Home Blog Page 2

Stigma, grief and love: a conversation with my mum

I’m sitting with my mum, Kim, ready to talk about my brother, Karl, who passed away 13 years ago this month. The ripple effects of his loss are still deeply felt across our family.I’m sitting with my mum, Kim, ready to talk about my brother, Karl, who passed away 13 years ago this month. The ripple effects of his loss are still deeply felt across our family. His absence is a shadow that never quite lifts — especially around this time of year.

Karl’s struggle with drugs began when he turned 16. Heroin came into his life not long after, his addiction took hold frighteningly fast. Our house was chaotic — four sisters under one roof, and poor Karl stuck in the middle of it. He must’ve felt like he never had a moment’s peace. I was only four years old when he started taking drugs.

My mum often shares what it was like juggling the needs of a busy household with the daily crisis of supporting a child in addiction. Even now, when we drive around Swindon — where we lived back then — she points out spots where she used to drop him off to pick up drugs. She talks about how honest he was with her. Too honest, sometimes. He’d tell her everything, even the things she didn’t want to hear.

Karl battled addiction on and off for 11 years. He was never given the opportunity for residential treatment or community support and Karl died on 21st April 2012.

During these years, my mum found support through Release, a criminal justice charity. She often recalls something Colin, a worker there, once told her: ‘The average life expectancy of someone in active addiction is around 11 years.’ When Karl reached that 11-year mark, my mum says she felt an odd sense of relief — like maybe he had escaped the fate. But then, we lost him.

I now work for Phoenix Futures, which has fortunately led me to work on the Anti-Stigma Network. So, I ask mum: what was it like being the mother of someone who used drugs and alcohol — in a society that often doesn’t understand?

She tells me about the stigma she felt, how people would talk about her and our family. How others assumed she’d failed as a parent — because if she hadn’t, ‘How could her son have ended up using drugs?’

My mum went beyond to try and help him, like most mothers. We moved to a tiny town, hoping to escape the cloud of judgment that had formed around us. I recall my sister telling me of being in school and her peers knowing every gory detail of our ‘heroin addict’ brother as it was plastered in the papers.

My mum tells me about the times she’d go with Karl to the pharmacy for his methadone. If other customers were around, he’d be told to wait and then taken into a side room, as though his presence was something shameful. That blue prescription that lets everyone know why he’s in there, a target for judgement. After he moved out, he started going to a different pharmacy. The new pharmacist was kind which seemed so rare. She even asked if he wanted the methodone without fluroide as he was paranoid about his teeth.

The ripple effects of his loss are still deeply felt across our family
She tells me about the stigma she felt, how people would talk about her and our family. How others assumed she’d failed as a parent

I asked my mum: did you experience stigma just for being his mum? ‘Yes,’ she said, ‘even from the start — that first GP appointment, we arrived and his friend’s mum was the receptionist, it became gossip. Close family started taking a sidestep, they were distancing themselves because of what he was going through and the shame that comes along with supporting someone in addiction. It was isolating beyond words, I was living a double life.’

Karl carried that stigma too. Mum told me how, when he left prison and stopped using, he was paranoid, he felt shame for what he had been through because nobody understood. He didn’t want any of us — his sisters — to ever go down the same path. He stopped seeing himself the way we did.

My mum recalled going to a housing appointment with him and hearing, ‘If you’re a drug addict you get everything.’

Even after he died, the stigma didn’t stop. Mum said, ‘When I tell people my son died, they ask what happened. I tell them — but I think, he wasn’t in a car accident. He wasn’t a soldier at war. He was a young man who used drugs. And I’ve laid myself open to judgment because of the society we live in. But I won’t lie about him.’

That stigma didn’t just follow Karl. It followed all of us. And it still does. Mum said, ‘Society sees people who use drugs as the lowest of the low. That they don’t deserve help, or dignity.’

These are questions we don’t ask often enough — about the people who love someone through addiction. The ones who sit in waiting rooms and endure the looks and whispers, and still hold out hope, trying to support someone in active addiction is hard enough alongside the shame brought on by a society that reads stigmatising headlines.

As I talk to my mum about Karl, we reflect not only on what he went through, but how the world around him — and around us — responded. Karl’s name frequented the local paper and he was offered little dignity, just a label to erase his identity. This dehumanising language tells the public this person is not worth care or complexity.

 

This one from 2005. The headline reads: ‘Last chance is given to addict.’ And right underneath it, my brother is described as a ‘young thug’. Just those two words — ‘addict’ and ‘thug’ — flattened his entire life, struggles, and identity into something disposable. Something shameful.

 

There was no context. No mention of the kindness he showed to his family and his soft caring nature, the honesty with which he faced our mum, or the resilience it took to keep trying. Just stigma, dressed up as journalism.

And it didn’t stop with the press. One comment still sticks with us: ‘Some people do a hell of a lot less and go to jail… I still think it’s disgusting.’ Another: ‘The only way to get off drugs is to send people to prison.’ As if addiction is a crime to be punished, rather than a health condition to be treated. As if prison is a substitute for compassion.

 

This language didn’t just affect how strangers saw Karl. It shaped how he saw himself.  And for us — his family — it meant living in a town where people whispered, judged, and assumed. Where my mum was blamed. Where love was never enough to prove we were trying.

Stigma didn’t just follow Karl, it wrapped itself around all of us.

Fern.

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


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

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

This content was created by the Anti-Stigma Network

Healing together: the power of peer support in mental health

For Mental Health Awareness Week (12-18 May), Remi Bolhassani, psychological wellbeing practitioner at HMPS Warren Hill and Hollelesy Bay, shares her experiences of working as a wellbeing practitioner with some of the country’s most vulnerable people.

The recent music hit ‘Anxiety’ by Doechii is a clear sign that mental health is reaching more areas of popular culture than ever before. It is good to see people are talking more about how they feel and are more able to describe their mental health using terms like ‘anxiety’ and ‘depression’. This is important, as to be able to support our mental health, we need to better understand it and be able to name what we feel is happening.

Working in the NHS Talking Therapies service (previously IAPT) at HMP Warren Hill and HMP Hollesley Bay, it is heartwarming to see men of every age and at every stage of their lives come through our doors asking for help. Many have been recommended by a friend and brought down to our office, showing the support and care that these men give to each other. Often, they are very nervous, feeling they are making a big deal out of nothing, whereas others have a detailed understanding of what is going on with their mental health at that moment and are seeking more support.

Psychoeducation on what mental health is and what it is not (a fixed place) can help people to feel that they are not alone and give them back the power to decide how they would like to be supported.

Healing Together: The Power of Peer Support in Mental Health
Individuals are not only seeking support for themselves but are willing to take care of others in need

One of the ways we do this is in our psychoeducational groups. From discussion around anxiety and depression to healthy relationships and understanding ‘who am I?’, the groups are safe spaces where open conversations are facilitated. Nothing in my work has given me more joy and hope than seeing the inmates support, encourage, and actively listen to each other. This level of peer support goes beyond what we as practitioners can do, as it imparts empathy, hope, and care from those who are in a similar position and whom they see day to day.

This epitomises the power of community, where individuals are not only seeking support for themselves but are willing to take care of others in need. So, as we acknowledge our own mental health needs, it is good to be mindful of others who may be struggling and signpost them towards support.

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


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

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

This content was created by the Forward Trust

Irish campaigners keep up alcohol health labelling pressure

A coalition of health organisation representatives has been briefing Irish government officials about the ‘possible backtracking’ on the introduction of the country’s alcohol health labelling regulations.

Irish campaigners keep up alcohol health labelling pressure
‘People have a right to know the risks associated with alcohol consumption and to make informed decisions’

The briefing is designed to ‘cut through the industry disinformation that has been swirling around government’, says Alcohol Action Ireland (AAI). Ireland was the first country to commit to mandatory health labelling for alcohol products, with the regulations due to come into force next year after a three-year lead-in period.

Last month more than 75 organisations signed an open letter urging the government to guarantee that the regulations go ahead and were not ‘derailed or delayed’ by industry lobbying. The regulations are part of the Public Health (Alcohol) Act which was signed into law with ‘overwhelming support across party lines’, AAI points out.

‘Some of our senior politicians seem to be living in the disinformation space created by the alcohol industry around labelling,’ said AAI CEO Dr Sheila Gilheany. ‘This briefing is about giving politicians the facts. Many politicians are only too happy to meet with industry representatives but would baulk at meeting those representing public health, and one wonders where they get their information, or disinformation, from. It’s hard to get the proper picture when you’re only listening to one side. Let’s not forget, people have a right to know the risks associated with alcohol consumption and to make informed decisions.’

Provisional data shows ‘remarkable’ fall in predicted US overdose deaths

Provisional data shows ‘remarkable’ fall in predicted US overdose deathsProvisional figures from the US Centers for Disease Control and Prevention (CDC) show a ‘remarkable nearly 27 per cent decrease’ in predicted drug overdose deaths last year compared to 2023, the agency has announced.

An estimated 80,391 people died as a result of drug overdoses in 2024, down from 110,037 the previous year – the steepest one-year decline ever recorded. While overdose fatalities have been steadily falling each month since the end of 2023 overdose remains the leading cause of death for Americans aged 18-44, CDC points out, ‘underscoring the need for ongoing efforts to maintain this progress’.

The provisional figures cover all deaths including foreign residents, and so are likely to be up to 500 higher than the official annual data, CDC points out. Several states recorded decreases of 35 per cent or more with only two, South Dakota and Nevada, showing an increase. Deaths involving opioids fell to 54,743 from more than 83,000 the previous year, while deaths involving methamphetamine and cocaine were also down.

Provisional data shows ‘remarkable’ fall in predicted US overdose deaths
Deaths involving opioids fell to 54,743 from more than 83,000 the previous year

However, more than a million people in the US died a drug-related death in the first two decades of this century, with the country’s opioid crisis officially declared a public health emergency in 2017. A recent report in the journal JAMA Pediatrics found that almost 19m children in the US were estimated to be living with at least one parent or primary caregiver with a substance-use disorder, while an earlier report in JAMA Psychiatry showed that an estimated 321,566 US children lost a parent to drug overdose in the decade to 2021.

Provisional drug overdose death counts here

See the June issue of DDN for an interview with Jim Duffy, executive director of Boston-based harm reduction organisation Smoke Works

Home Office issues new synthetic opioid guidance

Home Office issues new synthetic opioid guidanceNew recommendations to help police, local authorities and public health organisations be better prepared to tackle the threat posed by synthetic opioids have been issued by the Home Office.

The advice includes sharing data between police, coroners and health services, making sure police are trained to confidently administer naloxone, fast-tracking drug testing when suspected synthetic opioids are seized, and ensuring out-of-hours resources are available to respond to incidents around the clock. More than 20,600 police officers now carry naloxone daily in the UK, the department adds, and have administered it more than 1,200 times since 2019. There are now 32 police forces in the UK either using or piloting naloxone, with another 12 committed to either piloting or rolling out its use.

Home Office issues new synthetic opioid guidance
More than 20,600 police officers now carry naloxone daily in the UK

Although synthetic opioids are most commonly found in heroin supplies, they are also becoming ‘increasingly present’ in illicit sedatives and painkillers, the Home Office states. In March Public Health Scotland warned that ‘nitazene-type opioids’ had been identified in drug samples linked to a spate of ‘sudden collapse’ overdoses, while last year EMCDDA said that all but one of the seven new synthetic opioids reported to the EU’s early warning system were highly potent nitazenes – the highest number notified in a single year.

‘This advice will help save lives by ensuring local authorities know how to respond to incidents more quickly and efficiently, as will the vital rollout of naloxone across our police forces,’ said policing minister Dame Diana Johnson. ‘Already there are hundreds of examples of police officers carrying this lifesaving medicine. I am deeply grateful for their unwavering commitment to protect some of the most vulnerable people in our communities.’

Local preparedness for synthetic opioids in England here

Record-breaking cocaine seizures ‘now the norm’ globally

Record-breaking seizures of cocaine are now the norm across the world, according to analysis by the InSight Crime think tank – ‘yet these multi-ton interdictions likely made only a small dent in what has become one of the most lucrative and violent industries for Latin American organized crime’, it says.

Record-breaking cocaine seizures ‘now the norm’ globally
Seizures are at record levels in both production and transit countries

Seizures are at record levels in both production and transit countries, the organisation states – ‘across the board, cocaine production soared and traffickers explored new markets to profit from their never-before-seen levels of supply.’

Last year, analysis by UNODC found a potential increase in cocaine production in Colombia of more than 50 per cent compared to 2022 levels, the tenth consecutive annual rise, while Europol has repeatedly warned that the extreme violence associated with the cocaine trade was now also ‘taking its toll’ on Europe.

According to the InSight Crime report, cocaine seizures in Peru doubled last year, while Bolivia and Ecuador also saw record-breaking levels of seizures. In El Salvador, meanwhile, seizures increased by more than 600 per cent compared to 2023.

Most cocaine has traditionally arrived in Europe via ports like Antwerp and Rotterdam, with more than 300 tonnes seized across EU member states in 2021 alone. However, increased law enforcement pressure in Belgium and the Netherlands has ‘likely forced traffickers to seek new routes’, says InSight Crime, with Spain strongly repositioning itself as the primary point of entry into Europe – ‘due to its past role as the epicentre of Latin American organized crime in the region.’

InSight Crime 2024 cocaine seizure round-up here

First… do no harm

Tobacco harm reduction is a low-cost, easy-to-deliver intervention that has genuinely transformative potential. A new course aims to equip professionals with everything they need to introduce it to their clients, as DDN reports

A briefing paper from the Global State of Tobacco Harm Reduction (GSTHR) late last year highlighted that when the Office for National Statistics first started compiling its UK smoking figures half a century ago, more than half of men – and more than 40 per cent of women – were smokers. Now, however, we’re fast approaching the ‘landmark’ moment when the proportion of vapers will overtake smokers, it pointed out (DDN, November 2024, page 6).

Analysis by anti-smoking charity ASH found that vapes are by far the most popular and effective aid used by people trying to stop smoking, with almost 3m people saying they’d used them to successfully quit during the five years to March 2024 (DDN, September 2024, page 4). But myths around vaping persist, not helped by media scare stories and the ongoing opposition of some public health bodies, and the number of people who mistakenly believe that vaping is as harmful as – or even more harmful than – smoking continues to increase.

Tobacco harm reduction is a low-cost, easy-to-deliver intervention that has genuinely transformative potential. A new course aims to equip professionals with everything they need to introduce it to their clients, as DDN reports

These myths are among the issues being addressed by a new online course from Knowledge Action Change (KAC), the organisation that runs the GSTHR project. The free course offers a ‘solid introduction’ to tobacco harm reduction and its evidence base, placing it firmly in the context of other, more long-established aspects of harm reduction.

Encouraging as many smokers as possible to switch to safer nicotine products – not just vapes but heated tobacco products, nicotine pouches and snus – provides a ‘massive’ harm reduction opportunity to cut the rates of smoking-related disease, says GSTHR, which hopes the course will help to promote the evidence base to a much wider audience.

Designed to take a total of around two or three hours in separate modules, the course has been developed in partnership with public health experts, researchers, and medical professionals, and funded by a grant from Global Action to End Smoking. It covers the primary safer nicotine products, which groups and populations could most benefit, and the main public health debates – including myth-busting. The format includes reading modules, videos and practical exercises, and is designed to be as flexible and interactive as possible.

Those successfully completing the final assessment will receive a certificate to add to their professional portfolio. They will also, says GSTHR, be equipped with the ‘knowledge and tools needed to make informed decisions and advocate for effective harm reduction approaches’ – that is, able to properly define tobacco harm reduction and its key principles, recognise the importance of risk-proportionate regulation, and evaluate the range of critiques and challenges.

Tobacco harm reduction is a low-cost, easy-to-deliver intervention that has genuinely transformative potential. A new course aims to equip professionals with everything they need to introduce it to their clients, as DDN reportsPrevious initiatives from GSTHR include its Tobacco Harm Reduction Scholarship Programme, launched in 2018, which now has a 100-plus alumni network worldwide that has helped to increase awareness and capacity among professional sectors in more than 50 countries. GSTHR has also highlighted how tobacco harm reduction could have transformative effects for rough sleeping communities, as well as people accessing drug and alcohol services (DDN, February 2024, page 6) – around half of whom are smokers, according to OHID figures.

Professionals such as social workers should also be given the tools to promote tobacco harm reduction, GSTHR argues, as they’re frequently the ‘initial, and in some cases, only’ point of contact with a range of marginalised people – according to WHO figures around two thirds of people with severe mental health conditions are also smokers.

The Understanding Tobacco Harm Reduction course is open to anyone, with ‘only one eligibility requirement’, says KAC co-founder and emeritus professor at Imperial College London, Gerry Stimson – ‘a desire to reduce smoking and tobacco-related harm.’

Tobacco harm reduction is a ‘potentially game-changing public health approach’, he states ‘Maybe you work with clients or patients whose tobacco use impacts their lives, or maybe you’re interested in new ways of tackling social issues.’

Sign up for Understanding Tobacco Harm Reduction here

People with co-occurring substance use and mental health disorders ‘suffering harm and premature death’, says RCPsych

People who have a co-occurring substance use disorder and another mental health disorder (CoSUM) are suffering harm and premature death after being excluded from care, warns a new report from the Royal College of Psychiatrists (RCPsych).

People who have a co-occurring substance use disorder and another mental health disorder (CoSUM) are suffering harm and premature death.

People with CoSUM not only experience poorer health but have higher mortality and suicide rates than people who have either an individual mental illness or substance use disorder, the document says – and are being ‘failed by a system that is not designed or equipped to meet their complex needs’. Drug treatment and mental health services typically work in silos and consequently ‘don’t have the appropriately trained staff and resources’ to treat both conditions simultaneously, it states.

In the decade to 2014 in England more than half of patients treated by mental health services who died by suicide had a history of substance use issues, the report points out, but just 11 per cent were in contact with substance use services. Up to 70 per cent of people accessing community substance use treatment also have a mental health disorder, it adds, with 44 per cent of people in community mental health treatment reporting problems with drugs and/or alcohol. The situation in England is exacerbated by the fact that substance use services are commissioned by local authorities outside of NHS structures, it says, ‘contributing to poor coordination of care and avoidable harms’.

The most recent RCPscyh census of its workforce showed that a quarter of consultant addictions psychiatrist posts were vacant or filled by locums. RCPscyh is calling on the UK and devolved governments to ‘provide substance use and mental health services with the training, staff and funding they need to address these difficulties’, including the implementation of a co-ordinated approach in England and Northern Ireland where patients are managed based on the severity of their illnesses and level of need.

The report follows a wide-ranging study led by Glasgow Caledonian University late last year which found that services across the UK remained ‘ill-equipped’ to properly meet the needs of people with co-existing substance use and mental health issues, with people in areas of deprivation ‘the worst hit’.

People who have a co-occurring substance use disorder and another mental health disorder (CoSUM) are suffering harm and premature death after being excluded from care, warns a new report from the Royal College of Psychiatrists (RCPsych).
‘Without improvements… this most vulnerable group will continue to be stigmatised and forgotten’

‘People experiencing both mental health and substance use disorders are some of the most vulnerable in society and have the poorest outcomes and greatest treatment need,’ said lead author Professor Owen Bowden-Jones. ‘They also constitute a significant proportion of people receiving substance use and mental health treatment making their needs a high priority. We must move on from the current system of siloed care, which creates unnecessary barriers to access and generates further stigma. Instead, this group of people deserve a system which can co-ordinate their often-complex treatment with the support of appropriately trained clinicians working collaboratively and compassionately.

‘This report, which reviews the situation across all four nations, provides practical advice and information for healthcare professionals while also making recommendations for governments, commissioners and standard setting bodies to improve services,’ he continued. ‘Without improvements in staff training, clinical protocols, service pathways and performance monitoring, outcomes will remain unacceptable, and this most vulnerable group will continue to be stigmatised and forgotten.’

Co-occurring substance use and mental health disorders (CoSUM) available here

From lived experience to leadership

Even with the best intentions, harnessing lived experience can often mean asking people to ‘step into our world, speak our language’ says Jordon Field. Here she describes how her organisation is helping to redefine commissioning in Essex.

Jordon FieldEven with the best intentions, harnessing lived experience can often mean asking people to ‘step into our world, speak our language’ says Jordon Field. Here she describes how her organisation is helping to redefine commissioning in Essex.

In 2017, Ben Hughes, head of public health at Essex County Council, recognised a critical gap in how drug and alcohol services were being shaped across the county. He believed local authorities needed to go beyond simply gathering feedback – they needed to meaningfully embed the voices of lived experience into every level of service design and delivery.

‘While I could sit in my office and make decisions about where to spend my budgets – and base them on the best knowledge available – it was never going to be based on actual experience,’ Ben reflected.

Determined to change the system, Ben proposed a bold new approach: a commissioning model built with lived experience at its core. With the support of Essex County Council, this radical vision became a reality – and the Essex Recovery Foundation was born.

Essex Recovery Foundation - lived experience

PEOPLE POWER
Essex Recovery Foundation is a pioneering charity dedicated to building a visible recovery community in Essex. Our mission is to use the voices of those with lived experience to influence how services function and to change perceptions of addiction and recovery. Through this innovative approach, we’re aiming to make Essex a place where recovery is celebrated and supported.

‘The essence of Essex Recovery Foundation is simple: put the power to shape and commission drug and alcohol services into the hands of those who use them,’ said Nathan Marsh, our chair. ‘Too often, when we seek feedback from service users, we ask them to step into our world, speak our language, and then draw conclusions from small sample sizes. Even with the best intentions, this approach rarely cultivates meaningful change or community ownership. We believe there’s a better way – one that delivers better outcomes for everyone involved.’

This belief is already starting to influence real change. In partnership with Essex County Council, Essex Recovery Foundation has led a transformative shift in the commissioning of drug and alcohol services, and the Psychosocial Alcohol Intervention and Recovery Service (PAIRS) and Community Rehabilitation contracts became the first to be re-tendered using this lived experience-led model.

Even with the best intentions, harnessing lived experience can often mean asking people to ‘step into our world, speak our language’ says Jordon Field. Essex
The Essex Recovery Festival offers a unique space for people to come together, have fun, share experiences, and celebrate community. The festival celebrates the power of music, creativity, and connection in recovery

NEEDS ASSESSMENT
The process began with a rigorous needs assessment carried out by our team of community researchers, all of whom have personal experience with addiction. Drawing on the voices of people affected by addiction across Essex, the assessment helped us shape and design new service specifications which directly reflected the needs and priorities of the recovery community.

Essex Recovery Foundation also played a direct role in evaluating the bids. Sitting alongside commissioners from Essex’s Drug and Alcohol Public Health team, our team had an equal voice in scoring applications against community-developed criteria.

