Home Blog Page 14

National Apprenticeship Week 2023

Photo by Glenn Carstens-Peters on Unsplash

Alex Armstrong, Turning Point’s Acting Apprenticeship Lead, discusses his journey and work during National Apprenticeship Week.

I am delighted that it is National Apprenticeship Week. We’re celebrating with a variety of events; from webinars for future learners and managers to the launch of our apprenticeship community. We will hold our first Apprenticeships Graduation & Awards ceremony at the end of the week to recognise programme participants and graduates, as well as the managers who have contributed to the success of our apprenticeship programme.

Turning Point and apprenticeships

Turning Point apprenticeships are designed to support and nurture people in reaching their full potential, whether that is a management path or a sidestep into an area of interest.

Turning Point has been utilising apprenticeships for our existing workforce and how we can upskill the future leaders within the organisation within various apprenticeship standards and disciplines within the workplace. Apprenticeships require functional skills in English and Math, which may not have been achieved in school. Turning Point collaborates with our providers to assist colleagues in completing their function skills prior to or concurrently with their apprenticeship.

Our primary focus has been on developing our front-line teams through care and management apprenticeships ranging from level 2 to level 7. This has given 117 Turning Point colleagues who have/will have a recognised qualification.

To date, Turning Point has completed 55 apprenticeships, with our national average of 85% achieving a Merit or Distinction.

My apprenticeship journey 

From my own personal experience of completing my own apprenticeship during Covid 19, the Turning Point approach is about supporting and developing our people to achieve success.

Turning Point and the provider’s assistance was critical for me. I had a mentor to whom I could turn for advice, and I had regular phone calls with my tutor to ensure I was on the right track. Working with the team also provided me with opportunities to be a part of projects that I would not have been a part of prior to beginning my apprenticeship.

As a result of completing my apprenticeship, I have gained additional responsibilities such as National Apprenticeship Week and the apprenticeship programme. Examining Turning Point’s strategic approach to apprenticeships and professional development. I have close working relationships with managers, learners, and providers, and what I enjoy most about my job is seeing how colleagues progress and achieve. Particularly during their learning stage. Seeing them overcome a challenge and seeing their confidence grow.

Benefits of apprenticeships

We’ve seen colleagues advance through the apprenticeship scheme, from support worker to senior support worker to team managers, running their own services by completing apprenticeships alongside their day job.

We have established clear career paths and opportunities for future growth for our colleagues. Individuals’ practises may vary greatly while on the programme, depending on what they are studying that month. They can apply their knowledge, skills, and behaviours to the work environment. We are also considering future apprenticeships, as well as participating in research groups and exploring new apprenticeships to help develop our teams and establish new working relationships with providers and universities throughout England.

Turning Point has also joined the Apprenticeship Ambassador Network and the Apprenticeship Diversity Champion Network, pledging to make apprenticeships more accessible and inclusive, as well as to improve our social mobility and reach out to a broader workforce.

Apprenticeships are helping develop the future for our workforce and this is the most exciting part to seeing colleagues progression.

Read the full blog 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

HIV Testing Week 2023 and Turning Point’s HIV Strategy

Photo by Bermix Studio on Unsplash

Turning Point Medical Director, Dr David Bremner, shares the new Turning Point HIV Strategy and the organisation’s work during HIV Testing Week.

This week is national HIV Testing Week. Across the country, Turning Point services are working with partner organisations to run HIV testing events and calling on people to get tested and know their status.

This week we are also launching the Turning Point HIV strategy, the aim of which is to ensure everyone that Turning Point supports in our drug and alcohol and sexual health services can easily access testing, treatment and ongoing support for HIV.

We have made great progress in tackling HIV in the UK; however, there is more to do and drug and alcohol treatment providers have a key role to play if we are to meet the government target to end new HIV transmissions by 2030. HIV prevalence amongst people who inject drugs in the UK is low but estimates suggest the risk of contracting HIV for this group is 22 times greater than for the population as a whole. People who inject drugs can be marginalised, they can face barriers to accessing services and are more likely to be diagnosed late.

Testing is quick and easy. Most tests come back negative, but it’s always better to know. If you test positive, it’s important to know you can live a long and fulfilling life with HIV. There’s support available to help you comes to terms with a positive diagnosis and modern HIV treatment means you can’t pass it on to others.

We consulted with people living with HIV, staff and partner organisations in developing the strategy which is guided by three underlying principles:

• Challenging stigma surrounding HIV within services and beyond. This will be achieved through the provision of robust staff education and training, and by providing clear information regarding HIV for people supported by our services.
• Ensuring key messages relating to HIV testing and treatment are clearly communicated. It is important that we achieve wider understanding regarding the fact that when HIV is diagnosed and properly treated it is undetectable and untransmissible.
• Ensuring all of our services are a safe space in which people we support who are living with HIV can access support and discuss their diagnosis and treatment.

We have lots of examples of good practice within services and over the coming period we will be focussed on sharing the learning from these – improving training for staff, the quality of information, advice and support we provide and our work with partner organisations. We are part of the generation that will stop HIV.

Read the full blog 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

Drinking age

This year marks the tenth anniversary of Dry January. But are those who are least likely to take part – older people – the ones who would most benefit? DDN reports. 

older drinkersAccording to research published by Alcohol Change UK at the end of December, around 8.8m people – roughly one in seven UK adults – were planning to take part in Dry January this year. How many actually made it to the end of the month without a drink is of course a different matter, but the figure shows how firmly established the campaign – now in its tenth year – has become. 

It comes as alcohol-related deaths and hospital admissions continue their upward trajectory. There were 280,000 alcohol-specific hospital admissions in England in 2019-20, while the broader measure that includes a secondary diagnosis linked to alcohol saw almost 980,000 – one in 20 of all admissions.

According to the latest ONS figures, meanwhile, 2021 saw alcohol-specific deaths across the UK reach their highest-ever level at more than 9,600 – a 7 per cent increase on 2020 and almost 30 per cent higher than 2019. Again it’s worth remembering that these figures only include deaths that are the result of conditions ‘wholly attributable’ to alcohol – primarily alcoholic liver disease – and according to ONS are therefore likely to account for only a third of all deaths that could be considered alcohol-related.

As usual, the alcohol-related death rate for men was far higher than for women, but what has changed in recent years is the age of those likely to be drinking the most. While the popular perception of ‘binge drinkers’ still tends to be of groups of people in their teens and twenties stumbling around town and city centres, according to the latest Health survey for England the people most likely to drink more than the weekly guidelines are now men aged between 55 and 74 and women aged 45 to 64.

Generational shift

One key reason for this generational shift in drinking patterns is that these are people who grew up at a time when excessive drinking was seen as the norm, with habits long-since becoming ingrained – especially as most of their friends are likely to drink at similar levels. ‘It’s those influences that the baby boomer generation had – that whole alcogenic environment,’ consultant old-age psychiatrist and visiting research fellow at South London and Maudsley NHS Foundation Trust, Dr Tony Rao, tells DDN. ‘It’s a combination of peer pressure, habit and lifestyle, and if you put all those into the mix you’ve got a generation that’s not ready to look at anything beyond that.’

Covid impact

COVID has also had a significant impact on drinking patterns, with research from a range of organisations coming to essentially the same conclusion – that while many moderate drinkers reduced their consumption during lockdowns and the pandemic as a whole, many of those who were already drinking too much began drinking even more. Researchers have warned that this is likely to cast a ‘long shadow’ on health, with a report from the University of Sheffield stating that it could lead to 25,000 additional deaths and almost 1m hospital admissions over the next 20 years. And again, it’s often older people who are most affected. ‘During that period of lockdown, the percentage change in people drinking over 50 units a week was consistently higher among 65 to 74-year-olds, which is very surprising,’ says Rao. 

Tony raoWhile public health campaigners consistently urge the government to tighten up what are seen as the toothless regulations around alcohol marketing, most proposals to do so tend to focus on young people – as is reflected in the consultation being carried out by the Scottish Government at the moment, with its plans to tackle sports and events sponsorship and statement that marketing is ‘associated with an increased likelihood that children and young people will start to drink alcohol’. Given this ongoing generational shift in drinking patterns, are they maybe barking up the wrong tree?

‘Definitely,’ Rao states. ‘We had the Drink Wise, Age Well project that lasted for seven years, but what I think we urgently need now is a nationwide public health campaign to show older people not only the extent of the problem but also how they can play a part in their own harm reduction.’ 

While Dry January is very much based around people who are already health-aware, what’s needed with older people is something to raise that awareness of harm, he stresses. ‘I think older people still see this kind of mind shift among younger people as very woke, very nanny state, because they don’t appreciate the true extent [of the harm] – “It’s not my problem, it’s someone else’s problem.” There’s all this ONS data and the media stories around it saying that younger people are drinking less – and that’s all well and good – but what they’re not saying is that older people are drinking far more compared to the same generation 50 years ago.’

It’s an issue that has to be tackled on two fronts, he believes. ‘We need a public health campaign on alcohol-related harm, but we also need to develop clinical services so there’s better screening and brief intervention. Not just because it would help to catch things early, but it would help to give addiction services a better understanding of the extent of the problem.’ And within those services there needs to be a multi-disciplinary approach, he adds. ‘You need the medical side to look at mental health disorders, the nursing and psychology side to engage people in reducing stigma and opening up about their drink problem, and then you need the social focus on community integration and recovery. It can take decades to achieve that kind of thing.’ 

Does Dry January Work?

dry januarySo does Dry January itself work, or is it just a way for people to think ‘I’ve done that, now I can go back to bingeing on 1 February?’ ‘There’s always this misconception with alcohol, because it’s such a stigmatising subject, that either you drink or you’re abstinent,’ he states. ‘But I think the longer-term impact for a large number of people is that it’s given them the chance to reflect on having healthier lifestyles and really looking at the part that alcohol plays in their lives.’ Alcohol Change UK, however, found that just 10 per cent of over-55s were planning to take part, a missed opportunity given they’ve often ‘been quite hedonistic, and are quite health-naïve’, he says. 

While there’s obviously still large numbers of young people who drink heavily, it’s looking as though this overall shift in drinking patterns may well turn out to be permanent. One factor may be something as simple as alcohol not being seen as cool anymore among a growing proportion of younger people – for a generation whose every action is scrutinised on social media, getting drunk and losing control perhaps isn’t something particularly attractive. ‘I think there are three components,’ says Rao. ‘There’s seeing parents and grandparents who’ve suffered from alcohol problems, there’s the health aspect – they’re a much more health-aware population – and then there’s the cost of living. They can’t afford to – they’re probably more likely to go and have a craft beer every month than drink every week.’

Loud and consistent

In terms of where alcohol health campaigns should now be turning their focus, it doesn’t help of course that there’s been no alcohol strategy for a decade. And when one does finally come it’s highly likely to focus on young people, Rao points out. ‘So we need louder and more consistent voices for the older population, who are suffering. I really don’t think that at a political level, or a clinical level or a public health level, it’s really been taken seriously enough. I think the other reason is that there’s probably an attitude – not just among older people that they don’t want to change their habits – but among society as a whole of “why shouldn’t older people be allowed to enjoy themselves?”’ But what we know from definitive and robust reviews is that older people tend to do much better in terms of treatment and recovery than younger people. So it’s never too late.’  DDN

Government bans 11 synthetic opioids

Eleven more synthetic opioids are to be banned following recommendations by the Advisory Council on the Misuse of Drugs (ACMD), the Home Office has announced.

policing minister Chris Philp.
‘Synthetic opioids are highly dangerous substances, which ruin lives and devastate communities,’ said policing minister Chris Philp.

Ten nitazenes, along with brorphine, will be become class A substances, with legislation being brought forward ‘as soon as possible’. 

ACMD was commissioned to investigate the drugs after they were linked to rising rates of overdoses in other countries, and found that one substance – isotonitazene – had been implicated in the deaths of 24 people in the UK In 2021. The other substances to be added to class A of the Misuse of Drugs Act are butonitazene, etodesnitazene (etazene), flunitazene, metodesnitazene (metazene), metonitazene, n-desethyl isotonitazene, n-piperidinyl etonitazene (etonitazepipne), n-pyrrolidino-etonitazene (etonitazepyne), protonitazene and brorphine. Public Health Scotland (PHS) recently published an alert about the increased availability of nitazenes, warning that they posed a ‘substantial risk of overdose, drug-related hospitalisation and drug-related death’. Some of the drugs had been found in pills being sold in Scotland as ‘oxycodone’, it said. 

‘Synthetic opioids are highly dangerous substances, which ruin lives and devastate communities,’ said policing minister Chris Philp. ‘We must stop these lethal drugs from reaching our streets, to prevent more tragic deaths and other harmful consequences of addiction. Drugs like these erode our society and we accept the Advisory Council on the Misuse of Drugs’ recommendations, to bring proper penalties on their supply.’

Meanwhile, the Australian Government has announced that it is changing the classification of MDMA and psilocybin to allow prescribing by authorised psychiatrists for certain mental health conditions. Australia’s Therapeutic Goods Administration (TGA) will permit prescribing of MDMA for the treatment of PTSD and psilocybin for treatment-resistant depression from 1 July.  The decision ‘acknowledges the current lack of options for patients with specific treatment-resistant mental illnesses’, and means that psilocybin and MDMA can be used therapeutically in a ‘controlled medical setting’, states TGA. 

‘Psychedelic substances psilocybin and MDMA are an emerging treatment for people experiencing post-traumatic stress disorder and treatment-resistant depression, where first-line therapies have failed,’ said a statement from the Royal Australian and New Zealand College of Psychiatrists. ‘The therapeutic use of psychedelic substances should only occur under rigorous conditions, overseen by an authorised psychiatrist, with careful oversight by an institutional research ethics committee, and careful monitoring and reporting of efficacy and safety outcomes. For approval to prescribe, psychiatrists will need to demonstrate appropriate training, patient selection, evidence-based treatment protocols and patient monitoring.’

DDN February 2023

What’s the message for older drinkers?

DDN magazine 2023Dry January is firmly established as a popular campaign, with  millions of people taking part. But we have a problem. As our cover  story discusses (p6), a very small proportion of these were over  55 – the very age range found most likely to be drinking more than  the weekly guidelines, with ingrained habits and a peer supported drinking social life. The outlook for their health is worrying – but how do we encourage them to take the risks seriously and play an active part in their own harm reduction? There’s no doubt that  a new alcohol strategy is well overdue – but it must go beyond  a focus on young people and have absolute relevance to the  self-defined ‘moderate drinkers’ of an older generation who are routinely consuming more than 50 units a week.

On the theme of wellbeing, we have helpful ideas throughout  the issue on looking after staff while they take on board the stresses and strains of clients with many complex needs, together  with strong and inspiring partnerships on projects ranging from mental health to hepatitis C.

And for a story with many plot twists, its fair share of villains and an eye-watering level of deception, read about the fight to end the reign of the killer cigarette (p16). Will the combustible cling to power – or will vaping save the day? 

As always, we want your views!

Read the February issue as an online magazine or download the PDF here

Claire Brown Editor of DDN Magazine

Claire Brown, editor

Please send your letters and comment to claire@cjwellings.com 

Disruptive force

The genie’s out of the bottle – embracing tobacco harm reduction could end smoking within a generation, says Knowledge Action Change. DDN reports.

disruptive force ddn magazine featureSmoking causes at least 8m deaths every year – more than from HIV/AIDS, tuberculosis and malaria combined. Despite this global public health crisis, the number of smokers worldwide has remained static at 1.1bn over the past two decades.

In The right side of history, Knowledge Action Change (KAC)’s third report in a series on the global state of tobacco harm reduction, Harry Shapiro looks at past, present and future. Why have there been so many false starts to find safer ways to use nicotine? How have consumers themselves influenced the development of tobacco harm reduction? What’s been the response of public health and tobacco control organisations? What role has the tobacco industry played in all of this? And the key question: ‘Are we now going to see the opportunity to end smoking slip away – leaving the tobacco industry to continue profiting from the sale of combustible cigarettes?’

The report is a fascinating and disturbing read. It’s a story of innovation, but equally a story of ignorance, greed, corruption, neglect, inertia and privilege as we see the emergence of much safer products being regulated and dismissed to further confirm deadly combustible cigarettes as the number one choice. As we read about the burden of tobacco-related death and disease falling disproportionately on people who are poor, vulnerable and disadvantaged, we are reminded of tobacco companies’ sham promotion of ‘safer’ cigarettes (for which they were penalised in the 1990s) with a filter that was nothing more than a PR exercise. Their products remained deadly, and they knew it.

Breakthrough

The twist in this story is that the breakthrough in tobacco harm reduction was consumer driven and not the result of public health policy dealt from on high. Individual innovators began experimenting for a safer vaping product, motivated by their desire to quit smoking. An American man came close, but China gave their candidate the backing and a new industry was born. Developing an export market quickly, China offered the world the opportunity to try vaping instead of smoking. 

Harry Shapiro, the report’s author, explains how interest and excitement spread through internet forums, chat rooms and websites – ‘what’s all this e-cig stuff that I keep reading about in the newspapers? Is it going to help me? Are they safe? Where can I get them? How much do they cost?’

Politicians, regulators and law-makers were all completely caught off guard, he says. ‘They had absolutely no idea what to do with these products – is it tobacco? Should we make them medical products?’ And in the absence of knowledge, they took some bad advice from otherwise credible sources like the World Health Organization (WHO). ‘And of course, if you’re going to develop policies on the back of bad advice, what you finish up with is bad policy – and this is what has happened in many countries.’

Just as health and regulatory authorities moved towards restricting the products, consumers – the thousands who had benefited from vaping – began to advocate for their right to use them and this had a direct influence on policy.

But there was still a massive obstacle: the tobacco control establishment had spent millions of dollars over decades to fight the tobacco war – and it was a war against nicotine, not just cigarettes.

Simple Life

hiring jobs
Hiring Now! – Smoking Cessation Team Leader, Redbridge. Click for details

Life was much simpler before vaping arrived on the scene, explains Shapiro. ‘You had evil nasty tobacco companies over there, and their legal products were the devils. The angels were over here – the doctors, the clinicians, the public health people and so on. And there was clear blue water between them. But then the waters got extremely swirled up and muddy.’

Despite all the evidence on the efficacy and safety of the new products, many of the tobacco control organisations could not entertain the idea that safer nicotine products could play a part in reducing death and disease, and resorted to perpetuating ‘fear, uncertainty and doubt’. Perhaps rooted in moral and ideological objections, there was a complete unwillingness to consider that people could use nicotine recreationally outside the context of nicotine replacement therapies.

Their negativity had a serious impact, sowing doubt among health professionals. People coming forward looking to switch from smoking were likely to be met with ‘junk science’. Instead of being reassured that vaping was a safer option, they were more likely to be encouraged to go ‘cold turkey’ instead, which felt impossible for most. As Shapiro points out, ‘this plays straight back into the arms of the tobacco companies who are still making millions of dollars a year selling cigarettes.’

Slow progress

As a public health social scientist as well as KAC’s director of research and policy, Professor Gerry Stimson is extremely frustrated by the slow progress and unwillingness to act on evidence.

‘Here was an opportunity to massively reduce the burden of premature death and ill health caused by cigarettes – the potential of vaping products and snus was obvious and exciting to us,’ he says. The consumer interest and activism around vaping seemed as if it could consign a massive global health issue to the history books, and at virtually no cost to governments. ‘So we started our work on tobacco harm reduction with some cautious optimism.’ His colleagues were used to difficult issues – they worked in drugs harm reduction, HIV and AIDS, the criminal justice system, homelessness, mental health – but they hadn’t estimated the extreme challenges of working in the area of tobacco control and reduction.

Failure to lead

Realising the overnight revolution wasn’t going to happen, they prepared for a long uphill struggle. ‘My enthusiasm as a public health scientist wasn’t matched by the enthusiasm of my public health colleagues,’ says Stimson. Making matters worse, philanthropists who believed nicotine in all its forms was bad, were actually throwing money at preventing safer nicotine products from reaching their target market. It’s resulted in ‘a pretty dismal lack of progress’ over 20 years in reducing the statistic of 1.1bn smokers.

While realistic that it takes time to change consumer behaviour and patience for governments to work through regulations, he also understands the equation for tobacco companies. Why would they rush a transformation to new products while they continue to profit so handsomely from selling combustibles? His anger as a public health expert is directed at WHO and their failure to lead on this. Why are they not using their role – and the evidence – to shift people away from smoking? He says there needs to be an urgent review of WHO leadership in tobacco control.

Despite the challenges he is determined to remain optimistic about good products and consumer demand, demonstrated by an estimated 80m vapers globally. ‘This is a major disruptive force,’ he says. ‘For me it’s not whether safer nicotine products will predominate over combustibles, but when.’  DDN

Read the three reports on the global state of harm reduction, including The right side of history at: https://gsthr.org/resources/thr-reports/ 

                                                   —————–

A story of smoke and seduction… 

vintage cigarette advertThe story of tobacco began with Christopher Columbus and crew encountering people putting rolled up leaves in their mouths, setting fire to them and inhaling the smoke. This was in 1492 in what is now known as The Bahamas, and as it spread throughout Europe it became used in the form of tobacco powder (snuff), chew, pipes, hookahs and cigars.

James I of England wanted to ban tobacco, but his short-lived prohibition turned into taxing it heavily instead to fund a round of expensive wars, triggering a thriving trade in tobacco smuggling.

The soldiers of the Crimean War and American Civil War took to hand-rolling cigarettes to get a quick nicotine hit. Then came three crucial developments – the development of flue-cured tobacco (milder, sweeter, with a relatively high nicotine content); production of the first safety matches; and the invention of the mechanical cigarette-rolling machine, which could turn out 70,000 cigarettes a day.

Cigarette advertising proved effective propaganda as smoking became a symbol of success, emancipation, and even robust good health, with smoking doctors appearing in adverts. By the end of the Second World War, nearly half of Americans aged 18 and over were smoking at least a pack a day.

During the 1950s evidence of the link between smoking and (previously very rare) lung cancer began to emerge, and by the mid-1960s there was strong enough evidence to show that smoking caused cancer.


Related articles

(Features, August 2023): DDN visited the Global Forum on Nicotine in Warsaw to hear about the challenges of mainstreaming tobacco harm reduction.

