduce its harm and tackle health inequalities in the long term’.
The Scottish Government has published a new paper on drug law reform that calls on the UK government to implement decriminalisation ‘of all drugs for personal supply’.
The document’s other proposals include immediate legislative changes to allow full implementation of harm reduction measures like consumption rooms and drug checking, and a ‘roadmap for further exploration of drug law reform’. The proposals follow recommendations made by the Drug Deaths Taskforce in 2021, the Scottish Government says.
Decriminalising personal possession would ‘allow people found in possession of drugs to be treated and supported rather than criminalised and excluded’, as well as giving them a better chance of employment. The criminal justice approach, meanwhile, is ‘not just an obstacle to people’s recovery but is also less effective than a more public health focussed approach at encouraging positive behaviour change’, the document states. Scotland’s attempts to introduce consumption rooms have previously been blocked by Westminster.
Scottish drugs policy minister Elena Whitham: These are life-saving proposals, grounded in evidence
‘These are ambitious and radical proposals, grounded in evidence, that will help save lives,’ said drugs policy minister Elena Whitham. ‘We want to create a society where problematic drug use is treated as a health, not a criminal matter, reducing stigma and discrimination and enabling the person to recover and contribute positively to society. While we know these proposals will spark debate, they are in line with our public health approach and would further our national mission to improve and save lives. We are working hard within the powers we have to reduce drug deaths, and while there is more we need to do, our approach is simply at odds with the Westminster legislation we must operate within.’
The policies could be implemented by the Scottish Government either through the devolution of further powers – including the 1971 Misuse of Drugs Act – to Holyrood, or through independence, she added. ‘An immediate way for these policies to be enacted would be for the UK government to use its existing powers to change its drug laws. Scotland needs a caring, compassionate and human rights informed drugs policy, with public health and the reduction of harm as its underlying principles, and we are ready to work with the UK government to put into practice this progressive policy.’
In 2021 there were 1,330 drug misuse deaths registered in Scotland, a fractional decrease on the previous year but still the second highest ever recorded. The country has consistently had the highest drug-related death rate in Europe, and in 2021 then-first minister Nicola Sturgeon stated that her government ‘took our eye off the ball’ when it came to addressing the issue.
A coalition of charities and organisations including SDF, Release, Transform, Cranstoun, IDPC,HRI, Youth Rise and INPUD have signed a statement of support for the paper, with Release calling it ‘a groundbreaking document’.
Niamh Eastwood of Release: UK government must support this groundbreaking, life-saving document
All four nations of the UK are in the middle of a public health crisis, with drug-related deaths at an all-time high in all countries,’ said Release executive director Niamh Eastwood. ‘The Scottish Government should be applauded for putting forward policies that could literally save lives. The UK government must act now by either reforming our outdated laws or give Scotland the power to do so. Countries across the world are ending criminal sanctions for possession of all drugs and others are moving towards legalising and regulating cannabis. The UK looks backward compared to what is happening across the Americas, Europe and parts of Asia.’
The document demonstrated ‘commendable political leadership from the Scottish Government on this crucial issue’, added Transform CEO Alex Feis-Bryce. ‘Rather than pandering to “tough” populist narratives, this UK government and The Labour Party must support Scotland in delivering these proposals, and take note that this is the best way to end the drugs crisis in the rest of the UK as well.’
Bristol City Council has issued a safety warning after ‘an unusually high number of serious, heroin-related health incidents’. Six people have died and ‘many more’ have needed emergency care, it states, with early indications that the incidents relate to a ‘dangerous batch of heroin’ in circulation. ‘This alert is being issued because there is a serious threat to life,’ the council states.
The heroin-related incidents have led to deaths and admissions to emergency care
So far, four arrests have been made and a ‘substantial quantity of suspected heroin’ seized, according to Avon and Somerset Police. ‘We’re working closely with all our partner agencies in response to this series of tragic incidents,’ said superintendent Mark Runacres.
‘This is an unusually high level of health-related incidents, so it is important that people are made aware and take the appropriate actions needed to help protect themselves from harm whenever possible,’ said the council’s public health director Christina Gray. ‘Our city offers robust substance use services, and we remain committed to collaborating with our partners to ensure that those in need receive the necessary assistance and support.’
‘Countless’ lives have been saved by naloxone.
Over the last ten days ‘countless’ lives had been saved by naloxone, added treatment team service manager at Bristol Drugs Project (BDP), Lydia Plant. ‘BDP can issue naloxone to anyone that needs it – you may be able to save someone’s life with it.’
