February 5, 2025

Turning Point’s services in Leicester are seeing an increase in the number of clients – predominately men from the Punjabi Sikh community – struggling with addiction to poppy seeds.

In October, we delivered a national poppy seeds training session attended by GPs specialist doctors, prescribers, peer support workers, team leaders and recovery workers. The feedback ranged from people admitting they’d never heard of addiction to poppy seeds, to others saying they’d seen some clients but their knowledge was limited. Our aim was to raise awareness of the issue, how to engage with clients, and the treatment we provide.

Poppy seeds come from the plant that produces opium, but possess no opium content themselves. Instead, the opium alkaloids are found in the poppy latex, which is a milky white fluid that exudes from the pod when it’s cut. During harvesting and processing, however, the seeds can become coated with the opium fluid.

Unwashed poppy seeds are available online, often labelled as ‘organic’ or ‘natural’

Washed and processed poppy seeds are used in pastries, cakes, porridge and other foods. People also take poppy seeds by mouth for asthma and other conditions, while poppy seed oil is used in manufacturing to make soap, paint and varnish. Depending on the methods of harvesting and geographical origin of the plant, unwashed poppy seeds may have higher amounts of opium alkaloids such as morphine, codeine and thebaine on their seed coats compared to washed poppy seeds. Farmers who wish to increase the opium alkaloid content on the poppy seed make cuts in the opium pods before they ripen, which allows the latex to seep onto the seeds.

In fact, consuming certain poppy seed food products can lead to a positive urine test result for opiates – as little as one bagel or muffin can affect results for up to 60 hours – and when someone discontinues the regular use of unwashed poppy seeds, it can produce the same symptoms as withdrawing from any other opiate.

Unwashed poppy seeds are usually crushed and ground down to make into tea – or the pods are put directly into the tea – and in the US deaths associated with use of unwashed poppy seed tea have been reported in the scientific literature.

In the Punjabi community in India – and here in Leicester – it’s socially acceptable to drink poppy seed tea. We’ve been to community events in places like Gurdwaras where older Punjabi men laugh it off and say it’s just ‘doda’ or ‘afeem’ – the Punjabi words for poppy seeds. Even younger people at the gym will mention that their friends use it. It’s so commonly used that it’s not even considered a drug, rather something that helps with anxiety and stress, and we also see it used by builders who say it helps them work harder.

However, due to changes in availability and cost over recent years, it’s become a bigger problem. In the past you could buy it very cheaply, but prices have now tripled and it’s having an impact on families. While some people may have it as a one-off energy booster – like a cup of coffee – when it begins to affect someone’s day-to-day life is when they need help. We want to make sure people understand the addictive nature of poppy seeds and know that there is support available.

Dilesh Popat Turning Point — Dilesh Popat working on awareness training at Turning Point’s Leicester headquarters

When opium poppy cultivation in Afghanistan plunged by an estimated 95 per cent following the Taliban’s 2022 ban it led to a drastic drop in the availability of heroin alongside an increased demand for other drugs, including poppy seeds. Unwashed poppy seeds are widely available, often in large quantities, and sold in retail outlets across Leicester. They are also easy to buy online.

Local shops sell ground poppy seeds in containers for around £20-£30, but some clients have told us the cost has increased to £70-£100 in some shops. As a result, we’ve seen a lot more people come to us with addiction issues as it’s costing them hundreds of pounds a week and affecting their family lives.

We’re also seeing the powder form of the drug that’s made from the milky latex of the poppy being sold under the counter. Not only is this illegal, it is significantly more potent than poppy seeds and more likely to be cut with other substances. We’re hearing that batch strength varies from shop to shop, with clients telling us products from some shops leave them with stronger after-effects such as drowsiness and headaches, and the presence of nitazenes in the drug supply is an increasing concern.

While we suspect the ground forms of both the poppy seeds and the milky latex are sometimes adulterated with paracetamol or sleeping tablets, we don’t know if synthetic opioids are ever present. We advise the people we support to buy poppy pods and grind them themselves, to ensure it hasn’t been mixed with any other substance.

Research into the ground poppy seed supply is needed to understand exactly what is being put into this commonly available substance, so we can offer informed harm-reduction advice to the public.

Poppy seeds can be just as addictive as any other opiate, and physical and psychological dependence can develop quickly. We prescribe the same for poppy seeds as we would for somebody using heroin – either buprenorphine or methadone.

Buprenorphine has been well tolerated and serves as an effective treatment option for the clients we’ve worked with – it also offers flexibility in dose reduction, with 0.4 mg increments supporting a structured detoxification process. In our experience of working with clients prescribed methadone, however, we’ve found that reducing poppy seed use can be particularly challenging. Many struggle to decrease their reliance on poppy seeds while on methadone, and in some cases their poppy seed use actually increases alongside their methadone intake. This pattern can create a cycle of dependence that becomes difficult to break, and clients have also frequently reported that methadone makes them feel drowsy and sluggish, which leads them to seek additional stimulation – including continued or increased use of poppy seeds.

All the clients we’ve supported for addiction to poppy seeds have so far been men. We do know that women also use it, but the stigma and shame of women engaging in treatment services – especially in the south Asian community – is a significant barrier.

There’s a big drinking culture within the Punjabi Sikh community. However, baptised Sikhs are prohibited from consuming alcohol or any drugs, making it a taboo subject. This presents a major challenge – it’s the reason why people are reluctant to talk about the issue of poppy seeds publicly, or seek support from recovery services.

Dilesh Popat is national diverse communities lead and Sadaf Akhtar is advanced practitioner diverse communities at Turning Point

HARMINDER’S STORY

Harminder (not his real name) is a builder based in Leicester. He started using poppy seeds in Punjab, where he said everyone uses it even though it’s considered shameful in the Sikh community to use drugs. His usage escalated when he moved to the UK five years ago – he said it was so easily available that he used to buy the seeds from Asian florists. When he first started taking poppy seeds, he felt powerful and it would give him the strength to get through the day’s work. After a while, however, it started having less of an effect, which led to him increasing the amount he took on a daily basis.

Harminder poppy seeds He was spending around £70 a week on poppy seeds and it started impacting his family and work life. He would struggle to wake up in the morning to go to work, and was constantly having to find ways to hide his use from his wife.

A friend recommended him to Turning Point, where he was prescribed buprenorphine and given regular support over the phone and in person to slowly reduce his usage. He’s now been abstinent for almost 18 months.

Harminder says he knows many colleagues and members of his community who are struggling with poppy seeds. He believes it should be given the same priority as heroin when it comes to raising awareness of its dangers and the support available.

Alcohol-specific deaths hit highest ever level

News

DDNWeb

February 5, 2025

Alcohol-specific deaths hit highest ever level — The figure is an increase of almost 40 per cent since 2019

There were 10,473 deaths from alcohol-specific causes registered in the UK in 2023, according to the latest ONS figures, the highest number on record.

The figure is more than 400 higher than the previous year’s then-record total of 10,048, and an increase of almost 40 per cent since 2019.

As in previous years, the death rate for men was around double that for women and the North East had the highest alcohol-specific death rate of any English region – at 25.7 deaths per 100,000 people, compared to 11.5 per 100,000 in the East of England region. Scotland and Northern Ireland had the highest overall rates of alcohol-specific deaths – at 22.6 and 18.5 per 100,000, respectively – while the rates for England and Wales were 15 and 17.7 per 100,000.

Alcohol-specific deaths only include those that can be wholly attributed to alcohol – such as alcohol-related liver disease – and exclude deaths from causes ‘that are made more likely by alcohol’ such as heart disease or various cancers. While 2023’s total is the highest recorded, however, the overall rate of alcohol specific deaths has actually decreased slightly from 16.6 per 100,000 in 2022 to 15.9 per 100,000, ONS points out.

Alcohol deaths — ‘The drivers of this crisis are well known – cheap, easily accessible alcohol and aggressive marketing that normalises excessive drinking’

The figures painted a ‘bleak picture of the ongoing harm caused by alcohol across the UK’, said Alcohol Health Alliance chair Professor Sir Ian Gilmore. ‘The drivers of this crisis are well known – cheap, easily accessible alcohol and aggressive marketing that normalises excessive drinking – as are the solutions proven to reduce harm. Measures such as minimum unit pricing, improved advertising regulations, mandatory health warnings on labels, and better investment in alcohol treatment services must be implemented across all UK nations without delay.’

‘We’ve seen record-high deaths from alcohol in the UK every single year since the pandemic,’ added Institute of Alcohol Studies chief executive Dr Katherine Severi. ‘This simply cannot become the new normal, so the government must make tackling alcohol harm a top priority in 2025.’

Alcohol-specific deaths in the UK: registered in 2023 available here

Caught in the act

Features

DDNWeb

February 4, 2025

We commend Ireland for their progressive approach in prioritising public health,’ is how the WHO responded to Ireland becoming the first country to commit to mandatory labelling for alcohol products back in 2023 (DDN, June 2023, page 4).

The Public Health (Alcohol) (Labelling) Regulations, which were signed into law in May that year, form part of the wider Public Health (Alcohol) Act (PHAA), section 19 of which – covering pre-watershed bans on TV and radio ads for alcohol – came into force last month (see news, page 5).

The labelling regulations stipulate that all alcohol labels would need to clearly show not just the number of calories and grams of alcohol contained, but also health warnings about the risk of liver disease, alcohol-related cancers and drinking while pregnant (DDN, June 2023, page 4). Campaigners in the UK have long been calling for similar measures here, and Labour previously committed to mandatory labelling that included nutritional information and up-to-date low-risk drinking guidelines while in opposition (DDN, July/August 2019, page 5). So what lessons can we learn from Ireland’s experience?

Labelling guidelines
The labelling guidelines are set to be introduced next May after a three-year lead-in period, but in 2023 the Alcohol Action Ireland (AAI) charity called on the alcohol industry ‘not to cause any further delay’ and to demonstrate their commitment to better business practices by adopting the new labelling ahead of the implementation date.

Few people will be surprised to learn that no company has voluntarily done this. In fact there’s been ‘an ongoing campaign disparaging the need for labelling,’ AAI’s CEO Sheila Gilheany tells DDN, which even includes calling into question the evidence around alcohol and cancer. ‘The industry will always say things like it’s only at very high levels of alcohol consumption that there’s any possible problems, but that’s not the case. They’re certainly continuing to do that, and they’ve certainly sought meetings with government officials and ministers. Another thing they do very well is hoover up ex-TDs [teachta dála – members of the Irish parliament’s lower house] or ex-senators and employ them as lobbyists. We see a lot of that.’

As many have pointed out, the alcohol industry’s playbook is not dissimilar to that of the gambling sector – that the problem lies with a small group of people who don’t use the products responsibly (DDN, December/January, page 11).

‘It’s always about putting the responsibility onto the individual, and trying to ensure that the business which profits from the sale of its product or services isn’t held in any way responsible,’ says Gilheany. ‘It’s a deeply unfair thing, especially when this is an industry that has tried very hard to hide evidence of the harms.’

Large numbers of people are still unaware of many of the risks related to alcohol, she points out – ‘whether that’s cancer or other harms, and they’re certainly encouraged to drink alcohol in a way that’s even more likely to cause those harms because of the saturation marketing. You see all this stuff about responsible drinking and we’d be always saying, “Well, what about responsible trading and marketing?”

Marketing perception
Aside from its ubiquity, alcohol marketing affects everyone’s perception of the product as it’s ‘always shown as a risk-free activity that’s often central to things that are important to you’, she states ‘– whether that’s sport or music or family or friends, or in our case national identity.’

Caught in the act feature — Ireland has long had an image as a country where booze can be seen as inextricably linked with having a good time – something that the drinks industry is inevitably keen to promote

Indeed, Ireland has long had an image as a country where booze can be seen as inextricably linked with having a good time – something that the drinks industry is inevitably keen to promote. ‘The tourist board here frequently does surveys, and people say they mainly come for things like the scenery,’ she says. ‘Obviously they may well drink while they’re here, but it’s not the primary reason they visit. The industry will also claim that it’s essential to Ireland’s economy, whether that’s trade or tourism or employment. But if you look at the facts, Ireland’s alcohol exports are about 1 per cent of total exports, so it’s a tiny fraction of our economic activity.’ And when it comes to employment the industry will also ‘count every possible job and ascribe it to alcohol’, she says. ‘They always include hotels and restaurants, even though those aren’t businesses that are solely dependent on the sale of alcohol.’

While industry pushback on everything from MUP to tackling sports sponsorship or product labelling is inevitable, the general public are actually behind many of these things, she points out. ‘Typically when we do polling for things like restrictions in advertising – such as the broadcast watershed – you’d have more than 70 per cent in favour. And that’s really not surprising, because of the scale of the problem here. There’s no family that’s been left untouched by an alcohol issue – people are harmed in a multitude of ways. So there’s not really anyone saying, “I want to see more alcohol ads”. But of course we do see more alcohol ads.’

Deep industry pockets
It’s always instructive to look at advertising as a proportion of industry spend, she says. ‘If you’re a typical business – you’re selling coffee, you’re selling shoes – you’d probably spend about 10 per cent of your turnover on marketing. That’s kind of an industry standard. But the alcohol industry spends much, much more. Diageo was spending in the order of 18, 19 per cent of turnover at one point.’

alcohol advertising — ‘If you’re a typical business you’d probably spend about 10 per cent of your turnover on marketing. But the alcohol industry spends much, much more’

And it’s these very deep industry pockets when it comes to advertising and marketing that create another significant issue, she says, and one that’s rarely discussed. ‘It means you have a whole other industry – actually two industries – very much bound up in this product. You have marketers and marketing companies, but you also have the publishers. Whether that’s online, print, TV or radio, they’ve become very big players in all this.’

It’s taken almost seven years since the pre-watershed restrictions were signed into law for them finally to come into force, and while the labelling restrictions are due to be enacted in 2026, two key parts of the PHAA are yet to be commenced. These are section 18, covering ads in publications, and section 13, which places restrictions on the actual content of ads. And it’s the latter that the industry are ‘ferociously’ resisting, says AAI.

This is because it ‘restricts the contents to facts, stripping out the industry myths which are used to recklessly promote consumption,’ and, again, requires the inclusion of health information and warnings. ‘But even if they were published tomorrow, what happens is they have to go to the European Commission and there’s a process to be gone through there,’ she says. ‘So we’re still a very long way off getting that done.’

Regulation dilution
Is she worried that industry pressure will mean that when they do finally come into force they’ll end up being watered down? ‘That’s always the concern,’ she says. ‘But I’d say the industry game at the moment is to delay them as much as possible.’ The problem with this is that everything – the labelling regulations, the content regulations – is designed to work together. ‘They complement each other and should be brought in at the same time. It’s just desperately frustrating because, among other things, what you could see happening is people saying, “so did it make any difference?” And we’re saying the whole thing is meant to act as a package – it’s not that this is the magic bit and that bit is something else. It’s designed to work together, so it’s undermining the legislation to be doing it in these bits and pieces, without a coherent path.’

Ireland’s Public Health Alcohol Act Joined-up thinking
Speaking of a coherent path, AAI and others have also been lobbying for the establishment of an Office for Alcohol Harm Reduction in the hope of creating that oft-cited but usually mythical thing, ‘joined-up government’ – on this issue at least. ‘We need people who have the time and resources to be firstly gathering the information that’s needing to be looked at, different policy options, and most of all to be coordinating it across government. Because what we see all the time is we have the Department of Health who are seeking to reduce alcohol use, and then we have a multitude of other departments which act contrary to that – for example proposals from the Department of Justice to increase availability through longer licensing hours.

‘So we’re very keen on this idea of an alcohol office, of needing people with fresh thinking,’ she continues. ‘We need to be looking at things like internet marketing, we need to be looking at other harms and harms to children in particular. Look at the number of children right now living with a parent with an alcohol problem. A quarter of the adult population in Ireland grew up with alcohol harm in the home, and it carries a devastating impact. Think of the costs of that alone – individual costs like mental and physical health and wellbeing – but also on an economic basis. It makes so much sense to look at all of this in the round.’

The friend that won’t leave

Breaking someone’s close bonds with alcohol is no easy matter, Dr Roger Prudham told an audience of GPs.

The ‘really dramatic increase’ in deaths from alcoholic liver disease represented an ‘incredible explosion’ in the toll on the population, Dr Roger Prudham, consultant gastroenterologist, told the recent RCGP and AP conference, Managing addictions in primary care. His chart showed the burden of disease from alcohol dwarfing that of hepatitis B, hepatitis C and metabolic dysfunction-associated steatohepatitis (MASH). ‘Yet the allocation of resources for alcohol doesn’t match that epidemiology,’ he said.

Signs of liver disease in the hands, jaundice, gynaecomastia, ascites, hepatosplenomegaly, abdominal wall varices, oedema, and encephalopathy were all things to look out for during assessment. ‘But you may have nothing at all, or you may look perfectly fine because the liver is an incredibly forgiving organ – it doesn’t give you any pain or discomfort.’

Importantly, that first conversation needed to be ‘brutally candid but also kind and non-judgemental’. He encouraged asking specific questions – ‘“What do you drink?” “How many bottles/cans a day?” “How many times a week do you buy that?” “Does that include what you drink at the pub?” – instead of “How many units do you drink?” When you get into those specific questions, people find it much more difficult to prevaricate.’

Alcohol is ‘a very seductive drug, it’s universally available, and it’s socially accepted everywhere’

Lifestyle advice included a gradual reduction in alcohol consumption, withdrawal support (community-based where possible), chlordiazepoxide to manage withdrawal, thiamine and multivitamins, and nutritional support. Prudham advocated vigilance for worsening oedema, encephalopathy, jaundice, bleeding, and fluid balance and added, ‘I also think it’s sensible to think about alcohol addiction as a disease, not to make a moral judgement or to think that somehow somebody is defective if they’ve got an alcohol-related problem, because it’s a very seductive drug, it’s universally available, and it’s socially accepted everywhere.’

For medical interventions in primary care, he advised spironolactone and furosemide to help mobilise oedema, low sodium, and lactulose for treating encephalopathy. But what really worked was ‘probably not the medicine’ but ‘a brief intervention, a word from a healthcare professional when you’re going from 30 to 40 units a week’.

He believed minimum unit pricing, cognitive behavioural therapy and a multidisciplinary approach were all effective, alongside finding something else to do – ‘Boredom, I think, is the biggest promoter of recidivism,’ he said. ‘You’re going to need something to replace the alcohol.’

‘Urgent action’ needed to address Scotland’s alcohol harms

News

DDNWeb

February 4, 2025

SHAAP and Alcohol Focus Scotland have written to Scottish health secretary Neil Gray demanding urgent action to tackle the country’s alcohol harms.

The Scottish Government declared alcohol harms a ‘public health emergency’ four years ago, and although there has been ‘some action’ since then – such as increasing the rate of MUP to 65p – there ‘has not been the ambition nor urgency required’ to address the scale of the problem, the letter states.

Last year Audit Scotland published a report stating that the Scottish Government had been slow to progress key national strategies such as alcohol marketing reform or the workforce plan for the treatment sector, despite the country recording its highest number of alcohol-related deaths since 2008. ‘The workforce is under immense strain,’ Audit Scotland said. ‘And the increased focus on drug harm is shifting attention from tackling alcohol issues.’ The report wanted to see the Scottish Government working with key stakeholders to identify and agree actions to address alcohol harm by the middle of this year.

Scotland alcohol harms — ‘For too long the drugs deaths crisis has overshadowed alcohol’

‘Scotland continues to face an unacceptable level of alcohol related harm, with 1,277 people losing their lives to alcohol in 2023,’ said SHAAP chair Dr Alastair MacGilchrist. ‘This requires an emergency response but so far we haven’t seen one from the Scottish Government. For too long the drugs deaths crisis has overshadowed alcohol. The dual problems of alcohol and drugs harms are equally important, but they need to be tackled differently. Treatment for alcohol problems often differs from treatment for drug problems so relying on National Mission on Drugs Deaths money to improve services for alcohol problems is not going to work. We need a dedicated alcohol strategy which sets out a package of measures designed to tackle the price, marketing and availability of alcohol. This should be matched by increased investment in treatment services and recovery organisations.’

Letter available here

One in four Welsh drug deaths now involves cocaine

News

DDNWeb

February 4, 2025

One in four Welsh drug deaths now involves cocaine — Cocaine is now the third most common substance in the country’s drug-related death figures

Cocaine was involved in 65 deaths in Wales in 2023, according to the latest statistics from Public Health Wales, ‘accounting for a quarter of all drug misuse fatalities’.

This means that cocaine is now the third most common substance in the country’s drug-related death figures, after opioids (at 66 per cent) and benzodiazepines. There were almost 377 drug poisoning deaths recorded in Wales in 2023 – up from less than 320 the previous year – of which more than 250 classified as drug misuse deaths.

‘These figures are consistent with information from local services that reflect increases in both powder cocaine and crack cocaine use across Wales,’ said head of the Public Health Wales substance misuse programme Rick Lines. ‘These evolving trends point to a need to expand our services to meet the needs of stimulant users generally, and particularly people who smoke crack cocaine who are often particularly vulnerable.’

Wales drug deaths cocaine — The data again showed the links between ‘social and economic deprivation and overdose risk’

The data again showed the links between ‘social and economic deprivation and overdose risk’, he added, with drug-related deaths ‘eight times more likely in the most deprived areas than in the least deprived. This shows that drug services alone are not the answer to reducing deaths, and that addressing wider determinants must also be a focus of our response.’

Meanwhile, chief officer at Glasgow’s Health and Social Care Partnership, Pat Togher, has told the BBC that cocaine is the most used drug at the city’s recently opened consumption room, the Thistle. Of the 239 times the facility had so far been used, 87 per cent were for cocaine, he said.

Harm reduction database Wales: drug related mortality available here

DDN February 2025

DDNWeb

February 4, 2025

How can we deny the health risks of alcohol?

It’s hardly surprising that the alcohol industry is reluctant to commit to clearer labelling – but calling into question the evidence of health risks is an unacceptable turn (p6). Pointing the finger at ‘a small group of people who don’t use the product responsibly’ is a cynical tactic, but denying the level of risk (including links with cancer) is a crime against public health.

With its sights on positive change, the recent GPs conference brought clinical evidence and data to help us consider how we practise (p8 & 21). But we also have a useful reminder not to stall while we wait for our ideals to be realised (p20) or for poor treatment practice to be overridden or ignored (p18).

A decade after Michael Marmot identified the root causes of health disparities, with strategies to address them, we hear that they have in fact worsened, with drug and alcohol use a key driver (p19). So should we be concerned that the system change championed by Carol Black is going more slowly than she would like, three years on from her independent review (p14)? There have been clear areas of progress but the disconnect on mental health between drug treatment and the NHS is one of the issues we’re not yet getting to grips with. If you can contradict this, we’d love to hear from you.

Read the February issue as an online magazine (you can also download it as a PDF from the online magazine)

Claire Brown, editor

No judgement

Features

DDNWeb

January 28, 2025

‘There were 5,448 drug related deaths in 2023 – that’s 5,448 people who have died.’ As Maddie O’Hare reminded delegates at the HIT Hot Topics conference of this stark statistic, she added that policy and practice were not fit for purpose, and that ‘keeping people alive is the minimum we should do’.

Fortunately, there was ambition among female leaders to support women facing multiple challenges, making sure they not just survived but went on to thrive, and the conference heard from some of them.

Drug testing was another issue that caused tension between women and their key workers, with scepticism around the accuracy of the tests. They also used up a lot of the valuable time of an appointment – ‘If I have 30 minutes with a client, I don’t want them spending 20 of it in the loo taking a test,’ said one participant.

Paula Kearny from the SAOL Project in Dublin told delegates about their work with disadvantaged women whose addiction might be the primary issue but where it was often a symptom of underlying problems relating to poverty, abuse or mental health.

SAOL did not insist on drug-free recovery but focused on helping women find their strengths and what they wanted from life. ‘When a woman walks through the door they are greeted with tea and chats not judgement and stigma,’ she said. ‘Many of the women accessing SAOL have suffered severe trauma and may have controlling partners – the service tries to wrap around them and support them. We need to stop continually punishing women and making it hard for them.’

This was one of the things that made Stella Kityo tired – tired of working in a system that seemed set up to make people fail, tired of people being re-traumatised, and tired of things not changing. As a women’s specialist who had worked in all kinds of environments, she supported and empowered women in diverse circumstances. ‘Women don’t want reducing, they want options, a voice, a time to heal,’ she said. ‘There needs to be a collective change.’

Sex workers faced multiple stigma – not least from other women, said Grace Sumner from the Women’s Inclusion Health Collective. The criminalisation of sex workers caused problems, with sex workers 12 times more likely to be murdered than women not involved in sex work. ‘But sex workers are well organised and have strong unions and groups – they don’t need to be rescued, she said.

support for women — Sex workers faced multiple stigma – not least from other women

The government’s plans to adopt the ‘Nordic model’ which criminalises clients rather than workers would push workers in the sex trade to take greater risks and engage in more dangerous situations to protect their clients, she said. There needed to be more open and honest discussion about practical harm reduction – such as new sex workers understanding the value of mirrors to know what was happening behind them, and the importance of hiding all ID and ways of being identified.

Julie Smedley shared her experience of visiting sex workers as part of an outreach team, which did not initially go the way she expected. ‘I was naive and thought I would change everything,’ she said. ‘Women asked for a script and laughed when I suggested an appointment in two weeks’ time.’