Bethany Teague, one of Essex Recovery Foundation’s community researchers and a key voice in the process, shared her reflections: ‘The experience was both fascinating and inspiring. Sitting around that table, we weren’t just observers – we were equals. Our voices, shaped by our community insights and lived experiences, carried weight. It was empowering to see how our perspectives were not only heard but actively influenced the outcome. There were moments where I spotted things others had missed, and scores were adjusted based on our feedback. It showed just how valuable our input was.’

Bethany also noted how encouraging it was to see bidders directly incorporate insights from the community research into their proposals. For example, from the feedback we’d collected, the recovery community had highlighted the need for greater out-of-hours support. The chosen provider has responded by extending services into two weekday evenings and weekends, as well as launching a 24/7 online chat feature with AI-assisted support. Additionally, in response to calls for more inclusive access, especially for hard-to-reach groups, the provider has expanded to 28 outreach locations and introduced home visits for individuals unable to travel.

GROUNDBREAKING MODEL
This groundbreaking model marks a fundamental shift in how public services can – and should – be designed. By placing lived experience at the centre of commissioning, Essex Recovery Foundation is not only shaping more effective and relevant services but is also challenging the status quo of top-down decision-making.

Laurence Hickmott, chief executive officer of Essex Recovery Foundation, highlights the importance of creating safe spaces for people with experiences of addiction to feel comfortable to participate in this process: ‘It’s important that we recognise that these groundbreaking achievements are not possible without the courage of those people who shared their experiences and ultimately trusted us to turn that insight into action. So much of this success belongs to our incredible community engagement team, who’ve built meaningful relationships with people affected by addiction throughout Essex.’

From lived experience to leadership

BEYOND COMMISSIONING
Our commitment to community empowerment goes far beyond commissioning. We run weekly recovery spaces across the county: safe, welcoming environments where people can connect, share, and support one another. We’re also proud to host the annual Essex Recovery Festival, which is taking place from 8 to 10 August – a vibrant, sober celebration that brings together individuals in recovery and allies from all walks of life.

Most recently, we launched the Essex Recovery Fund, a unique, community-led grant programme that supports grassroots projects created by people in recovery, for people in recovery, and voted on by the recovery community itself. It’s yet another example of how we’re aiming to flip traditional models on their head and prove that lived experience is not just valuable – it’s vital.

We believe that what’s happening in Essex is more than a local success story – it’s a blueprint for how communities across the UK could rethink recovery, inclusion, and public health. As the results continue to speak for themselves, one thing is clear. When you give people with lived experience the power to lead, real change follows.

Jordon Field is head of strategy and communications at Essex Recovery Foundation

Cranstoun response to new synthetic opioids report

Local preparedness for synthetic opioids in England reportFollowing the publication of the Local Preparedness for Synthetic Opioids in England report, Cranstoun has welcomed further recommendation and guidance for Combatting Drugs Partnerships, but has continued the call for further measures which will help to prevent drug-related harm and deaths.

In North America, both the US and Canada called public health emergencies because of the severity of the issue of synthetic opioids, and we believe that recommendations to make us better prepared are still being missed. The crisis there is so severe that the former homeland security secretary in the US described synthetic opioid overdoses as ‘the single greatest challenge we face as a country’.

In the US, drug deaths there have risen by around 147% in just a decade from 2013-2023 – with 115,592 dying from drugs in 2023 alone across both countries – and there is no sign that this problem is going away.

The latest data available for the UK shows that nitazenes were linked to 179 deaths over a 12 month period between 1 June 2023 and 31 May 2024. This is a marked increase on the first six months where just 54 deaths were recorded. It is known there is a lag in the recording of data, and that deaths related to nitazenes were likely not logged as such, given that they were not tested for routinely in postmortem examinations.

Commenting on the report, director of new business & services at Cranstoun, Megan Jones, said, ‘We welcome the measures in this report, so far as they relate to reporting and data sharing, and working to expand the carriage of naloxone.

Response to Local preparedness for synthetic opioids in England report
‘There seems to be a lack of ambition when it comes to really getting upstream and preventing the harm which synthetic opioids pose to our communities’

‘However, it is disappointing that there seems to be a lack of ambition when it comes to really getting upstream and preventing the harm which synthetic opioids pose to our communities.

‘Some simple recommendations, which we announced back in the summer of 2023, would allow all organisations working to prevent harm caused by drugs to work more effectively. The Home Affairs Select Committee published a comprehensive report on drugs in 2023, which made some similar recommendations which have not been acknowledged in this report.

‘Expanding drug checking and testing services would go a long way to provide more rapid responses to changes in local drug supplies, allowing all partners to respond effectively.

‘We welcome discussions which providers had as part of the exercises around overdose prevention sites in areas where there are significant issues. We believe that these sites, as all of the global evidence suggests, would save lives and prevent harm.

‘We note that the UK government currently has no plans to change the Misuse of Drugs Act, however these facilities could still operate without changes to this legislation. There are also several evidence-based schemes which in the UK, have been evaluated positively, yet are not being considered for expansion.

‘We’re concerned that – given drug deaths impact the people from the most deprived areas significantly more – this could lead to greater pressure on emergency and wider health services. This is why we need to see more measures put in place to help us prevent harm from these highly dangerous substances.

‘Without having a greater number of tools in our arsenal to respond to synthetic opioids, it can feel like we are trying to reduce harm with our hands tied behind our backs. Getting ahead of the curve is essential and it feels that time is slipping away unless we see rapid changes in our national response.’

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


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

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

This content was created by Cranstoun

Lincolnshire police reach milestone in life-saving naloxone training

Lincolnshire Recovery Partnership celebrated a significant achievement on Tuesday, marking the training of 250 Lincolnshire Police officers to administer naloxone, a life-saving medication that can reverse the effects of opioid overdoses.

Lincolnshire police reach milestone in life-saving naloxone trainingNaloxone, available from drug treatment providers and some pharmacies, is a crucial first aid tool in combating the rising tide of opioid-related incidents. Lincolnshire Police have integrated naloxone training into their broader strategy to address drug use in the county, partnering with Lincolnshire Recovery Partnership, which offers free and confidential services related to drug and alcohol use.

The officers are trained to use Nyxoid, a nasal spray version of naloxone, and Prenoxad, an easy-to-use injection. To date, 270 officers have received training, with 231 equipped with naloxone, making Lincolnshire Police one of the leading forces in the country in naloxone implementation.

Special constable Felstead-Solley, one of the trained officers, emphasised the importance of naloxone for all operational officers. ‘I feel naloxone is important for all operational officers to have as our number one priority is to save life and limb. It is a really good tool to have especially when it can save lives,’ he said. ‘People overdosing, whether by accident or not, are in need of help. There is a huge drug issue in our community and country, people turning to drugs are still people, they just need help.’

The Home Office has projected an increase in drug-related deaths due to the rise in synthetic opioids like nitazenes, which are up to 500 times more potent than heroin. Recent figures indicate at least 400 drug-related deaths across the UK linked to nitazenes. Last year, the government classified 15 synthetic opioids, including 14 types of nitazenes, as Class A drugs.

naloxone training
Future training sessions will be integrated into police officers’ continuous professional development (CPD) and student officer training

Lincolnshire Police and Lincolnshire Recovery Partnership plan to continue their collaboration, focusing on naloxone training for teams in the east of the county ahead of the summer tourist season. Future training sessions will be integrated into police officers’ continuous professional development (CPD) and student officer training.

Stephen Knubley, deputy director of intelligence for Lincolnshire Police, said, ‘Lincolnshire Police recognise that a multi-partnership approach is essential in addressing the impact illicit drugs have on our communities and specifically how important the issue of naloxone is in mitigating the threat that synthetic opioids pose.

‘We know that the naloxone is safe, highly effective at reversing opioid overdoses, and can save the life of someone who may otherwise have died.

‘We have now reached a milestone with over 250 Lincolnshire Police officers and staff having been trained. This is testament to the support and commitment of the Lincolnshire Recovery Partnership team and highlights how policing supports a whole systems approach to keeping all our communities safe.’

Robyn Wight, acting consultant in public health at Lincolnshire County Council, said, ‘Preventing premature death is a priority for public health and having over 250 police officers trained to carry naloxone is a great step forward in helping to reduce drug related deaths.’

naloxone training
Naloxone ‘is easy to carry, simple to use and should be part of everyone’s first aid kit’

Elli McNally, harm reduction and health promotion lead at Lincolnshire Recovery Partnership, highlighted the life-saving potential of naloxone. ‘People’s lives can be saved by naloxone. It is easy to carry, simple to use and should be part of everyone’s first aid kit. I’m really glad that Lincolnshire Police want to start carrying naloxone, and we’ve had a good reception for it in the training with most officers taking a kit.

‘Police are often the first on the scene if a person overdoses and can have the opportunity to save their life. The police’s awareness and willingness to support naloxone helps to remove barriers between people using substances and the police and opens up conversations for people to be aware of and access support if they want to.’

Adam Sutcliffe, senior operations manager at Lincolnshire Recovery Partnership, added, ‘Training over 250 officers to be able to administer naloxone is a remarkable achievement and demonstrates the great progress we are making here in Lincolnshire.

‘More people are able to respond to an emergency and potentially save a person’s life. It is further evidence of our collaborative approach, working with the police to support and save people.’

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


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

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

This content was created by Turning Point

Participants needed for new LJMU research study on discrimination and wellbeing

Participants needed for new LJMU research study on discrimination and wellbeingLiverpool John Moores University School of Psychology is leading on a study which explores experiences of discrimination faced by different groups of people, including those affected by substance use.

They are looking for individuals who care for somebody with an alcohol/substance use problem to take part in a short survey (between 5-10 minutes). The survey will ask about your everyday experiences and mental health. You can also choose to enter a prize draw for one of ten £20 Amazon vouchers upon completion of the survey.

To find out more about the study and to take part in the survey click here.

Or use this QR code:

LJMU research study on discrimination and wellbeing

The survey can be completed on a mobile device for convenience.

If you’d like more information about the study or have any questions, please contact the research lead Dr Andy Jones: a.j.jones@ljmu.ac.uk

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


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

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

This content was created by Adfam

Unheard cries: Maternal Mental Health Awareness Week 2025

Ania Couchinho, Forward’s research and impact lead and expert in Black maternal health, highlights the importance of providing mental health and addiction support for all women this Maternal Mental Health Awareness Week 2025 (5-11 May).

Maternal Mental Health Awareness Week 2025The birth of a child is often described as one of life’s most joyful milestones. But for many Black women, this experience is accompanied by a silent struggle with postnatal depression (PND) – a condition that can become even more complex when combined with the weight of addiction.

Mental health support for new mothers is not one-size-fits-all. For Black women, cultural, social, and systemic factors often shape how depression is experienced and whether it is treated or overlooked. When mental health needs go unmet, some women turn to substances to numb the pain. In this blog, we dive deeper into the intersection of PND and addiction among Black mothers and why addressing both is essential.

Understanding postnatal depression (PND)
PND is a mood disorder that affects women after childbirth, marked by persistent sadness, anxiety, exhaustion, and difficulty bonding with the baby. It affects around 1 in 7 women, but Black women are far less likely to receive a diagnosis and treatment.

The overlap between PND and addiction
Mental health and addiction are deeply interconnected. When PND goes untreated, some women, especially those with limited access to emotional support or therapy, may turn to substances like alcohol, cannabis, or prescription medications to cope. This self-medication can quickly spiral into dependency.

Postnatal Depression

Why is this particularly relevant for black women?

  • Unaddressed pain: Due to stigma, cultural expectations, or mistrust in the medical system, many Black women do not receive mental health care for PND. The emotional pain doesn’t disappear – it gets buried, often under substances used to dull its edges.
  • Stigma of ‘being a bad mother’: Black women face increased scrutiny in motherhood. Admitting to struggling emotionally or with substance use can carry fears of judgment, shame, or even involvement from social services. This leads many to suffer in silence.
  • Historical over-policing of black mothers: The criminalisation of substance use in motherhood disproportionately affects Black women. While white women may receive referrals to treatment, Black mothers are more likely to face punitive action. This discourages many from seeking help for addiction or PND in the first place.
  • Generational trauma and coping mechanisms: Generations of racial trauma and systemic stress often result in maladaptive coping mechanisms being passed down. Addiction is rarely just about the substance; it’s about survival in a system that routinely fails Black women.

Barriers to recovery and healing

  • Lack of dual-diagnosis care: Many addiction treatment programmes do not address co-occurring mental health disorders like PND. Without addressing the root cause, recovery is incomplete, and relapse is more likely.
  • Limited cultural competency in services: Black women often report feeling misunderstood or stereotyped in traditional recovery settings. Cultural shame around addiction and mental health can also be a deterrent to seeking support.
  • Why this matters – the cost of silence: When PND and addiction intersect, the consequences can be devastating for the mother, the child, and the family as a whole. These conditions affect maternal bonding, increase the risk of child neglect, and can lead to long-term mental health issues for both mother and child.
Maternal Mental Health Awareness Week 2025 (5-11 May)
Black mothers deserve the same access to compassionate, effective, and culturally aware care as anyone else

But this isn’t just a personal health issue – it’s a social justice issue. Black mothers deserve the same access to compassionate, effective, and culturally aware care as anyone else.

What needs to change

  • Integrated mental health and addiction support: Services must offer trauma-informed, culturally competent care that treats both PND and substance use disorders together.
  • Policy reform: Decriminalising substance use during pregnancy and instead promoting treatment-based approaches can help protect Black mothers and keep families together.
  • Community-led solutions: Programmes led by Black women, like maternal support groups, peer recovery networks, and culturally relevant doulas, can break through barriers of stigma and build trust.
  • Public awareness: Normalising conversations about both PND and addiction within Black communities is essential to dismantling shame and opening pathways to healing.

Black mothers deserve to be heard and healed
The path from PND to addiction isn’t paved by weakness. It’s paved by neglect, silence, and unmet needs. Black women are fighting for their mental health in a world that often refuses to see their pain. To support them, we must listen, advocate, and build systems that prioritise healing over punishment, understanding over judgment.

The journey to motherhood should not come at the cost of a woman’s mental health or dignity. It’s time to rewrite the story – one that centres Black women’s voices, experiences, and power to heal.

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


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

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

This content was created by the Forward Trust

Moral support

Working with people with complex needs can be hugely rewarding, but it can also be traumatic. That’s why organisations need to protect their staff from the effects of moral injury, say Steven Batten and Dr Stephen Donaldson.

The area of moral injury and staff distress is seldom discussed within the fields of drugs and alcohol, homelessness, and mental health services. Moral injury and moral distress are often mislabelled as PTSD, and while the symptomology may be similar, the process which the distress stems from is very different.

While PTSD is usually the result of fear-based events – abuse, a car crash, a near-death experience – moral injury stems from being prevented from doing what you believe is ethically and morally right.

Those working with clients who have experienced multiple disadvantage can often encounter traumatic situations, so understanding and recognising the signs and symptoms of moral injury is important for ensuring the wellbeing of staff and the efficacy of services provided to those with multiple and complex needs.

moral injury

A 2009 article in Clinical psychology review describes moral injury as occurring when individuals are prevented from acting in ways that align with their ethical and moral beliefs. Moral distress refers to the repeated exposure to potentially morally injurious events, and is a recognised clinical term. Moral distress creates a sense of frustration and emotional pain when individuals recognise the right course of action yet feel powerless to overcome the barriers to following that course.

Moral injury and distress may also contribute to feelings of fatigue or hopelessness. Staff can experience a sense of detachment from their client, creating barriers to the delivery of effective inter­ventions and care. Emotional numbness, or cynicism towards the work, can also develop as a way of self-protection from further distress and injury. This can create an internal psychological discourse leading to feelings of guilt and shame – for example, staff can experience dilemmas when faced with service criteria and thresholds which lead to the exclusion of those with com­plex needs (for example, dual diagnosis).

So what can be done? We can tackle moral injury and moral distress by taking a multi-tier approach. At the individual level, monitor your own wellbeing when you may feel that your values and your actions are misaligned. When feeling that they’re prevented from following the right course of action, people can become cynical, experience feelings of guilt or shame, or withdraw from usual interactions. Seeking out a trusted colleague and spaces for reflection is essential to explore these feelings and possible different perspectives.

Intervention at a team level, meanwhile, is a wonderful opportunity to promote healthy daily habits that can be shared amongst the team. Check-ins with each other are key to fostering a cohesive, supportive, working environment. These check-ins also help people to notice if a colleague is struggling, and to provide support in a non-judgmental environment. Organisations may wish to consider group reflective practice as a standard provision to help staff discuss the emotional impact and sources of moral injury in a supportive atmosphere.

At leadership level, supervision with staff serves as a point of contact for staff to reflect and manage their own wellbeing. It’s also an opportunity to discover possible organisational factors or workplace cultures that may be hindering an individual’s ability to act in line with their own and organisational values.

Eradication of moral injury cannot be achieved – the focus should be on reducing the sources of moral injury and having the opportunity to discuss these issues in a non-judgmental space
Eradication of moral injury cannot be achieved – the focus should be on reducing the sources of moral injury and having the opportunity to discuss these issues in a non-judgmental space

Finally, at system level, those with multiple needs require multi-professional and multi-agency approaches to support their care and recovery. It’s in this space, however, where moral distress can be most experienced. Working in partnership around a person is essential yet is not without its own challenges. Systems such as charities, local authorities and the NHS must work together with potentially incongruent rules and policies – this requires an open and honest dialogue at a strategic governance level to facilitate changes and enable excellent quality of care.

When staff are supported and skilled to notice and manage their emotional health, they’re less likely to experience burnout. It’s important to recognise that eradication of moral injury cannot be achieved – the focus should be on reducing the sources of moral injury and having the opportunity to discuss these issues in a non-judgmental space.

By recognising the signs of moral distress, promoting constructive dialogues, and providing support, organisations can become healthier work environments that prioritise the mental health and the moral and ethical values of their staff. It’s through this recognition and proactive response that real change can be achieved.

Steven Batten is clinical psychologist in training, Humber Teaching NHS Foundation Trust. Dr Stephen Donaldson is consultant clinical psychologist, REACH team/professional lead for psychological professions, Tees Esk and Wear Valleys NHS Foundation Trust.

The cuckoo’s nest

With cuckooing finally about to become a specific criminal offence, Karen Jones describes how a Surrey outreach service has been providing support to its vulnerable victims.

Surrey is leading the way in supporting victims of ‘cuckooing’ through a specialist outreach service. Part of local charity Catalyst Support, the service has been running since 2018 and is the first of its kind in England.

Cuckooing is when the homes of vulnerable people are taken over and used for criminal activities – in the same way that cuckoos lay their eggs in the nests of other birds. Befriending vulnerable individuals, fear tactics or manipulation may be used by the perpetrators to gain access to a person’s home, often leaving the victims in unsafe situations or displacing them completely. This type of activity is closely linked to county lines drug trafficking, where people are used to supply drugs from major cities to suburban, rural and coastal areas.

The cuckooing outreach service was piloted in partnership with Surrey Police. Part of the impetus was the realisation that once perpetrators had been removed from the property, the vulnerable person was often left alone to get their confidence back and rebuild their life – and that there was a need to support them through this process. By seeing people in their own homes, when it is safe to do so, the team is able to get a clearer picture of what’s going on for them.

The perpetrators will often initially befriend people to obtain entry to their property. Karen, a service manager at Catalyst Support leading the cuckooing outreach team, explains: ‘There’s a stereotype people think of when they imagine cuckooing victims, but it can happen to anyone. It could be your family member or neighbour. Fifteen per cent of our clients have had no history of drug or alcohol use, and perpetrators can be local dealers as well as family members.’

cuckooingLACK OF AWARENESS
Many people have never heard of cuckooing until it happens to them. ‘I allowed what I thought was my friend into my property to stay,’ says one victim. ‘Never did I consent to them taking over my property and me being a prisoner in my own home. I’ve never felt so scared and powerless. I’d never heard of cuckooing and never thought my so-called friend could be my nightmare.’

Lisa Townsend, Surrey’s police and crime commissioner, sees the lack of awareness around cuckooing manifest itself in victims struggling to self-report: ‘The harm caused to these victims is devastating. Troublingly, most victims of cuckooing will remain hidden, both from police and from agencies poised to help them out of danger, like Catalyst Support’s fantastic cuckooing service.’

Catalyst Support works at raising awareness of cuckooing to make sure that fewer people fall victim and so that neighbours, friends and family can spot the signs. Karen lists some things to look out for in the behaviour of a vulnerable person: ‘They might start talking about a new friend who’s helping them. They might become withdrawn or cancel home visits. Somebody else might start answering their phone. They might appear to be more financially unstable.’

Referrals for cuckooing have come from family members, doctors, neigh­bours, vicars and friends, so it’s important that as many people as possible are aware of this practice, how to spot it and how to report any concerns.

For many years, the lack of awareness around cuckooing extended to the legislation against it, and cuckooing is still not currently recognised as a crime – something that leaves victims feeling unseen and limits opportunities for police intervention. Catalyst Support works to help victims feel valid in their experience. One service user says, ‘You saw me as a victim and made me feel visible. It gave me a way out, it helped me build up my self-worth and improve my quality of life.’

A STANDALONE OFFENCE
There has been tireless campaigning to have cuckooing recognised as a standalone offence. Tatiana Gren-Jordan, former head of the Modern Slavery Policy Unit at The Centre for Social Justice says, ‘In March 2024, 1,284 cuckooed addresses were visited in one week of national intensive police enforcement action on county lines drug dealing. This provided clear evidence that this issue is of national importance.’

cuckooing victims

Finally, in February 2025 the crime and policing bill included looking at new legislation,  which will mean that cuckooing will finally become a criminal offence in its own right (DDN, March, page 4).

‘Catalyst Support cuckooing team welcomes the first steps to recognising cuckooing as a stand-alone crime,’ says Karen. ‘We hope that making it a criminal offence will make a difference to the support available to victims, as well as deter perpetrators from exploiting vulnerable people. Cuckooing has long been a hidden crime, and the impact it has on vulnerable victims has often not been recognised. There is still stigma from both sides: agencies thinking people invited the perpetrators in as they “wanted some free drugs”, and also victims feeling they will not be believed or are not worth it. We hope that the change in the legislation will help the victims to be seen and receive the support they require and build resilience to avoid further exploitation.’

IMPROVING THE SUPPORT
As the first specialist outreach team in England to support victims of cuckooing, we welcome the improvements in identification of cuckooing and new laws that will allow professionals to take action. Catalyst Support will continue to provide an assertive outreach service and further support to both victims and partner agencies to help address cuckooing in our communities.

Since the initial pilot, the team has received more than 588 referrals from victims aged between 18 and 93. Cuckooing can affect people of any age or background – although there are some vulnerabilities which can increase susceptibility to victimisation.