(News, August 2023): 40 per cent of smokers in the UK think that vaping is ‘as or more risky’ compared to smoking up from 27% last year.

(News, June 2021): Health professionals can recommend e-cigarettes as tools to help stop smoking, according to new draft guidance from NICE and PHE.

Read more articles on tobacco harm reduction, vaping and smoking cessation in the DDN archive.

 

 

 

All Being Well

The wellbeing of people who suffer from a substance use disorder is compromised in many ways. Their physical health is affected by the chaotic lifestyle that often accompanies it – this commonly includes poor nutrition, lack of exercise, and irregular sleeping patterns. There are also the secondary complications linked to substance use, such as high blood pressure, cancer and liver disease, in addition to injuries that can be sustained from reckless behaviour.  

Mental health is severely affected too, and there is an abundance of research evidencing the link between addiction, anxiety, depression, and suicide. Cognitive function is impaired through having a maladaptive reward system, where value is placed on securing access to drink and drugs, irrespective of the consequences. Beyond this, the fallout – such as broken relationships, loss of earnings, and even loss of freedom – all significantly impair wellbeing.

Wellbeing is defined as ‘the state of being comfortable, healthy or happy’. What can be assumed is that in reaching recovery, an individual has implemented a series of important changes that move them beyond reliance on drink and drugs – these changes, while often challenging, inherently improve wellbeing by abating the enduring consequences of active addiction. 

In the longer term, wellbeing continues to improve as an individual finds new meaning and purpose, develops healthier ways of behaving, and establishes positive relationships that are conducive to recovery. From this it’s reasonable to conclude that improvements can be experienced from the point an individual decides to change.

Addiction treatment services can leverage this to make the transition from addiction to recovery a more optimistic experience – one where positive engagement can help motivate an individual to apply themselves in the process of change and growth. It also gives insight into what a life beyond addiction can offer. 

There are many ways in which services can promote and improve wellbeing, ranging from innovative therapeutic interventions to providing a varied and enriched treatment schedule where time is dedicated to wellbeing activities that accommodate individual capabilities and preferences. There are boundless examples of activities that this can include – playing sport, visiting an animal sanctuary, painting or meditation, to name a few. 

Furthermore, fun and light-hearted activities can help connect an individual to a less troubled version of themselves, where they are able to appreciate the benefits of being in the moment. Offering a range of different wellbeing opportunities means service users not only have choice but also the opportunity to branch out and positively experience things in ways that are new to them.

Beyond this there are also the intrinsic values of an organisation and the people within it. If an organisation values the wellbeing of its staff, and proactively seeks to improve and uphold it, then service users are more likely to experience a holistic wellbeing experience. A healthy staff group is better positioned to conduct themselves in a way that cultivates wellbeing.  

As an example, speaking to someone who recently completed treatment having arrived with no more than the clothes they were wearing, they recalled a member of staff kindly bringing in a spare pair of trainers on their first day. While this might seem relatively inconsequential when viewed against the overall treatment received, it was transformational for the individual, as they saw the potential in a caring and positive relationship. 

When reflecting back on this moment, they identified it as instrumental in opening their mind to connecting with others and accepting support. Moments such as these demonstrate that even a small change in wellbeing can have a positive effect on treatment outcome. 

At Acorn Recovery Projects a unique programme of work known as positive addiction recovery therapy is offered to service users. This is designed to strengthen recovery, improve wellbeing, and set the foundation for people to flourish in recovery. The programme uses the G-CHIME model of addiction recovery, and delivers interventions based on personal growth, connectedness, hope, identity, meaning in life and empowerment. Those who have completed the programme have reported a notable improvement in all listed wellbeing domains, as well as an increase in their recovery capital.  

Staff at Acorn receive specific training to enrich the treatment experience of their service users, for example therapists have recently been trained to deliver drum therapy, adding to the catalogue of experiential interventions and therapies that are already delivered. Beyond this staff are encouraged to take time out of their working day to organise and participate in wellbeing activities that they enjoy and that will benefit service users, for example, hill walking, playing with pets, gardening projects, jam sessions, baking, dancing, and playing games.

Lisa Ogilvie is a counsellor at Acorn Recovery Projects, and a doctoral student at the University of Bolton specialising in addiction recovery and wellbeing.

 

Justice Served

In a follow-up to our recent three-part commissioning series, Tony Margetts looks at commissioning drug and alcohol services from a criminal justice perspective.

justice served commissioning articleBritain has long used criminal law and criminal justice agencies as a key part of its response to drug use. While alcohol and tobacco have been regulated and licensed, other drugs fall under the venerable Misuse of Dugs Act 1971 or the more recent Psychoactive Substances Act 2016. 

While this approach has been the subject of much debate – with critics suggesting a more tolerant and health-based approach may serve the nation better – this article looks at the response of criminal justice agencies to the national drug strategy, and the challenge of commissioning in a complex and fragmented landscape. 

Dame Carol Black
Dame Carol Black

Dame Carol Black said in her first report, ‘More than a third [of the 82,000+ people in prison] are there due to crimes relating to drug use (mostly acquisitive crime). These prisoners tend to serve very short sentences, have limited time in prison treatment and poor hand-offs back into the community. They are highly likely to re-offend.’ This finding influenced much in the 2021 drug strategy and this article considers the implications of this.

These agencies, with overlapping but not identical interests, will be commissioning in a complex landscape. The government, in its guidance to local partners, has asked areas to set up Combatting Drugs Partnerships to coordinate a local response to the national drug strategy. 

These are mostly working on a local authority level and are chaired by directors of public health, making the involvement of prisons – which operate across local authority areas – challenging. The partnerships will also have to implement the ‘three strikes’ response to drug testing currently being contemplated by the Home Office as part of the controversial Swift, certain, tough white paper. 

The last ten years have seen a considerable loss of experienced staff from prison and probation services, and both drug and alcohol knowledge and commissioning experience has been lost. Clinks, in a series of reports on the work of the voluntary sector within criminal justice, has highlighted the inflexibilities of Ministry of Justice (MoJ) as a partner. The services are also working under considerable staffing pressures, making the day job hard enough. 

So, what are the priorities for commissioning in the criminal justice system? Here are a few suggestions:

EDUCATION

Improving the knowledge levels around drug and alcohol treatment within the staff of criminal justice services so that they can contribute to joint commissioning appropriately. This means both a better knowledge of the evidence base for drug treatment and better commissioning skills. One of the objectives of criminal justice services is reducing re-offending and this requires good, accessible treatment services.

IMPROVED OFFERS

Improving the preventative and diversionary offer within the criminal justice system for people whose offending is related to drug use. This is an area that has been a focus for some police, fire and crime commissioners (PFCCs), including the West Midlands, but should be developed further and linked to the liaison and diversion services.

BARRIERS TO TREATMENT

Working not just to increase the numbers in treatment but also looking at the barriers to treatment for people with multiple problems. This is a key part of the Project ADDER pilots but needs to be a concern among all commissioners. Many of the people with drug and alcohol problems within criminal justice services are not in treatment.

JOINT WORKING

Better joint working between the staff of criminal justice agencies and treatment providers – informing sentencing recommendations and appropriate enforcement of community sentences and licences for released prisoners

CONTINUITY OF CARE

Ensuring continuity of care between prison and the community and drug treatment, informing the supervision and enforcement of prison license conditions. At present there appears to be a prison/probation pathway relating to post release license and another between prison healthcare and community services with limited joint working to support prisoners after their release. This is a key role for the newly created health and justice partnership coordinators within the Probation Service.

Tony Margetts is a drug and alcohol treatment commissioning consultant

 

 

                                                      ——————–

 

The criminal justice system is a broad term – key commissioners are: 

national probation services

HM PRISON AND PROBATION SERVICE (HMPPS) 

Part-privatised in 2014, The National Probation Service is now part of the civil service and sits with prisons in HM Prison and Probation Service (HMPPS). Drug treatment was the subject of a ‘disappointing’ thematic inspection in 2021 which included a raft of recommendations for the new model probation service. The probation service is working to improve the offer for drug and alcohol-related offending, including the commissioning of drug and rehabilitation services and increasing the use of community sentences requiring treatment for drug and alcohol problems.

The National Probation Service also commissions services, including some for offenders with drug and alcohol problems, and works with a number of third sector organisations who are also providers of local authority and prison commissioned services and who are represented by an umbrella organisation, Clinks.

The prison service has a strategy from 2019 which will need an update to bring it in line with the 2021 drug strategy. The direction of this can be judged from a white paper prepared under Dominic Raab in 2021 – now back at the MoJ – which looked at increasing the use of testing, making treatment, including abstinence-based treatment available to prisoners, and expanding ‘incentivised substance-free living units’, which sound like a sort of rehab unit in prison.

POLICE AND PFCCS

PFCCs have considerable discretion in what – if any – drug and alcohol services they commission, with approaches ranging from the recently discontinued heroin assisted treatment in Middlesbrough to calls to reschedule cannabis as a class A drug.

LOCAL AUTHORITY PUBLIC HEALTH COMMISSIONERS

Commissioners are responsible for commissioning community drug and alcohol treatment services, including the treatment elements of drug rehabilitation orders and alcohol treatment requirements, which are imposed by courts and can be breached by failing to comply with treatment. Some areas are piloting government schemes to address the needs of people with multiple problems, particularly Project ADDER, which looks at improving access to treatment for offenders and Changing Futures, which looks at people with multiple problems including offending, homelessness, mental health, and domestic abuse.

NHS ENGLAND

nhs englandOften overlooked as a commissioner of drug treatment, NHS England is responsible for healthcare in prisons, including drug and alcohol treatment and liaison and diversion services designed to assess the health and social care needs of people arrested by the police. It also commissions the Reconnect service, which is currently being rolled out nationally and which is designed to improve continuity of care between prison and community drug treatment services.

 

Government pledges housing support cash for areas most in need

Up to £53m is to be allocated to 28 local authorities across England to improve housing support for people in drug and alcohol treatment, the government has announced. ‘People in treatment for drug and alcohol dependence are often easier to support if their housing needs are addressed at the same time,’ the Department of Health and Social Care (DHSC) states.

Manchester will have rapid response ‘prevention hubs’. Pic: Billy Wilson

The money will go to the areas with the greatest need, across all regions of England, says DHSC, and will allow local authorities to establish housing support schemes tailored to their local populations. The funding will also ‘test the impact’ of providing extra housing support to improve recovery, it adds.  

The aim is to help people in treatment achieve sustainable, long-term recovery through maintaining independent living, and is part of the government’s commitment to improve recovery outcomes as part of its ten-year drug strategy, DHSC states. It will also enable the recruitment of specialist housing caseworkers to help people to access and maintain safe and suitable accommodation.

In Manchester, the caseworkers will work from three ‘prevention hubs’ and will be able to provide a rapid response to any housing issues, while in Wigan people with experience of drug and alcohol treatment will help people who are struggling to maintain independent living. Staff across treatment services and housing in Lancashire, meanwhile, will have a training programme to establish a joined-up system of care for people experiencing homelessness.

The money forms part of the £780m announced in the wake of the drug strategy, with the programme lasting for three years. The 28 allocations are all in excess of £1m, with other local authority areas including Bristol, County Durham, Essex, Kent, Kingston upon Hull, Leeds, Liverpool and Middlesbrough.

Addressing housing needs was a critical part of my review, said Dame Carol Black

Addressing the housing-related needs of people in treatment with drug and alcohol dependence was a critical part of my Independent review of drugs,’ said Dame Carol Black. ‘I am pleased that government is working with 28 local authorities across England to test the effectiveness of housing support interventions over the next three years. Learning from these areas will inform and drive forward the ten-year drugs strategy, making the case for safe and supportive housing in recovery from addiction.’

People in drug treatment with housing problems do less well with recovery, said OHID’s Rosanna O’Connor

‘We have known, for too long, that people in drug treatment with housing problems do less well in their recovery,’ added OHID’s director of addictions and inclusion, Rosanna O’Connor. ‘What we know less about is how to address these problems. For the first time, dedicated funding is available to improve housing support. The Office for Health Improvement and Disparities and the Department for Levelling Up, Housing and Communities are working closely with 28 local authorities up until 2025 to test and learn from specific approaches to housing support for this population, and government will take the learning from these areas forward as part of its work to implement the drugs strategy.’

The latest OHID figures on young people in treatment, meanwhile, show that there were 11,326 under-18s in contact with drug and alcohol services in 2021-22 – 3 per cent up on the previous year but more than 50 per cent lower than in 2008-09. Around half of all young people in treatment had issues with alcohol, while almost 90 per cent reported problems with cannabis. Problems with ecstasy and powder cocaine stood at 8 per cent each, while the number of young people seeking help for heroin was below 0.5 per cent.

Young people’s substance misuse: treatment statistics for 2021-22 at www.gov.ukread the report here

See the March issue of DDN for more on housing and recovery

 

 

 

Canadian province decriminalises opioids and cocaine

The Canadian province of British Columbia (BC) has decriminalised the use of drugs including opioids, cocaine, methamphetamine and MDMA.

canada parliament
The national government’s health department, has granted British Columbia an exemption under the country’s Controlled Drugs and Substances Act

People found in possession of up to 2.5g of drugs will no longer be arrested or charged, the province states, nor will they have the drugs seized by police. 

The move is a ‘critical step to end the shame and stigma that prevents people with substance use challenges from reaching out for life-saving help,’ the province’s government states. Health Canada, the national government’s health department, has granted British Columbia an exemption under the country’s Controlled Drugs and Substances Act to decriminalise personal possession and use, with police instead offering information on local treatment and recovery options. The province has been working with the police to develop training resources and guidance for more than 9,000 frontline officers, as well as ‘building new pathways’ into health services, it says. 

British Columbia has stressed that the drugs themselves remain illegal, and possession will still be illegal on school grounds or at childcare facilities. The local and national government will work together to evaluate the exemption and ensure there are no unintended consequences. Canada became the first G7 country to legalise and regulate recreational cannabis in 2018 and recently made international headlines when it revised down its recommended drinking guidelines to just ‘one to two’ alcoholic drinks per week.

British Columbia’s minister of mental health and addictions, Jennifer Whiteside
British Columbia’s minister of mental health and addictions, Jennifer Whiteside

‘We know criminalisation drives people to use alone,’ said British Columbia’s minister of mental health and addictions, Jennifer Whiteside. ‘Given the increasingly toxic drug supply, using alone can be fatal. Decriminalising people who use drugs breaks down the fear and shame associated with substance use and ensures they feel safer reaching out for life-saving supports. This is a vital step to get more people connected to the services and supports as the province continues to add them at an unprecedented rate.’

‘Every day, we are losing lives to overdoses from the increasingly toxic illegal drug supply,’ said Canada’s associate health minister Carolyn Bennett. ‘We are committed to stopping this tragic epidemic with bold action and significant policy change. By supporting British Columbia in this exemption to the Controlled Drugs and Substances Act, our government is providing the province with the ability to help divert people away from the criminal justice system and toward the health and social services they need. We look forward to continuous collaboration with the province to measure the public-health and public-safety outcomes, help save lives and bring an end to this crisis.’

Make sure people’s drinking habits are correctly recorded, NICE urges GPs

People asked about their drinking should have the information ‘added to a validated questionnaire’ to identify if they need help, according to a new draft quality standard issued by the National Institute for Health and Care Excellence (NICE).

doctor
Information on people’s alcohol consumption should be ‘correctly and appropriately stored’

Thousands of people each year are potentially missing out on brief interventions or referrals to treatment services, the institute says. 

Of more than 600,000 dependent drinkers in 2018-19, less than 30 per cent were receiving treatment, according to the most recent OHID figures. Information on people’s alcohol consumption should be ‘correctly and appropriately stored’, the NICE guidance says, which would also help to avoid people being repeatedly asked about their drinking. Alongside GPs, NICE is urging secondary and social care services, criminal justice agencies and community and voluntary services to make sure that systems are in place for the use of validated questionnaires when asking people about their drinking. 

Director of the Centre for Guidelines at NICE, Dr Paul Chrisp
Director of the Centre for Guidelines at NICE, Dr Paul Chrisp

‘Many of us are asked about our alcohol use when we interact with health services, but if an appropriate questionnaire is not used, people with alcohol problems could be slipping through the net and may not be receiving the support they need,’ said director of the Centre for Guidelines at NICE, Dr Paul Chrisp. ‘We know a large number of people who are dependent of alcohol are not receiving treatment and this could be for a variety of reasons, but as part of a health and care system that continually learns from data, we do know that using a validated questionnaire provides commissioners with the information they need to organise appropriate services.’

Meanwhile, a new report from Public Health Scotland (PHS) has found that the introduction of minimum unit pricing (MUP) in Scotland in 2018 has had minimal effect on the drinks industry. The report measured the industry’s economic performance across five metrics – number of firms, turnover, employment, output value and gross value added. The off-trade has been characterised by lower sales volumes, but at higher prices, the report states, with the industry already having ‘moved on’ from MUP by mid-2019 and the legislation ‘largely not a day-to-day concern’. The industry had argued that MUP would have a significant economic impact in the years prior to its implementation.  

director at Frontier Economics, Andrew Leicester
Director at Frontier Economics, Andrew Leicester

‘Our analysis of detailed quantitative data broken down by country and sub-sector of the alcoholic drinks industry does not find compelling evidence of observable impacts of MUP on industry performance in the years immediately following its introduction,’ said lead researcher and associate director at Frontier Economics, Andrew Leicester. ‘Case study interviews from across different parts of the industry largely validate this view, recognising that MUP clearly did affect the behaviour of producers and retailers to adapt rapidly to new limits on pricing, but not in ways that appear to have significantly affected overall industry performance in the medium-run.’ 

Alcohol use disorders update at www.nice.org.uk/guidance/indevelopment/gid-qs10164/consultation/html-content-3

Minimum unit pricing: Impacts on the alcoholic drinks industry in Scotland at www.publichealthscotland.scot/publications/minimum-unit-pricing-impacts-on-the-alcoholic-drinks-industry-in-scotland

‘Need’, by Kristy

Read the runner-up from Adfam’s Family Voices Competition 2022. Family Voices is an annual poetry and creative writing competition open to families affected by substance use to share their experiences.

Needed. They needed it, but I always thought it was a choice. Every night, until that creeped into the day. Functioning at first, and then not. Keeping it hidden, and then not. The drink. The drinking didn’t stop. Both sink. At first it was a Wednesday night treat, a quarter once a week. A social drink or two as I lay behind a sofa at their friend’s house. The need soon took, a slow hook. The quarter turned into a litre and every night they took. Teacher’s whiskey their only teacher, they wouldn’t be schooled by me.

Needler. She wouldn’t let it go. Tugging on me. Wanted a daughter to be more, and then less. Stay at home and look after, help her feel loved. They cast me in a role and told me they blamed me, almost gave up on me. “You went away, and we couldn’t cope. Like a death it was, we’re bereaved”. In this story it didn’t matter that the drinking started years before, always the drink that had them wanting, wanting more.

Needy. What about what I need? Parents that I didn’t need to parent please. I used to laugh it off, humour my armour, describe myself to others as Saffy from Ab Fab. Laugh about the things they’d send through the post (the classic used pizza cutter). I held so much anger and this anger turned into fear – I needed to be different from you. I had to. I defined myself through my difference to them, but I still feared that the same self-fulfilling prophecy would come for me, a right stitch up. What if I’m not a good mum? What if I drink too much like them? What if I am what they told me I am? “It’s okay” I say to that little girl sewn inside. I’ve had years of practice, besides. As a daughter of alcoholics, I’m watchful, vigilant, self-aware and attuned. I can read others’ needs and that’s just part of who I am.

Needless. “Your family looked perfect from the outside. I never knew”. Behind closed doors and not yet on the street. What a waste, needless. They had everything then, lost it all. Him his life and her, eventually, me. Not a punishment but a boundary held fast. It was a release to end contact and stop answering the drunken calls, the guilt trips. Birthdays and Christmas cards yes, photos of my son, their grandson, yes, but that’s my limit now. I’m sure it fits their story of me, but I release you. I release your hold in me as it’s me who needs. It’s my time now and I need to heal.

Read the full blog 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

Cumbria’s community drug and alcohol treatment service rated ‘Good’ across the board by CQC

Humankind, in partnership with The Well Communities, is proud to announce that Recovery Steps Cumbria has received a rating of “Good” in all areas from the Care Quality Commission (CQC), the independent regulator of health and social care in England.

The community-based service in Cumbria offers a range of support including clinical, health and wellbeing, access to employability coaches and connections to housing.

This is the first CQC review of Recovery Steps Cumbria since it began operating in October 2021 and underlines the early progress made by our team and partners. To date, the service has supported 2,952 people across Cumbria.

In particular, the CQC praised our workforce for treating the people they support “with compassion and kindness”, noting that they “understood the individual needs of clients” while ensuring they “actively involved clients in decisions and care planning”.

The Recovery Steps Cumbria team were further commended for their ability to assess and manage risk, and their adherence to good practice and safeguarding procedures. The care plans they developed were described as holistic, recovery-oriented, and informed by comprehensive assessments.

The CQC also recognised the multidisciplinary approach of teams across our Cumbria hubs, which gave access to the full range of necessary specialists. This care was “easy to access”, with staff planning and managing discharge well and developing alternative pathways for people whose needs it could not meet.

Finally, the CQC recognised that Recovery Steps Cumbria was well led, with governance processes that ensured that its procedures ran smoothly.

Paul Johnson, Commissioning Manager for Children, Adults and Public Health at Cumbria County Council said: “We are delighted to see the commissioned Cumbria Addictions Service consistently received ‘Good’ across the board in its recent CQC inspection, after just a year of being in operation. Particularly so as it had to get the new service up and running during the pandemic.

“We look forward to working together with our provider over the coming months and years to make this an ‘Outstanding’ service.”

Rachel Savchenko, Operations Director for the North West at Humankind, said: “It is testament to our people at all levels that we have received a ‘Good’ rating across the board in Recovery Steps Cumbria’s first CQC review.

“We are excited to continue serving our community by providing the support and resources necessary for individuals to achieve lasting recovery.”