This doubled her determination to help, and as part of WithYou she set up a service in Liverpool’s red light district that aimed to overcome the barriers of location, waiting times, flexibility, and stigma. Taking the service to the women also removed their concerns about meeting any of the ‘three Ps’ – punters, pimps and perpetrators – who might be attending a mainstream service.

Many of the women who came along wanted a script, and while there was initial scepticism around other support offered this gradually lessened, leading to the IRIS project. Launched in December 2023, it provided holistic wraparound services where most needed.

The devastating global consequences of the war on drugs and lack of safe supply were illustrated by Lynn Jeffreys from EuroNPUD who showed a slide with 47,162 dots representing drug deaths in her native Canada. ‘If I was trying to do this for the USA there wouldn’t be enough space for all the dots,’ she said.

DDN Conference 2025: Bright Sparks!

DDNWeb

January 27, 2025

The DDN Conference is over for another year – huge thanks to all of this year’s visitors, speakers, exhibitors and sponsors. Take a look at our conference coverage below, with more coming soon!

Watch the video highlights here.

Take a look at a selection of photos from the day here.

Read some fantastic visitor feedback here.

If you have any feedback, photos or video clips of the day, we’d love to hear from you. Please share on social media using the hashtag #ddnconf or send to us directly via DM or by emailing carly@cjwellings.com

DDN Conference 2025

THE DDN CONFERENCE IS BACK FOR 2025!

DATE: Thursday 10th July 2025
VENUE: The National Motorcycle Museum, Birmingham

'My favourite conference' – @judithyates1

DDN Conference 2025

'Inspiring and thought-provoking discussions – new ideas aplenty to bring away, collaborate, and turn into positive change' – @lukeoneil84

Programme

We are delighted to unveil our 2025 conference programme.

With discussions on multiple disadvantage, individual placement and support, LEROs, the ketamine challenge, and much more, our packed programme promises an excellent day.

Click here to view the conference programme and speaker information.

NEW for 2025! We’re excited to announce some lunchtime activities to keep you entertained. Don’t miss the B3 / BSAFE Recovery Arts & Crafts Workshop as well as music from record label Not Saints!

'As always, great conversations and inspirational speakers' – @ViaOrg_

Delegate places

Activism, debate, networking, inspiration, campaigning, practical advice and support… you’ll find it all at the annual DDN Conference. Your voice matters: come to Birmingham to engage in the biggest conversation about better, fairer treatment for all. You’ll be inspired, informed – and have an enjoyable day among friends, partners and new contacts.

Ticket prices from £99. Follow the link below to purchase tickets.

If you are looking to send a group of delegates, please contact ian@cjwellings.com for details.

Buy tickets

'The event had lots of great speakers and offered an excellent opportunity to network' – @VoicesActionCh1

Exhibition and sponsorship

Would you like to exhibit at this year’s DDN Conference?

With over 500 delegates and in excess of 30 exhibitors, the DDN Conference is the event to connect with everyone in the sector, showcase your products and shine a spotlight on your services!

Space is very limited so contact ian@cjwellings.com today for more information.

Already booked to exhibit?

Find out everything you need to know for the day, including timings, venue details, accommodation and set up; information for stand deliveries; delegate names; and invoicing here.

'Good motivation for peer support and lived experience… some awesome speakers' – @HarmReductionUK

Accommodation

The DDN team will be staying at The Arden Hotel, which is five minutes from the venue and close to the train station and airport. The conference room rate is £120 which can be booked by calling (0)1675 443221 and quoting reference GA003143.

There are other hotels nearby including Castle Bromwich Hall Hotel, which is just off the M6 and less than 20 minutes from the venue. Rooms start at £80 including breakfast.

'A humbling and inspiring day' – @CGLinWF

DDN Conference 2024: catch-up

DDN Conf

Missed the 2024 conference? Attended but want a refresher?

Read full conference coverage in the September 2024 issue of DDN!

'Mint turn out as always' – @GBMC73

EMAIL ALERTS
The DDN Bitesize email keeps you updated with the latest news, features, jobs and events from DDN magazine. Sign up for our email alerts here to receive updates and details of the DDN Conference.

DATE
The DDN Conference takes place on Thursday 10th July 2025.

VENUE
The National Motorcycle Museum, Birmingham. For information on how to find the venue and parking, click here.

TIME
Registration from 9am, conference 10am-3:45pm.

TICKETS
You will be issued with your ticket and delegate bag on arrival. If you are attending as part of a group we do not need all of the names, just the number of delegates.

PROGRAMME
The order of the day, including all session and speaker information, can be found here.

CATERING
Refreshments are provided. There will be a tea and coffee break in the morning and a full cooked lunch (including vegetarian and vegan options) in the afternoon.

EXHIBITION
If you are booked to exhibit, everything you need to know about the running of the day is here.

ADDITIONAL TICKETS
If you have colleagues that want to come and have not booked yet, there is still time! You can book tickets online here.

USEFUL INFO
Wifi is available.
You will receive free entry to the Motorcycle Museum from 3:45pm.

If you cannot find the answer to your question, please contact Ian Ralph:
ian@cjwellings.com – 07711 950 300

We look forward to seeing you all at the DDN Conference 2025!

Supported by:

Forward’s rough sleeper breakfast clubs: empowering lives through community

Partner Updates

DDNWeb

January 23, 2025

As a previous frontline drug and alcohol worker, I tend to think I know what to expect from ground-level projects. As I was heading to the inaugural Forward Trust Dinner Club, I imagined something akin to what you might expect at a school canteen: an echoey space, plastic chairs and heaps of well-intended, but ultimately unidentifiable, pasta bake. How wrong I was. Instead, what I encountered went far beyond my expectations, says Abbie MacGregor, community service development manager.

As I arrived early to the Canterbury’s Dinner Club, held at the Snuggery Café tucked on the High Street just beyond Canterbury’s landmark Roman city walls, I was immediately struck by the welcoming atmosphere. The aroma of freshly ground coffee and hot food filled the air, and I was met by a beaming man behind the counter, whose smile only grew as I stated my credentials: ‘I’m from the Forward Trust.’ This gentleman (named Ali), it would transpire, was one of few local business owners who didn’t flinch when asked to host a Dinner Club for the local homeless community. I asked him what made him say yes, he shrugged as if to say ‘why wouldn’t I?’.

Forward’s Rough Sleeper Breakfast Clubs — Ali and Beth at the Snuggery

After settling in the corner, a crowd began to bubble outside. I could see through the window groups of people exchanging pleasantries, laughing and hugging. Taken aback by the sense of community, I began to understand this wasn’t just about food, it was about fostering connection, dignity, and hope among guests. As the doors opened, cheerful chatter flooded the space, guests greeted staff, said hello to Ali, found a spot to land, and orders were taken.

This is where the real magic began – while waiting for orders of freshly cooked meals, Beth (a service manager at Forward) and her Risk of Rough Sleeping (RORS) team circulated the tables. It was like a masterfully choreographed dance: checking in on guests, asking about their health, their families, before twirling to another table to help a guest fill in a form or register with a GP. The whole team evidently took a genuine interest in guests wellbeing – the sort of routine that would muster Craig Revel Horwood’s lesser-seen 10.

The dedication of the RORS team has meant that 135 people have been fed and 29% of attendees at these breakfast clubs have since entered treatment with the Forward Trust (data taken from one quarterly report during 2024-25).

Forward’s Rough Sleeper Breakfast Clubs: Empowering Lives Through Community — Two of the breakfast/dinner club guests

I asked a guest how she’s felt coming to the breakfast club, and she told me that the ‘personal touch’ made her ‘feel a bit human again’ after a prolonged period of rough sleeping. Her table companion, a louder and more outspoken character, boldly offered that: ‘it is AMAZING… genuinely it’s one of the highlights of my week!’ – before shooing me away with a wink as her jacket potato arrived.

The food offerings were impressive – not just in variety but in nutritional quality. An À La Carte approach as opposed to the canteen buffet I had been conjuring. An older, softly spoken man told me it was a ‘chance to feel like I’m going out to a restaurant like a normal person’. He said he even makes ‘a bit of an effort to look smart’ before coming along. The whole operation had a sense of grown-up seriousness to it, side-stepping some of the pitfalls of other charitable projects I’ve seen that can be patronising or tokenistic.

Beth and her team’s work didn’t finish there. They were busy burying themselves in boxes in the opposite corner, pulling together care packages for guests to take away with them. Toiletries, clothes, rain ponchos, and backpacks – all proper quality stuff too – offered to each guest. In recent months, they have handed out over 220 naloxone kits to this community alone – a lifesaving intervention (Q2 24-25).

Forward Trust rough sleeper breakfast and dinner clubs — Guests enjoying the dinner club

I left the club feeling inspired by the work being done there. It was more than just a place to eat; it was a transformative environment where individuals found hope, support, and connection. The commitment of the staff and the resilience of the guests demonstrated the power of community in overcoming adversity. The dinner club stood as a testament to what can be achieved when compassion and collaboration come together to uplift those in need.

This initiative forms part of the East Kent community drug and alcohol service, which Forward has delivered since 2017. The breakfast and dinner clubs are funded specifically by the Office for Health Improvement and Disparities via Kent County Council.

Is your business interested in participating in this scheme? Contact us for more information: Canterbury@forwardtrust.org.uk

This blog was originally published by the Forward Trust. You can read the original post here.

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

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

This content was created by the Forward Trust

Cranstoun colleagues walk 100km in one day to raise vital funds for family support

Partner Updates

DDNWeb

January 23, 2025

Colleagues from Cranstoun Worcestershire braved the January weather to take on an enormous fundraising challenge of walking 100km in one day.

A team set off from the Worcester office, walking over the Malvern Hills, around to Tewkesbury, up through Pershore and back to Worcester in a 22-hour challenge to raise vital funds.

Every few hours a support crew made up of colleagues Milly, Kate and Courtney would meet up with the walkers to provide hot drinks and make sure the team had everything they needed.

The aim was to support Cranstoun’s M-PACT (Move Parents & Children Together) group programme, which supports parents struggling with substance use to make positive changes, improve communication with their family and build relationships for the future.

After pushing through pain, blisters and exhaustion, the team managed to raise more than £1,000 for M-PACT, as well as an additional £400 raised for the British Heart Foundation during their challenge.

Jess Brown, Head of Fundraising at Cranstoun, said, ‘Well done to our incredible team of challengers, completing a 100km trek to raise funds for Cranstoun’s M-PACT service! Alex, Matt, Sandra, Hannah and Rich managed this impressive feat in just over 22 hours, helping to secure the future of this vital programme, supporting families affected by drug and alcohol use.’

This blog was originally published by Cranstoun. You can read the original post here.

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

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

This content was created by Cranstoun

The shape of stigma: reflections for the year ahead

Partner Updates

DDNWeb

January 23, 2025

As we step into a new year, it’s natural to reflect on the past and look forward to the future. It’s peak season for reflective blogs, annual reports and the like.

But instead of cataloguing everything we’ve done at the Anti-Stigma Network, we want to focus on one key realisation from the past year, which is our thoughts about the shape and scale of stigma and the opportunity we have to address it.

Over the past year, as we’ve spoken with people from all walks of life, one thing has become strikingly clear – no one is immune to stigmatising thinking. Whether someone uses, has used substances or never touched them, stigma weaves itself through all our daily lives in both subtle and overt ways.

The breadth of spaces and relationships
Stigma permeates our everyday interactions, shaping how we treat others and are treated in return. It exists in personal relationships, workplaces, and broader societal structures from healthcare and justice to welfare, housing, education, banking and wherever else in life you can exist and experience.

Deep within all of us
Stigma lives in the stories we inherit and experience that help form our beliefs – stories from our families, literature, the media, and the arts. These narratives influence how we see ourselves and others. They teach us who belongs, who doesn’t, and how we should judge those around us.

From the bottom to the top of structures and institutions
Stigmatising thinking is present in all organisations at all levels. Whether that be community, regional or national policies, laws, major institutions or even within spiritual beliefs.

Just as no one is immune from stigmatised thinking, every one of us has a role to play in understanding and addressing it. — Just as no one is immune from stigmatised thinking, every one of us has a role to play in understanding and addressing it

Stigma across time
Perhaps most strikingly, stigma transcends individual lifetimes. As well as being present in all lifestages and life events from birth to death, people can be stigmatised before they are born and long after they’ve passed. History is full of examples where stigma shapes legacies and erases contributions.

What this means for us all
Recognising the shape and scale of stigma can feel overwhelming. But this also presents an opportunity. Just as no one is immune from stigmatised thinking, every one of us has a role to play in understanding and addressing it. We have countless spaces to work in, countless moments to intervene, and countless opportunities to challenge. Whether unlearning inherited beliefs, being mindful of personal interactions, or advocating for policy change, each action matters.

This blog was originally published by the Anti-Stigma Network. You can read the original post here.

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

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

This content was created by the Anti-Stigma Network

Ring fence funding and prioritise prevention, say ‘people’s panel’ members

News

DDNWeb

January 22, 2025

Funding to address Scotland’s drug harm ‘public health emergency’ should be ring fenced and prioritised on prevention, says the report from the ‘people’s panel’ set up to look into the issue last year.

A culture change will be needed to address the problem, says the document, which has now been sent to MSPs. While the panellists acknowledged that progress had been made – particularly with the country’s naloxone programme and the opening of Glasgow’s consumption room – there was an urgent need for ‘brave and bold action’.

This should also include public awareness-raising campaigns, better information sharing between government agencies, and more involvement of people with lived experience. ‘The pay and fair working conditions of people with lived experience needs to be equitable with that of equivalent public sector workers in the drug and alcohol field,’ the report adds.

‘More radical pilot schemes’ were also needed, along with a renewed focus on 18-44-year-old men who, while making up a large proportion of the death statistics, were ‘being missed by services’.

A ‘lack of urgency’ in responding to drug harms had reinforced the stigma already associated with them, the report states. ‘The panel strongly believe that the same conversations keep happening, with the same actions being agreed but not enough has been implemented. The panel have concluded that the length of time taken to address this issue is unacceptable.’

The most recent Scottish drug death figures saw a total of almost 1,200 fatalities – the highest rate in Europe – with 80 per cent involving an opiate. A report from the country’s auditor general late last year found that while the Scottish Government had made some progress in implementing treatment standards and increasing residential treatment capacity, it had still been ‘slow to progress’ key strategies like its workforce plan. The auditor general’s previous report had concluded that Scotland’s treatment sector was characterised by ‘complex’ delivery leading to problems with accountability and difficulties in tracking what the funding was actually achieving.

The people’s panel was requested by the cross-committee on tackling drug deaths and drug harms, and formed after the Scottish Parliament sent letters to 5,000 randomly selected residential addresses. Twenty-three panel members were then selected, who met over the course of two weekends to hear evidence from people working in the sector, people with lived experience, academics, researchers and others. Their report will now ‘help inform the cross-committee’s scrutiny of matters related to reducing drug deaths and tackling problem drug use,’ the Scottish Parliament says.

people's panel Scotland — ‘All the evidence we heard highlighted the urgency for action from the Scottish government to implement brave and lasting change’

‘I found participating in the people’s panel humbling,’ said panel member Mairi McIntosh. ‘The team at the Scottish Parliament organised a diverse range of experts and worked hard to lay out the worrying and rapid escalation in drug-related deaths and harms in Scotland. All the evidence we heard highlighted the urgency for action from the Scottish government to implement brave and lasting change. I am hopeful that our report shows that as voices from across Scotland, representing different backgrounds and lives, some directly affected by the issues of drug harm and death and others not, that we want the Scottish government to acknowledge the causes and barriers like stigma and discrimination and realise that we cannot afford to not take bold action now.’

People’s panel on reducing drug harm and deaths in Scotland: final report available here

Grieving families ‘routinely denied’ inquests that take gambling into account

News

DDNWeb

January 21, 2025

Families of people who have taken their own lives as a result of gambling-related harm are being ‘routinely denied inquests that properly consider gambling’, says a new report.

The inquests are also failing to take into account the ‘role of gambling companies and the wider gambling landscape’ within their scope, says the study, which was carried out by researchers at Birkbeck, University of London and the University of Bath in collaboration with the Gambling with Lives charity.

This failure to properly take gambling into account is despite the ‘best efforts’ of the families to present evidence and raise the issue, says the report, which is the first to look at coroners’ inquests among families bereaved by gambling-related suicide.

Researchers conducted interviews with 14 family members over a ten-year period, and their experiences were found to ‘align with those of other bereaved people’ interviewed for the wider Voicing Loss project. The families generally ‘perceived there to be an unwillingness for the deceased’s gambling and the role of gambling companies to be included within the scope of the investigation and inquest’, the report states, despite many going to ‘considerable lengths to provide details of the gambling and submit detailed evidence to the coroner’.

This evidence was then either accepted without comment or ignored altogether, the document says, with no subsequent mention of gambling on the record of inquest or death certificate. This narrow scope means opportunities to help to prevent future deaths and inform debates about gambling reform are being missed, the researchers state.

gambling inquests — This failure to properly take gambling into account is despite the ‘best efforts’ of the families

‘It was so quick it was unbelievable,’ said one interviewee of their experience. ‘I just found it cold. It’s like a conveyor belt. We seemed to be in there, out there and they disposed of 30 years of life… It was as if they wanted to get the next one in, and nobody seemed to be bothered that my son had taken his life.’ Another described how they’d explained to the coroner’s officer ‘that I was certain that it was gambling that was the problem. And his words to me were something like, “Well the coroner’s not going to be interested in that”.’

‘The fact is, nobody is interested,’ said another. ‘We know, and have got proof…that he died from a gambling addiction. There’s – be it bank records and his emails and all that – evidence to show that, and nobody cares. To us, he’s dead; nothing can be done. But it is the prevention of future deaths that should be important, and you’d hope someone would care about that, and they don’t seem to.’

More than 10 per cent of almost 10,000 respondents to the Gambling Survey for Great Britain had ‘reported suicidal thoughts or an attempt to end their life in the previous 12 months’, the report points out, with an evidence review by PHE previously finding that people with gambling problems were ‘at least’ twice as likely than the general population to die as a result of suicide (DDN, November 2021, page 4).

Other studies have put the risk far higher. A 2022 evidence review published in the Frontiers in Psychiatry journal looking at studies from across the world concluded that ‘quantitative evidence suggests that suicidality is high among those who gamble at harmful levels. In clinical populations and in treatment services for problem gambling, between 22 and 81 per cent of individuals have been found to have suicidal ideations, while between 7 and 30 percent of individuals have had suicide attempts’.

Grieving families ‘routinely denied’ inquests that take gambling into account — People with gambling problems were ‘at least’ twice as likely than the general population to die as a result of suicide

‘Gambling may be called the hidden addiction but most families knew about the gambling or found out about it very soon after the death of their family member,’ say Gambling with Lives co-founders Liz and Charles Ritchie, who lost their son Jack to gambling-related suicide in 2017. ‘We do not want to lay the blame for this failure at the door of any individual coroner, but see it as part of the wider lack of understanding about the dangers of gambling and ignorance of the long-established link between gambling and suicide, which has been perpetuated by the gambling industry. The information and training needs are obvious – and these extend far beyond the coronial system. To ensure that future gambling deaths are prevented it is vital that the government ensures that every death is fully investigated and lessons are learned.’

We were not included – there was no thought about our loss: experiences of the inquest process among families bereaved by gambling-related suicide available available here

Stopping cannabis use cuts psychotic disorder risks

News

DDNWeb

January 20, 2025

Cannabis users’ risk of developing psychotic disorders ‘appears to decrease with time once they stop using the drug’, according to a report from King’s College London’s Institute of Psychiatry, Psychology and Neuroscience.

There is extensive research that heavy cannabis use is associated with the development of psychosis, alongside poor mental health and sleep issues, with daily users and users of high-potency cannabis facing ‘particularly increased risk’, the researchers state.

However, the study – published in the Canadian Journal of Psychiatry – found that it took around 37 weeks of abstinence for a person’s risk of developing psychosis to return to the same level as someone who’d never used the drug. For some people who regularly used high-potency strains, however, there could still be an elevated risk even after more than 180 weeks.

Researchers used a multi-centre study of first-episode psychosis among almost 900 people across Europe and South America, and compared the findings to more than 1,200 people without psychosis. They analysed current and lifetime cannabis use, duration and frequency of use, potency of the drug used, time since cessation, and age of first use.

‘Our study, which is the first to examine whether the risk of a psychotic disorder goes down if a person ceases cannabis use, is vital,’ said joint senior author Dr Isabelle Austin-Zimmerman. ‘As the legalisation of cannabis continues to grow, so too will the number of people using the drug. Our study provides important evidence confirming that sustained cessation of cannabis use is associated with a decreased risk of psychosis.’

Mental health charities have previously warned that moves to legalise cannabis for recreational use in the UK risked ‘fuelling the nation’s mental health crisis’. ‘One third of all new patients diagnosed with psychosis in London would not have got ill if they hadn’t used high-potency cannabis,’ said chair of the Rethink Mental Illness charity’s clinical advisory group, Sir Robin Murray, with the organisation urging policy makers to make sure that any debates around legalisation reflected the ‘possible impact on the most vulnerable and those living with – or at risk of – severe mental illness’.

Meanwhile, drug seizures in England and Wales were up by 13 per cent in the year to March 2024, according to the latest Home Office figures. More than 80 per cent of the seizures were by police, with 19 per cent carried out by the Border Force.

Border Force seizures were 57 per cent up on the previous year, mainly driven by herbal cannabis seizures, the Home Office states. They also seized their largest ever quantity of powder cocaine, at more than 26 tonnes – a 75 per cent increase on 2022-23. The quantity of heroin seized, however, was down by 54 per cent to 441kg, the lowest quantity seized since the late 1980s.

Cannabis use cessation and the Risk of psychotic disorders: a case–control analysis from the first episode case – control EU-GEI WP2 study available here

Seizures of drugs in England and Wales, financial year ending 2024 available here

Wales considers raising minimum unit price to 65p

News

DDNWeb

January 16, 2025

A report on the impact of MUP in Wales has recommended raising the minimum price from 50p to 65p per unit – as the Scottish Government did last year – in order to ‘sustain the policy’s value and positive impacts’.

MUP came into force in Wales in 2020, after legislation was passed two years earlier.

While assessing the impact of MUP against the backdrop of ‘the pandemic, persistently high levels of inflation and the cost-of-living crisis’ had been challenging, said mental health minister Sarah Murphy in a written statement, evidence showed that the legislation had ‘had an impact on the sale of cheap, high-strength alcohol products, with prices increasing. This has resulted in customers purchasing less of this type of product and fewer retailers stocking them.’

A study by the National Centre for Social Research found that there had been a ‘statistically significant’ impact on the number of alcohol units purchased by households after MUP’s introduction. ‘Initially, there was a marked increase in alcohol purchases in Wales following its introduction, coinciding with the COVID-19 mitigation measures. However, this surge was smaller in Wales than in England, and subsequently alcohol purchasing declined more rapidly in Wales after the pandemic,’ it says.

MUP Wales minimum unit price — ‘Despite price increases, drinkers were reported by service providers as continuing to find ways to afford alcohol’

However, interviews carried out for the National Survey for Wales and included in the government reports found that – as was the case after MUP was introduced in Scotland – some people were cutting back on food and other essentials to buy alcohol. ‘Yeah, we do skip things, skip food, skip paying bills,’ one service user said.

‘Despite price increases, drinkers were reported by service providers as continuing to find ways to afford alcohol through methods like buying in bulk, “shoplifting, sex working, stealing from family members and taking out loans” as well as cost-sharing amongst friends or begging,’ says Assessing the experiences and impact of minimum pricing for alcohol on service users and service providers: final report.

‘The only effect that minimum pricing has had is to make my drinking worse,’ another service user reported. ‘You look and you think, I can’t have my [white cider brand name], which fills you up dead quick and makes you too bloated to drink anymore. You have to end up switching to wine, which is all stronger. Then you think, “Whisky’s the same price”, and you end up with a bottle of whisky. Then once you start on the whisky you have a bottle a day, then you’re on two bottles a day.’

Written statement: independent evaluations of minimum unit pricing for alcohol available here

Review of the introduction of minimum pricing for alcohol in Wales: contribution analysis available here

An evaluation of effects on minimum unit pricing of alcohol available here

Assessing the experiences and impact of minimum pricing for alcohol on service users and service providers: final report available here

Assessing the impact of minimum unit pricing for alcohol on the wider population of drinkers available here

Xylazine ban comes into force

News

DDNWeb

January 16, 2025

Xylazine has been banned as a class C substance, the Home Office has announced. The ban follows a recommendation from the ACMD last year.

The drug, a non-opioid known as ‘tranq’ or ‘tranq dope’ in the US – especially when mixed with fentanyl or heroin – has been associated with a range of dangerous side effects, including large skin lesions.

The new legislation sees 22 substances banned under the Misuse of Drugs Act, six of which will now be controlled as class A. A generic definition of nitazenes has also been introduced, designed to stop people circumventing the law by adjusting a substance’s composition.

xylazine banned — A generic definition of nitazenes has also been introduced, designed to stop people circumventing the law by adjusting a substance’s composition

‘Synthetic drugs cause devastation wherever they are found – to individuals, to families, to our town centres and our communities,’ said policing minister Dame Diana Johnson. ‘I have been concerned about the growing presence of these drugs on UK streets and I don’t think enough has been done in recent years to get a grip on it. Stepping up efforts to tackle this threat will form a key part of this government’s approach to drugs, which we hope to set out later this year. As part of our Plan for Change and mission to make our streets safer, we are dedicated to driving down drug misuse and harms through prevention and treatment while acting quickly to stop the criminals peddling these harmful substances.’