Karen Jones is team leader for the cuckooing outreach service at Catalyst Support

REBUILDING A LIFE

Sarah (whose name has been changed for confidentiality) was cuckooed when, grieving the loss of her partner and struggling with complex mental health challenges, she sought solace at a local drop-in centre. There she was befriended by a drug dealer who then brought a gang to her home to use as a base for their county lines operations.

Sarah was forced out of her bedroom and lived in fear until the police and the Catalyst Support team stepped in. Once the police had become aware of the situation, they removed the immediate threat with a partial closure order, and Catalyst Support’s cuckooing team stepped in to support Sarah. They connected her with a GP, arranged bereavement support, referred her to local food banks and even helped to bring her place back to what she felt was an acceptable living standard.

Today, Sarah’s home is secure, and her confidence has grown – she’s reconnecting with friends, redecorating her flat and enjoying regular bike rides. She continues to engage with support services, which is helping her to break free from isolation and rebuild her life.

For more information about Catalyst Support’s cuckooing outreach service contact karen.jones@catalystsupport.co.uk  

Go to catalystsupport.org.uk/services/specialist-outreach/surrey-cuckooing/ for useful resources on cuckooing

DDN May 2025

Taking a new approach has paid dividends

DDN May 2025‘I allowed what I thought was my friend into my property to stay… I’ve never felt so scared and powerless.’ Our cover story (p6) looks at cuckooing – a situation terrifying for victims and largely invisible to the outside world. It’s also a long-hidden crime that, after much campaigning, is about to be recognised as a specific criminal offence. Surrey’s Catalyst Support team help us identify the signs of this devastating form of exploitation and give guidance on helping victims – not only to escape the trap, but also to recover their confidence and sense of self-worth.

Meanwhile in Essex, we hear how lived experience has gone right to the heart of the commissioning process, with Essex Recovery Foundation directly influencing how services are designed and run (p10). The door was opened from the inside by a head of public health with the courage to take a new approach, and it’s paid dividends. All parties are energised by better outcomes for everyone and a transformative shift in commissioning.

And for further inspiration read about LEROs as nimble, responsive, entrepreneurial frontline providers (p18). Effective partnerships are thriving!

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

Claire Brown Editor of DDN Magazine

Claire Brown, editor

Delphi fundraising duo take on Great Manchester Run for The ARC

Delphi colleagues are taking on the Great Manchester Run this May to raise money for The ARC community hub.

Delphi fundraising duo take on Great Manchester Run for The ARCJessica Weatherby and Stephen Caddy from the DARS team will be running on Sunday 18 May in a bid to raise £1,000. Jess will be running the 10k route, whilst Stephen takes on the half marathon – which is a whopping 13.1 miles.

Talking about what the donations will fund, Jessica said, ‘We’re hoping to put the money towards the community garden, the community kitchen and starting women’s groups as well.’

It’s not just Jess and Stephen taking on the challenge either. Three prisoners from HMP Manchester will be running the half marathon race alongside them from on-site treadmills in the prison gym.

The trio’s aim is to raise awareness of The ARC and to help their own recovery journeys.

Based on Robert Street in Manchester, The ARC offers support with substance misuse with an added community kitchen for the homeless, providing hot drinks and meals as well as clothing for those in need.

The community hub provides a warm welcoming space for people to grow and build a new life for themselves, whether this is the local community or ex-offenders from local prisons. It provides mental health and recovery-based services aiming to become physically, mentally, and emotionally well and a responsible member of society.

If you’d like to donate, head to the team’s Go Fund Me page

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


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

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

This content was created by Delphi Medical

Time to urgently target liver disease, campaigners tell Scottish Government

The Scottish Government needs to urgently prioritise the early detection and treatment of liver disease, says a call to action from more than 70 organisations including royal colleges, alcohol and drug partnerships, charities and recovery groups.

liver diseaseThe government should expand testing to detect liver disease in at-risk people in the community, says the collective – an approach proven to be ‘highly effective and cost-effective’. This would allow people to be identified sooner and given the right care and support, rather than waiting for the disease to become irreversible, it states.

The number of Scots living with chronic liver disease is projected to increase by more than 50 per cent by 2044, according to a recent report from Public Health Scotland (PHS) – equating to an additional 23,100 people. More than 70 per cent of chronic liver disease cases are caused by alcohol, with Scotland’s most recent alcohol-specific death figure the highest in 15 years.

Four years on from declaring alcohol deaths a ‘public health emergency’ the Scottish Government’s commitments to addressing the crisis have been delayed or paused, says the call to action. The number of people in treatment dropped by 40 per cent in the decade to 2021-22, the document states, with services reporting people presenting later and with more complex needs. Audit Scotland has also highlighted the lack of investment and focus on alcohol services, it points out.

Time to urgently target liver disease, campaigners tell Scottish Government
The collective also wants to see nurse-led alcohol care teams established in hospitals

In addition to increased testing, the collective also wants to see nurse-led alcohol care teams established in hospitals to identify people with alcohol problems and provide specialised support, as well as more funding for treatment services through a levy on alcohol retailers, and improved access to detox facilities – including within hospitals.

‘For too long we have seen deaths from alcohol continue to rise,’ said acting chief executive of Alcohol Focus Scotland, Laura Mahon. ‘We need concrete measures to prevent this. Time is running out for this government to demonstrate genuine results, so together with partners, we’ve provided a roadmap for delivery. Now we need to see clear leadership and investment. Earlier detection of liver damage is essential because of its life-saving potential. A number of these initiatives are already happening at a local level and could be scaled up and enable people with serious or potentially life-threatening alcohol problems to be identified sooner and supported more effectively, reducing their risk of experiencing further harm.’

It was also important to look at the bigger picture, she added. ‘People don’t just become unwell overnight. We are continually being fed the message that alcohol has an essential role in our lives, normalising drinking and influencing our consumption habitsWe need to challenge this with well evidenced and cost-effective prevention measures adopted as part of a robust strategy for now and into the future.’

RADAR
Meanwhile, the latest quarterly RADAR ​report from PHS shows a 17 per cent increase in suspected drug deaths in the three months to February 2025 compared to the previous quarter

Meanwhile, the latest quarterly RADAR (Rapid Action Drug Alerts and Response) ​report from PHS shows a 17 per cent increase in suspected drug deaths in the three months to February 2025 compared to the previous quarter – at 251. The suspected drug death figures are based on the reports of police officers attending scenes of death, and are different from the official statistics published by National Records of Scotland. ‘As the availability and composition of substances change, so too does the profile of drugs contributing to harm,’ the report states. ‘There is an urgent need for coordination to improve Scotland’s ability and agility in responding to polysubstance use and a continually evolving drug market.’

Call to action available here

Rapid Action Drug Alerts and Response (RADAR) quarterly ​report April 2025 available here

Message from the frontline

I have been a community-based drug and alcohol worker since the late ’90s. Much has changed – some positive, but mostly very negative – over the last 15 years.

I have been a community-based drug and alcohol worker since the late ’90s. Much has changed – some positive, but mostly very negative – over the last 15 years. Most of my time was spent in the third sector and over the first ten years I was very proud of this. Often at the vanguard of harm reduction, we clearly had a positive impact on society – reducing drug-related deaths, IV-related harms, HIV and BBVs.  

Back then drug teams were staffed by very experienced professionals from a range of backgrounds, contributing to a skill mix that served the client base well. Our roles were varied and we held caseloads of no more than 25-30, which gave us the cognitive and emotional capacity to deliver. A mix of Tier 2 and 3 work felt like a good strategy for worker wellbeing. New innovative projects, approaches and services all seemed to make the field head in a direction that would eventually tip over into real policy change.

I have been a community-based drug and alcohol worker since the late ’90s
With these caseloads how are we supposed to retain everyone’s story in a meaningful, reflective way?

Skip forward to 2025 and we are faced with the ‘corporatisation’ of that third sector – behemoth charities vying for funding in a race to the bottom. The result? Unrealistic bids accepted by poor commissioning processes throughout the country. Many experienced staff have left because of extreme burnout from exceptionally complex caseloads to be replaced by young, inexperienced staff who are lucky to receive a few sessions of e-module-based training. They are told to ‘shadow’ colleagues for learning and then given caseloads of 50 and above. Their colleagues don’t have time to support them as they are also sinking, then burnt out in a year or two. Some return; most don’t.

As drug and alcohol workers we are hearing people’s stories and trying our very best to deliver interventions. But with these caseloads how are we supposed to retain everyone’s story in a meaningful, reflective way? In some areas workers have simply become OST monitors.

Pay continues to be depressed – in 2001 I was on £24k and I know some services are still only paying this. The caseloads and complexity, combined with unachievable contracts and current HR and management practices are leaving people psychologically and emotionally exhausted – quite clear from observing sickness and staff retention rates. Micromanagement is rife, with further stress from chasing KPIs, which can translate as workers being far more focused on evidencing the work than doing the actual work – often on computer systems not fit for purpose.

community-based drug and alcohol worker

Dame Carol Black’s review highlighted some of these issues, but the field has been promised a recognised qualification standard and meaningful workforce plan for aeons. However, while the voices of service users and service CEOs is heard, the workforce is not. I have seen many people come into the field with massive potential to help those living with addiction, only to leave again.

Our policy direction is opposite to where it needs to be. With new emerging threats, harm reduction should be expanded rapidly. Addiction needs to be recognised as the public health issue it is – and while I understand the need for a criminal justice element within the sector, it should not be the dominant focus.

I have many colleagues and friends who share this experience up and down the land. Most of the small local independent charities that developed our approach have disappeared, swallowed up by corporations. There seems to be a lack of drive from CEOs to lobby government and be innovative – or maybe even daring.

The opening of the Glasgow safer injecting facility is the first real innovation for a while. The UK pioneered the harm reduction model and yet we have found ourselves years, if not decades, behind our European and Commonwealth neighbours. There is still a huge amount of fantastic work being done across the nation – however, I fear this is in spite of the above and not because of it. The norm is an overstretched workforce suffering poor mental health and, in some examples, providing a skeleton service. I’ve heard of people in some areas having caseloads of 80 – and you are literally only doing telephone contacts and OST management at this number.

Message from the frontline
The caseloads and complexity, combined with unachievable contracts and current HR and management practices are leaving people psychologically and emotionally exhausted

I’m writing this to shine a light on fundamental issues, for the workforce in particular. The constant drive for increased numbers in treatment without a correlating investment in the workforce is destructive, whereas a healthy workforce working with a trauma-informed approach and a balanced number on their books would have positive outcomes for service users. I have a passion for the field and a huge desire to see change before I get too old and retire.

I am currently fortunate to work in a specialist team within an NHS service. A reduced caseload and good worker support means I can focus on my job and deliver to a good standard. We’re a multidisciplinary team of staff with years of experience, but that’s not to say we don’t have our issues as the pressures are the same everywhere.

I do not want to detract from the good work that is completed every day in the field, but after knowing people who have suffered mental health episodes, divorce and even a return to a former drug dependency, I feel the issues for the workforce should be investigated properly, to hold power to account.

Name and address supplied

Open door policy

We need to make the principles of ‘no wrong door’ and ‘inclusive person-centred care’ a reality for people experiencing thoughts of suicide, says Robin Pollard.

When people reach out for support for suicidal thoughts or feelings, self-harm, suicide attempt(s) and/or bereavement by suicide, they should get the care they need – the first time they ask for it, and wherever that may be. They must also be treated as individuals – listened to and respected, their personal wishes and perspectives priori­tis­ed, and offered the lead in decisions about the care they receive.

WithYou, along with our partners at the Suicide Prevention Consortium (DDN, May 2024, page 16) believe these two principles of ‘no wrong door’ and ‘inclusive person-centred care’ are fundamental for ensuring effective, compassionate care for people experiencing suicidality. However, since forming the consortium in 2021, we’ve consistently heard about a critical and concerning gap between policy and practice.

thoughts of suicide

Though the recent Suicide prevention strategy for England clearly calls for a ‘no wrong door’ approach, many people still encounter rigid eligibility criteria, services working in silos, and stigma. This prevents them from accessing the help they need, and disproportionately affects people with co-occurring needs, such as alcohol use and/or stigmatised diagnoses such as personality disorder. Too often mental health services exclude individuals with alcohol-related issues, while alcohol services are unwilling or feel unable to discuss mental health or suicidality. This siloed approach exacerbates risk factors and denies people holistic, person-centred care.

This month, the Suicide Prevention Consortium brought together learning from our previous projects and published our latest report, offering insights and practical actions to improve the implementation of these principles. The report, co-produced with people with lived experience, identifies four actions (all equally important) where sustained and significant effort is required from policy makers, commissioners and practitioners to make these principles a reality for people experiencing suicidality.

1. FOSTERING COLLABORATION
Collaboration – between services, staff and people receiving support – must be at the heart of service design and delivery. Services need to work in a joined-up way, collaborating with each other and the people they support. This includes improving technology and ensuring data can be shared securely, as well as involving people with lived experience in design, implementation and evaluation of services.

2. PRIORITISING INCLUSION
Services should take an inclusive, holistic approach, recognising individuality and the diverse ways people access support. A person’s identity, background or specific needs must not be a barrier to accessing high-quality care. Individuals should be empowered to make decisions and engage openly with health­care professionals without fear of judgment. Accessible and culturally sensitive approaches are essential for building trust and ensuring meaningful support.

suicide
We can create a system where everyone who takes the brave step to ask for help receives it, and no-one is turned away

3. BUILDING CONFIDENCE
Staff awareness should be raised, and ongoing training provided, to boost confidence in delivering compassionate, patient-centred care. It’s also vital that good practice is recognised and celebrated – many practitioners are already delivering compassionate, inclusive care. The principles of ‘no wrong door’ and person-centred care should not, therefore, be presented as another new initiative.

4. WORKFORCE SUPPORT
It’s essential to prioritise the mental health and wellbeing of staff, so they can effectively support people affected by suicide. Staff need time and space to reflect on their experiences of supporting people experiencing suicidality, as well as support to manage the impact of providing care. These are crucial for creating supportive environments for staff and minimising the potential impact of compassion fatigue or vicarious trauma, which impact both on the wellbeing of staff and on their ability to provide optimal care.

While national guidance promotes these principles, lived experience and practitioner insights have repeatedly highlighted significant gaps in implementation, especially for people with co-occurring needs or those from marginalised communities. With a collective commitment from policymakers, practitioners and the wider community we can create a system where everyone who takes the brave step to ask for help receives it, and no-one is turned away. By acting together, we will save lives.

Report available here

Robin Pollard is head of policy and influencing at WithYou. The Suicide Prevention Consortium is led by Samaritans and includes WithYou, National Suicide Prevention Alliance (NSPA) and Support After Suicide Partnership (SASP)

WithYou on the Kiltwalk

WithYou on the Kiltwalk
Top: At the finish line; Bottom left: WithYou in the Borders team at the start line; Bottom right: Louise (right) and her daughter Orla (left)

This weekend, some of our WithYou team took part in the Kiltwalk, Scotland’s largest mass participation walking event. Staff, their family members and their dogs covered a combined 214 miles across the west of Scotland, and raised more than £4,100 for our charity.

Louise Stewart, director of operations at WithYou in Scotland, walked with her daughter Orla. She said, ‘Even the rain couldn’t dampen the spirits of our incredible WithYou walkers! I am so proud of everyone who donned some tartan and took part in the Kiltwalk to raise funds for our services in Scotland.’

The Hunter Foundation, founded by philanthropist Sir Tom Hunter, underwrites Kiltwalk, ensuring that all money raised by walkers goes to the charities of their choice, plus gift aid.

Sir Tom, who led the walkers on both days, said, ‘I believe the magic of Kiltwalk is quite simple: in every community across Scotland, there are people who need a wee hand up, and there are good folks like you who get up in the morning and help them. All the Kiltwalk does is simply connect you. There isn’t a prouder Scotsman on the planet than me this morning.’

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


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

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

This content was created by WithYou

Soul food

As Alcohol Change UK publishes its Feeding Recovery Handbook, Andrew Misell describes how something as simple as a meal can give people a sense of connection and purpose.

As Alcohol Change UK publishes its Feeding Recovery Handbook, Andrew Misell describes how something as simple as a meal can give people a sense of connection and purpose.Since the earliest times, the making and sharing of food has been one of the main ways humans have connected with each other. As well as sustaining our bodies, food brings us together. Most of us have a favourite food. And when someone offers to make us a meal, we take it as a sign that they wish to welcome us. In short, food matters.

But we know that when alcohol dominates someone’s life, food can be relegated to a very minor role. People who are alcohol-dependent are often underfed, underweight, malnourished, and socially isolated. We wanted to under­stand more about this, and what we could do about it. That’s why we started the Feeding Recovery Project.

We began in 2019, commission­ing researchers from Swansea University to interview people who were accessing support for alcohol issues about their relationship with food. Interviewees gave a range of reasons for eating less (or not eating at all) during periods of heavy drinking. Some said they lacked any real desire for food, often because drinking left them feeling too full, ill, or lethargic to eat. Others said that the chaos of their drinking life had left them without any kind of eating routine. And some could see clearly that their lack of enthusiasm for food was linked to a general lack of self-esteem – a sense that they didn’t deserve to be fed and looked after.

Soul food Alcohol ChangeBut as well as talking about the reduced role of food in their lives, many expressed a real longing to eat more and better food, and to enjoy the social aspects of eating. As one person put it, ‘Giving somebody a meal is more than just feeding them – it’s a way of connecting with somebody’.

We wanted to work out how best to bring these latent desires for connection through food to life. And in April last year we received a small Welsh Government grant that enabled us to do just that. During a six-month project from July to December 2024, we spent time with people who were attending cooking and food-sharing sessions at two centres in South Wales – Barod and the Nelson Trust – to learn from their experiences.

What we heard from them was both unsurprising and profound. People told us that they want connection – they enjoyed eating, but the thing they enjoyed most was eating with others, talking with others, and making friends. They appreciated having opportunities to make positive choices about what they wanted to eat, and found that to be a stepping stone to retaking control of other aspects of their lives.

Feeding Recovery Handbook

Just like anyone else would, they told us that they wanted to eat in a dignified environment – one that felt like a restaurant or a home, not a soup kitchen. Above all, people told us that food was filling more than one gap in their lives. As well as filling their stomachs, cooking and eating sessions fill gaps in their day when they might otherwise be bored, unoccupied or using alcohol to pass the time.

It’s clear from the Feeding Recovery Project that hosting sessions where people experiencing serious alcohol harm can make and share food offers real opportunities for positive engagement and harm reduction. In the Feeding Recovery Handbook, we’ve set out how such sessions can be successfully run. Our hope now is that agencies across the UK will pick up the Feeding Recovery Handbook and start implementing their own projects to help more people to make and enjoy food as part of their recovery.

Handbook available here

Andrew Misell is Alcohol Change UK director for Wales

Almost half of people with ketamine use disorder not in treatment

Almost half of people with ketamine use disorder not in treatment
The study is the largest of its kind to ‘explore the experience of people currently living with ketamine addiction in-depth’

Nearly half of people who are affected by ketamine use disorder are not seeking any support or treatment, according to a new study led by the University of Exeter and University College London (UCL).

The study, which is supported by NIHR and published in the journal Addiction, is the largest of its kind to ‘explore the experience of people currently living with ketamine addiction in-depth’, says the University of Exeter. Researchers studied more than 270 people through both interviews and questionnaires, with many respondents saying they were unaware of the risks of dependency until their use was already out of control – one referred to the drug as ‘the heroin of a generation’. Many also said they felt ‘too embarrassed’ to seek treatment.

Ketamine use in the UK has reached ‘record levels’, with 269,000 adults reporting using it in the year to March 2024. The drug was controlled as a class C substance in 2006 and then reclassified as class B in 2014, on the recommendation of the ACMD. However the Home Office is currently seeking the ACMD’s advice on whether to reclassify it as class A.

ketamine use disorder
Almost 60 per cent of participants in the study felt there was ‘definitely not’ enough awareness of the risks associated with ketamine use

Sixty per cent of the people studied in the new report had experienced bladder or nasal problems, with 56 per cent reporting organ cramping – ‘K cramps’ – which can often mean people then using more of the drug for pain relief. Almost 60 per cent of participants in the study felt there was ‘definitely not’ enough awareness of the risks associated with ketamine use, which can include the need for a urostomy bag or even full bladder removal. Participants also reported a lack of understanding among many health professionals – ‘all they did was give me painkillers and send me on my way’, said one.

Participants in the study reported that their the primary initial motivations for using ketamine were dissociation (73 per cent), self-medication (53 per cent) and the drug’s psychedelic effects (56 per cent). At the time of the survey, the primary reasons for continuing to use it were dissociation (57 per cent), self-medication (50 per cent) and relaxation (40 per cent). Trials are currently underway to investigate the drug’s suitability for clinical use in treating people with alcohol problems.

‘We know that ketamine use is on the rise, with a number of high-profile tragedies linked to ketamine addiction,’ said Professor Celia Morgan of the University of Exeter. ‘Meanwhile, a growing number of clinical trials are finding therapeutic benefits involving ketamine in carefully-controlled environments, combined with therapy. Our research is the first to analyse in-depth the experience of people using very large amounts of ketamine, and shows the devastating physical health problems people can face with dependent ketamine use. Our study also highlights the barriers that people with ketamine addiction face when they try to seek treatment, often being sent away from treatment services.’

women in treatment
Meanwhile a new report looks at the experiences of women in substance use treatment, and explores what a more suitable system would look like

Meanwhile a new report from the Centre for Justice Innovation looks at the experiences of women in substance use treatment, and explores what a more suitable system would look like. Effective treatment needs to be compassionate and respectful, person-led and non-coercive, and respect women’s dignity and agency, said participants – as well as address the root causes of substance use problems and help to build strength and resilience. The document calls on the government to prioritise women with unmet needs, improve data collection, and expand the use of ring-fenced treatment funding to ‘encompass the full range of women’s treatment needs’.

‘The needs of women who use substances problematically are wide-ranging, interconnected and often rooted in trauma,’ the report states. ‘This means that conventional standalone treatment services can be ineffective at helping women achieve their desired recovery. We need to move away from fragmented systems with siloed funding processes and disjointed services towards whole system approaches that recognise women with multiple unmet needs as a distinct population with intersecting needs.’

The landscape of ketamine use disorder: Patient experiences and perspectives on current treatment options available here

‘To be listened to… and actually heard’: Women’s perspectives on effective substance use treatment and support available here

Changing lives through improved digital access

Changing lives through improved digital accessAt Via, we’re helping to bridge the digital divide by distributing 50 refurbished laptops to people who use our services, thanks to the Good Things Foundation’s National Device Bank. 

Every year, 1.5 million tonnes of tech go to landfill, while many people across the UK lack access to digital devices.

The National Device Bank, run by the Good Things Foundation, provides vital digital access by refurbishing and redistributing donated devices to those in need. The initiative supports people experiencing financial hardship, helping them stay connected, access essential services, and improve their employability prospects.