Becky White, Area Manager at Recovery Steps Cumbria, said: “We are pleased to receive this recognition from the CQC and are fully dedicated to continuing to provide such safe, compassionate, and effective care to the people of Cumbria.

“I would like to thank our fantastic teams for all their hard work and commitment since the launch of Recovery Steps Cumbria. We know that we are progressing every day and hope to build on this rating further.”

Read the full blog 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 Humankind

 

Myanmar opium poppy cultivation up by a third

Opium poppy cultivation in Myanmar is estimated to be up by 33 per cent compared to the previous season, according to the United Nations Office on Drugs and Crime’s 2022 opium survey report. The area under cultivation has increased by around 10,000 hectares, it says, with farmers also using ‘more sophisticated’ practices.

The report shows farmers using more sophisticated practices.

The report covers the first season since the military takeover in the country in 2021, with the increase in cultivation recorded against a backdrop of ‘significant social, economic, security and governance disruptions’, says UNODC. Whereas previous poppy plots tended to be small and poorly organised, the evidence collected last year points to increasing sophistication and higher density ‘hotspots’. The national yield estimates indicate an average of almost 20kg of opium per hectare, the highest ever since UNODC started measuring.

An increase in prices combined higher production means that farmers will have earned more than twice as much from opium in 2022 than in the previous year, the document points out. COVID-19 left Myanmar’s economy ‘critically weak’ and this, combined with the military takeover, has pushed more rural households to rely on opium, with the estimated value of the country’s opiate economy now anything up to US$ 2bn – around 3 per cent of GDP.

Myanmar is the world’s second largest producer of opium after Afghanistan, with UNODC warning in 2021 that the world’s drug markets could be ‘flooded’ with Afghan heroin following a significant increase in the opium harvest there (www.drinkanddrugsnews.com/drug-markets-could-be-flooded-with-afghan-heroin-warns-unodc). Following the Taliban’s takeover of the country and subsequent ban on opium production, cultivation increased by 32 per cent, says UNODC, with increasing prices leading to a tripling of income for farmers.

Opium cultivation is likely to expand, says UNODC.

Opium cultivation in Myanmar had previously been declining for almost a decade following a surge in synthetic drug production, particularly methamphetamine. ‘Economic, security and governance disruptions that followed the military takeover have converged, and farmers in remote, often conflict-prone areas in northern Shan and border states have had little option but to move back to opium,’ said UNODC regional representative Jeremy Douglas. ‘At the end of the day, opium cultivation is really about economics, and it cannot be resolved by destroying crops which only escalates vulnerabilities. Without alternatives and economic stability, it is likely that opium cultivation and production will continue to expand.’

Report at www.unodc.orgRead it here

Make naloxone routinely available to police, paramedics and public, says Turning Point

Turning Point is calling on the government to make naloxone routinely available to the police, paramedics and the general public, as only treatment and healthcare staff are currently able to distribute the drug.

Turning Point chief executive Julie Bass
‘We urge the government to act now to widen access to naloxone to prevent needless deaths,’ said Turning Point chief executive Julie Bass

While police in Scotland routinely carry naloxone kits, officers across the UK – along with probation staff and anyone else who regularly comes into contact with drug users – need to have easy access to naloxone, the charity states. 

Last year, more than 90 per cent of respondents to a consultation by the Department of Health and Social Care (DHSC) agreed that paramedics, prison staff and others should be able to issue naloxone without a prescription, with more than 60 per cent saying the drug was difficult to access in the event of an overdose. However, ministers ‘have yet to act on the responses,’ Turning Point states. 

Almost 4,900 drug poisoning deaths were registered in England and Wales in 2021, 6 per cent up on the previous year and more than 80 per cent higher than a decade ago. 

As a provider of treatment services, Turning Point has been distributing naloxone kits to police with impressive results, it says. One officer, PC David Jeeves of Avon and Somerset Police, recently saved someone’s life with naloxone after receiving training from Turning Point. ‘It was a team effort,’ he said. ‘You often feel helpless in these situations, waiting for the paramedics to arrive. With services stretched to breaking point, you don’t know how long they may take to get there. It felt really good to be able to make a difference and save their life.’

‘We urge the government to act now to widen access to naloxone to prevent needless deaths,’ said Turning Point chief executive Julie Bass. Each drug death is a tragedy that could be avoided. Naloxone isn’t a magic solution but has been proven to save lives. Everyone working in public services should always carry a kit, and people using drugs, their families and friends. Naloxone should be seen as first aid, to be used in an emergency like an epi-pen, and become routine for anyone who might witness an overdose.’ 

Another increase in suspected Scottish drug deaths

There was an increase in suspected drug deaths in Scotland between October and November last year, according to the latest quarterly Rapid Action Drug Alerts and Response (RADAR) quarterly ​report from Public Health Scotland (PHS).

SDF CEO Dave Liddell
‘Synthetic opioids have entered the illegal drug markets in other countries and have been associated with an immediate rise in overdose deaths,’ said SDF CEO Dave Liddell

There were 109 suspected drug deaths last November, compared to 93 in November 2020 and 89 the previous year. 

However, all other healthcare indicators of harm and service utilisation remained ‘stable and below expected levels’, the alert says, with Scottish Ambulance Service naloxone incidents between September and November lower than in previous years and drug-related hospital admissions ‘considerably lower’. PHS has been publishing quarterly updates in response to the country’s ongoing drug-related deaths crisis, and the figures relate to reports by attending police officers rather than official information from death certificates and forensic pathologists. 

The predominant picture of drug-related harm is still polydrug use involving benzodiazepines, opioids and stimulants, the report states, with partners ‘advised to strengthen harm reduction and support measures with particular consideration for those who may have limited contact with health and social care services’. Although 2021 saw a tiny reduction in Scotland’s drug-related death total, the figure had been increasing for a decade before that and the death rate remains by far the highest in Europe. 

RADAR has also published an alert about the increased availability of a group of high-potency synthetic opioids called nitazenes, which ‘pose a substantial risk of overdose, drug-related hospitalisation and drug-related death’. Nitazenes are a new addition to Scotland’s drug supply, and have been sold as ‘oxycodone’ pills. The RADAR alert encourages professionals to increase naloxone distribution, share harm reduction information and increase awareness around overdoses. 

‘Synthetic opioids have entered the illegal drug markets in other countries and have been associated with an immediate rise in overdose deaths,’ said SDF CEO Dave Liddell. ‘This has not occurred in Scotland but this alert demonstrates why we need to be extremely vigilant about changes in the drug market. In preparation, we should increase the supply of naloxone to people who are vulnerable and those close to them, and we should make sure people using drugs are aware of substances and products of particular concern. SDF is working with others to ensure Scotland is prepared for issues that may arise. The need for the provision of drug checking services for people who use drugs is becoming more urgent.’

British Army extends funding for Project Reset

Project Reset, a programme of education, intervention, and treatment for alcohol use and gambling aimed at soldiers in North Yorkshire – run as a collaboration between Humankind, North Yorkshire Horizons, and the military – has been funded by the British Army for an additional 12 months. 

The success of the project has led to an almost doubling of investment for 2023, which will significantly enhance the support provided to serving military personnel. 

Project Reset has also been recognised by the Defence Medical Services, specifically the Surgeon General, as a model for best practice. It now sits as a pilot under the Chief of Defence Peoples space for the consideration of a possible rollout across Defence services in the UK. 

While our Mil-SMART recovery programme will continue as a weekly support group available within the Catterick Garrison Community Hub and as a virtual offer, Project Reset focuses on harm reduction and prevention. 

It uses presentations to whole units around the dangers and consequences of alcohol use, gambling, and other addictive behaviours, while also educating people how these link to mental health, self-harm, and suicide. 

Working in partnership with Departments of Community Mental Health, Unit Welfare Officers, and military Medical Centres, the project has played a pivotal role in retaining soldiers who would otherwise have been discharged. 

Nicky Booth, Area Manager at North Yorkshire Horizons, said: “I’m delighted that Humankind has secured a full year of increased funding for Project Reset and Mil-SMART delivery. 

“This extension is an excellent opportunity to grow the current service and our collaboration with the armed forces further. It is vital that we continue to support our local military personnel by addressing the risks of alcohol use, gambling, and other addictive behaviours.” 

Ruth Hasney, Project Reset Facilitator and Recovery Coordinator at North Yorkshire Horizons, added, “I am so happy that the Project Reset contract has been extended and the funding increased. 

“This recognition demonstrates that we are aligned with the British Army in how much we value the support offered. We have worked so hard to achieve the outcomes the project has generated to date, and I am so excited to see how Project Reset can evolve in 2023.”

The increase in funding will allow Project Reset to provide:

  • A case worker for one full day per week of military-specific support to Unit Welfare Officers, allowing for additional one-to-one appointments.
  • A continuation of current provision with one case worker providing support to Catterick Garrison, including one Mil-SMART group per week provided face-to-face at the Catterick Garrison Community Hub.
  • Referrals to Humankind’s North Yorkshire Horizons recovery service where additional support is required for harmful drinking.
  • Attendance at health fairs promoting the project and raising awareness of the risks of harmful drinking and other addictive behaviours.
  • The delivery of presentations at welfare conferences and to units as required.
  • A walk and talk support group in the Catterick area.
  • A Facebook peer support page, offering weekly updates, tips, and advice on coping skills and positive messages.

Read the full blog 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 Humankind

 

The Ley Community development update

Following Phoenix Futures’ merger with the Ley Community, we are in the process of developing the service for reopening in late Summer 2023.

We are very pleased that the Ley Board and Phoenix Group Board have agreed that the service should be a specialist women’s service. This complements the other specialist residential services the Phoenix Group deliver including New Oakwood Lodge an Enhanced Therapeutic Community (TC) offering combined mental health and substance use care, Harper House, Specialist Family Service Scotland and The Specialist Family Service England and Wales.

We know that people who come to residential treatment benefit from intensive interventions provided in our psychologically informed environments. We have a long tradition and high level of expertise in delivering specialist residential services and look forward to opening this much needed service this year. 

Here we explain what the service will provide and why it is so needed within our treatment system in England. 

The range of therapeutic approaches employed in residential treatment, and the ability to coordinate care around an individual’s specific needs, makes residential treatment especially suitable for people with more complex needs and for those who “have not benefited from previous community-based psychosocial treatment” (NICE 2007). Residential treatment can remove barriers to drug and alcohol treatment such as homelessness and childcare and matches people who need higher levels of multi-disciplinary care to co-located multi-disciplinary staff teams who have lower case loads than in community settings.  

Most residential treatment services are mixed gender with gender-specific features, whereby the majority of the treatment experience is shared (recognising shared treatment needs) and gender-specific sleeping areas and gender-sensitive treatment are provided. This mixed-gender approach recognises shared needs whilst enabling specific support for women with different patterns of substance use from men and that women are more likely to be involved in sex work, have more extensive histories of trauma and abuse, are more likely to have childcare responsibilities and experience intersectional societal stigma. This is a very successful approach for many and indeed Phoenix’s results show that women make huge progress in their recovery in these settings. 

However, for some women with certain characteristics and circumstances, the largely mixed nature of most residential treatment is a barrier to benefiting from the residential experience. There is not a definitive set of characteristics and circumstances but they typically involve low self-worth and difficulties maintaining supportive healthy relationships because of repeated past abuse and trauma by men. Women may also need more confidential and well-planned safe access to services to escape immediate risk from coercive relationships.

From Phoenix’s experience of providing Grace House, a women’s service based in London, we found that disordered eating and self-harm are also common support needs that are less well provided for in mixed-gender services, even those with effective gender-sensitive treatment. Grace House showed us that women-only services, characterised by both all-female residents and staff teams, can provide a specially designed environment and programme, delivered by an appropriately trained staff team, that can help women feel safe and empowered. This sense of safety enables honest and open discussions about shared women-specific issues creating an improved community of support between residents and a focus on building individualised and highly personal skills and resources to aid long-term recovery. 

Grace House also showed us there are challenges in providing women-only services. Environments need to be designed to meet very specific requirements, residents need more time with their support staff, activities need to be carefully planned, and staff need appropriate training, support and supervision to work with clients and keep themselves safe. Clients required safety to access the service and stability to build trusting relationships with staff and engage with the treatment. Services need to be integrated with wider health and social care  and a network of specialist support for women before, during and after treatment. Appropriate post-treatment housing and aftercare are essential. 

At Grace House, we showed that this is achievable and with the launch of the new drug strategy and funding, a renewed focus on health equality and new commissioning quality standards we believe now is the time to develop a new women-only residential treatment service. 

As we develop the service we’ll be calling on women with lived experience of the Ley Community and Phoenix’s residential services to help. We believe the rich life-changing legacy of the Ley Community will live on through this new service. 

Read the full blog 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

Solace’s silent disco

SIG’s Solace Centre service held a silent disco for their 2022 Christmas celebration, which was a resounding success.

Catherine Bingham, Interim Manager of Solace, said, “As a change to the norm, this year the Solace Centre’s members wanted a ‘knees up’, a get together to celebrate Christmas, so we arranged a ‘silent disco’ – yes, a disco, but with a twist. Instead of music being pumped out of loudspeakers, songs are transmitted directly to sets of headphones which each party-goer wears (55 in total). It was great to see so many beaming smiles and groovy dance moves!” 

Some members of the centre who attended the event said:

“Solace was rocking around the Christmas Tree having fun – thank you, this makes such a difference to my mental health.” – JK

“Fantastic. What a night. Good music, company and festive cheer.” SG

“Fun, lively, really boosted my mental health before Christmas.” – MW

“Good music, good feelings. Helps you forget problems for a while.” – SJ

“Very enjoyable. Christmas can be stressful for some, lonely for others. So, getting together was a perfect antidote.” – KK

“These events brighten our spirits and keep us optimistic. Solace is a family, and like all families, it’s great when we get together and celebrate.” – PB

Norman Alcide, SIG’s Equality, Diversity & Inclusion Programme Manager, who attended the event, added, “It’s just occurred to me that travelling to the Solace Centre and sharing some excellent activity time with participants and staff is becoming a bit of a habit that I’m unwilling to break. It started with the pool competition before morphing into an arts and crafts session, and most recently, I experienced my first silent disco. Having been recently exposed to regular episodes of Strictly, I sensed there was enough data in my memory bank to get through this unique activity.

“At first, it felt a little bizarre and took a bit of adjusting to, particularly when removing my headphones set off and hearing an entire room singing the song I was listening to in unison. However, it wasn’t long before I found my space on the dance floor and was twirling away with everyone else and had one of the best times ever.

“A massive thank you to the participants and staff at Solace for meeting me halfway and building the amazing sense of rapport we share; I feel so much part of this community and urge everyone to accept any opportunity that presents itself to visit this superb centre.”

Read the full blog 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 Social Interest Group

Number of people in alcohol treatment up by 10 per cent

The number of people being treated solely for alcohol issues was almost 85,000 in 2021-22, up by 10 per cent from the previous year, according to the latest figures from the Office for Health Improvement and Disparities (OHID).

Dr Richard Piper, CEO of Alcohol Change UK
Dr Richard Piper, CEO of Alcohol Change UK

However, the figure is still less than the peak of more than 91,600 in 2013-14. 

People being treated for alcohol alone made up 29 per cent of all adults in treatment, second only to those in treatment for opiate use at 49 per cent – the number of people in treatment for opiates fell slightly from 140,863 to 140,558.

Overall there were 289,215 adults in contact with drug and alcohol services in 2021-22, up from 275,896 the previous year. The number of adults entering treatment was 133,704, which was relatively unchanged from the previous two years.  

The number of people starting treatment for powder cocaine was up by 11 per cent to 21,298 – slightly below 2019-20’s peak figure of 21,396 – while the number entering treatment for crack was at its lowest level since 2015-16. The number of people using crack with opiates fell from more than 21,000 to less than 19,000, although the number using crack without opiates rose slightly to just over 4,700. 

A sixth of all people entering treatment – and a third of those entering treatment for opiates – reported having a housing problem, while 70 per cent of all adults starting treatment stated that they had a mental health treatment need. More than half of all people entering treatment were smokers, although just 4 per cent had been offered referrals for smoking cessation. There were 3,742 recorded deaths of people in treatment in 2021-22, although OHID points out that these ‘might not be alcohol or drug-related’. 

Commenting on the increase in people in alcohol treatment, Alcohol Change UK chief executive Dr Richard Piper told the BBC that around 600,000 people currently needed treatment with the vast majority still not accessing it. ‘Evidence shows that, for many people, the COVID-19 pandemic led to an increase in their drinking with those already drinking heavily most likely to have been drinking more,’ he added.

WDP and FitbyCords secure new partnership

Leading drug and alcohol charity WDP has teamed up with activewear brand FitbyCords to offer its Capital Card users bright and comfortable gym wear socks. 

The activewear socks are available at WDP Harrow and service users can obtain them directly from the ‘grab and go’ cabinets using their Capital Card points at any time the service is open.

Users of the WDP Capital Card earn points by engaging in drug and alcohol treatment and can then usually spend their points on positive activities and products in their local community at our Spend Partners, such as gyms or eateries. 

FitbyCords offered to supply some of their specialist gym wear socks to the WDP Harrow hub after visiting the service, as they wanted to help individuals who were struggling.

Cordelia Esson, owner of FitbyCords, said, “I attended the Recovery Month event at the Harrow service, it was such an eye-opening experience. The people who attended spoke about their experiences in life and how the WDP has helped them on the road to recovery. I am so glad I got the opportunity to see and hear what goes on, it also gives me an insight into what the organisation does.”

Max Griffiths, Capital Card Manager, added, “At the Capital Card we are very conscious of the cost of living crisis and with the winter season upon us, this exciting partnership means Harrow service users can use their Capital Card points to purchase a gift for themselves or a loved one, and keep warm!”.

Read the full blog 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 WDP

A partnership between national and local charities launches in Bradford

A partnership between national and local charities launches in April 2023 providing drug and alcohol treatment and recovery services across Bradford District.

The new service, named, ‘New Vision Bradford will be led by the national charity Humankind with partners Project 6, The Bridge Project and Create Strength Group who have been working and supporting people across the district for many years. New Vision Bradford aims to improve outcomes for people with issues around alcohol and drugs across the district, better meeting the needs of the area’s diverse communities.

Executive Operations Director for Humankind Ted Haughey said: ‘We are delighted to be working across the District, delivering a treatment and recovery service that builds on our existing services locally both in Bradford and West Yorkshire. Humankind has extensive experience of providing successful substance misuse services across England. With the local knowledge, links and infrastructure of our partners feel we are uniquely placed to effectively mobilise and deliver the new service.’

Humankind Regional Operations Director Lee Wilson said: ‘Humankind has been working in Bradford for a number of years supporting homeless people through our highly regarded No Second Night Out service. I’m thrilled that we will now be delivering the substance misuse service in the city. Personally, I have wanted to deliver the service for several years and I can’t wait to get started. Working with our partners we are aiming to deliver a unique and outstanding service to the people of Bradford District.’

Jon Royle, CEO of The Bridge Project: ‘Bridge has been delivering high quality treatment and recovery services across Bradford for almost 40 years and we are delighted to be working with our new partners on new Vision Bradford, offering a broader range of interventions. Our priorities now are to support our fantastic staff through the transitionary period and deliver better outcomes for the people who use our services.”

CEO of Project 6 Vicki Beere said: ‘Project 6 is delighted to be part of this new partnership delivering substance use services across the district. We have a much-needed opportunity to build inclusive and accessible services across Airedale and Wharfedale and look forward to the partnership developing these; alongside colleagues from the wider health and care system. Our priority for the next few months is to support our staff and the people who use our services through this process.’

Project Lead of Create Strength Group Dave Memery said: ‘Create Strength Group are excited to be part of this inventive and vital recovery partnership that will see Bradford district benefit from a dynamic and integrated solution. We look forward to working with our dedicated and forward-looking partners, achieving, and growing together developing a world class treatment & recovery system that Bradford deserves.’

New Vision Bradford will include a range of support including harm reduction, care coordination, clinical and psychosocial therapeutic interventions. Create Strength Group will provide support for people who become abstinent to create a lived experience-led recovery community for the district.

New Vision Bradford has been commissioned by Bradford Metropolitan District Council and the NHS West Yorkshire Integrated Care Board (through the Bradford District and Craven Health and Care Partnership). The service will launch on April 1st 2023.


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 Humankind

 

A new job and career in 2023

Photo by Glenn Carstens-Peters on Unsplash

Forward’s Executive Director for Employment Services Asi Panditharatna gives some practical advice for achieving your employment goals in 2023.

Happy new year, everyone!

The new year marks a fresh start for all of us – a time for change. For many people, this can include anything from starting a new job or apprenticeship to beginning a new training course or becoming self-employed.

If this is something you want to do, but don’t know where to start, Forward can help. Based on our experience as a leading careers advice, employability and skills provider, here are six things you can do immediately:

  1. Prepare a plan: Set goals and objectives and write them down. Your plan should be realistic and not underestimate the amount of time and effort it will take to achieve your goals. Always regularly review and update your plan based on your progress and feedback from others. This is called effective updating, so you can make your plan better each time you review it.
  2. Research your future career: If you are not sure about what you want to do in 2023, then definitely speak to a careers advisor or access the free resources on the National Careers Service. This gives you the opportunity to assess your skills and provides excellent information and resources on around 800 different career profiles. Find out more here.
  3. Develop your skills: There are lots of Government funded programmes you can access for free, particularly if you are unemployed. This includes courses run through the Adult Education Budget provision, including those run by The Forward Trust in Kent and London, with a focus on ‘Green Skills’. Alternatively, perhaps try our free enterprise/self-employment services. More information can be found via the following links:
     

  4. Be prepared to network: If you want to get ahead in your career, then it’s good to make connections. Use LinkedIn, look the part at face-to-face meetings, and get over your nerves by ‘faking it’. This means preparing well, knowing who you might be meeting, preparing a brief introduction you can use i.e. talking points, and practising at home in advance to make sure you feel comfortable.
  5. Focus your search: Once you have shortlisted your career, training or self-employment options, try to focus your search a bit more. For example, if you are interested in Green Sector jobs, there will be specific job boards or training courses you can do. This will also help you to find out more about the sector and the requirements for working or training in it. A focused approach can produce better results.
  6. Interview with impact: Make sure you are doing the essential things: look the part, present yourself well, and do the research into the employer you are interviewing with. To do a great interview, you will need also to interview with impact, so do not forget to:
    • Be curious: Ask thoughtful questions and listen well. This will help you discover common ground with your interviewer and leave a lasting impression. It is probably not a good idea to ask questions that sound like you are interviewing them, but rather ones that show your interest in the organisation and its future.
    • Map your career journey: Interviews are an opportunity to show off your interpersonal and communication skills. Interviewers may start with something along the line of, “Tell me about your career to date”. Take a creative approach and, instead of your entire career history, focus instead on a few simple bullet points with specific high points or moments relevant to this role, including how each step led you to the next, and ultimately brought you to the job you are interviewing for.
    • Practise: The more you practise answering interview questions aloud, the more confident you will be when it is real. Start with these questions and practise in front of a mirror (or with your tutor, advisor or coach). You can record it on your phone and play it back to yourself.

