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Vital challenge
Kaleidoscope was one of the original drug services in England, and a pioneer of harm reduction services, campaigning against long waiting lists by providing rapid access to treatment. Over time local authorities improved the services to their own drug using population and the need for our services was reduced. At the same time, however, I saw many small drug services struggling to survive, losing their community based, charitable services to the large corporate drug services. The campaigning voice was beginning to get quieter as services recognised that responding to the demands of the commissioners was more important than meeting the needs of the service user.
So 13 years ago we were offered a route out of England to establish drug services in Newport, South Wales. There were significant problems in Wales with access to treatment and poor treatment outcomes. At the same time there seemed to be a real commitment to tackle the issues of drug and alcohol use that came from government and the local communities, which was incredibly refreshing. In Wales there was a communitarian approach with the concept of co-production key before the term itself was even invented. Recovery was an important element to any treatment service, but so was harm reduction.
Recently ARCH Initiative joined the Kaleidoscope family and I find myself back in England, saddened to see the decline of good service provision across the border as massive cuts to provision take hold. I was however pleasantly surprised to hear of Collective Voice and attended its meeting. Having reflected on this brief experience, I feel deeply troubled.
In Wales we provide services, at some level, to all the 22 counties. In our work there is not a single example where we do it alone we work in partnership. In England I do not get this sense of genuine partnership working and certainly not from Collective Voice. How do I have common cause with any agency that puts commercial prosperity over the needs of service users? How do I work with people who used to be passionate advocates of harm reduction, but because the political winds have changed have tried to emerge as recovery champions?
I see huge cuts to services in England, where the solution has been to make contracts ever bigger, which of course can only be delivered by the McDonalds/Burger King-like services offering cheap, off the hook solutions at the cost of more localised and specialist services. What we need to do is rage against cuts to services, and advocate for innovative community-based solutions that have a passion to serve the needs of people coming to them.
I hope that a new voice can be heard, made up of smaller organisations coming together, offering cost effective service delivery while maintaining their commitment to their values – campaigning services that are able to support government policy when it is right, but to work with the service user community when it is wrong.
Martin Blakebrough, group chief executive, Kaleidoscope Project and ARCH Initiatives
Northern stars
When will we south of the border in England follow the successful trail-blazing example set by our Scottish neighbours, with their pioneering and successful approach to the national, and in fact worldwide, drink and drug problems?
In 2011 Scotland introduced naloxone on prison release and it has been massively successful, and we now see an application being made for the UK’s first safe consumption room in Scotland.
It is unbelievable to even contemplate a system where part of the pack you would leave prison with would not include naloxone. Tolerance levels are low so it’s risky to use, and the natural thing to do following release is to stay with old friends, possibly using ones, and to have a hit to celebrate freedom.
The stats and figures citing the harms on society overall from alcohol speak for themselves these days, and we live in a society where alcohol is readily available 24 hours a day on virtually every street corner in the land. It is more affordable than ever, and we are seeing the consequences. It would therefore make a lot of sense to try and manage this risk by introducing sensible price restrictions – as Scotland is attempting to do with minimising unit pricing – as a form of harm minimisation.
In my opinion Scotland’s approach to drink and drug problems is to be commended – it is a liberal and refreshing one. We need to move away from the moral, financial and target-based approach and instead move forward with a harm reduction based, compassionate approach aimed at longer lasting success, rather than a short-term commissioner and government pleasing approach.
Karl Newton, peer mentor
Breaking barriers
Here in Hastings we read with interest Claire’s comments in the dual diagnosis editorial (DDN, November, page 3). Fulfilling Lives is a Big Lottery funded project set up in 12 areas across the country where it is acknowledged that a higher percentage of people with multiple and complex needs and a dual diagnosis are likely to call home.
Agencies here are aware that there is a need to re-engage with the issues that historically act as barriers to access, diagnosis, treatment and recovery for people with a dual diagnosis, particularly when you add homelessness into the mix. It is early days, but the membership of the recently set up dual diagnosis meeting grows, interest is sparked and those involved are keen to examine their part in the process from a solution-based perspective.
Progress is made and alliances formed. Will this result in systems change and more people receiving appropriate treatment? Yes, we believe so!
Gary French, area lead, BHT Fulfilling Lives