A separate alert issued by Cranstoun states that ‘there have been confirmed reports in various locations around Britain of unusually strong opioids contained in a number of drugs; heroin, OxyContin (oxycodone) and “street benzos”. In this alert we are asking people to be extra cautious as these strong opioids may be in widespread circulation, rather than confined to particular areas. There have been a number of recent deaths across Britain linked to them. These strong opioids contain fentanyls and nitazines which are 30-500 times stronger than heroin. We would advise people who use heroin to be additionally cautious, especially if they inject.’
Via is proud to announce that it is launching a new and exciting joint venture with UK private investment company, Amitis Group, to take over treatment provision at Awakn Clinics London.
Awakn Life Sciences Corp (Awakn) is a clinical stage biotechnology company developing therapeutics to treat addiction with a near-term focus on alcohol use disorder. In addition to research and development (R&D), Awakn operates a healthcare services business unit with clinics in the UK and Norway.
Awakn recently announced that it will be exiting from healthcare service delivery to focus solely on biotechnology R&D.
Following Awakn’s restructure, Via’s joint venture with Amitis Group has acquired Awakn London Limited, a central London clinic trading as Awakn Clinics London. Via is now leading all treatments and therapies at the Awakn Clinics London with implementation starting from 5 July 2023.
The ground-breaking treatments involve the use of ketamine, in a controlled and supervised setting as part of a range of psychotherapy sessions, to help people access and process difficult emotions and experiences. It has shown positive results in managing a range of mental health conditions, including depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol relapse prevention.
Anna Whitton, CEO of Via said: “This is an incredible opportunity for Via to be at the cutting-edge of new therapeutic treatments and is a significant step forward in the potential to bring these treatments into the mainstream, with a view to facilitate access to people most in need. We’re excited about this partnership, the opportunity to continue engaging with the innovation, impact and research journey, and also collaborating with partners and colleagues in the drug and alcohol sector.”
Dr Arun Dhandayudham, Executive Medical Director at Via and Chief Medical Officer at Awakn added: ‘Ketamine-assisted psychotherapy is a significant development in the field of mental health and addictions treatment, and we’re thrilled to be a part of it. As medical professionals, it’s our responsibility to ensure that people have access to the most effective and safe treatments available. We look forward to expanding the availability of this treatment and to continue to research its potential benefits and risks. This treatment has shown promising results in clinical trials and offers hope to those who have not found relief from traditional therapies. I’m very confident that bringing Awakn Clinics London under the Via umbrella will be a powerful way to drive this treatment forward and give so many people fresh hope.”
Roz Gittins,Director of Care Standards and Practice Improvement at Via and a member of Drug Science’s Medical Psychedelic Working Group commented: “This is a really exciting time for Via to be leading the way on the use of medical psychedelics in clinical practice. I’m looking forward to support leading on this joint venture to enable greater access and improved research in the management of mental health conditions.”
Dr Rachel Britton, Clinical Lead at Via and Consultant Pharmacist at Awakn said: “I’m joining Via at an exciting time as we look to bring psychedelic medicine towards the mainstream. I’ve been fortunate to work with Awakn from the very beginning, establishing the first clinic of its kind in the UK. I look forward to working with the staff teams to build momentum and offer an alternative where existing therapies have failed.”
Anthony Tennyson, CEO of Awakn Life Sciences Corp. stated: “When we launched the first clinic in the UK, our goal was to be able to provide greater access to medicine to those in need. We are happy to transition Awakn Clinics London to Via, allowing us to focus on our efforts on research and development of therapeutics to treat addiction, especially our phase 3 trial of Ketamine assisted therapy for alcohol relapse prevention, where we are working with ten NHS trusts and the University of Exeter under a NIHR grant, with a goal to have the treatment available throughout the NHS. We look forward working closely with Via to gather additional real world evidence to support our ongoing research.”
Adam Feldheim, Partner at Amitis Group stated: ‘’We are extremely happy to invest and partner alongside Via in this new venture. Via is a leader in providing addiction and mental health care in the UK and we are looking forward to working closely with them in bringing their expertise and standards of care to this new frontier.’’
This blog was originally published by Via. 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.
Phoenix Futures opened the doors at Knatchbull Road to showcase what’s on offer at the unique abstinent supported housing service
Last Wednesday, Lambeth housing (Knatchbull Rd) opened its doors, inviting people in to get a feel of what’s on offer at the unique abstinent supported housing service. It was a pleasure to be able to meet people, from professionals who have been making referrals for years to people curious about whether the service could be a good next step for them. The weather was stunning and the mood matched the June sunshine.
Visitors, who included prospective referrers, people interested in moving into the house, people currently living there and others who have already moved on from Knatchbull Road into their own independent accommodation were treated to an impressive spread of perfectly seasoned jerk chicken, a mountain of mouth-watering jollof rice, and piles of beautifully made sandwiches that would have made M&S jealous – all prepared by Doris and the current residents of the house.
