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One part of the toolbox

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With the UK’s first consumption room opening in Glasgow it’s important to remember that these facilities should be seen as part of a wider package of interventions

After years of legal wrangling Scotland opened a drug consumption room in Glasgow. Responding to local need for such a facility to support people who have struggled to find a safe place to use drugs, this will hopefully ensure that these individuals receive the care and support they need.

All the evidence to date suggests that engaging the local community is crucial to ensuring support for the opening of drug consumption rooms. Addressing concerns about these facilities increasing drug use activity in a locality is important in winning hearts and minds. Fortunately, research shows that drug consumption rooms reduce drug paraphernalia litter such as discarded needles and syringes. Rather than an increase in drug use, the evidence suggests that those who use these services actually reduce their use of drugs.

Informal drug consumption spaces have existed for some time, Peter Krykant set up such a facility a few years ago in Glasgow when he bought an old ambulance to provide a safe space for people in the area to use drugs.

A drug consumption room should be viewed as one of several interventions that are needed to reverse the rising trend in fatalities
A drug consumption room should be viewed as one of several interventions that are needed to reverse the rising trend in fatalities

The barriers to establishing a drug consumption room in the United Kingdom have been overcome thanks in no small part to the building of local partnerships between healthcare and local politicians. Recognising the need for a radical response to the rising number of drug fatalities in Glasgow and Scotland has been crucial to this type of innovation. Scotland has the highest rate of drug-related deaths in Europe, so new thinking is needed if this is to be addressed.

It would be unrealistic to think that a drug consumption room will be enough to reduce drug-related deaths, however. Instead, it should be viewed as one of several interventions that are needed to reverse the rising trend in fatalities.

Drug consumption rooms engage a group of people that don’t access other services such as GPs or specialist drug treatment. These facilities are therefore really important in providing a way of ensuring that some of the most marginalised groups are provided with healthcare that could improve their lives and reduce the risk of premature death.

Hopefully this innovation won’t be a one-off. Although a good start, it is critical that these facilities are provided across the UK. Given the record number of people dying as a result of drug use, we need to provide all the evidence-based interventions we can to reverse the growing number of individuals and families affected by drug fatalities. It may not be popular with voters, but politicians need to advocate for those most at risk of drug-related deaths.

Ian Hamilton is an associate professor at the University of York

MPs pass tobacco and vapes bill

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MPs pass tobacco and vapes billMPs have voted to pass the tobacco and vapes bill by 366 to 41. The bill has now passed its third reading and committee stage in the House of Commons, and will go to the House of Lords next month.

Originally drafted by the previous government, the bill was shelved after the announcement of an election before finally being introduced to Parliament last year.

Its measures include phasing out the legal sale of tobacco to anyone aged 15 or younger with the aim of creating a ‘smokefree generation’, as well as tightening the regulations on vape flavours, packaging and displays.

‘Today, MPs have taken a major step forward on the journey to end the harm caused by smoking for good,’ said ASH chief executive Hazel Cheeseman. ‘Since the link between smoking and lung cancer was first established, smoking has claimed more than 8m lives in this country. This historic legislation was first tabled by a Conservative government and will be passed by a Labour one, backed by all four corners of the United Kingdom. It is a rare policy that unites the country in a shared commitment to change. Phasing out the sale of tobacco will protect future generations from the harms of smoking – and sooner or later, smoking will be just a footnote in this country’s history.’

MPs have voted to pass the tobacco and vapes bill by 366 to 41
‘Sooner or later, smoking will be just a footnote in this country’s history’ – ASH chief executive Hazel Cheeseman

She also welcomed the confirmation that funding would continue for the ‘swap to stop’ scheme, which provides free vaping products for people trying to quit smoking. ‘The measures to tackle the irresponsible promotion of vapes in the bill are needed and welcome – however, it is important that people quitting smoking still have access to vapes as a safer alternative. The continuation of the funding for the swap to stop scheme is therefore important, particularly for reaching those on low incomes where smoking rates are highest.’

Earlier this week the Department of Health and Social Care (DHSC) also announced funding for 80 apprentice enforcement officers to help stop ‘harmful tobacco and vape products finding their way into neighbourhood shops’ as well as underage sales.

Wastewater analysis shows shocking spike in ketamine consumption

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Since 2021, the Home Office Wastewater Analysis Programme (WWAP) has taken samples from wastewater treatment plants (WWTPs) across England and Scotland to calculate the quantity of illicit drug consumption.

Wastewater analysis shows shocking spike in ketamine consumption
Ketamine consumption is estimated to have increased by 85%

Data published on 17th March from samples taken from 16 treatment plants reveals ketamine consumption is estimated to have increased by 85%. National addiction and recovery charity The Forward Trust says that this shocking trend is to be expected as it comes at a time when:

  • Addiction to ketamine in the UK has more than quadrupled since 2016
  • Ketamine use is estimated to have more than doubled – tripling in those under 25
  • Adults entering treatment with ketamine problems has increased from 1,551 in 2021-22 to 2,211 in 2022-23

According to government statistics, opiate dependency, cannabis or cocaine are currently three of the most common drugs causing people to seek help in Britain – but the huge increase in young adults aged 16-24 taking ketamine is due to its cost and accessibility.

Mike Trace, CEO of the Forward Trust, said, ‘Ketamine was once seen by many as a “safe” party drug. Sadly, as we know from families such as Barney’s (Taking Action on Addiction case study) we are also seeing an increase in long-term health conditions and fatalities caused by the use of ketamine.

wastewater analysis
‘We are seeing an increase in long-term health conditions and fatalities caused by the use of ketamine’

‘Ketamine abuse is soaring, with young people all over the UK seeking treatment for addiction and irreparable damage to their bladders – it is also known to cause paranoia, muscle paralysis, and liver damage, alongside many other side effects.

‘Addiction isn’t a marginalised issue in society. It runs deep and spreads wide. People are living with addiction all around us. And yet the stigma, misunderstanding and the fear of judgement is holding people back from getting the help they need.

‘Perceptions of addiction need to change. We need to build compassion and understanding around addiction and support people to ask for help without judgement, discrimination or stigma.

‘Recovery is possible with the right support and everyone should have the opportunity to access it before they reach rock bottom.’

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

Turning Point responds to the chancellor’s Spring Statement

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Responding to the chancellor’s Spring Statement, Julie Bass, chief executive of health and social care provider Turning Point, said:

Turning Point responds to the Chancellor's Spring Statement
‘It feels like an already precarious social care sector is being pushed to the brink’

The chancellor’s Spring Statement confirmed a harsh reality for both people in receipt of social care and care providers.

While we welcome the investment in employment support, the government’s planned cuts to welfare are a significant source of anxiety for people with disabilities and long-term health conditions.

Minimum wage rates and employer National Insurance contributions increase from next month and, unlike other parts of the economy, we are much more limited in our ability to increase prices.

While we understand the fact that that the chancellor’s plans are driven by geopolitical instability and weak economic performance, from where we sit it feels like an already precarious social care sector is being pushed to the brink.

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

European MDMA market rapidly evolving, say EUDA and Europol

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Europe’s criminal groups are expanding MDMA production, refining their trafficking methods and ‘extending their reach to new countries and regions’, says a new joint report from Europol and the European Union Drugs Agency (EUDA).

European MDMA market rapidly evolving, say EUDA and Europol
The European MDMA market is estimated to be worth almost EUR 600m a year

The European MDMA market is estimated to be worth almost EUR 600m a year, the document says. This equates to around 72m ecstasy tablets consumed in the EU, with more than 12m Europeans having used the drug at least once in their lifetime.

While MDMA is usually made using large industrial reactors – the ‘high pressure’ method – manufacturers are constantly adapting their production processes in response to shortages of precursor chemicals or equipment. Restrictions on the availability of high-pressure reactors, for example, has led to producers in the Netherlands switching to the ‘cold method’, which is associated with increased risk of fires and explosions.

Precursor chemicals are usually obtained by criminal networks with links to legitimate businesses, the report points out, while producers also bypass legal controls by sourcing unregulated alternative substances from China and elsewhere. Producing MDMA can also generate up to 3,000 tonnes of chemical waste a year – which is ‘typically dumped away from the production sites, causing health hazards, environmental damage and costly clean-ups’.

MDMA
Social media platforms and instant messaging apps are increasingly being used to sell MDMA

Outside of the ‘buoyant’ EU market and profitable markets in Asia and Oceania, there are signs that Latin America is becoming an increasingly important destination for European MDMA, the report states – using traditional cocaine trafficking routes ‘in the opposite direction’. Gangs also sometimes engage in ‘barter deals’, it says, where MDMA is exchanged for cocaine ‘with no monetary exchange’. Meanwhile, social media platforms and instant messaging apps are increasingly being used to sell MDMA to customers online, in addition to traditional dark web markets.

In the late 1980s and early ‘90s, ecstasy pills typically contained around 80mg of MDMA – by the mid 2010s, however, tablets containing as much as 250mg were being found for sale on the dark web. The average MDMA content per tablet was as high as 170mg in 2019, the report states, but had fallen to 144mg three years later – likely the result of the temporary fall in demand during the pandemic. Research by The Loop found that almost half of the MDMA sold at English music festivals in 2021 was in fact fake – up from just 7 per cent two years previously.

European MDMA market
While the trend of seeing rising amounts of MDMA in pills ‘seems to have reversed’, potent tablets are still very much in circulation

While the trend of seeing rising amounts of MDMA in pills ‘seems to have reversed’, potent tablets are still very much in circulation, the report warns. ‘Serious harms associated with exposure to MDMA are considered relatively rare, but MDMA acute toxicity is known and the availability of high-strength products increases the risk of adverse health effects – including fatal outcomes,’ it states.

‘Understanding the evolving MDMA market is essential for developing effective responses,’ said EUDA executive director Alexis Goosdeel. ‘MDMA remains a popular drug in nightlife and music festival settings, so ecstasy tablets that contain high amounts of MDMA, or unexpected ingredients, pose serious risks. Harm reduction measures, like drug-checking services, are crucial to mitigate the dangers. Tailored prevention and treatment services are more critical than ever, as MDMA tablets may contain new psychoactive substances that could have harmful consequences.’