Home Office circular available here

At your service

DDNWeb

January 14, 2025

While the terminology has changed over the years – with a shift from ‘service user involvement’ to ‘lived experience’ – how the treatment and recovery workforce offers opportunities for people who have experience of substance use and related issues is of great value. Lived experience has become both a buzzword and a cornerstone of recovery-oriented systems of care (ROSC) in the UK. The transition from a person accessing a service to a professional working within it is a significant journey, offering opportunities for both personal growth and enhanced service delivery.

This article is based on my master’s research at Middlesex University, supported by a bursary from the Society for the Study of Addiction (SSA). The study explored the experiences of people with lived experience working in the treatment and recovery sector, focusing on the motivations, benefits, challenges and value they bring to services.

service delivery — Research highlights the positive impact of peer support, including improved client retention, reduced stigma, and enhanced recovery outcomes

Research highlights the positive impact of peer support, including improved client retention, reduced stigma, and enhanced recovery outcomes. As experts by experience, these individuals bring authenticity and empathy that fosters trust and connection with those accessing services. It’s also prudent for me to point out that peer roles for people with current ‘living experience’ are equally of value, for the same reasons.

This qualitative study, conducted through semi-structured interviews and interpretative phenomenological analysis (IPA), revealed key themes reflecting the transition from service user to worker.

Employment as recovery capital
Employment plays a dual role for individuals with lived experience – it provides financial stability while also reinforcing their recovery journey. Participants highlighted how meaningful work enhanced their self-esteem and sense of purpose, describing their roles as vital components of their recovery capital.

Reciprocity in peer work
Many participants cited a strong internal motivation to help others, rooted in their own recovery stories. Peer support roles enabled reciprocal therapeutic relationships, benefiting both the practitioner and those they served.

lived experience service delivery — Women, particularly mothers, faced additional scrutiny and barriers when accessing services and seeking employment

Key moments and mentors
The transition to employment often involved pivotal moments where their lives took a turn as well as the significant people who provided mentorship and encouragement. These affirming experiences were instrumental in building the confidence needed to succeed in their roles.

Challenges and stigma
Despite these benefits participants reported challenges, including stigma – whether in their previous workplaces, from colleagues in the sector or from wider society. Women, particularly mothers, faced additional scrutiny and barriers when accessing services and seeking employment.

To address these challenges and maximise the potential of lived experience practitioners in peer support worker or other roles, several best practices have been identified:

Training and professional development
Comprehensive training tailored to the needs of lived experience practitioners is essential. Continued Professional Development (CPD) opportunities can reinforce skills, self-belief and value within the workforce. Training should also include clear guidelines on professional boundaries to support a healthy working environment.

Support structures
Regular supervision and peer mentorship are critical to sustaining the wellbeing of lived experience staff. Accessible policies and consistent support ensure that practitioners feel valued and equipped to manage workplace challenges.

Organisations must actively combat stigma and ensure that all staff – whether they possess lived, living, or learned experience – are respected and supported

Cultural and organisational integration
Integrating lived experience practitioners into multidisciplinary teams requires a culture of inclusivity. Organisations must actively combat stigma and ensure that all staff – whether they possess lived, living, or learned experience – are respected and supported.

Reducing stigma
Beyond internal policies, the sector must address societal and in-sector stigma through advocacy and education. This includes creating inclusive messaging, a mindfulness of terminology, and policies that acknowledge the unique challenges faced by women and other marginalised groups.

The inclusion of lived experience practitioners offers transformative potential for the UK treatment and recovery sector. By valuing their unique insights, providing robust training and fostering inclusive work environments, organisations can harness the expertise of these practitioners to improve service outcomes.

By supporting the transition to ‘professional’ staff member, the sector can not only enhance recovery outcomes but also demonstrate the true value of lived experience in building a more inclusive and effective system of care.

Stacey Smith is a consultant, researcher and trainer

Back to the future

Features

DDNWeb

January 14, 2025

As expected, drug-related deaths (DRDs) across the UK have tragically increased again, with no clarity in the recent ONS statistics on the timeline of many records. As a leading harm reduction collective, we advocate for a return to standalone harm reduction hubs, policy changes, and a refocus on commissioning specifications to engage those most at risk of harm and higher mortality rates.

In 1987, the late great Russell Newcombe coined the phrase ‘high time for harm reduction’, urging policymakers to focus on reducing the harms from drug use rather than solely on cessation. Thirty-seven years later, UK policy has not significantly shifted from futile attempts to eradicate drug use, with an inadequate focus on harm reduction remaining.

Since 2010, the UK strategy has not supported any modernised approaches to harm reduction, instead focusing on abstinence and crime reduction as the primary drivers for change. The 2021 drug strategy mentions harm reduction only once, alongside targets for reducing deaths and increasing treatment availability. The strategy did not introduce any significant changes in approach or key harm reduction strategies, such as diamorphine-assisted treatment, expanded needle and syringe programme (NSP) provision, overdose prevention centres or drug checking.

Hot Topics Lynn Jefferys — HIT Hot Topics delegates heard from powerful harm reduction speakers including Lynn Jefferys (right)

Hot Topics
At the eleventh HIT Hot Topics conference in Liverpool, we were once again given hope that the harm reduction wilderness days may be over in other parts of the world – with global recognition of its importance continuing to emerge. Niamh Eastwood, executive director at Release, called for harm reduction hubs separate from drug treatment services – dedicated, safe spaces to engage people in a way that meets their needs. We imagine this space would include access to NSP, advice and harm reduction interventions to reduce people’s vulnerability to BBVs, bacterial infections and a range of other harms and importantly a chance to engage around wider health needs. Does this remind you of anything? (Specifically thinking about the NTA’s Models of Care).

As discussed previously in DDN (Dec-Jan 2024, page 20), the replacement of tiered models of care with integrated recovery services has made many people reluctant to engage with NSP services located in treatment services also delivering prescribing. The one-stop shop approach has highlighted that many people who inject drugs miss and prefer the confidential, anonymous approach to NSP provided by tier 2 services.

Hot Topics also featured senior public health practitioner Alan McGee, part of the team that developed the Mersey model of harm reduction. He presented a critical analysis of past and present drug policy and historic activism examples, including a mobile van in late ‘80s Liverpool that distributed injecting equipment to peers for secondary supply. There are other examples from across the UK where harm reduction activism created a public health approach which undoubtedly reduced the harms and threats of HIV and other communicable diseases, but much of that best practice has been lost over the years.

HIT Hot Topics Conference — Sam Rivera (right)

Two other speakers highlighted progressive practices outside the UK. Sam Rivera discussed how overdose prevention centres (OPCs) in New York created a safe harm reduction space, while Dr Nabarun Dasgupta from the Remedy Alliance for the People in North Carolina spoke about drug checking and naloxone development, underpinned by true altruism.

We enviously listened to these stories of activism and courage, including Lynn Jefferys from EuroNPUD’s description of how Jeremy Kalicum and Eris Nyx – co-founders of the Drug Users Liberation Front (DULF) – jeopardise their own liberty to save lives in Canada by offering a safe supply in response to a public health crisis.

What next?
The question remains: what do we do next in the UK? It’s vital that we address the regression in harm reduction and we call for a change in policy – just as Russell did back in 1987. The call to action for more dedicated harm reduction hubs is timely, urgent, and crucial if we are to have any hope of catching up with our international colleagues and reducing DRD rates.

Considering the lack of discreet, dedicated harm reduction interventions and the gaps created by losing tier 2 services, it stands out how the needs of people who inject drugs – those who do not want to engage with structured treatment or who want that treatment separate from their injecting practice – have been neglected throughout the recovery policy decade. While it’s great news that Scotland has overcome opposition from Westminster to open a life-saving overdose prevention centre, in England it remains a political barrier. But it’s within our ability now to provide commissioned and much needed low threshold enhanced harm reduction hubs that can also help save lives.

Tier 2 harm reduction services were successful due to being part of a mandated four-tiered commissioning model under the NTA’s Models of Care. So, in looking to regain some of this protected space for harm reduction interventions, is it local conversations that are needed to readdress the needs of people who inject drugs, or a redirection in national strategy?

Tier 2 services have remained in Northern Ireland, referred to as low threshold services commissioned by the Public Health Agency (NI), and separate to prescribing services provided by the five NHS trusts. As a result, expertise in harm reduction has been maintained and developed. These low threshold services are provided by the voluntary sector, and almost all have their roots in providing services for people experiencing homelessness – who face a range of life-challenges and that services with higher thresholds struggle to engage with.

We know that some places, such as Bristol, continue to provide stand-alone harm reduction services. Through several re-commissioning cycles, Bristol Drugs Project (BDP) have retained a specialist team of harm reduction workers, offering a drop-in advice centre, NSP and a clinic where people can get wound care and other nursing services. Structured treatment services are kept separate, and the benefits are clear.

Enhanced hubs
Release have shown leadership in the opening of their harm reduction hub and the peer led approach to NSP in Hackney by the London Joint Working Group on Substance Use and Hepatitis C are good examples of activism in action. Enhanced harm reduction hubs unattached to treatment services could offer drug checking, a safe consumption space and accessibility for marginalised groups such as women, sex workers and homeless people.

Harm reduction HIT Hot Topics Conf — Juan Fernández Ochoa

Integrated recovery services offer important structured clinical treatment, things like individual placement and support (IPS) and group work to a certain group of people motivated for change. But focus has been lost on the offer for the many other at-risk people needing access to the range of low threshold interventions described.

More services have now reverted to clinical vans, mobilising the offer and widening the reach of service delivery – realising that people are not hard to reach, but that services and their configurations can be unattractive or inaccessible to marginalised individuals. Could it be that this full-circle approach back to assertive action, engaging peers, and working within communities is part of the answer?

One thing is certain. Without swift action, changes to commissioned models, wider collaboration, and more lobbying for change, the rising deaths and increasing harms faced by those most at risk will continue. The need for spaces to attract people into enhanced harm reduction is loud and clear.

Iain ‘Buff’ Cameron is project manager, harm reduction services at Extern; Jon Findlay is national harm reduction lead at Waythrough; Peter Furlong is national harm reduction lead at Change Grow Live; Deb Hussey is national safer lives lead at Turning Point; Lucy O’Hare is training manager at HIT; Maddie O’Hare is deputy director at HIT; Chris Rintoul is innovation and harm reduction lead at Cranstoun.

UK’s first consumption room opens in Glasgow

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January 13, 2025

The UK’s first safer drugs consumption facility (SDCF) has opened in Glasgow. The Thistle, in the city’s east end, is backed by £2m annual government funding and will provide a ‘supervised healthcare setting where people can inject drugs in the presence of trained health and social care professionals in a clean, hygienic environment’, the Scottish Government says.

The aim of the service is to reduce both the harms related to injecting drug use and the negative impact that outdoor injecting can have on communities, as well as supporting people ‘to access help to improve their lives’, states the Glasgow Health and Social Care Partnership (HSCP). The facility aims to be open from 9am to 9pm every day for people aged 18 or over, with staff on hand to ‘monitor injecting activity, provide harm reduction advice to minimise the risk of overdose and intervene with assistance if a person does overdose’, says HSCP.

The consumption room was finally green-lit by Glasgow’s Integration Joint Board in late 2023 after Scotland’s lord advocate clarified the legal issues surrounding the proposed facility by 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 service was originally scheduled to open in October last year but was delayed pending final checks on the building.

UK’s first consumption room opens in Glasgow — Scotland has long had the worst rate of drug-related deaths in Europe

Scotland has long had the worst rate of drug-related deaths in Europe, with almost 1,200 people dying as a result of drug misuse last year.

While the facility was not a ‘silver bullet’ it was ‘another significant step forward, and will complement other efforts to reduce harms and deaths’, said the country’s first minister, John Swinney.

‘Scotland’s public health and human rights-based approach to tackling drug misuse means we’re focused on ensuring our healthcare services are not only listening to people but also drawing on their experiences as we work to support them,’ he continued. ‘Families and those with lived experience have been pivotal in bringing change and helping shape our response to drugs misuse in Scotland. Those with lived experience have been involved in designing the service and had input on staff recruitment. Indeed, people with lived experience, who know what it’s like to see people injecting drugs in unsafe conditions, have joined the workforce at the facility.’

drug consumption room Glasgow — ‘This new service should be seen as a watershed moment ushering in a new era of a pragmatic, effective and health-centred approach to drugs’

‘With around 200 similar facilities in 20 countries globally, some operating for decades, the evidence they save lives, reduce street injecting and discarded needles, and help get people into health, welfare and treatment services has been clear for many years,’ said head of partnerships at Transform, Martin Powell. ‘So, while we welcome a SDCF finally opening in the UK, we also mourn all those lost and harmed unnecessarily by the inexcusable delays to getting these essential facilities in place – not just in Scotland, but across the UK. This new service in Glasgow will be the first of many I’m sure, and should be seen as a watershed moment ushering in a new era of a pragmatic, effective and health-centred approach to drugs.’

More information available here

Advertising watchdog upholds complaints against rehab referral companies

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DDNWeb

January 10, 2025

Complaints against a number of addiction treatment referral companies have been upheld by the Advertising Standards Authority (ASA).

The companies – Action Rehab, Addiction Recovery Systems (trading as Rehab Guide), Help 4 Addiction, Rehabs UK, Serenity Addiction Centres and Which Rehab Ltd – have been directed by the ASA to revise their advertising practices to ensure transparency about referral roles, remove any misleading claims about affiliations or service provision, and avoid unverifiable claims about professional credentials or access to services.

Some of the companies were found to have implied they were direct providers or unbiased advisors, despite earning commission as referral agents, or to have improperly used the logos of organisations like the CQC or GMC to suggest accreditation or endorsement. Some of the adverts were also found to have exaggerated the organisations’ access to local services or implied that immediate placements were possible. There was also found to be misleading use of titles like ‘specialist’ or ‘counsellor’ to imply expertise or professional qualifications.

The rulings ‘reveal widespread misleading practices in the addiction treatment referral industry’, says the campaign group EMCAT (Ethical Marketing Campaign for Addiction Treatment). ‘These companies misrepresented their roles, affiliations and services, failing to disclose their financial incentives and referral-based business models.’ A complaint against UK Addiction Treatment (UKAT) for failing to make clear that it owned the facilities it was referring people to from its www.uk-rehab.com site was also upheld.

referral rehab — ‘These companies misrepresented their roles, affiliations and services, failing to disclose their financial incentives and referral-based business models.’

‘This is just the beginning,’ said EMCAT’s operational manager Evelyn McKechnie. ‘It’s unprecedented to see so many rulings published in one day, targeting ads that exploit some of society’s most vulnerable individuals.’

The ASA has subsequently ruled against another company, Compare Rehab, again following a complaint by EMCAT. The advert, from July last year, included prominently displayed wording like ‘Helping You Find An Addiction Rehab Centre in The UK’ and ‘Find Addiction Treatment In Your Area’ while disclaimers about the company’s business model – that it was not a healthcare provider but instead earned commission as a referral service – were located at the bottom of the page. Complaints about failure to clearly disclose commercial intent and misleading claims about local treatment options were both upheld.

The issue was raised in the Commons on 7 January by Liverpool Walton MP Dan Carden. ‘Last month the Advertising Standards Authority ruled against seven companies posing as treatment providers or impartial advice services, or failing to make clear their role in earning commission when they were in fact brokers,’ he said. ‘And I can tell the minister there are many more of these companies that escaped this particular ruling. They are able to mislead families while taking cuts of up to 40 per cent of fees being paid directly to treatment providers. Can we make sure that this ruling by the Advertising Standards Authority is the start of something new, where we can seek to regulate practices properly?’

ASA ruling on Action Rehab available here

ASA ruling on UK Addiction Treatment Ltd (UKAT) available here

ASA ruling on Serenity Rehabilitation Ltd (trading as Serenity Addiction Centres) available here

ASA ruling on Rehabs UK available here

ASA ruling on Help 4 Addiction Ltd available here

ASA ruling on Addiction Recovery Systems Ltd (trading as Rehab Guide) available here

ASA ruling on Which Rehab Ltd available here

ASA ruling on Compare Rehab (Marren Healthcare Ltd) available here

Ireland’s ban on pre-watershed alcohol advertising comes into force

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DDNWeb

January 10, 2025

A ban on TV advertising for alcohol products before 9pm has come into force in Ireland. Section 19 of the Public Health (Alcohol) Act 2018 (PHAA) also includes a ban on radio ads for alcohol between 3pm and 10am the following day.

The restriction is ‘particularly important given that Diageo is currently number 4 advertiser to children in Ireland, and at least 50,000 children start to drink every year,’ said the Alcohol Action Ireland (AAI) charity.

However, two further sections of the act – which relate to the content of alcohol ads, and ads in publications – are still to be enacted. The former, section 13, is being challenged by the alcohol industry as it contains requirements to include health information such as cancer warnings. Long known for its drinking culture, in 2021 Ireland was ranked 9th highest for per capita alcohol consumption among OECD countries – although this had fallen to 16^th by 2023.

Ireland became the first country to commit to mandatory alcohol labelling when the Public Health (Alcohol) (Labelling) Regulations were signed into law two years ago. Along with the PHAA, they mean that all labelling will need to state the amount of alcohol contained, calorie content, and warnings about alcohol-related cancers, liver disease, and drinking while pregnant. The move was commended by the WHO for its ‘progressive approach in prioritising public health and setting a precedent in the EU with the introduction of mandatory alcohol labelling’.

‘Ireland is rightly praised internationally for its leadership in passing the PHAA, which is a suite of quite modest measures designed to provide some degree of protection from the tactics of an aggressive industry acting against the population’s health through relentless marketing,’ said AAI CEO Dr Sheila Gilheany. ‘AAI and many others have strongly campaigned for years for its introduction and since it was passed alcohol consumption per capita has dropped by 10 per cent, which is positive.

‘However, the fact that the broadcast watershed is only coming into force now, almost seven years after being signed into law, and that not all sections of the PHAA are in force yet shows the power of the alcohol industry’s lobbying efforts to stymie and delay progress,’ she continued. ‘The different sections of the PHAA are designed to complement one another, and the legislation’s public health benefits will only be fully realised when all the sections are enforced. With Ireland still drinking at a level 40 per cent higher than HSE lower-risk guidelines, this is an imperative.’

Government to seek ACMD advice on reclassifying ketamine

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DDNWeb

January 9, 2025

Policing minister Dame Diana Johnson is to write to the Advisory Council on the Misuse of Drugs (ACMD) to commission advice on whether to make ketamine a class A substance, the Home Office has announced.

Illegal use of ketamine – which is currently controlled as class B – reached ‘record levels’ in the year to March 2023, with almost 300,000 adults reporting using it. Prolonged use of the drug can cause serious bladder problems that can require surgery or even bladder removal in some cases, as well as issues with the kidneys and urinary tract. ‘Recent reports have shown ketamine is often an ingredient included in “pink cocaine”, the dangerous synthetic drug cocktail taken by users without knowing what mix of substances it contains,’ the Home Office adds.

The Home Office has a statutory duty to consult the ACMD under the Misuse of Drugs Act before it can make any changes to legislation. Ketamine was previously controlled as a class C substance in 2006 and reclassified as class B in 2014, after advice from ACMD related to the increasing evidence of bladder damage caused by frequent use.

Illegal use of ketamine reached ‘record levels’ in the year to March 2023

The ACMD will now ‘assess the evidence of the health and social harms of ketamine when misused’ and submit their findings to the Home Office.

‘Ketamine is an extremely dangerous substance and the recent rise in its use is deeply concerning,’ Johnson stated. ‘Through our Plan for Change and mission to make the nation’s streets safer, we will work across health, policing and wider public services to drive down drug use and stop those who profit from its supply. It is vital we are responding to all the latest evidence and advice to ensure people’s safety and we will carefully consider the ACMD’s recommendations before making any decision.’

New year, new beginnings: embracing wellbeing and future health initiatives

Partner Updates

DDNWeb

January 7, 2025

Happy New Year from Turning Point! In this blog, our chief executive, Julie Bass, discusses the exciting activities and initiatives we have planned for 2025. From starting the year with our wellbeing reset campaign, to innovative health and social care projects, there’s a lot to look forward to as we continue to make a positive impact in our communities.

Happy New Year to you all.

The beginning of a new year tends to be a time to reflect, and it can be a good opportunity to think about changes we might want to make. Invariably, my mind turns to my health and wellbeing, and I look for ways in which I can create a wellbeing reset to support me as I try to create new and better habits.

It can be a good time to focus on several different elements, such as how we manage stress, how we engage with the local community, and our relationship with alcohol and exercise. Colleagues at Turning Point will be providing many useful tips throughout January on our social media and we hope these are helpful should you decide to make some changes. Whatever you decide, we encourage you to be kind to yourself as these early few months can be quite challenging.

As we look forward to the year ahead, we at Turning Point are also focusing on the future of health and social care with the forthcoming publication of our Health and Social Care Future’s essay collection. After hosting a series of webinar discussions with a range of incredible panellists on some of the most pressing topics facing health and social care, each panellist wrote an essay on a variety of themes. These included the future of mental health in the UK, how to adapt to the changing drug supply and how best to get people out of long stay hospitals. We are seeking ways to collaborate and come together with others across health and social care to consider possible solutions to most effectively meet the huge demand that we are experiencing.

health initiatives — We are focusing on the future of health and social care with the forthcoming publication of our Health and Social Care Future’s essay collection

Themes that emerge from the essays are the critical role of both political and personal leadership, of collaboration and partnership, of the importance of strong guiding values – social justice, solidarity and inclusion. They also highlight the resilience of individuals in the face of adversity, their courage, their determination and their strength.

It is incredibly energising to feel the hope and optimism that is woven throughout the collection which inspires possibility and is galvanising as we seek to collectively respond to these challenges.

The essay collection highlights pressing issues that will need to be addressed in 2025 and the years to come. With the government’s NHS 10-year-plan expected in the spring of this new year, we encourage the government to remain steadfast in ensuring that adult social care, mental health and drug and alcohol services are supported as well, to ensure that these services can continue their vital work to support the most vulnerable in society.

For us here at Turning Point, 2025 will see us continue to advocate for a wider analysis of how social determinants impact public health, and through the work with the APPG on Complex Needs and Dual Diagnosis, advocate for trauma-informed, innovative and integrated approaches for those with complex needs who so often slip through the net.

We wish you happiness and health throughout the year and beyond. No year is ever without its ups and downs, but through the power of resilience, community and connection, there is so much that we can support each other with and together I have no doubt we will continue to have significant positive impact.

This blog was originally published by Turning Point. You can read the original post here.

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

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

This content was created by Turning Point

Via’s success and journey towards hep C micro-elimination

Partner Updates

DDNWeb

January 7, 2025

We’re proud to share our hepatitis C micro-elimination impact report for 2021-2024.

At Via, working towards eliminating hep C in our services is a key priority for us and our teams have been working tirelessly through enhanced testing, diagnosis and support, and ensuring that treatment pathways are available and accessible.

Working in partnership with Gilead Sciences, and as part of the Drug Treatment Services Providers Forum, we’ve reached many milestones over the past three years:

To date, seven of our community service sites have achieved hep C micro-elimination.

Our Via Harrow service was our first service to do this and the sixth London borough to reach this impressive goal.

So far, two of our service sites have also maintained this status after six months and we expect more to follow.

Between November 2021 and August 2024, our teams carried out 4,966 dry blood spot tests across our Via-led services.

We also helped 156 people who tested positive to start treatment so they could become free of hep C.

Carly, who attends our Via Greenwich service, told us: ‘Starting treatment was so easy. The whole process was very professional, I felt safe. So happy with the outcome, life changing, and painless compared to old treatments in the past. Thanks for all the support.’

Impact Report — ‘We know what this means for the quality of life and the wellbeing of those who use our services, so this is a really transformational achievement’

One of our team members in Cheshire West and Chester, Alice, shared: ‘Often our clients can struggle with engaging with medical interventions, for various reasons. Being able to support our clients at Unity House in Ellesmere Port with accessing hep C treatment has proved valuable and successful. I believe this is in part due to the fact the service is a safe space for the client. Having seen the reactions of successful treatment, the feeling of improved general health and increased likelihood of exploring health with professionals shows hep C treatment has a positive impact on all areas of life.’

Tom Sackville, Executive Director of Services at Via, said: ‘It has been fantastic to see the huge progress that has been made towards the micro-elimination of hepatitis C across Via. We know what this means for the quality of life and the wellbeing of those who use our services, so this is a really transformational achievement. I want to pay tribute to all of those within Via, as well as all the local and national partners, who have supported this work and we look forward to continuing to celebrate further progress in the near future.’

Marlon Freeman, National Hepatitis C Coordinator at Via, also commented: ‘I am pleased to present this report, which highlights the significant collaboration and organisational advancements Via has achieved in driving sustainable progress toward hepatitis C micro-elimination. It is an honour to join our partners at the Gilead Hepatitis C Drug Treatment Services Provider Forum in showcasing the meaningful impact our work has had on the communities we serve. We trust this will serve as evidence of how partnerships with the NHS and third-sector health organisations can effectively enhance health outcomes and reduce health inequalities among those who use substances.’