Visitors were able to get an insight into how the group programme works, how the residents take responsibility for running the house, and hear some first hand experience of how the service has allowed people to take control of their own recovery, learning skills that for some of the returning ex-residents, have continued to help them manage challenges far beyond addiction.
Much like the stories of the inspiration people who have gone through the service, Knatchbull Rd is a great example of creativity and determination beating adversity. Previously commissioned by Lambeth council, the service was decommissioned due to funding cuts but was supported to continue its work with people in recovery through housing benefits, which also opened the service up to people without a local connection.
Since then Doris Onwuasoanya has run the service, putting together and delivering an adaptable group programme to support the people we work with to maintain abstinence, understand and manage their relationship with substances, and develop life skills to support their independence and quality of life when they move on into their own accommodation.
In the last few years the service has been hit with more challenges; having lost some main referrers in the closure of London-based detox services and the challenges posed by lockdowns and the pandemic, we went from nearly always having a waiting list, to struggling to attract referrals. This event was put together as part of a push to increase knowledge of the service, and highlight the amazing outcomes achieved by the people who pass through it.
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.
A blog post detailing Humankind’s review and subsequent remodelling of the support we provide to people accessing our services for alcohol related issues, by Stacey Smith, Director of Nursing, and Oliver Standing, Director of Communications & External Affairs.
Dame Carol Black’s recent Independent Review of Drugs shone a welcome light on services for people struggling with their drug use. Happily, it led to a new Drug Strategy and much-needed increase in resourcing for our treatment and recovery systems (albeit during a cost of living crisis). Whilst these changes have benefited some people with alcohol support needs due to the integrated nature of many services, alcohol in and of itself was not including in the scope of the review.
When it comes to supporting people with alcohol problems, as a society, we have never got it right. Alcohol harm has been frustratingly over-looked by successive governments. Over four in five people in England drinking at dependent levels remain outside our support systems. Alcohol related deaths have tragically rocketed in recent years, increasing 27.4% from 2019 to 2021.
At Humankind we are proud of our work in response to this challenge, but we aren’t complacent about the levels of need that still exist. Our DrinkCoach online support platform has delivered almost 1,000 coaching sessions in the last year, with over 21,000 people receiving identification and brief advice (IBA) in the same period through its online test. Our All Party Parliamentary Group (APPG) last week brought together parliamentarians in Westminster to hear from the Association of Directors of Public Health’s drug and alcohol lead Alice Wiseman and other speakers on reducing alcohol related harms.
For Alcohol Awareness Week this year, we are proud to say that we have taken the next step in our organisational response.
Alarmed by the increasing number of alcohol related deaths, low numbers of community detoxifications and increasing complexity in the support needs of older people accessing services, we brought together a multi-disciplinary team within Humankind to discuss and review our alcohol support options.
The group recommended greater focus on the full complexity of physical and mental health needs, as well as those of our diverse populations, a broader focus on alcohol treatment as a specialism and a new look at how we see access and engagement particularly from the viewpoint of people using services.
As a result, we have fully redesigned our alcohol support journeys for people entering our services, incorporating evidenced based tools for assessment and a range of treatment options based on need, choice, and health. We have recognised that we need to work differently, ensuring we develop partnerships to support the varied levels of treatment options, from harm reduction advice and information to brief interventions and community detoxification. We have developed specific pathways for older people and those in the criminal justice system.
Whilst this certainly won’t ‘fix’ our support systems in one go, it does feel like an important step forward.
Our early adopter sites in Bradford, Cumbria and London are now implementing the new model and generating the real-world findings we will need to update and optimise it for the rest of our services. Haringey’s HAGA is continuing its proud tradition of innovation in response to alcohol, which has existed since 1981. As the new pathways embed and evolve throughout Humankind, we will collect and share our learning, culminating in a Year One report published in Alcohol Awareness Week 2024.
Please do get in touch if you would like to learn more about the project. By working on structures within Humankind itself we aim to model some of the changes we would like to also see at a system level. There are multiple ways to bring those about, and we are proud to advocate alongside colleagues through the Alcohol Health Alliance, as well as via our APPG.
It is our hope that the welcome recent focus on drugs can be broadened to cover alcohol and that this, and successive, governments can demonstrate the leadership necessary to develop a comprehensive and strategic approach to reducing alcohol related harm and increasing levels of effective support.
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.
The NHS is to open seven new gambling clinics this summer to cope with ‘record’ demand, it has announced. The new clinics will take the total number to 15.
Last year saw around 1,400 people referred for help with gambling issues, almost a third up on the previous year and a four fifths increase on the year before that. The new treatment centres will be in Blackpool, Bristol, Derby, Liverpool, Milton Keynes, Sheffield and Thurrock, and offer CBT, family therapy and aftercare, NHS England states, bringing the treatment capacity across all 15 clinics to 3,000 people a year.