EU drug market: MDMA – in-depth analysis available here

WithYou responds to the Spring Statement 2025

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Spring Statement
‘My thoughts are with our clients and their families, and the impact these cuts will have on their lives, and their recoveries’

Simon Phillips, CEO of drug, alcohol and mental health charity WithYou, said:

Much of the commentary surrounding today’s Spring Statement from the chancellor has focused on balancing the nation’s books and whether Rachel Reeves will stick to her self-imposed rules on spending.

My thoughts though, are with our clients and their families, and the impact these cuts will have on their lives, and their recoveries, in the coming weeks, months and years.

Last week the government announced billions of pounds of cuts to disability benefits. The DWP’s own assessment of these cuts, published today, finds they will drive 250,000 more people, including 50,000 children, into poverty.

In today’s Spring Statement the chancellor has built on that announcement with further cuts to Universal Credit.

The Joseph Rowntree Foundation forecasts that on average all families will see a fall in living standards under this government, and that the poorest families will deteriorate twice as fast. Deaths and harms relating to drugs and alcohol are highest in the most deprived areas of the country where we see more people likely to experience poverty, insecure housing and childhood trauma.

WithYou responds to the latest Spring Statement 2025
‘We need the government to focus their policies on improving the lives of the poorest in this country’

Last year the chancellor promised there would be no return to austerity, but to many of our clients the difference between then and now will be academic, as they struggle to keep their homes, feed their families, and maintain their recovery.

Our staff will continue to work tirelessly to support anyone impacted by drugs, alcohol or poor mental health, but we need the government to focus their policies on improving the lives of the poorest in this country. We cannot stop drug- and alcohol-related deaths if people don’t have safe places to live, access to health and mental health services, and a safety net for when they need it. We understand there are very challenging external circumstances facing the UK, but it is a political choice to make the most vulnerable pay the cost. The links between poverty and harm caused by drugs and alcohol are well-evidenced, and we fear increasing the number of Britons in poverty will ultimately lead to more people needing support.

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

Going upstream

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Helping people link past trauma to current pain can be a catalyst for change

Helping people link past trauma to current pain can be a catalyst for change says Warren Larkin, as DDN reports.

At the recent RCGP/AP conference in Manchester, consultant clinical psychologist Dr Warren Larkin presented on trauma and resilience-informed practice.

Relating to developmental trauma – trauma that happened during childhood – he highlighted the following Adverse Childhood Experiences (ACEs): physical, sexual and emotional abuse; living with someone who was experiencing problematic drug and/or alcohol use, had serious mental illness or who had been incarcerated; exposure to domestic violence; parental loss through divorce, death or abandonment; and neglect.

The more childhood trauma people were exposed to, the worse their health, mental health, and social outcomes were likely to be. ‘So it’s very strange that we still don’t ask people about childhood trauma as a routine part of our assessment,’ he said.

‘If we can help people link their past trauma to their current pain... maybe that’s a catalyst for change.’ WARREN LARKINA 1998 study found people with four ACEs – compared to those with none – were five times more likely to use illicit drugs, seven times more likely to self-identify as being addicted to alcohol, and 12 times more likely to attempt suicide. A 2015 study of the English population also found ‘this association between adversity exposure and health harming behaviours’ – people with four ACEs were twice as likely to be binge drinkers, three times more likely to be smokers, and 11 times more likely to have used heroin or crack cocaine. A recent study found that those with exposure to one of the ACEs on the list were 4.3 times more likely to develop a substance addiction.

‘If we can help people link their past trauma to their current pain, and the way they’re attempting to cope with that pain, maybe that’s a catalyst for change,’ said Larkin. ‘We need to ask people what’s happened to them, because if you don’t ask people, they don’t tell you, and if they don’t tell you, they’re going to get the wrong help.’ He referred to a 1998 study in which 82 per cent of psychiatric inpatients disclosed trauma when they were asked, compared to 8 per cent volunteering their disclosure without being asked. ‘Eighty-two per cent versus 8 per cent, it’s pretty obvious what we need to do – but professionals worry about asking these questions because we worry about making it worse,’ he said.

Larkin stressed the importance of trauma-informed care, and said it was important to normalise routine and targeted enquiry – just as with domestic abuse and suicide intent enquiry – to offer the right help sooner, ‘because treating the symptoms while ignoring the cause isn’t working.’ He concluded by quoting Desmond Tutu: ‘There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.’

The power of persistence

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Working with hard-to-reach populations like vulnerable women means taking the time to properly build trust

Blackburn with Darwen, located in East Lancashire, is a diverse and vibrant borough known for its industrial heritage and strong community spirit. Nestled amidst scenic countryside, the town is home to historic landmarks and an impressive network of parks and green spaces.

However, similar to neigh­bour­ing towns in the north west of England, the town faces issues around substance use and the challenge of encouraging women to access support. That’s why women’s support services from Spark are so important.

Spark is a trusted substance misuse service, providing confidential alcohol and drug services on behalf of Blackburn with Darwen Council. Regulated by the Care Quality Commission (CQC), Spark provides effective treatments and teaches strate­gies for long-lasting change, with the aim of improving physical and mental health as well as increasing self-worth and the ability to start rebuilding supp­ortive and positive relationships.

vulnerable women
Zoe Brindle builds trust through her weekly outreach service, providing Blackburn’s sex workers with supplies needed to reduce harm and stay safe

VULNERABLE WOMEN
Understanding that anyone can be affected by addiction, Spark supports people of all ages, backgrounds and cultures, including children, young people, families and hard to reach groups. And as the town has seen an increase in assaults against vulnerable women, its women’s services have never been more vital.

Recovery practitioner Zoe Brindle has worked at Spark for three years. She works hard helping women who struggle to organise their own lives, providing a vital lifeline for those with chaotic lifestyles.

Acknowledging that not every­one chooses to go to rehab or detox, Zoe helps women reduce harm and live safer life­styles. She does this through organising and attending medical appoint­ments and health screenings, and working closely with the women to ensure they have the supplies they need to minimise risk. This can include BBV testing, pregnancy testing and signposting to other services. ‘It’s quite like hand holding,’ she says. ‘I don’t focus on drugs and alcohol recovery, I focus on getting medication sorted, wounds sorted, attending appointments.’

BUILDING TRUST
As many vulnerable women don’t actively engage with services, Zoe builds trust through her weekly outreach service. Every Wednesday, she heads into Blackburn to provide the town’s sex workers with supplies needed to reduce harm and stay safe. ‘We start by giving them clean equipment and condoms, and from there we get chatting and that’s when I can help them with whatever they need,’ she says.

The Spark outreach van is packed full of essentials many of the women need, but often can’t buy for themselves. From condoms and wipes to vitamins, panic alarms and naloxone, Zoe hands out the daily essentials needed to help active users. Also in her van are two drawers of snacks – a favourite among many of the women. ‘Many of them don’t have people who care about them, that’s why I let them know they can ring me anytime – I’d rather them have someone than no one.’

During the three years she’s been working in her role, Zoe has seen an increase in violence towards vulnerable women. To combat this growing issue, she frequently works with the dedicated RASSO (rape and serious sexual offences) team in Lancashire Police to help keep women safe.

‘Many women won’t go to line-ups on their own without professional support – that’s why it’s important to provide a support service and organise appointments for them,’ she states. ‘There are a lot of pre-trial appointments, but it’s essential to assist them through the process to get the best result in the end. It will ensure more dangerous men are kept off the streets from harming more women in future.’

‘Women who struggle with social issues don’t want to repeat their story. They want one person who can be a confidante.’ LOUISE MARSDENHEALTHIER FUTURES
Vulnerable women often face intergenerational cycles of poverty and addiction, starting at birth. Specialist substance use midwife Louise Marsden has been in her role – which is dual commissioned by East Lancashire Teaching Hospitals and Spark – for the last 13 months, using her previous experience as a midwife and nurse to support women in creating pathways towards a healthier future for themselves and their babies. ‘Having a baby is a good time in people’s life to make the changes,’ she says. ‘It gives people a reason to seek help.’

Louise provides compre­hensive education on the effects of substances like alcohol, cannabis, cocaine, and prescription drugs on pregnancy and newborns – including miscarriage, preterm birth, and sudden infant death syndrome. She also discusses critical topics such as safe sleeping, the impact of substance withdrawal on babies, and the likelihood of hospital stays for neonatal monitoring.

‘Once women are referred to us, we try to get as much information as possible and provide holistic care,’ she says. ‘Women who struggle with social issues don’t want to repeat their story. They want one person who can be a confidante. I get to know them inside out and that’s mutually beneficial. The trust allows us to help more. They need to know what is available and how to access that support.’

Louise recalls one particularly moving case of a young woman born into substance misuse who lived in foster care for many years. After four previous pregnancies were removed from her care, she decided to engage with services following her mother’s passing.

PARENTAL BOND
Despite homelessness and significant personal challenges, Louise and recovery practitioner Katie Newman supported the 25-year-old through housing, prenatal care, and delivery. The courts recognised the woman’s commitment and allowed her to retain custody of her baby. ‘The bonding she has with her baby and confidence to be a parent is really rewarding to see,’ says Louise.

The Power of Persistence - vulnerable women feature
Spark’s dedicated women’s recovery group provides safe spaces for women to connect each week. This month, as part of International Women’s Day, Spark will be celebrating women and raising aware­ness of women’s rights

Louise and Katie work closely together to help provide the best outcome for women seeking substance use support during pregnancy. While Louise focuses on pregnancy support, Katie concentrates on creating a recovery pathway – including signposting and supporting women into rehab, detox and future services.

‘This work requires patience, compassion, and a non-judgmental approach,’  says Louise. ‘When women are ready to engage, the transformations are incredible. The rewarding part is seeing how people grow. When people see that women can change with opportunity and have the tools and opportunities, that’s rewarding too.’

SPECIALIST CARE
Spark is a recovery collaborative, providing a wide range of support across Blackburn with Darwen through partner groups and local community venues. Each of the recovery partners offers specialist care, ensuring people receive the support they need for every step of their recovery journey.

Despite the progress, challenges persist. Limited housing options for women and the rising use of substances like ketamine among younger populations emphasise the ongoing need for services like Spark.

Spark’s work in Blackburn is a testament to the power of persistence, empathy, and collaboration. For women facing substance use issues, services like Spark provide a lifeline, offering hope and a path toward a healthier future for themselves – and their babies.