As part of the National Digital Inclusion Network, Via has previously distributed smartphones, tablets, and SIM cards to those facing digital exclusion in our services.

The newly secured 50 refurbished laptops will be distributed over the next three months, with 20 specifically allocated to IPS (Individual Placement and Support) clients to support them in finding employment and developing their digital skills. To ensure fair access, there is an online application form, which people can complete with the support of their Via keyworker.

The difference a device can make
The impact of previous digital support initiatives has been life-changing for many people who use Via services.

One individual, previously rough sleeping, was given a refurbished smartphone as part of her Staying Safe Plan. This enabled her to keep in contact with keyworkers and access vital support services, helping her rebuild her life. She described it as ‘organising my days and looking forward to a new life’.

Asha shared how access to digital resources transformed her life: ‘I feel so much better since receiving the Data from Good Things Foundation. It enabled me to do so many things like completing courses at Via. It has also helped me manage appointments for me and my kids. I am more confident now, compared to how I felt before.’

At Via, we’re helping to bridge the digital divide by distributing 50 refurbished laptops to people who use our services, thanks to the Good Things Foundation’s National Device Bank.
‘This initiative is about more than just handing out devices. It’s about giving people a real chance – these laptops represent opportunity and hope’

Mohammed, a past recipient of a refurbished tablet, also spoke about the positive impact it has had on his family: ‘Me, my wife, and my son all use it for different things. I’ll be using it to do my online training as a peer mentor at Via.’

Pam Xenitellis, qualifications coordinator at Via, said, ‘I am absolutely delighted that our application to the National Device Bank has been successful, and we have been granted 50 refurbished laptops to gift to service users in need. This incredible opportunity will make a significant difference in the lives of those we support, empowering them in countless ways by opening up new opportunities and breaking down barriers. It’s a wonderful step forward in our commitment to ensuring digital inclusion for the people who use our services.’

Harj Bansil, IPS service manager at Via, said, ‘For many of the people we support through the IPS programme, the journey into employment is already filled with challenges – lack of confidence, limited resources, and barriers that most of us take for granted. Not having access to something as basic as a laptop can make that journey feel that much more difficult. This initiative is about more than just handing out devices. It’s about giving people a real chance – these laptops represent opportunity and hope. They offer our clients the digital tools they need to move forward, not just in their employment journey, but in their lives as a whole. At Via, we believe everyone deserves the tools to thrive, and this partnership allows us to turn that belief into real, life-changing impact. We’re grateful to the Good Things Foundation and proud to be part of something that brings hope and a brighter future to those who need it most.’

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


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

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

This content was created by Via

Journey Recovery and Wellness Centre, Ballito, South Africa

Your Journey begins here…

Ballito, Durban Journey Recovery and Wellness Centre

Nestled in the heart of Ballito, Journey Recovery and Wellness Centre is one of the leading rehab centres in Durban, providing a comprehensive and upscale approach to rehabilitation and health. Our modern centre exudes a cosy, hotel-like atmosphere that facilitates compassionate care. With our innovative treatment model, we address more than just addiction. We offer comprehensive services for trauma, anxiety, depression, and other psychiatric conditions.

We support our clients’ wellness by accommodating those with work or other commitments. With our tailored care, we address each client’s unique goals and needs. Our balanced treatments encourage healthier habits that foster a more rewarding, sober life.

‘Amazing facilities, super comfortable, excellent food, house staff friendly and helpful, counsellors are caring and professional, owners are hands-on and caring.’

 

Discovering our rehab in Durban

Journey rehab DurbanAs one of the top rehab centres in Durban we provide a peaceful space that fosters healing. We use treatments for addiction and mental health conditions based on professional guidance. This way, individuals battling these concerns can regain control of their lives.

With evidence-based therapies and holistic methods, each client’s care is extensive. Our specialised rehab programmes combine medical expertise, psychological support, and wellness practices.

 

What to expect

Journey Recovery and Wellness CentreOur rehab facility in Durban provides hotel-like comfort and amenities and serene surroundings. This facilitates a compassionate approach to treatment, allowing shame-free growth for each client.

For relaxation, clients can access Wi-Fi, Netflix, live sports, and DSTV Premium. Activities like fishing, beach walks, and poolside and equestrian exercises can rejuvenate clients.

 

‘The staff are non-judgemental and are nothing but supportive and compassionate – they welcome you with open arms and you feel like you’re a part of a family. The facility itself is a homely and comfortable environment. There is no better place to grow and recover.’

 

Our services – tailor made to suit your needs

Journey services

Substance abuse can influence all areas of your life. This ranges from physical and mental well-being to relationships and general quality of life. That’s why our rehab services are integrated to help target and heal all areas affected by the addiction.

To make treatment more accessible, we offer various levels of care, such as:

 

Journey Ballito DurbanEvaluation
We’re committed to building trust with our clients. To do this, we respect the complexity and individual circumstances each addiction involves. Part of this includes addressing the underlying causes of addiction.

At Journey, we believe that pain and trauma are pivotal factors in addiction. Therefore, assessing treatment options depends on the unique needs of each client. For clients with essential commitments, we allow monitored phone or laptop access.

Interventions
We understand how distressing it can be to watch a loved one resist help. At Journey, we collaborate with seasoned social workers who specialise in addiction. This way, your loved one will receive unwavering support to help them accept recovery.

Through interventions, families can address their loved ones’ addictions in a caring manner. Our multidisciplinary team’s expertise is available to make this process more manageable.

Detox
A medically supervised detox is available for all incoming clients. With our state-of-the-art facilities, clients can comfortably undergo the detoxification process. Our caring staff manages individualised adjustments to ensure clients are safe.

Inpatient treatment
Our inpatient treatment provides 24/7 supervision without the distractions of everyday life. As one of the top rehab centres in Durban, we offer private and semi-private rooms with ensuites and two clients per room. Clients can enjoy our spacious lounge and dining room with a seaside view.

Part of inpatient treatment includes group, individual, and family therapy. Proven techniques like cognitive-behavioural therapy (CBT) can also be implemented. This allows clients to tackle the causes of their addictions. Through healing and trauma counselling, clients can rebuild relationships and develop coping mechanisms.

Outpatient programme
Our outpatient programme will offer flexibility for clients to fulfil other obligations. Clients will receive intensive treatment while still living at home. With evening sessions, treatment will naturally slot into daily routines.

The programme will include various counselling modalities. To help with maintaining sobriety, we’ll incorporate aftercare support. This can range from relapse prevention techniques to continued education. After more intensive treatments, this programme provides tools for a lasting recovery.

Ballito, Durban Journey Recovery and Wellness CentreDual diagnosis treatments
Mental health and substance abuse are often connected. We ensure a non-judgemental space to unpack the root of each psychiatric concern. Conditions include bipolar, anxiety, depression, burnout, eating disorders, and addictive behaviours.

We integrate wellness methods and personal healing with scientifically backed techniques. This includes processes like:
• Inner-child work
• Self-esteem workshops
• Yoga
• Mindfulness
• Solution-focused therapy.

‘I highly recommend Journey Recovery and Wellness Centre. The counsellors are incredible as well as the owners, Yonit and Clive, who are also extremely hands-on with the patients. The counselling team is beyond knowledgeable about addiction.’

 

We can offer you or your loved one the support and guidance needed to get back on track. Our programme is more than just dealing with addiction – it’s about giving you the tools to build a healthier, happier life.

 

Journey Wellness Centre contactContact us
We are open 24/7 for you and your family.
Call: +27 82 447 6727
Email: admin@journeycentre.co.za

 

Journey Recovery and Wellness Centre, Durban

Johannesburg Journey Recovery and Wellness Centre…

Journey Recovery and Wellness Centre, one of the leading Rehabilitation Centres in Johannesburg, South Africa

Journey Recovery and Wellness Centre, one of the leading rehabilitation centres in Johannesburg, South Africa, offers a distinctive, upscale approach to rehabilitation and wellness. Our innovative treatment model extends beyond addiction recovery, embracing a comprehensive range of services for trauma, anxiety, depression, and other psychiatric conditions.

We are committed to supporting our clients through their unique paths to wellness, accommodating those with work, study, or other commitments. As one of the premier rehabilitation centres in Johannesburg, we foster a balanced life, empowering our clients to cultivate healthy relationships and embrace a fulfilling, sober lifestyle tailored to their individual goals and circumstances.

Our services

To make treatment more accessible, we offer various levels of care, such as:Journey Recovery and Wellness Centre, Johannesburg, South Africa

• Evaluations
• Interventions
• Drug and alcohol detox
• Inpatient treatment
• Halfway house
• Outpatient programme

‘Eternally grateful to Journey for helping change and transform my life. I was able to battle and overcome my darkest episode mentally thanks to every member of Journey’s team. I now live a much more stable and enjoyable life.’

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK and around the world, we have created ‘spotlights’ that provide information about the services they offer to help you make an informed decision for yourself, your client, or your loved one.

Rooting for recovery

Can psychedelic plants help to heal us, asks Andria Efthimiou-Mordaunt.

In its bare bones, 12-step addiction recovery is a group of people sharing their trials and tribulations in an effort not to get into trouble with drugs anymore. Psychedelics in Recovery (PIR) is a seven-year-old offshoot, as ever birthed in the USA.

The three founding members of PIR used ibogaine – a shrub root-extract long used by the Bwiti Tribe of the Gabon – as it has been found to heal opiate addiction, with the added bonus of not having to go through horrendous withdrawals. Apart from the use of psychedelic medicine, PIR is also different because you don’t need to have a problem with addiction to access its group support. You could be the ‘adult child of an alcoholic’, for example.

Most people coming off opioid drugs using ibogaine will require ‘integration therapy’ – as in talk therapy to look at what sometimes-profound revelations or even inner visions were seen during the psychedelic ‘journey’.

People love ibogaine because it can be a big help with kicking heroin, but like MDMA and horse riding it has killed a tiny number of people. So, not entirely risk-free – though my own experience was very positive decades ago, and I have a borderline mental health illness which could have made me more vulnerable to adverse reactions. There are many stories of people who came off of opiates with ibogaine, but it remains banned in most countries unless it is used in research.

Can psychedelic plants help to heal us
Ibogaine is a naturally occurring compound, found in the root of the Tabernanthe iboga plant, also known as the iboga bush, a shrub native to Gabon, Equatorial Guinea, and Republic of the Congo. Ibogaine can stress the kidneys and liver, but the small number of deaths associated with taking the drug have been attributed to its effect on the heart

When one of us takes ibogaine for addiction relief we first must have our hearts monitored throughout the process, and our livers also need to be examined to ensure they are not too damaged by hepatic disease. Ibogaine is not for anyone. It’s a powerful entheogen, and even one of the Shulgins tried to put me off it 25 years ago!

I experimented with the microdosing of psilocybin in 2024 for about two months, to address trauma and depression. Initially I really felt hopeful, even to the point that maybe I could heal my physical pain that way. But these were temporary fixes – albeit ones I still feel very grateful for. Theoretically, one is supposed to access talk therapy in parallel – but psychedelic psychotherapy is still largely an unregulated market with psychotherapists often charging way too much.

In short, psychedelic therapy might have worked for me in several ways if I could have afforded it, and I know I’m not alone there. Microdosing ibogaine freed me of years of SSRI use, followed by the psilocybin helping me let go of the opioids. But while it was a welcome break from both, the physical pain became too much to cope with again. I had to go back to the NHS to re-introduce my painkillers, but I did halve the dose.

PIR is a community-based, fast-developing not-for-profit support group. Within PIR, there are also two groups, which are for LGBTQ and BIPOC family. I go to both as a Cypriot bisexual.

Psychedelic therapy is seen as an ‘outside issue’ in traditional 12-step, but they both use the 12-step programme, so they have more in common than not. ‘Higher powers’ are regularly invoked by 12-step groups for support and guidance, but in PIR religious terminology has been taken out of the literature, though some members have a deep interest in spiritual paths.

Many psychedelic meds are illegal, often expensive and the debate about their efficacy is still seen as inconclusive. These medicines should be made legal and thereby regulated ASAP as they are helping people get over chemical dependencies, OCD and depression. The USA looked into legally regulating MDMA for treating PTSD, but said more research was necessary.

The John Mordaunt Trust invited a leading psychedelic researcher from Imperial College, London, to one of its board meetings. He shocked us explaining how expensive a treatment dose of MDMA from big pharma is. I’m not an expert in all this, but over 25 years I have witnessed improvements in the lives of 15 friends, and of course, Australia has effectively legalised MDMA for non-psychotic mental health treatment.

We are in a scary historical era, and I’ve tried to investigate the use of these plants for my mental health, with some success. One US doctor told me that they can now reconnect neurones broken by mental health trauma with these incredible entheogenic plants, which gave me great hope.

Andria Efthimiou-Mordaunt MSc is an activist. Usersvoice.org

Campaigners urge Irish government to make sure mandatory alcohol health labelling goes ahead

Campaigners urge Irish government to make sure mandatory alcohol health labelling goes aheadAn open letter signed by more than 75 health organisations and others is urging the Irish government to guarantee that the introduction of alcohol health labelling goes ahead next year. The signatories want to make sure that the planned introduction is not ‘derailed or delayed by alcohol industry lobbying’, says the Alcohol Action Ireland (AAI) charity.

Ireland became the first country to commit to mandatory health labelling for alcohol products in 2023, in a move lauded by WHO and other health bodies. While the labelling guidelines are set to be introduced next May after a three-year lead-in period, AAI says the industry has been conducting ‘an ongoing campaign disparaging the need for labelling’.

The introduction of health labelling will ensure that consumers ‘are given the facts’ about health risks, AAI says, including the links with cancer and liver disease and the risks of drinking while pregnant. ‘It is essential that the public is provided with facts about alcohol as opposed to the spin from an immensely profitable, global industry which leaves the individuals, families and the state to pick up the tab for the damage its products cause,’ the letter states. ‘The alcohol industry should have no influence on public health policy.’

alcohol health labelling
The introduction of health labelling will ensure that consumers ‘are given the facts’ about health risks

The open letter shows the extent of the ‘deep disquiet in the health and social community to the mooted re-examination of alcohol health information labelling,’ said AAI CEO Dr Sheila Gilheany. ‘The legislation for these labels was passed in 2018 after extensive debate and with support from right across the political spectrum, matched by ongoing strong public support of over 70 per cent for the measure. Critically the debate was informed by the research base which was clearly articulated by multiple health experts and advocates, many with deep experience of the harms from alcohol. Since then, the evidence has only grown stronger. Ireland should take pride in its leadership in this regard.’

Meanwhile, a new report from the IPPR think tank says there is widespread public support for government intervention to improve health, with more than 60 per cent of 2,010 people surveyed backing the extension of smoking bans to more public spaces. ‘These findings dismantle the long-held assumption that bold health policy is politically risky,’ said head of health at IPPR, Sebastian Rees. ‘In reality, voters across the political spectrum see improving public health as a top priority and want the government to do more to allow them to live healthier lives.’

Open letter available here

The health mandate: the voters’ verdict on government intervention available here

Power to the people?

We need a long overdue exploration of power dynamics in community drug and alcohol treatment services, say Deanne Burch and Dr Georges Petitjean

In early 2020 the global pandemic had a significant effect on the wider NHS but also community drug and alcohol treatment services, forcing services to rapidly change how they delivered care as well as prescribing practice (see table below). In community drug and alcohol treatment services the need to protect the public and staff by minimising contact during lockdowns meant the unprecedented rapid risk review of every person on opioid substitution treatment (OST), as well as reducing pharmacy collection frequency or supervision for the majority.

We need a long overdue exploration of power dynamics in community drug and alcohol treatment services, say Deanne Burch and Dr Georges Petitjean.The outcome of this rapid change in prescribing practice, and the inability for prescribers to have OST supervision as a safety net, was increased anxiety – namely the very real concern that many people might overdose and the expectation of a large number of opioid-related deaths.

PRESCRIBING PRACTICE
Prescribers rely on the Drug misuse and dependence: UK guidelines on clinical management (‘orange guidelines’) for reassurance that their prescribing practice follows a consensus of safety and an evidence base. A part of this guidance relates to OST collection frequency and supervision by a pharmacist, which during the earlier period of the COVID-19 pandemic was required to be adapted by prescribers across the country.

Following the pandemic, Inclusion (part of Midlands Partnership University NHS Foundation Trust) conducted an evaluation study – Giving up the guidelines: a qualitative evaluation of disrupted prescribing of opioid substitution therapy in a rural UK county during and following the COVID-19 pandemic – to explore the period of time from the first national lockdown to post-pandemic. The study had one question in mind – what was it like being a prescriber in community drug and alcohol services during the pandemic?

Among the findings of this study was that prescribers were initially fearful of the impact of the prescribing changes but some later perceived benefits. All had concerns about the potential for increased overdoses or deaths, and many had fears around the legality of their own prescribing practice. While national data from methadone related deaths is available and continues to be analysed, the service studied did not see a significant increase in deaths itself during this time.

However, supervised consump­tion may mean there is less illicit methadone available to people not engaged with services, and therefore can have a protective effect on the wider community. Prescribers also had mixed views regarding how greater flexibility in OST collection had given people better ownership of their medication, with some noticing a reduction in the use of heroin. Prescribers in the study also noticed a shift in power dynamics, and some reported later feeling a greater sense of flexibility with the orange guidelines.

We need a long overdue exploration of power dynamics in community drug and alcohol treatment servicesPOWER DYNAMICS
The issue of power dynamics observed within the study is particularly thought provoking.  Some prescribers observed a change in people feeling more empowered to self-manage their OST where they may not have done so previously. This – alongside seeing how hard staff within the services worked to deliver OST to home addresses as well as conducting welfare calls – was perceived by prescribers to have enabled people to feel a greater sense of care from professionals.

When the relaxation of the new prescribing practices came into effect, prescribers in the study experienced challenges when encouraging people to come back into the service for appointments. They also encountered some resistance when increasing the frequency of collection of OST or returning to daily supervised consumption.

Following the pandemic, some changes made to practice during the lockdowns – such as telemedicine – have been kept in some form. The services have also altered the way assessments and reviews are delivered, having learnt there are other methods to deliver care in some circumstances. However, many prescribers described the need to complete some medical assessments face-to-face to effectively assess physical health needs.

power dynamicsPOSITIVE CHANGE
There were positive examples of changes to practice resulting in benefits, such as the use of online psychosocial therapy groups. One prescriber noted this was more accessible for people with anxiety, and some saw increased interest in accessing groups this way during the pandemic. In our organisation post-pandemic we have now seen a slight decrease in the number of people placed on daily supervised OST. With the participants in the study raising issues around empowerment and conflict, however, we are left with a question around how power dynamics might play a role in community drug and alcohol treatment services.

As practitioners, prescribers or service providers we may need to explore the concept of power dynamics in further detail, perhaps with supervised consumption as a starting point.  Supervised consumption was implemented for a reason, and it continues to have a significant role in reducing deaths – both in terms of its intended recipients and in reducing the risk of diversion. There is a very real complexity in balancing the risks between opioid overdose, diversion of methadone and methadone-related overdoses while involving people accessing drug treatment services in the decision-making process around their treatment.

However, the pandemic and changes to practice may suggest we need to better understand how we achieve the equilibrium between managing risks and being unnecessarily restrictive. Further exploration of how we personally interpret policies and guidance alongside our own personal preferences and biases, may be needed. Additionally, we may need to give thought to how the concept of power dynamics is reflected upon, both in practice and during training.

TOUGH QUESTIONS
If we are working in drug and alcohol treatment services we automatically have a position of power which we must be aware of, and we need to be conscious of how this may affect the people we serve. We might also need to ask ourselves the tough question of whether power dynamics plays a role in people not accessing community drug and alcohol treatment services, and, vitally, how we better balance the management of risks with enabling the empowerment crucial in a person’s recovery – however they define recovery for themselves.

If we need to review how power dynamics play out in other parts of the care we deliver, perhaps we also need to consider the complex landscape of stigma, and how it affects people in other parts of the healthcare system.

Do we have it in us to take a new look at how we operate in the context of power dynamics?

Community drug and alcohol treatment servicesDeanne Burch is programme lead for Hep C U Later and Dr Georges Petitjean is clinical director and medical lead at Inclusion, part of Midlands Partnership University NHS Foundation Trust

Adferiad’s Cheryl Williams appears on ITV’s Lorraine to discuss the impacts of ketamine use

Cheryl Williams, strategic lead of gambling and other harms at Adferiad’s Parkland Place Rehabilitation Unit in North Wales, recently appeared on ITV’s Lorraine. Chatting with Lorraine Kelly alongside James Lee Williams/The Vivienne’s sister Chanel Williams, Cheryl offered her expertise on the far-reaching impacts of ketamine, with use currently at an all-time high in the UK.

Adferiad LorraineOn the accessibility of ketamine, Cheryl said, ‘What we’re finding from some of our units is that it’s actually more accessible than alcohol. If you go into a shop to buy alcohol it’s Challenge 25, but [ketamine] obviously through Snapchat, through the platform X, through WhatsApp, they just need to put an emoji out.’

Following the announcement of her family’s courageous decision to work with us on our upcoming National Lottery-funded Anti-Stigma Campaign, Only Human, Chanel highlighted the need for better awareness and understanding surrounding ketamine and other substances to foster a culture where those struggling with addiction feel more comfortable to speak out and seek help.

Talking about the impact that the tragic loss of her brother has had on their family, Chanel said, ‘It’s completely devastated us all, it was so unexpected. He loved life, so now reflecting on everything, you just think “what can you take from this now, and what can we do”. So as a family, we’re really passionate about turning this into something where we can make a difference, where we can make change and raise awareness around the drug ketamine, the dangers that are associated with that, and that’s part of his legacy if we can help just one more person.’

Through the Only Human campaign, we hope to honour James’ memory by sharing his story to raise awareness of the far-reaching impact of substance use, and break down the barriers caused by stigma that stop people from reaching out for help with their drug and alcohol struggles.

Watch the full Lorraine interview here

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


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

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

This content was created by Adferiad

One in four women in prison being held on remand

One in four women in prison being held on remandMore than a quarter of all women in prison are being held there on remand, according to a new briefing from the Prison Reform Trust. This includes women who are ‘severely mentally unwell’ and should be receiving treatment in the community, says Resetting the approach to women’s imprisonment.  

The majority will have committed low-level, non-violent offences and almost nine in ten are assessed as posing a low to medium risk to the public, the trust states – in 2023, just 32 per cent of more than 3,600 women remanded by magistrates were eventually sentenced to a prison term. Some women who are considered to be in a ‘mental health crisis’ are remanded for their own protection or as a ‘place of safety’, it adds.