To find out more about hep C micro-elimination, our partnership working, what we’ve learnt on our journey to micro-elimination and what’s next, check out our Via Hep C Impact Report here.

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.

This content was created by Via

Reclaiming the narrative

Features

DDNWeb

January 6, 2025

It’s time to change the narrative around substance treatment for Black and minority ethnic communities, says Kevin Ruddock.

In October last year, Black History Month reflected on the theme of ‘reclaiming narratives’. For me, that means more than just acknowledging the past. It’s about breaking down the barriers that still exist today and increasing understanding, particularly around substance misuse and how it’s seen in Black and minority ethnic communities.

There’s a misconception that substance use is a moral failing, but it’s much more complex than that. It’s often tied to things like structural racism, economic inequality, and a lack of access to mental health support. For many Black individuals, these factors make it harder to seek help. Our role isn’t just to treat people but to understand the barriers they face and to work with them to overcome those challenges.

In Coventry, only around 3.5 per cent of our service users come from Black communities. That’s a huge disparity given the diversity of the city. We know that we’re not reaching everyone who needs our services, and that’s a problem we need to address. People from these communities often face stigma and cultural barriers that make it harder for them to engage with services like ours. There’s also a lack of trust in institutions – particularly health services – which makes it even harder for them to come forward.

Building trust
This isn’t an issue with one simple solution. We can help to build trust by ensuring our own organisation is as diverse and representative as possible, but we also need to be reaching out to underserved communities. One of the key ways we’re looking to tackle this issue is through ‘community champions’, an initiative that grew directly from our work with Byron Taylor from the organisation Settlement Support. Byron was concerned that the health needs of the Black African community in Coventry weren’t being met, and he also highlighted that many people were uncomfortable advocating for themselves – particularly when it comes to sensitive issues like substances.

We knew we needed to approach this carefully, so we spent time building relationships and listening to what communities wanted. We attended community events, often in partnership with Byron, and through those conversations we identified people who were interested in becoming champions. We spoke at church services and other community gatherings, making sure that people felt comfortable asking questions and offering feedback. As Molly Cox, who is leading the project, says, ‘The key to this approach has been asking what they need, rather than telling them what we think they need.’

The champions are people from within the community who we train to act as advocates. They understand both the community’s needs and what we can offer, which helps bridge the gap. ‘They’re essentially advocates for both their community and for Change Grow Live,’ states Molly. ‘They can have those initial conversations with people who might otherwise avoid treatment and make them feel more comfortable.’

Navigate the system
Champions are there to help individuals navigate the system, whether that’s by being present at appointments, acting as translators, or just making sure the person feels supported. One of the key things we’ve learned is that flexibility is crucial. You can’t expect every community to fit into the same structures or timeframes. When we first started working with Byron, he made it clear that Sunday was the best time for us to engage, as that’s when people would gather for church. We don’t usually work Sundays, but we knew we had to make it happen if we wanted to build trust.

Trust is a big issue for many Black and minority ethnic groups, who have longstanding mistrust of institutions like ours

It’s that willingness to adapt and meet people where they are that’s allowed us to start building stronger connections with the community. Trust is a big issue for many Black and minority ethnic groups, who have longstanding mistrust of institutions like ours. The community champions help us break down those barriers by acting as a trusted voice. They’re from the community, so people are more likely to listen to them and feel comfortable opening up about their problems.

‘It’s not just about getting our voice out there – it’s about giving the community a platform to have their voice heard,’ says Molly. ‘The champions advocate for their community to us, and for us to their community. It’s a true partnership.’

An effective model
The work we’ve done with Settlement Support and the Black African community in Coventry has shown us how effective this model can be. But we know that this is just the beginning. We’re looking to replicate the community champions model with other groups, including the Polish and Sikh communities – because we recognise that every community has its own unique challenges.

We know people aren’t always comfortable coming to us, so we need to go to them. That’s the key to all of this – getting out there and making sure our services are accessible, approachable, and responsive to what people need. It’s not just about getting more people into our services. It’s about reclaiming the narrative around how people from underrepresented communities engage with substance treatment.

We’re still learning, and we expect to keep refining our approach as we get more feedback from the communities we serve. But one thing is clear. The community champions are helping us build trust and change lives.

Kevin Ruddock is services manager at Change Grow Live in Coventry. If you’d like to find out more about this project or discuss this work in more detail, please get in touch at Kevin.Ruddock@cgl.org.uk

Local heroes

Features

DDNWeb

January 6, 2025

Drug harm continues to be a significant problem in the UK, with 19 per cent of people who inject sharing needles according to the most recent Unlinked anonymous monitoring (UAM) report from the UK Health Security Agency. And drug-poisoning deaths have hit the highest level in 30 years – fuelled by a 30 per cent rise in fatalities involving cocaine and the introduction of synthetic opioids such as nitazenes into the drug supply (DDN, November, page 4).

For the London Borough of Hackney, an area with a diverse population and pockets of severe need, these issues mean that not only is investment in harm reduction services vital – so is innovation in how they work. This led to the creation of the Hackney Harm Reduction Hub last year.

The service was set up by the London Joint Working Group on Substance Use and Hepatitis C (LJWG) and The Hepatitis C Trust, and is funded by Hackney Council and NHS England. At the heart of the project is a peer-driven model that draws on lived and living experience of substance use in its design, and among its staff and volunteers.

A new lease of life
‘Before I got involved with hepatitis C work and the Hackney hub, I knew about needle use and the liver risks, and I had family affected by it, but I felt isolated and alone,’ says Anne-Marie, a volunteer with the service. ‘Volunteering with the hub has given me a new lease of life – I can get out there and meet others. That’s what I like about the service. We’ve knocked on doors in the hostels and gotten groups of people to come along. It brings people together.’

The goal is a welcoming and inclusive environment where those seeking support can be met where they are – physically and emotionally – to access all the equipment they need, be signposted to other services, and receive support from peers who understand their circumstances. This came about after a scoping report highlighted the loss of services that provide needle and syringe programmes (NSP) (DDN, February 2022, page 5), as well as issues with quality and stigma even in those that remained.

Using a van and trailer provided by Hackney’s community wellbeing team, the service would be operating in Ridley Road Market in the centre of the borough for a day a week, before adding another day and branching out to other sites. The hub’s team scoped hotspots where drug use was most common, identifying consistent sites so that clients knew where the van and trailer would be running. By providing high-quality harm reduction services in familiar settings, the team can engage people who might otherwise avoid other service offers and locations.

Once embedded in communities, the hub provides resources like needle and syringe provision, hepatitis C testing, naloxone and testing strips to enable people to check for nitazenes, fentanyl and xylazine. ‘The service means people can test their heroin before putting it in their body,’ says peer coordinator with The Hepatitis C Trust, Richard Jacklin. ‘There had been a wave of seven overdoses when we started. There are fewer now – it’s going to take time, but the message is getting out there. And the community have started to tell us “try this area, try that hostel”. They’re worried about the overdoses too.’

Expanding brief
The scope of the service has expanded as the year has gone on, including work to develop a wound care pathway for people who find services difficult to access, referrals for housing needs and engagement with partner organisations to test for other blood-borne viruses, making every contact count. The hub’s staff and volunteers have made links with local charities in the substance use, sexual health, and homelessness spaces, and with the Greenhouse Practice, a GP surgery that specialises in supporting the homeless population in the borough.

The hub is led by a strategy group, which includes representation from both providers and commissioners, and a volunteer strategy group that ensures service user insights are continually shaping delivery and outcomes. The hub has supported 170 people with equipment or advice, and also supports the wellbeing team in providing meals and hot drinks as a means to build a rapport and sustain engagement.

In between the hub’s core service days, its team have fanned out into hostels to find and reach clients as a regular part of their outreach. A recent visit to a hostel near London Fields saw five people tested for hepatitis C, all of whom were positive, as well as the provision of harm reduction advice and equipment. The team from the Hackney Harm Reduction Hub engaged 12 residents during a 12-hour session, and then laid plans to return and introduce new lived experience peers to the residents.

Mobility continues to be a key theme as the service evolves. The hub’s team are exploring options like Zipcars, bicycle rentals and public transport vouchers to increase the mobility of its peer volunteers and clients. A new freephone line has also been set up for people to request delivery of supplies to wherever the person requires or alert the team to drug waste hotspots, so that the hub can help clean up dangerous waste in the borough.

Tackling risk
While the Hackney Harm Reduction Hub has made strides, efforts to distribute safer inhalation devices such as pipes remain a point of legal contention. A survey of people visiting the Hackney hub found demand for this type of equipment – many people are using pipes for both crack and heroin, and use of homemade pipes is putting people at significant risk. This has driven a joint submission from LJWG, Haringey Council public health team, The London School of Hygiene and Tropical Medicine and Release to the Metropolitan Police for a ‘letter of comfort’, that gives permission for safer inhalation pipes to be distributed.

Hackney Hub — Using a van and trailer provided by Hackney’s community wellbeing team, the service began operating in Ridley Road Market in the centre of the borough for a day a week

The project faced other trials as well, but has been able to adapt. People who use drugs were relocating due to increased police presence during scoping exercises, for example, so outreach planning now avoids overlaps with enforcement activity. Managing living experience volunteers’ conflicting commitments was proving a challenge, so The Hepatitis C Trust’s volunteer coordinator introduced a tailored support package and volunteer time prioritisation plans.

Looking forward
Looking forward, the service is strengthening its data collection to gain deeper insights into the demographics, health needs, and service preferences of its clients, to better shape and guide the service. A further survey, incentivised with vouchers, will gather feedback from service users to make sure the needs of some of Hackney’s most vulnerable residents are being met without asking too many questions when initiating relationships.

As we continue to aim to eliminate hepatitis C as a major public health concern and support people to understand the risk of harm posed by drugs – including synthetics – the Hackney hub represents a new way of tackling harm reduction. Through a community-led and rooted approach and close partnerships among voluntary and public bodies, Hackney is setting an example for cities across the UK and beyond on how to approach substance use with dignity and support.

Elliot Bidgood is at Principle Consulting working with the Hackney Harm Reduction Hub

Social Interest Group’s Gill Arukpe Awarded MBE

Partner Updates

DDN

January 3, 2025

Social Interest Group’s CEO Gill Arukpe has been awarded an MBE in the New Year’s Honours list in recognition of her remarkable 46-year career in the charity sector.

Her dedication and tireless efforts have significantly impacted the lives of countless vulnerable individuals, particularly those experiencing homelessness and mental health challenges.

Gill has been recognised for her work at Shelter, where for 17 years she championed the rights of homeless individuals. She continued this work at Novas Scarman Group and then at Turning Point, focusing on mental health and substance abuse support. Her first CEO role was at Penrose Options in 2009 which demonstrated her leadership for social justice and community development.

In 2014, as the founding CEO of the Social Interest Group, Gill began building an organisation that supports a wider network of charities in their mission to provide essential services to vulnerable people. 10 years on, Social Interest Group continues to offer strategic support and delivers impactful services through its subsidiary front-line charities. Gill has been a vocal advocate for the homeless and those with mental health issues, with campaigns to raise awareness that have driven policy changes to address these issues.

Gill Arukpe said: ‘Homelessness and mental health are now at chronic levels. We must continue to work together to find sustainable solutions and provide the necessary support to those in need.’

Dr Karl Marlowe, Chairman of Social Interest Group said: ‘Gill’s MBE is a testament to her unwavering commitment and the profound impact of her lifetime’s work. Gill’s legacy in the charity sector is one of resilience, and relentless advocacy for the most vulnerable of society.’

This blog was originally published by The Social Interest Group.

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

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

This content was created by The Social Interest Group

Make alcohol harm a ‘top priority’ for 2025, campaigners urge Streeting

News

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December 20, 2024

A letter to health secretary Wes Streeting from members of the Alcohol Health Alliance (AHA) is urging the government to make alcohol harm a top priority for next year.

There were more than 8,200 alcohol-specific deaths in the UK last year, a ‘harrowing’ figure that nevertheless ‘only represents the tip of the iceberg’, the campaigners state – ‘when cases where alcohol was a contributing factor were considered, the true toll is likely three times higher’.

Alcohol-specific deaths in England have increased by more than 40 per cent since 2019, the letter continues – a ‘devastating’ rise that has ‘never been seen before’. There are also 950,000 alcohol related hospital admissions per year, says AHA, whose members include treatment providers, royal colleges and academics. Hospitalisations and deaths are also disproportionately concentrated in more deprived communities, the document points out, with the North East’s death rate more than twice that of London.

The AHA is calling on the government to implement minimum unit pricing (MUP) in England, as well as increase funding for – and access to – alcohol treatment services.

Campaigners north of the border recently criticised the Scottish Government for not introducing a compulsory public health levy on drinks retailers in its December budget. Scotland’s alcohol-specific death rate now stands at its highest level for 15 years.

alcohol harm — ‘Now is the moment to show that we value human lives over profit’

‘Each of the 8,274 deaths in 2023 represents a life cut tragically short – a loved one whose absence leaves a void that can never be filled,’ said AHA chair Professor Sir Ian Gilmore. ‘Alcohol-related harm does not occur in isolation. It ripples through families, often leaving children to bear the brunt of grief and trauma. The devastating rise in alcohol deaths should serve as an alarm for the new government to act with urgency.

‘We have the evidence, and we know the solutions,’ he continued. ‘Now is the moment to show that we value human lives over profit. Without bold, decisive action, these preventable deaths will continue to climb. Addressing alcohol harm must be a top public health priority in 2025, and it requires a cross-government effort to turn the tide on this public health crisis.’

Letter available here

Lack of funding certainty putting stop smoking services at risk

DDNWeb

December 19, 2024

The lack of certainty around long-term funding for stop smoking initiatives is putting services at risk, warns a new report from ASH and Cancer Research UK.

Tobacco control was rated as a ‘high or above-average’ priority in almost 90 per cent of councils – up from just over 60 per cent last year, and the highest level it has ever been. However, local authorities reported that the lack of funding certainty ‘has made recruitment, planning and commissioning a challenge’, says the document, putting stop smoking services at risk.

The previous government committed an extra £70m annually to stop smoking services until 2030, as well as introducing a ‘swap to stop’ initiative to provide free e-cigarettes to people who wanted to quit. Around 2.7m people in the UK had used vapes to successfully quit smoking in the last five years, according to research by ASH earlier this year.

While the current government has committed to maintain the funding in the coming financial year, there is uncertainty over the public health grant – which contributes half of the cost of local stop smoking services – as well as the swap to stop scheme, national media campaigns, and other initiatives. ASH wants to see the government match the previous government’s investment and implement a ‘polluter pays’ levy on tobacco firms, ‘who continue to make massive profits selling a lethal addiction’.

‘Local services to help people quit smoking are a vital part of a roadmap to a smokefree country,’ said ASH’s policy and public affairs officer Jim Pattison. ‘However, the short-term nature of current funding undermines this goal, making it difficult to effectively plan, commission and deliver such services. A levy on tobacco companies would secure long-term funding and allow councils to accelerate progress towards a smokefree future, ending the harms from smoking for good.’

‘Although incredibly welcome, short-term ring-fenced funding leaves vital, life-changing stop smoking services dependent on unstable financial arrangements,’ added policy lead for addiction at the Association of Directors of Public Health, Alison Challenger. ‘While this extra £70m of funding has helped thousands of people to quit, to create a Smokefree UK we need to be able to give consistent support to people trying to quit over the coming years. The public health grant should, in theory, give that stability, but a decade of cuts has reduced it in real terms by 28 per cent per person. Multi-year public health funding settlements would allow directors of public health to provide services that are tailored towards the needs of residents in their local area.’

Danger zone

Features

DDNWeb

December 18, 2024

JANUARY
The latest OHID figures show a 10 per cent increase in the number of young people in contact with drug and alcohol services. At just under 12,500, however, the figure is still lower than the pre-COVID total of 14,291. Meanwhile, Britain’s first regular drug-checking service opens its doors in Bristol – licensed by the Home Office, financed by the local council, and operated by the Loop and BDP.

FEBRUARY
‘Fifty per cent of our heroin users will not die from heroin, but 50 per cent of smokers will die because they smoke,’ GSTHR’s David MacKintosh tells DDN, as he stresses the huge potential for tobacco harm reduction in drug and alcohol services. GPs are failing to warn patients of the dependence risk of prescription drugs like opioids, benzodiazepines and gabapentinoids, says an NIHR-funded study, while the Public Accounts Committee warns that the drug strategy’s ambitions won’t be achieved without funding certainty.

MARCH
The number of people sleeping rough in England is up by a quarter – and by 120 per cent since 2010 – but the figures are still a likely underestimate of the real total, charities warn. Executions for drug-related offences are up more than 40 per cent in a year, according to the latest analysis by HRI, while EMCDDA states that ‘extreme drug-related violence’ is taking its toll on Europe, with proliferating drug gangs having a ‘corrosive effect on the fabric of society’.

APRIL
After the government bans 14 nitazenes in the previous month, a report from King’s College London states that the potent non-opioid xylazine is also now established in the UK’s drug market – and ‘not limited to heroin supplies’. Given that the crisis with nitazenes and other synthetic drugs was entirely foreseeable it’s ‘unforgivable that we’re so badly prepared’, Kevin Flemen tells DDN. And as the Scottish Parliament votes to continue with MUP and increase it to 65p, the UK’s alcohol-specific death toll hits an all-time high, at more than 10,000.

MAY
OHID and NHS England launch a ten-year workforce plan, including new addiction psychiatry posts and training curricula for drug and alcohol workers and peer support staff. As the UK government tries to contain an ever-growing crisis by banning six more synthetic opioids, there’s a rare note of optimism from across the Atlantic as the US records a slight fall in its ‘staggeringly high’ drug-death statistics.

JUNE
Six of the seven new synthetic opioids reported for the first time in Europe are nitazenes, EMCDDA reports, while the UNODC’s World drug report warns that the drugs are ‘increasingly posing major health risks’. Meanwhile, 2m of the world’s 2.6m annual alcohol-related deaths are among men, says WHO.

JULY
Following its election win, the newly installed Labour government includes the tobacco and vapes bill in the King’s Speech after it was abruptly shelved by the outgoing administration, and – unsurprisingly – nitazenes and other synthetic drugs are among the topics discussed at ‘Stronger Together’, the 16th annual DDN conference. ‘When I first joined Turning Point there was a series of overdoses from something we called ‘iso’ – because nobody could pronounce isotonitazene – and naively we thought it had gone away,’ Deb Hussey tells delegates. Now, however, nitazenes were ‘being found in everything – they’re crossing genres’.

AUGUST
Scotland records yet another increase in drug-related deaths, with 1,172 registered last year, and the National Crime Agency warns that a ‘significant escalation’ in the use of nitazenes as a cheap way of increasing the strength of substances means there has ‘never been a more dangerous time to take drugs’.

SEPTEMBER
The government announces plans to ban xylazine – the effects of which, as a non-opioid, can’t be reversed by naloxone – along with 21 other drugs. As the minimum unit price in Scotland goes up by 15p the country records its highest alcohol-specific death toll since 2008, while campaigners warn that new MPs need to be wise to the industry’s lobbying tactics.

OCTOBER
Drug deaths in England and Wales are up by 10 per cent on last year, to 5,448. This includes a more than 30 per cent rise in cocaine-related deaths – the 12th consecutive increase – as UNODC reports that already record levels of production of the drug are set to rise further, with a potential increase in Colombia of more than 50 per cent. As analysis by PHS finds that two thirds of the people dying drug-related deaths in Scotland lived alone and half had previously had a non-fatal overdose, the Scottish Parliament sets up a ‘people’s panel’ to ask the public how to tackle the problem, while services still aren’t properly equipped to deal with dual diagnosis, say researchers at Glasgow Caledonian University.

NOVEMBER
Afghan opium cultivation levels are slowly increasing again – 19 per cent up on last year – following a 95 per cent drop after the Taliban’s poppy ban. Meanwhile, the county lines ‘business model’ is shifting, say police chiefs, in the wake of increased law enforcement action. While there are still 1,500 organised crime groups involved, activity now tends not to cross police force boundary areas. The tobacco and vapes bill, with its ambition to create a ‘smokefree generation’, is finally introduced to Parliament, and a certain DDN magazine celebrates its 20th anniversary!

DECEMBER
While the gambling industry – much like alcohol companies – tries to shift the focus onto a small cohort of ‘problem’ people, ultimately it’s ‘big corporations who design and provide these products – and they have to bear responsibility for the consequences,’ Glasgow University’s Heather Wardle tells DDN. Meanwhile all eyes are on what newly elected president Donald Trump and his cabinet picks – such as yet-unconfirmed healthcare choices Robert F Kennedy Jnr and TV doctor Mehmet Oz – could mean for a country that often sees around 110,000 drug-related deaths a year.

Scottish government launches charter of rights for people affected by substance use

News

DDNWeb

December 16, 2024

A charter of rights for people affected by substance use has been launched by the Scottish Government, designed to ‘improve the experience of anyone needing support’.

The charter contains ‘key human rights’ drawn from national and international law, including the right to the highest attainable standard of physical and mental health, the right to a healthy environment and the right to an adequate standard of living.

Developed by the National Collaborative, which is made up of service providers and people with lived experience, the charter has been recognised as the first of its kind by the UN Office of the High Commissioner for Human Rights.

Scotland has by far the worst rate of drug-related deaths in the whole of Europe, with 1,172 registered last year. People in the country’s most deprived areas are more than 15 times more likely to die from drug misuse than those in the least deprived, National Records of Scotland (NRS) points out.

‘We want every person experiencing harm from alcohol or drug use to be able access the support they need and through our £250m national mission on drugs we’re taking a wide range of actions,’ said first minister John Swinney. ‘This charter is a key part of that mission and draws on the experience of communities and families affected by substance use. It significantly strengthens our public health and human rights-based approach to substance use-related harms and, over time, it will contribute to significantly improving and saving lives.’

‘Criminalisation and prohibition have failed to reduce drug use and deter drug-related crimes,’ added UN high commissioner for human rights, Volker Türk. ‘We need new approaches prioritising health, dignity and inclusion, guided by the International Guidelines on Human Rights and Drug Policy.’

Scot parliament Charter of Rights — ‘Ministers should focus less on promising to do things and more on actually doing them’

An editorial in the Scotsman, however, stated that it was ‘right to be cynical’ about the charter ‘amid the ongoing scandal over the shockingly high number of drug deaths’ in the country. ‘The 2011 Patient Rights Act created a legal requirement that NHS patients should receive treatment within 12 weeks of it being agreed,’ it said. ‘In the first six years of the law’s existence, it was broken nearly 120,000 times. Earlier this year, 7,146 patients had been waiting longer than two years for treatment on an in-patient or day-case basis, with 1,324 waiting more than three years, and some unfortunate souls left languishing for up to seven. As we argued after Keir Starmer’s attempted relaunch featuring several “milestones” for his government to achieve, ministers should focus less on promising to do things and more on actually doing them.’

Charter of Rights for People Affected by Substance Use 2024 available here

My Voices 2024 – Turning Point’s most recent event celebrating our 60th year

Partner Updates

DDNWeb

December 16, 2024

My Voices 2024 – our most recent event celebrating our 60th year – was held in Birmingham, and brought together people we support, family members and colleagues from all over the country to connect and share experiences.

It was amazing to have such a range of people represented – with everyone generously sharing their thoughts on substance use, mental health and learning disability services. Throughout the day, people shared their perspectives around reducing stigma, accessing and reaching services they need, and what good communication and connection looks like to them.

Stigma and discrimination remain ever-present in many people’s lives and can originate from society, employers, the media, and even our friends and family. People supported by our substance use services spoke about the pervasiveness of stigma surrounding drug use.

‘I remember one day my sister asking, “why do you hang out with those people” and I remember thinking, what do you mean those people – I am one of those people. It was really hard hearing this from my own sister.’

Many individuals supported by our learning disability services expressed the exhausting and constant struggle to be seen and valued within society. Within and beyond services, it is important that we are all advocates for people with a learning disability.

‘When I was younger and first tried to get a job, I remember overhearing someone saying “ugh, she could never hold down a job”. This really stuck with me… we need to start focusing on what people CAN do instead of what people CAN’T do… even if it’s as small as taking out the bins.’

Turning Point My Voices 2024 — Stigma becomes internalised, where you come to believe the negative messages or stereotypes about yourself

For many, stigma becomes internalised, where you come to believe the negative messages or stereotypes about yourself. Within substance use, for example, this often makes people more reluctant to access services.

‘I think a great example of internalised stigma is the fact so many people want (service) hubs to be as discrete as possible – in places where no one goes out of fear of being recognised.’

Accessibility with health and social care remains a key issue and more needs to be done to ensure services are reaching those in need. This includes not only increased and strengthened outreach programmes but also fully capitalising on the moments when an individual first contacts a service. First impressions are crucial, and this is no different for our services.

‘When people walk through the (service) door – that is a golden moment – you may never see that person again. Services need to do everything they can to make sure that opportunity is grasped with both hands.’

Many people supported by Turning Point have multiple or complex needs. Their needs may have been overlooked or ignored. People struggling with mental health spoke about the fact that their diagnosis often overshadowed their other needs.

‘If you have been given a diagnosis, this tends to become all that people see. It makes it hard to get support for any other needs.’

The day finished with a session focusing on communication and connection. This really solidified for me what makes Turning Point so special – the community we have built over the past 60 years supporting people across learning disability, substance use and mental health.

The connection and collaboration between our peer mentors, along with the thousands of individuals who work or volunteer within our services and those who are supported by our services, together, shape Turning Point into an organisation to be proud of.