Spark recovery servicesEmma Marsden is senior communications officer at Spark

To support or access Spark recovery services, please visit sparkbwd.org.uk

Social Interest Group CEO steps down

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Social Interest Group (SIG) has announced the departure of CEO Gill Arukpe, MBE, after 16 years of visionary leadership. Gill’s tenure has been marked by remarkable growth, impactful partnerships, and a steadfast commitment to empowering society’s most marginalised individuals.

Chair of SIG Dr Karl Marlowe praised Gill’s contributions, stating, ‘Under Gill’s leadership, SIG has expanded from a three to a five member organisation, extended its national reach across London, to Brighton, Luton, Bedford, Kent, and Liverpool, and significantly increased sustainable funding from approximately £12 million to £32 million over the past eight years. Her dedication has not only strengthened the organisation but also transformed the lives of many by increasing local employment opportunities within SIG’s services.’

Reflecting on her journey, Gill shared, ‘After 16 incredible years as CEO of Penrose and the founder of Social Interest Group, I have made the decision to step down. It has been an honour to lead passionate and professional teams, forge strong partnerships, and work alongside commissioners and key decision-makers to drive systemic change in housing, health, and social care services. The individuals we serve have been my greatest source of inspiration. I believe now is the right time for a new leader to guide SIG into its next chapter.’

What lies ahead for Social Interest Group?
The board of trustees has appointed Cathy Kane as interim CEO. Cathy brings extensive experience in the charity sector, having held strategic, advisory, and finance roles at Peabody Trust, Terence Higgins Trust, the Royal Courts of Justice Specialist Advice Bureau, and Thrive. She also served as CEO of Just Advocacy, championing the rights of individuals with learning difficulties, autism, and complex needs. With a strong background in delivering organisational change within health and social care, Cathy is well-equipped to continue SIG’s mission.

As Gill Arukpe steps down, she leaves Social Interest Group in a strong position to carry forward its mission: empowering individuals through powerful partnerships and innovative solutions that bridge service gaps and support recovery, reablement, and resettlement.

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 Social Interest Group

Alcohol Change UK appoints new chair

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The board of trustees at national alcohol harm reduction charity Alcohol Change UK has elected Mick Urwin as its new chair.

Alcohol Change UK appoints new chair
Mick Urwin

After more than two years serving on the board at Alcohol Change UK and taking a leading role in its various sub-committees, Urwin brings a wealth of understanding and experience across policing, community projects and the charity sector. He steps into the role following the unexpected death of former chair Prof Isabelle Szmigin in December 2024 and an election process among the board of trustees.

Urwin is a retired police sergeant who specialised in alcohol harm reduction, creating policies and strategies to tackle underage drinking and alcohol-related anti-social behaviour and violence in the night-time economy. He is a former member of the National Police Chiefs Council Licensing and Alcohol Harm group, where he advised the chief officer lead and Home Office. In addition to his work with Alcohol Change UK, he is an advisor to his local police & crime commissioner as a subject matter expert on alcohol
harm, acts as the chair of a local community project tackling underage drinking, and is vice chair of the board of trustees for One Punch UK, a charity focused on raising awareness of the devastation of a single punch or act of violence where alcohol is often a contributing factor.

CEO of Alcohol Change UK, Dr Richard Piper, said, ‘Having already contributed hugely to the success of Alcohol Change UK as a trustee since October 2022, I am delighted that Mick will step into the role as our new chair. While this was in difficult circumstances, following the sudden death of our wonderful, previous chair Prof Isabelle Szmigin, Mick was elected with the overwhelming support of his fellow board members, who saw that he will bring his passion, expertise, and brilliant listening and relationship management skills to the role.’

Alcohol Change UK chair
Mick Urwin; Joy Allen, Durham police & crime commissioner; Richard Piper, CEO Alcohol Change UK

Mick Urwin added, ‘It is an honour to be elected by my fellow trustees as chair of the Alcohol Change UK board. The tragic loss of our previous chair, Isabelle Szmigin, was devastating for her family, friends and everyone at Alcohol Change UK. As a board, our sympathies, thoughts, and prayers are with them. My intention is to build on Isabelle’s exceptional work and carry her legacy forward.

‘This role is a significant responsibility, particularly given the vital work the charity does in tackling alcohol harm. This is especially important following the launch of our new, ambitious strategy in 2024, which aims to reach more people than ever who are at risk of harm caused by alcohol.

‘With 30 years of experience as a police officer, I have witnessed firsthand the devastating impact of alcohol on victims and offenders – and the ripple-effect on families, entire communities and society. But these harms are not inevitable, and my experiences were a driving force behind my decision to join the board and contribute to meaningful solutions that will make a difference.

‘I’m looking forward to leading the board as we implement our new strategy, ensuring that we continue to provide evidence-based information and support to everyone affected by alcohol harm and those involved in tackling it, whilst also advocating for vital systemic change.’

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 Alcohol Change UK

China executes four Canadians for drugs offences

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China executes four Canadians for drugs offencesChina executed four Canadians for drug-related offences earlier this year, according to the Canadian authorities. The four – whose identities are being withheld – were dual citizens.

A report earlier this month from Harm Reduction International (HRI) said that 2024 was the ‘deadliest year’ for drug-related executions in a decade, with 615 known executions carried out worldwide. However, the agency stressed that the figure excludes the ‘hundreds – if not thousands’ of executions carried out in countries like China, North Korea and Vietnam, where state censorship means that realistic figures are unobtainable.

While China is second only to Iran as the ‘world’s biggest executioner for drug offences’, according to HRI, a report from Amnesty International says it remains the world’s leading executioner overall, and is believed to have executed ‘thousands of people’ in 2023.

‘These shocking and inhumane executions of Canadian citizens by Chinese authorities should be a wake-up call for Canada’
‘These shocking and inhumane executions of Canadian citizens by Chinese authorities should be a wake-up call for Canada’

Another Canadian citizen, Robert Schellenberg, was sentenced to 15 years for drug trafficking by China in 2018, which was then amended to a death sentence the following year. While the Chinese authorities later upheld the death sentence despite an appeal, he was not among the four people executed earlier this year.

‘These shocking and inhumane executions of Canadian citizens by Chinese authorities should be a wake-up call for Canada,’ said secretary general of Amnesty International Canada’s English-speaking section Ketty Nivyabandi. ‘We are devastated for the families of the victims, and we hold them in our hearts as they try to process the unimaginable. Our thoughts also go to the loved ones of Canadian citizens whom China is holding on death row or whose whereabouts in the Chinese prison system are unknown. They deserve answers and justice, not the sickening worry they have been subjected to because of years of separation and uncertainty.’

The death penalty for drug offences: global overview 2024 available here

Death sentences and executions in 2023 available here

Number of Scots living with chronic liver disease set to rise by more than 50 per cent by 2044

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The number of people with chronic liver disease in Scotland is projected to increase by 54 per cent by 2044, according to a report from Public Health Scotland (PHS) – equating to an additional 23,100 people.

Number of Scots living with chronic liver disease set to rise by more than 50 per cent by 2044More than 70 per cent of chronic liver disease cases are caused by alcohol, with the most recent alcohol-specific death figures for Scotland recording the highest number since 2008. The percentage of liver disease deaths where alcohol was the primary cause has almost doubled since the beginning of the 1980s, while the rate of hospital stays for chronic liver disease also rose by 12 per cent in the decade to 2022-23. Many liver cirrhosis patients are diagnosed in hospital emergency departments, as the disease often shows no symptoms until its final stages.

‘Over 70 per cent of this liver disease burden is due to alcohol and these figures underline the severity of the public health emergency from alcohol that Scotland is facing, with the latest figures showing alcohol is directly responsible for 1,277 deaths annually,’ said chair of SHAAP Dr Alastair MacGilchrist. The increase in liver disease was ‘not inevitable’, however. ‘There are many missed opportunities to intervene to reduce heavy alcohol intake before liver damage occurs,’ he continued. ‘We now have the tools to do this and early detection of liver disease in at-risk individuals such as heavy drinkers needs to become routine practice.’

The ‘shocking’ figures once again highlighted the fact that Scotland was in the grip of ‘an ongoing alcohol emergency’, added deputy chief executive of Alcohol Focus Scotland, Laura Mahon. ‘It doesn’t have to be this way. Each of these deaths is entirely preventable, and there are a range of well evidenced and cost-effective prevention measures available which could be adopted. These include increased use of non-invasive liver scans to enable those at high risk to be identified sooner and provided with care and support to address their liver problem and their alcohol use. Restrictions on alcohol marketing and introducing clear health warning labels on alcohol products should form part of a new comprehensive alcohol strategy.’

Meanwhile, the fall in smoking rates in England is showing signs of stalling in some areas
Meanwhile, the fall in smoking rates in England is showing signs of stalling in some areas

Meanwhile, the fall in smoking rates in England is showing signs of stalling in some areas, according to a Cancer Research UK-funded study by University College London (UCL). Smoking rates have fallen more quickly in the North – which traditionally had the highest smoking prevalence – narrowing the ‘significant gaps’ across the country, says Cancer Research UK. ‘The study suggests that smoking rates in the North of England are now as low as in the South,’ it states.

Scottish burden of disease: future prevalence and burden of chronic liver disease available here

Trends in smoking prevalence and socio-economic inequalities across regions in England: A population study, 2006 to 2024 published in Addiction available here

Unequal to the task

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Women who use drugs are still being let down by treatment and criminal justice systems across the world

As Trevi chief executive Hannah Shead told the 2023 DDN conference, women may make up more than 50 per cent of the UK population, but their treatment needs still often aren’t being thought about in a ‘specialised, specific way’ (DDN, September 2023, page 7). While things have started to improve – she told DDN last year that she’d seen more willingness to understand women’s needs as different (May 2024, page 10) – there’s clearly still some considerable distance to go.