Good luck and we wish you every success in 2023!

Read the full blog 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

Canada revises low-risk drinking guidelines to ‘one to two’ drinks per week

Just one to two standard drinks per week is considered low risk to health, according to Canada’s updated alcohol guidelines. Between three and six per week represents a moderate risk, while the more consumed above that the higher the risk of ‘seven types of cancer, most types of cardiovascular diseases, liver disease and violence’, states Canada’s guidance on alcohol and health.

The guidance aims to help people make informed decisions about their drinking.

The new guidelines, which are designed to support people in ‘making informed decisions about their health’, substantially revise the country’s previous guidance from 2011 which recommended no more than 15 drinks a week for men and ten for women. ‘For your health, less is better,’ says The Canadian Centre on Substance Use and Addiction (CCSA), which published the guidelines. ‘If you’re going to drink, don’t exceed more than two drinks on any day,’ it adds. ‘The more you drink, the higher your risk.’

The UK’s own drinking guidelines were revised down from 21 units a week for men and 14 for women to 14 for both men and women in 2016 with the aim of ‘keeping the risk of mortality from cancers or other diseases low,’ the government stated at the time. This was because the ‘links between alcohol and cancer were not fully understood in the original guidelines, which came out in 1995.’

Canada’s new guidance is the result of a two-year research project led by CCSA and funded by Health Canada, the government department responsible for national health policy. The project involved looking at almost 6,000 peer-reviewed studies, and an expert panel of more than 20 scientists. In 2018 Canada became the first G7 country to legalise and regulate recreational cannabis (www.drinkanddrugsnews.com/cannabis-becomes-legal-in-canada).

‘People have a right to know this information,’ said CCSA chief executive Alexander Caudarella. ‘The evidence is clear that every drink counts. It’s also clear that it’s never too late to make changes. Any reduction in alcohol use can be beneficial. Health professionals can now better determine an individual’s risk and collaborate with their patients to improve their health.’

‘Canadians need to know there are serious health risks associated with drinking alcohol, including elevated risk of multiple types of cancer,’ added CEO of the Canadian Cancer Society, Andrea Seale. ‘Many Canadians are unaware that alcohol consumption increases the risk of cancer, and most don’t realise they are drinking unsafe amounts. This guidance is so important because it clarifies that the less alcohol you drink, the lower your cancer risk.’

Canada’s guidance on alcohol and health: final report at ccsa.caread it here

WithYou is delighted to announce the appointment of a new Chair of Trustees, Anne Chapman.

Anne, who has been a Trustee of WithYou’s Board since 2015, had also held the role of Vice-Chair of Trustees from 2018.

Anne succeeds in this role Lord Alex Carlile, former Chair of the Board, who stepped down in October 2022 after completing two three-year terms in office which, in his address in the last Annual Report and Accounts of the charity, he referred to as ‘six demanding, stimulating and inspiring years’.

New chair of trustees at With You, Anne Chapman
New chair of trustees, Anne Chapman

Anne brings a wealth of experience to the role, she is a trained solicitor and is the Company Secretary and Assistant Director of Governance and Compliance for housing association, Golding Homes. Anne is also the Vice-Chair of the governing board of the Chartered Institute of Housing and Deputy Chair of the Eldon Housing Association. Previously she has chaired two NHS trusts and held board positions for charities and school governing bodies.

Anne said: ‘I am delighted to continue my journey at WithYou, now as the Chair of the Board of Trustees. It is such an important time for the drug, alcohol and mental health support sector as we consider the long-term societal impact of Covid on our service users, and the ongoing cost-of-living concerns. The work WithYou does to support those most in need is phenomenal and I am thrilled to be able to continue working with our dedicated staff to support some of the most vulnerable people in our society, improving their lives.’

Read more


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 With You

The impact of the cost of living crisis on families affected by substance use in the UK

adfam cost of living surveyAdfam is running a new online survey to understand the experiences and challenges faced by families affected by substance use during the cost of living crisis in the UK. 

The cost of living crisis is having a devastating impact on families across the UK who are struggling to make ends-meet.

We know that many families affected by substance use already suffer financial hardship as a result of their situation and we are looking to find out how the cost of living crisis is exacerbating things even further.

Responses will provide Adfam with vital evidence of what families are currently experiencing, which will be used to inform our work and to try and achieve change through service provision, policy and greater awareness and understanding.

The survey should take no longer than 10 minutes to complete, and is open until Monday 6 February 2023.

Find out more and take part in the survey 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

Fentanyl behind 80 per cent increase in New York overdose deaths

Fentanyl use has driven the massive rise in overdose deaths in New York City

Drug overdose deaths in New York City have increased by almost 80 per cent since 2019, the city’s health department has announced, largely driven by an increase in fentanyl use.

There were 2,668 overdose deaths in the city in 2021, 27 per cent up on the previous year and a 78 per cent increase since 2019. Fentanyl was detected in 80 per cent of the deaths, with ‘evident disparities by age, race, poverty level and neighbourhood of residence’, the health department states. The city distributed more than 32,000 fentanyl test strips along with almost 160,000 naloxone kits in the first nine months of last year, it added.

‘These deaths are heart breaking and many, if not most, are absolutely preventable,’ said health commissioner Dr Ashwin Vasan. ‘As a city we must use every evidence-based tool at our disposal to reach people with services and – most of all – support and compassion. As a society, stigma, shame and fear have worsened the situation and delayed the deployment of proven solutions. We must use these ever-worsening outcomes to combat this fear and to meet people where they are with care, and our team is working on an expanded response plan to continue fighting this crisis.’

Last year saw America’s first two safe injection facilities open in New York in an attempt to tackle the country’s ongoing opiate crisis (www.drinkanddrugsnews.com/first-safe-injection-facilities-in-us-open-in-new-york). There were almost 108,000 overdose deaths in the US as a whole in 2021, according to the Centers for Disease Control and Prevention (CDC), a 15 per cent increase on the previous year. The country has now seen more than a million overdose deaths since CDC began collecting the data in 1999.

BDP’s inspirational founder Maggie Telfer dies aged 63

The CEO and founder of Bristol Drugs Project (BDP), Maggie Telfer, has died aged 63, the charity has announced. Telfer founded the organisation with a group of probation officers in 1986, in response to the lack of support for people who used drugs in Bristol.

She was also instrumental in establishing the first sub-Saharan needle exchange, Kenya’s Omari Project, and was awarded the OBE in 2007. ‘Maggie’s work was defined by her drive to challenge the inequality and stigma faced by some of the most vulnerable people in our society,’ the charity states.

‘We are all devastated by the loss of a much-loved colleague,’ said BDP’s chair of trustees, John Long. ‘She has led the charity from strength to strength, across five decades. Maggie’s leadership, compassion and indomitable spirit inspired all around her. Our sadness will be matched by the sorrow of many people and their families whose lives were improved and transformed by her work. The city of Bristol has lost one of its truest champions.’

Scottish Government committed to tackling ‘public health emergency’ of record drug deaths

The Scottish Government has re-stated its commitment to tackling the country’s ongoing drug deaths crisis in its response to the final report from the Drug Deaths Taskforce. Measures were being taken across a range of policy areas including employment, education and justice, as well as health and social care, the government stated.

The taskforce’s final report, which was published last summer, called for a ‘major cultural change’ and a new kind of treatment system defined by quality and genuine choice (https://www.drinkanddrugsnews.com/time-for-a-complete-culture-change-says-drug-deaths-taskforces-final-report). Concentrated social deprivation was a major contributory factor to the crisis, it said, along with a healthcare system that ‘often sees only the drug problem and does not recognise the person’, discouraging many from accessing the help they need. Overhauling the system was necessary to ensure that people with substance issues received parity of ‘treatment, respect and regard’ with other health conditions, it stressed.

Auditor general Stephen Boyle said drug and alcohol data was not good enough and that there was a lack of transparency on spending.

Action was also needed to make the treatment system easier to navigate, the task force document stressed. A report by Audit Scotland earlier last year called for a clear plan to improve ‘complex’ drug and alcohol services, adding that the range of organisations working across different sectors meant that lines of accountability were not always clear. While there had been ‘more drive and leadership’ from the Scottish Government it was ‘still hard to see what impact policy is having on people living in the most deprived areas, where long-standing inequalities remain,’ said auditor general Stephen Boyle. ‘Drug and alcohol data is not good enough, and there is a lack of transparency about how money is being spent and allocated.’

Despite a 1 per cent reduction in deaths in 2021 – the first fall in almost a decade –Scotland’s drug death rate has been consistently higher than anywhere else in Europe, and is more than three and a half times greater than that for the UK as a whole. Scotland’s alcohol-related deaths are also at their highest level for 13 years, despite the introduction of minimum unit pricing. As is the case with drug fatalities, the death rate remains far higher in the country’s most deprived areas (www.drinkanddrugsnews.com/scottish-alcohol-deaths-at-highest-level-for-13-years/).

Many of the Drug Deaths Taskforce’s 20 recommendations and almost 140 action points were already being addressed, the Scottish Government said, with new announcements including a stigma action plan and more money for children and families and treatment services within primary care settings. All the measures were underpinned by two principles – that ‘services treat problem drug use the same as any other health condition, and that people with lived experience are involved in policy decisions’, it said.

Drugs minister Angela Constance: ‘We cannot underestimate the scale of this crisis.’

‘We continue to face a public health emergency and cannot underestimate the scale of this crisis,’ said drugs minister Angela Constance. ‘The Drug Deaths Taskforce was formed to provide independent expert advice on our response to this emergency and this cross-government action plan includes a broad range of initiatives which will not only support the complex needs of people who use drugs but also help support prevention and early intervention.’

Drug Deaths Taskforce response: cross government approach at www.gov.scot/publications/drug-deaths-taskforce-response-cross-government-approach/

WDP to provide IPS Into Work employment support to Islington residents

Photo by Tim Gouw on Unsplash

WDP has announced that it has been successful in its bid to deliver an Individual and Placement (IPS) service in Islington for residents with substance misuse needs. 

This is in addition to WDP’s existing West London Alliance contract in nine West London boroughs.

The IPS Into Work service will provide high-quality employment support to residents of Islington, who have substance misuse needs, to support them into paid and sustainable employment.

Since early 2019, WDP’s award-winning IPS Into Work service has focused on achieving sustainable employment to help reduce stigma, enrich lives, boost local economies, develop additional talents, and create workforces that reflect the diversity of their local communities.

The IPS Into Work service in Islington will have a dedicated and focused team that will build people’s skills through training and work experience in an inclusive and supportive environment. Working in collaboration with commissioners and services in the borough, the service will comprise three distinct IPS components: Information, Advice and Guidance (IAG); Individual Placement Support (IPS) and Active Volunteering.

DDN Jobs
See IPS Employment opportunities on DDN Jobs

Lisa Luhman, Commissioning Manager for Public Health, said: “Islington are excited about the development of the new employment support service, and believe the service will achieve great outcomes for some of our most vulnerable residents”.

Paul Anders, IPS Programme Manager for Office for Health Improvement and Disparities, added: “We’ve already seen the difference that finding work via IPS is making to people around the country. We’re delighted that WDP is able to expand its provision in London – this will create great new opportunities for Islington residents.”

Craig Middleton, WDP’s Executive Director of Services, also said: “We are excited that we will be able to offer our amazing IPS service to individuals in Islington. Working with a range of partners and stakeholders, this will allow people to realise their ambitions and aspirations to gain volunteering, training and paid employment based on their preferences.”

Read the full blog 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 WDP

Synergy’s Rosie shaves head to save Christmas

Rosie Hunt from SIG Penrose Synergy service bravely decided in December to shave her head to raise money to buy Christmas dinners for Synergy participants and their families.

In 2021, many Synergy participants were left without Christmas dinner when local charities that provide food for the festive period were inundated with huge numbers of Luton residents asking for help with meals.

Thanks to the money that Rosie raised, 23 people and their families were given the ingredients to make a full traditional Christmas dinner. Rosie approached a local butcher who kindly gave a discount on turkeys, and Penrose Roots to Recovery supplied the vegetables. There were also Christmas puddings for everyone.

Donations also came from colleagues at SIG Penrose, Synergy, and Rosie’s friends and family. Over £400 was raised.

Well done, Rosie! We are really proud of this incredibly generous, heartfelt (and brave in this weather!) gesture. Your selfless act truly epitomises the true meaning of Christmas – love, and goodwill towards others.

Read the full blog 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 Social Interest Group

Focusing on health and wellbeing in the new year

Turning Point’s National Head of Service, Davinder Jhuty, discusses focusing the new year on health and wellbeing and making manageable resolutions.

At the beginning of each new year, many of us set some new year’s resolutions, whether they be big or small, from running a marathon to learning a new language. If you do take a moment to focus on things that you would like to achieve in the coming year, it is important not to put too much pressure on yourself. Tips when making new year’s resolutions: 

  1. Set achievable goals: don’t set yourself up for failure with something that’s completely unachievable. You can always set new goal posts during the year when you reach it.  
  1. Don’t compare: It’s harder than ever before, in the age of social media, to remember that nobody is perfect – even if it appears that way online. Instead of setting goals based on what you think others are achieving, outline small to large objectives based on your own personal track and timeline.  
  1. Prioritise self-care: looking after your health and wellbeing isn’t selfish, it’s a necessity that needs to be at the top of your priority list. Make new year’s resolutions that will help improve your mental and physical health such as more physical activity. That doesn’t mean you have to run a marathon, it could be as simple as walking to the local shops once a week.  

A healthier lifestyle is a common resolution, and everyone can take steps to improve their health and wellbeing, but some people might need some extra support to make a change. Turning Point’s Health and Wellbeing Handbook can be used by support workers or family carers supporting someone with a learning disability to make changes in order to improve their health and wellbeing. It is full of information and practical tips within that ranges from healthy lifestyles to staying safe, emotional health, physical health, sexual health, and relationships.  

This resource has been developed collaboratively with colleagues from across Turning Point, bringing together expertise in the areas of drugs, alcohol, mental health, sexual health, healthy lifestyles and learning disability to develop a tool which can be used across our services.   

Health and wellbeing mean different things to different people. For instance, we might consider it being illness free, eating a balanced diet, taking exercise or feeling able to cope with the stresses of everyday life.  

Many people with a learning disability have poor health outcomes. The life expectancy of women with a learning disability is 18 years less than average. For men with a learning disability, it’s 14 years less (NHS Digital 2017). Access to healthcare is a key factor in this difference but adopting a healthier lifestyle can also make a big difference in a person’s overall health and quality of life. People with a learning disability should have the same opportunities to improve their health and wellbeing as anyone else.  

People need good information if they are to make informed choices about their health and wellbeing, have access to the services they need, and feel comfortable to take advantage of those services and support.  

Using the Handbook, we hope to empower the people we support across all settings to set their own goals for the year. I am excited for the year ahead and to see what people will achieve in terms of their own health and wellbeing goals in 2023.  

Read the full blog 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

Forward’s Social Impact Report 2021-22

Forward has released its Social Impact Report for work conducted in 2021/22.

Forward’s fifth annual impact report, and the biggest and most comprehensive yet, it showcases our growing reach and expanding range of support, including:

  • 16,121 people directly supported across the country, with a further 3,729 people engaged and helped through our online chat support service, reaching and connecting the most isolated and disadvantaged groups in society;
  • Six service categories across 70 distinct projects, encompassing substance misuse, mental health, employment, support for people on probation, housing, recovery, and family and young people’s services;
  • With all service categories receiving consistently outstanding feedback from service users, partners, commissioners and inspectors.

As well as detailed breakdowns of each service area, you can read about a rich variety of special projects and initiatives including:

  • The Opportunity Escalator, supporting service users into training and employment;
  • Our unique range of abstinence-based recovery programmes, delivered in prison, residential settings, and in the community, both online and face-to-face;
  • Forward Connect, our network of recovery communities facilitating mutual aid and peer support;
  • Our M-PACT programme for families affected by addiction;
  • Enterprise Clubs, offering self-employment support and start-up funding;
  • The Worth programme for vulnerable women at risk of violence.

The report also provides details of our ground-breaking campaigns, Taking Action Against Addiction and More than My Past, which have had a huge impact on raising awareness of the challenges our clients face, breaking down stigma and building belief in recovery. Plus much more!

Read the full blog 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

‘It’s up to us!’

Opening a conference about stigma, Roy Lilley began with a personal story. His dad was ‘born illegitimate’ as it was regarded back then. The status thwarted his chance to go to the Royal School of Music at the form-filling stage. He came back from WWII with shell shock and went to a mental health hospital where they gave him electric shock therapy. Later, struggling to make a living in post-war austerity Britain, he couldn’t get a job in the grocery trade where he’d started, as he’d been in a mental institution. 

Roy Lilley – NHS Writer, Broadcaster, commentator and conference speaker
Roy Lilley – NHS Writer, Broadcaster and commentator

‘That’s a story about stigma,’ said Lilley. ‘It happened a long time ago, but it has relevance. Stigma changes people’s lives.’ Whatever the context – and ‘it doesn’t matter if they’re unfortunate enough to be dependent on a drug’ – it was still stigma, and as prevalent now (he gave Twitter as an example) as when it impacted his father’s life in the 1920s.

Thinking about three categories of stigma could help to tackle it, he said. Self-stigma was about internalising feelings of shame and lack of self-belief; social stigma involved taking on negative attitudes towards yourself and your family members, while structural stigma was built into the system.

So what could we do about any of this? ‘It’s up to us – up to people like you who work in the sector,’ said Lilley. He offered a phrase from his earlier writing about stigma: ‘Stigma is a burden borne by people with quite enough of a burden already. It’s our job to lighten their load.’

A good approach started with curiousness. ‘When you think you’re doing a good job, how do you know someone isn’t doing it better? You don’t know.’ This approach led him to set up the Academy of Fabulous Stuff to share best practice, and he urged people to ‘pinch it with pride’. He believed that we wouldn’t improve health services by league tables, inspections and embarrassing people. ‘The only way to improve our services is by being curious, by opening our minds,’ he said. ‘Our minds are the parachutes – they’re better when they’re open.’

The next important factor was to improve skilfulness by training, aiming to ‘improve everyone’s skills base by one notch’. He appealed to budget holders to give time to people to improve their skills base, something that could be done in-house through dialogue, by talking to each other, if money for training was tight. We should aim to ‘lighten the load by taking one brick at a time’ and days like these [the online conference] were ‘when people come together to lighten people’s load’.

The other important strand was helpfulness, he said. ‘Test everything you do – is this helpful?’

So how do we get rid of stigma? His response to this was that we don’t. Stigma was ‘part of prejudice, part of life, the ugly bit of humanity’. Rather, we needed ‘to make people understand that no one sets out to take drugs and destroy their and their families’ lives. We have to look beyond that’ and attempt to understand it: ‘If you were born when they were born, taught what they were taught, you would think like them.’

Everyone had a history, a back story, and were unlikely to have been born in a bundle of rags in a doorway, but ‘most of us were lucky to take the right fork in the road’. He gave the example of a sportsman – breaking a leg would result in plenty of support, but the complete opposite if they had a substance misuse problem.

anti stigma campaignMoving on to a panel discussion, conference chair Danny Hames asked, ‘how do we tackle stigma in the NHS?’

‘The separation of drug users needs to be called out,’ said Kate Hall, who had been involved in a ‘See the person, hear their story’ campaign. ‘We need to lobby from the top. There needs to be a complete intolerance of how people with addiction issues have been treated over the years.’ Despite the health focus of the Dame Carol Black review, the drug strategy had become very crime focused – a ‘silo approach’. ‘We need to work really collaboratively to make sure we’re doing the best we can for people who are facing really marginalising behaviour,’ she said. ‘It wouldn’t be tolerated in any other healthcare setting.’

Andy Ryan, head of services at Changing Lives, had experienced stigmatising treatment himself, with a hospital doctor telling him ‘these beds are for people who are really sick, you know’. While acknowledging that stigma was ‘an unfortunate offshoot of stresses and pressures of the system’, he urged everyone to look at education and language. He also highlighted a ‘systemic problem around teams’ and called for transparency in tackling stigma together, including working with employers. We should also help people to understand the causes of addiction, especially the link with trauma, and to explore the potential of psychosocial interventions. ‘Be curious not critical,’ he said. ‘That could really link us together.’

Howard King offered a perspective as MD of a large community trust that included mental health. While disappointed that the drug strategy focused on crime, it was also an opportunity to work with people when they were brought into the criminal justice system – to turn the stigma of being separated from society into a chance to connect them with services. We needed to resist the NHS culture of working in blocks, even though it was ‘easier to push people off and refer them to someone else’ and be curious about how we could help them.

‘We can deal with all these stigmas but not in one go – it’s a brick-by-brick approach,’ concluded Lilley. ‘As we say in the academy, start with the person and work backwards. It never fails.’

Challenging Ignorance

hep c u later campaign‘Get that druggie out of my hospital.’ Tony Mullaney (now training and development coordinator at Hep C U Later) described the barriers that disclosing his hepatitis C status had put in front of his healthcare. A hospital had insisted on moving his operation to the end of the day so they could clean everything down. When he had an intravenous line in, nurses wouldn’t take it out for him. A dentist wouldn’t treat him at the mention of hepatitis C, even when he told the dentist he was antibody positive.