This blog was originally published by Turning Point. You can read the original post here.

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

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

This content was created by Turning Point

Bridge the Gap

Features

DDNWeb

December 13, 2024

Bridge the Gap is Surrey’s first trauma-informed outreach service for residents facing multiple disadvantage. Lisa Byrne explains.

A specialist trauma-informed outreach service is showing that partnering with local charities is leading the way for individuals facing multiple disadvantage.

Bridge the Gap (BTG) was launched by Surrey County Council as part of the government’s Changing Futures programme in a bid to improve the lives of Surrey residents experiencing multiple disadvantage.

These people have almost always experienced some kind of early trauma which, over time, can lead to issues such as mental ill health, substance use, contact with the criminal justice system or homelessness.

These individuals are usually known to traditional services, having sought support many times before. However, they can end up falling back through the gaps due to their complexities and, through no fault of their own, fail to meet service criteria and expectations. That’s when people can become ‘re-traumatised’ by the very services set up to help them.

multiple disadvantage — Lisa, left, Jamie, fourth from left, with BTG team

The Bridge the Gap consortium is made up of a group of 11 local charities that have partnered with Surrey County Council to provide a specialist offer of support. The charities form part of the Bridge the Gap VCSE Alliance, supporting people experiencing multiple disadvantage. BTG support is provided by a team of 24 specialist outreach workers – some bring lived experience to the workforce and are employed through an Alliance of Surrey’s voluntary, community and social enterprise (VCSE) organisations.

‘Through Bridge the Gap we’re providing support to the most traumatised and socially excluded people,’ says Joanne Tester, CEO of Guildford Action – one of the 11 charities, which has supported residents with multiple disadvantage for more than 30 years. ‘Forming relationships with these vulnerable people is a crucial part of Bridge the Gap, which considers the underlying trauma someone has experienced in the past. The programme focuses on a person’s strengths, rather than their issues and complexities. By taking a trauma-informed strength-based approach, the service sees beyond a client’s presentation and supports them towards their own personal goals.’

multiple disadvantage - BTG — Jo Tester, centre, with outreach workers from Oakleaf

This way of working is a ‘game changer’ for Surrey, she adds. ‘I cannot imagine us going back to how things were before Bridge the Gap, and the powerful vision that now shapes our work.’

Clients don’t have to be abstinent from substances to receive support. Workers are trained to continually assess dynamic risks, offering a service that is risk aware, while providing a co-occurring conditions support pathway. This includes timely access to mainstream substance use and mental health treatment services, if and when the client desires or is ready for it. This aims to avoid, wherever possible, failure and re-traumatisation.

‘Our specialist outreach workers are skilled at offering harm reduction advice,’ says programme manager Lisa Byrne. ‘At the same time they motivate individuals to engage and benefit from wider social care support, healthcare, benefits, housing, and other services, while reconnecting with their communities. Workers keep small caseloads and shape relationships built on trust. They understand that complex multiple disadvantage takes time to address, and they support people to make positive life changes, while making sure they don’t fall through gaps between services.’

The system can be overwhelming and complex, leading people to become ‘service weary’, she continues. ‘The only targets we aim to meet are those the individuals set for themselves such as improved self-esteem, greater sense of physical and mental wellbeing and increased confidence and agency.’

BTG workers continue to support people over time to make positive life changes. Workers provide leadership and advocate for their clients, sometimes challenging operational and strategic obstacles that can present themselves when people are seeking support. When the client is ready the workers will help to engage with specialist services at the request and pace of their client.

Bridge the Gap outreach workers are clinically supervised by a consultant clinical psychologist, and the service follows an evidence-based approach that addresses the degree of childhood, prolonged and on-going trauma that people facing multiple disadvantage experience.

‘Perhaps the most important thing to remember is that a lot of early trauma is relational,’ says Byrne. ‘It can have occurred at the hands of people who can sometimes be in positions of power or were caregivers of some kind. Those affected by relational trauma often need to engage in effective relationships to access the care, support, and interventions they need. However, the impact of their trauma means they may be the least likely to seek or receive this help and support.’

BTG adheres to the trauma-informed principles of: safety, trust and transparency, empowerment, voice and choice, collaboration, intersectionality and respect for diversity and peer support. By doing this the service aims to provide a person-led service, as far as is possible, which is always genuinely person-centred.

This approach means the person’s own language and preferences are used, and there is no reliance on diagnostic labels or definitions to access support from Bridge the Gap.

‘My story, strengths and hopes’ is a Bridge the Gap psychological approach to capture and understand an individual’s story, strengths and goals. This formulation model is then utilised to inform their outreach support plan, including ways in which they and others can promote keeping them safe and well. It provides a means of capturing the key details of conversations with clients, ensuring their strengths and priorities are known and can be shared with other services. This is used as a passport and guide when engaging with other services to ensure the support provided aligns with their personal goals.

The VCSE consortium, in partnership with Changing Futures Lived Experience and Recovery in Action, has co-produced this human learning system approach that continues to evolve. Jamie Poole, lived experience project manager for the Changing Futures programme with Surrey County Council, said his own lived experience has helped to shape the person he is today. ‘Having accumulated more than 18 years of experience in recovery, and through my work in the fields of addiction, mental health, criminal justice, and housing, I have leveraged both my personal experiences and professional knowledge to assist others,’ he says. ‘The value lived and living experience brings to the conversation when designing and commissioning community services cannot be underestimated.’

To find out more about Surrey’s Bridge the Service contact Lisa Byrne, Changing Futures programme manager – lisa.byrne1@surreycc.gov.uk

Myanmar remains world’s leading source of opium

News

DDNWeb

December 12, 2024

Myanmar is still the world’s leading source of opium and heroin following the Taliban’s imposition of a ban on opium cultivation in Afghanistan, says the latest analysis by UNODC.

Opium cultivation in the country remains at high levels ‘after three years of growth’, says Myanmar opium survey 2022: cultivation, production and implications. Cultivation in Afghanistan, however, fell by 95 per cent in the year after the 2022 ban came into force, with Myanmar overtaking it as the world’s largest opium source last year.

‘The amount of opium produced in Myanmar remains close to the highest levels we have seen since we first measured it more than 20 years ago,’ said UNODC regional representative Masood Karimipour. ‘As conflict dynamics in the country remain intense and the global supply chains adjust to the ban in Afghanistan, we see significant risk of a further expansion over the coming years.’ Farmers growing opium in Myanmar ‘do not get rich, but are simply trying to make a living and meet their families’ basic needs amidst challenging circumstances,’ added UNODC country manager for Myanmar, Yatta Dakowah.

Meanwhile, more than half of individual placement and support (IPS) clients successfully obtained work during a follow-up period of up to 18 months, according to the first report on the expansion of IPS for adults in treatment in England. ‘IPS achieved positive results regardless of their primary drug use,’ says the OHID report – which matches NDTMS data with HMRC employment records – with four out of five sustaining their employment for 13 weeks or more.

‘There was a clear association between positive alcohol and drug treatment outcomes and successful employment,’ the document states. ‘The expansion of IPS across England will be completed during 2024-25 and these promising findings provide continued evidence of the effectiveness of the programme.’

UNODC report available here

IPS for alcohol and drug dependence: data linkage outcomes report available here

The government’s ‘biggest reforms to employment support for a generation’ must not overlook people in recovery from substance use

Partner Updates

DDNWeb

December 11, 2024

The newly launched ‘Get Britain Working Again’ white paper (released 26 November) demonstrates the new government’s commitment to help people who are not working into employment if they can. But they must include targeted support for people in treatment for substance misuse – and for wider health issues, says Asi Panditharatna MBE.

The Forward Trust welcomes the ambition and initiatives set out in this white paper, and we hope to see charities and social enterprises at the forefront of the design and delivery. Action is critical for government to support people with addiction and mental health issues that contribute to unemployment, along with tackling insecure work, zero-hour contracts, low pay, and inflexible jobs that trap people in a cycle of dependency on Universal Credit.

This is the government’s first significant intervention to achieve an ambitious 80 per cent employment rate, and while The Forward Trust welcomes the additional £240 million investment and focus on Trailblazers and the Connect to Work programme it must keep its eye on hard-to-reach people.

We are pleased to see there is an expansion of Individual Placement and Support services through Connect to Work. However, it should build upon their supported employment programmes for people who want to work but are also participating in Substance Misuse Treatment schemes.

Get Britain Working Again We know that many people living with addictions – or with health issues – want to work. With the right support, it can be transformational for individuals and their employers.

The Forward Trust agrees that Job Centre Plus (JCP) transformation is essential to raise the employment rate. From the ground up it’s imperative that JCP managers and work coaches collaborate with charity expertise through faster and more flexible local commissioning and partnering on specific initiatives such as job and careers fairs and self-employment events.

We also welcome the Youth Guarantee to provide opportunities for 18-21 year olds. To get this right, we must learn from previous programmes and focus on aspirational careers advice, training, focusing on skills, behaviours, oracy and creative thinking for the world of work, intensive-in-work support and a commitment to the Good Work Standard by employers.

Similarly, the Trailblazer areas are also welcomed. We would urge that consideration is given to how Combined Authorities and Local Government will continue to fund and commission these in the future through devolution deals.

employment and skills - Get Britain Working Again — We recommend greater alignment between employability and skills programmes

Finally, self-employment and business start-up must be seen as a critical pathway for some individuals into economic activity. It provides a creative path when others are challenging, particularly for individuals in long-term unemployment.

Crucially, we recommend greater alignment between employability and skills programmes so that adults in particular can improve their skills, knowledge, resilience and behaviours to access sustainable employment and careers.

We will continue to work with the government to help create conditions for a sustainable, productive workforce of the future.

This blog was originally published by the Forward Trust. You can read the original post here.

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

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

This content was created by the Forward Trust

UK more likely to donate to food banks and furry friends than UK kids this Christmas

Partner Updates

DDNWeb

December 11, 2024

Drug, alcohol and mental health charity WithYou reveals that this Christmas the UK is most likely to donate to foodbanks and animal charities, but only 10% of people would donate to charities supporting young people and even less (5%) would donate to a drug and alcohol charity.

This new polling launches when many young people are in crisis. NHS England data showed that in 2023, one in four young people (eight to 16-year-olds) had a probable mental disorder. In addition, the Office of Health Improvement and Disparities revealed that 79% of young people who entered drug and alcohol treatment services during 2022-23 started using substances before the age of 15.

Stephen McCulloch, executive director of communications and fundraising at WithYou, said, ‘Imagine being a teenager, struggling with your alcohol or drug use, or trapped in a cycle of self-harm. Instead of looking forward to the festive season, you’re just trying to get through the day, coping with a pain you don’t know how to talk about. No young person should ever feel like this, especially at Christmas.

Christmas donate — ‘WithYou is launching its Christmas appeal to raise much needed funds for young people and we challenge the UK public to overlook that stigma and dig deep’

‘We applaud the UK public for giving so generously, especially when we know it can be an incredibly expensive time of year for a lot of people and living costs are continuously rising. But we are concerned that some causes, such as young people and people who have difficulties with mental health, drugs and alcohol are being overlooked. Far too many suffer in silence because they fear judgement or feel too ashamed to ask for help.

‘So today, WithYou is launching its Christmas appeal to raise much needed funds for young people and we challenge the UK public to overlook that stigma and dig deep. Every pound you donate will go towards giving a young person the tools, resources and support they need to build a better tomorrow. With your generosity we can continue to offer hope to those who feel there is none.’

WithYou’s Christmas appeal will raise money to provide crucial services for young people affected by drugs, alcohol and mental health challenges. A donation of just £15 could pay for a one-to-one session with a case worker, providing guidance and support; £20 could fund a 90-minute group session in a school, creating a safe space for children to talk; and £100 could pay for five wellness kits for young people who are self harming or in crisis.

To donate to WithYou’s Christmas appeal, click here

Charities people in the UK are most likely to donate to this Christmas:

Food banks and hunger relief charities (21%)
Animal charities (19%)
Mental health charities (15%)
Health focused charities (14.5%)
Elderly support charities (14%)
Young people charities (10%)
Environmental charities (10%)
Disaster relief charities (9%)
Human rights organisations (6%)
Education and literacy charities (5%)
Drugs and alcohol charities (5%)

This blog was originally published by WithYou. You can read the original post here.

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

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

This content was created by WithYou

Via – New Beginnings – Brent maintains hep C micro-elimination

Partner Updates

DDNWeb

December 11, 2024

Via hep c — Via – New Beginnings – Brent colleagues at Cobbold Road

We’re delighted to announce that Via – New Beginnings – Brent has successfully maintained its hepatitis C micro-elimination status at the 6-month mark. This is Via’s second service to re-declare this status.

A massive shoutout to everyone involved, especially to our partners Central Northwest London (CNWL) NHS Trust, and our BBV champions and nurses for their critical roles in this achievement.

We’d also like to thank our amazing recovery practitioners, who diligently conduct dry blood spot tests for those starting their treatment journey with us, making sure that we break down barriers and reduce stigma along the way.

Max Griffiths, service manager at Via, said, ‘To have maintained hep C micro-elimination 6 months after our initial announcement is amazing. It feels even more momentous than 6 months ago as it affirms that our pathways for testing and treating hepatitis C are excelling. Well done to everyone in the New Beginnings partnership.’

Via – New Beginnings – Brent — Willesden Hub team members

Abby Campbell, sector manager/non-medical prescriber at CNWL, said, ‘Reaching the 6-month mark in our journey toward hepatitis C micro-elimination is a testament to the strength of our partnership. Together, we have transformed our commitment into action, and with each milestone, we draw closer to a future free of hepatitis C. Well done, everyone! Here is to continued collaboration, progress, and the promise of lasting change.’

Marlon Freeman, national hepatitis c coordinator at Via, said, ‘A job well done for the New Beginnings team in Brent on achieving this milestone again. It is amazing to see the perseverance in BBV testing through some challenges the past few months. A special recognition to our BBV nurse whose strong leadership has made re-declaring hep C micro-elimination possible. Looking forward to 1 year of micro-elimination in 2025 and beyond.‘

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.

This content was created by Via

DHSC launches first ever survey of treatment workforce

News

DDNWeb

December 10, 2024

A national survey of the frontline drug and alcohol treatment workforce has been launched by the Department of Health and Social Care (DHSC).

DHSC survey — ‘Anyone struggling with drug and alcohol dependence should be able to access the help and support they need to live a fulfilling life. This can only happen with a strong workforce that is fit for the future.’

The department wants to hear from ‘all employees in local authority-funded drug and alcohol treatment and recovery services, commissioning teams, and those working in lived experience recovery organisations,’ it says, to understand the challenges they face, the support they need and what keeps them motivated. The survey will cover issues like high caseloads, as well as the lack of training opportunities and job security.

The results will be used to inform the implementation of DHSC’s ten-year strategic plan for the drug and alcohol treatment and recovery service (2024-34), which aims to ‘transform and strengthen’ the workforce over the coming decade.

‘Anyone struggling with drug and alcohol dependence should be able to access the help and support they need to live a fulfilling life,’ said public health minister Andrew Gwynne. ‘This can only happen with a strong workforce that is fit for the future. I urge people in the sector to have your say.’

Meanwhile, new research from the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London and South London and Maudsley NHS Foundation Trust has found that genetic predisposition to schizophrenia and frequent cannabis use have ‘independent links’ to the likelihood of developing clinical psychosis. The results will help to identify people at higher risk and develop preventative strategies, researchers say.

‘Our study is the first to estimate the risk of psychosis from both cannabis use and genetic predisposition to schizophrenia,’ said Dr Edoardo Spinazzola of IoPPN. ‘Interestingly, we found no evidence of an interaction between the two, suggesting they influence the risk of psychosis through separate pathways and could potentially have an additive effect where those with increased genetic risk who use cannabis are highly likely to develop psychosis. Through further analysis of cannabis use of different frequencies and potencies, we have shown that highest risk for psychosis is in those with greater genetic predisposition to schizophrenia who use high potency cannabis daily.’

Survey available here until 24 January

10-year strategic plan for the drug and alcohol treatment and recovery workforce available here

The impact of schizophrenia genetic load and heavy cannabis use on the risk of psychotic disorder in the EU-GEI case-control and UK Biobank studies available in the journal Psychological Medicine available here

Time to act

Features

DDNWeb

December 9, 2024

The gambling industry is at a ‘crucial juncture’, the recent Lancet Public Health Commission on Gambling reported, as it becomes more and more digital in nature and the lines between gambling and gaming become increasingly blurred (DDN, November, page 4). What’s more, the report adds, governments have so far paid too little attention to gambling-related harms – and are doing far too little to prevent them.

When the review of the 2005 Gambling Act was announced it was two and a half years before the gambling white paper finally saw the light of day, and even then it contained almost nothing about advertising or marketing (DDN, May 2023, page 5) – despite the fact that whenever the public is surveyed on the subject, most people are in favour of tighter regulations.

Vested interests
‘We know there are a lot of vested interests and a lot of lobbying in this space,’ says lead author of the Lancet Public Health commission report, Professor Heather Wardle of the University of Glasgow. ‘And it’s not just the gambling corporations, it’s also the broadcast media. So it’s a hotly contested space, but what’s really interesting is how other countries’ governments are taking the steps and saying, “You know what? We are going to ban this.”’

A recent report commissioned by GambleAware found that the UK had far more lenient rules than comparable countries like the Netherlands, Germany, Italy or Spain, many of which are taking action to crack down on marketing. And they’re doing so on a ‘similar, or even lesser, evidence base for their particular countries,’ Wardle points out. ‘Whereas our government is taking the line that there’s no evidence to say that advertising causes harm, although they do accept that advertising causes increased consumption. But of course we know that increased consumption is associated with the increased risk of harms.’

It was a Labour government that brought in the 2005 act, which controversially helped to liberalise the advertising and marketing regulations, but could the current government be the one that finally takes decisive action to address gambling-related harms?

‘It’s unclear as yet,’ she says. ‘There were some promising signs when they actually mentioned gambling reform in their manifesto under public health commitments – the first time it had actually been put under a public health or health improvement banner. But there were perhaps some more concerning signs when they then said, “We’re going to work with the industry to make sure these reforms are implemented in a responsible way,” which very much felt like a continuation of the status quo. Part of their policy commitment is a focus on prevention so if that’s then threaded through into gambling policy it could be very positive. But it’s a big if. We’re sitting tight and waiting to see what happens.’

Surveillance economy
Most people thinking about gambling are likely to picture a betting shop or a casino – not a highly sophisticated digital ecosystem with online products that are ‘designed to be rapid and intensive’, as the commission says. ‘Like any online commodity, this is driven by data and insight,’ she says. ‘It’s about how people can use and surveil the information that you as a consumer willingly give to these companies, because that’s the quid pro quo of them providing you with the products. So once you start situating this more within the kind of surveillance economy framework, you start thinking about it in a different way.’

Gambling is also becoming increasingly normalised at an early age, with ‘loot boxes’ in children’s games and so on. Is this something most parents are even aware of? ‘I think most parents will be aware that the gaming industry is rapacious in its ability to extract cash from kids,’ she says. ‘Anyone who’s got children who play games knows that they’re constantly coming to you going, “Can I just have some money to buy this?” That’s the way the gaming industry is now recouping its cash, based on what we call the ‘freemium’ model – upselling the purchase of items in the games.’

What parents are less likely to be aware of – ‘unless you’re actually sitting there playing the games yourself’ – is the mechanisms that underpin them, she points out. ‘And I know in the past the government has tried to shift the focus onto parents – that they should be much more involved in policing it themselves. But as a parent myself, you don’t always have the time to be constantly looking over their shoulder at what they’re doing. I’d rather have the responsibility placed on the corporations to not embed these things in products for my kids the first place.’

‘Problem’ cohorts
On the question of assigning responsibility, the gambling sector tends to push much the same narrative as the alcohol industry – shifting the focus and responsibility to a small cohort of ‘problem’ people. ‘It’s the common theme of corporate practice that runs throughout gambling, alcohol, tobacco, that there’s this small percentage of people who are disordered or don’t use the products properly, and if you just deal with them everybody else will be fine. Which is fundamentally at odds with the evidence base about how harms are distributed across the spectrums of behaviours. It’s big corporations who design and provide these products, and they have to bear responsibility for the consequences of the things they’re putting into the market.’

This public narrative of ‘a disordered few’ who can’t control themselves leads inexorably to the issue of stigma, something that’s just as pernicious in the gambling world as the drug and alcohol sector – perhaps even more so. ‘That narrative layers on the shame,’ she says. ‘People think, “Why can’t I just get control of myself? Everybody else can.” You can see how that builds and people feel ashamed in terms of seeking help, even when there’s help available – we don’t have long waiting lists for the NHS gambling treatment.’

For most people experiencing gambling harms it’s ‘very, very hidden,’ she says. ‘When you talk to people with lived experience, the partners often don’t know what’s the driver behind the difficulties they’re experiencing until it gets to crisis point. Because people who are experiencing that level of difficulty with gambling are very, very good at hiding it and they become very adept at lying to their loved ones. With alcohol or drugs there are going to be some physical cues that people would be picking up on which you just don’t have with gambling.’

Women’s stigma
And when it comes to stigma – again as with alcohol and drugs – it’s frequently women who are the most affected. While the stereotypical image of a gambler is probably still a man in a bookie’s or at a poker table, the ubiquity of online gambling hasn’t just made it possible to gamble 24 hours a day, it’s also made it far more accessible for women. As with many things, this was then exacerbated during lockdown, with a YouGov poll of almost 10,000 women using the Problem Gambling Severity Index finding that up to 1m women may now be at risk of gambling harm.

‘If you read a media article about a woman who’s experienced gambling harms it’s often framed in that kind of abrogation of duty to their family and children’ she says. ‘A comparative article for a man would tend to be “they stole this much money” or “they did this to their employers.” It doesn’t locate it in the same familial context, though of course the actions of a man will impact on the family just as much. There’s also this additional gendered aspect of what is and isn’t appropriate female behaviour, which exacerbates the shame that women can feel. And yet we know that many women experience gambling harms, need help, and should get that help – free from judgment and free from stigma.’

Conservative estimates
So what would she say to those commentators who maintain that the statistics on gambling harm are overblown and not realistic. ‘I would say that many of the statistics we’ve got are actually conservative,’ she states. ‘They’re not blown out of proportion at all, because what our statistics are not doing is measuring the impact on others. And we know that impact is wide reaching and can have hugely detrimental effects on people’s health and wellbeing. They’re not actually even measuring the full range of experiences and negative consequences that people can have from gambling.’

The most common tool – the Problem Gambling Severity Index – doesn’t include gambling’s impact on relationships, she points out. ‘And we know that getting information from marginalised communities is going to be difficult as well, so there are many reasons why these statistics should probably be considered as the most conservative basis, rather than a high-level basis.’

So if she could get the government to enact one piece of legislation, what would it be? She doesn’t hesitate. ‘Prohibition of the advertising, sponsorship and marketing,’ she states.

Anti-Stigma Network YouTube channel

Partner Updates

DDNWeb

December 6, 2024

We’re delighted to announce that we’ve launched the Anti-Stigma Network channel on YouTube.

If you didn’t manage to catch our first webinar last week, ‘Ethics in Focus: The power and principles of telling stories of substance use’, you can now check it out – please share it far and wide to help dismantle stigma!

All opinions matter and we would be grateful if you could give us your feedback on the webinar so we can improve future collaborations. The form is anonymous and takes about five minutes to complete.

We are developing some of our communications so look out for our next monthly guide in February. In the meantime, we encourage you to follow us on social media for the latest updates and news: Instagram, LinkedIn, BlueSky.

The big news to lookout for is that we have two more webinars in the pipeline – the first one coming in January will feature a fantastic panel of guest speakers, discussing the stigma faced by people from minoritised communities. We will confirm more details soon, so keep a lookout.

And finally, it’s Addiction Awareness Week. Taking Action on Addiction seeks to improve everyone’s understanding of addiction to help end stigma and calls for addiction to be treated as a serious mental health condition. You can read more about it here.

Thank you for your continued support, together we are stronger.

The Anti-Stigma Network team

This update was originally published by the Anti-Stigma Network.

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

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

This content was created by the Anti-Stigma Network

Scottish budget ‘misses the mark’ in tackling alcohol harm, say campaigners

News

DDNWeb

December 6, 2024

The Scottish budget ‘will miss the mark’ in tackling the country’s alcohol-related harms, says Alcohol Focus Scotland (AFS).

A ‘mix of funding cuts and missed opportunities amount to a disappointingly lacking budget’, says the charity, which has questioned the Scottish Government’s commitment to addressing the ‘alcohol harm emergency’. There were 1,277 alcohol-specific deaths registered in Scotland last year, the highest number for 15 years.

Scotland’s budget this week allocated £80.9m funding for alcohol and drugs, which at just £500,000 up on the previous year amounts to a ‘real terms cut’, says AFS. £60m will go to the country’s national mission on drug deaths, leaving £20.9m for treatment, prevention and ‘dealing with the consequences of problem alcohol and drug use’.

Health campaigners had urged the government to introduce a compulsory ‘public health supplement’ on drinks retailers in the budget, with the money used to fund preventative interventions. This was not included and the government had also failed to take on board Audit Scotland’s recommendations that an increase in funding to tackle alcohol harm was urgently needed, AFS states.