It’s a situation that’s obviously not limited to the UK. Gender might well be mentioned as a priority for a great many drug strategies and policies, but the reality was that there ‘were not enough programmes that are genuinely gender-based and tailored to gender needs’, EUDA executive director Alexis Goosdeel told the recent Health and social responses for women who use drugs — perspectives from Latin America, the Caribbean and Europe webinar.

women who use drugs - Linda Montanari

Drug use and its conse­quen­ces were often treated as if they were ‘gender neutral’, said principal scientist at EUDA, Linda Montanari – despite there being a range of differences in risk factors, behaviour and more. These included mental health issues, pregnancy, childcare and even imprisonment. ‘A big issue among women who use drugs is gender-based violence,’ she said – whether current, or issues like previous sexual abuse with its associated trauma. Although there were efforts to overcome barriers to accessing treatment, many countries still had no gender-specific interventions at all, while in others they were often exclusively focused on pregnancy and maternity. ‘Of course a very important aspect, but there are many other issues that need to be tackled,’ she stated.

COMPREHENSIVE APPROACH
These barriers to accessing treatment obviously included stigma – something that was ‘multiplied’ for women – along with women’s comparative lack of economic resources, and the very real fear of having their children taken away. But it was vital to look at the intersections between all of them, she stressed. ‘Women have specific needs because they use drugs but also because they’re parenting or pregnant, because they’re involved in sex work, they’re from an ethnic minority or they’re in prison. It’s really necessary to have a comprehensive and holistic approach.’

When it came to lack of economic resources, Latin America and the Caribbean was the most unequal region in the world, said Corina Giacomello, a professor at Mexico’s Universidad Autónoma de Chiapas – with more than 170m people not having enough income to meet their basic needs. Poverty affected more women than men of working age, with the region facing ‘persistent’ gender inequality. There were also inequalities of access to health services between and within countries, as well as between urban and rural areas, and for indigenous populations.

While the number of women using substances In Latin America was lower overall than for men, the gap closed among younger generations and in the case of controlled medicines was reversed, she pointed out. Despite ‘increasing evidence on the vulnerable situations of women who use substances’ drug policies still tended to maintain a male-centred approach. Not only was there low availability of exclusive services for women, but services for women who’d experienced gender-based violence generally often didn’t accept women who used drugs – ‘reproducing the forms of violence and symbolic and institutional discrimination that puts the lives of women and their children at risk’.

STARK DISPARITIES
And nowhere is this gender disparity more stark than in criminal justice. Drug offences were one of the leading causes of incarceration for women in the region, particularly women from poor households. Children of parents deprived of liberty for drugs offences were also an ‘invisible population’ in both the drugs and children’s rights agendas, she added.

women's servicesIn Uruguay, in a prison population of almost 16,000 people, 14,700 were men and 3,300 women, said Mariana Silva of Uruguay’s National Drug Secretariat. However, when it came to drugs offences, 58 per cent of those jailed were women. In Europe, meanwhile, women accounted for 5 per cent of the prison population, said Montanari. ‘They don’t commit other crimes as much as men, and they tend not to commit violent crimes. But the link with drugs is very important. The proportion of women in Europe for drug law offences is maybe not as high as in Latin America, but when we look at those who have problems with drugs and are in prison for acquisitive crimes the percentage becomes huge.’

But it’s not just the proportion of women jailed for drugs offences, it’s how they’re treated while they’re imprisoned – and anyone thinking these kind of disparities don’t apply to the UK would be wrong. According to an HM Inspectorate of Prisons report published in February, the lack of care to meet women’s basic needs is causing such distress that ‘they resort to harming themselves’.

Uruguay is now attempting to address some of these issues in its own criminal justice system, and last year launched its ‘national plan on problematic drug use for persons deprived of liberty’ – one of the strategic objectives of which was to ‘incorporate a gender and diversity perspective’ and recognise that ‘women and other vulnerable groups may have different needs that must be specifically addressed.’

SOCIAL PENALTIES
More widely, barriers to accessing drug treatment for women in Uruguay included ‘unsafe places’ and a lack of spaces for children, said Silva. This was despite much higher consumption among women of tranquilisers and other medic­ally prescribed drugs. Women tended to seek help for others and not themselves, she added, the result of ‘greater social penalties for the same behaviour’. Complex problems needed complex responses, she said, including raising public awareness of the rights of drug users, and training medical staff to avoid moralising and prejudiced approaches. Drug policies needed to have a ‘comprehensive and balanced approach’ with a ‘cross-cutting human rights and gender per­spective’, she stressed. Incorpor­ating gender into its drug policies would allow Uruguay to make inequalities ‘visible’, she said, and build targeted responses that en­sured gaps were narrowed as well as avoid stigmatisation and discrimination.

women
HM Inspectorate of Prisons report at https://hmiprisons.justiceinspectorates.gov.uk/hmipris_reports/time-to-care-what-helps-women-cope-in-prison/

Europe had much to learn from Latin America and the Caribbean, said Goosdeel – unfortunately including around the increase in drug-related violence, something they’d ‘faced for many more years than us’. This also meant a growing risk that ‘all drug policy in Europe could shift towards only repression and the war on drugs and war on people using drugs’, he said, something that would ‘again be at the expense of vulnerable groups.’ In many cases the response of the state could increase vulnerability instead of reducing it, he warned.

It was important to guard against these shifts, he said, and this year would see an evaluation of the current European strategy on drugs. EUDA was looking for ‘concrete proposals’, he said. ‘If we do as the European Parliament suggests and just present statistics when we can with detail on sex and gender then I’m afraid it’s partly useless. We can’t consider that the job is done just by splitting the data. It’s not enough.’

What was needed was information that could allow ‘punchy recommendations’ to be made to member states, he said. Drugs were changing, which was bringing new problems, while ‘the stigma on women – especially women who are pregnant or who have children – is so huge that they do not feel they’ll be helped. Some are afraid that social services will take their children, so what are the concrete things that we can do together? After 30 years of discussion, we know what the priorities are. So how can we concretely provide help?’

Get it out there

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Get it out there - naloxone feature

I recently presented on naloxone at a conference where I was introduced as a ‘poacher turned gamekeeper’. I didn’t take offence – I’ve been called much worse over the course of my recently finished 30-year policing career.

But it did make me question the impact I’d had in relation to drugs over my career, from the overdose deaths that I routinely attended in my early years as an officer in Hull – wholly unaware of the existence of naloxone or how it could have helped me save lives – to arresting for simple possession, and on to my strong advocacy of naloxone with Durham Constabulary, and national policing as a whole, towards the latter end of my career.

Figures from the Office for National Statistics almost perfectly encapsulate the span of my career, and they’re not pleasant reading. Between 1993 and 2023 the age-standardised mortality rates for deaths by any opiate in England and Wales rose from 8.4 deaths per million people to 43.8 – an increase of 421 per cent. To make that real, that’s 2,551 deaths during 2023. We need to do more to prevent the deaths.

The Human Medicines (Amendments Relating to Naloxone) Regulations 2024 (HMR) came into force in December last year. While I used the previous regulations to raise the profile and use of naloxone within policing, these new amendments have the potential to become the most significant moment in the battle against opioid-related deaths in the UK in recent years.

naloxone legislation

WIDER ACCESS
For years, harm reduction advocates have called for broader access to naloxone. The recent HMR amendments reflect not only these calls, but also the feedback received during recent public consultations on widening the availability of naloxone.

At its simplest, the amendments significantly increase the number of organisations permitted to supply naloxone – in its nasal and intramuscular formats – to others, without the need for a prescription. Previously the regulations had restricted this ability to those employed or engaged by drug treatment service providers. These new changes allow for people working in the following groups to now do the same – police services, prison services, youth justice services, registered midwives, registered nurses, registered paramedics, registered pharmacy professionals and medical services with HM armed forces.

What’s particularly exciting is that these changes provide the opportunity to reach new cohorts of individuals who may not possess naloxone because they either don’t access traditional drug treatment services or regularly see a GP, or they may have previously been offered naloxone but declined. The addition of these new groups represents an opportunity to extend naloxone’s lifesaving potential to more people than ever before.

LOCAL PROVIDERS
While the new groups specified in the regulations are self-explanatory, the regulations also create a new entity, that of ‘local naloxone provider’ (LNP). People working for, or engaged by, an LNP will be able to benefit from the same naloxone exemptions as those groups already mentioned – the ability to provide naloxone without prescription.

Get it out there naloxone

So who are, or who will be, the LNPs? Interestingly the legislation doesn’t specify, but it’s not a giant leap to envisage that these would include existing support organisations, peer groups, drop-in centres, outreach workers, and more. By increasing the opportunities to supply naloxone, the regulations create opportunities for LNPs to step up and play a central role in overdose prevention. This ‘on your doorstep’ approach ensures naloxone is available in the settings where local providers know it’s needed and can have the greatest impact.

Operating as networks the LNPs will be run on behalf of the government and the devolved administrations by another new entity, the naloxone supply network coordinators. These coordinators will ensure that the requirements set out in the legislation are complied with, encompassing issues such as training, storage, record keeping and data sharing.

IMPLEMENTATION CONSIDERATIONS
While the legislative amend­ments are a significant step forward, the real challenge lies not only in their adoption, but also in their implementation. A couple of issues stand out as a priority.

Firstly, training and education: the regulations outline specific requirements that must be adhered to – only by doing so can an LNP retain its status and ability to supply naloxone. Foremost among these are ensuring that those supplying and administering naloxone are appropriately trained to do so. Without a doubt this would include an understanding of how naloxone works, recognising the signs of an opioid overdose, providing aftercare, and confidently administering the medication. Alongside this there are the more administrative elements such as stock control systems, storage conditions related to temperature and security, and recording procedures that would cater for issues such as batch recalls.

Peers at Medway Hope on the streets of Chatham in 2022. For years, harm reduction advocates have called for broader access to naloxone
Peers at Medway Hope on the streets of Chatham in 2022. For years, harm reduction advocates have called for broader access to naloxone

Secondly, partnership working: in my experience collaboration is at the heart of successful harm reduction. Working alongside public health teams, commissioned treatment providers, peer providers and community organisations – pushing the police to be in a position where the possession, use, and supply of naloxone was routine – has highlighted that we must all work together to take advantage of this opportunity. Together, alongside existing innovative provision such as ‘click and deliver’ or postal naloxone, we can create seamless distribution networks across our regions, while tailoring them to local needs.

WHAT’S NEXT?
The amendments to the HMR are another stepping stone towards improved harm reduction, but we all need to work together to effectively implement them. Local authorities, public health teams, commissioned services, community organisations, peer groups and naloxone advocates should seize this opportunity to make naloxone a medication so commonplace that its use is well understood, it’s easily available, it’s normalised, and comes without stigma.