‘Stigma isolates people, pushes them away, makes them feel they don’t belong,’ he said. Furthermore, it made people with hep C afraid to disclose their status. People in prison didn’t want others to find out – ‘hep C is whispered about… people won’t share a cell.’ 

At home he felt stigmatised by his own family: ‘My mum washed my clothes on a hot wash so no one else could catch it.’ Even peers stigmatise each other, he said, as ‘no one wants to catch it – there’s ignorance on how it’s spread’.

So what could we all do to combat hep C stigma? Louise Hansford, Hep C U Later coordinator, said we needed to ‘demystify it, talk about it, make it OK for people to have hep C’.

Much of the stigma related to ignorance – she described how her friend was antibody positive, but the nurse appeared in full PPE and goggles when she had her baby. She had also had ‘horrendous experiences’ herself and believed it was ‘not through vindictiveness’. In the past, recovery workers didn’t talk about hep C, but now we needed to make it acceptable to have it. 

Hep C treatment had transformed her, and to see that replicated in other service users was ‘phenomenal’. ‘No one sets out to be a drug user with hep C,’ she said. ‘We need to get back to our core values.’

One in seven planning to do Dry January

8.8m people are planning a ‘Dry January’

One in seven UK adults is planning to abstain from drinking in January 2023, according to a survey by Alcohol Change UK.

An estimated 8.8m people said they were planning to take part in Dry January, up from 8m last year. Three out of ten said they also planned to drink less overall next year.

A quarter of respondents reported drinking more this year than in 2021, with 16 per cent saying worries around the cost-of-living crisis had caused them to increase their drinking. One in seven added that they’d prioritised buying alcohol over essential items like groceries. According to the latest Health survey for England, twice as many men report regularly drinking over the chief medical officer’s 14 units a week guidelines as women (www.drinkanddrugsnews.com/ecstasy-use-halved-during-pandemic). Among young people who drink, anxiety after drinking was cited as a factor in them deciding to reduce the amount they consumed by 36 per cent of respondents. Forty per cent of under-34s reported regularly experiencing ‘hangxiety’, compared to 12 per cent of over-35s.

January 2023 will mark the tenth anniversary of Dry January. Of those planning to take part, one in three said they’d prefer to do so with Alcohol Change UK’s resources – such as the Dry January app and motivational emails – than do so on their own.

Ailar Hashemzadeh: More and more of us have found our drinking creeping up

‘Over the past few years, things have been incredibly tough for so many people and the cost-of-living crisis is making things even tougher,’ said Alcohol Change UK’s director of research and public affairs Ailar Hashemzadeh. This has led to more and more of us finding our drinking creeping up, particularly for those of us who were drinking more heavily to start with. Since its launch ten years ago, Dry January has provided a brilliant opportunity for hundreds of thousands of people to take a break from drinking and have a total reset.’

Meanwhile, more than 450 organisations and individuals have written to the Home Office condemning the proposals for harsh new penalties for drug possession set out in the controversial Swift, certain, tough white paper. Organised by Transform and Release, the letter has been signed by the BMA, NHS Addictions Providers Alliance, Faculty of Public Health, Association of Directors of Public Health, Change Grow Live, Addiction Professionals, Forward Trust, Kaleidoscope, With You, Turning Point, Cranstoun and others. The white paper’s proposals – which many people believe to be unworkable – include confiscating the driving licences and passports of people convicted of drug possession offences.

‘With drug-related deaths in the UK increasing the government could have chosen to use this moment to conclude that the punishment-first model is ineffective and instead to adopt an evidence based, public health attitude to illicit drug use,’ said chair of the BMA’s science board Professor David Strain. ‘Alas instead with this white paper it appears to be doubling down on a failed model by promoting ever harsher sanctions that perpetuate the stigma and shame already acting as a barrier to individuals seeking help, and ultimately discouraging drug users from seeking the healthcare services they need.’

Alcohol Change Dry January

Open letter here 

Alcohol duty freeze extended by six months

The freeze on alcohol duty has been extended by six months, from February 2023 until the beginning of August, the Treasury has announced. The move is to ‘reassure and provide certainty to pubs, breweries and distilleries facing tough challenges ahead’, it says. 

richard piper alcohol change
Dr Richard Piper CEO of Alcohol Change UK said ‘Eroding the value of alcohol duty yet again will cause significant harm.’

Chancellor Jeremy Hunt announced in the Autumn Statement that duty rates would go up in February, reversing the decision made by his predecessor Kwasi Kwarteng. Any decision on duty rates will now be held until the Spring Budget next March, however, and not come into effect until August. This will align with the introduction of ‘historic reforms to the alcohol duty system’, the government adds – the simplification of the system originally announced by then-chancellor Rishi Sunak in October 2021, and welcomed by alcohol health campaigners as it includes different rates based on the strength of drinks (DDN, November 2021, page 4). 

‘Today’s announcement reflects this government’s commitment to responsible management of the UK economy and supporting hospitality through a challenging winter,’ said exchequer secretary to the Treasury James Cartlidge. ‘The alcohol sector is vital to our country’s social fabric and supports thousands of jobs – we have listened to pubs, breweries and industry reps concerned about their future as they get ready for the new, simpler, alcohol tax system taking effect from August.’

Alcohol Health Alliance chair Professor Sir Ian Gilmore said ‘The government need to start putting people’s health before big businesses.’

Charities and campaigners, however, have condemned the decision and are urging the government to reconsider. ‘We are deeply disappointed that the government has decided to freeze alcohol duty again for six months, after promising earlier this year that it would not – this is equivalent to a real-terms cut,’ said Alcohol Change UK chief executive Dr Richard Piper. ‘Eroding the value of alcohol duty yet again, by failing to even match inflation, is damaging to all of us as taxpayers and will cause significant harm.’ The decision to ‘subsidise’ alcohol producers was ‘totally unfair’, he stated, with Diageo seeing a jump in its profits this year of more than 18 per cent. 

The government needed to ‘start putting people’s health before big businesses’ profits straight away’, added Alcohol Health Alliance chair Professor Sir Ian Gilmore. ‘Furthermore, this decision will actually serve to put more pressure on pubs by helping supermarkets to maintain the low prices that undermine sales in the hospitality sector.’

Open letter to Home Office from 500 public health and criminal justice experts calling for a rethink of drug possession proposals

Photo by Marcin Nowak on Unsplash

Together with Transform Drug Policy Foundation, Release has organised an open letter condemning the Government’s proposed approach to drug possession offences for the lack of evidence behind their decision-making.

Release has been very clear about its position towards the Government’s latest White Paper “Swift, Certain, Tough: New Consequences for Drug Possession”, setting out its harsh approach to so-called “recreational drug users” which we condemned in our consultation response.

Together with Transform Drug Policy Foundation, we have organised an open letter signed by more than 500 experts in public health and criminal justice condemning the proposed approach for the lack of evidence behind their decision-making. In a time where the rest of the world is moving forward, legalising cannabis and removing criminal sanctions for the possession and use of other substances, the UK is increasingly regressing, turning our drug policy into a draconian artefact.

A copy of the letter can be found below:

We express our serious concerns over the proposals in The Home Office’s ‘Swift, Certain, Tough: New Consequences for Drug Possession’ White Paper released in July 2022. The proposed extension of punitive policing targeting people who use drugs runs contrary to the overwhelming body of evidence and threatens to draw limited resources into policies likely to exacerbate a range of social and health harms.

The proposals focus on punishing ‘so-called recreational users’ who are not dependent on drugs. Targeting this large population will require a dramatic scaling up of policing, including the use of stop and search. Stop and searches for drugs already account for two-thirds of all searches, disproportionately impacting marginalised and ethnic minority communities, particularly Black people. These proposals will further undermine trust in law enforcement and already-strained community police relations.

The Home Office’s own research has stated that the £1.6 billion a year spent on drug law enforcement has little impact on drug availability. Home Office research has also concluded there are no clear links between intensity of punitive enforcement and levels of use. But punishment and criminalisation of people who use drugs has repeatedly been shown to undermine health and life opportunities of the most vulnerable individuals and communities, fuelling stigma and discrimination, and creating obstacles to proven health and social interventions.

As drug related deaths reach new records, the Government should be targeting limited resources on health interventions proven to reduce harms. These proposals will do the opposite.

We urge the Government to instead develop a genuinely public health centred approach. and focus on evidence-based health interventions that target those in need, while avoiding harmful punishment and criminalisation of the very groups we are seeking to support. This process can usefully be informed by emerging UK and international best practice, not least the growing evidence base, and ongoing research, from existing Police diversion programmes already operating in 14 UK Police authorities.

To read the full blog post, click 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 Release

Ecstasy use halved during pandemic

Reduced social contact is likely to have contributed to lower ecstasy use

Rates of ecstasy use fell by 47 per cent among all adults – and 72 per cent among 16 to 24-year-olds – between the year ending March 2020 and the year ending June 2022, according to the latest Crime survey for England and Wales (CSEW) figures from ONS, with less than 1 per cent of adults reporting taking the drug. Rates of nitrous oxide use also fell from 8.7 per cent to 3.9 per cent among those aged 16-24.

The reductions contributed to an overall drop in the reported rate of last-year class A drug use among all adults from 3.4 per cent to 2.7 per cent, and among 16 to 24-year-olds from 7.4 per cent to 4.7 per cent. The reduced rates of use were likely the result of restrictions on social contact during the COVID-19 pandemic, says ONS, although rates of cocaine use were unchanged.

Just over 9 per cent of all adults and almost 19 per cent of 16 to 24-year-olds reported last-year use of any drug in the year ending June 2022, unchanged from the year ending March 2020. The proportion of 16 to 59-year-olds classing themselves as ‘frequent’ drug users (once a month or more in the past year) also remains largely unchanged at 2.6 per cent. Almost half of illegal drugs were obtained through friends or colleagues, compared to just under 23 per cent from a dealer.

The CSEW figures are based on data collected between October 2021 and June 2022, and while they are the first set of figures comparable with pre-COVID data they are based on a lower response rate than usual ‘which may affect the quality of the estimates’, ONS points out.

The survey shows a shift in drinking patterns

Meanwhile the latest Health survey for England found that around 80 per cent of people had drunk alcohol during the last year, with just under 50 per cent drinking at least once a week. Just under 30 per cent of men had drunk over the recommended guideline of 14 units during the last week compared to 15 per cent of women. In a sign of the shift in drinking patterns over recent years, men aged between 55 and 74 were now most likely to exceed the weekly guidelines, along with women aged 45 to 64. Five per cent of men drank over 50 units a week, while 2 per cent of women regularly drank more than 35 units a week.

Drug misuse in England and Wales: year ending June 2022 at https://www.ons.gov.uk/ – read it here

Health survey for England, 2021 part one at https://digital.nhs.uk/ – read it here

South-west rehab wins European award for addiction treatment

Broadway Lodge, an abstinence-based residential treatment centre for addiction located in Weston-super-Mare, are celebrating an award win at the European Awards in Medicine.

They were selected by a judging panel as a finalist along with four other treatment centres across Europe in the ‘Addiction Treatment’ category. Broadway Lodge was chosen as the winner, announced at the award ceremony held in central Paris on Tuesday night. The European Awards in Medicine was established to ‘reward talent, perseverance and dedication’ of organisations and individual professionals from across Europe in the medical sector.

Broadway Lodge Marketing Officer Charlotte Thorpe
Broadway Lodge Marketing Officer, Charlotte Thorpe

Charlotte Thorpe, Marketing Officer at Broadway Lodge accepted the award. Thanking the judging panel for choosing Broadway Lodge, she also said ‘We truly love what we do and the work that is done here is often life changing and sometimes, life saving. So to be recognised is a massive achievement for us and we are really proud…We’ll continue to treat addiction with compassion, understanding, warmth, kindness and empathy and look forward to treating many other people who come through our doors in the coming months and years ahead.’

Founded in 1974, Broadway Lodge has been treating addiction for almost 50 years, helping thousands to overcome addictions to a range of substances and behaviours including alcohol, illicit and prescription drugs, gambling, sex and gaming. It was the first treatment centre in Europe to introduce the spiritual 12 step programme into the schedule and it continues to remain important to Broadway Lodge today because of its success in helping addicts to sustain recovery for life.

broadway lodge rehabIt’s not only the individuals themselves that Broadway Lodge work with to improve their life and future, but relatives of anyone whose wellbeing has suffered as a result of a loved one’s addiction, with the online Family Programme they run every month.

Find out more at: www.broadwaylodge.org.uk

 


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 Broadway Lodge

 

WDP Greenwich is rated ‘Good’ by CQC

WDP has announced that the Care Quality Commission (CQC) has rated WDP Greenwich as ‘Good’ across the board.

The CQC inspectors highlighted that the team “treated clients with compassion and kindness” and that they “understood the individual needs of clients and supported [them] to understand and manage their care and treatment.”

The report shares that staff “developed holistic, recovery-orientated care plans informed by a comprehensive assessment” and that they “provided a range of treatments suitable to the needs of service users and in line with national guidance around best practice.”

The inspectors also identified areas of outstanding practice in the service, namely:

  • WDP’s Capital Card scheme, where service users can earn points by attending appointments and engaging with treatment, and then spend their points on positive activities in their local community.
  • In-house motivational and confidence-building courses available to service users, such as NOVA and Next Steps, as well as a peer mentoring programme and development opportunities for volunteers.

The report includes some excellent feedback from service users. The inspectors reported that service users described staff as “approachable, non-judgemental and supportive”.

One individual told the inspectors that their recovery, and continued attendance at the service, was due to the kindness and support they received from staff. 

Service users also said that the group programme was supportive, “family-like” and run by clinicians who were knowledgeable. They also felt encouraged to ask questions and learn about their treatment, and that they were listened to whenever they had concerns.

Councillor Denise Scott-McDonald, Cabinet Member for Health and Adults’ Social Care, said: “We are pleased to note that WDP Greenwich received a good rating from CQC. Since the launch in 2020, during the first week of lockdown, WDP has tackled many challenges and increased demand. Despite this, the team has remained committed to delivering a specialist holistic treatment and recovery service to residents in Royal Greenwich.

“The strong rating reflects the professionalism, dedication, commitment, and care the team at WDP Greenwich delivers. The service manager and staff team can be proud of the recognition of the hard work this inspection provides, and our residents can be reassured that they have a good service that can respond effectively to their needs.”

Tom Sackville, Executive Director of Services at WDP commented: “We are extremely proud of this excellent CQC report acknowledging the high quality of our service in Greenwich.  It is a credit to the team for their hard work and commitment to our service users, as it recognises the importance we place on providing a service which is tailored to the needs of each person who comes to us for support.

“Our WDP Greenwich service is hugely important for the local community and we look forward to continuing to support our service users’ recovery and identify even more ways to reach out to those in need. Working closely with our commissioners is a key feature of our success – it is a partnership we value immensely and hope to continue to build on.”

Read the full blog 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 WDP

Let’s do this together

Not that many years ago, seeing a commissioner’s name come up on my phone was inevitably followed by a deep breath to compose myself, an unconvincingly cheery greeting and mentally scanning through potential reasons for a cold call. Lately, I’ve more often been the one calling our commissioners, asking if they have time for a quick chat, cheery greeting 100 per cent organic.

In March, we began mobilising the RhEST team, a brand-new service that was commissioned as part of the new pan-London substance misuse rough sleeper pathway. Its remit is to engage with people who are or have been rough sleeping and require support from substance use services, with a view to supporting them into those services and, in particular, to help them access inpatient treatment. The vital importance of this is reinforced by the latest ONS figures, which show that two-in-five deaths of homeless people are drug-related (see news, page 4).

One exciting element of the specification for the service was the clear expectation that the service feed back to the commissioner around the experiences of the team and the people we work with when trying to access services. During our regular catch-ups and contract monitoring meetings we’ve had opportunities to discuss anecdotal examples of some of the work we get to see as a pan-London team, including common practices that pose a barrier to people accessing support as well as innovations that have opened services up to them. 

These conversations don’t feel like frustrated rants – they feel optimistic because there’s a real drive from all involved to ensure the best possible outcomes for the people we work with, backed up with a strategic capacity/potential to actually enact/influence change on a city-wide scale, and that’s a hugely motivating feeling.

For example, in our first few weeks we saw that many services would book appointments via text and mobile, and if the person didn’t turn up their attempts to re-engage would again be limited to attempted phone contact, which if unsuccessful would often mean the case was discharged. 

We know that owning, topping up and keeping a phone is extremely difficult for a lot of people who are rough sleeping, so we’ve begun speaking to partners internally and externally about how services which are already so stretched can develop joint-working plans with outreach teams to make contact with their rough sleeping clients to increase longer term engagement and reduce the amount of time spent texting and calling a number that’s probably no longer in use. 

We aim to collect and develop examples of smart approaches that services that are already so stretched can adopt to make sure they’re as accessible to our cohort as possible. 

As well as the general sense of collegiality in our partnership with our commissioner at City of London, some of the other things that have felt like game changers are incredibly simple. For example, having case studies form a part of our reporting has allowed us to have much more nuanced conversations around the work the service is doing for the people we work with on an individual basis, moving away from the sometimes dehumanising act of reducing performance to numbers, and also giving space for us to discuss some of the complexities we are responding to instead of purely using the space to prove performance. Anecdotal evidence around trends also allows us to use the meetings to inform joint strategies to target specific areas and issues, for example boroughs with low referral rates or under-represented demographic groups.

In our Essex service, this kind of relationship with their commissioners directly resulted in genuine system change. Phoenix’s Changing Futures team raised concerns with their commissioners about a gap that was consistently identified in the delivery of all the projects – namely the fact that individuals with mental health needs who did not meet secondary mental health services criteria but were in need of lower-level interventions to support their wellbeing had no real options for the necessary support. Through continued discussions with commissioners Full Circle were able to bridge this gap with the mental health wellbeing team (MHWBT). 

This service has been invaluable to the work Phoenix are delivering in the region, as the MHWBT are able to provide a range of swift interventions to stabilise and support clients, while in turn alleviating pressure on other agencies who don’t have the necessary clinical expertise or capacity.  Due to the positive outcomes of the work the MHWBT are completing alongside Phoenix, commissioners are exploring how this provision can continue to be funded and mainstreamed as part of their Essex drug and alcohol commissioning plan.

While we’re still facing the same huge challenges – recruitment, increasing complexity, high demand – this way of working together with our commissioners, being able to share actions, reflect together, and strategise as one team with a common goal, as well as being held to account, feels essential if we hope to achieve our shared ambition to end drug related deaths in the rough sleeping population. 

Ellie Grieg is Phoenix Futures regional housing manager south.

 

Adfam interviews Cllr Jay Hayes

In November, councillor Jay Hayes met with Rob Stebbings from Adfam to talk about his personal experience of being in a family affected by substance use, and his view on the role local government can play in supporting other families that are impacted by this issue.

Tell us about your experience of being affected by a family member’s substance use

My dad has been drinking since he was 12 years old, he’s now in his 60s. Growing up, only recently have I come to realise how some aspects of my life were different to other people. When my dad would pick me up from primary school on a Friday, instead of going out playing with other kids my age, or to after school clubs, the first point of call was the pub. We would be in the pub until about 7pm, we would then go to the shop to buy some cheap beer, then back home. As I got older, I would stay with my dad at weekends and from age 12 he started buying me and my brother beer as well. He would buy two four-packs of cheap beer, have four to himself after a day at the pub and me and my brother would split the other four. Comparing that to my mother, who would never do that and never drank at home, it was a complete contrast between the two.

It seemed normal growing up, we didn’t see that there was an underlying problem. My brother has since gone on to develop his own problem with drugs after he was made homeless and was sofa surfing. I saw the impact on him too, it became a priority for him, like my dad, it was the number one priority. My dad would prioritise spending money on beer first, shopping second. There were a few instances I remember, where we would come home after the pub, and there would be no food for me and my brother. He rang my mum up, she was so angry. There were times where we had to walk into the city centre, because we couldn’t afford the bus fare because we’d been in the pub the night before.

In what ways has this impacted on you?

When my dad moved away from Nottingham our relationship became more strained. My dad was wanting to be in the pub watching the football, whilst I was doing different things but because they didn’t materialise around his interests, it felt as though he wasn’t interested in what I was doing. We ended up not talking for a long period, around six years or so. For me, I felt better for it because I was away from that environment.

It wasn’t until I saw other kids’ lifestyles that realised it wasn’t normal to be spending hours at the pub at a young age and drinking at home. At secondary school, when other kids started going to the park and trying alcohol for the first time, for me it didn’t feel right because I’d already experienced that at home from a young age. That was in a way a life that I missed, a normal growing up experience that was taken away from me, and I missed out on those friendship and stories you create growing up. Ultimately it turned out for the better and had a big impact on my life.

For me now, it impacts me on the way I manage my money. If I had the choice of staying in or going to the pub, I stay in because I know I’ll have money to buy food, shopping, and get the things that I need. I’ll also never bring alcohol back to the house; it doesn’t feel right. This isn’t a place I want to have alcohol. If I want to have alcohol I want to have it when socialising with friends, not at home on my own.

It also gave me some inspiration, and made me think what can I do not to be like that, and do better? It motivated me to do better and drove me to keep working hard and pushing forward. I didn’t want to be like that and be that person. It also really drove me to stick with education. I failed my GCSEs but then ended up getting an Honours degree. I had to restart my education but had the determination to power through. My dad and brother on the other hand would do odd jobs that they needed to do, not to make ends meet, but to get what they needed for substances or alcohol. They did what they could to get money, not to support themselves but to support their addiction.

Tell us about your motivations and inspirations behind becoming a councillor.

There are so many different aspects as to why I became a councillor.

A lot of the people that I grew up and went to school with, at around ages 15/16 were experimenting with drugs, smoking weed etc., which is not necessarily a problem, but there were a lot of people that never grew out of that. It stuck with them. I felt that I had that lived experience; I’ve been around people who still struggle with it, and those who are devastated by the impact. I felt, in comparison to the person I replaced on the council, I was a better person to be able to step into that position of authority and speak about my own experiences, not jut around substance use but also growing up on benefits, poverty, being a victim of domestic violence. Having all of those experiences as a youngster, I felt that if people I grew up around and other young people in the area see me doing something, it could inspire others too.