‘With a real terms cut to funding on alcohol prevention and treatment, and the failure to re-introduce the public health supplement on alcohol retailers, the budget in its current form is disappointingly lacking in the ambition and determination needed to tackle Scotland’s alcohol emergency,’ said AFS deputy CEO Laura Mahon. ‘Three years ago, the Scottish Government used their budget to declare alcohol a public health emergency, yet this year made no mention of a crisis that has only worsened during that time – with alcohol deaths hitting a 15 year high in 2023. The Scottish Government has repeatedly pointed to funding for the national mission as evidence that they are taking alcohol harm seriously. Yet Audit Scotland has now confirmed what Alcohol Focus Scotland has been saying for some time – that tacking alcohol onto the national mission for drugs is totally insufficient for the scale of the problem and has led to reduced focus on tackling alcohol harm.’

The rate of premature deaths from alcoholic liver disease in England was up by 3.6 per cent between 2022 and 2023

Meanwhile, the latest analysis from OHID shows that the rate of premature deaths from alcoholic liver disease in England was up by 3.6 per cent between 2022 and 2023, to 5,984. ‘The England rate of premature deaths from alcoholic liver disease between 2001 to 2023 has increased by almost 60 per cent,’ it adds. There were 8,274 alcohol-specific deaths in England overall last year, almost 5 per cent up on the previous year and 64 per cent up from 2006. The alcohol-specific death rate was highest in the North East, at more than 25 per 100,000 population, and lowest in the East of England, at 11.5 per 100,000.

‘It is absolutely tragic to see yet another increase in deaths from conditions wholly attributable to alcohol,’ said head of alcohol policy for Fresh and Balance, Sue Taylor – ‘with the worst rates here in the North East. Behind these statistics are families and communities, shattered by the impact that alcohol can have. This is particularly pertinent in the run up to Christmas, when we see a saturation of alcohol advertising, countless promotions in supermarkets and unavoidable pressures to drink – all of which we know can tip people suffering from alcohol addiction over the edge.’

Liver disease profile, December 2024 update available here

Alcohol profiles for England: short statistical commentary, December 2024 available here

Proud To Say 2024 campaign

Partner Updates

DDNWeb

December 5, 2024

Every December, Turning Point’s #ProudToSay campaign offers a point of reflection on the previous year and highlights moments to be proud of and celebrate, writes Julie Bass, chief executive at Turning Point.

The response that we have received this year has been fantastic – it is a great joy and privilege to read about people’s stories and achievements.

Every individual we support has a different story and the things they are proud of demonstrate this diversity. It may be achieving a personal best in recovery, talking openly about their mental health struggles or moving onto more independence.

What am I proud of?
I am proud to say that in the year of 2023/2024 we supported a total number of 197,594 people and 96% of our regulated services are now rated good or outstanding by the CQC, which is testament to the hard work and quality of care provision by our colleagues across the country.

This year, Turning Point marked its 60th anniversary by celebrating in many different and wonderful ways across the organisation. In January we launched our campaign to tell the ‘Story of Turning Point in 60 objects’ with the aim of using everyday objects submitted by colleagues, people we support and partners, to tell some amazing and important stories. We asked people to submit their story using an everyday object, as an accessible method of sharing moments of hope and inspiration. Over 100 people shared their objects and story with us, 60 of which were exhibited at Kensington Palace in June, an incredible visual exploration of the 60 objects.

We also commemorated our 60th year by hosting an insightful webinar series with a range of incredible panellists to discuss some of the most pressing topics in health and social care. We were joined by the Rt. Honorable Patricia Hewitt to discuss the role of the VCSE sector, as well as Michael Linnell to explore how to tackle the synthetic opioid crisis, and Robin Miller to consider how to better prevent long stays in hospital for people with learning disabilities. The webinar series was extremely well attended and offered a great platform to connect and share on important issues facing the sector.

I am proud to say that Turning Point continues its dedication to engagement and involvement, particularly championing the voices and stories of the people we support. This November, people we support from up and down the country gathered at our My Voice event in Birmingham to discuss topics that matter to them, including reducing stigma, service accessibility, and improving communication and connection. It is these moments of co-production and collaboration that strengthen our ability to offer services that are truly informed and person-centred and allow people we support to connect with one another.

I am proud to say that we celebrated September’s Recovery Month through a range of national events to highlight the incredible strength and importance of recovery. A highlight of this month was Hendrik’s award at the Recovery Street Film Fest in Sheffield. Hendrik is a long time Turning Point volunteer Peer Mentor, who has worked through his own recovery to be able to support others with similar experiences. Hendrik was shortlisted for his recovery film where he shared his experiences, the theme of which was belonging. We are so proud of Hendrik for being shortlisted and additionally winning third place. Hendrik’s bravery to share his own story so candidly is an inspiration to us all.

When I look back at the work we have done in 2023-24, I am proud to say that our impactful services continue to expand. I am proud to see a range of initiatives that have improved the experience of people who need support. We have gained new services in London to support local people with sexual health, including new young people’s and adult services in Lambeth, Southwark and Lewisham. Additionally, we have secured a new community drug and alcohol treatment service in Bristol with a focus on local expertise, partnering with local services deeply rooted within the community to create a truly collaborative and innovative service. We have expanded our network of services in Nottingham and gained new services in Lincolnshire and Wakefield, as well as launching the Blue Light Together platform to support the wellbeing of the Blue Light Community.

I know all too well there is so much more to be proud of this year which hasn’t been mentioned – many of our proudest moments come from those small interactions that take place daily, between colleagues and people we support up and down the country. This year at Turning Point has highlighted the importance of connection, celebration and community, and I look forward to carrying these themes forward into 2025.

This blog was originally published by Turning Point. You can read the original post here.

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

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

This content was created by Turning Point

New poll reveals toll of addiction across the UK

Partner Updates

DDNWeb

December 3, 2024

As Addiction Awareness Week 2024 begins, we commissioned research into the scale of dependency in the UK. On our behalf, Ipsos interviewed a representative sample of 2,139 UK adults aged 16 to 75. Just over one in 10 (11%) had experienced addiction to alcohol, drugs, medication, or gambling at some point in their lives.

Nearly half of UK adults (47%) have either experienced or know someone who has lived with drug, alcohol, medication or gambling dependency. Countrywide, this equates to around 23 million adults affected by addiction.

Our data reveals that alcohol is the most prevalent dependency (49% among those with personal experience), followed by drugs or prescription medication (38%) and gambling (32%).

This is not a pandemic blip, as some hoped: 31% of people with personal experience of addiction say their consumption of alcoholic drinks is higher than before March 2020. One in 10 (10%) of those who have consumed alcohol since March 2020 say drinking is now part of their daily routine.

We also conducted research into the wide-ranging impacts of the UK’s addiction crisis. We do not use this word lightly: in 2022, 10,048 deaths from alcohol-specific causes were registered in the UK, the highest number on record. The following year, 5,448 deaths related to drug poisoning were registered, according to official government data.

Among those living with addiction, both directly and indirectly, more than half (54%) say their physical health has suffered. Other negative impacts include emotional or psychological distress (53%), financial issues (46%), and relationship problems (41%).

The poll also highlights one of the biggest barriers to tackling this crisis: the stigma of dependency. Between 21% and 43% of those with experience of addiction say that shame would stop them seeking support from one of nine sources, including their GP and employer.

Addiction continues to be a hidden condition – but it does not have to be this way.

Addiction affects everyone, but recovery is possible.

Join our campaign: Taking Action on Addiction

This blog was originally published by Taking Action on Addiction. You can read the original post here.

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

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

This content was created by Taking Action on Addiction

Increase investment in alcohol treatment, Scottish Government urged

News

DDNWeb

December 3, 2024

The Scottish Government is being urged to boost its investment in alcohol treatment ahead of tomorrow’s budget.

It should also introduce a ‘public health supplement’ on alcohol retailers, with the money used to fund preventative interventions to help people ‘before they reach crisis point’, says a briefing paper from Alcohol Focus Scotland (AFS). Retailers should be paying towards the health and social costs of alcohol-related harm based on the ‘polluter pays’ principle, it says.

The document also calls for a national needs assessment to be carried out to better understand the demand for, and availability of, services.

Almost 1,300 alcohol-specific deaths were registered in Scotland last year, the highest number since 2008. A report last month from Audit Scotland, however, said that the government had been ‘slow to progress’ its key national alcohol and drug strategies and found that service delivery was ‘complex’, with a wide range of partners and little overall accountability. ‘Most alcohol and drug funding goes to NHS specialist services to treat people at crisis point – this means there is limited money to put into preventing people getting so ill in the first place,’ it said.

Alcohol-specific deaths in Scotland are up by 25 per cent since before the pandemic, the briefing paper points out, likely caused by both increased rates of harmful drinking and reduced access to services. ‘If these changes in consumption persist into the long term, it is estimated that this will lead to around 7,500 more deaths and 70,000 more hospitalisations by 2040, costing £82.2m in hospital costs alone,’ it states.

Although Scottish drug death rates have long been the worst in Europe, the Scottish Government had established its drug deaths task force, appointed a dedicated drugs minister and announced a ‘national mission’ supported by £250m in funding. ‘There have been no equivalent developments specifically focusing on reducing alcohol harm,’ the paper points out. While more than 90 per cent of Scottish alcohol and drug partnerships had drug death review groups, just 7 per cent had carried out alcohol death audits in 2022-23 – ‘despite the fact that more people die from alcohol harm than drug harm’.

Prevention activities could include funding the early identification of alcohol-related liver disease, the paper continues – ‘a silent killer that is largely asymptomatic in its early stages’, with three quarters of cirrhosis patients diagnosed in A&E. This could include targeted fibrosis assessments in primary care and community settings, including non-invasive liver scans.

‘Early detection of alcohol-related liver disease not only allows an opportunity to prevent hospital admissions and avoidable deaths, but it also provides motivation for people to address their alcohol problems,’ said consultant liver specialist at Glasgow Royal Infirmary, Professor Ewan Forrest. ‘Our community-based project using a specialised liver scan in the North-East of Glasgow identifies people with significant liver disease before they develop symptoms. This approach could significantly reduce the burden of alcohol-related illness and death.’

More than 10 per cent had ‘experienced addiction' — More than 10 per cent had ‘experienced addiction’

Meanwhile an Ipsos survey of more than 2,100 people commissioned by the Forward Trust-led Taking Action on Addiction campaign found that more than 10 per cent had ‘experienced addiction to alcohol, drugs, medication, or gambling at some point in their lives’. Almost half had either experienced – or knew someone who’d had – a dependency, equating to around 23m people UK-wide. Alcohol was the most prevalent dependency, at just under half of those with personal experience.

‘This is not a pandemic blip, as some hoped,’ the campaign states. ‘Thirty-one per cent of people with personal experience of addiction say their consumption of alcoholic drinks is higher than before March 2020.’ Among those living with addiction, ‘both directly and indirectly’, more than half said their physical health had suffered, with other negative impacts including ‘emotional or psychological distress (53 per cent), financial issues (46 per cent), and relationship problems (41 per cent)’.

Alcohol Focus Scotland briefing: Scottish budget 2025-26 available here

Taking Action on Addiction campaign available here

Startling statistics

Features

DDNWeb

December 2, 2024

The recent ONS drug-related deaths data revealed that fatalities involving cocaine rose by over 30 per cent last year (DDN, November, page 4), and currently stand at nearly ten times the rate of a decade ago. It’s crucial that a concerted effort is made by the government and public health services to tackle this worrying development.

The rise in cocaine-related deaths is a result of a combination of factors. There has been an increase in the purity of cocaine, which makes it potentially more toxic and more lethal. It has also become easier and cheaper to get hold of, and more people are using it – some in larger quantities, putting themselves at greater risk.

Increasing supply
According to the European Union Drugs Agency (EUDA) cocaine purity has been on an upward trend for a number of years, and in 2022 reached a level 45 per cent higher than in 2012. In the first half of 2022, 50 per cent of the samples tested by 18 drug checking services across eight EU countries exhibited a purity ranging from 80 per cent to 100 per cent. By the first half of 2023, this equivalent share was 55 per cent.

Global cocaine production has increased year-on-year since 2014. In 2022, more than 160 tons of cocaine were confiscated in Antwerp and Rotterdam alone, and much more got into Europe undetected, evidencing the increasing demand for the drug.

Across the sector we’re seeing an increase in the number of clients presenting with cocaine and polysubstance use, with people using cocaine alongside other drugs such as alcohol, cannabis and MDMA. As a stimulant it’s often combined with something that will bring people down at the end of the night such as benzodiazepines and/or alcohol. Sometimes a drug-related death is a combination of the cocaine and other substances.

In 2020, a government review of the UK’s £10bn drugs market found a sharp rise in illegal drug use, particularly among the middle classes. The UK has the second highest rate of cocaine use in the world, with studies suggesting it’s both fuelled by – and fuelling – the country’s drinking culture.

Societal attitudes
There seems to be a shift in attitudes towards cocaine consumption, with it being seen as more socially acceptable. We’re also seeing an increase in use among women and across different ages. Cocaine and alcohol in particular are both commonly used in social settings by people who use substances casually/recreationally, and people sometimes use the two together in order to prolong nights out and allow alcohol consumption for longer periods. This is not a phenomenon unique to the UK, of course. In Bern, high rates of cocaine use have led to discussions of a pilot scheme to allow its legal sale.

While using cocaine and alcohol together is often recreational, mixing the two increases the risks, with a new toxic substance formed in the body – cocaethylene. There are known associations with cardiotoxicity from cocaethylene, something that our sector and our clinicians need to be more aware of. There are also considerations around the possible habit-forming nature of always using both substances together – according to EUDA more than 50 per cent of people with cocaine use issues also struggle with alcohol dependence.

The age profile of people who die as a result of their cocaine use is younger than for opiate-related deaths, with the most common cause of death related to cardiovascular events linked to the heart and blood vessels – such as strokes, heart attacks, and cardiac arrhythmia. Cocaine use may unmask underlying conditions – cardiovascular issues are one of the leading causes of death in the British population, and cocaine use might make those deaths happen much earlier. The latest EUDA data revealed a time lag of 13 years between first cocaine use – on average at age 22 – and first treatment for cocaine-related problems, on average at age 35.

Intervention
The lack of any substitute prescribing for cocaine can make treatment feel less attractive, but Turning Point’s recently reviewed RECLAIM psychosocial intervention aims to meet people where they’re at – in the understanding that many people using cocaine will be ambivalent about behaviour change in the context of a drug which can be powerfully reinforcing, but with equally powerful ‘comedowns’.

The intervention offers two structured individual sessions based on discussing harm reduction in the context of motivational interviewing, and exploring the person’s values and goals. The person can then choose to join a four-session rolling group programme with other people using the same or similar substances to enhance social support, and explore future mutual aid options if helpful.

cocaine deaths This four-session rolling group is facilitated by recovery workers and peer mentors, trained and supervised in use of the intervention. It aligns with NICE guidance in its use of cognitive behavioural therapy principles, motivational interviewing and in the understanding that most people who use cocaine will experience dysphoria. It also uses elements of acceptance and commitment therapy to continue focus on core values as a motivator for continued change.

For some people, use of RECLAIM and engagement with mutual aid – such as SMART Recovery – will be enough to begin to make the desired changes. For others, particularly those with co-occurring mental health difficulties, a longer period of treatment – including groups such as recovery skills and mindfulness-based relapse prevention – would be helpful in terms of sustaining changes in conjunction with work on increasing social support and behavioural activation.

Positive change
Contingency management is the reinforcement of positive behavioural change – such as attendance at appointments or negative urine tests – through a reward such as a voucher payment. Internationally, there’s strong evidence for the effectiveness of contingency management in the treatment of cocaine use. However, it’s very rarely used.

Where it is used, it’s mainly related to physical health interventions and mostly targeted at people using opiates. Barriers to use of contingency management include funding, the administrative burden, and sustainability. Politically, it’s not uncontroversial; however, the increased rates of cocaine use and cocaine related deaths suggest that this is an approach worthy of consideration by government and the sector.

There’s a lot we can offer for people using cocaine, including relevant, targeted information which is adapted for different age groups so the decisions people make are based on having the full facts. Cocaine isn’t typically associated with drug-related deaths in the popular imagination, and younger people are also less likely to be aware of their mortality.

Reducing harms
We need to support people to start considering their options with regards to how they can use less cocaine, or use it more safely. Experts have called for a public health campaign to alert people to the risks of the drug, but there is evidence to suggest that ‘scare tactics’ simply don’t work in changing behaviour.

In one area where Turning Point currently operates, the local police proposed a campaign that linked cocaine use to significant criminal activity, such as domestic abuse, child trafficking or gangs. We supported the police to realign this messaging to focus on reducing harms and increasing understanding of possible health impacts. As providers, it’s important that we work with our system partners on the evidence base for behaviour change.

Public health campaigns must start from a point of compassion. We’ve learnt from work we have done around promoting naloxone and safer injecting equipment that the most effective approaches are developed in conjunction with people who use drugs.

The 30 per cent increase in cocaine deaths is alarming in itself, but a further consideration for the sector is the change in the opiate market and the possibility that this could also happen within the cocaine supply. This would expedite the rising deaths, and further highlight the need for the sector to respond.

Natalie Travis is national head of service at Turning Point

I NEEDED COKE TO FUNCTION

Danny sniffed his first line of cocaine at 13 – the start of a problematic relationship with it, until he sought help.

Danny has been abstinent from drugs for 11 months. He has just completed the peer mentor programme at Turning Point, and volunteers at The Hepatitis C Trust and at his local church. The 45-year-old said the last year has been ‘the best time of my life’.

It’s been a remarkable turnaround for Danny who spent 27 years using and selling cocaine. ‘I sniffed my first line of cocaine at 13 and I smoked my first pipe of crack at 17,’ he says. ‘I tried heroin a few times in prison, but I got nothing off it, so I weren’t chasing it. I was addicted to Valium. My whole life’s just been drugs. I didn’t have a clean day from the age of nine up until I was 44 – every day I done something.’

Danny explained that his drug use was a way to deal with the trauma of being sexually abused as a child. ‘I found drugs, and that just covered all my problems,’ he says. Describing himself as a ‘functioning crackhead’, Danny gives an interesting insight into an issue that’s faced by many cocaine users who often believe they’re not dependent on the drug. He’s worked all his life, first as a plasterer and then as a forklift driver. ‘It sounds stupid, but I thought I didn’t have a problem because I could get up and go to work after a couple of hours sleep and sniff cocaine all day at work and then get home and smoke crack all night – I thought I could do that for the rest of my life.’

Danny reveals that the birth of his grandson, who his daughter named after him, and then
her telling him that she felt he wouldn’t make it past 2023 was one of the reasons he sought help. ‘I couldn’t stop for my kids, which is very selfish, but I weren’t ready. It sounds horrible but you can’t stop for anyone but yourself. People can try and get you to stop, and you won’t stop.’

Danny reached out for help at Turning Point services in Suffolk where he spent a year receiving support to come off cocaine. ‘I’ve come out just a hundred times better than I ever have been throughout my whole life,’ he says. ‘I’ve never been this positive. I’ve got my family back. And I’m just looking forward to helping as many people as I can at Turning Point.’

JUST A REGULAR NIGHT OUT

Coke’s become as socially acceptable as alcohol in my respectable community, says Joanna.

When I was at uni I used to find coke very seedy and wouldn’t touch it. Plenty of others did it, off mirrors, but I didn’t join in. I couldn’t do it.

A few years later I was in a pub in London and one of my friends offered me some. I was pissed at the time and I can’t really remember how it felt. But I did it again and it started to become very moorish, especially when drinking. In fact I only ever did it when I was drinking, and it still goes hand in hand with drinking for me. I think if I started doing it when I’m not drinking it’d be time to have a word with myself.

I tend to set parameters with my husband and friends before we start, including a cut-off time for bed so we don’t stay up all night. I used to feel bad staying up late and found it hard to function the next day through lack of sleep. Despite our best intentions it doesn’t always happen and we can stay up too late – but sleep has become more important as we’ve got older. The thing is, I feel worse after a night of just alcohol, and the coke stops you getting so drunk.

I don’t do very much coke compared to other friends and can make it last all night. If someone offers me more, I take what I need and give the rest back. It gives me a feeling of wellbeing and confidence. Other people might say it makes me chat shit! But it makes me feel good.

Everyone’s on it. I know so many people that do it and it’s become very normalised – ‘oh yeah, it’s just coke’. It’s become much more socially acceptable. And it’s very easy to get hold of – it usually turns up in less than ten minutes.

DDN December 2024/January 2025

DDNWeb

December 2, 2024

At what point is intervention possible?

We’re so quick to compartmentalise – as if that makes treatment easier. Early trauma, chaotic drug use… rehab. Social scene, few too many drinks, hiding a hangover… be careful not to overdo the legally sanctioned fun.

Slightly confusing then, to look at a substance through both lenses. We’re familiar with the devastating effect cocaine can have on lives. What’s interesting is the cultural normalisation that’s contributing to the statistics (p6). If drug use starts in a safe setting and escalates, at what point is intervention relevant – or possible? Using it as a way to avoid drinking too much (aside from using it to keep going for longer) is a twist on harm reduction that we may not have contemplated, but it’s risky. The two substances combine to form toxic cocaethylene, increasing the risk of heart attack and stroke – but who’s familiar with that?

It’s complicated, but we need to look at the stats and focus on an effective response – cocaine-related deaths increased by a third last year.

As we look back on the year we’re grateful for inspirational partnerships and individuals who tackle obstacles at full tilt and don’t take ‘go slow’ for an answer. Keep going – we’re right there with you!

Enjoy the festive season!

Read the December/January issue as an online magazine (you can also download it as a PDF from the online magazine)

Claire Brown Editor of DDN Magazine

Claire Brown, editor

Number of adults in treatment up by 7 per cent

News

DDNWeb

November 29, 2024

There were almost 311,000 adults in contact with drug and alcohol treatment in the year to March, according to the latest OHID figures – 7 per cent up on last year. It represents the biggest rise since 2008-09, and the highest number of adults in treatment since 2009-10.

People in treatment for problems with opiates were the largest group at 44 per cent, a 4 per cent drop from last year, while 30 per cent were in treatment for alcohol. The number of adults entering treatment was up from just under 138,000 to almost 159,000, with the proportion of people starting treatment for powder cocaine reaching its highest ever level, at 19 per cent.

A fifth of people starting treatment had no home of their own, rising to almost 40 per cent of those starting treatment for opiates, while nearly three quarters of adults starting treatment reported a mental health treatment need. Nearly half of people in treatment said they were smokers, compared to just 13 per cent of men and 10 per cent of women in the general population.

Almost half of the 137,477 people who exited the system had successfully completed treatment, while the number of people who died while in contact with services stood at 1.3 per cent, a slight fall from the previous year.

There were 14,352 children and young people in drug and alcohol treatment during the same period, 16 per cent up on the previous year but still more than 40 per cent lower than the 2008-09 peak figure of 24,494. Almost 90 per cent were in treatment for cannabis, while just under 40 per cent had problems with alcohol, 9 per cent with ecstasy and 8 per cent with powder cocaine. Eighty per cent of children and young people said they’d started using substances before the age of 15, with 56 per cent reporting polydrug use. Almost half said they had a mental health treatment need, up from just over 30 per cent in 2018-19.

In Scotland, cocaine has now overtaken heroin for the first time as the most commonly reported main drug used by people starting treatment, according to new PHS figures – at 30 per cent to 28 per cent. Of the people who’d used opioids in the previous month, 63 per cent had a take-home naloxone kit.

Meanwhile, opium production in Afghanistan remains more than 90 per cent down on 2022 levels, according to UNODC. Just over 430 tons of the drug have been produced this year, the agency estimates, which is 30 per cent up on last year but 93 per cent lower than in 2022 when the Taliban imposed its ban on poppy cultivation. Earlier this month UNODC released its opium cultivation figures, which showed that cultivation had increased by almost 20 per cent compared to last year, to 12,800 hectares – but was still far below pre-2022 levels of more than 230,000 hectares.

‘A second year of low opium cultivation and production presents opportunities and complex challenges,’ said UNODC chief executive Ghada Waly. ‘International efforts must be coordinated to ensure that this decline is not replaced with production of dangerous synthetic drugs such as methamphetamine within Afghanistan or the wider region.’

Adult substance misuse treatment statistics 2023 to 2024 available here

Children and young people’s substance misuse treatment statistics 2023 to 2024 available here

Drug and alcohol information system (DAISy): overview of initial assessments for specialist drug and alcohol treatment 2023/24 available here

UNODC report available here

Back from the brink

Partner Updates

DDNWeb

November 28, 2024

Karen Biggs, chief executive of Phoenix Futures, on saving the last residential rehab for families in England.

We were recently forced to announce that despite significant investment in drug treatment in recent years none of this funding had reached residential treatment services. Combined with short-term and sporadic funding processes this left the National Specialist Family Service based in Sheffield, the last residential family treatment service in England, on the brink of imminent closure.

We are delighted, to say the least, to announce that the future of the service has now been secured. Closure plans have been cancelled and we are looking forward to a future we had thought was disappearing from sight.

The support of frontline drug treatment staff across the country has been invaluable, and with the convening support of OHID and the efforts of substance use commissioners across England, CGL and amazing specialist support organisations Women’s Reform and Mother2Mother, we are back from the brink!