By working together you can help translate these amendments into real, measurable outcomes – lives saved, families supported, and communities strengthened. Make the most of this new opportunity, one that many of us in this sector have pushed for. Contact your local public health team, engage with your local drug treatment provider, link in with peer groups, and set the ball rolling on establishing local naloxone providers in your area. Even if you don’t become actively involved in an LNP, there’s going to be a substantial increase in demand for advice and guidance from the numerous organisations that are newly able to supply naloxone, so offer your expertise where you can.

I’m in no doubt that had I possessed naloxone earlier in my career the opportunities for me to save lives would have been greater. I’ve worked towards the position where police officers all over the country now routinely use naloxone, but it’s now over to you to take advantage of this fantastic new opportunity to get naloxone into the hands of those that may benefit from it.

Since retiring from the Durham Constabulary Jason has established Meecham Consulting, continuing his passion for harm reduction and providing training, guidance, and policy development services tailored to local needs. Contact him at jason@meechamconsulting.com

Global executions for drug offences ‘at crisis levels’

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Global executions for drug offences ‘at crisis levels’
2024 was ‘the deadliest year on record since 2015’ for drug-related executions

More than 615 people were executed for drug-related offences last year, according to Harm Reduction International (HRI). There were also almost 380 death sentences imposed, with more than 2,300 people currently on death row for drug offences worldwide.

Thirty-four countries still retain the death penalty for drug-related offences, says The death penalty for drug offences: global overview 2024. After some ‘cautious optimism’ in the years between 2018 and 2020 there has been a steady increase in executions since 2021, the document states, with the trend reaching ‘crisis levels’ in 2024 – ‘the deadliest year on record since 2015’.

Known executions were up by 32 per cent from 2023’s figure of 467, and by ‘a staggering’ 1,950 per cent from 2020. The figure of 615 known executions, however, does not include the ‘hundreds – if not thousands’ carried out in countries like China, North Korea and Vietnam, where state censorship means there is little chance of realistically establishing how many people have been killed.

Global executions
The increase signalled a ‘renewed commitment to this barbaric practice as a tool of drug control’

Iran was responsible for just under 80 per cent of all known drug-related executions worldwide – at 485 – while the biggest increase was in Saudi Arabia, where 122 people were executed, up from just 2 in 2023. The increase signalled a ‘renewed commitment to this barbaric practice as a tool of drug control’, says the report, and ‘far from being sanctioned for its actions’ Saudi Arabia was then awarded with hosting the 2034 World Cup. Singapore also saw eight people hanged for drug trafficking between August and November 2024 alone, the document points out.

At least 18 of the people executed in 2024 were women, while 136 were foreign nationals. ‘The finding on foreign nationals is a stark reminder of the overrepresentation of this group among people sentenced to death and executed for drug offences, driven both by marginalisation and the unique barriers of navigating foreign criminal legal systems,’ the report states.

Report available here

Public Health Scotland issues warning after increase in ‘sudden’ overdoses

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Public Health Scotland issues warning after increase in ‘sudden’ overdoses
A ‘nitazene-type opioid’ has been identified in some samples linked to the overdoses

Public Health Scotland (PHS) is urging caution after the recent increase in overdoses – some fatal – among people using heroin. Some of these have been characterised by ‘sudden and rapid collapse’, the agency states, often requiring multiple doses of naloxone to reverse the overdose.

A ‘nitazene-type opioid’ has already been identified in some heroin samples linked to the overdoses, says PHS, with more testing needed to determine the specific type. The overdoes have occurred ‘across Scotland in multiple areas’, the agency warns, with the nature of the country’s drug supply meaning that people in all areas may be at risk of increased harm. January’s quarterly RADAR (Rapid Action Drug Alerts and Response) report from PHS found the drug supply throughout the country remained ‘highly toxic and unpredictable’.

‘We are very concerned about the presence of synthetic drugs like nitazenes within the unregulated drugs market across Scotland,’ said PHS consultant in public health medicine Dr Tara Shivaji. ‘Nitazenes are potent opioid drugs, which can be many times stronger than heroin and other common opioids such as morphine. This means even a small amount poses an increased risk of overdose or death. There are ways to reduce the risk of overdose when taking drugs, but there is no safe way to take nitazenes.’

‘We are keen that people who use drugs and their families and friends are aware of the risk, and what they can do to reduce that risk,’ added Scottish Drugs Forum CEO Kirsten Horsburgh. ‘There is nothing unique here in terms of what can be done. Please try to avoid using alone and make sure naloxone is available. Make sure you know how to recognise a possible overdose and what you can do to help. In the absence of local drug checking services, we would encourage people to send samples to WEDINOS. Staff in services in contact with people who use drugs can raise awareness of our shared concern and what people can do to protect themselves and others.’

Meanwhile, alcohol-specific deaths in Wales were up by almost 16 per cent in 2023
Meanwhile, alcohol-specific deaths in Wales were up by almost 16 per cent in 2023

Meanwhile, alcohol-specific deaths in Wales were up by almost 16 per cent in 2023, to 562, according to the latest figures from Public Health Wales. Two thirds of the deaths were among men. There were also more than 12,000 alcohol-specific hospital admissions, almost 70 per cent of which were among people aged 50 and above. People in the country’s most deprived areas were nearly three times more likely to be admitted for alcohol-specific conditions than those from the least deprived, the agency adds.

‘This report highlights the stark health inequalities in Wales, showing that individuals in the most deprived areas are disproportionately affected by alcohol-related issues,’ said public health consultant Helen Erswell. ‘It underscores the vital need for investment in prevention-focused initiatives that can reduce future health risks, ultimately supporting longer, healthier lives for everyone in Wales.’

Data mining Wales: the annual profile for substance misuse 2023-24 available here

Tackling gambling-related harm as a public health concern

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Tackling gambling-related harm as a public health concernOn 11 March, Forward was proud to participate in a conference presented by Breakeven in Southend-on-Sea to raise awareness of gambling-related harm as a public health concern, says Carwyn Gravell.

Forward supports thousands of people every year through a range of commissioned services in prison and community settings including substance misuse, mental health, employment, housing and offender rehabilitation. The people we support often present with more than one of these needs, frequently exacerbated by poverty and disadvantage. Our approach, always, is to work with the person as a whole, regardless of the particular service by which they first came to us. In this context of addressing multiple complex needs on a daily basis, we have long been aware that gambling harm was being experienced by many people we were already supporting, and that this problem was growing (e.g. a survey of our prison clients in 2020 showed that 1 in 4 thought they had a gambling problem).

gambling-related harmTo help tackle this prevalence of gambling harm, we wanted to work with specialist partners and, in the East of England, we have developed a partnership with Breakeven who are the regional arm of the National Gambling Support Network. The work with Breakeven started a few years ago in Southend-on-Sea where Forward delivers the community drug and alcohol service, and where the commissioner also recognised the connection between gambling and substance misuse. In Southend, we now routinely ask our clients about gambling as part of our assessment and then refer them to Breakeven (who co-locate in the same building) for one-to-one support. We also run group sessions together including women’s groups. The approach with clients is to ‘keep gambling the conversation’, raising awareness and reducing stigma.

Forward was proud to participate in a conference presented by Breakeven in Southend-on-Sea to raise awareness of gambling-related harm as a public health concern.Building on this work in Southend, we also partner with Breakeven in our prison services in the region where we deliver mental health support (talking therapies) alongside substance misuse services. Most recently we have run ‘cross training’ with Breakeven where staff from both organisations share their mutual expertise, further raising awareness and improving referral rates. This lays the foundation to expand our partnership across the East, including our substance misuse services in East Kent, Thurrock and Medway.

The Forward Trust BreakevenThanks to the work of Breakeven and many other organisations who took part in the conference, many more people are recognising the nature and extent of gambling-related harm and – crucially – many more people are stepping forward for vital support. But there’s more to do. A new levy on the gambling industry comes into effect in October, which will raise £100m annually to fund treatment, prevention and research, enabling Breakeven and others to continue their work. Guidance was also recently published by the National Institute for Health and Care Excellence on gambling harm, which included recommendations for health and social care providers to start asking their service users about gambling and to refer people for specialist assessment and treatment. Forward welcomes this guidance and are pleased to have already embedded this approach in Southend.

The conference was a fitting celebration of all we have achieved to date with Breakeven, and the launchpad for further work to come. The conference was also noteworthy for the presence of many members of Southend-on-Sea’s public health commissioning team, demonstrating their enlightened recognition of the importance of gambling-related harm as a public health concern. More local authorities now need to follow Southend’s lead and to start implementing an integrated approach to commissioning which recognises the prevalence of gambling-related harm alongside other public health concerns.

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

Pioneering census sheds light on the hidden reality of women’s homelessness

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Change Grow Live has taken part in a ground-breaking project to address the unique challenges faced by women experiencing homelessness. 

Pioneering census sheds light on the hidden reality of women’s homelessness
Chantel Hopkins, outreach team leader

The National Women’s Rough Sleeping Census, led by Solace Women’s Aid and the Single Homeless Project, aims to uncover the hidden reality of women’s homelessness and the challenges that are often overlooked by traditional outreach services.

With Chantel Hopkins leading the initiative for our Leeds Street Outreach service, the project has helped to create a better understanding of women’s homelessness and what we can do to support the people who need it most.

Understanding the need
Homelessness among women often manifests in ways that make it harder to detect. Unlike men, women are less likely to sleep openly on streets due to safety concerns. Instead, they find shelter in precarious situations, such as staying with strangers, engaging in sex work, or seeking refuge in 24-hour establishments like fast food restaurants or libraries.

‘So many women are transient when they’re homeless,’ Chantel explained. ‘They move between places like drug dens, stay with men, or ride buses all night. These women are effectively homeless, but because they aren’t rough sleeping in a visible way, they’re missed by conventional outreach.’

The National Women’s Rough Sleeping Census was first introduced in 2023, with support from Change Grow Live, to bridge this gap and help bring the complex realities of women’s homelessness to light.

women homelessness
Women are less likely to sleep openly on streets due to safety concerns

In Leeds, data gathered by Change Grow Live alongside other organisations has helped to create a broader understanding of women’s situations and their support needs.