I’m now the executive assistant for health and culture on Nottingham City Council and working with the public health team has furthered my understanding around alcohol and drugs and made me think more about my relationship with my dad and brother, and how people view who an alcoholic is. Often people think it’s someone who’s unemployed, sitting in the pub or an armchair all day drinking beer, but there are many people who can drink all night and go to work the next day, and go through the same cycle over and over again. Since working with the public health team, I feel more confident speaking out about my own experience because I understand it more myself, what the causes are, why people are the way they are.

What role can local government play in championing and tackling the issue of substance use and its impact on families?

Locally we can do lots around alcohol licensing which plays a big role in this.

Also looking at potential local campaigns, which could turn into national campaigns, we could be doing more to challenge parents who are buying alcohol with and for young children, and raising those questions.

We also need to look at how we can work better with local authority health partners including the NHS, mental health services, pharmacies shops etc. to identify people affected by these issues and establishing at what local support can be given.

In addition, we need to be training frontline staff, such as social workers so that if they go to a house and spot signs of problematic substance use around children, they know how to raise that safeguarding concern confidently and appropriately.

The most important thing we can do is intervention and prevention. Making families feel that if they do have someone who is addicted to alcohol, they can speak out about it. We need to take away that fear that people could lose their child, which is a big barrier for people seeking help. The fear that if someone admits they are an alcoholic their children could be taken away stops a lot of people. We need to get over that because it’s not true. By asking for help it’s showing you are making those steps and showing that you want a better future for yourself and your kids. We need to do a lot of work around tackling that locally.

Many years ago in Nottingham, to prevent having so many children in care and foster care which comes at a huge cost to the council, we started looking at early intervention work; stopping those children from coming into care, putting resources into family support services and preventing that child from what should be a last resort. We need to widen that more with people suffering from alcohol, drugs and mental health issues. That is the one thing that scares people the most, the fear of their kids being taken away.

What would you like to see change on a local and national level so that families are better recognised and supported?

I previously worked for a short time in Boston, Massachusetts. There was someone there that was alcohol dependent, and they have a law that identifies alcohol as a health issue, rather than as a criminal issue. If you turn up drunk to work, and your employer knew you had a dependence on alcohol, they can turn you away but they can’t sack you. We need something similar here to strengthen that and to look at it as a health issue rather than a choice.

With drugs and possession, I don’t think it’s right to continue to target and criminalise people using drugs. They’re the people that need the intervention and help to get it off. The people supplying the drugs, promoting it and encouraging people to do it are the ones causing the damage and need to be targeted and challenged more.

We also need to do more national campaigning around this issue. The success that has been had around mental health campaigning, around how it’s ok to not feel ok, we need to have similar discussions around substance use, to support people to speak out, whilst having the support network in place to enable people to speak out. We also need more high profile people in Parliament who have experienced it and have a good understanding of it, to ask questions about it and speak out about it.

Looking at children in pubs, I think we should look at introducing age restrictions at certain times in pubs. For me growing up I could be be in a pub until 10pm at times. They need to look at that, and determine what is an appropriate time for a child to be a pub. I can understand family meals etc. but after 6-7pm is it suitable for a seven/eight-year-old to be in the pub at that time with their family? We should think about legislation could be in place to tackle that.

We’ve spoken to a lot of kids in care about the language used and that’s something we can also look at locally with people in recovery, and the language that is used towards them. By using much friendlier language shows a better understanding and is a better way of encouraging people to speak out and access support.

Final thoughts and reflections

In the current climate, with the housing situation and cost of living crisis, things are getting even more challenging and can turn people towards drugs and alcohol even more.

In Nottingham, we made financial wellbeing part of our health and wellbeing strategy, which is important because it plays such an important part. If you are struggling financially, you’re likely to be more stressed, and people in looking for stress release can turn to substances.

There was analysis done around smoking, and that people would save £2,500 per year if they quit smoking. It would be interesting to look at how much it’s costing individual around alcohol and drug consumption and show people what could be done with that money instead. It could reset people’s priorities; realise they could have a better life for their family. With my brother, he was able to turn things around, he’s now got a partner, five kids; now he has his own kids he’s seen the damage it can cause and his priorities are different as a result.

Read the full blog 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

Alcohol-specific deaths in the UK reach highest ever level

There were more than 9,600 alcohol-specific deaths registered in the UK last year, according to the latest figures from the Office for National Statistics, the highest number ever recorded. The total was 7 per cent up on 2020 and 27 per cent higher than 2019, says ONS. As in previous years the death rate among men was roughly double that for women.

The figures only relate to deaths that are the result of conditions wholly attributable to alcohol, such as alcoholic liver disease – the cause of most of the deaths – and therefore does not include all the deaths that could be attributed to alcohol, ONS points out. Alcohol specific deaths are likely to account for just a third of the total number of deaths that could be considered alcohol-related.

Alcohol-specific deaths have risen sharply since the beginning of the COVID pandemic

While Scotland and Northern Ireland had the highest death rates, there were ‘statistically significant’ increases in England, Wales and Scotland compared to 2019, the last pre-COVID year, ONS states. This death rate had previously remained stable between 2012 and 2019. Alcohol-specific death rates have risen in every English region since 2019, with the highest rate in the North East for the eighth year running.

‘Alcohol-specific deaths have risen sharply since the onset of the coronavirus pandemic, with alcoholic liver disease the leading cause of these deaths,’ said James Tucker of ONS. ‘This rise is likely to be the result of increased alcohol consumption during the pandemic. Research has suggested that people who were already drinking at higher levels before the pandemic were the most likely to have increased their alcohol consumption during this period.’

Prof Sir Ian Gilmore: Every life lost leaves a devastating impact

‘It is a national tragedy that the number of deaths caused by alcohol has increased once again across the UK, with every life lost leaving behind a devastating impact on families, friends, and communities,’ stated Alcohol Health Alliance chair Professor Sir Ian Gilmore. ‘COVID-19 saw the number of alcohol deaths increase sharply across the UK, and the continuation of this upward trend in today’s figures should raise alarm bells in Westminster. Research modelling the impact of the changing consumption patterns during the pandemic predicts that there will be nearly 10,000 more premature deaths by 2035 if drinking does not return to pre-pandemic levels, as well as the untold harm caused to others. It is all too clear that we are amidst a public health crisis, and urgent action is needed to address these levels of harm. We desperately need the UK government to deliver on well-evidenced policies, such as an effective alcohol duty system, to reverse this tragic trend.’

Alcohol-specific deaths in the UK: registered in 2021 at www.ons.gov.ukread it here

Facing the Future

In the third part of our commissioning series we look at what’s needed to get the sector in the right place to deliver a world-class treatment system.

Read Parts one, two and three

face the future commissioning in DDNIn the first of this three-part series we surveyed the commissioning landscape after a decade of shrinking budgets (DDN, October, page 12) and in part two we looked at how local areas go about making sure that people with lived experience are part of their partnership structures – in a meaningful way (DDN, November, page 12). In this final part we focus on where we go from here, and what’s ultimately needed for better commissioning. 

Two of the words people most often use when it comes to effective commissioning are honesty and trust. Joint commissioning manager at Cornwall Council, Kim Hager, explains that her relationship with provider With You has always been an ‘entirely joint approach’ – one that’s made far stronger by a willingness to be frank on both sides. When the council’s supplier management team carried out an appraisal of the relationship, what came through was ‘high challenge, high support’, she says. ‘We both said, “we’ll take that”. It’s very robust, very challenging, but they know it’s for the right reasons.’

Mutual understanding

Kim HagerThe mutual understanding is that both organisations are constantly learning together, she points out – something she feels is vital. ‘I’ve noticed in some other areas that they devolve so many things to their provider – the case management system, the engagement, everything – but we don’t do that. It’s been dialogue all along – dialogue, challenge, support, and they know we’ll fight their corner when required.’ 

Meanwhile, trust obviously needs to be an ‘essential component of a strong and positive working relationship with commissioners’, says executive director of services at WDP, Craig Middleton. ‘The commissioners I work with are quite progressive in terms of finding new and exciting ways to solve a problem – that’s genuinely the case. It’s about having conversations with people and saying “this is what’s happening” or “this is what we need” and working together, a co-production of solutions.’ From there, all parties work can work together on a mutually agreed plan – key to delivery of which will be maintaining that trust, he says. 

Building trust

‘I think commissioners are doing that’ agrees executive director of new business at With You, Sarah Allen. ‘As a provider we really invest in building trust with commissioners. I think the more open and transparent we are as an organisation the better.’ The additional funding coming into the sector has led to some ‘really collaborative conversations’ with commissioners, she says, and ‘being really open around saying, “These are areas we’ve not been able to focus on, we want to drive this forward – how do we do that together?” It can also be about making sure the right partnerships are in place outside of these relationships, she stresses, if that’s what’s necessary to meet the needs of service users. ‘No one provider can do everything on their own – we need that collaboration locally. Commissioners are open for that innovation and working with us to do that, and I think that’s really exciting.’

However, while commissioners have been supportive with innovation, up to now providers may sometimes have had to go external sources to fund that innovation. 

‘The benefit we have now is that additional money is coming into commissioning teams to be able to work side-by-side with us and see that through,’ Allen says, ‘rather than us hoping that we can secure funding through grants or trusts or additional funding streams to support it. If anything it’s going to help us plan to be more innovative and creative and think longer term, because those other funding streams would normally be one or two years. So I think there’s enormous potential to really grow and embed that innovation across different services.’

rosanna oconnorThe government is making ‘a record investment in drug and alcohol treatment and recovery of £532m over three years, as our part of the bold ten-year drug strategy,’ director of the Addiction and Inclusion Directorate at the Office for Health Improvement and Disparities’ (OHID), Rosanna O’Connor, tells DDN. ‘This is to improve the capacity and also the quality of drug treatment to reduce harm and help people initiate and sustain recovery.’  

There is new investment totalling almost £900m over three years, with £780m to improve treatment and recovery – of which £532m will be invested to improve local authority drug and alcohol treatment and ensure more collaborative invigorated partnerships, she says. ‘We want to see high-quality services that meet local need and allow for innovation. As part of this, we are supporting partnerships to foster and support recovery communities and lived experience recovery organisations.’

Robust framework

For commissioning to truly deliver it also needs a robust framework, and the government’s wide-ranging overview of what good commissioning should look like – the Commissioning Quality Standard (CQS) – was published in the summer in response to one of the key recommendations of the Carol Black review. ‘What substance misuse has lacked over the time I’ve been in it – which is a decade – is central leadership on procurement, so it’s useful that commissioners know what they’re working with,’ says executive director of development at WDP, Graham Howard. 

Local authority commissioners have traditionally faced a wide range of challenges, he points out. ‘They have to look at what national best practice is, NHS procurement regulations, and their own local team who are across the procurement of all the services a council runs tendering processes for – that could include building contracts, cleaning, waste disposal, all kinds of things.’ 

Consistent standards

craig middletonThese local teams will want to apply consistent standards across those contracts, so if the new standard allows commissioners and procurement teams to work together to tweak tendering methods for drug treatment contracts where needed it will be ‘really useful’, he states. ‘For example, sometimes you get price/quality splits that are very highly in favour of price, which I don’t think are very helpful when investment should be going to frontline delivery as much as possible.’ Commissioners may have had to use that split because the local authority uses it across all its procurement, so ‘more of a sense of central best practice’ for local commissioners to use will be very helpful, he states. 

The CQS has been well received, says O’Connor, and ‘aims to support partnerships to improve the consistency and quality of treatment and recovery systems in England. It has been welcomed by commissioners, providers and partners – in particular, feedback has praised how the CQS understands commissioning as a process of system leadership and development. We look forward to supporting local partnerships as they work towards meeting the standards over the course of the drug strategy.’

So are we genuinely entering a new era for commissioning, and the treatment field in general? ‘Notwithstanding the backdrop that public finance and government policy are quite changeable at the moment, I’ve not seen anything like the Dame Carol Black report in the ten years I’ve been doing this,’ says Howard, ‘nor have I seen something that’s actually translated into policy so quickly and with impact. It’s quite difficult to get attention on our sector and that actually managed it, and I think the government investment has actually been very much in line with what the report says is needed.’

Time and investment

‘The investment is long overdue,’ says Allen. ‘It’s extremely welcome and the recommendations in Dame Carol Black’s report are absolutely vital to us as providers to be able to reinvigorate the sector and get back to where we need to be, and we hope that investment commitment to 2025 remains for that stability.’ For the sector to be able to deliver on the strategy it will need that time and investment, she says – ‘without that it will be really hard to achieve some of those commissioning standards.’

Although treatment funding escaped the knife in the chancellor’s recent Autumn Statement, the great unknown remains what will happen to the new investment after the first three years. 

‘Hope for the best, prepare for the worst’ might be a wise strategy, says Middleton. ‘We’re having conversations with commissioners trying to understand what the plans are for the next few years, because obviously there’s a commitment up to a certain point but we need to understand what’s going to happen after that as soon as we can. With the new money, the sector obviously has an opportunity to grow again, and we’ve got to bring in a whole new generation of practitioners to meet the expectations of the new investment.’  

Service impact

sarah allenIf the funding is maintained, however, then ‘we should absolutely be seeing its impact in services,’ says Howard. ‘Some of that will take a longer amount of time, because one of the problems Dame Carol Black identified was that certain professional and medical roles have been diminished, and those can’t just be created out of thin air. We need to get people training for them and going through years of study, so even in a ten-year cycle we might potentially only start to see the dividends of that towards the end.’

So does that mean that people should possibly try to manage their expectations? ‘Commissioners and providers need to be both pragmatic in the short term in the context of the current challenges, but also remain ambitious about improving the quality of treatment in the longer term,’ says O’Connor. 

‘It’s vital that we increase the skills mix of the workforce if we are to deliver high-quality treatment and recovery systems which reduce harm and help more people to initiate and sustain recovery. OHID has commissioned Health Education England to develop a ten-year workforce strategy that will set out a clear roadmap for the future, including the training of registered professions.’

The government has also commissioned a new drug and alcohol treatment and recovery capability framework, which is due to be published next summer, O’Connor points out. ‘This will be a refreshed drugs and alcohol national occupational standards, reflecting the sector’s current needs. Work will begin soon to scope and develop this framework with the sector.’ 

Support and development

‘I think we’re in a position where those who want to can seize the ground and make a good job of it,’ says Hager. ‘It’s what’s behind the standard to support commissioners who aren’t experienced, to understand what commissioning is – or could be – the evidence around it and approaches they can take. Those who’ve been around a while know how to navigate that, but we’re a minority. 

There needs to be support for commissioners to develop in their role. The standard’s good for that, but it’s about how much people buy into that – how do we develop the learning? In our joint commissioning group we discuss ‘what do we mean by commissioning’, because often what you encounter in local authorities is they just think it’s shopping and procurement. It’s strategic leadership and acting on behalf of the people we represent, making the best use of the resources available. We’re that link. Transforming commissioning isn’t just about transforming procurement – it’s about a learning approach, not a top-down approach.’ 

Skill sharing

graham howard‘It’s a really interesting time,’ says Allen, and retaining some of the hybrid models and approaches around staff training and development that developed during the pandemic will be important. ‘That very virtually-based offer – we’ve got really skilled and experienced staff, and we need to make sure those new staff coming in have the opportunity to work alongside and be close to them, and have the combination of face-to-face and different training options. 

‘It’s sharing those skills and best practice that’s really going to allow the workforce to develop – a lot of people have worked in this sector for a long time, and we need to value that. We’re going to be having staff coming in with less experience and we need to do as much as possible to wrap around them so they don’t feel overwhelmed by this.

‘I am optimistic and I’m going to remain optimistic,’ she says. ‘I think we also have a huge sense of responsibility. We want to show that this funding works and has impact, and if we want to make the argument for continued investment beyond 2025 we need to deliver on that. We can’t waver on that passion, commitment and enthusiasm – we have to remain committed on that path.’ DDN

We welcome your thoughts, feedback and experiences on commissioning and hope to take the conversation forwards from this series of three articles (Oct, Nov and Dec/Jan issues). Please email the editor.

This series has been produced with support from an educational grant provided by Camurus, which has not influenced the content in any way.

Proportion of smokers falls to lowest ever level

Last year, 13.3 per cent of UK adults were current smokers, according to the latest Office for National Statistics (ONS) report, down from 14 per cent in 2020 and the lowest proportion since records began. Scotland had the highest proportion at 14.8 per cent, while the lowest was in England at 13 per cent.

There are around 6.6m smokers in the UK

There are currently around 6.6m smokers in the UK, says ONS. Just over 15 per cent of men are current smokers compared to 11.5 per cent of women, consistent with previous years. The highest proportion of current smokers is in the 25-34 age range at 15.8 per cent, and the lowest the over-65s at 8 per cent. The decrease in smoking rates may be partly explained by an increase in vaping and e-cigarette use, says ONS, with the highest vaping rates among 16 to 24-year-olds. While 6.4 per cent of over-16s reported vaping in 2020, by last year this had risen to 7.7 per cent.

Hazel Cheeseman: ‘Smoking is still the biggest cause of preventable illness and death.’

However, anti-smoking charity ASH has warned that without renewed action the government is still likely to miss its ‘smokefree’ England target in 2030, defined as fewer than 5 per cent of the population still smoking. Last month the All Party Parliamentary Group (APPG) on Smoking and Health called for an immediate windfall tax on tobacco companies, along with an additional ‘polluter pays’ levy to help pay for the ‘shortfall in funding for tobacco control and public health’ (DDN, December/January, page 4).

‘Smoking is still the biggest cause of preventable illness and death so the progress shown today is great news,’ said ASH deputy chief executive Hazel Cheeseman. ‘But government must not be complacent. They first promised to publish a new tobacco control plan for England in 2021 but we still have seen no plan for how they will meet that goal. Without one we will not meet the vision of being smokefree by 2030.’

 Adult smoking habits in the UK: 2021 at www.ons.gov.uk – read it here

From Harm to Hope one year on

Nic Adamson – Deputy Chief Executive at Change Grow Live

Is the UK’s drug strategy at a crossroads, asks Nic Adamson, Deputy Chief Executive at Change Grow Live.

A year ago this week, the publication of the Government’s 10-year Drug Strategy, From Harm to Hope, promised a bold new direction for UK drug policy.

The strategy implemented Dame Carol Black’s hard-hitting report that laid bare the consequences of years of under-funding and fragmented commissioning and called for whole systems change. Change Grow Live and our partners on the ground and in government accepted the challenge to deliver change for the people who use services.

Progress has been made. A more collaborative approach to commissioning. Joint efforts to attract more people to work in the sector. New ways to measure success with input from people who use our services. And we are starting to see green shoots.

As Dame Carol Black said recently, we’ve come a long way in the last twelve months, but a year on, we also face challenges. 2022 has seen political change and an economic downturn. The Government is reviewing its priorities and funding commitments. Extra funding for the Drug Strategy will be eaten into by inflation.

One year on, we must hold to the positive vision of From Harm to Hope and most importantly, its ambition to transform services, not just deliver more of the same. Substance use is a chronic health condition – when we treat it like that change is possible. We’ve seen it. Services that fit the person, and not the other way round, encourage trust. We need to ensure that people are not defined by the things that have led them to seek support but are met and respected as individuals with goals and ambitions of their own.

As we push ahead with the drug strategy, let’s recognise that no organisation on its own can be as powerful a force for change as we can be together. It’s up to all of us in our sector and beyond to ensure that we work together, to address wider health and economic inequalities faced by people, families, friends, and communities.

A year after publication, the drug strategy is starting to make a difference, but this is a long-term challenge. We all need to continue to be bold and relentless. Change Grow Live and our partners, volunteers and staff are determined to keep the agenda front of mind for decision-makers and to make it a reality on the ground.

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 Change Grow Live

Sharing the Love

HIT Hot Topics came back stronger than ever with a message of solidarity on peer-led outreach and a call to redouble action on drug-related deaths and ill health. DDN reports, photography by nigelbrunsdon.com

Read it in DDN Magazine 

The stage was set for the first Hit Hot Topics conference for three years – and the tenth anniversary event. Pat O’Hare held up a ‘chill out’ leaflet from 30 years ago and recalled how HIT’s advice on taking ecstasy ‘caused a lot of fuss’. Times had changed but the challenges around harm reduction were no less significant. Coming together as a community was so important, said chair Niamh Eastwood of Release, because ‘it provides us with resilience’.

Colleen Daniels, public health lead at Harm Reduction International (HRI), set the scene by drawing on the Global state of harm reduction report. The last two years had seen a slight increase in uptake of harm reduction interventions, she said. There had been a decrease in injecting but more people taking drugs overall, and both the COVID pandemic and the Ukraine war had had a significant impact on harm reduction services – their availability, accessibility and quality.

People of colour, women, LGBTQI+, migrants and refugees faced additional barriers and it had become obvious that the ‘war on drugs has worked as a means of racial control’.

‘Massive Gaps’

There were also ‘massive gaps’ in prison harm reduction, and barriers to effective therapies such as hepatitis C medication, which was ‘extraordinarily expensive’ in some countries. Naloxone, ‘one of the most cost-effective interventions in public health’, was still not enough of a priority in tackling the ‘massive issue’ of overdose.

The data on mortality and morbidity showed that funding for harm reduction was only 5 per cent of what was needed in low- and middle-income countries. It was a situation affected by an ‘antiquated colonial top-down approach’, she said.

‘We have to look back to look forward,’ said Peter Furlong from Change Grow Live, who spoke from long-standing personal experience of pioneering harm reduction. ‘The new drug strategy says we’ll have world class treatment system – but what’s happened to the evidence?’ he asked. We’d lost the balance of harm reduction, treatment and recovery and the sharp increase in drug-related deaths ‘comes back to abandoning harm reduction’.

The purity of drugs had increased, cocaine-related deaths had risen significantly, and Dame Carol Black’s review showed that ‘money alone will not fix this’. ‘We have to redesign services to make them more attractive, involving people who use drugs,’ he said. ‘We need to make treatment easier to access.’