The key challenge we faced was the spot purchasing of placements (pay-by-night per resident funding). Spot purchasing means that each family had to argue their case for an individual funding package across budgets that span adult and children, rehab and social services. It is too complicated for families in need of urgent support and already overburdened social workers and drug treatment staff. Due to such an amazing response from so many we have been able to move the service to a block funding model that will improve access for families and enable us to plan for the future.

The National Specialist Family Service provides a unique opportunity to offer parents the core benefit of treatment alongside specialist parenting and childcare support. Research suggests that substance use treatment alone is not a protective factor for families striving to stay together. There is a growing body of research to demonstrate the effectiveness of whole-family interventions for families where parents experience substance use problems.

There is so much more work to be done and with the future of the service secured, we will now move back to supporting families to stay together, evidencing what works, fighting stigma and pushing for appropriate support for parents and pregnant women.

This blog was originally published by Phoenix Futures. You can read the original post here.

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

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

This content was created by Phoenix Futures

DDN’s double decade

Features

DDNWeb

November 28, 2024

How to get the drugs out of crime
Drugs minister Caroline Flint talks to DDN about drug and alcohol strategy…

‘Caroline Flint’s experience as MP for Don Valley leads her to the view that “a person addicted to class A drugs is a mini crime wave”. She argues that stealing and begging have become inextricably linked with feeding a drug habit, and points to the high positive drugs test rate among those arrested for acquisitive crime…

‘It was primarily to try to break the cycle between drugs and crime that led the Labour administration to develop the national drugs strategy, first published in 1998 and updated in 2002 – and which has fuelled a significant increase in funding for both treatment and prevention initiatives…

‘Flint points out that effective treatment for people with drug problems requires not only more and better services – the initial focus of the government’s approach to treatment – but also a more joined-up approach between agencies, a key element of the new Drug Intervention Programme (DIP) initiative (the renamed Criminal Justice Intervention Programme).’

A ‘new normal’
Natalie realised heroin addiction was ruining her life and began treatment, starting with a detox…

‘It was strange trying to re-establish a ‘normal’ life. I was so used to gouching out every night in my clothes that I had forgotten the process of going to bed. I was thinking one night, “well, what do you do? You must put your nighty on.” It’d been so long since I’d done that. I put my nighty on and I got in bed and I thought, “well, what do you do now? Right, people set their alarms don’t they?” So I did that. The feeling was so strange. It was also a strange feeling when I stopped using heroin and became aware again of simple things, like the taste of food, birds singing and springtime.’

World of Wired
Prof David Clark explained his grassroots initiative WIRED, which pioneered merging real world activities with a high profile web based communication system…

‘I knew that WIRED has to be involved in both virtual and real world activities, fostering a strong grass roots initiative which has long-term continuity and stability. My vision was big – very naively so – but then what we are tackling is enormous. As far as I could see there are plenty of people who want to become involved in tackling substance misuse problems but don’t know how to get involved. They need something to which they can belong and contribute.’

David Clark went on to write a brilliant series of Background Briefings giving insights into all aspects of addiction – all available in our website archive.

Making the code
Simon Shepherd, chief exec of the Federation of Drug and Alcohol Professionals (FDAP) on launching a new code of practice for the sector…

‘Traditionally there has been a view that people with ongoing drug or alcohol problems should not work in this field. And many take the line that they should not do so for at least two years of having had a problem (the so-called ‘two-year rule’). While some practitioners felt that this made sense, many more felt it unfair and short-sighted, and we ultimately concluded that a more flexible approach was needed.’

A day in the life
Extract from a day in the life of community support worker Dave Watkins…

‘11.30. A call from my mate Larry in the cells, David was picked up again last night. Drunk and disorderly again. Out the door. In the car. Down to the cells. He’s sorry, not sure what happened, won’t happen again. Talk to Larry, another court appearance for both of us, but not today – I can take him home. The importance of networking. We’re lucky here, we all seem to sing off the same hymn sheet – agency workers, social services, probation, courts, hospitals, mental hospitals, doctors, DSS, wet houses, dry houses, local health board. If your approach is right, people generally want to help not hinder you. It’s so important to know that you’ve got back-up.’

Pace too slow on alcohol strategy
‘Alcohol campaigning has, it seems, been a little slow to get the results it needs. Tacked on to a number of major drug reports as a reference – “this could also apply to alcohol” – the needs of those who have drifted from using alcohol for regular relaxation and social confidence to desperate dependency, have been neglected. The DATs who have become DAATs may be doing their best, but it seems up to the persistent minority to remind government that targets are not set for shifting, and that a report on alcohol services due on such and such a date means that there are services looking out for a framework and a promise of commitment.’
(DDN editor’s column)

No room at the inn
Rosie Brocklehurst was frustrated at slow progress for the many affected by alcohol problems…

‘Right now there seems to be an unspoken consensus that we must wait for more evidence-based data. We must wait until hugely increased levels of alcohol-related harm, rising trends of misuse and irresponsible behaviours, deaths, child abuse, broken families, and unquantifiable levels of individual human suffering, come spilling out of the research databases and onto analysts’ graphs…

‘I try to seek comfort by periodic night-time reading of the six pages in a 95-page strategy that talks about treatment tomorrow, maybe, and live in my own little fantasy world, dreaming that perhaps a few million quid for treatment might fall off the back of a beer lorry owned by some of those nice alcohol industry people. Meanwhile, in the committee chambers and conference halls, we talk about the criminal and the victim as if they are always separate entities, and fail to set a permanent place for the end user at the policy table for fear she might slur her words.’

Culture change needed to tackle binge-drinking
‘A cultural shift is the only way to change British drinking habits, according to Dr Jane Marshall, consultant psychiatrist at the National Addictions Centre. ‘There’s a reticence to consider a link between alcohol and violence,’ she said. Doorkeepers still keep serving people who are worse for wear… We laugh at drunk people for doing crazy things.’
(News item)

Abstinence or harm reduction?
Neil McKeganey, professor of drug misuse research at the University of Glasgow was involved in research – discussed here in his article – which the Scottish Drugs Forum (and many readers, through letters and articles) called ‘unhelpful and manipulative’…

‘In Scotland over 1,000 drug users were asked about the change in their drug use that they were seeking to bring about on the basis of having come forward for treatment. Almost 60 per cent of the drug users interviewed said that the only thing they were aiming for was to become abstinent from the drugs to which they had become addicted. Less than 10 per cent of those interviewed identified harm reduction as the sole change they were looking for. On the basis of these results, it is abstinence not harm reduction which reflects drug users aspirations from treatment. These findings have touched a raw nerve…

‘Rather than simply asserting that our harm reduction services are achieving both reduced harm and the recovery from addiction, we had better start to find out if this is the case in reality. I suspect that it is not, and that we have prioritised harm reduction at the expense of abstinence.’

DDN is still brought to you (entirely free of charge!) by Claire Brown, Ian Ralph, Jez Tucker, David Gilliver, and our new web editor Carly Woodhead. We’d love to hear from you, especially if you’ve been with us over the years – and even more so if DDN has made a difference to your working life and career. Maybe you found your job with us!

Picture this…

DDNWeb

November 28, 2024

My name is Bobby and I’m an addict. I’m 42, originally from East London, and I work as a recovery and dependency practitioner.

After a 20-year battle with cocaine addiction, which ended with my using drugs every single day against my own will, I’m pleased to say that thanks to regularly attending 12-step meetings, getting a sponsor armed with the facts, and working through and continuing to practise the 12 steps in my life every day, I have now been clean and sober for nearly five years. Moreover, I am happy.

My life used to be so dark, hostile and full of depression, anger, fear and rage. Today my life is peaceful, vibrant, content and filled with hope and gratitude.

Step 12 states, ‘Having had a spiritual awakening as a result of these steps, we tried to carry the message to the still suffering addict and to practise these principles in all of our affairs.’ I have always been a creative person, but was always too scared of what others would think to actually share my work. Now I’m using my creativity to practise my Step 12 and share my experience of hope, faith and courage with others.

My dream is for one person to see my comic, to relate to it and to seek out a 12-step meeting for themselves.

If I can recover from addiction one day at a time, then so can anybody. There is a podcast on my website – if you’re struggling then please listen to our stories, see if you can relate and if so, get yourself to a 12-step meeting in your area.

Or get in touch and I will help point you in the right direction as much as I can.

Read Bobby’s comic book story here

Government confirms compulsory levy for gambling operators

News

DDNWeb

November 27, 2024

The government has confirmed its plans to impose a statutory levy on gambling company profits. The compulsory levy will ‘generate £100m for the research, prevention and treatment of gambling harms,’ says the Department for Culture, Media and Sport (DCMS), with half of the money going into the NHS-led gambling treatment system.

The levy, which was first announced in last year’s poorly received gambling white paper, will be charged to all licensed operators and the money raised will be ringfenced, says DCMS. The government will also introduce stake limits for online slot games, set at £5 per spin for over-25s and £2 for 18-24-year-olds. Online slots are considered a higher-risk product ‘associated with large losses, long sessions and binge play’, DCMS states.

The levy – which will replace the current voluntary arrangement that sees some companies paying ‘as little as £1 a year’ – will be charged at a set rate of between 0.1 per cent and 1.1 per cent of gross gambling yield (GGY) or equivalent, for all holders of a Gambling Commission licence, says DCMS. The new levy system will be subject to formal review within five years.

gambling levy — ‘Gambling harm can ruin people’s finances, relationships, and ultimately lives’

In addition to the 50 per cent of funding generated going to NHS England – alongside Scottish and Welsh bodies – for a ‘comprehensive support and treatment system’, another 30 per cent will go towards prevention activities such as training for frontline staff and public health campaigns. The remaining 20 per cent will go to UK Research and Innovation (UKRI) and the Gambling Commission for research to ‘inform future policy and regulation’.

‘Gambling harm can ruin people’s finances, relationships, and ultimately lives,’ said gambling minister Baroness Twycross. ‘We are absolutely committed to implementing strengthened measures for those at risk, as well as providing effective support for those affected. The introduction of the first legally mandated levy will be instrumental in supporting research, raising awareness and reducing the stigma around gambling-related harm. We are also helping to protect those at risk, with a particular focus on young adults, by introducing stake limits for online slots. These measures will help build an NHS fit for our future and strengthen protections whilst also allowing people to continue to gamble safely.’

Prevention-based alcohol strategy urgently needed, say health professionals

News

DDNWeb

November 27, 2024

There is an urgent need for a new national alcohol strategy with a ‘strong focus on treatment and prevention’, says a new report from the Medical Council on Alcohol (MCA).

The need for a health system response to alcohol-related harms also calls for better access to community-based alcohol services, which ‘reach fewer than one in five people with alcohol dependence’, as well as more funding for alcohol care teams in acute hospitals.

Integration of care pathways also needs to be improved, the document states, to make sure people with complex needs get the right support. More than 70 per cent of adults and almost half of young people entering alcohol treatment also require mental health treatment, the report points out, while just under half of people who died by suicide while under the care of mental health services in the decade to 2020 had a history of problematic alcohol use.

Prevention-based alcohol strategy — Without action, alcohol harms will be an ever-increasing burden on health services

The last alcohol strategy was published 12 years ago. However, 2022 saw more than 10,000 deaths from alcohol specific causes registered in the UK, according to ONS figures – the highest number ever recorded. Alcohol is the leading risk factor for premature death and illness among 15-49-year-olds in England, MCA points out, and ‘disproportionately affects the most socially and economically disadvantaged, exacerbating existing health inequalities’.

Without action, alcohol harms will be an ever-increasing burden on health services, says MCA, which is an independent charity of health professionals that is ‘not primarily a campaigning organisation’. However, its members have been involved in the creation of various alcohol-related guidelines, including the NICE quality standards and the UK alcohol treatment clinical guidelines.

The report ‘reinforces what we already know – alcohol-related harm is a growing and preventable crisis,’ said lead author and professor of addiction psychiatry at the University of Southampton, Julia Sinclair. ‘While alcohol consumption is often normalised in our society, the scale of its impact on health and social inequalities cannot be ignored. Now is the time to act decisively to reverse these trends, or we risk placing an even greater burden on our health system and losing more lives unnecessarily.’

Meanwhile, the tobacco and vapes bill has passed its commons vote by 415 votes to 47, meaning the legislation will likely become law. ‘Ending the harms from smoking is not a party-political issue; it is backed by voters of every political persuasion,’ said ASH chief executive Hazel Cheeseman. ‘This was clearly shown in tonight’s debate, where MPs from across the political spectrum voiced their support for phasing out the sale of tobacco to future generations.’

More than 240 people died while homeless in Scotland last year, according to the latest records from National Records of Scotland (NRS), with the number dying from drug misuse increasing from 89 to 100. Almost 80 per cent of deaths were among men. ‘Half of homeless deaths in 2023 were people aged under 45, with the most common age group for both female and male deaths being 35 to 44,’ said senior assistant statistician Beth Watson.

MCA report available here

NRS figures available here

On the brink

Features

DDNWeb

November 26, 2024

Despite significant investment in drug treatment in recent years none of this funding has reached residential treatment services. This failure, combined with short-term and sporadic funding processes, has led to England facing the loss of its last residential family treatment service. Tragically, this means that more families will suffer from a treatable condition and children will be separated from their parents, creating unnecessary intergenerational trauma.

Phoenix announced the closure of the National Specialist Family Service based in Sheffield in October. Unless sustainable funding can be secured in the next month, the service will close early in the new year. As we contemplate the loss of the last of these vital services we look back on their history and consider why parents with substance use needs are excluded from effective care.

Repeated evaluations have found that residential family drug and alcohol treatment services are very successful at helping parents overcome their drug and alcohol use, supporting them to become safer and more effective parents and successfully resettling them back into their communities. Longitudinal studies also show that the families stay together in the long term – completion rates for family services are high, at an average of 86 per cent. There is a growing body of research to demonstrate the impact of whole-family interventions for families where parents experience addiction.

There is now only one residential service in England that can provide drug and alcohol treatment to parents whilst they care for their children. That service is at risk of closure despite the evident need for the service and the high quality of provision. The key issue Phoenix faces is that spot purchasing of placements (ie pay-by-night per resident funding) is a block to both access and sustainable provision.

Spot purchasing means that each family has to argue their case for an individual funding package across budgets that span adult and children, rehab and social services. It is complicated for families in need of urgent support and already overburdened social workers. Spot purchasing also means that providers are living hand to mouth, unable to plan for any guaranteed income despite having significant fixed costs. It’s a quirk of history that means – unlike most specialist care services and community drug treatment services – the family service is funded by referrers, with their own budgetary and operational pressures, rather than funding the residential provider directly.

Phoenix Futures opened its first family residential service in 1987. Since then, thousands of parents have been able to address substance use issues in a residential setting while they take parental care of their children. Over the last 40 years Phoenix has developed specialist family residential units in London, Brighton, Bexhill and Sheffield. We established the services in response to the need for parents and pregnant women to be able to access intensive treatment without being separated from their children. This treatment option encouraged more parents to address their addiction, reducing trauma experienced by children and their families.

Family rehab programmes recognise the integral role of family in the recovery process and provide valuable support, education, and resources for both the individual struggling with addiction and their loved ones. By addressing family dynamics and relationships, these programmes contribute to improved treatment outcomes and enhanced quality of life for everyone involved.

The National Specialist Family Service provides a unique opportunity to offer parents the core benefit of treatment alongside specialist parenting and childcare. The service supports families to achieve a range of outcomes specifically for them, such as improved communication skills to help resolve conflicts, rebuild trust, and improve relationships among family members. Addressing underlying issues within families – such as trauma, codependency or enabling behaviours – can establish and reinforce healthy boundaries within the family dynamic.

Addiction often strains relationships and causes emotional pain and conflict within the family. Family rehab programmes provide opportunities for healing, forgiveness, and reconciliation, allowing family members to address past harms, rebuild trust, and strengthen their bonds.

Evidence shows that investment in addiction services for parents delivers safe, effective treatment as well as significant value for money to the public purse. Research shows that these services break the intergenerational transfer of drug and alcohol use from parents to children. These services also create a network of family-focused resources including maternity care, specialist midwives, health visitors, perinatal mental health, GP services and more, all accessed from one residential setting.

It’s devastating that all this will be lost because of a failure to create a simple funding mechanism that works for families and their professional support.

James Armstrong is director of marketing and innovation at Phoenix Futures

Further reading: Five years on and nothing has changed, by Karen Biggs, chief executive, Phoenix Futures

MPs to vote on tobacco and vapes bill today

DDNWeb

November 26, 2024

MPs are to vote on the tobacco and vapes bill today, the government has announced, moving the UK ‘one step closer to becoming smoke-free’.

The bill was introduced to Parliament earlier this month, having been first introduced by the previous government but subsequently shelved following the announcement of a July election.

The bill includes proposals to phase out the legal sale of tobacco to anyone currently 15 or younger, along with ‘ambitious plans to protect children from vaping’, including restrictions on flavours, packaging and retail displays, as well as a ban on advertising and the sale of vapes in vending machines. The bill will be backed by an additional £70m of support for stop smoking services, the Department of Health and Social Care (DHSC) states.

‘Subject to consultation, the sale of vape flavours that overtly appeal to children – such as bubble gum, gummy bear and cotton candy – could be brought to an end, alongside restrictions on vape packaging that is designed to appeal to young people,’ says DHSC. The ban on vape advertising and sponsorship will bring regulations in line with those for tobacco, it adds.

The bill will also give the government powers to extend the existing indoor smoking ban to some outdoor spaces, including children’s playgrounds, and outside schools and hospitals, again subject to consultation.

MPs to vote on tobacco and vapes bill today — ‘Without urgent intervention we’re going to have a generation of children with long-term addiction’

‘The number of children vaping is growing at an alarming rate and without urgent intervention we’re going to have a generation of children with long-term addiction,’ said health secretary Wes Streeting. ‘It is unacceptable that these harmful products are being deliberately targeted at children with brightly coloured packaging and flavours like “gummy bear” and “rainbow burst”. The tobacco and vapes bill provides the protection that children and young people need to avoid a life imprisoned by addiction. That’s why it’s so incredibly important it is voted through.’

‘Every day around 350 young people start smoking, and two thirds of long-term smokers will die due to smoking,’ added ASH chief executive Hazel Cheeseman. ‘Passing this bill is a vital way the government can start to end the unprecedented harm caused by tobacco, protecting the health of the next generation by ensuring they won’t become addicted to smoking. Alongside the legislation funding is necessary to help the millions who currently smoke to quit and accelerate the creation of a smokefree country, and the announcement today is welcome.’

Meanwhile, the government is planning to confirm a compulsory levy on the gambling industry ‘as soon as this week’, according to the Guardian. The levy, which would force companies to pay a small proportion of their profits towards gambling treatment, research and prevention, would come into force next April. The proposals formed part of the government’s controversial gambling white paper, which was published in April last year.

See tobacco harm reduction feature in November’s DDN and gambling feature in the December-January issue

Five years on and nothing has changed!

Partner Updates

DDNWeb

November 25, 2024

In November 2019 I wrote a blog called ‘no apology for my outrage’ which announced the start of the closure process for a women’s residential treatment centre in London called Grace House, writes Karen Biggs, chief executive of Phoenix Futures.

In that blog I spoke of the systemic issues that were preventing women from accessing residential treatment in a service that had just been rated as outstanding by CQC. The service closed in early 2020.

Five years later almost to the month I started the consultation process for the National Specialist Family Service based in Sheffield. You may have seen the service featured in a 2017 documentary broadcast on BBC2. Sadly, that consultation was to close the service, the last remaining residential substance use treatment option for families.

In the intervening five years I have been highlighting what is wrong with the way we fund and access residential treatment in this country. And despite the Dame Carol Black review agreeing the system is broken and needs funding reform and despite firm commitments in the drug strategy to correct those failures, nothing has changed.

So why are we facing the closure of the last remaining drug and alcohol treatment option for families?

There are three reasons:

The unnecessarily complicated process faced by families wanting to access the service, having to navigate multiple funding streams, that design-in barriers rather than creating opportunities for engagement and assessing clinical need.
The huge reduction in residential rehab funding in recent years – despite the significant investment in the wider treatment sector no additional money has come into the residential treatment sector.
The challenges women face in approaching social services for support is driven by stigmatising approaches and the genuine risk of their children being taken into care.

It is not because:

Women don’t want to access the service – not all mums who use drugs or alcohol want to access residential provision of course, but many do.
The service isn’t of a high enough standard – it is rated outstanding by Ofsted for its childcare provision and achieves 85% completion rates.
There isn’t an evidence base for residential treatment.
It doesn’t deliver value for money – our most recent Social Return on Investment report shows that Phoenix’s service alone has saved £14 million for the state over the last three years.

When I had to close Grace House many people said to me afterwards – ‘I didn’t realise it was that bad if only you had come to us and asked for help.’

Therefore, I have been asking government commissioners and the sector for help to save this service for the last 18 months because if we don’t:

Women and their children will have no residential treatment option in England.
Pregnant women who use drugs won’t have any 24/7 treatment option to support them through to the birth of their child and beyond.

So what is the solution?
There are many alternative funding options but it will mean compromise and the current ‘gatekeepers’ of residential funding will need to change.

But the bottom line is this, as a sector we need to recognise the value of specialist treatment options for women and fund them appropriately and securely so:

Women can access them when they need them and aren’t shamed into the shadows.
More children aren’t unnecessarily removed from their families to face their childhood in the care system.
We don’t create more intergenerational trauma that ruins lives and has significant consequences for our health and social care system for years to come.

Can you help?
If you’re able to support us to avoid the closure of the National Specialist Family Service based in Sheffield, please do get in touch by emailing Karen.biggs@phoenix-futures.org.uk

This blog was originally published by Phoenix Futures. You can read the original post here.

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

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

This content was created by Phoenix Futures

A flexible approach to work

Features

DDNWeb

November 25, 2024

I was a heroin addict and alcoholic of the ‘hopeless’ variety, frequently stealing bottles of wine for breakfast in an attempt to stave off the anxiety of withdrawals until my dealers switched on their phones. Like many heroin addicts, I was incapable of functioning before my morning fix – unable to move from the sweat-stained sofa and unwilling to engage with life, barring the aforementioned shuffle to the off licence and payphone (obviously, I never had credit).

Paradoxically, as soon as that text came through – the one signifying chemical salvation, that simply said ‘on’ – I would leap into action, capable of crossing mountains (I was previously an addict in Snowdonia and did, literally, this).

This was me during my Exchange Supplies years (DDN, September, page 14), my whole ten years of working for the company – broken, desperate and, even worse, egotistical to boot. Senior management had a background of working directly with drug addicts and worse still (for them) a social conscience. This led to a conflict of purpose – mine the endless, selfish demands of addiction, theirs a commitment to do the right thing. At times this led to farcical situations which would have been comical if we weren’t dealing with ‘life-saving’ consequences.

Myself and a couple of other employees were active addicts who, by the nature of our condition, had a very clear agenda – primarily, to stop the withdrawals. This took priority over everything. For me, it came before food, hygiene, bills, childcare, the truth, the law, self-respect – everything. They say withdrawals are objectively like the ’flu, and there’s some truth in this. But imagine a ’flu you KNOW you’re going to catch every single morning. Recollect the poorliest you’ve ever felt, and now I’m going to tell you that I could relieve that for just £10. This is the compulsion that drove me as an addict.

Different priorities
Once I was well, a different priority emerged – getting more drugs and maintaining that high. Not so desperate but still a priority, albeit one that could now be overcome with a rationale and tempered by commitments. Ever-present but not so all consuming.

I’m referring primarily to heroin addiction. Many parallels can be drawn with other addictions like alcohol or benzos, but I recognise that crack cocaine presents a different experience. For me, crack was an extra, a payday treat (alright, mostly a daily treat), but one I would forgo in favour of the necessity of heroin.

This was the emotional soundtrack of my using. The objectives of Exchange Supplies as a social enterprise included offering employment to active addicts, providing self-respect, structure and stability, and promoting both personal and societal worth. Did this help me? Yes, no and maybe – it depends what you mean by help and how it’s measured.

flexible employment policies — Stuart had his 3.5 foot long dreadlocks cut to raise money for Shelter – and to see his old habits ‘float away’

Working for Exchange Supplies coincided with the worst period of my using career, although the next decade was also pretty bad. I’ve always categorically stated that this job kept me out of gaol and free from blood-borne viruses. Obviously, I can’t know this for sure. What I do know is the income kept me from making more desperate decisions, and having my time filled countered the lack of purpose that only ever exacerbated my addiction. Having a constant supply of injecting paraphernalia without the ball-ache of visiting my local drug agency was also a bonus.

A new normal
While I’d injected a handful of times before working at Exchange Supplies, regular injecting became the norm soon after joining the team. Was it the normalisation and desensitisation of injecting practices and paraphernalia? This was definitely a factor, but we will never know if or when I would have began injecting if I hadn’t taken the job. I’m most definitely not suggesting any culpability. The truth is, I was strong willed and pig-headed, well aware of the facts (if not the consequences) when I made my drug taking choices. However, my brief for this article was honesty around working at Exchange Supplies and the impact of their accommodating employment policies – and this is my truth.

Perhaps the most significant employment issue which needs to be considered when knowingly employing addicts and attempting to flexibly cater for their needs is the risk of ‘enabling’. Did Exchange Supplies’ employment policies prolong or even facilitate my addiction and alcoholism? Among other things, they allowed for flexibility in my punctuality. Time off to score and inject. A more tolerant attitude – although not carte blanche – for me to work whilst intoxicated.