Amanda Pritchard: ‘Record numbers are coming to the NHS for help.’
The Gambling Commission estimates the number of problem gamblers at almost 140,000, with the government’s recent – and much delayed – gambling white paper criticised by campaigners for failing to include meaningful measures to tackle advertising and marketing (https://www.drinkanddrugsnews.com/lukewarm-response-to-gambling-white-paper/).
‘In 1948 when the NHS was founded, you had to go to a bookies to place a bet, but now people can gamble on their phone at the touch of a button and everyone, young and old, is bombarded with adverts encouraging them to take part,’ said NHS chief executive Amanda Pritchard. ‘Record numbers of people are coming to the NHS for help to treat their gambling addiction, a cruel disease which has the power to destroy people’s lives, with referrals up by more than a third compared to last year.’
Neil O’Brien: ‘Gambling companies will pay their fair share towards the costs of treatment services.’
‘The stark rise in the number of people seeking NHS treatment for gambling-related harms shows the devastating impact it can have on people’s lives and health,’ added public health minister Neil O’Brien. ‘These new clinics will bring vital support to more parts of the country, so thousands more people can get the help they need. We have taken firm action to tackle gambling-related harms through our white paper, which includes our commitment to introduce a statutory levy so gambling companies pay their fair share towards the costs of treatment services.’
You Need To Get Angry
Drop in Overdoses
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.’ 
Further Provision
Prior to this, Simon was Macmillan’s Executive Director of Strategy and Performance, having been with the team since 2005. 
User Involvement
We held our first focus group last summer. Recruitment had initially been challenging – people thought it was a tick-box exercise, that their opinions wouldn’t be listened to, and it probably wasn’t until the second group meeting that they began to see their ideas were being taken seriously. 
At a concerning time for the sector with the increased overdose risk from synthetic opioids, this Carry Naloxone campaign is part of Turning Point’s 
Following the walk, the festivities will continue at the Recovery Village event. Taking place at Zebedee’s Yard, the village promises to be a vibrant hub of art, culture, and wellbeing. Attendees will have the chance to indulge in live music performances on a dedicated stage, admire thought-provoking art exhibitions, and explore various health and wellbeing stalls.
Earlier this year HCV Action – a network coordinated by The Hepatitis C Trust – released Taking the initiative: how England is eliminating hepatitis C, a report exploring the elimination programme and some of the main initiatives that have been developed under it. These have included efforts by NHS bodies, voluntary sector organisations and pharmaceutical industry partners to find, test and treat people in community settings, the criminal justice system, primary care, drug services, emergency departments and more. 
With funding for the elimination programme coming to an end at the end of March 2024, a new strategy will be needed to ensure that the work so far doesn’t go to waste, and that elimination is achieved by 2025. This is why The Hepatitis C Trust’s message for World Hepatitis Day 2023 on 18 July will be ‘don’t miss the target’, to keep up momentum and to ensure that years of work and £1bn of investment are built upon. 
At the moment the partners are still meeting every two weeks, which is a ‘really important as part of mobilisation’, Fry stresses. ‘We’re really keen to keep the momentum going, making sure we’re all on the same page.’ There will be at least monthly meetings, as well as the regular meetings around grants, meaning ‘constant discussion with the key partners’, she says. 
Service levels
Words from the floor:
Peers save lives!
Words from the floor:
Let’s talk about stigma
‘Every time someone writes some bullshit about us, get on social media and respond to it. We need positive depictions of people who use drugs.’ 
Me, myself, I… where do we go from here?
Words from the floor:
Cranstoun’s Worcestershire service had developed a peer-led naloxone team, PACKS – ‘peer-assisted community knowledge and support’, he said (
More than half of people who died a drug-related death died alone, he said. ‘We looked beyond our shores and took inspiration from safer injecting services, from the ‘Never Use Alone’ helpline in Australia, and the software developer in Canada who first designed the digital solution called Brave.’ Cranstoun asked if they’d work with them to develop a UK version of an app they’d first developed in Vancouver, he said – the result was Cranstoun’s Buddy Up (
Release is the national centre of expertise in drugs and drug laws. We were founded in 1967 – potentially making us the world’s oldest drugs charity – and we provide free, non-judgmental, specialist advice and information to the public and professionals on issues related to drug use and drug laws. We also fight for drug policy reform, so that in the future people who use drugs are treated based on principles of human rights, dignity and equality. To achieve this, we advocate for evidence-based drug policies that are founded on principles of public health rather than a criminal justice approach.
We are proud to work in partnership with many of the leading charities and treatment providers in the sector.
The government is currently consulting the industry on its views on a range of MUP rates – 50p per unit, the current level, as well as 60p, 70p and 80p or more. Health campaigners have long argued that the impact of the 50p level has been significantly eroded by inflation, and a 
