The focus of the morning’s panel discussion was the ‘challenges to making it happen’
‘Scripts should be available whenever anyone needs them – if the recovery message in local areas is about time-limiting, then that needs to be changed,’ stated Pete Burkinshaw of Public Health England (PHE) in the morning’s second session.
Chaired by service user coordinator Alex Boyt, Challenges to making it happen saw a panel of speakers discussing questions sent in by DDN readers. The first of these was, ‘When the NTA’s responsibilities were merged into PHE we were promised that recovery would be inclusive, but in our local area funding seems to be only for abstinence-based services. What’s the future for those on scripts?’
Kirstie Douse, head of legal services at Release and DDN’s legal columnist, told the conference that it had been her experience that people were being ‘forced to detox and reduce much faster than they would like, and that’s completely unacceptable’. Forced recovery was a ‘quick route to relapse’ added Bob Campbell of Phoenix Futures, while Birmingham GP Dr Judith Yates told the conference that, ‘we know methadone works for most people. There’s no one in the higher-ups that’s advocating time-limited treatment.’ Service user activist Anna Millington, however, stressed that ‘a lot of it is passive aggressive – being made to feel guilty about staying on methadone is just as bad as being forced.’
‘There is an incentive to get people off scripts,’ stated one delegate. ‘It’s called payment by results,’ while Bob Campbell stressed that, ‘like anything, it’s all about short-term measures. There’s no investment in people’s futures.’
The second question for panellists was, ‘In my area there’s only one GP who will see patients with drug problems. This is disgraceful. Why is it treated differently from any other illness?’
Services were not possible without some level of funding, said Judith Yates, and it was now down to people in local areas to campaign for them. Despite all of the arguments for shared care, however, drug treatment was ‘big business’ and increasingly in the hands of large organisations, said Kirstie Douse. ‘Unfortunately, that’s the direction it’s moving in.’
‘When I started in 1986, 0.2 per cent of general practice was looking after people who had problems with drugs and alcohol,’ said retired GP and former DDN columnist, Dr Chris Ford. ‘By 2011, the last year the figures were compiled, that had risen to 32 per cent.’ Part of that had been the result of service user advocacy, she stressed, but the field had entered ‘a period of chaos’ now. ‘How can people get care when their organisation is just going into tender or just coming out of tender? We need specialist care, and we have to stand up and be counted. We need to stand together, wherever you are on the spectrum – drug-free or using every day.’
‘If you want the services, do it yourself, love,’ said one delegate. ‘At Lancashire User Forum we did, and we’re massive.’
The session’s final question was on alcohol. ‘As it causes more harm to more people than drug use, why aren’t treatment resources allocated proportionately?’ panellists were asked.
There was no doubt that funding should be distributed proportionately, said Pete Burkinshaw. ‘I’m not arguing with that at all. But there seems to be a feeling of Newtonian Law developing around commissioners – that if you invest in alcohol then you need to disinvest in drugs.’
Funding for drug treatment was ten times that for alcohol, the session heard, while the government had also abandoned its plans to introduce minimum pricing. ‘The alcohol industry is a multi-million pound industry,’ said one delegate. ‘It’s like the Taliban or the Medellin Cartel having an influence on government policy.’
‘The only time money is given to drug treatment is when it affects mainstream society – the HIV crisis, crime,’ said another. ‘Now that crime is going down, what’s going to happen?’
‘There’s absolutely no distinction between drugs and alcohol,’ stated Pete Burkinshaw at the session’s end. ‘We’re seeing more and more completely integrated services. It’s totally down to local areas.’