Sleeping rough on the streets was the most common experience, followed by women who reported walking all night to stay safe. Many said they sought refuge in temporary or unsafe places, while others stayed with friends, relatives or strangers. Some spent their nights in A&E waiting rooms, in cars, or in fast food restaurants. One of the women who responded to the survey highlighted the danger: ‘It’s scary sleeping on the streets as a woman. I feel like more support is needed.’

The challenge of building trust
Building relationships with vulnerable women proved to be one of the most significant hurdles. ‘It’s been difficult because they don’t really know us yet, so they don’t trust us,’ Chantel noted. Despite this, her team made progress by consistently engaging with women in targeted areas.

Chantel adapted outreach schedules to better align with women’s needs. ‘We started going out later at night – from 10pm to 2am – because that’s when women tend to sex work. During the day, we’d check libraries, McDonald’s and places like that,’ she explained.

This persistence paid off. Chantel’s team successfully built rapport with some women, helping them secure accommodation and leave dangerous situations. ‘We’ve managed to get some women accommodated and out of harm’s way for the night,’ she said.

A national effort
The census was part of a broader national initiative, expanding from its origins in London to 65 local authorities in 2024. Over 1,000 women participated in the 2024 survey, shedding light on the true extent of rough sleeping among women. Eleanor Greenhalgh, women’s rough sleeping policy manager at Solace Women’s Aid, emphasised the significance of this work: ‘These responses demonstrate once again that women’s rough sleeping is drastically underrepresented in statutory figures, and that gender-informed techniques can improve access to support for women.’

Homeless women face unique obstacles in accessing services
Homeless women face unique obstacles in accessing services

She also highlighted the contribution of our teams in delivering the census: ‘The support of Change Grow Live has meant that the census team has been able to produce statistics, findings and reports that have had significant impact already, supporting services and authorities to write new policies; secure funding for specialist roles and accommodation to support women; and make longer-term gender-informed changes to practice.”

Addressing systemic barriers
One of the census’s most important takeaways was the urgent need for systemic change. Homeless women face unique obstacles in accessing services, particularly when it comes to securing housing.

‘Women are often not believed,’ Chantel said. ‘Some areas won’t accept the word of outreach teams to verify that a woman is rough sleeping. They expect to see her bedded down on the street, which doesn’t capture the reality of how women survive.’

This scepticism can lead to harmful practices. ‘We’ve heard stories of women being told to sleep under streetlights so they can be verified.’

Chantel advocates for a ‘soft verification’ process, similar to that adopted in Camden, where outreach teams’ assessments are trusted even if a woman is not visibly rough sleeping. ‘It’s about recognising the expertise of outreach workers who know these women and can confirm their circumstances,’ she said.

She is also working on establishing a female-only hub for homeless women. The hub would provide a safe space for women to access services, discuss issues and de-escalate conflicts that sometimes arise on the streets.

Chantel Hopkins | Outreach Team Leader‘There’s a lot of conflict among women on the streets, and we don’t have anywhere specific for them,’ Chantel said. The hub would bring together partners such as drug and alcohol services, Safer Leeds, and others to offer holistic support.

Eleanor Greenhalgh also reinforced the impact of the census in driving systemic change: ‘These findings have gained the sustained attention of regional and national governing bodies and made media headlines, helping to communicate this work to the public and local authorities across the country.’

The path forward
The Women’s Rough Sleeping Census has already led to tangible changes, such as increased awareness, better collaboration among agencies, and more tailored outreach practices. However, Chantel is clear that more work remains. ‘We need to make this a national priority,’ she said. ‘It’s great that services are doing something different because of the census, but we need government support to address these issues at scale.’

For Chantel, the ultimate goal is to ensure that no woman is left unsupported simply because her homelessness is less visible. By continuing to expand the Women’s Census and advocating for systemic change, she and her colleagues at Change Grow Live are paving the way for a more inclusive and compassionate approach to homelessness.

As Eleanor Greenhalgh put it, ‘Not only does the census collect data, but it is an example of successful collaboration of over 120 organisations and local authorities working together across sectors to make change for women. It shows the drive and dedication of practitioners throughout Change Grow Live and across the country in their tireless work to make the census happen each year.’

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

Accelerate away from the safe ground

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Can true gender equality ever be achieved without considering the epidemic of violence against women and girls? For this year’s International Women’s Day (8 March) Phoenix chief exec Karen Biggs considers how we ‘accelerate away from the safe ground’.

Accelerate Action - gender equalityThe theme of this year’s International Women’s Day is Accelerate Action, calling for ‘increased momentum and urgency in addressing the systemic barriers and biases that women face, both in personal and professional spheres’. The world Economic Forum says at the current rate of progress it will take until 2158, which is roughly five generations from now, ‘to reach full gender parity’.

The ‘safe ground’ of conversation on gender parity is gender parity in employment. Touting our gender pay gap figures, our in house approaches to supporting women in leadership. How we create environments at work that allow women to flourish, to navigate the labyrinth of dead ends, detours, unusual paths and complexities that women face in their work-life balance.

That is all really important. I do it and have done it myself for many years and I am proud of the work people in my organisation do to support the women we employ to thrive. But if we are serious about addressing the systemic barriers and challenges all women face, we have to reach into that less safe ground of the traumatic lives of women whose stories are mostly unheard or whispered, written off as complex, and stigmatised into believing their pain is self-inflicted with only themselves to blame.

Artist Anna Siviero designed a graphic to support the IWD theme this year. She wanted to convey ‘action, speed, instinct, rebellion and the propulsive energy that rage can have to drive change’. That spoke to me.

gender equality
Women die at the hands of men’s rage every three days in the UK

Rage, of course, can be negative. The Femicide Census tell us that women die at the hands of men’s rage every three days in the UK. The under reporting we know exists means the real figure is likely to be much higher than that.

We would all agree, wouldn’t we, that men’s violence against women and girls is the most pernicious manifestation of sex inequality? Of course, men kill men, and more men are killed by violence than women. It is the way women are killed, the motivation for the killing and the life experience of women before they are killed that makes femicide an equality issue.

In the UK, women are killed in their own home, by partners or ex-partners, often when they try to leave a violent relationship and often in front of their children or alongside their children. Women involved in sex work who are killed are younger. They are less likely to be killed by a partner and more likely to experience dehumanising sexual violence around the time of their death.

Until we understand what the root cause of that horrific reality is and what role we all have to play in addressing it, we aren’t going to end violence against women and we aren’t going to achieve gender parity for every woman.

The government has pledged to halve [men’s] violence against women in a decade. Of course I applaud that. I challenge myself, the organisation I lead and the initiatives I am involved in, to take action to identify opportunities to contribute to that mission.

gender
The government has pledged to halve [men’s] violence against women in a decade
The roles that I have created provide obvious opportunities to do that:

  • Ensuring the services we deliver continue to question how we can reach more women without judgement, to provide care, compassion and practical support on their terms.
  • Through our gender work addressing some men’s toxic attitudes to women.
  • To speak truth to power – to challenge policy and practice that creates barriers for women or stigmatisation that force women to hide.
  • To celebrate women’s successes, strengths and resilience and create common ground across women’s universal experience of life.
  • And to say sorry when I could have done more and learn from that mistake.

Sometimes I channel my rage created from the stories I hear, the lives lived, the battles won and lost. Sometimes that rage makes me less effective but mostly it does give me energy to drive change.

We can accelerate away from safe ground this International Women’s Day and give ourselves a real chance of achieving gender parity for every woman.

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

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

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

This content was created by Phoenix Futures

Duterte flown to The Hague, as lawyers file petition

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Duterte flown to The Hague, as lawyers file petitionFormer Philippine president Rodrigo Duterte has been flown to The Hague, following his arrest at Manila airport. Duterte was taken into custody after the International Criminal Court (ICC) issued a warrant accusing him of crimes against humanity as part of his brutal ‘war on drugs’.

Duterte’s lawyers have petitioned that he be returned to Manila, maintaining that the arrest was unlawful as Duterte had previously withdrawn the Philippines from the ICC. However, the Philippine government’s official newswire service, the Philippine News Agency (PNA), stated that ‘all the legal procedures’ had been followed.

‘We do not do this because it was derived from or came from ICC,’ said Philippines president Ferdinand R. Marcos Jr. ‘It’s a request to the Philippine government from Interpol to enforce the arrest warrant, and of course we comply with our commitments to Interpol.’

Duterte The Hague
‘This momentous event sends a message to human rights abusers everywhere that one day they could be held to account’ – Bryony Lau

Duterte’s daughter, Sara Duterte – currently the country’s vice president – has stated that her father was ‘kidnapped’. The Marcos government, which had originally challenged the ICC’s jurisdiction, later said it would work with Interpol if an arrest warrant were issued after a rift developed between the Marcos and Duterte camps. The warrant contains allegations about extrajudicial killings during both Duterte’s presidency and his previous tenure as mayor of Davao City.

‘Former president Duterte’s arrest and transfer to The Hague is a long-overdue victory against impunity that could bring victims and their families a step closer to justice,’ said deputy Asia director at Human Rights Watch, Bryony Lau. ‘This momentous event sends a message to human rights abusers everywhere that one day they could be held to account. President Marcos has begun to chip away at the longstanding impunity for drug-related killings in the Philippines. He should follow through by rescinding Duterte’s orders that unleashed the “war on drugs,” and prioritise comprehensive reforms of the Philippines police.’

drug trafficking
Meanwhile, new drug trafficking routes are now opening up in war zones – UNODC

Meanwhile, new drug trafficking routes are now opening up in war zones, UNODC executive director Ghada Waly told the latest session of the Commission on Narcotic Drugs in Vienna. This, coupled with the dark web’s ‘new black market’ for synthetic drugs, was helping to fuel global instability, she warned.

‘Today, the illicit drug market is becoming more unpredictable, driven by the impact of synthetic drugs,’ she said. ‘Trafficking routes run through war zones and rule of law vacuums, from Haiti to the Levant to the Golden Triangle, fuelling instability.’ Cryptocurrencies were also allowing traffickers to ‘move illicit profits undetected’ while social media platforms had become ‘major channels for promoting and advertising drugs online, particularly targeting young people and vulnerable users.’

While the reporting of the first nitazene – isotonitazene – to the UNODC was as recent as 2019, 25 more had now been reported. ‘Synthetic drugs have become one of the most urgent and elusive drug challenges that we face,’ she said. ‘They are evolving every day, expanding in reach and growing in potency.’