Tackling Exclusion

The need to tackle exclusion became clearer as the day went on. Jesse Bernard, a writer, DJ, researcher and filmmaker talked about three events that had shaped his own experience – being excluded from school, censorship of his music (drill, a subgenre of rap), and policing related to drugs.

He learned the hard way that people of colour were treated differently when he was suspended from school, but ‘nothing happened to the other [white] kid’. There were ‘school to prison pipelines – if you’re kicked out of school, you’re more likely to end up in prison’.

Censorship of black music and criminalisation of artists had ‘always been there’, from jazz in the 1910s onwards. Musicians had endured all kinds of suppression including broadcasting bans, shows being cancelled and being forbidden to record. Artists had evaded censorship by inventing new words and slang, which were shared rapidly online.

Mackayla Forde, a poet and academic known as Red Medusa, took up the narrative. Black people had been subjected to violence, lies – and to disproportionate stop and search.

Did people who made global drug policy consider race? A search of key words in 41 documents suggested they didn’t. Words and terms such as race, racism, racist, and racial injustice didn’t feature. ‘Our story has not been included in the literature,’ she said.

Dynamic peer networks were helping to rewrite the narrative. Phoenix – aka Mohawk, a ‘rebel educationist’ – travelled to parties around California with information and a ‘pharmacopeia to help hydrate people and help them think about harm reduction’. From being a ‘raver, engaged in a lot of drug use, getting whatever I could to enhance my experiences’, Mohawk rose to the challenge of outwitting the NYPD to distribute water, evading arrest, and – with the aid of a borrowed spectrometer – running a drug-checking lab from an apartment living room, ‘Ubering samples back and forth from a party to give people the information.’

The need for this intervention was acute, particularly with such high risks from a tiny amount of fentanyl. ‘I feel I have to work outside of an institutional context,’ said Mohawk. ‘There are a lot of people like me, low income, people of colour, at very great risk.’

Sharing Information

Karin Silenzi de Stagni had had similar experience of needing to find people and intervene at the right time. As part of a small volunteer-run charity called Psycare UK, she shared information – at parties, schools, music events, festivals – wherever people might come into contact with recreational drugs. ‘Young people taking drugs is part of human nature – it’s a natural thing to do, to discover, to know,’ she said. ‘So we try to take the stigma out and create bridges with health services. And because we are peers and not in uniform, we are approachable.’

Prohibition led to lack of information and all kinds of risks – adulteration and misidentification of drugs, dosing errors, adverse interactions from polydrug use, and effects of pre-existing medical conditions. Added to festival conditions – lack of sleep, sensory stimulation, lots of people, bad weather – psychedelic drugs could magnify the mindset and setting and lead to symptoms that appeared to be common with psychiatric illnesses. Psycare took ‘a non-conventional approach without medication and without burden on the NHS’ to help the person understand and integrate their experience, and tried to work with them afterwards. ‘We’re non-judgemental and listening is key,’ she said. ‘We allow the process to unfold and let them acknowledge their capacity to treat themselves. It’s a mutual learning experience.’

Self esteem and respect

Using drugs for 42 years, 18 of them injecting, had informed Lee Hertel’s decision to create Lee’s Rig Hub in Minneapolis, ‘a space to drop in and hang out’, with access to syringes, HIV testing, information and the internet. Until then, ‘services were delivered in a very stigmatised setting, with people expected to stand outside in all weathers and temperatures,’ he said. His hub was a place for camaraderie, which made a ‘great difference to self-esteem and self-respect’. It also acknowledged that ‘people want to get high’ and got on with ‘meeting and educating more and more people’.

Haven Wheelock met her challenge while living and working in Portland, Oregon – ‘founded as a white supremacist state, with some of the highest rates of substance use and misuse in the country, where drug laws always disproportionately affect black people’. Her work at Outside In, helping to link marginalised and homeless people with health and wraparound services, made her realise the desperate need to increase care for people who use drugs.

With support from the Drug Policy Alliance, she became chief petitioner for decriminalising small amounts of all drugs. It resulted in a transfer of millions of dollars in tax from the legalised cannabis market to create a harm reduction programme across the state from naloxone rollout to distributing crack pipes. A peer-led council (‘over half of people on it have been incarcerated and there are no cops’) was deciding where the money goes and there had already been ‘great progress’ in distributing naloxone and crack pipes. The council’s work was not easy, as it was ‘a messy process – messy and passionate’ with untrained people, she says. ‘But we have a lot of passion and the potential is amazing.’

Distributing crack pipes was also a hot topic in the UK, as Dr Magdalena Harris of the London School of Hygiene and Tropical Medicine explained. The safe inhalation pipe provision (SIPP) project had been driven by the significant rise in crack use alongside neglect of the relevant harm reduction. There was ‘little incentive for people who use crack to go through the door of services’, she said.

Prohibition of crack pipes had led to an increase in pipe sharing and crack injecting, which were both associated with ‘a lot of health harms’. People were also resorting to making their own pipes, which might not be heat resistant, have sharp edges and result in vapour inhalation being overly hot – all significant issues ‘in relation to a vulnerable population’.

The project was working to try and change the law and had police and crime commissioner support, but she was feeling frustrated at the hurdles to get it off the ground. ‘Efforts have stalled – people are not certain about the legality,’ she said. ‘We have to demonstrate that it won’t cause harm, but we can’t do it as it’s against the law.’ The Ethics Committee was concerned it would cause undue harms to a vulnerable population, but as a qualitative researcher she was excited at being able to address people’s needs and urged anyone interested to get involved in the collaborative project.

Hep C Elimination

As a project with the full weight of UK government – and World Health Organization – support behind it, the goal of hepatitis C elimination by 2025 seemed to be within reach. But as Tracey Kemp, Change Grow Live’s harm reduction lead explained, much of the significant progress was down to working with invaluable Hepatitis C Trust peers, ‘a force to be reckoned with’ and part of ‘an army of us working together’ to test and treat.

Harm reduction pathways were ‘the golden thread’ in making testing and treatment accessible to all, and this meant ‘meeting people where they’re at,’ she said. ‘Gone are the days when you could only get treated in treatment centres. We’re rocking up in car parks and at people’s doors’ to make sure of not losing people who were not in structured treatment. Sustaining elimination would depend on having adequate harm reduction, including syringe provision, and collaboration and partnerships – including working with other providers to engage people in treatment.

Uncomfortable questions

With a clear evidence base for effectiveness, the project was meeting clearly defined goals. So hearing about Danny Ahmed’s experience with the diamorphine assisted treatment (DAT) programme in Middlesborough raised many uncomfortable questions. The programme, also known as heroin assisted treatment (HAT), had been celebrated as a highly successful intervention, but was being discontinued through lack of funding from the local authority.

As the programme’s clinical lead at Foundations, Ahmed had seen ‘huge levels of engagement – 97 per cent’ from the people involved. Middlesborough had the highest number of people using heroin in the country and with half of its wards deprived, there was ‘no better place to look at alternatives to traditional treatment models,’ he said. Patients were relatively young (an average age of 38-40) and had ‘medieval levels of life expectancy’ as well as being likely to have mental health issues and be impacted by early trauma. ‘It was obvious we needed to do something,’ he said.

Starting in October 2019 the programme operated for three years, using two rooms with injecting booths and offering wraparound support (DDN, November 2019, p5 and DDN November 2020, online news). Many individuals became completely abstinent from street heroin, and many reduced their use of alcohol and street tablets. Furthermore, he says, ‘the biggest outcomes were the connections, not related to drugs… there were vast increases in physical health, mental health and wellbeing. Staggering changes… people were able to get their own housing.’ There was also a 60 per cent reduction in crime.

At £16.50 per person per day, he was told that DAT was too expensive. But on what terms? Of those who didn’t take part in the programme, six died and 43 had custodial sentences. ‘We heard that the programme has failed,’ said Ahmed. ‘But it hasn’t. Commissioning has failed, the drug strategy has failed and people who use drugs have been failed.’

‘We hear that there’s no demand from treatment services for this treatment,’ added Niamh Eastwood. ‘We need to tell OHID that there is. Fifty per cent of people who are dying aren’t in treatment.’

Hearing throughout the day about such dynamic work to scale seemingly insurmountable challenges certainly demonstrated a harm reduction community ready to fight for its lives.

DDN December 2022

Thank you for sharing your amazing work!

DDN Magazine December 2022Speakers at Hit Hot Topics talked of dilemmas, frustrations and being on the wrong side of the law (p6). But what shone from their talks was the bravery, resilience, determination and clear purpose in making life (a lot) better for their peers. Some of them made uneasy choices and compromised their own safety. Others are struggling through the disappointments and setbacks of funding cuts that make no sense when held against the evidence. We have to hope that cost-effectiveness will be weighed up in human terms.

Our review of the year (p17) reminds us of the struggles at home and abroad, and the pressures we all face. One big positive that seems to have come out of it all is a renewed appetite to work in partnership – particularly the culture of more informed commissioning (p14 and p21) and a harnessing of the collective energy to tackle stigma (p18). We’re also fully involved in helping to skill up the workforce, so please keep participating in our careers series, which focuses on counselling and therapy this month (p22).

I hope you enjoy the festive season and get some time to relax. We’ll be here online and back in print on 6 February. And as the year draws to a close, thank you for sharing your amazing work with us and being part of the DDN community. Take this hug and pass it on!

Read the November issue as an online magazine or download the PDF here

Claire Brown Editor of DDN Magazine

Claire Brown, editor

Please send your letters and comment to claire@cjwellings.com 

Festive Fears

xmas tree in prisonPeople in prison often need extra support at this time of year, says Pam Hassett.

Christmas is almost upon us, and it can be an especially hard time for people in custody. With the Christmas period seemingly starting earlier and earlier each year, the impact it can have on the people that we support cannot be underestimated.  

We hear people talking openly about the stress this causes them, not only because they know they will not be with their families over the Christmas period and won’t be there to see the joy on their children’s faces when they open their presents, but also their feeling of guilt and shame that they feel for not being there.  

This time of year tends to be a time of reflection for the people that we support, not just on the year gone by but on where they find themselves now and the circumstances which led them here. I would say this is not necessarily a negative thing, as it’s a chance to explore these feelings, sometimes for the first time. It can also bring back memories from their own childhood Christmases, and feelings about how they want their children’s Christmases to be from now on. This can bring them motivation to address the reasons why they are where they are right now. 

With all of this in mind there is the added pressure of the availability of substances. There is the temptation of wanting to block out these feelings and fall back on old ways of thinking – to ‘have a day off’ and get out of their own head, something which is explored on a one-to-one basis and in groups. It is still amazing to me how honest the people that we support are in expressing their feelings. It feels like ‘we’re all in the same boat together’. We encourage people to support each other over this time, to get together and talk about how they’re feeling. 

In the run up to Christmas from 1 November the team get together and discuss Christmas and how we can best support people at what can be their most vulnerable time. Every year, in the two weeks leading up to Christmas we attend reception daily and see everyone who is being released. We talk to them about harm reduction and how to keep themselves safe if they do end up using drugs or alcohol. We also hold a daily drop-in service on wings, which gives people a chance to come and have a chat to us in a safe confidential space.  

We hold a feedback forum for people to have their say on how they would like to be supported over this period, and what they want that support to look like. The top feedback we have received every year has been to just simply sit down, share their feelings and to have a listening ear. 

In the run up to Christmas we also hold support groups with no specific topic to be addressed. It’s simply to talk about what’s going on for people right now, and to share their feelings with their peers and gain support. This is where they tend to realise that they all share the same feelings of guilt and remorse at where they find themselves at Christmas. This leads to bonds being formed and a feeling that they can support each other over this time. Distraction packs are also available for anyone who needs them – these take the form of crosswords, Sudoku and colouring books.

We also can’t forget about the families who are impacted by their loved ones being in custody.  We arrange a family day, which means that families can have an extended half-day visit, and we also arrange for food to be provided and activities for the children and dads to do together. The hall is decorated, and families get the opportunity to spend more time with their loved ones. Pictures are taken of families as a memento of the day, and judging by the feedback received these are always greatly appreciated by everyone.

Apart from family days, by far the most popular activity is Christmas card-making, especially for their children. The people that we support take great pride in their creations, and it gives them a feeling of accomplishment in doing something personal for their children. Quizzes and bingo are always a big hit, especially when the prize is extra PIN credit to enable them to have extra contact with loved ones.

In the lead up to Christmas we also have a harm reduction campaign, which is a great opportunity to reach everyone in the establishment and spread the harm reduction message. In addition to this everyone is given harm reduction advice during one-to-one meetings, and we utilise our peer supporters to spread the message across the prison as they have access to people outside of our 9-5 working day.

Our peer support programme is now well established after COVID and it can be invaluable in offering support when we are not here. Peer supporters have an open-door policy so anyone can pop in and see them when they are struggling. They are easily recognisable in their Phoenix Futures t-shirts and the peer supporter sign outside their cell door. 

This Christmas will no doubt be a very busy time. However, our focus will be to support people through it and maybe spread a little festive cheer along the way.

Pam Hassett is Phoenix Futures service manager at HMP Wayland

 

We need to talk about… Spiking

nightclub spikingWas the recent spate of scare stories around needle spiking driven by something other than concern for potential victims, asks Nick Goldstein.

Nick Goldstein is a service user
Nick Goldstein

Spiking is a polysemous word, meaning it has several definitions ranging from impaling with something pointed, to a rapid rise in something, to being ‘shot in the ass’ – the last one is from the Urban Dictionary. The definition of ‘spiked’ that concerns us, though, is when someone puts alcohol or drugs into another person’s body without their consent. Spiking has been around as long as people have been getting intoxicated. It’s an old and far too common story that occurs for a variety reasons, ranging from revenge to a poor sense of humour to much darker motivations – spiking people or pets really isn’t funny or cool.

In fact, spiking someone for any reason at all is immoral and a form of chemical assault. If people want to make the hopefully informed decision to get high that’s fine with me (law enforcement may view it differently), but forcibly altering someone’s consciousness is always morally wrong. The darkest variety is to incapacitate someone as a prelude to an assault, often of a sexual nature, and specifically the recently much-reported alleged use of a syringe to deliver the spiking.

The first alleged cases date back to 2019 and quickly became ‘a new phenomenon’ according to Jason Harwin, the National Police Chiefs Council’s drugs lead. Incredibly the police received 1,382 reports of spiking with a needle in under six months – that’s compared with 1,903 total spikings for the entire preceding year. Universities, nightclubs, bars, student unions et al warned anyone with a pulse, and the BBC carried a special warning on the news. So, a huge new danger stalks the land, right? 

I’m not so sure, and I say that with some expertise on this subject. I might not have spiked anyone else, but I’ve spiked myself tens of thousands of times over decades. I wouldn’t claim to be an expert on astrophysics or Balinese shadow puppetry, but I am an expert in the baleful art of injecting drugs and my initial problems with spiking with a needle are technical.

Once one gets beyond the emotions and headlines and examines the idea of needle spiking with cold logic it starts to fall to pieces. Let’s take a look at the technical aspects. Firstly, you have to acquire a suitable drug. No point spiking someone with speed or LSD, you’re looking for a sedative or soporific, and even with the internet you need to be able to access illegal drugs. You also need to be sure the drug can be prepared for injection and know how to prepare it without losing the active drug in a pool of gunk that will just set and jam your works. Then you need to access an appropriate syringe – I’d imagine a smaller works would be best, maybe a .5? Certainly anything above a 1ml would be useless. Do you know where to access works? Because most people don’t.

Ok, we’ve got our drugs and works together. So, when are you going to prepare the drugs for use? I can’t see prepping in a club or pub toilet being a good idea, but if you prep it at home how do you get the loaded syringe into a venue? You really don’t want to carry a loaded syringe in your pocket because of the chance of accidentally depressing the plunger leaving you with an empty syringe and a wet pocket, but if you put the loaded syringe in a protective container it becomes more likely to be found by bouncers.

Anyway, let’s say we’ve managed to get a loaded works into a venue and I spot someone I want to spike. How is this done without anyone noticing, bearing in mind you have to stick someone with the syringe and then depress the plunger? It is possible to use one hand for both tasks, but it’s not easy. So we’ve managed to inject someone in an often poorly lit and packed room. What then? At best you’ve given an IM shot, which means it will come on slowly over 15-20 minutes. Do you follow the victim hoping she’ll somehow fall into your clutches… really?

Technically this makes no sense. Maybe I’m just being cynical, but in this case something more than my cynicism appears to be happening because there have been precisely zero convictions for this offence. In fact, not one person has even been charged. To be clear, I’m not claiming spiking with a needle never happens. It’s a large planet with a lot of people out there so most things will happen, but that doesn’t mean there’s some sort of epidemic of crazed perverts lurking in the bushes armed with a syringe and ill intent.

I believe what we are seeing in the media response to this subject is a good old-fashioned drug scare story. We’re appear to be in crack baby/marijuana fiends territory, and I expect in time needle spiking will be debunked too. The problems come when the media attention turns the scare story into political action, and with stretched budgets the last thing any of us needs is for money to be pissed away on a myth. Coda, this shouldn’t need saying again, but spiking with or without a needle is always wrong no matter the reason.    

Nick Goldstein is a service user

Fired Up

Gozney drug recovery

Cooking pizza saved Tom Gozney from oblivion, and gave him the impetus to turn his life around.

I turned to alcohol and drugs when I was young, lost and struggling to understand myself and where I fitted in in the world. In my early years I was always a timid, sensitive kid and then when I started school I began to struggle. Unbeknownst to me, I had dyslexia. But it was at a time when dyslexia wasn’t really recognised and I didn’t understand why I found everything so difficult when other kids were doing so well. I began acting out through frustration – I adopted this persona of the clown and the naughty kid that really wasn’t me, but it got me attention and made me popular.  

 When I was 13, I was introduced to a friendship group outside of school that were smoking and using drugs and it felt like a natural progression for this persona I had embraced. It felt good to be a part of something. For the first time I really felt comfortable in my own skin, part of a group of boys that felt, at the time, like brothers. Drugs and alcohol became intertwined in my perception of who I was and allowed me to switch my brain off, or at least slow it down for a bit. At that time, it all felt manageable and fun but it wasn’t long before I was expelled from school for reckless behaviour.  

By the time I was 16 it had got bad. My mum took me into a rehabilitation centre after overhearing a conversation and realising I had been using hard drugs. I just thought I was doing what all teenagers do and so I rejected it and refused help. The reality of my parents finding out and trying to help/protect me drove me out the house and to the escapism of drugs even more.  

I finally realised I might have a problem was when I tried to stop and couldn’t. I got into trouble with the police – the reality of going to a prison was sobering and I knew I wanted to change. This wasn’t the person I wanted to be or who I felt I was deep down. But I couldn’t stop and it turned my world into a horrible rollercoaster where my issues with drugs and alcohol got worse with inconsistent periods of sobriety and then intense relapses and benders. 

One evening I was attacked by eight boys when leaving a club. I lost all my teeth, broke my eye socket and smashed my skull. As a result of my injuries after the attack, I was struggling to eat or drink and that triggered an insane escalation. In rehab they always say there needs to be a rock bottom but there was no moment until then. That was my rock bottom.  

With the support of my mum and girlfriend I finally admitted I was ready to accept help.  

We found a rehabilitation centre in South Africa that focused on addressing the deep-rooted causes of my issues and helping heal them. Even then I tried to sabotage it. I was petrified. But I think I knew deep down something had to change and that I was capable of so much more.  

Rehab and my recovery journey was so hard but my life was instantly better for it. I was determined to prove everyone wrong and finally get sober. I was blessed with a councillor called Oliver who truly helped me flourish, helped me unearth the severity of my issues and accept the damage they had caused. He changed my perspective and allowed me to be vulnerable. He changed my life.  

Leaving treatment and returning home at 21 and sober was really challenging. I threw myself into cooking, there was something in the ritual of it I could just lose myself in, and it became a beacon of light for me in a tough time. I started having my mates over for dinners and one night we made pizza. Unlike other dishes or dinners, everyone rolled up their sleeves and got involved. I witnessed this insane sense of community and connection and it felt special.  

I was inspired and began building my own brick pizza oven by hand. Building the oven and the experience of hosting those pizza nights gave me a purpose and a safe space to reconnect with loved ones. I don’t think anyone at the time really knew how much that oven meant to me. It saved my life and ultimately changed it for the better. All my mates started asking me to build them an oven and I became obsessed with the ritual, determined to build the best oven I could. I rediscovered my love for design and coupled with my drive for others to experience what I had. My company Gozney was born.  

We’ve done some incredible things since, and I’ve built a business beyond my wildest dreams all with the aim of bringing that experience to as many people as possible. Today, the hardest thing for me in my life is maintaining balance, and it’s something I know I’m going to have to continue to work on. 

You are worthy. You are capable. You have purpose. You are not alone.  

Tom Gozney is founder of Gozney. Sales of his Signature Edition Roccbox pizza oven will raise funds for With You’s work across the UK.

 

Two in five deaths of homeless people drug related

Almost two in five deaths of homeless people last year were related to drug poisoning, according to the latest figures from the Office for National Statistics (ONS). The proportion remains consistent with previous years (www.drinkanddrugsnews.com/two-in-five-homeless-deaths-now-drug-related).

Deaths of homeless people have increased by more than 50 per cent in a decade.

There were almost 750 deaths of homeless people in England and Wales registered in 2021, says ONS, which also included more than 70 alcohol-specific deaths and almost 100 suicide deaths. By comparison, the number of deaths involving COVID-19 was 26, although this was twice the figure for the previous year.

The ONS data defines someone as homeless if they have been sleeping rough or using emergency or temporary accommodation at or around the time of death. Almost 90 per cent of the overall deaths were among men – again, consistent with previous years – and the highest number was recorded in the 45-49 age group. Most deaths were registered in London – at more than 150 – and the North West, but death registration delays mean that some of the deaths occurred in previous years, ONS points out. The number of deaths among homeless people has increased by more than 50 per cent since the ONS data time series began a decade ago.  

‘The deaths of 741 homeless people in England and Wales registered in 2021 represents an increase of 7.7 per cent (or 53 deaths) from 2020,’ said James Tucker of the ONS social care and health division. ‘The latest figure is more in line with pre-pandemic levels following a notable fall in 2020, although it’s too early to say whether this is a resumption of an upward trend in homeless deaths. Any death in these circumstances is a tragedy and our estimates are designed to help inform the work of everyone seeking to protect this highly vulnerable section of our community.’