Continuing to employ me during periods of sub-standard work also gave me the finances to use more, and even working with other addicts could have been seen as helping me build up a drug using/scoring network. It’s also significant that this was mirrored in my home life – the importance given to holding down a job led to loved ones lending me money to score and looking after drugs for me – simply to ensure I got to work.

Better or worse?
There are some massive issues here – I asked Andrew, the managing director at Exchange Supplies, if they ever questioned whether they thought they were enabling me. ‘It was pretty much a daily question’, he joked in all seriousness. He then proceeded to say he tends to avoid using the word ‘enable’, and I know what he means. There’s very little that would have stopped me from using barring a drug drought, and although ‘powerless’ over my addiction I had enough agency to beg, borrow and steal (and a few other options in my arsenal – including bottles of cough syrup and dried poppies, both of which would stupefy a non-user, but barely touched the sides for me).

Poignantly, he proceeded to tell me he’d rather pose the question ‘to what extent and in what ways are we making things better or worse?’

I’d definitely say it was psychologically beneficial to be in work, and I was proud of both my job and my employment status. It added a semblance of structure and order to my life – no mean feat. The wage took the desperation out of my using – I’ve already mentioned avoiding gaol and disease. A good analogy I think is one of those extendable dog leads – at times they probably drew it in too short, at others they definitely allowed me to run too free. Andrew continued, ‘Sometimes there was a fine line to tread between keeping you engaged, and giving you enough time and money to make things worse… we could have “enabled” you less, the reason we didn’t was that, in my judgement, we could have lost contact with you… and without our enabling (which came linked to income, structure, support), things could’ve been even worse, and therefore more dangerous.’

These dangers were highlighted by an Observer article earlier this year which stated: ‘UK drug users are 13 times more likely to die than their European counterparts…the urge to punish drug addicts doesn’t make them go away. It just entrenches them in their misery, dependent on state provision, unable even to begin to help themselves.’

What is success?
In many ways I was part of an employment experiment – run on good intentions and that definitely made mistakes, during which I happily took the piss. Was it a success? If the intended result was to get me clean and sober as quickly as possible, it failed miserably. However, if the aim was to improve my quality of life as a using addict, or, the unquantifiable aim of being a bridge to normal living, providing some of the tools and learning which contribute to where I am today, it was an unqualified success.

I didn’t achieve sobriety during my period working for Exchange Supplies, but there were some who did. But should lifelong abstinence be our only yardstick? We know rehabs have a woefully low ‘success’ rate when measured by long-term sobriety. Should we instead be looking towards intangibles, such as seeds sown, quality of life, compassion and personal connection? Aren’t these elements of the human condition, so difficult to measure, the real markers of success? Especially if, like me, a key factor of recovery was the journey of addiction itself.

In retrospect, would I have advised Exchange Supplies to deal with me exactly as they did? No, and I doubt Andrew would either. I would, however, fully support the overarching policy of their employment model. This is essentially the same as when I was employed, just tweaked – with many of the spanners I threw removed, polished and ready to be used more appropriately. Am I glad I was treated exactly like I was, with some of its beautifully flawed judgement calls? 100 per cent.

Stuart Lloyd is several years into recovery and has become a writer

Working for ten years in West Dorset as a community drug worker during the ‘90s as heroin arrived in our community, and setting up needle exchange and methadone prescribing with local GPs, was a fascinating place to be.

Building long-term relationships with people, and helping them with their struggles with drugs, employment, and employers deepened my conviction that there’s a huge amount of wasted talent amongst the community of people who use drugs, and that the feudal levels of power given to companies and managers under capitalism are wrong and widely abused.

It was so clear to me that the simple facets of employment – such as conduct and time-keeping – could be herculean struggles for people who use drugs, and which could be made so much easier with a bit of compassion, understanding and flexibility.

At the time, I never thought I would ever be able to do anything about it or prove that these beliefs were right, but in the early 2000s, as a harm reduction activist, I had taken on the task of sourcing citric acid sachets for people who inject and soon found myself needing help with the warehousing, packing, and distribution. I had no hesitation in knocking on the doors of former clients to ask if they wanted to come and work with me, and so began a 20 years of developing a practice of employment policies that enable us to benefit from the experience, skills, knowledge and networks of people who use drugs, and retain them in our workforce.

employer employee I hadn’t been Stuart’s caseworker, so I didn’t know him when he replied to the ad we’d put on the notice board at the drug service – but it soon became clear he had in spades all of the issues that I’d seen make it so hard for other people who were opiate dependent to stay in employment.

I totally respected his determination not to be exploited by capitalist bosses, although we all sometimes wished he’d pull his finger out and do a bit more actual work as, over time, we began to learn to balance the need for support with the ability to provide support. We also learned how to be well enough staffed for the work to be meaningful, but not so ‘efficient’ that people being off heaped guilt on them for letting people down, and built stress and resentment amongst their colleagues.

Stuart’s degree was in linguistics, and if there was a PhD in pedantry, he’d have one. This was (kind of) great for me – if I set a boundary, he’d test it. If I was inconsistent, he’d point it out. If something wasn’t fair, he’d make sure everyone knew.

I didn’t always appreciate it at the time, but it’s no bad thing for everything to be tested to the limit. It accelerated the learning, and the after-the-fact analysis of successes and failures helped us form our compassionate collective responses to all the tricky issues that can arise – lateness, leave, absence, intoxication, and drug use on the premises – into a coherent, personalised, but consistent harm-reduction informed framework that really works.

We may not have always got it exactly right – there’s always what if’s – but we are clear that without the structure, meaning, support and something/someone to fight against over those ten years the path for Stu would likely have been much darker with, as he says, hepatitis C, overdose and prison all likely outcomes.

The value of having people who are part of the community we serve as part of the workforce can’t be overstated. The access, knowledge, commitment and connections they bring are invaluable, and the lessons we learnt with Stuart have made things a lot smoother in the years since for us. And, I’m sure, for him too.

Andrew Preston is the founder/managing director of Exchange Supplies

Adfam at 40 – Chris Lee: ‘one of the most stigmatised healthcare conditions in the country’

Partner Updates

DDNWeb

November 22, 2024

This year marks a special year for Adfam as we celebrate our 40th year. Throughout 2024, we have been reflecting on the past 40 years, the progress that has been made in supporting families affected by substance misuse, as well as looking to the future.

Through a series of articles over the course of the year, Adfam has spoken to a range of key individuals active in supporting and advocating for families affected by substance misuse.

For our latest ‘Adfam at 40’ article we speak with Chris Lee, director of strategy and partnerships at Change, Grow, Live, who previously also worked as a drug and alcohol commissioner in Lancashire.

Fascinated by the breadth and complexity of the topic
Chris has been working in the drug and alcohol sector since the late 1990s and his first exposure came after completing a degree in psychology, taking on the role of assistant psychologist within a local community drugs team. He remembers turning up for his interview in a suit, attracting some puzzled looks in the waiting room! Chris was bitten by the topic almost immediately and immersed himself within the sector. He quickly moved to become a frontline worker, then a team leader, before studying a masters in drug use and addiction, taking on a service manager role in a criminal justice service, then moving into commissioning in Lancashire where he stayed for many years, before taking on his current role at Change, Grow, Live.

‘It’s just rolled over the years, the longer I do it, the more fascinated I am by the whole breadth of the complexity of the topic. It’s not a single-issue thing, it touches every walk of life. I find it hard to know how you can’t be fascinated by it.’

In the early days, Chris has vivid memories of the family dynamics that would often arise when working with service users. He describes often seeing parents of substance using children at the end of their tether. Seeing it with his own eyes was an early indicator and expanded the notion for him that addiction is not an individual problem.

Chris felt somewhat ill equipped in dealing with and responding to some of these issues at the time. Where training for frontline professionals is far more rigorous now, back then it was more of a case of learning on the job. However, Chris took those experiences with him as his career progressed, determined to champion the needs of families within each of his roles. When he became a commissioner in Lancashire, responsible for thinking about the design of services and looking at things from a systems perspective, he made it a priority to include families.

Challenges getting families on the agenda
Chris suggests that the drug and alcohol treatment agenda is probably one of the most stigmatised healthcare conditions in the country. There are very few other healthcare conditions where people are so marginalised, excluded and out of the mainstream. Families are very much subjected to that stigma too, and where society stigmatises the agenda, it’s no wonder that at a policy level it doesn’t get the consideration it should. Chris hopes that, under the new government, families will get more recognition through the national drugs strategy.

This isn’t through want of trying, there have been many publications and efforts in the past arguing for greater inclusion of families, but the lack of funding available within the drug and alcohol space has often proven a stumbling block. Looking at the envelope available to fund treatment services, even with the new money in the system, there’s not enough there to offer treatment at the level it should be, and the money that should be there for families isn’t filtering out.

‘The elephant in the room is funding. Drugs strategy money has been eroded by the cost-of-living crisis and rampant inflation. It can’t deliver on what it has set out to deliver. From when it was written down, the world has changed since then. It’s not worth what it should have been.’

Chris has long argued for a national service specification which would cover a whole remit of things that should be included within a treatment system, and families ought to be a key part of that.

Services working in collaboration is another important factor in ensuring families, and other issues relating to substance use are recognised and addressed. It’s important to see how one organisation with a specialist set of skills can align with another, and Chris highlights a joint service between Adfam and CGL in Gateshead supporting families affected by substance use, as an example of this.

‘I would love for us to be in a situation where the sector collaborates rather than is deemed to be in competition all the time. People can be specialists in certain areas and work together.’

Looking ahead to the future
Chris goes by the notion that as professionals in the sector, we should never think that we’ve done enough, nor assume that we’ve done it well enough. We should always be looking to improve, develop and to do things better for the people we are here to support.

He describes some of the stunning work he’s seen in the sector over the years, particularly during austerity with scarce resources at play, and how inspiring it still is to see so many workers go the extra mile. There are a lot of people working in the drug and alcohol sector who genuinely care, and a lot of people who really need the help they provide.

Looking ahead to the future, for things to really change, we desperately need to tackle the stigma targeted at people affected by substance use and their families, which is still so great.

‘I’m not saying they are more or less worthy than others in society, but they are equally worthy than others in society, and that’s the point.’

There are also questions we as a sector need to constantly ask ourselves in order to improve. How can we make the lives of workers better? How can we make the offer at the front door better for service users and families? How can we reframe the population health change that we need to do?

While government has put money in, it’s still not enough to make the changes that are needed. Even with the drugs strategy money on the table, we are still only at the 2018 equivalent levels of funding, according to research undertaken by the Health Foundation, leaving us several years behind where we should have been. Those that are in the sector are going to have to continue working really hard to ensure people affected by substance use and their families get the support they need.

Chris Lee is Director of Strategy and Partnerships at Change, Grow, Live. For more information about CGL visit changegrowlive.org

This blog was originally published by Adfam. You can read the original post here.

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

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

This content was created by Adfam

Community champions

DDNWeb

November 22, 2024

Over the past 12 years Red Rose Recovery has gone from strength to strength, spreading roots across the North West. We asked them to share their story.

A need to nurture
Founded in 2012 to build recovery infrastructure in Lancashire, Red Rose Recovery has become nationally recognised as a pioneering organisation in developing recovery systems and creating opportunities for people affected by substance misuse, mental health and offending behaviours. RRR’s founding purpose was to provide employment opportunities to people marginalised by society, and the lived experience model is in RRR’s DNA – it now employs more than 120 people with experience of addiction, the criminal justice system, homelessness, or other complex issues. As a LERO, RRR staff’s relatable experience provides inspiration and hope to people who are struggling to find a way forward.

Core to RRR’s model is the relationship it creates with each individual – it offers inclusive, accessible, person-centred, trauma-informed and co-produced services with people at all stages of recovery and has a strong track record of collaborating with recovery community partners to enable new groups to emerge and grow. It recognises that the greater good of our communities is best served by having a broad range of groups and activities and is committed to building healthy community ecosystems across the UK – as shown by the infrastructure support provided to the emerging LERO and user forums across the North West.

Mike Wearden, managing director, Red Rose Recovery

Every voice is heard
As a true lived experience organisation, 97 per cent of Red Rose Recovery’s staff have lived experience of multiple disadvantages, with an organisational culture that believes in people and their capacity to change and grow. We help to advocate for those who are continually stigmatised and marginalised, with the aim of changing the narrative. Our community is one where every voice is heard, and those seeking treatment have a say in what their treatment looks like – a community where power is shared and learning passed on.

We have forged excellent relationships with commissioners in Lancashire and beyond, built on trust and mutual respect. Twelve years ago, Lancashire County Council public health commissioners took a leap of faith in establishing the Lancashire User Forum (LUF). Its aim was to give a voice to the voiceless and create a platform – not only for Red Rose Recovery to be born but for an independent space to thrive.

The LUF isn’t owned by anyone, it exists to serve the community and Red Rose Recovery merely lends its infrastructure to aid in its running. We have proved that the model can be replicated and is sustainable beyond the individual – and that by identifying leaders in other geographical areas, they can be nurtured and empowered to create change. Recovery is sustained when we reach back for those behind us. We have a responsibility to pass on what we have learned, to empower the community as a whole, to lend our infrastructure to those next in line, to support with training and development, and to help create seats at the tables of power.

Now we have established recovery communities in not only Lancashire, but also in Blackburn with Darwen and North Yorkshire, with other areas to follow soon. Our proven model, underpinned by belief from commissioners and involvement of the grass roots community, takes a lot of hard work, but the results are there for all to see.

Sarah O’Mara, RIO contract lead and team leader north, Red Rose Recovery

A successful model
The Lancashire User Forum (LUF), supported and underpinned by Red Rose Recovery (RRR), has been a model we have long aspired to see replicated across the country. My focus is on identifying spaces where individuals with lived/living experience and organisations can collaborate with us to build all-inclusive communities, and where people feel empowered to develop a strong sense of identity that provides them with a stake in society.

This identity is grounded in solid systems, processes, and resources, ensuring that individuals not only receive support but also become active participants in shaping it. We foster meaningful relationships, challenge stigma, and create pathways for both personal and collective growth.

Our emphasis on the Five Ways to Wellbeing – connect, be active, take notice, keep learning, and give – ensures that we are fostering holistic health and wellbeing. We focus on the strengths and potential of individuals and communities, rather than on deficits. The LUF model, with its emphasis on collaboration and empowerment, has demonstrated significant success and our aim is to continue building supportive, inclusive systems that help people to thrive and contribute to their communities.

Peter Yarwood, director of strategic engagement and training, Red Rose Recovery

Spreading our roots
Roots Community is the Blackburn with Darwen recovery forum started up in May 2022 to support and mobilise the recovery community locally. Our co-produced aims are to connect those in recovery with others; improve engagement in activities that enhance wellbeing; empower the community through a voice in decision-making and service provision; provide opportunities through employment, training and volunteering; and inspire hope in those seeking recovery, professionals, family members and the wider community.

We do this through a calendar of ten regular weekly activities including community clean-ups, a guerilla gardening project, cooking, gym, fishing, goal-setting, music sessions and planning meetings. We also have representation at operational delivery group meetings, a place on the BwD Community Network Board and regularly involve Roots members in consultations with NHS, service providers, mystery shopping exercises and research projects that shape service delivery.

Our members are drawn from all stages of recovery/pre-recovery, with no requirement to be abstinent or subscribe to specific recovery models or activities. All we expect is mutual respect and adherence to reasonable behavioural boundaries.

Rolonde Bradshaw, team leader, Roots Community Recovery Forum

Let’s mobilise
Project FREE is a very small LERO in Bury, Greater Manchester which for nearly two years has been supporting men coming out of prison to resettle effectively in the community. It hasn’t been directly commissioned by any organisation or authority but has grown from local recovery networks. Several small public sector grants and private donations have enabled venue hire, refreshments and volunteer expenses to run drop-ins, group sessions and activities.

It came about because Bernard, the project co-ordinator, wanted to invest his own recovery capital in helping people stuck in a pattern of substance use and offending behaviour, as he was for many years. He used his friendships and connections to mobilise support and establish a monthly steering group for strategic direction.

So far so good for Project FREE – the power of lived experience in helping people make and sustain positive change is undeniable and learning from other LEROs like Acorn Recovery and Red Rose Recovery has been invaluable. These larger groups have a responsibility to incubate ‘micro-LEROs’ and create opportunities for people like Bernard and his volunteers. Perhaps we overthink how to incorporate lived experience into the overall system and should focus on creating an environment where relationships can grow and ideas can be put into action.

Tom Woodcock, Project FREE steering group member, chair of RRR board

A unique opportunity
North Yorkshire Connected Spaces is a LERO that sits under the umbrella of Red Rose Recovery. At the heart of every recovery journey is a story – one of resilience, struggle, and eventual triumph. As a LERO we are more than a support network – we are individuals who have walked the same path.

We believe that those who have lived through addiction and recovery are uniquely positioned to offer guidance, understanding and hope to those currently struggling – sharing experience fosters a deep sense of trust and connection. Each member of our team has faced the challenges of addiction, sought recovery, and is now dedicated to helping others. We understand the fear, uncertainty, and shame that can come with addiction – and we know the incredible transformation that recovery can bring. Research shows that peer support can significantly improve outcomes, increasing engagement, reducing relapse rates, and fostering long-term sobriety.

We offer hope to those who may feel isolated or hopeless. Moreover, as advocates, we work to change the narrative around addiction, shifting the focus from punishment to recovery, from stigma to support. Together, we can transform lives and communities, one story at a time.

Emma Plant, NYCS community engager

New campaign: Addiction Awareness Week #AAW24

Partner Updates

DDNWeb

November 19, 2024

Addiction Awareness Week is the cornerstone of the Taking Action on Addiction campaign.

Now in its fourth year it provides a period of intense focus on addiction and recovery, its impact on people, families and society in the media, social media and public debate. By spotlighting real stories through new research, events and emotional, compelling storytelling, we are able to change misunderstanding and enable more people to speak openly about their experiences.

During the week of 30th November – 7th December, we will deliver a range of activities to drive interest and awareness of our national campaign. Through our emotive and thought provoking activations we want to generate more conversations on addiction in the media and social media than we have done before.

With your support we can continue to highlight the everyday nature of addiction – that it affects everybody. While addiction can involve tragic consequences, this year we will highlight the hope that recovery is possible.

By building digital communities of support we will make it acceptable to share, to speak out, to show empathy. It will help to de-stigmatise addiction and all it encompasses, one strong step at a time – helping people living in the grip of addiction to see that they are worthy of support.

Get involved – download our social media toolkit
If you’d like to support this year’s campaign on your social media channels you can use our new social media toolkit.

This blog was originally published by Taking Action on Addiction. You can read the original post here.

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

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

This content was created by Taking Action on Addiction

The age of overwhelm

Features

DDNWeb

November 18, 2024

Advances in technology have propelled young people – and their problems – into a different age, so how can we reach them? DDN reports from Cranstoun’s social justice conference.

‘What are your biggest challenges?’ This question brought a range of answers from young people, said Vicky Branch, Cranstoun’s head of children and young people. Mental health, loneliness, access to services, waiting lists, substance use, bullying, violence… many issues emerged and many were not being addressed early enough before becoming problematic.

So how could we think about earlier interventions? Young people’s centres were being closed and there was a lack of inclusive social spaces and activities. Simple steps made a big difference – Routes had been created as a youth hub from free space in Dudley’s Merry Hill shopping centre. With Cranstoun’s innovation fund it had become an open access, walk-in service and a safe space for help, support and guidance, which was co-produced with young people.

Phil Harris, a treatment specialist and author, had experience of developing services for the transition to adulthood. ‘We’re not only having to prepare children for adult life – but one that’s changing rapidly,’ he said. Challenges for future generations were ‘not things we grew up with’ and the challenges converged ‘in the age of overwhelm’.

One in ten children had a mental health condition – an upward trend reflected in the 100,000 children treated for mental health issues each year. ‘The modern world is having an impact and anxiety is the shift we’re seeing,’ he said. Specific technology-influenced problems and terms such as ‘doomerism’ had emerged, where ‘the doomer goes down a rabbit hole of nihilism and defeatism’.

The transition point from child to adult was a ‘particularly sensitive period’ and there were long waiting lists for support – the time delay between symptoms and treatment meant that 250,000 children were waiting. Symptoms could seem like something else – psychosis might appear to be depression – and in fact it was rare to find someone with a single presentation. Furthermore, we were seeing that ‘some disorders we thought were the same are profoundly different’.

‘We need a big shift in how we think about mental health and look at environments and brain development,’ he said. New approaches might include AI and digital therapies, including games.

Loneliness and the cost of living are some of the biggest problems facing young people, said Connor (left) and Winter, who contributed to the discussion on challenges for the next generation

‘Violence casts a long shadow over children’s lives,’ added Caleb Jackson, head of youth at the Youth Endowment Fund. A children, violence and vulnerability study had assessed the youth sector’s role in preventing violence and found that while youth activities were popular, youth service cuts were huge and had made delivery challenging. ‘We need to reach, rather than say hard to reach,’ he said and offered approaches to reducing youth violence through the YEF toolkit.

Students Organising for Sustainability (SOS) had conducted their annual survey about students’ relationships with drugs and alcohol. Hannah Head, who ran their drug and alcohol impact training (and was also a member of Students for Sensible Drugs Policy) highlighted a zero tolerance approach and lack of knowledge in many universities. But there were barriers to universities having a harm reduction focus, she said – including misunderstanding of drugs laws – and there were obvious opportunities for interventions and initiatives that were being ignored. Greater trust between universities and their students would offer chances to communicate on health and wellbeing and be much clearer about a harm reduction approach and support. Bristol were doing this well with large posters on campus and an onsite drugs advisor, while Leeds were using Instagram stories as a more effective way of engaging than just posts. It was essential that students knew the risks and understood about drug safety, she said. A Universities UK Drug Taskforce report* had acknowledged harm reduction and – despite being ‘watered down’ by the time it was released – had said that universities should adopt a harm reduction approach.

*Enabling student health and success, available here

HARMINDER’S STORY

The friend that won’t leave

THE DDN CONFERENCE IS BACK FOR 2025!

DATE: Thursday 10th July 2025 VENUE: The National Motorcycle Museum, Birmingham

'My favourite conference' – @judithyates1

'Inspiring and thought-provoking discussions – new ideas aplenty to bring away, collaborate, and turn into positive change' – @lukeoneil84

Programme

'As always, great conversations and inspirational speakers' – @ViaOrg_

Delegate places

'The event had lots of great speakers and offered an excellent opportunity to network' – @VoicesActionCh1

Exhibition and sponsorship

'Good motivation for peer support and lived experience… some awesome speakers' – @HarmReductionUK

Accommodation

'A humbling and inspiring day' – @CGLinWF

DDN Conference 2024: catch-up

'Mint turn out as always' – @GBMC73

EMAIL ALERTS The DDN Bitesize email keeps you updated with the latest news, features, jobs and events from DDN magazine. Sign up for our email alerts here to receive updates and details of the DDN Conference.

DATE The DDN Conference takes place on Thursday 10th July 2025.

VENUE The National Motorcycle Museum, Birmingham. For information on how to find the venue and parking, click here.

TIME Registration from 9am, conference 10am-3:45pm.

TICKETS You will be issued with your ticket and delegate bag on arrival. If you are attending as part of a group we do not need all of the names, just the number of delegates.

PROGRAMME The order of the day, including all session and speaker information, can be found here.

CATERING Refreshments are provided. There will be a tea and coffee break in the morning and a full cooked lunch (including vegetarian and vegan options) in the afternoon.

EXHIBITION If you are booked to exhibit, everything you need to know about the running of the day is here.

ADDITIONAL TICKETS If you have colleagues that want to come and have not booked yet, there is still time! You can book tickets online here.

USEFUL INFO Wifi is available. You will receive free entry to the Motorcycle Museum from 3:45pm.

If you cannot find the answer to your question, please contact Ian Ralph: ian@cjwellings.com – 07711 950 300

We look forward to seeing you all at the DDN Conference 2025!

I NEEDED COKE TO FUNCTION

Danny sniffed his first line of cocaine at 13 – the start of a problematic relationship with it, until he sought help.

JUST A REGULAR NIGHT OUT

Coke’s become as socially acceptable as alcohol in my respectable community, says Joanna.

DATE: Thursday 10th July 2025
VENUE: The National Motorcycle Museum, Birmingham

EMAIL ALERTS
The DDN Bitesize email keeps you updated with the latest news, features, jobs and events from DDN magazine. Sign up for our email alerts here to receive updates and details of the DDN Conference.

DATE
The DDN Conference takes place on Thursday 10th July 2025.

VENUE
The National Motorcycle Museum, Birmingham. For information on how to find the venue and parking, click here.

TIME
Registration from 9am, conference 10am-3:45pm.

TICKETS
You will be issued with your ticket and delegate bag on arrival. If you are attending as part of a group we do not need all of the names, just the number of delegates.

PROGRAMME
The order of the day, including all session and speaker information, can be found here.

CATERING
Refreshments are provided. There will be a tea and coffee break in the morning and a full cooked lunch (including vegetarian and vegan options) in the afternoon.

EXHIBITION
If you are booked to exhibit, everything you need to know about the running of the day is here.

ADDITIONAL TICKETS
If you have colleagues that want to come and have not booked yet, there is still time! You can book tickets online here.

USEFUL INFO
Wifi is available.
You will receive free entry to the Motorcycle Museum from 3:45pm.

If you cannot find the answer to your question, please contact Ian Ralph:
ian@cjwellings.com – 07711 950 300