The world needs gender-specific tobacco harm reduction

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BY NAFISAT DASOLA JIMOH

Tobacco harm reduction (THR) is a transformative public health opportunity, saving people’s lives by offering safer alternatives to smoking for those who are unable or unwilling to quit nicotine. However, much THR dialogue has overlooked the specific challenges and needs of women – especially in regions of the world where cultural, social and economic barriers most compound the risks associated with smoking.

The world needs gender-specific tobacco harm reductionWomen smoke at lower rates than men worldwide, but still suffer over 2 million annual smoking-related deaths. And women who do smoke are disproportionately impacted by health consequences. Beyond the general risks of cancer, heart disease, and respiratory illness, women face specific threats such as reproductive health complications, cervical and breast cancers, and higher susceptibility to smoking-related heart disease and COPD.

Women’s smoking behaviors are particularly often influenced by stress, societal expectations, and the intersection of gender and socioeconomic status. While men may smoke openly, women’s smoking is frequently hidden in many cultures, making it harder to reach them with public health interventions.

Although the prevalence of smoking among women in Africa, for example, is relatively low, the harms they face are substantial. According to the World Health Organization, approximately 22,000 women die annually from tobacco-related diseases in the region. Additionally, about 64 percent of adult deaths due to second-hand smoke there are among women – a reminder of the indirect toll that is often forgotten.

In many communities, smoking among women is especially stigmatized, limiting their access to cessation and harm reduction resources. Societal norms often portray smoking as a male habit, further alienating women who need support.

These realities underline the need for targeted harm reduction strategies, with tailored messaging and programs that resonate with women’s experiences and circumstances.

Read the full article on filtermag.org

Duterte arrested for ‘crimes against humanity’

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Duterte arrested for ‘crimes against humanity’Former Philippine president Rodrigo Duterte has been arrested after the International Criminal Court (ICC) issued a warrant accusing him of crimes against humanity following his notorious ‘war on drugs’. Duterte was arrested at Manila airport earlier today after arriving from Hong Kong.

Nicknamed ‘Duterte Harry’ and ‘the punisher’, Duterte was elected president in 2016 after promising on the campaign trail to ‘fatten the fishes’ in Manila Bay on the bodies of dead criminals. Prior to his election, his long stint as the mayor of Davao City in the south of the country had seen him accused of supporting the extra-judicial killings of offenders.

Human rights groups believe the total number of people killed in Duterte’s brutal war on drugs may be as high as 30,000, with Amnesty International estimating that more than 6,000 people had been killed in the first six months of his presidency alone – after he ordered police to kill anyone they believed to be connected to the drugs trade. ‘State forces and vigilante groups have followed through these orders ruthlessly,’ the human rights NGO said at the time. He had recently been campaigning to run again for mayor of Davao.

Duterte’s war on drugs
The total number of people killed in Duterte’s war on drugs may be as high as 30,000

A report by Amnesty International in 2019 focused on 20 cases that appeared to be extrajudicial killings, pointing out that while the Philippines government had itself acknowledged at least 6,600 killings by police, the evidence pointed to ‘many thousands more killed by unknown armed persons with likely links to the police’. The following year, a report by Geneva-based World Organisation Against Torture (OMCT) and the Philippine Children’s Legal Rights and Development Center found that, of more than 120 killings of children and young people that were carried out between July 2016 and December 2019, 40 per cent were committed by police and the rest by ‘unknown individuals, often masked or hooded assailants’, some with direct links to police.

The ICC had been monitoring the situation in the Philippines since early 2018, and formally requested an investigation into crimes against humanity in 2021. However, Duterte withdrew the Philippines from the ICC during his presidency, with his lawyer now stating that the arrest is unlawful.

Duterte’s arrest was a ‘long-awaited and monumental step for justice for the thousands of victims and survivors of his administration’s “war on drugs”, which turned much of the Philippines into a nation of mourning’, said Amnesty International’ secretary general, Agnes Callamard. ‘The man who said “my job is to kill” oversaw the killing of victims – including children – as part of a deliberate, widespread and well-organised campaign of state-sanctioned killings.’

The ICC investigation, however, only covered ‘some of the crimes committed over the past decade’, she continued. ‘Former president Duterte was at the centre of a grave human rights crisis in the country, but he is not the only one suspected of criminal responsibility, nor have violations stopped since he left office. It is incumbent on the present government that investigations and prosecutions do not end with his arrest and extend to domestic-level accountability for all those responsible for human rights violations in the “war on drugs”. The Philippine authorities must now surrender Duterte to the ICC in The Hague to face trial for the alleged crimes against humanity.’

Taking back control

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Choosing an alcohol-free lifestyle meant confronting peer pressure and ‘sober shaming’, says Scott Woolley.

I first became sober curious in 2012. At that time, there was no sober curious movement, no term for it, and the alcohol-free drinks market didn’t exist (other than Beck’s Blue). The Dry January challenge hadn’t emerged, so there was no social proof, no community, and little visible support or alcohol prevention outside of crisis intervention. I felt alone.

From 2013 to 2015, I tried taking breaks from alcohol, drinking only a handful of times in that period. But ‘sober shaming’ and peer pressure made it difficult to stay alcohol-free for longer than I’d have liked.

If we haven’t had a rock bottom moment or accessed treatment, it can be challenging to explain why we want to stop drinking
If we haven’t had a rock bottom moment or accessed treatment, it can be challenging to explain why we want to stop drinking

In 2015, I was sober shamed during a night out and told ‘All this no drinking, it needs to stop. You need to knock this on the head.’ That moment pushed me to commit to a one-year alcohol-free challenge. I was nervous about abstaining forever because of stigma. I didn’t want to spend the rest of my life explaining why I wasn’t drinking. I needed time and perspective to understand my relationship with alcohol. After completing my first year, I extended my alcohol-free challenge by another year and then decided to commit to lifelong abstinence.

One of the hardest parts of participating in the Dry January challenge – or any alcohol-free journey – isn’t just exploring our own relationship with alcohol, but dealing with how others react. If we haven’t had a rock bottom moment or accessed treatment, it can be challenging to explain why we want to stop drinking.

Over the years, I’ve often heard, ‘You don’t have a problem, so why stop?’ Many still view drinking on an outdated spectrum – either you’re fine or you’ve lost control – the mentality of drink as much as you can (as long as you don’t hit rock bottom). But the reality is, alcohol affects us all differently. It’s not about how much we drink, but how it affects us.

alcohol-free sober shamingSadly, stigma exists in two forms when it comes to alcohol – one for those who have been in crisis or sought help, and another for those who choose not to drink. The judgment of not managing a relationship with alcohol or ‘failing’ to stay in control is where individuals can be labelled and exposed to exclusion and judgment. When we choose not to drink by preference, we face a different kind of stigma – sober shaming, as well as exclusion and judgement. In my experience, the less of a ‘problem’ it seems to others, the more we’ll be questioned on our decision to quit.

Both types of stigma are harmful, and create barriers to people seeking support or making positive changes to their relationship with alcohol, no matter the reason.

In a community poll for our sober collective Arclett, stigma was voted as a bigger barrier to becoming alcohol-free than cravings, showing just how powerful and damaging stigma can be. People can stop or reduce their drinking, but choose not to because they’re worried about the spotlight it shines on them.

Around 200,000 people took part in the Dry January challenge this year, adding social proof for those looking to pause, stop, or improve their relationship with alcohol. But sadly the choice to be alcohol-free still carries stigma. Once the one-month challenge ends, we’re often back to explaining why we don’t drink – because alcohol remains the only drug in the world we have to justify not using.

Stigma was voted as a bigger barrier to becoming alcohol-free than cravings
Stigma was voted as a bigger barrier to becoming alcohol-free than cravings

To highlight the growing social proof, the Dry January challenge, which started in 2013 (with just 4,000 participants), saw over 175,000 participants in 2023. It’s amazing to see how much the conversation around choosing not to drink has evolved, and how much more accessible it is for those curious about life without alcohol.

There’s still work to be done, but I believe we’re heading in the right direction. The goal isn’t to live in a society where alcohol doesn’t exist, just where we don’t have to justify why we’re not drinking, and where there are fewer alcohol harms.

I am not anti-alcohol, I am pro-choice, and at Arclett we’re committed to reducing the stigma surrounding an alcohol-free lifestyle. By normalising sobriety, we create more space for healthier choices and make it easier for people to seek support when they need it.

Scott Woolley is founder of Arclett. Find out more here

Scott’s story is featured by the Anti Stigma Network (ASN). Get involved to tackle stigma, share resources and join a growing network that’s driving change.

Hidden harm

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Military sexual trauma MST

Military sexual trauma is something that’s rarely discussed – in fact it’s not even formally recognised by the UK authorities. But if your clients are veterans struggling with their alcohol use there are questions you need to ask, says Tony Wright.

As a social worker in the voluntary sector, I’ve witnessed the profound and lasting impact of trauma on individuals who often feel invisible in society. Nowhere is this more apparent than in the lives of male military veterans who have survived military sexual trauma (MST). The reluctance of the UK government and Ministry of Defence (MOD) to recognise MST among men leaves many struggling in silence, often self-medicating with alcohol as a desperate coping mechanism.

Forward Assist, a charity dedicated to supporting veterans, recently published Liquid armour, a report shedding light on the realities of MST survivors and their relationship with alcohol. The findings are both harrowing and revealing, and highlight how alcohol becomes a tool for survival in the absence of trauma-informed services tailored to the unique needs of male survivors.

Tony Wright
Tony Wright with The Company of Communicators’ 2023 Clarity in Charity Communications Award, for Forward Assist’s work with women veterans

HIDDEN POPULATION
MST is not formally recognised in the UK, despite being acknowledged by the US Department of Veterans Affairs as any unwanted sexual experience during military service. The stigma surrounding male survivors creates a culture of silence. While reports indicate that between 5 and 10 per cent of military men in western nations experience sexual assault, under-reporting remains a significant barrier to addressing the issue. Many victims fear being labelled as weak or facing questions about their masculinity and/or sexuality, leading them to self-isolate and suffer alone.

Survivors of MST often endure post-traumatic stress disorder (PTSD), depression, anxiety, and other complex mental health conditions. The betrayal by fellow service members and the institutions meant to protect them leads to deep-seated mistrust, shame, and self-doubt. Many are left feeling marginalised, unable to access appropriate services, and with little recourse but to turn to alcohol as a means of temporary escape.