So important that we focus on prevention, says St Mungo’s chief executive Emma Haddad

‘Each one these people was someone’s child, sister or brother – all with their own hopes and dreams,’ said St Mungo’s chief executive Emma Haddad. ‘Health and homelessness are inextricably linked and it is an awful reality that sleeping rough causes chronic illness and can lead to premature death, with the average age of death for someone living on the streets being around 30 years earlier than the general population. The government’s recently published rough sleeping strategy has a strong focus on prevention and tackling the root cause of homelessness. Today’s data shows yet again why it is so important we implement this to prevent people from ending up on our streets in the first place, especially as winter approaches, the current cost of living crisis worsens, and more people are facing losing their homes.’

Volunteering/Fundraising at SIG – Jas’ Story

 

Jas Uppal, a Psychology Facilitator in the Prison Service, has raised money for the SIG Bridge House service.

Volunteers are an integral part of our SIG community. Not only do they volunteer at our services, but they also undertake fundraising efforts on our behalf.

Earlier this year, our Bridge House service was given a boost with the support of a charity runner at the Hampton Court half marathon.

Jas Uppal, a Psychology Facilitator in the Prison Service decided to run the Hampton Court half marathon and raise money for charity.

Jas knew that she wanted to raise money for a smaller charity and one that meant a lot to her. She wanted to find a charity focussed around helping women who have faced some sort of difficulty in their life. Her mother is a single mother who has faced hardship and witnessing this has really helped Jas to appreciate the strength a woman has and how raising children on their own is not an easy job. When she saw the work that our Bridge House service does, she felt motivated to support other women.

Jas’ initial target was £200, and she achieved this early on after circulating her JustGiving page to family and friends, so she raised the target to £250. This target was also reached, and she continued to fundraise via social media and work.

The mothers and children at Bridge House were very thankful to Jas and made her a banner of support and encouragement before the race. The women said: “We are all very grateful to Jas for taking on the marathon to raise funds on behalf of Bridge house families, thank you and good Luck!

Jas completed the race in her estimated time of 2 hours and 16 minutes.

Everyone at SIG and in particular the Bridge House service is grateful to Jas for her efforts.

Whether you decide you’d like to fundraise like Jas or to volunteer at one of our services, we would like to hear from you. Please contact us: Volunteering – Social Interest Group – Social Interest Group

Read the original blog 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 Social Interest Group

Scottish alcohol sales down 3 per cent since MUP

Minimum unit pricing (MUP) led to a 3 per cent net reduction in alcohol sales in Scotland in the three years after its implementation, according to a report from Public Health Scotland (PHS) and Glasgow University.

shelf of alcohol
Supermarket alcohol prices increased by around 18 per cent following the introduction of MUP

The reduction was to off-trade sales, the report states, with ‘no observed impact’ to sales in pubs and restaurants.

The report follows PHS research that found the average price of alcohol in Scottish supermarkets rose by nearly 18 per cent after MUP was introduced in 2018, bringing it in line with the traditionally higher prices of convenience stores and hitting sales of own-brand spirits, strong ciders and multi-packs. The MUP level of 50p is currently under review, and the Scottish Government is also consulting on increasing the restrictions around alcohol marketing as well as reviewing its alcohol brief interventions programme. 

Alcohol-related deaths in Scotland, however, are at their highest level for more than a decade, with a PHS report from earlier in the year finding that MUP was having little effect on dependent drinkers, some of whom were choosing to spend less on food and utilities and more on alcohol. 

PHS public health intelligence principal Lucie Giles
PHS public health intelligence principal Lucie Giles

‘The latest data shows a reduction in per-adult sales of pure alcohol in Scotland at the same time as an increase in England and Wales was observed,’ said PHS public health intelligence principal Lucie Giles. ‘We found net reductions in per-adult sales of cider, perry, spirits and beer, and net increases in per-adult sales of fortified wine and wine. Taken together, the overall impact of MUP on total per-adult alcohol sales in Scotland was a 3 per cent net reduction, driven by a reduction in off-trade sales.’ 

Minimum unit pricing had been ‘effective’, added public health minister Maree Todd, a conclusion that took into account factors such as the impact of the pandemic, seasonal variations, household income and comparisons with England and Wales. ‘Minimum unit pricing is achieving what it set out to do – a reduction in sales overall with a focus on the cheap high-strength alcohol, which is often drunk by people drinking at harmful levels,’ she said. ‘Further studies on MUP, including a final evaluation report, which is due next year, will examine how MUP has impacted on alcohol harms.’

public health minister Maree Todd
Public Health Minister Maree Todd

Meanwhile, a separate report from PHS has recorded a fall in the country’s rate of drug-related hospital stays. There were 12,474 drug-related hospital stays in Scotland in 2021-22, it says, with the rate of stays now 235 per 100,000 population, down for the second consecutive year from 283 per 100,000 in 2019-20. The highest rate was for opioids, at 106 per 100,000 population, which has also decreased for the second consecutive year from its peak of 141 per 100,000 population.

Evaluating the impact of minimum unit pricing (MUP) on sales-based alcohol consumption in Scotland at three years post-implementation, and Drug-related hospital statistics: Scotland 2021 to 2022 at www.publichealthscotland.scot

 

Strength in Numbers

Women recover differently and need space to heal, says Annalice Argyle.

Read it in DDN Magazine

Annalice Argyle
Annalice Argyle

I’m a woman in long-term recovery (13 years) from alcohol, substance misuse and surrounding issues. I am also a mother, daughter, partner and sister – a change-maker, a person with purpose and a social entrepreneur. I’m lucky and privileged enough to be a position to be able to shout about recovery and happy to be a voice for those who don’t have one.   

Seven years ago I set up my own grassroots independent advocacy charity, The Recovery Advocates and Consultants UK (TRAC UK) to provide a voice, education, peer advocacy and empowerment. During COVID the service naturally morphed into a safe and supportive place for women to recover for as long as they want to engage. We find that women love the women-only space to establish healthy relationships with themselves and other females who want to reclaim their lives, which can prove to be a very powerful and empowering healing experience.

We are based in Teesside but through our online women-only recovery and wellbeing hybrid hub we work with women nationally and internationally, offering female-orientated paths. We believe that each person will have a different path to recovery and our holistic approach allows us to offer clients choice in their own journeys. 

We believe that women recover differently to men. We are not ‘people in recovery’, we are women in recovery who need to be free from shame, stigma and misunderstandings. We need to manage and heal our trauma and have the space to talk about women-specific coexisting issues. We need to be heard and feel safe. Many women have completed our programmes, confidence-building projects and recovery in the community, and are able to confront the barriers they face. We believe that recovery is much more sustainable if the foundations are firmly rooted in their local area with their children and alongside a community of supportive women.  

We sustain our charity through an event we set up called WoW – Women Only Wellness – which showcases the many ways to wellness through workshops and healthy food. It’s accessible to all women from the age of 16 as we are passionate about breaking the generational cycle.

We began to be recognised for our work in 2019 when we started winning awards, and TRAC UK has since been a finalist in the prestigious Tees Business Awards, where I won in the ‘inspiring others’ category. Recently we were nominated for a Northern Power Women Award for the second year running and I was shortlisted for a national She Inspires award for the work I do to help women recover.  

I was absolutely delighted to be a finalist as even though the nomination is for an individual it raises TRAC UK’s profile, spreading awareness and giving hope to others as well as showcasing the work that we do. Entries came from countries including Denmark, India, South Africa, the US, the UAE, Australia, Malaysia, Sri Lanka, Pakistan, Egypt and Bangladesh, as well as from across the UK. The awards offered ‘a special way of recognising truly amazing women from around the world,’ said founder Gulnaz Brennan. With over 2000 nominations in 17 categories, she said it was ‘incredibly challenging’ to draw up the shortlist.

It feels great to be recognised for a job well done. It’s not that we need to be validated but we do believe our work is special and makes huge differences to one of the worst areas for alcohol and drug problems, and where women suffer particular stigma. It’s been an outstanding couple of years for TRAC UK and we continue to go from strength to strength, building our vision of a women’s recovery movement reaching women around the globe and showcasing the many ways to recovery and wellbeing.

wow women only gathering 2023It’s the people involved in TRAC UK that deserve the praise – the staff and volunteers today and over the years, and the women and men who are part of our movement wherever they are on their journey and who help to shape the service. The work that goes into ensuring that the service develops and doesn’t stagnate is phenomenal, and the trustees are behind the scenes allowing us to grow and move forward together.

I’ve come a long way and have worked very hard to reclaim my life. I’m proud of that and hope I inspire others to do the same and find a way out their situation.  

Annalice Argyle is founder of Lobster Recovery CIC and TRAC UK, www.tracuk.uk

The She Inspires awards are being held on 24 November at Bolton Whites Hotel live and online. More information at sheinspires.org.uk

Portrait photo by Rebecca Marwood Photography 

 

The Loop given charity status

The Loop drug-checking service has been granted charity status by the Charity Commission, the organisation has announced. Earlier this year its new, regular drug-checking service in Bristol became the first of its kind to be licensed by the Home Office (DDN, June, page 4).

Charitable status will help The Loop to develop its services, including drug checking at festivals.

The commission undertook a comprehensive legal review of the organisation’s activities and ‘determined drug checking as a legal and charitable activity in the UK’, the Loop states. This will help the organisation to further develop its services and reach more people and communities, it says, as well as improving opportunities to secure further funding.

The Loop has also appointed a new CEO, Kay Porter, and full-time administrator Ursh Skeet. ‘It’s an amazing time to join The Loop; all the continued energy and commitment of so many over the past ten years has enabled us to get to this next stage in our development,’ said Porter. ‘The recognition and registration as a charity will mean that our health services and the important information we generate through drug checking will now reach more people in more places across the UK, and greatly assist in reducing drug-related harm.’

Meanwhile, a new report on the recreational use of nitrous oxide has been published by EMCDDA. A ‘profitable and expanding supply chain has developed’, it says, with specialised internet stores directly promoting the gas for recreational use or offering it under ‘the guise of its use to make whipped cream’ – noting that suppliers are now selling larger, 15kg cylinders of the substance aimed at the recreational market, rather than the previously more common small 8g cartridges.

Although poisonings associated with nitrous oxide are still relatively rare, they are on the increase and are associated with heavier use. Cases in Denmark rose from 16 in 2015 to 73 in 2021, while 134 cases were reported in France in 2020 — up from just ten in 2017.

Alexis Goosdeel: Rise in nitrous oxide use is ’cause for concern’

‘The rise in the recreational use of nitrous oxide in some parts of Europe is a cause for concern,’ said EMCDDA Director Alexis Goosdeel. ‘There is a general perception among users that inhalation of nitrous oxide is safe. Yet we see that more frequent or heavier use of the gas increases the risk of serious harms, such as nervous system damage. It is therefore important to avoid normalising and unintentionally promoting its use. Targeted interventions and further research are needed to increase understanding of the risks and reduce harms.’

Recreational use of nitrous oxide: a growing concern for Europe at www.emcdda.europa.eu

Reflecting on Turning Point UK being a social enterprise and why it matters

Julie Bass, Chief Executive at Turning Point
Julie Bass, Chief Executive at Turning Point

Julie Bass, Chief Executive at Turning Point, reflects on what it means to be a social enterprise in 2022 and why it matters.

Although there are over 100,000 social enterprises in the UK, many people are unfamiliar with the term or what it entails in practise. 

My name is Julie, and I am the Chief Executive of Turning Point, a social enterprise that offers services in the areas of substance abuse, mental health, learning disability and wider public health services. I’d like to use this opportunity, on Social Enterprise Day 2022, to discuss the work that social enterprises do and the challenges we face today. 

What exactly do we mean by a social enterprise? 

Fundamentally, social enterprises are businesses which trade for a social or environmental purpose. Like any other business, social enterprises seek to make a profit and succeed commercially. Social enterprises contribute around £60 billion to the UK economy and currently employ over two million people.  

Yet their core operations (who they employ, and how they use profit) must align with efforts towards reducing inequality, improving social justice, or improving upon environmental sustainability.  

Social enterprises work in every sector of the UK economy – from providing local community resources to waste management companies. Turning Point is one the many social enterprises within health and social care – a sector in which social enterprises account for a third of all community healthcare providers. 

Social value

Social value is a core component of a social enterprise and has been increasingly present within the commissioning landscape for a number of years. Social value can highlight the role services play in creating economic, social and environmental value for communities. For providers it allows us to demonstrate the added value we bring to health and social care services. For us social value is a demonstration of our efforts in tackling health inequalities. 

At Turning Point, social value is at the heart of what we do. Our social value strategy sets out our ambitions around promoting wellbeing, reducing worklessness, providing volunteering opportunities, apprenticeships, bursaries, supporting access to education, training and employment, investing in the local economy and supporting local community organisations. 

In 2021/22 Turning Point delivered £27.7m of social value, including an investment of £3.38m within local community organisations.  

The wellbeing of our staff and the people we support is a major priority for us. During 2021/22 we provided over £1.5m in social value through our college wellbeing programme.  

Our work in embedding social value within the services we provide is not a completed task but a journey we are still embarking on; we will always strive to find new ways to benefit the communities we support and work alongside.  

Challenges

The pressures of the cost-of-living crisis are significant for many – including for social enterprises. Providers find themselves trapped between two financial pressures: on the one hand they want to pay their skilled workforce as much as they can, and on the other, they are limited in the resources they have to pay these additional uplifts given their financial dependence upon local government and the NHS. As soaring inflation rates leads to real term reductions in budgets – Turning Point, as well as many other providers – are faced with gaps between funding and provision costs to maintain high service quality. 

With the Chancellor’s fiscal budget (to be released later today) – it is important for the Government to recognise the scale and importance of social enterprise within not just the healthcare sector but also beyond. This recognition needs to be partnered with adequate funding so social enterprises can continue to provide excellent, much needed services to some of the most vulnerable groups in the UK. We cannot let our most vulnerable fall through the cracks – particularly at a time, like the present cost-of-living crisis, where these cracks in the system become more pronounced. 

Read the original blog 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

Scots consult on alcohol marketing curbs

The Scottish Government has launched a consultation on restricting alcohol marketing, in order to ‘reduce the appeal of alcohol to our young people’.

alcohol bottles
Alcohol marketing involves a range of channels – including branded merchandise

Marketing restrictions have been identified by the World Health Organization (WHO) as one of the three ‘best buys’ in terms of cost-effective measures to reduce alcohol-related harm, the government says. 

Alcohol marketing involves a range of channels – including TV, billboard and online advertising, sports and events sponsorship, and branded merchandise – and is ‘associated with an increased likelihood that children and young people will start to drink alcohol’, the government says, or drink more if they already drink. It can also influence higher-risk drinkers and act as a trigger to people in recovery. 

Among the proposals set out in the consultation are phasing out sponsorship deals, banning alcohol advertising in outdoor public spaces, and reducing in-store promotions. Marketing restrictions have already been introduced in France, Norway and Ireland, the government points out. ‘Young people in Scotland, as well as people in recovery and their families, have told us directly that they see a lot of alcohol marketing and want us to take action to tackle this,’ it states. 

Scotland currently has almost 700 alcohol-related hospital admissions per week, with rates of alcohol-related deaths and hospital stays eight times higher in the country’s most deprived areas than the least deprived. Although the introduction of MUP in 2018 hit sales of strong ciders, supermarket own-brand spirits and multi-pack deals, last year still saw Scotland record its highest level of alcohol-related deaths for 13 years, at 1,245.

Alcohol Health Alliance chair Professor Sir Ian Gilmore called the increase ‘devastating’.

‘Exposure to alcohol marketing makes children start drinking earlier and drink more,’ saidAlcohol Health Alliance chair Professor Sir Ian Gilmore. ‘It can also make it hard for heavy drinkers to cut down. Yet alcohol marketing is all around us – in shops, on TV and billboards, even on the shirts of our favourite sports teams. We welcome the Scottish Government’s plans to stem the tide of alcohol marketing, especially potential limits to sports sponsorship. Alcohol is a harmful and addictive product, and, like tobacco, its marketing must be restricted accordingly. The UK government should follow this example and bring in protections to stop children seeing unwanted alcohol marketing. With alcohol deaths at record high levels, we need bold action from the government to tackle this public health crisis.’

Meanwhile, 93 per cent of ambulance staff in the North East of England surveyed by Balance say that dealing with intoxicated patients is wasting valuable capacity and resources, with 40 per cent saying they’ve received threats of physical violence on at least six occasions. Just one in ten said they’d never been threatened by an intoxicated patient or member of the public while on duty. ‘The increased risky drinking we saw on the back of the pandemic is likely to lead to thousands of extra cases of disease and premature death,’ said Balance’s head of alcohol policy Susan Taylor. ‘And for 999 crews it has created additional pressure on already stretched services.’

Consultation here until 9 March.

 

Turning Point’s Julie Bass responds to the Autumn Statement

Julie Bass, Chief Executive at Turning Point
Julie Bass, chief executive at Turning Point

Today, Chancellor Jeremy Hunt set out the government’s budget in the Autumn Statement. Responding to the announcement, Julie Bass, chief executive at Turning Point, said:

Jeremy Hunt has prioritised the NHS and social care and targeted support for the most vulnerable in today’s budget, which is welcome. However, the below inflation increase in funding for the NHS is a risk and more detail is needed on planned investment in social care.

The health and social care sector has struggled from underinvestment, widespread workforce issues, as well as the twin shocks of the pandemic and the cost of living crisis. Protecting the NHS is paramount as is acknowledging the crucial role played by the wider system, including public health and social care services; both in the effective functioning of the NHS, as well as supporting the most vulnerable.

 We support the government’s commitment to increasing the national living wage and this will help address the workforce challenges in social care with vacancies which are currently sitting at 165,000. Clarity is needed on the extent to which the additional investment in social care will cover the increased costs this will entail. We welcome the government’s plans to develop an independently verified workforce plan for health and social care.

We are very pleased that the Chancellor has uprated benefits in line with inflation and prioritised targeted support for those at the sharp end of the cost-of-living crisis, including those with a disability. This winter is going to be difficult for many and we must not let the most vulnerable fall through the cracks.

Jeremy Hunt has prioritised the NHS and social care and targeted support for the most vulnerable in today’s budget, which is welcome. However, the below inflation increase in funding for the NHS is a risk and more detail is needed on planned investment in social care.

The health and social care sector has struggled from underinvestment, widespread workforce issues, as well as the twin shocks of the pandemic and the cost of living crisis. Protecting the NHS is paramount as is acknowledging the crucial role played by the wider system, including public health and social care services; both in the effective functioning of the NHS, as well as supporting the most vulnerable.

We support the government’s commitment to increasing the national living wage and this will help address the workforce challenges in social care with vacancies which are currently sitting at 165,000. Clarity is needed on the extent to which the additional investment in social care will cover the increased costs this will entail. We welcome the government’s plans to develop an independently verified workforce plan for health and social care.

We are very pleased that the Chancellor has uprated benefits in line with inflation and prioritised targeted support for those at the sharp end of the cost-of-living crisis, including those with a disability. This winter is going to be difficult for many and we must not let the most vulnerable fall through the cracks.


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

Supermarket alcohol prices in Scotland rose by 18 per cent after MUP

The average price of alcohol in Scottish supermarkets rose by 17.9 per cent per unit after the introduction of MUP, according to a Public Health Scotland report. The price increase in convenience stores, meanwhile, was 6.3 per cent, says Evaluating the impact of MUP on alcohol products and prices 2022

MUP came into force in Scotland in May 2018, and has been set at 50p per unit ever since. The report analyses off-trade prices in the year following its implementation, as well as the impact on container size, strength and multipack deals, alongside comparisons with England and Wales. Overall, average prices in Scotland increased from 60p per unit to 66p, compared to an increase of just 60p to 61p in England and Wales.

The 17.9 per cent increase in supermarkets saw prices rise from 56p to 66p per unit, compared to 63 to 67p in convenience stores, creating similar pricing levels for both. The largest increases were for products priced the lowest comparative to their strength, with cider rising by 25 per cent per unit and own-brand vodka by 18 per cent. Sales of ciders and own-brand spirits in containers of one litre or more were down, as were sales of beer and cider in large multipacks.

‘In the first 12 months after MUP was implemented, we found that, especially for products that were priced below £0.50 per unit of alcohol prior to MUP, prices went up, the amount sold in larger container sizes went down, and sales also declined,’ said public health intelligence adviser at Public Health Scotland, Dr Karl Ferguson.

Alison Douglas: ‘People in Scotland respond to price.’

‘This research shows that people in Scotland respond to price,’ added chief executive of Alcohol Focus Scotland, Alison Douglas. ‘We have changed what we buy and reduced how much we buy due to minimum unit pricing. As expected we’ve seen the greatest decrease in sales of high strength, cheap products. In particular some strong ciders have seen a 90 per cent decrease in the natural volumes sold in convenience stores. We’ve also seen people switching to smaller size packs and lower strength products. The overall effect of these changes has been a reduction of 3.5 per cent in total off sales of alcohol, according to previous research.’

Meanwhile, the alcohol industry represents an impediment to achieving many of the UN’s sustainable development goals (SDGs), according to report from the Institute of Alcohol Studies (IAS). The industry creates huge amounts of waste, says People, planet, or profit: alcohol’s impact on a sustainable future, as well as destroying biodiversity and using up vital water resources in regions suffering shortages. It also facilitates human rights abuses including wages below the poverty line and vulnerability to exploitation and forced labour, it adds, especially in the Global South. Despite this, the industry still attempts to use corporate social responsibility to ‘position itself as an engine of development’, the document states.

‘As a society we know that we need to reduce our consumption across products generally, due to the burden on natural resources and biodiversity,’ said head of policy at IAS, Jennifer Keen. ‘However alcohol has a dual harm, as not only does it negatively impact the environment, but also kills millions of people around the world every year. So reducing alcohol consumption, through known, evidence-based population measures – such as reducing alcohol’s affordability through an increase in duty – will improve both the health of people and also the planet.’

Reports at publichealthscotland.scot and www.ias.org.uk