Women ‘tend to commit less serious offences than men,’ says the briefing, with theft from shops the most frequent offence – a crime frequently linked to drug use. Nearly two thirds of sentences given to women in 2023 were of less than six months, it adds, and 40 per cent of these were for theft from shops, ‘despite widespread recognition that short prison sentences are harmful and ineffective’. As well as being on short sentences, the majority of women in prison are likely to have ‘multiple, complex and often unmet needs’ and be primary carers of children, it says.

women in prison
Recent analysis found that women entering prison were more likely than men to report issues with drugs or alcohol

Recent analysis by HM Inspectorate of Prisons (HMI Prisons) found that women entering prison were more likely than men to report issues with drugs or alcohol, and more likely to report feeling depressed, suicidal or having other mental health issues. A separate HMI Prisons report from earlier this year found that the rate of self-harm in women’s prisons had ‘rocketed’ in recent years and was now more than eight times higher than in male prisons. The study also found ‘astonishing gaps in basic decency’ and an over-reliance on physical force to manage women who were in ‘acute and obvious crisis’.

‘With the establishment of a women’s justice board and the introduction of a mental health bill, the government has made some welcome progress in improving the treatment of women in the justice system,’ said Prison Reform Trust chief executive Pia Sinha. ‘However, the figures highlighted in this briefing show there is still much to do. We know what works to tackle women’s offending. What is needed now is sustained long-term investment and the political will to implement it.’

Report available here

North Wales nurse who lost her brother runs London Marathon this weekend for drug and alcohol charity

Alex Jones, 34, is set to take on the ultimate challenge of running the London Marathon to raise money and awareness for WithYou, a national charity supporting more than 100,000 people with problems with drugs, alcohol or their mental health across England and Scotland.

North Wales nurse who lost her brother runs London Marathon this weekend for drug and alcohol charity
Alex Jones with daughter (left) and mother (right)

Following the loss of her brother four years ago, who struggled with a problem with drugs, Alex is determined to raise money to help others in his situation.

Alex said, ‘My brother faced a difficult battle with drug addiction beginning in his teenage years, stemming from his personal traumas. Despite his efforts and eventually entering therapy, the toll on his body, combined with an undiagnosed heart condition, tragically led to his passing four years ago.

‘In my role, I witness the struggles of individuals dealing with addiction, alcohol dependency, and mental health issues. This is why I am committed to running a marathon for WithYou, which is dedicated to helping those facing these challenges.

‘This endeavor not only inspires me to become the best version of myself but also allows me to raise crucial funds for a cause that truly matters. I am proud to take on this challenge and contribute to making a difference.’

Stephen McCulloch, executive director for marketing, communications and fundraising at WithYou, said, ‘We’re very grateful to Alex for taking on this momentous challenge. I ran the London Marathon for WithYou two years ago, and I know just how demanding it is. Doing it for a cause close to your heart shows so much generosity and strength.

‘Every pound donated will go towards helping people struggling with drugs, alcohol and mental health problems. Just £16 can pay for a support session with a trained advisor via our webchat service – enabling people to get anonymous support from wherever they are. With your generosity we can continue to offer hope to those who feel there is none. When it comes to creating change, every step counts.’

If you want to support Alex, you can visit her fundraising page here


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

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

This content was created by WithYou

Unintended consequences

Refusal to prescribe benzodiazepines to dependent users is pushing people towards a dangerous unregulated market

Each month the National Drug Treatment Monitoring System (NDTMS), facilitated by Release, collects anecdotal reports from drug users and workers around the country and combines this with data from drug-checking service WEDINOS to try to gain some insights into what is happening in the UK drugs market. The network’s findings consistently show that people who use benzodiazepines continue to face many risks from the illicit benzo supply.

For the period December 2024 to February 2025, roughly one third of all drugs sold as benzodiazepines were missold, either containing a different benzo, or a drug from an entirely different family altogether. February 2025 also saw the first reports of pills containing ethylbromazolam, a new benzodiazepine not previously detected in the UK market. ‘Research chemical’ benzos such as this are becoming increasingly common across Europe, as manufacturers try to evade existing legislation in countries which have not yet imposed blanket bans on psychoactive substances.

Of all the drug samples they received containing a nitazene in 2024, just over half were sold as benzodiazepinesWe are also continuing to see drugs sold as benzodiazepines that instead contain nitazenes, a category of synthetic opioid. Analysis of WEDINOS data by the Benzo Research Project found that of all the drug samples they received containing a nitazene in 2024, just over half were sold as benzos. These pills pose a particular risk, as many benzo users are opioid-naïve and so are at a much higher risk of overdose. What’s more, they may not be aware of how to respond to an opioid overdose, and are less likely to carry naloxone.

Given this context, it’s vital that our services are able to provide a safe supply of benzodiazepines for people who are dependent on these drugs. Maintaining a dependence without experiencing dangerous withdrawals, avoiding increased tolerance, or reducing at a safe and manageable rate become almost impossible if you can’t guarantee the pills you’ve bought contain the correct drug – let alone the correct dosage.

In spite of these dangers, we’re still finding that many drug services are unable or unwilling to prescribe benzodiazepines for dependent users. Recently we were in touch with Dan, a client who, after having been in treatment for some time, sought additional support for his use of illicit diazepam. Despite the dangers of benzo withdrawal, he was told by his prescriber that the service does not prescribe benzos under any circumstances.

Furthermore, this decision came not from the lead clinicians at the service, but from the local authority commissioner. This is contrary to chapter 4, section 10 of the UK guidelines on clinical management of drug misuse and dependence, which supports clinicians to prescribe substitution medication for the managed reduction of benzodiazepine dependent people.

The decision not to prescribe benzodiazepines to dependent users is putting lives at risk. We do not expect opiate users to manage their own dependencies without medical support, while dependent drinkers have access to a safe and regulated supply of alcohol and are closely observed and supported while they undergo medical detoxes. So why are we expecting benzo users to manage their own dependencies with an unregulated and unsafe drug supply?

benzodiazepines
People who develop a dependence on benzos shouldn’t have to win the postcode lottery in order to access effective treatment

It’s also important to examine the role of commissioners in decisions like this. Clinicians are understandably frustrated that the treatment options available to them are being limited. Yet it’s not clear which levers can be pulled to challenge these decisions, or to hold commissioners accountable.

Many of the risks associated with illicit benzodiazepine use are a direct result of prohibition. An unregulated market can push people towards poorly understood research chemicals that are less likely to see them criminalised. Manufacturers of illicit drugs are also more likely to produce stronger tablets at a higher price than lower-strength tablets that they’d have to sell more of.

For treatment services, however, there’s still much more that can be done to mitigate some of the risks. People who develop a dependence on benzos shouldn’t have to win the postcode lottery in order to access effective treatment, yet still the offers from our services vary wildly from town to town. Finally, we need to reintroduce mechanisms that can hold commissioners accountable when unpopular decisions are made. Without these positive changes, the lives of benzodiazepine dependent people will continue to be put at unnecessary risk.

Fraser Parry is drugs advocacy and support advisor at Release

Lucie Jones – I am a…

Lucie Jones – I am a...

WHAT MADE YOU WANT TO WORK IN THIS FIELD?
When I qualified as a nurse 32 years ago, all I wanted to do was work in this type of field, specifically in homelessness. I’ve always had a passion for the marginalised in society, so I qualified as a nurse and then went directly into working in a hostel for the homeless.

Throughout my career, I’ve worked in a variety of different areas. I’ve managed rough sleepers’ projects, sex worker projects and worked in prisons, secure units and with prolific offenders. I’ve run a project for young people at risk of sexual exploitation and then worked in community and drug and alcohol services.

My work is so varied; you come across so many different people with multiple and complex needs. That’s been my passion.

WHAT DOES A TYPICAL DAY LOOK LIKE?
We come across lots of different people with different life experiences and from all walks of life every day. You’ve got to be very flexible, patient, and understanding – no two days are the same.

My role as prescriber with the complex needs and rough sleeper groups has been about developing excellent engagement skills to reach underrepresented groups and people who aren’t accessing services.

A typical day could be to go to a homeless hub and run a drop-in clinic for people to get into drug and alcohol treatment or visit hostels, temporary housing, and night shelters to offer outreach to people who don’t feel comfortable coming into the service. As a prescriber, I’d be talking to them about the different treatment options and health interventions available. I would be assessing their needs and offering support and health interventions, as well as developing treatment plans to aid their chances of recovery.

As a prescriber, you might be offering vaccinations and tests for blood-borne viruses, issuing naloxone or initiating opiate substitute therapy. You could be referring to pathways for treatment, giving harm reduction advice, or improving health outcomes.

Lucie Jones, WithYouWHAT DO YOU FIND MOST REWARDING?
Seeing people re-engage with services and access the support and treatment they need because of the way we are working with them – my team is about delivering an excellent service and quality interventions to our community. I raise my team’s awareness of how to respond to people’s needs differently and upskill them to work with complex people in whatever way produces the best outcomes for them.

Being able to engage some­one in the right environment and in the right way has a massive impact. Issues they had when they were younger might be affecting them now, so I look at the barriers that prevent them from accessing support. I look at what environment they might engage best in and what trauma they might have gone through that causes them to need a different response from services like ours.

Some of the most complex, entrenched, hard-to-engage people have really engaged because we changed their environment, put the right member of staff there, and changed the way that we speak to them. We’ve had some amazing responses and this has been the most rewarding thing for me. We’ve had so many good outcomes for people who have mental health issues or learning difficulties, who are neurodivergent, or who have experienced all kinds of trauma. We build the trust, and they start opening up and want to talk.

WHAT WOULD YOU LIKE TO CHANGE?
There’s a lot of training and awareness-raising needed around complex needs – for partner agencies, hospitals, GPs etc. All the different services need to have training around the importance of trauma-informed approaches and environments. If we worked with our clients in different ways, outcomes would improve across the board.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
Recently we had two members of staff join us as prescribers. They had worked in completely different fields and said they wished they’d come to this sector years ago. They absolutely love it. Each member of our team brings their own set of unique skills and abilities. This job is just so interesting and rewarding – and we’re a friendly, approachable and happy team!

 

DDN JobsSee opportunities like Lucie’s on DDN Jobs

The long game

Advances in opioid substitute treatment such as long-acting injectable buprenorphine can lead to life-changing outcomes and experiences, says the team at Via

Buprenorphine was first licensed for medical use in the UK in 1978 as a painkiller. It was later approved for use in opioid use disorder (OUD) treatment in 1999. In 2018, a new long-acting buprenorphine injection was licensed in the UK for the treatment of OUD and it became available for clinical use in early 2019.

Via was the first state-funded treatment provider to offer long-acting injectable buprenorphine (LAIB) in England and Wales. Here we hear from key stakeholders at Via and Liverpool John Moores University (LJMU) about their latest research into the predictors and outcomes of LAIB vs oral medication, and the life-changing impact LAIB can have on the people it’s prescribed to.

Dr Yasir Abbasi, executive medical director at Via
Dr Yasir Abbasi

Dr Yasir Abbasi, executive medical director at Via
In 2019, Via worked with our commissioner in the London Borough of Redbridge to successfully pilot the use of long-acting injectable buprenorphine (LAIB).

‘I believe [LAIB] represents a significant step forward in the treatment and recovery from opioid dependence. Since making this treatment available in Redbridge, the feedback from patients has exceeded expectations.’ (Andrew Hardwick, integrated strategic commissioner, London Borough of Redbridge)

By 2023, we were successfully delivering LAIB across six localities, and therefore gathering valuable treatment data that could show the effectiveness and impact of using LAIB in community services. As part of Via’s innovation and research unit, I was keen to explore how we could design an evaluation utilising this data and established a research partnership with Liverpool John Moores University.

Professor Cathy Montgomery, professor of psychopharmacology and health inequalities at Liverpool John Moores University
Professor Cathy Montgomery

Professor Cathy Montgomery, professor of psychopharmacology and health inequalities at Liverpool John Moores University
‘This is one of the first investigations of person-rated outcomes and demographic factors in people prescribed LAIB versus oral MOUD (medications for opioid use disorder)’ (Montgomery, Abbasi, De Silva, et al, 2024).

IN OUR RESEARCH STUDY, WE AIMED TO EXPLORE
–  the factors that influenced the likelihood of an individual being prescribed LAIB
–  whether LAIB has a significant impact on people’s wellbeing and quality of life.

We analysed the treatment data of 501 people accessing Via services between August 2022 and August 2023. Anonymised data was taken from six Via services, and we compared 235 individuals prescribed LAIB with 266 people receiving oral medication. To identify what factors predicted whether someone would be prescribed LAIB, we used available demographic information. To examine whether LAIB had an impact on a person’s wellbeing and quality of life, we compared:
–  The difference in Treatment Outcome Profile (TOP) scores; the change between the first and final recorded TOP scores.
–  Summary TOP scores; the average across all an individual’s TOP scores.

HEADLINE FINDINGS
–  Predictors: People prescribed LAIB were significantly younger, had significantly more treatment episodes and significantly higher rates of employment.

–  Outcomes: The people prescribed LAIB reported significantly higher quality of life. The analysis of the TOPS summary scores also found that those using LAIB reported significantly greater psychological and physical health. 

Devon De Silva, innovation and research unit manager at Via
Devon De Silva

Devon De Silva, innovation and research unit manager at Via
The objective of Via’s innovation and research unit is to evaluate the interventions that we deliver, ensuring they are evidence-based and make a meaningful difference to the lives of the people we support. To help us better understand the findings from this research, I conducted interviews with three Via clinicians and six people who use our services.

The interviews gave us an insight into the predictors of how people will engage with LAIB and also showcased the real-life positive impact that LAIB can have on people’s quality of life:

PREDICTORS
–  More treatment episodes – due to the limited funding for LAIB, services have to prioritise who they offer it to, and this can include prioritising those ‘struggling with engagement or that are high risk’.
–  High rates of employment – those who are employed may find it difficult to regularly attend a pharmacy, so may also be prioritised.
–  Significantly younger – those who were older appear to be less likely to engage with LAIB: ‘maybe because they’re used to methadone’.

OUTCOMES
Key themes included people:
–  having ‘no sweating, no withdrawal’
–  being able to ‘engage in [their] relationship[s]’ again
–  now ‘having [their] own business… making a profit’
–  feeling ‘normal again’ due to no longer having to go to the pharmacy, a place they’d felt stigmatised
–  having ‘forgotten the fact [they’d] had a drug addiction’

One individual described LAIB as his ‘desperate last chance’ and that he is now ‘able to focus, am clean and can concentrate on… life.’

LAIB

We’re not saying that LAIB solves every issue or that it’s even suitable for everyone. But what our research and interviews do show is that LAIB can make a significant difference to the lives of the people who are prescribed it.

We believe LAIB should be a treatment option available for people, and that more research is required to help address the challenges of limited funding for LAIB within the sector. Via and LJMU have recently secured additional funding to explore the socio-economic benefits of LAIB, to aid with this ongoing challenge.

INCREASED QUALITY OF LIFE
Quotes from people who were interviewed:

‘With heroin, you wake up needing a fix but now we can lie in bed and have a tea… we can engage in our relationship.’

‘Having to go to the pharmacy all the time… [they] looked down their noses at you and treated you like you’re nothing… [LAIB has] made me normal again.’ 

‘Heroin affected my sleep… I’m now running on my own energy. Buzzing on life.’

‘Ten years ago I was sleeping in my car, now I’ve got my own business, my own house, my partner.’

‘I’ve got a young man with mental health and his mum is his carer. [LAIB] gives them one less thing to worry about.’

Via was the first state-funded treatment provider to offer long- acting injectable buprenorphine (LAIB) in England and Wales

Championing positive masculinity to redefine how young men engage with support

What does it mean to be a man? And can positive masculinity play a role in encouraging young men to reach out for support? These are some of the questions at the heart of In Your Corner, an innovative project by Change Grow Live offering a fresh approach to drug and alcohol support by meeting men where they are – both physically and emotionally.

Championing positive masculinity to redefine how young men engage with supportIn a society where hypermasculinity – marked by aggression, emotional suppression, and a reluctance to seek help – is deeply ingrained, many young men struggle to engage with traditional support services. In Your Corner is tackling this issue head-on, by focusing on a positive vision of masculinity that encourages vulnerability, trust, and meaningful reflection and conversation.

Understanding the need
In Your Corner was born out of the realisation that young men aged 18-30 were not engaging with drug and alcohol recovery services. Despite being the largest demographic in the probation system, fewer than 10% were accessing available support.

When young men leave the criminal justice system, they often face barriers that make it difficult to reintegrate into the community. Many have disengaged from traditional support services, left feeling unheard and misunderstood.

‘It just brought about a question for us,’ explained Change Grow Live’s Myka Wilshire, who leads the project. ‘Why, given that it’s such a large caseload for probation nationally, are we as a drug and alcohol service not working with a very large percentage of those people?’

Further consultation revealed that hypermasculinity played a major role in disengagement. Young men often resisted accessing help due to deep-seated social expectations around toughness and self-reliance. Traditional services, with their rigid structures and formal settings, did not appeal to them.

A relationship-driven approach
Instead of expecting young men to fit into conventional service models, In Your Corner is designed to fit around them. The project emphasises flexibility and relationship-building, moving away from structured sessions in probation offices towards informal, real-world interactions.

positive masculinity
Myka Wilshire, hypermasculinity project lead for Change Grow Live

‘Our staff are working in a much less formal environment,’ Myka explained. ‘We’re generally not meeting people in probation or in services. We’re trying to meet them where they feel comfortable – whether that’s a coffee shop, a gym, or out on a walk.”

This approach is proving transformative. Darren Clarkson, a frontline worker, describes a young man who had never engaged with support services before but agreed to go running with him. ‘For me, that’s a massive win,’ Darren said. ‘This guy had been through four structured services before and always disengaged. But now, he’s engaging because we’re doing something he actually wants to do.’

The power of trust
Building trust is at the core of In Your Corner. Many participants have experienced significant trauma and lack faith in institutions. Establishing relationships based on mutual respect is key to breaking down those barriers.

‘What the project is giving us is the opportunity to build real, more meaningful relationships,’ said team member Lowell Crisford. ‘For some of these young men, I think it’s the first time someone has genuinely taken an interest in them.’

The impact of these relationships is profound. Chai Burrell, another worker on the project, recalled one participant telling him: ‘I wouldn’t have even got out of bed today if it wasn’t for you and this service.’

Meeting people where they are
A defining feature of In Your Corner is its adaptability. Rather than imposing a rigid framework, the project allows workers to tailor their support to the individual, so that interventions can be woven naturally into everyday conversations. This has significantly reduced dropout rates, said Myka. ‘The staff are doing a mix of things – some are walking and talking, others are embedding interventions around activities.’

This flexible approach creates space for conversations that wouldn’t happen in a formal office setting. ‘Imagine being 21 and someone wants to sit down and talk about your emotions,’ Lowell said. ‘No chance. But if we’re walking, if we’re talking about something else, suddenly they’re telling you everything you need to know.’

In Your Corner positive masculinityA model for the future
The success of In Your Corner has sparked discussions about its potential for wider implementation. Darren believes that it should be socially prescribed, with young men being referred to the service through GPs and community networks. ‘The way I see it evolving is that this should be everywhere. Imagine if this was something that could be recommended by your doctor: “You’re struggling? OK, here’s someone who will check in with you once a week, go for a run with you, take you to try something new.”’

Although funding remains a challenge, enthusiasm for the project is growing. Efforts are being made to integrate it into additional services, including youth provision and prison-based interventions.

The project has also opened up discussions about the role of masculinity in shaping young men’s lives. While In Your Corner initially set out to address hypermasculinity, it has evolved into something more: a space to explore positive masculinity.

‘It started out looking at toxic masculinity,’ Myka explained. ‘But we didn’t like that term – it felt negative. Hypermasculinity says the same thing, but without the judgment. And now, we’re asking an even bigger question: Do young men even know what positive masculinity looks like?’

Many participants struggle to define what being a man means to them. As part of the project’s evaluation, staff use an exercise called The Man Box, which asks men to list society’s expectations of both men and women. ‘What we’re finding is that a lot of them haven’t even thought about it before. It’s really eye-opening,’ said Myka.

Championing positive masculinityThe path forward
As In Your Corner continues to grow, the team is committed to refining and expanding the model. One area of focus is supporting staff, who deal with intense emotional situations daily. ‘We’re not skimming the surface,’ Myka explained. ‘Our workers are hearing some really raw, difficult things. So we’re bringing in clinical supervision to make sure they’re supported, too.’

There’s also recognition that the conversation needs to extend beyond young men. ‘Masculinity directly affects women, too,’ Chai pointed out. ‘We need to be educating young women as well, because understanding these dynamics is important for everyone.’

Ultimately, In Your Corner is about reimagining support for young men – not just in the criminal justice system, but in society more broadly. By prioritising relationships, meeting people where they are, and challenging outdated narratives about masculinity, Change Grow Live is proving that meaningful change is possible.

As Darren summed up, ‘If we can stop young men falling through the cracks now, we’re not just changing their lives – we’re changing the future.’

This blog was originally published by Change Grow Live. You can read the original post here.


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

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

This content was created by Change Grow Live

Rotherham volunteer wins award for supporting others after alcohol recovery

Rotherham volunteer Darren Fox has won the Determined Volunteer Award from drug and alcohol charity WithYou for his work supporting others following his own recovery from issues with alcohol.

Rotherham volunteer wins award for supporting others after alcohol recoveryDarren received numerous nominations for his inspiring work at Rotherham Alcohol and Drug Support (ROADS) including from recovery worker Lucy Boyes, who said, ‘Darren has consistently shown willingness to provide his support, knowledge, experience and compassion to both the clients and the staff. Clients have reported that they felt understood and inspired by Darren’s determination, dedication and his person-centred approach. His determination is inspiring to not only the clients, but also to the staff at Rotherham, as he demonstrates a passion and commitment to the role.’

Rotherham Alcohol and Drug Service (provided by WithYou) provides free and confidential services, without judgement, to adults and young people facing challenges with drugs and alcohol across Rotherham.

‘I am delighted to receive this award,’ Darren said. ‘I would recommend volunteering 100%. It keeps me on the straight and narrow. It not only allows me to give back because I can help new cohorts due to my lived experience, it also keeps me personally focussed. I find it extremely rewarding and I’m totally enjoying what I’m doing.

‘The staff at WithYou in Rotherham are fantastic and supportive. They’re always willing to help and explain things. They make me feel valuable and that my experience and input counts.’

WithYou’s next volunteer awards will take place during Volunteers’ Week 2025, Monday 2nd – Sunday 8th June. These annual awards, delivered in collaboration with the Marsh Charitable Trust, offer colleagues, volunteers and clients the opportunity to recognise volunteers like Darren, who live WithYou’s values.

Darren’s story
I was referred to WithYou through my GP who knew I had a problem. It was mainly alcohol, but I did a few recreational drugs as well.

I worked on a reduction plan first and then I went to a residential detox in Doncaster for 10 days. That went really well and after a couple of months I got back in touch with WithYou and started to attend the drugs sessions. I went to as many sessions and groups as I could as I found them really helpful.

