Coverage from the 8th national service user conference

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Challenging times

Delegates at The challenge – getting it right for everybody heard a succession of powerful and inspiring presentations on the theme of overcoming obstacles.

‘We’re working and living in challenging times,’ said Carole Sharma of FDAP as she introduced the day’s opening session, Working with service users at all levels. ‘Today’s theme is getting it right for everybody, and that’s the important thing, whether they’re abstinent, still using or professionals. So let’s quit beefing, and get on with getting it right.’

Linda ChanThe challenge facing Linda Chan from Build on Belief (BoB) was saying goodbye to the people she’d known for 25-30 years when she stopped using drugs, she told the conference. ‘I started using at 15 and used for 32 years,’ she said. ‘The challenge wasn’t getting off drugs, but staying off. I couldn’t talk to normal people – my social skills were non-existent and I didn’t trust anybody.’

Needing a way to fill her days she decided to try volunteering, but soon came up against another challenge. ‘You had to be off your prescription and not using for two years. But then I found out about BoB, where you can volunteer even though you’re scripted.’

The effect volunteering had on her mental health was ‘amazing’, she said. ‘With the right support and encouragement I began to realise that, even though I was still scripted, I could really make a difference. I used to believe that as a user for 32 years I had nothing to offer, but I soon learned how important it was for people to have someone advising them who’d been through the same experience.’

Helped by BoB’s policy of giving its volunteers first refusal on new vacancies, she took up a post helping to design services and workshops in west London. ‘We’re getting 35-40 people through every day now. I really wish I’d known there were places like BoB around – I could have stopped earlier with the right support and encouragement.’

BoB’s philosophy was to see recovery as ‘getting a life’, she told delegates – ‘getting off drugs is one thing, getting a life together is an entirely different matter’ – and the majority of its volunteers were still in treatment. Another integral part of its outlook was to make sure that no one was turned away, she stressed. ‘I don’t care how many times you’ve failed at treatment – I did all of this while I was still scripted. Don’t limit yourself because of a script. If you’re stable and scripted, you can do anything you want to.’

Steve DixonSteve Dixon of recovery CIC Changes UK described to delegates the challenge of building social capital, helping people develop independent living skills and move into long-term sustained recovery. His organisation aimed to tackle addiction, homelessness and offending, working closely with probation, prison and treatment services as well as the Department for Work and Pensions (DWP). It also tried to place peer mentors in job centres and operated an abstinence-based community rehab, he told delegates.

‘The biggest weapon you can have is a recovery community – the rest takes care of itself. If you put someone in the middle of that, they’ll be alright. You need people who’ve been where you’ve been.’

While anyone volunteering with Changes UK had access to accredited training, the organisation had been keen to set up training for people who wanted to do something outside of health, social care and the drugs field. ‘You don’t have to be a drugs worker,’ he told the conference. The organisation had joined forces with a local college to provide accredited courses, and it also aimed to provide high quality services – including a garage, café, gym and recording facilities – to the wider community.

‘The challenge is to create a sustainable revenue stream, otherwise you’re always under that cosh,’ he said. ‘We want to generate profit. That’s my dream – that we don’t need funding from anyone. Nothing that’s worth it in life is easy, but there’s always enough little moments to remind us why we do what we do.’

Tony LeeTony Lee of support group REPS told the Meaningful activism session how he’d been homeless in London before moving into a hostel that had a substance misuse unit. He trained as a peer support worker then went on to become a mentor, delivering harm reduction advice on an outreach basis in Soho. ‘We were talking to people in their own community – that’s crucial,’ he stressed.

In 2005 he’d moved back to Fleetwood in Lancashire, setting up REPS a year later. ‘Fleetwood had nothing, no community support. There was a treatment service that was run off its feet, and they didn’t even know what peer support was.’

All of the organisation’s activities were done without any substantial funding meaning the challenge was to be innovative and imaginative, he said, and REPS provided activities such as walking, hiking, bird-watching and fishing alongside peer support. ‘We support people through community detoxes and stabilisation, and we’ve recently started working with people on licence from prison as well. The challenge now is to go on to become a registered charity or a CIC.’

Annette Dale-Perera‘There’s some brilliant work going on at the moment, but we do have some challenges, one of which is Ian Duncan Smith trying to time-limit OST,’ said chair of session two, Annette Dale-Perera, a member of the Advisory Council on the Misuse of Drugs (ACMD). Behind the scenes, Public Health England (PHE), John Strang and others had been ‘trying to back these people off and get them to recognise the evidence base’, she said, but Ian Duncan Smith’s insistence had led to the ACMD’s recovery committee being tasked with investigating the issue.

The committee had been asked to look at the evidence around whether people were being maintained on OST for longer than was necessary or desirable, and whether the evidence supported the case for a time limit. ‘We gave him direct answers,’ she told delegates. ‘When we looked at the stats it showed that 10-15 per cent were on OST for five years or more, while 40 per cent actually left within six months and 55 per cent within a year. So the answer we gave him was that the evidence did not support bringing in time-limited OST. In fact, there’s strong evidence that it leads to relapse and that acquisitive crime goes up.’

A time limit could also result in medical or legal challenges, the committee had pointed out. ‘But the ACMD are concerned about the quality of OST – there are some real challenges here,’ she stressed.

Rosanna oConnorOther issues facing the sector, said PHE’s Rosanna O’Connor, were concerns over funding being lost and treatment no longer being a political priority. ‘We do have a drug strategy that’s a framework within which we can expect all local authorities to operate,’ she said, but this was coupled with a very strong localism agenda and devolved funding and responsibilities. ‘Local authorities are supposed to know what’s best for the local community, and they often do. But it does mean that you have to make your voices heard with councillors and influential officers in your local authority.’

There were worries about the scale of retendering and the amount of turbulence this was causing in treatment systems, she acknowledged – ‘a concern for us as much as for you’ – as well as around drug-related deaths. ‘Sixty per cent of these are people who hadn’t been in treatment. So there’s a major challenge around the attractiveness and accessibility of the treatment system, and how to reach those people outside the safety net that the system provides.’

But the biggest challenge was perhaps that where there had once been ‘hundreds of millions of pounds’ in the pooled treatment budget, money for treatment was now part a much larger public health grant, with the drugs part no longer ring-fenced. Nor was there any longer the ‘oversight and influence’ of the NTA, she said.

‘What we at PHE can do is hold up a mirror to local authorities and say, “this is what’s happening in your local area, and we can provide support with what you’re not doing well”. Some were very receptive, others less, she told delegates.

‘So it needs your help alongside ours.’