I then started to volunteer at WithYou. I did training and got my DBS check through and I’ve now been volunteering since May 2024.

Rotherham volunteer Darren Fox has won the Determined Volunteer Award from drug and alcohol charity WithYouMy role involves lots of things and is really varied. I support the Resilience Group on Mondays which has about 10-16 people attending, looking at triggers and how not to give in to temptation. I run a walking group and a snooker group on Wednesdays and the MAP group on Fridays. This is all about building up people’s resilience, goal setting, and finding your own recovery pathway. There’s a different subject each week. It usually starts with introductions and a welfare check-in round the group. We work through any issues together and help where we can.

I’m also on the new volunteers board and help with recruitment including doing interviews.

I created a WhatsApp group for clients to reach out and chat to each other, giving support on all sorts of things.

Other things I do include: dry blood spot testing, helping with the needle exchange, helping on urine screening, helping going drug and alcohol testing, supporting people going to residential detox, and support with assessments.

The snooker group on Wednesdays involves taking around 8 people to Snooker for All.  It lets people get away from normality for a few hours and takes them completely away from thinking about drugs and alcohol or talking about drugs and alcohol. Lee who runs Snooker for All also gives coaching sessions to them all.

People who are attending groups regularly are starting to come into volunteering and I also support them through that.

It’s very isolating coming through addiction and the groups are so helpful. It really feels like I’m helping.

The key question I ask everyone is what have you done today that takes courage and people mostly say nothing. So I always say you walked through that door. That takes courage.

 

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


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

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

This content was created by WithYou

New Adfam & CGL service in Coventry

Adfam is thrilled to announce its new service for families affected by substance use living in Coventry, delivered in partnership with Change Grow Live.

New Adfam & CGL service in CoventryThe service, officially launched on 9 April, provides remote 1:1 support for people living in Coventry that are affected by a loved one’s substance use.

This new service helps people to find ways of coping with their loved one’s substance use, explore their experiences and get support with the many challenges of having a loved one with a substance use problem.

Some of the topics people may explore during the sessions include:
1. A chance to ‘vent’ and express your feelings.
2. Understanding addiction and why your loved one may make choices that are hard to understand.
3. How best to support your loved one (if you want to).
4. Support to cope with overwhelming feelings.
5. How to communicate positively and reduce conflict with your loved one.
6. What to expect from treatment services.
7. How to rebalance things to make some space for you.
8. How to support and explain things to children.

For an initial call or to find out more about the service, complete our referral form at
adfam.org.uk/coventry

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


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

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

This content was created by Adfam

Note to self

Self-tracking tools

GEARÓID AND SELF-TRACKING
When I started my master’s degree in counselling in 2005, I was introduced to routine outcome monitoring. This involves using valid and reliable assessment instruments to track a client’s progress. Good examples of these tools include the Outcome Questionnaire (QC) and the Outcome Rating Scale (ORS).

These tools allowed me to collaboratively review each client’s progress on a weekly basis. If a client was at risk of a poor outcome – such as dependency or deterioration – this process helped us identify it early in treatment and explore ways to adjust our approach. The goal of routine outcome monitoring is to support a successful outcome, meaning the client feels better and functions more effectively week by week as they recover from a distressing and difficult time in their life.

In 2014, I began developing tools for people to use independ­ently of therapy to monitor their progress. I called these self-tracking tools (DDN, June 2024, page 18). They are based on the same psychometric principles as professional assessments, measuring aspects like social role function, intrapersonal distress, and interpersonal distress. Many people have found these tools invaluable in their recovery journey.

Self­-tracking peer mentors use these tools to empower their mentees, facilitating them to reflect on and discuss their progress
Self­-tracking peer mentors use these tools to empower their mentees, facilitating them to reflect on and discuss their progress

Self-tracking peer mentors use these tools to empower their mentees, facilitating them to reflect on and discuss their progress. This collaboration between mentor and mentee fosters new insights and action plans for continued growth while also preventing common pitfalls – either getting worse (deterioration) or getting stuck (dependency).

Last year, I asked a self-tracking peer mentor – someone I deeply respect for his pioneering spirit, and who has supported many of my clients – to share his experience. Here it is.

Gearóid Carey is a Delphi DARS recovery practitioner at HMP Manchester, the author of Recovery Made Simple – Why Suffer? and the founder of 2-Step Recovery.

MARK’S EXPERIENCE
My name is Mark, and I’ve been a recovery peer with the Delphi drug and alcohol recovery service in my community for the past year and a half. My role offers many types of support to service users who are at different stages of their recovery. What works for one may not work for all.

One of the best tools is self-tracking. To explain, I have been working with one lad called Dave for nearly a year now. We started with weekly self-tracking where we were able to fine tune and see what kinds of things were working well for him and what areas needed to be improved.

Self-tracking tools can be invaluable for both clients and peer mentors, say Gearóid Carey and Mark HughesDave had been very with­drawn, not working, and struggling with day-to-day things like routine and structure, difficulties with staying abstinent, and the impact that all of these things had on his mental health. Over the course of the last year, however, he has made massive improvements.

After a few months of working with him, we moved on to the monthly self-tracking sheet. During this time, Dave has remained focused and has engaged well with self-tracking. He now has a full-time employment – he is a cleaner, and has completed biohazard training. He has become more confident and looks so much better.

Self-tracking has been a great tool for Dave. It’s not a cure – it’s quite simply a great way to look back and reflect. I’ve found that for some service users it’s been a great tool to open up dialogue, especially when they might be finding it difficult to say what’s on their mind. I also use a self-tracking tool to monitor my wellbeing in my role as a recovery peer, which is really very helpful – especially during the busier weeks.

Given the benefits I have observed from a mentor’s perspective, I fully recommend self-tracking. It’s an adaptable tool that can be used in many different environments.

Scottish drug-related hospital stays up by 15 per cent

Scottish drug-related hospital stays up by 15 per cent

The number of drug-related hospital stays in Scotland increased by 15 per cent last year, according to new figures from Public Health Scotland (PHS).

There were 11,136 drug-related hospital stays in 2023-24, up from 9,654 in 2022-23. Almost half of the people admitted to hospital for drug-related reasons lived in the country’s most deprived areas, the agency adds.

The overall rate of drug-related hospital stays was 212 per 100,000 population, up from 2022-23’s rate of 186 per 100,000 but below the 2021-22 level of 242 per 100,000. The highest stay rate – at 91 per 100,000 – was for opioids, while the highest patient rate was among 35-44-year-olds, at 373 per 100,000. The stay rate for cocaine reached its highest ever level, at 39 per 100,000.

Scottish drug-related hospital stays - cocaine
The stay rate for cocaine reached its highest ever level

A person can have more than one drug-related hospital stay within a financial year, the report points out, with 11,136 stays among 8,535 patients in 2023-24. The combined drug-related stay rate increased more than threefold between the end of the 1990s and 2019-2020, it adds, from 87 to 289 stays per 100,000 population – followed by a decrease and then the current rise.

Public Health Scotland last month issued a warning after an increase in ‘sudden overdoses’ that often require multiple doses of naloxone to reverse, with its quarterly RADAR report from earlier in the year warning that the presence of nitazenes and other potent synthetic drugs meant the country’s drug supply remained ‘highly toxic and unpredictable’.

‘It’s very concerning that the number of people going into hospital for drug-related reasons is rising again, despite the increased focus on the issue in recent years,’ said Abbeycare’s Gordon Peacock. ‘It is clear that more needs to be done to prevent people reaching crisis point, so they do not end up requiring NHS treatment after taking drugs or overdosing.’

Drug-related hospital statistics: Scotland 2023-24 available here

Dechrau Newydd drug service closure raises concerns for most vulnerable

The Dechrau Newydd drug intervention service in North Wales has closed, with concerns raised about the impact on some of the region’s most vulnerable people.

Dechrau Newydd drug service closure raises concerns for most vulnerable
‘This is not just a step backward – it is a failure to protect the most vulnerable’ – Kaleidoscope

Operated by drug and alcohol charity Kaleidoscope, the service provided support to people involved in the criminal justice system across six counties, including those leaving prison. The closure has resulted in the loss of 20 staff roles.

Kaleidoscope said it was ‘deeply saddened’ by the decision, warning of a likely rise in crime and additional pressure on the prison system as a result. ‘This is not just a step backward – it is a failure to protect the most vulnerable,’ the charity said. It added that the service had offered essential harm reduction and recovery support, including employing people with lived experience.

The Office of the Police and Crime Commissioner for North Wales said a new service model was being developed following the end of the contract with Kaleidoscope. A spokesperson said the aim was to minimise disruption and ensure that people who needed help continued to receive support.

Dechrau Newydd had provided harm reduction services, opiate substitute prescribing and care coordination for people in, or at risk of entering, the criminal justice system.

The closure comes amid wider discussions about how services for people with drug and alcohol problems should be delivered across Wales.

Ketamine misuse: understanding the dangers

Prolonged ketamine use leads to cognitive impairment, dependency, and conditions like ketamine bladder syndrome. Early education and integrated mental health support are critical to tackling ketamine addiction effectively.

ketamine misuseKetamine misuse is on the rise, becoming an alarming trend particularly among younger people. This growing issue doesn’t just affect individuals but resonates across society, bringing significant mental and physical health consequences.

Recent figures from the Office for National Statistics (ONS) highlight the doubling of ketamine use since 2016, with tripling rates among those under 25. This surge in popularity can be linked to its low cost and accessibility.

The rise in ketamine misuse isn’t just a statistic. It’s a stark warning that we need to better understand this drug, its effects and why it has become so attractive, particularly among younger people.

What is ketamine and why is it popular?
Originally developed as an anaesthetic for humans and animals, ketamine is a dissociative drug that creates a trance-like state, distorting perceptions of sights and sounds. While used legitimately in certain medical and psychiatric settings, illicit recreational use has skyrocketed in recent years.

Owen Bowden-Jones, a consultant psychiatrist and founder of the pioneering Club Drug Clinic, sheds light on this rise in popularity. He explains, ‘My sense is the vast majority are using it to self-medicate for emotional distress. That would suggest to me they found a pharmacological short cut to managing their mental health.’ (source).

Ketamine’s dissociative qualities make it immensely appealing to individuals seeking to escape feelings of emotional or psychological distress. Combined with its widespread accessibility and relatively cheap prices, it’s no surprise that usage rates are surging among younger age groups.

How Ketamine Affects Mental & Physical Health
Recent figures from the ONS highlight the doubling of ketamine use since 2016, with tripling rates among those under 25

The mental health effects of ketamine misuse
The misuse of ketamine poses significant risks to mental health, affecting both short-term cognition and long-term psychological well-being.

1. Addiction and dependency
While ketamine initially offers escapism, consistent use can lead to addiction and dependency. Repeated exposure rewires how the brain experiences pleasure and pain, making it harder to cope without the drug.

Specialist clinics have reported an explosion in ketamine-related dependency cases. The Guardian notes that the number of people seeking NHS treatment for ketamine addiction more than doubled from 2019 to 2023, particularly among young people.

2. Mental health challenges
Ketamine use is often driven by an attempt to self-medicate underlying issues, such as anxiety, depression or trauma. However, prolonged use exacerbates emotional instability, leading individuals to become trapped in cycles of dependency.

Tragically, as experts highlight, there remains a significant gap in mental healthcare services for users, leaving many to rely on ketamine’s ’emotional anaesthesia’ when formal therapy is not accessible.

3. Cognitive impairment
Ketamine misuse damages cognitive functions, including memory, attention span, and problem-solving skills. This neurotoxic impact can impair daily life for users, from academic challenges to strained interpersonal relationships.

The physical health effects of ketamine misuse

ketamine bladder
One of ketamine’s most well-documented consequences is its severe effect on the bladder

1. Bladder and urinary issues (ketamine bladder syndrome)
One of ketamine’s most well-documented consequences is its severe effect on the bladder. Long-term misuse can cause a condition often called ketamine bladder syndrome or ketamine-induced cystitis, leading to urinary incontinence, intense pain, and lasting damage to the bladder lining. Unfortunately, the onset of pain is often only relieved by using more ketamine because readily available pain medication such as paracetamol and ibuprofen isn’t strong enough, leading to a vicious cycle of further physical damage and worsening symptoms that can be irreversible.

2. Liver and kidney damage
Extended use of ketamine can damage major organs, including the liver and kidneys, due to its toxic metabolic byproducts. These conditions usually worsen with continued use, especially among those who inject the drug.

3. Risk of overdose
Like many recreational drugs, ketamine comes with a significant risk of overdose. Overdosing may cause breathing difficulties, unconsciousness, or even death due to its suppressive effects on the central nervous system. This danger escalates further when ketamine is mixed with other substances.

The need for early intervention: early intervention & education
Owen Bowden-Jones describes ketamine as a ‘national problem’ and emphasises the importance of connecting addiction treatment with mental health services. Currently, many young users ‘fall through the cracks’ due to the systemic divide between these support systems.

Educating young people about the risks of ketamine is essential to curbing its growing popularity. Traditional harm reduction campaigns must be adapted to resonate with younger audiences and counteract ketamine’s reputation as a ‘safe’ party drug.

Given the isolating nature of ketamine addiction, creating community-led support networks can help break the cycle of misuse. Online and local recovery groups can offer non-judgmental spaces for individuals to access guidance, share experiences, and seek help.

Ketamine and its growing impact
Ketamine’s rising popularity among young people highlights broader societal and mental health issues we cannot ignore. From its devastating physical effects, like bladder and liver damage, to its role in worsening mental health challenges, the consequences of unchecked misuse are profound.

For more information on ketamine misuse and how we can help with residential treatment, please visit our dedicated ketamine addiction page.

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


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

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

This content was created by Broadway Lodge

The hidden gambling games in everyday life

Gambling addiction affects many people in the UK, with troubling statistics highlighting the scale of the issue:

  • 0.5% of adults (246,000) in the UK have an addiction to gambling (source)
  • A further 2.2 million people are either problem gamblers or at risk of addiction (source)
  • 44% of people suffering ‘problem gambling’ are classified as at ‘high risk of suicidal behaviour’ (source)

The Hidden Gambling Games You Encounter Every Day – Are They Crossing the Line?While the UK has stringent restrictions on advertising products like cigarettes, alcohol, and soon fast food, gambling-related promotions continue to permeate daily life.

All you need to do is look at football in the UK. Of all the 20 Premier League teams more than half of the clubs have gambling sponsors on their shirts (despite a ban on this coming into play for the 2026/27 season). When watching a football match on TV you can see adverts before the game and at half time, and often the advert contains a bet to be made on that specific game which is only more enticing. And, even during the game, you will see the advertising boards around the pitch promote betting brands. At one point there was even a football player, who after scoring a goal, lowered his shorts to reveal the top of his underwear which was sponsored by a betting brand.

This overt promotion of gambling is a growing concern, but what’s more unsettling is the presence of gambling-style mechanics embedded in other parts of daily life. These ‘hidden gambling games’ mimic the same risk – such as financial instability, addiction, and loss – even though they aren’t regulated as heavily as traditional gambling.

Here’s a closer look at some examples and why they deserve your attention.

hidden gamblingInvestment apps that blur the line
Investment has long encouraged financial growth through strategy and careful decision-making. But modern investment apps, often targeting younger users, introduce an element of playfulness that can blur the line between thoughtful investing and gambling-like behaviour.

For example:

  • Stock and crypto trading apps such as Robinhood (popular in the UK for its gamified approach) can make buying and selling feel like a video game. Features like confetti effects after a transaction and instant updates on gains and losses contribute to impulsive, adrenaline-fuelled decisions.
  • Spread betting platforms offer a way to speculate on the price movements of financial markets without technically ‘owning’ the asset, rewarding success with huge payouts – and punishing losses just as severely.

Such tools can encourage excessive engagement, creating a gambling-like rush without the label.

hidden gambling loot boxesLoot boxes in video games
Gambling isn’t restricted to just an adults-only activity. Loot boxes, which are purchasable in-game items containing randomised rewards, are a prime example of gambling mechanics targeting younger players.

Video games like FIFA boast loot boxes in ‘Ultimate Team’ packs, where players spend real money for a chance at getting rare, high-performance players. The allure of winning big and the suspense of the ‘reveal’ are eerily similar to the dopamine-triggering mechanics of slot machines.

Some UK lawmakers have even addressed their concerns over loot boxes, as studies suggest they can foster an early association with gambling behaviours in minors.

Dr. David Zendle, a leading researcher on the effects of gaming and gambling, has stated, ‘When we go beyond loot boxes, we can see that there are multiple novel practices in gaming that incorporate elements of gambling. All of them are linked to problem gambling, and all seem prevalent. This may pose an important public health risk. Further research is urgently needed.’

Remember, whether targeted at teens or adults, the financial risks remain real.

MCD monopoly gamblingThe McDonald’s Monopoly game and its gambling nature
The McDonald’s Monopoly game is a prime example of how gamification tactics can blur the lines between harmless entertainment and gambling. At first glance, it appears to be a fun promotional campaign, encouraging customers to collect game pieces from menu items for the chance to win prizes. However, the mechanics of this game mirror traditional gambling practices.

Players are incentivised to purchase more food items in an attempt to complete sets and win high-value prizes, effectively creating a purchase-to-play model reminiscent of a lottery. The odds of winning valuable rewards are deliberately low, with rare game pieces strategically limiting the chance of completing a set. Additionally, the enticing prospect of instant wins, such as free food or small giveaways, keeps participants engaged and coming back for more, much like slot machines rewarding small payouts to maintain player interest.

This creates a cycle where participants chase the illusion of easily attainable rewards, often spending more than they intended. The psychological impact of this is significant – it exploits the principles of intermittent reinforcement, a key component in gambling addiction, by providing unpredictable and sporadic ‘wins’ to retain engagement. While labelled as a promotion, the McDonald’s Monopoly game shares many behavioural and emotional hooks found in gambling, raising ethical questions about its marketing approach.

The warning signs to look out for
While the above activities may not technically fall under traditional gambling definitions, they can have similar consequences. Keep an eye out for these red flags:

  • gamblingRushed, emotionally driven decisions – If the activity feels like a rush or adrenaline spike, you may be falling into a risk-taking cycle.
  • Loss chasing – Spending more to recoup a ‘bad result’ or ‘unlucky streak’ is a classic gambling behaviour.
  • Financial impact – If an activity leaves you financially stretched, regardless of its category, consider pausing engagement and re-evaluating priorities.
  • Time investment – Spending excessive hours on the activity suggests it may have started to affect your life balance.

Stay cautious, stay empowered
It’s easy to get caught up in activities that are marketed as recreational or financially beneficial but mirror gambling mechanics. Education, mindfulness, and knowing when to say no are your best tools for staying ahead. Being aware of these ‘hidden gambling games’ gives you the power to make informed decisions – and, ultimately, keep control of your time and money.

For further information, take a look at our recent post Creating healthy hobbies to replace gambling or see our gambling addiction support page.

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


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

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

This content was created by Broadway Lodge

Alcohol deaths an ‘acute crisis’, say researchers

Alcohol deaths an ‘acute crisis’, say researchersThe increase in alcohol deaths in England since the pandemic represents an ‘acute crisis’ requiring urgent government action, says a study by researchers at the University of Sheffield and UCL. While the death rate was stable in the decade to 2019, the number of deaths then increased by a fifth in 2020 and a further 13 per cent between 2020 and 2022, it points out.

The researchers studied ONS figures for deaths caused solely by alcohol and estimated that almost 4,000 more people had died between 2020 and 2022 than would have been the case ‘if pre-pandemic trends had continued’. The largest increases were among men, people in deprived areas, and people aged 50 to 69, says the study, which is published in Lancet Public Health. Although there was an increase in deaths from acute causes – such as alcohol poisoning – the main increase in fatalities was the result of a ‘steep rise in liver damage caused by alcohol’, it states.

The increase in liver disease deaths was likely the result of increased consumption among heavier drinkers alongside factors such as ‘more frequent binge drinking’ and fewer people seeking treatment during the pandemic, it says. Persistent higher alcohol death rates post-pandemic have also been reported in Australia, Bulgaria, Estonia, Germany, Latvia and the US, the paper adds.

The most recent ONS figures showed the number of alcohol-specific deaths in the UK as a whole hitting their highest ever level, with almost 10,500 registered in 2023. As in previous years, the death rate for men was around double that for women, with the North East recording the highest alcohol-specific death rate for any English region. Alcohol-specific deaths only include those that can be wholly attributed to alcohol – such as alcohol-related liver disease – and exclude deaths from causes ‘that are made more likely by alcohol’ such as heart disease or various cancers, ONS points out.

alcohol deaths
Almost 4,000 more people had died between 2020 and 2022 than would have been the case ‘if pre-pandemic trends had continued’

A report from Public Health Scotland last month predicted that the number of people living with chronic liver disease in Scotland would increase by more than 50 per cent by 2044, equating to an additional 23,100 people, with more than 70 per cent of chronic liver disease cases caused by alcohol.

‘The increase in alcohol deaths is entrenching existing health inequalities, with large absolute increases among men and among people from deprived areas,’ said Professor Colin Angus from the University of Sheffield’s School of Medicine and Population Health. ‘Men, just as before the pandemic, are twice as likely to die because of alcohol compared to women, with almost three times as many additional alcohol-specific deaths in the most deprived areas compared to the least deprived.’

‘The sharp increase in alcohol deaths during the pandemic was no flash in the pan. The higher rate has persisted and is getting worse each year,’ added lead author Dr Melissa Oldham from the UCL Institute of Epidemiology and Health Care. ‘It is an acute crisis, and urgent action is needed to prevent further avoidable deaths. This includes substantial investment in health services to better detect and treat liver disease as well as policies to reduce alcohol consumption in the population as a whole, such as minimum unit pricing and advertising restrictions.’

Trends in alcohol-specific deaths in England, 2001–22: an observational study available here

Dead ends – the tobacco industry’s quest for a ‘safe’ combustible cigarette

BY GLOBAL STATE OF TOBACCO HARM REDUCTION (GSTHR)

combustible cigaretteFrom the 1950s onwards, the tobacco industry spent decades denying any link between smoking and disease. Yet at the same time, it dedicated much time and money trying to develop a ‘safe’ combustible cigarette. This would be a product that achieved the challenging dual aims of satisfying consumer demand for taste and nicotine delivery, while reducing concerns about public health. The search would not be simple.

This Briefing Paper sets out to tell the story of the roles played both by those within and outside of the tobacco industry.

Read the briefing paper here

Safer nicotine product taxation and optimal strategies for public health

BY GLOBAL STATE OF TOBACCO HARM REDUCTION (GSTHR)

Taxation has long been regarded as one of the most effective tools by traditional tobacco control groups for controlling tobacco consumption. Tax on tobacco products is intended to serve two main purposes: to decrease demand by increasing prices, making these products less affordable and less appealing, and to generate government revenue. Critics, however, suggest that tax is a blunt instrument, contributing to the economic inequalities faced by people who smoke and driving illicit markets.

Safer nicotine product

This Briefing Paper examines the current global situation regarding the taxation of safer nicotine products (SNP) and how this relates to product accessibility, before offering evidence-based policy recommendations for optimal taxation strategies in support of harm reduction goals and public health. Our primary focus is on nicotine vapes (e-cigarettes) and heated tobacco products (HTP) as these are the two dominant SNP categories with the most extensive data available. However, conclusions drawn here may apply to other SNP as well.

Our analysis centres on excise taxes, which differ from general levies like income tax or value-added tax (VAT). Unlike these broad-based taxes, excise taxes target specific products or activities, making them a critical area of interest in SNP taxation policy.

Read the briefing paper here

Safe as houses?

Safe as houses? appropriate housing provision

I read Simon Hattenstone’s article in the Guardian about the tragic death of Joe Black in a London hostel with mounting horror, frustration and sadness.

Joe Black’s death in a London hostel wasn’t just tragic, says Kevin Flemen. It was a painful reminder of the vital importance of appropriate housing provision.Both the subject – and the journalist who wrote it – reminded me of my own journey in the world of drugs and housing and why it matters so much.

Many moons ago, I was a young outreach worker in central London, working with people sleeping rough in the West End. All too many of those young people were trapped in the drugs/homelessness catch 22 – need to be in treatment or off drugs to get into housing, but can’t get into treatment or off drugs while unhoused.

The one treatment service that would take people who were homeless would only sign up the first three people in the queue on a Wednesday morning. For everyone else it was the roundabout of hostels where use was covert, ignored or detected and you were back on the streets. In this environment there was a grim but inevitable tally of drug-related deaths – overdoses, suicides, neglect, injuries.

Two deaths that changed my view of the work and the situation were those of two young men who were fatally stabbed by a local bar-worker when they slept rough in Soho. It affected me deeply at the time. The lads in question were Big Issue vendors, and Simon Hattenstone was, at the time, a journalist there, learning his trade. He wrote a piece about their lives and death after they were killed. I have a clipping of it still – the only published memorialisation of two lives cut short.

A NEW MODEL
For me, it was the start of a piece of work that has carried on now for almost three decades – working with housing providers to form drugs policy and practice which is lawful, as safe as possible, and fit for purpose. It has seen the emergence of a model which has been adopted by Shelter and Homeless Link, and Martin Powell at Transform worked extensively with a range of agencies to expand take up. Housing providers from Cornwall to Scotland have adopted and adapted the models developed 30 years ago to provide inclusive housing where the needs of residents are properly addressed and appropriate.

Based on Hattenstone’s article about the death of Joe Black, and stressing that I don’t know the provider involved and had no input into their policy or practice, it stood out as a startling throwback to the problems we have seen numerous times in supported housing – a catastrophic mismatch between policy and provision.

safe as housesThere is a need for a wide spectrum of housing provision. Drug-free housing is essential for some people looking to sustain abstinence. High-tolerance housing is equally essential for people using – especially in ways that may be hazardous – to provide an environment which is safer, can provide stability and offer the start of a journey which may include change.

IMPOSSIBLE SITUATIONS
Where it goes wrong is where the policy of one is applied to the other. This creates two impossible situations. One is where people who believe they are moving into drug-free housing are exposed to unacceptable risk, as the practice doesn’t ensure the housing is in fact drug free. The other outcome is where people who are known to have ongoing substance-related support needs are housed in a service where the policy doesn’t acknowledge or respond to those needs, again leading to unacceptable risks.

In the case of Holmes Road, about which Hattenstone writes, the policy starting points were all the tropes of a classic ‘zero tolerance policy’:

‘Residents had to promise not to take drugs on the premises – and, ideally, not at all’ and ‘Holmes Road management said any drug dealing on the premises was immediately reported to the police.’

The problem is – and has always been – that such policy and practice is unworkable and unsafe, where the provision is working with people who still use. At best it displaces the activity.

The mismatch creates all the ambiguity and confusion that Hattenstone’s piece illustrates, and is best summarised by this statement in the article, quoting the service manager for adult safeguarding in Camden:

‘It is noted that people may continue to use both legal and illicit substances during their stay. In light of this, staff extend advice and support, striving to mitigate potential risks and helping those who wish to cut down or quit entirely. Staff are also conscious that for some, drug use may be a means of coping, often due to past traumas or ongoing personal struggles. It’s crucial to mention that any illegal activities identified within the hostel are immediately reported to the police and could result in eviction.’

appropriate housing provisionTherein sits the contradiction and the failure. On the one hand the recognition of the need for a harm-reduction approach while simultaneously clinging on to a zero-tolerance ‘illegal activities will be reported to the police.’

LEARNING POINTS
Looking at the list of ‘key learning points’ (see box), these aren’t new and it’s deeply depressing that they even need to be restated. But the evidence from Hattenstone’s article is they must be restated.

All the tools needed to shape good, lawful, progressive and safer provision are available for use and have been implemented for years by a variety of organisations, including those in the London Borough of Camden.

The piece was a salutary reminder that amongst the shining examples of good practice that do exist in the UK, there are others that do not – and their failures lead to fatalities.

Kevin Flemen runs KFx which has offered training and resources on drugs and related issues since 2003. Email kevin@kfx.org.uk

Drug alert – fake ketamine

Cranstoun are aware of multiple reports in recent days from people experiencing unusual and potentially dangerous effects after using what they thought was ketamine. There appear to be two batches in circulation in multiple parts of England, in a wide variety of different areas.

  • Drug alert – fake ketamineOne looks like shards, just like ketamine does, but with a distinctive smell, not unlike mephedrone.
  • The other looks like white granules, which also has a distinctive smell, not unlike cocaine.
  • Both batches are likely to be variations of ketamine known as analogues. They have an unusually stimulating effect. At least one of them is also producing unpleasant and strong psychedelic effects.
  • Quite a few people have reported feelings of panic and chest pains related to both batches. One person also reported feeling that their throat was closing up.
  • A granular batch failed the Morris reagent test, turning it green rather than purple. This means it does not contain ketamine. It is not known how the shard-like batch behaves with reagent tests.
  • For various reasons it is difficult to draw conclusions from recent WEDINOS results – www.wedinos.org/index.php. The granular batch recently tested as containing no active component, but the side effects listed by the person who submitted the sample included stimulation and chest pains. The inability to identify any active component may be because the analogue is not yet in WEDINOS’ chemical library.

On the basis of the reports of chest pain we want to give to people who use ketamine the following advice:

  • One looks like shards but with a distinctive smell, not unlike mephedrone. The other looks like white granules also with a distinctive smell, not unlike cocaine

    When picking up a new batch, smell it first. If it smells unusual, throw it away or send it to WEDINOS.

  • If you are using a new batch of ketamine, make sure to start slowly and ease yourself in gently. The analogues may take longer to kick in than regular ketamine. Do not re-dose thinking it is just poor-quality ketamine.
  • If it has an unusually stimulating effect, throw it away or send it to WEDINOS.
  • If you or anyone you know has chest pains after taking ketamine, call 999 immediately. If you or anyone else have symptoms of panic, sit or lie down and perform breathing exercises. If this does not reduce the symptoms of panic within 15 minutes, or they worsen, call 999.
  • Don’t go off by yourself after using any drug, and don’t let others do the same.

If you have a Morris reagent test kit, which is legal to purchase online from www.reagent-tests.uk, use it. It is important to use a very small amount of ketamine when conducting the test, and to stir it thoroughly once both parts have been added. This can be done on a regular white plate or on ceramic dimple trays. If you have an unexpected result you should:

  •      Retest it again
  •      Send it to WEDINOS
  •      Bin it.

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


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

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

This content was created by Cranstoun

Drinking habits health research ‘a wake-up call’, says Alcohol Change UK

Alcohol harm across the drinking spectrumNew research looking at the drinking habits of 4,000 people is a ‘wake-up call’ on the associated health harms, says Alcohol Change UK. Even for people drinking below the 14-unit weekly guidelines there are links with poorer sleep quality, poorer dental health, higher prevalence of cancer and cardiovascular disease, and ‘reduced daily functioning’, it says.

The research, which was commissioned by Alcohol Change UK and carried out by the Behavioural Insights Team consultancy, states that the ‘negative impact of alcohol on the health and wellbeing of the UK population is widespread’. People drinking at above the chief medical officer’s 14-unit recommended limit but below the levels associated with dependency were ‘experiencing harms at a significant scale’, it says, with men – particularly those from lower socioeconomic groups – showing ‘stronger links between health problems and their alcohol consumption’.

While the relationship between drinking levels and healthcare costs is complex, the report ‘cautiously’ estimates that, compared to people who never drink, harmful drinking may cost the NHS an additional £729 per person per year, hazardous drinking an additional £522 per person per year, and low-risk drinking an additional £153 per person per year.

The document calls for the government to ‘turn prevention into reality’, with the introduction of statutory alcohol labelling including information on health risks, as well as minimum unit pricing and tighter restrictions on marketing and advertising. It also wants to see the restoration of the public health grant to ‘at least’ its 2015-16 levels. A multi-year funding settlement for treatment and support would allow service providers to ‘plan services, recruit staff, and crucially, reach out to the 82 per cent of the people dependent on alcohol who are not currently accessing services’, it states.

Drinking habits health research ‘a wake-up call’, says Alcohol Change UK
Compared to people who never drink, harmful drinking may cost the NHS an additional £729 per person per year

There were almost 10,500 alcohol-specific deaths registered in the UK in 2023, according to ONS figures – the highest number ever recorded and an increase of almost 40 per cent since 2019. The World Health Organization estimates the number of alcohol-related deaths a year globally at 2.6m, 2m of which are among men.

‘Millions of us feel the negative effects of alcohol in our daily lives,’ said Alcohol Change UK chief executive Richard Piper. ‘But because we’re surrounded by slick adverts pushing the idea that every occasion needs an alcoholic drink, and because parts of our cultures still treat alcohol as essential, rather than optional, it’s much harder for us to connect the dots. When we as a society do talk about the downsides of alcohol, it is usually something that happens to “other people”, or in hard-to-comprehend, faceless statistics about rising alcohol deaths.

‘This harm isn’t inevitable, and the solutions are right in front of us,’ he continued. ‘Our environment can be improved so that whenever we want to make a positive change to our relationship with alcohol, we are supported and not hindered: with more accurate information about the dangers of alcohol, better protection from efforts to get us to drink more, and improved access to independent, evidence-based support.’

Alcohol harm across the drinking spectrum available here

Have your say! Family support: what does ‘good’ look like?

Adfam family

For the past 40 years Adfam has been advocating for and supporting people that are negatively affected by a family member or loved one’s substance use.

Over that time we’ve learnt that no two families are the same and that no one approach suits everyone.

However, we’ve also found that there are guiding principles that many families value, along with ways of working that great services share.

Adfam family surveyThe views of families, experience of providers and expertise of academics are central to what we do, and we would be grateful if you can spare 5 minutes to complete our survey, to tell us what it is that you see working well for families and carers.

Responses will be used by Adfam to push for better services for families and carers.

This survey will be open until Monday 28th April 2025. All responses are completely anonymous.

Take part in the survey here

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


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

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

This content was created by Adfam

Counted out

When Adfam submitted FOI requests on family support spending, the results were alarming.

In 2024, Adfam marked its 40th year as a charity, and over the course of that year we reflected on the progress that’s been made over the past four decades in supporting families affected by substance use – as well as looking ahead to the changes needed for the future.

The distinct lack of support for families continues to be an issue, and despite the many millions allocated by the government to tackle substance misuse the people closest to individuals struggling with substance use – their family and loved ones – continue to be overlooked.

We estimate that five million people in the UK are negatively affected by someone else’s drinking or drug use, and we know many of these individuals play a crucial role in supporting their loved one’s recovery – providing emotional, financial, and practical support, while potentially saving the public purse in the long-term.

When Adfam submitted FOI requests on family support spending, the results were alarming. Families don’t count if they’re not counted, says Robert Stebbings

To address this, and to understand the level of support available to families, Adfam launched the most comprehensive survey of its kind. Last year we submitted Freedom of Information (FOI) requests to 154 local authorities across England, asking how much of their substance misuse budgets were allocated to family support and how many family members and carers had benefited.

KEY FINDINGS
The findings were shocking, to say the least. Of the 154 local authorities, only 72 were able to provide any data on the funding allocated to family and carer support. This means that in more than half of the country there is no available data on spending, leaving us unable to determine whether funding for families is increasing, decreasing, or remaining the same. By contrast, spending on residential rehabilitation, needle exchanges and substitute prescribing, are all routinely accounted for.

Among the local authorities that did report spending on family and carer support, the figures were alarming. Some areas allocated nothing at all, while others dedicated just 0.1 per cent or 0.2 per cent of their total substance misuse budgets. The national average sat at a mere 1.58 per cent.

INADEQUATE INVESTMENT
The current level of spending does not reflect the reality of what families go through. We know that substance use does not just affect the individual – the impact has far-reaching consequences for loved ones. Families and carers endure emotional distress, financial strain, and mental health difficulties, while experiencing stigma that causes them to feel isolated and suffer in silence. Many families struggle with the demands and pressures placed upon them, yet recognition or investment in support provision to address their specific needs is seriously lacking.

At present, while a plethora of information is routinely collected regarding individuals who seek help for their addiction, local authorities are not required to track the number of family members and carers receiving support. This lack of data collection prevents a clear understanding of the extent of need and hinders the effective allocation of resources.

Family support spending
Of the 154 local authorities, only 72 were able to provide any data on the funding allocated to family and carer support

THE NEED FOR CHANGE
This survey should serve as a wake-up call. How can we claim families are valued in drug and alcohol treatment when half the country cannot provide data on the funding allocated to support them? With an average spend of less than 2 per cent, it is clear that families affected by substance use are not a priority for most local authorities.

For the millions of families and carers whose lives are turned upside down by a loved one’s substance use, we need to do more to support them. These are real people, facing real challenges. Adfam is calling for a change in national reporting mechanisms, so that local authorities are required to track and report how many family members and carers are receiving support through substance misuse budgets. Providing this data, we believe, will mark a significant step in helping more families and carers to get the help they desperately need.

Families don’t count, if they’re not counted.

Robert Stebbings is policy and communications lead at Adfam

Over the threshold

A recent EUDA webinar heard from participants in France, Spain and Ireland about how low-threshold employment schemes with a harm reduction focus can help get people back on their feet – and reintegrated into society.

‘People used to say to me, “What if we just didn’t do housing?” or “Let’s forget about getting them into work,” Professor Dame Carol Black told DDN earlier this year (February, page 14). ‘But you’ve got to do all of it – you can’t pick and choose.’

Getting, or keeping, paid employment when struggling with substance issues can be far from easy, however. ‘The simple facets of employment – such as conduct and time-keeping – could be herculean struggles for people who use drugs,’ wrote Exchange Supplies’ Andrew Preston last year (DDN, November 2024, page 17). But they could be made ‘so much easier with a bit of compassion, understanding and flexibility’, he said. A recent EUDA webinar, Low-threshold employment programmes — can they be social reintegration gateways? heard from three schemes adopting just that approach.

EUDA webinar low-threshold employment schemesTAPAJ (Travail Alternatif Payé À la Journée – literally, ‘alternative work paid by the day’) is a French programme for 16-25-year-olds that provides ‘an alternative to unstable environments by allowing them to work, earn money legally and get support for their personal challenges’, its director Jean-Hugues Morales told the webinar. Aimed at people who were ‘homeless, socially disconnected, struggling with addiction’, it gave them ‘immediate and flexible’ work opportunities. Many lived on the streets and so couldn’t access traditional services, he added.

Based in Bordeaux, TAPAJ now operates across 70 locations in France and collaborates with more than 300 companies and organisations, including local authorities and big names like Renault, SNCF, JCDecaux and Ikea. ‘It’s designed to be flexible, immediate and to build trust,’ said Morales. ‘It’s not just about work – it’s a holistic programme.’

SIMPLE STEPS
TAPAJ firmly adopted a harm-reduction approach, he stated, with no requirement for participants to ‘stop their substance use or change their life.’ The programme had ‘three simple steps’, he explained. The first was immediate work access – allowing people to not only start working the next day but also get paid the same day, providing ‘immediate impact’. Next came tailored support plans covering people’s health, social, administrative, housing and justice needs. ‘During this phase we increase the working hours and expand the network of partners,’ he said, supporting a ‘shift in life trajectory’. In the third phase, the support became even more targeted – including care pathways and accommodation searches – continuing the move towards stability and self-sufficiency.

It was an approach that made it easy for young people to enter the programme ‘without pressure, while we’re gradually helping them to improve their situation,’ he said – including better access to mental health and drug and alcohol services. It had been evaluated through multiple studies over the last decade in France and Quebec, where it also operates, with all finding that the programme had a ‘significant positive impact’.

Low-threshold employment schemes with a harm reduction focus can help get people back on their feet

STREET INVOLVED
There was a ‘rich history of getting people back into work’ in Ireland, said CEO of the Dublin-based Ana Liffey Drug Project, Tony Duffin. His organisation worked with over-18s who were ‘street involved’ – experiencing various forms of homelessness – and who often had a history of trauma. Co-production and co-design of services with the people who used them was central to Ana Liffey’s ethos, he said, as was making sure they were paid for their time. ‘That reduces stigma and validates people’s contributions, which is really important. We’re working with people with multiple complex needs, who have very often given up on themselves and perhaps don’t see themselves as worthy of looking for employment.’

High levels of structural and systemic unemployment, particularly affecting young people, were a perennial problem for Spain, said Oriol Esculies of the Spanish NGO Proyecto Hombre. An ongoing project for the organisation was Programa INSOLA+, he said, which was designed to help people who were ‘at risk of social exclusion’ because of their drug problems.

Job reintegration was a key part of the recovery process, his colleague Manuel de la Cruz Rodríguez told the webinar, and one main objective was to develop personalised plans that boosted employability and promoted ‘integration in all areas of their lives’. The project had four phases – motivation, orientation, skills development and training, and finally more specialised guidance such as preparation for interviews, with the aim of providing ‘full autonomy,’ he stated.

It was a ‘huge project’, with a budget of €29m over six years, he said, including from the EU’s European Social Fund. But the impact was also huge – for every euro invested, there was a ‘social return’ of €5.19. ‘There’s value for the clients, their families, the public administrations. But there’s also an impact that we can’t measure – someone recovering their life.’

low-threshold employment schemes
Among the main challenges for projects such as these was building trust

BUILDING TRUST
When it came to lessons learned so far, among the main challenges for projects such as these was building trust, said Morales. ‘Many young people in these situations don’t trust institutions or programmes’, which meant it was vital to ‘meet people where they are’ and support them as they moved forward at their own pace. Trust also had to be built with the partner organisations, of course, ‘so we keep the process simple’, he said. Securing funding for TAPAJ was an inevitable challenge, with money coming variously from businesses, local authorities, NGOs and European programmes.

‘The important thing is that things are achieved – so professionals mustn’t let people down,’ Duffin stressed. ‘One of our peers was explaining to me how they’d recently lost a friend and had gone in on themselves, removed themselves from the outside world. But this work was bringing them back out, and they were feeling valued. It’s small steps – I’m talking about paying people for a day or two, not full-time employment – but it’s really important.’ Crucially it also diverted people away from ‘high-risk strategies’ for getting money, whether sex work or drug dealing, he said.

‘In an ideal world companies would come to us offering the jobs our people need,’ said Esculies. ‘But it’s not the case, so we must go to them and convince them that they have a social responsibility – but also that they’ll gain from this.’ This meant having a proactive strategy that required time, resources and the ability to properly engage with companies – a task for which Proyecto Hombre had now created a specific post.

LONG-TERM PROJECTS
Any project of this size required a huge amount of administrative work, he continued. This was particularly the case when accessing EU funding streams, and the fact that much of that money could arrive long after the work had been completed inevitably favoured larger, credit-worthy organisations that could absorb ‘cash-flow tensions’. So sustainable long-term projects would need either strong organisations or strong networks, he stated.

Low-threshold employment schemes, however, were flexible models that were always adaptable to the economic and social systems of other countries, said Morales. ‘But you have to maintain a harm reduction principle. Start with a strong pilot project, and after that you can focus on flexibility and scalability.’

Getting more businesses on board meant investing in ‘educating employers and the public in terms of campaigns that challenge stigma’ EUDA
Getting more businesses on board meant investing in ‘educating employers and the public in terms of campaigns that challenge stigma’

Getting more businesses on board meant investing in ‘educating employers and the public in terms of campaigns that challenge stigma,’ said Duffin. ‘Co-production is not unique to Ana Liffey – there are models across Europe and further afield – it’s just that it’s difficult to get it right.’ While sustainable funding for long-term project development was again a challenge, involving and paying people who use drugs was ‘creating healthier and safer communities – because people are engaging in a pro-social way’, he said

COMMUNITY OPPOSITION
There was also the significant issue of managing negative reactions from the community, delegates heard. ‘People who use drugs face stigma every day and are portrayed as criminals in the media – of course you have people who don’t want to work alongside them,’ said Duffin. ‘That’s not true of everybody, but it is a challenge. And the way to deal with that is to engage with people, that’s how you move things along. Being good neighbours and good work colleagues are all very important.’ If any municipalities were concerned that initiatives like TAPAJ would ‘attract more people in precarious situations to their area’, the best way of addressing this was always through open communication and demonstrating the long-term benefits, Morales added.

It was vital to recognise not just the value that someone brought to a job, but also the ‘profound impact it has on the person,’ said Duffin. ‘Their wider life, their family life, their housing situation, just reducing risks in their life. Employers, policymakers and communities need to invest and listen. Low-threshold employment is essential – for people who use drugs, people who are stable, and people in recovery.’

‘So let’s make it happen,’ said Morales.

DDN April 2025

One shocking case hints at how many more?

DDN April 2025Imagine this… that people without a home, struggling with addiction, and feeling disconnected are offered immediate and flexible work opportunities. And that this moves into tailored support plans for health and housing, leading to further progress towards stability and self-sufficiency. Such an action plan might seem as far away as the moon for many people – but through exchanging ideas and joining forces, such initiatives are taking place in France, Spain and elsewhere (p6). So why not here?

If evidence were needed that housing has to be more than just shelter, you will find it on page 10. One sad and shocking case hints at how many more, where an organisation’s policy completely mismatches need?

Another big question in this issue is the missing evidence of spending on family and carer support (p8). Are some local authorities really allocating nothing at all? And while we have contributions to energise and inspire, we must also ask – have we actually got the power dynamic right with people using our services (18)? Finally, turning the mirror on ourselves (p24), are we a happy and functional workforce or victims of chronic underinvestment? Let us know!

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

Claire Brown Editor of DDN Magazine

Claire Brown, editor

Use taxes to encourage switch to safer nicotine products, governments urged

Use taxes to encourage switch to safer nicotine products, governments urgedGovernments should be using their tax systems to encourage smokers to switch to using safer nicotine products instead of cigarettes, says a new briefing paper from the Global State of Tobacco Harm Reduction (GSTHR) project.

Taxation has long been seen by tobacco control groups as one of the most effective tools for controlling the use of cigarettes, says Safer nicotine product taxation and optimal strategies for public health. However, calls from organisations like the WHO to tax safer nicotine products at comparable rates to cigarettes could have ‘devastating consequences’ for public health, the document warns. Instead, governments should be using tax to make sure that cigarettes are ‘significantly’ more expensive than vapes or heated tobacco products, it states.

Tax is designed to serve two main purposes when it comes to tobacco, says the report – to reduce demand by increasing prices, and to generate revenue for the government. However, while higher taxes have helped to cut smoking prevalence rates in many countries, tax measures like those recommended by WHO could mean people returning to smoking cigarettes instead of using less harmful alternatives. At least 54 countries had imposed excise taxes on vapes as far back as 2023, the briefing says, while almost 70 countries had brought in excise taxes on heated tobacco products.

tax switch
All countries – even those where cigarette taxes represent significant sources of revenue – should be prioritising harm reduction, the paper stresses

All countries – even those where cigarette taxes represent significant sources of revenue – should be prioritising harm reduction, the paper stresses, as the long-term public health and economic gains far outweigh any short-term losses in revenue. Governments should also consider subsiding safer nicotine products, it adds. This would mirror the subsidisation of nicotine replacement therapies (NRT), which has ‘proven cost-effective,’ it states. ‘Given evidence that vaping products are even more effective than NRT in helping people to quit smoking, subsidising safer nicotine products could yield substantial public health and economic benefits, making it a logical and impactful policy choice.’

Analysis by ASH last year found that nearly 3m people had successfully used vapes to stop smoking during the previous five years, making them by far the most popular aid among people who had successfully quit. However, the proportion of people who mistakenly believe that vaping is as harmful as – or more harmful than – smoking continues to increase, with a study by Brighton and Sussex Medical School earlier this year finding that this was actively discouraging young people from switching to vaping.

‘Tax has played an important role in many countries in helping reduce smoking rates,’ said the GSTHR report’s author, Giorgi Mzhavanadze. ‘By using informed and evidence-based approaches to differentiate between combustible, hazardous tobacco products and much safer nicotine products there is a potential to hasten the demise of smoking and improve public health, benefiting individuals and communities.’

Report available here

Cranstoun partners with Durham PCC and police on new drug testing scheme

Suspected burglars, shoplifters and drug dealers are to be routinely drug tested when they are arrested in County Durham and Darlington.

Cranstoun partners with Durham PCC and Police on New Drug Testing Scheme
Across the UK, it is estimated that anywhere between one third and one half of all acquisitive crime is connected to drug misuse

Suspects taken into custody by Durham Constabulary will be tested to determine if they have recently taken class A drugs, including opiates, such as heroin or fentanyl, or cocaine.

Those who test positive will be referred to schemes where they can address their substance misuse and be offered the expert help they need to get off drugs. Anyone refusing the mandatory test will be charged with failure to provide a specimen, alongside any charges for the offence they were initially arrested for.

Officers hope that the programme will help get people away from drugs, which will in turn improve their life chances, reduce repeat offending and result in fewer victims of crime.

Sgt Stuart Simpson of Durham Constabulary said, ‘There is plenty of evidence that crime, particularly acquisitive crime, is fuelled across our force area by the use of class A drugs.

‘Drug Test On Arrest helps us to identify those whose offending is being driven by drug use and make sure they are offered the help they need.

‘If we can change their behaviour then, in the long run, that will lead to lower crime and, more importantly, fewer victims of crime.’

Drug Test On Arrest Cranstoun
‘Drug Test On Arrest helps us to identify those whose offending is being driven by drug use and make sure they are offered the help they need’

The £70,000 Drug Test On Arrest programme is a partnership between Durham Constabulary, the Police and Crime Commissioner and third sector provider Cranstoun.

Across the UK, it is estimated that anywhere between one third and one half of all acquisitive crime is connected to drug misuse.

Although the number of offences in County Durham and Darlington is falling, drug-related crime still generates thousands of victims every year.

Under Drug Test On Arrest, detainees brought into custody at the new Investigative Hub near Spennymoor will be tested for class A drugs if they are suspected of having committed one of a number of trigger offences, including burglary, robbery, shoplifting or drug supply offences.

They will then be tested using a simple saliva swab, which can be analysed and give an accurate result inside five minutes.

Anyone testing positive will be seen by an independent drug referral worker from the charity Cranstoun, who will offer advice on safer use and, if appropriate, they will be referred on to appropriate drug workers, typically getting an appointment within a week. Anyone refusing to attend these follow-up assessments could face additional charges of breaching the terms of their order.

Darren Nicholas, assistant director for criminal justice services at Cranstoun, said, ‘We know how effective it is to provide interventions on-site in police custody in order to support people into drug and alcohol treatment, and we have a strong track-record in providing these services.

Cranstoun Drug Testing Scheme
‘By reaching people physically on-site, we’re able to address the causes of their offending and break the cycle of substance related crime’

‘By reaching people physically on-site, we’re able to address the causes of their offending and break the cycle of substance related crime.

‘This work is supporting the police to prevent reoffending, reduce the harms caused by drugs, and help people to make safer choices and live safer, healthy lives.’

The new Drug Test On Arrest service started in January with one Cranstoun arrest referral worker. Cranstoun now have two workers on-site and are due to expand to a third worker in the coming weeks, which will result in the Cranstoun service operating seven days a week over extended hours, to provide the right interventions at the right time.

Although it remains far too early to assess the impact, initial activity during the first few weeks has shown 59 individuals test positive with 34 people receiving an intervention, of which 21 were referred to further treatment.

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


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

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

This content was created by Cranstoun

Mark Evans – I am a…

Mark Evans is a post-treatment recovery worker at WithYou. We asked him about his career path and role.

Mark Evans - I am a... WithYouWHAT MADE YOU WANT TO WORK IN THIS FIELD?
I came through the service myself, getting support for a problem with alcohol. I started volunteering and did that for about a year, and it was always somewhere I wanted to work and be involved with.

My role, as a post-treatment recovery worker, is for people who are either substance-free, or have reached their goals with their use of drugs or alcohol (for example, they’re drinking in a controlled manner), and they’re getting ready to leave the service. We’re bridging that gap because I think when people have become very used to having the help, it can feel like a huge loss and people have this fear of what’s outside and what’s going to be available for them afterwards. My role is to help with finding things for them in the community, or to get them to attend groups if they haven’t been doing that; to try and get them to build up relationships that are outside of the service so they feel happy moving into this community that’s outside of WithYou.

WHAT DOES A TYPICAL DAY LOOK LIKE?
It’s very varied. You essentially create your own diary of people you’ve got to see. It’s either having telephone call appointments with people or seeing people face to face and if there’s an activity or something they’d like to take part in, I can go along with them and help them out with that. If they want to attend a group, and they generally do on their own, we can go along with them to that as well. You get to learn how to manage your own diary, because you are in charge of your own workload.

I’ve done the training to run SMART recovery groups, so I cover those when people are off sick or on holiday. Also, as Shropshire is such a big area there’s two of us doing this role and covering the different areas, so I do one day a week in a different office. I really enjoy it because it’s nice to change locations and work with different people.

WHAT DO YOU FIND MOST REWARDING?
I think just being able to support people. It’s rewarding when I can discharge them from being in service, because I see them in that gap where they’re closed from active treatment – which is where they receive most of the support, and the most intense work – but before being fully discharged. In post-treatment, with me, there’s flexibility to be able to support them in the community.

WHAT WOULD YOU LIKE TO CHANGE?
I’d like to see more acceptance in society, I think, and understanding. People think they know what someone with alcohol or drug issues will be like – they put them in a category, and picture them as someone on a park bench with a bottle. People need to have this understanding that problems with alcohol or drugs can affect anybody from any walk of life and any profession. There’s no age distinction, no class distinction, anything like that. If you start talking to someone on the subject, I guarantee everyone has got either a friend or family member who’s had an issue with something.

I’d also like to change the language that’s used around it – like alcoholic, druggie, things like that. They’re just negative terms and I don’t find them helpful.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
Just go for it. If you’ve got a desire to understand people and support people, and if you’ve got a caring nature and a willingness to support others. Also, if you’ve had experience yourself, with either family members or yourself, working at WithYou can be a really good opportunity. There’s a lot of emphasis on lived experience here, which they value quite a lot as an organisation. A lot of people might be put off but it’s actually a help more than a hindrance, and it can help people with their own recovery as well doing work like this, because it keeps you in touch with your own thoughts and your own feelings around problems with drugs and alcohol.

WithYou is a really good organisation to work for and you’ll get out of it what you put in. If you put the effort in and you’ve got that willingness to support and help people, you will get a lot out of it yourself.

It’s not just about giving. You can get a lot out of helping and supporting people.

 

DDN JobsSee opportunities like Mark’s on DDN Jobs

Powerful new campaign to prevent drug deaths

New Vision Bradford, the district’s alcohol and drug service, has launched a groundbreaking campaign to increase the number of people carrying naloxone, a life-saving medication that reverses opioid overdoses.

At the heart of the ‘You Can Save a Life’ campaign is a stunning new film that illustrates the power of naloxone to prevent deaths. The film aims to challenge misconceptions, raise awareness, and inspire individuals to carry a naloxone kit – potentially saving lives in their communities.

Assistant director at New Vision Bradford Becky Norton said, ‘Opioid overdoses are a pressing public health crisis, and too many lives are lost needlessly. In 2023 there were 70 drug-related deaths in Bradford and District.

‘Most of those deaths were preventable if only naloxone had been available. By carrying naloxone, anyone – not just healthcare professionals – can step in and make a difference. This campaign is about empowering people to save lives.’

Naloxone is a safe and effective medication that can temporarily reverse the effects of opioid overdoses, including those caused by heroin, fentanyl, and prescription painkillers. It is available in easy-to-use kits from New Vision Bradford and anyone can use it with just ten minutes of training.

Behind the scenes of making the ‘You Can Save a Life’ film
Behind the scenes of making the ‘You Can Save a Life’ film

‘You Can Save a Life’ was developed in partnership with the University of Bradford, Bradford Royal Infirmary, ECHO Fire + Medical and West Yorkshire Police.

The campaign film is being shared across social media, community outreach programmes, on the Big Screen in Bradford city centre and at public events to reach as many people as possible. New Vision Bradford is also hosting training and distribution events where people can learn how to use naloxone and receive a free kit.

‘We want naloxone to be as common as carrying a first aid kit or knowing CPR,’ added Becky, ‘With more people equipped with naloxone, we can significantly reduce overdose deaths and support those in need.’

New Vision Bradford invites community members, healthcare professionals, and local organisations to join the movement and help spread the message.

The campaign and the film were launched at New Vision Bradford’s Pelican House site on 31st March 2025.

‘You Can Save a Life’ campaign

For more information on the campaign, to watch the film or to find out where to get a naloxone kit, visit newvisionbradford.org.uk/savealife or contact the service directly.

This blog was originally published by New Vision Bradford. You can read the original post here.


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

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

This content was created by New Vision Bradford

A new drug and alcohol service launches in Bristol

A new integrated drug and alcohol service, that will expand the reach of support available to residents across Bristol, launched on Tuesday, April 1st.A new integrated drug and alcohol service that will expand the reach of support available to residents across Bristol launched today (1st April).

Health and social care provider, Turning Point, has been awarded the contract by Bristol City Council to lead Horizons: Bristol’s Drug & Alcohol Partnership in partnership with Bristol Drugs Project (BDP) and seven other local organisations: The Nelson Trust, Hawkspring, One 25, Southmead Development Trust, Southmead Project, Wellspring Settlement, and Release.

Turning Point and BDP will combine their expertise in reducing the harm associated with substance use and providing high quality drug and alcohol treatment, with specialist interventions provided by their partner organisations, to offer a wide range of services under one umbrella.

Over the past few months, the partners have engaged with over 300 people in the community to understand what they want from a new drug and alcohol partnership brand in Bristol. A new website www.horizonsbristol.co.uk, along with a single number to call – 0300 555 1469, together provide a single point of access for anyone in Bristol who is looking for information or support relating to drugs and alcohol.

Bristol residents will have access to support whether they want to stop using drugs and alcohol entirely, reduce their use, or learn how to be safer.
Bristol residents will have access to support whether they want to stop using drugs and alcohol entirely, reduce their use, or learn how to be safer

Through this service, Bristol residents will have access to support whether they want to stop using drugs and alcohol entirely, reduce their use, or learn how to be safer. The team will provide a wide range of healthcare interventions and counselling, as well as advice and support related to employment and housing.

Dedicated teams will be available to support women involved in sex work, people who have experienced trauma, clients in contact with the criminal justice system, people who are homeless and friends and family members of people struggling with substance use.

The Horizons youth team will be dedicated to working with young people who want support, information, or advice about drugs or alcohol.

Nat Travis, national head of service for substance use at Turning Point, said, ‘We are excited to build on the work drug and alcohol service providers have done to support people in Bristol.

‘For over 60 years, Turning Point has embraced clinically led, evidence-based support that gives our service users a pathway to recover from substance use.

‘We look forward to working with BDP and our seven other local partners to deliver a more equitable service that supports people to make positive changes to their lives and improve their health and well-being.’

The team will provide a wide range of healthcare interventions and counselling, as well as advice and support related to employment and housing.
The team will provide a wide range of healthcare interventions and counselling, as well as advice and support related to employment and housing

There will be a new city centre hub at No. 10 Brunswick Square, next door to BDP’s existing base at No. 11, with service hubs also located at the Greenway Centre on Doncaster Road, and on Symes Avenue in Hartcliffe. Each hub will be expanded so that all services are available at each location.

Horizons are also working to finalise satellite locations where some services will be delivered at specific times.

Everyone supported by Horizons will have access to the full range of interventions from day one. This will mean that programmes such as needle exchange, which is currently only available in the city centre, will be available at all service hubs.

Within the first six months of the contract, the full range of clinical interventions, such as wound care, vaccinations, and blood-borne viruses (BBV) testing, will also be available at all service hubs.

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


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

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

This content was created by Turning Point

Celebrating Community Garden Week at The Forward Trust

Community Gardening Week

Community garden at Clouds House
Community garden at Clouds House

As the first week of April marks Community Garden Week (1st-7th April), I am excited to celebrate the power of gardening in transforming lives, fostering well-being, and strengthening our connection to nature, says Adejoke Idowu, Environmental and Sustainability Manager. This annual event shines a spotlight on community gardens and their role in bringing people together to cultivate not just plants, but also a sense of purpose, peace, and sustainability.

Seed to Table: a blooming initiative at Clouds House
At Clouds House, our Seed to Table initiative continues to flourish, offering both clients and staff an opportunity to engage in a therapeutic gardening experience. From planting seeds to harvesting fresh produce, this initiative provides a meaningful way for individuals to reconnect with nature, develop new skills, and experience the satisfaction of growing their own food. The fruits (and vegetables) of their labour go directly into our kitchen, providing nutritious, homegrown meals that nourish both body and mind and an added bonus is these foods can be traced from origin to end and back which also helps us in having a sense of what it takes to responsibly source our food at Clouds.

Garden beds at Clouds House (to be implemented at The Bridges – Hull)
Garden beds at Clouds House (to be implemented at The Bridges – Hull)

But the cycle doesn’t stop there! In our commitment to sustainability, food waste from Clouds House is carefully recycled into compost, enriching the very soil that nurtures our next harvest. This closed-loop system is a wonderful example of how we can work in harmony with the environment, reducing waste while promoting self-sufficiency and eco-conscious living.

Introducing a herb garden at The Bridges – Hull
Building on this success, we are thrilled to announce plans to introduce a small herb garden at The Bridges – Hull. This green space will serve as a sanctuary where clients and staff can relax, unwind, and take part in nurturing the plants they grow. The simple act of tending to herbs – whether watering, pruning, or simply enjoying their fragrance – offers a calming and restorative experience that can support mental well-being and personal growth.

Vegetable garden at Clouds House
Vegetable garden at Clouds House

The benefits of gardening: mind, body & planet
Mental health boost: Gardening has been widely recognised for its ability to reduce stress, anxiety, and depression. The rhythmic nature of planting and tending to plants encourages mindfulness, grounding individuals in the present moment and fostering a sense of accomplishment.

Physical health benefits: Getting hands-on in the garden provides a gentle form of exercise, improving strength, flexibility, and overall well-being.

Vegetables collected from the garden at Clouds House
Vegetables collected from the garden at Clouds House

Environmental impact: Community gardens contribute to a greener planet by reducing carbon footprints, supporting biodiversity, and promoting sustainable food production which are all part of our commitment as an organisation to be more impactful in our environment. Our composting efforts at Clouds House further reinforce our commitment to a circular economy, where waste is transformed into valuable resources for future growth.

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


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

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

This content was created by the Forward Trust

Outside in

What does ‘lived experience’ really mean, ask Julian Buchanan and Oscar Graham.

Policymakers frequently fail to listen to those they serve, making it impossible to understand their needs. ‘Nothing about us without us’ has long been a principle of the drug policy reform and harm reduction movements – and rightly so. In recent years, it has been good to see more agencies and institutions than before recognise this basic omission, and begin inviting people with ‘lived experience’ to participate in policy development, research and service delivery.

Clearly, however, there are risks of tokenism or highly selective invitations here, including among organisations purporting to be peer-led. And this raises nuanced issues which are worthy of exploration. In the drug field, what should ‘lived experience’ actually mean?

It could mean the person has at some point used psychoactive drugs regularly. The trouble is, that’s basically all of us. But while use of regulated drugs like alcohol or nicotine would be a fitting – and desirable – qualification for involvements in those areas, most of us would consider it inadequate as ‘lived experience’ for work around state-banned drugs.

INSUFFICIENT LIVED EXPERIENCE
We would point out that lived experience of legal drug use does not equate to that of illegal drug use. Though there is no obvious distinction between state-approved and prohibited drugs in terms of inherent risks, the difference concerns the impact of prohibition itself.

lived experienceBut that, in turn, is why simply having used prohibited drugs may be insufficient ‘lived experience’, if a person does not also have direct experience of prohibition enforcement.

Many white and wealthier drug users, in particular, do not. Because across the world, the drug war has – from its very inception – strategically targeted poor communities, people of colour, Indigenous people and many other marginalised groups.

To take one of countless global examples, a Māori New Zealander who uses drugs is far likelier than their white counterpart to have directly experienced any number of harms caused by prohibition enforcement. These include being frequently stopped and searched; being raided, arrested and incarcerated; being threatened with losing their children or their home; being denied employment or healthcare; and being subjected to forced treatment.

These human rights abuses are not universal experiences among people using prohibited drugs, but in many contexts they should be considered a necessary component of ‘lived experience’.

Drug use itself is also, obviously, far from a homogenous experience. Prohibited drugs range from depressants to stimu­lants, psychedelics and more. Moreover, people who use various types of drugs do not necessarily mix much, nor necessarily share much in common.

DRUG ELITISM
These differences are underlined by forms of ‘drug elitism’. Some who use cannabis or psilocybin mushrooms portray their ‘natural’ drugs as better than synthetic substances. Some who enjoy MDMA or LSD call for their ‘non-addictive’ drugs to be legalised, but draw the line at methamphetamine or heroin because of the potential for dependence. Some who inject steroids to increase muscle mass may resent being associated with people who inject other drugs. The list goes on.

Lived experiences of drug use often relate to very specific contexts. People who use prohibited drugs to self-medicate conditions like MS, ADHD, epilepsy or autism may have profoundly different experiences from others. People who use prohibited drugs such as coca leaves, kava or ayahuasca to engage in cultural or religious practices will have quite different motivations and experiences again.

Even among people using the same drug in the same culture, the nature of a personal relationship with that drug can vary dramatically. Can someone who has only ever used recreationally adequately understand a person whose use has involved a long-term struggle around their consumption and associated life impacts?

Lived experience and living experienceLIVED AND LIVING
Yet another distinction is between ‘lived’ and ‘living’ experience. To what extent, for instance, can a person who identifies as having experienced addiction, and who now self-describes as ‘clean’, meaningfully inform peer-led services for people currently using drugs?

Some (though by no means all) who refer to themselves as ‘clean’ can be evangelical in their belief that the only way people can get help is if they quit drugs. As peers, they would then approach policy development and service delivery quite differently to another person with lived experience, who believes in supporting ongoing drug use through harm reduction. In all walks of life, we all run the risk of projecting our own experiences and personal solutions onto others.

These thoughts should all factor into decisions about who should be considered ‘peers’ in different contexts; whom they represent, and importantly, whom they might struggle to represent. An organisation seeking to legalise and regulate drugs, for instance, should certainly seek peers with experience not only of prohibited drug use, but also of the ongoing impacts of prohibition enforcement.

All of the diverse groups of people who use drugs need and deserve to be heard and represented. But we believe that people who have suffered most under the drug war – primarily people of colour, Indigenous people, people with experiences of poverty, incarceration and chronic unmet needs – should be first to the table.

‘Nothing about us without us’ begins with the inclusion of those most excluded.

Dr Julian Buchanan was a pioneer of 1980s harm reduction in Merseyside. Now a retired professor in New Zealand, he helps to lead Harm Reduction Coalition Aotearoa (HRCA)

Dr Oscar Graham is an early-career biomedical science researcher based in New Zealand. He has recently become involved with local drug policy reform organisations and serves as the secretary for HRCA.

This article was originally published by Filter, an online magazine covering drug use, drug policy and human rights through a harm reduction lens (filtermag.org). Follow Filter on Bluesky, X or Facebook, and sign up for its newsletter.

Government announces £310m drug and alcohol grant funding

The government has published its 2025-26 drug, alcohol and recovery grant funding for local authorities. The allocations will see £310m go to councils to ‘build on their vital work of improving outcomes for people who need treatment and recovery support’ said public health minister Ashley Dalton in a written statement.

grant funding
The grants are in line with the recommendations from Dame Carol Black’s Independent review of drugs

The grants are in line with the recommendations from Dame Carol Black’s Independent review of drugs, the government states, and build on the public health grant allocations published earlier this year.

A number of grants that were previously used to support drug and alcohol treatment – the inpatient detoxification, housing support, rough sleeping drug and alcohol treatment and supplemental substance misuse and recovery grants – have this year been consolidated into a single grant, the drug and alcohol treatment and recovery improvement grant (DATRIG). Commissioning of inpatient detox will continue to be organised through regional or subregional consortiums, the government adds.

Full breakdown of funding allocations by council available here