COPING MECHANISM
The military has a long-standing drinking culture, often viewed as a bonding exercise or a way to unwind. But for MST survivors, alcohol becomes more than just a social lubricant – it is a shield, a numbing agent, a way to forget. Veterans interviewed in Liquid armour spoke candidly about their relationship with alcohol:

MST military sexual trauma‘My commanding officer once said that only Americans see a shrink, whereas the British go to the pub. That’s how I’ve dealt with every problem in my life since I left the army.’ 

‘I hoped I’d kill myself while I was drinking as I wasn’t brave enough to do it sober.’

‘Drinking made me feel cosy and warm… until I woke up.’

These stories illustrate the devastating cycle of self-medication that many MST survivors fall into. For some, alcohol is an unconscious attempt to suppress traumatic memories. For others, it’s an act of self-destruction – a slow suicide in the absence of hope.

INSTITUTIONAL BETRAYAL
Many MST survivors describe a sense of institutional betrayal that compounds their trauma. The military, often viewed as a ‘brotherhood,’ fails to protect them, and when they report their assaults they face disbelief, inaction, or even retaliation.

Even after leaving the military, barriers to support persist. Many veterans report being unaware of existing sexual trauma services or finding them unprepared to address the specific needs of men. Some avoid disclosing their experiences entirely, presenting instead with PTSD or alcohol dependency, which are more ‘acceptable’ within veteran services. The reluctance of the MOD to acknowledge male MST means there’s no dedicated funding, research, or policy change to address the issue. Without proper recognition, survivors remain in the shadows, left to navigate a fragmented system that fails to see them.

military sexual trauma (MST)
Veterans struggling with MST-related alcohol misuse face an increased risk of suicidal ideation

DEADLY CONSEQUENCES
The link between trauma and substance misuse is well-documented, yet male MST survivors remain an overlooked group in recovery services. The consequences of this oversight can be fatal.

Veterans struggling with MST-related alcohol misuse face an increased risk of suicidal ideation. Their pain is compounded by isolation, a lack of targeted mental health interventions, and a drinking culture that discourages vulnerability. Without tailored trauma-informed support, many will continue to spiral into addiction, homelessness, and early death.

One participant in Liquid armour reflected on the impact of alcohol misuse within the MST survivor community:

‘Watching friends die of alcohol misuse is soul-destroying. As an MST survivor, I know I could be next.’

ASKING THE QUESTION
When engaging with veterans who may be struggling with alcohol misuse, it is essential to ask about their experiences with trauma in a sensitive and non-judgmental way. A good practice approach is to use open-ended, trauma-informed questions that create a safe space for disclosure. Instead of asking direct or potentially re-traumatising questions like, ‘Have you been sexually assaulted?’ consider a gentler approach along the lines of: ‘Many veterans I work with have experienced distressing events during their service that continue to affect them. Sometimes, these experiences involve feeling unsafe, being pressured into unwanted situations, or facing harm from those around them. If anything like that has happened to you, I want you to know that you’re not alone, and there is support available. Would you like to talk about anything that’s been difficult for you?’

male MSTBy framing the question in a way that acknowledges common experiences, respects personal boundaries and reinforces available support, professionals can encourage survivors to seek help without fear of stigma or judgment.

SEEING THE INVISIBLE
Male MST survivors are not just statistics – they are men who served their country, who were betrayed by their own, and who continue to suffer in silence. The voluntary sector plays a crucial role in advocating for these men, but we cannot do it alone. Until MST is fully acknowledged, resourced, and integrated into recovery and mental health services, we will continue to see these men drink to forget, to cope, and, ultimately, to die.

As social workers and professionals in the voluntary sector, we must amplify their voices, demand policy change, and provide the trauma-informed care they deserve. We must ensure that no veteran feels their only option is the bottom of a bottle.

Tony Wright is CEO of Forward Assist

Separation has more impact on women’s drinking than men’s

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Separation has more impact on women’s drinking than men’sWomen are more likely than men to increase regular drinking during marital separation, according to a study by the University of Oxford’s Nuffield Department of Population Health and Trinity College Dublin. They are also more likely to drink at higher levels in the years afterwards, the researchers found.

The study looked at the drinking and smoking habits of more than 13,000 people in Australia to understand ‘how people cope with the stress associated with marital separation’. Researchers found that drinking and smoking increased for both men and women in the years leading up to – and at the time of – separation. However, women were more likely to increase their regular drinking and, while men’s drinking and smoking rates eventually returned to pre-separation levels, women’s rates ‘remained somewhat elevated for many years after’.

Women with children had the highest increases in both drinking and smoking
Women with children had the highest increases in both drinking and smoking, the report says

Although binge drinking increased in the period leading up to separation, the rise was ‘less pronounced’ than increases in regular drinking. Women with children had the highest increases in both drinking and smoking, the report says, adding that ‘self-reported data may underestimate the true extent of smoking and drinking behaviours’.

The findings highlight the need to ‘address the unique challenges that parents, especially mothers, face during marital separation,’ said joint lead author Dr Nicole Kapelle. ‘Women and parents face social and structural pressures during separation that might push them towards unhealthy coping mechanisms.’

‘With nearly half of all marriages in Western societies ending in separation, understanding and addressing the health risks associated with this stressful life change is essential,’ added co-author Dr Andrea Tilstra. ‘Our study lays the groundwork for targeted support and interventions that can help individuals, particularly those at greatest risk of smoking and drinking, to adopt healthier coping strategies.’

separation drinking
Research has consistently found that women were being under-served by many alcohol and drug services in the UK

Although the situation has improved in recent years, research has consistently found that women were being under-served by many alcohol and drug services in the UK, with inaccessible appointment times for women with children, intimidating mixed-sex spaces, increased levels of stigma, and lack of female key workers frequently cited as major barriers to women accessing – and remaining in – treatment. Despite gender being cited as a priority for many drug strategies and policies, the reality was that there were ‘not enough programmes that are genuinely gender-based’, EUDA executive director Alexis Goosdeel told a recent webinar on the subject.

Meanwhile, police in Blackpool have become the latest to issue a warning to people who use drugs after the deaths of three people in the area. ‘An investigation is underway following the deaths of two men and one woman,’ said detective inspector Isobel Garratt. ‘These deaths are suspected to be drugs related. Our advice would be for users to seek immediate medical attention if they notice any different symptoms or start to feel unwell.’ The warning follows similar recent alerts from police in Camden and staff at NHS Dumfries & Galloway.

Breaking bonds, changing habits: understanding health behaviors during and after marital dissolution published in the Journal of Health and Social Behavior available here

More than 30 people now taken ill in Camden, say police

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More than 30 people now taken ill in Camden, say policeThirty-three people in the London Borough of Camden have now been taken ill after taking what they thought was heroin, according to the latest update from the Metropolitan Police, with 17 attending hospital. Earlier this week police were only aware of nine cases in the Camden area.

Police say they are continuing to investigate the incidents, alongside partners including Camden Council. ‘Officers are not aware of anyone in a life-threatening condition, however they continue to liaise with hospitals and other agencies,’ the update states. The council says it is working with local outreach teams to increase access to naloxone and other support, as well as issuing alerts to local healthcare and accommodation services.

Camden
‘Analysis of substances recovered shows that what users believed to be heroin was in fact a dangerous synthetic opioid’

‘We continue to work alongside our partners, including the local council and health professionals, to establish the full circumstances and identify everyone who has been affected,’ said detective chief inspector Chris Soole. ‘Analysis of substances recovered shows that what users believed to be heroin was in fact a dangerous synthetic opioid. It is clear that this remains in circulation, especially in the Camden area, and it causes an extreme reaction. In one of the most recent cases, just after 8pm on Wednesday evening, Met officers gave emergency first aid to a man in cardiac arrest in Haverstock Road, Camden. He had taken what he thought was heroin and it is likely that the actions of those officers saved his life. This is the fourth day of our response to this critical incident, and it is absolutely clear just how dangerous this substance really is.’

An alert was also recently issued by NHS Dumfries & Galloway in Scotland over a spate of ‘sudden collapse’ overdoses occurring immediately after injection.

Meanwhile, the Northern Ireland Statistics and Research Agency (NISRA) has published its drug-related and drug misuse death figures for 2023. There were 169 deaths registered, it says – an increase of almost 50 per cent in a decade, but lower than the 2020 peak of 218. ‘It is important to note that registration-based figures build in delays arising from system-wide processes which can drive annual fluctuations in the series,’ the agency points out.

NISRA has published its drug-related and drug misuse death figures for 2023
NISRA has published its drug-related and drug misuse death figures for 2023

Unlike the rest of the UK – where the highest drug-death rates are among older people – the highest rate was in the 25-34 age group, says NISRA, with males accounting for around two thirds of the deaths.

As in previous years, the drug group mentioned most often was opioids. However, the most frequently mentioned specific drug was pregabalin – in 67 of the 169 registered deaths. Three quarters of deaths involved two or more substances, while the predominant drug mentioned in deaths involving only one drug was cocaine. ‘Drug-related and drug misuse deaths continue to be higher in areas of highest deprivation,’ NISRA states, with more than 60 of the deaths occurring in the Belfast local government district.

Drug-related and drug misuse deaths in Northern Ireland, 2023 available here

National Careers Week 2025: ‘Forward are partnering, mentoring, upskilling, and empowering younger people to have a better future’

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National Careers Week 2025: ‘Forward are partnering, mentoring, upskilling, and empowering younger people to have a better future’In support of National Careers Week 2025, The Forward Trust are taking proactive steps to address youth unemployment, especially in light of the concerning statistics reported in February 2025. The rise in the youth unemployment rate for 16-24 year olds from 11.9% to 14.8% highlights a significant challenge that needs urgent attention.

Kent is above the national average for youth unemployment
In February 2025, the unemployment rate in Kent increased by 0.9%, now standing at 3.5%, with 5.5% of 18-24 year olds in Kent currently unemployed, which is slightly above the national average of 5.4%. The Kent Government Statistical bulletin from February 2025 highlighted:

Regional disparities: Thanet has the highest level of youth unemployment rate at 10.1%, followed by areas such as Dover, Folkestone & Hythe, Swale, and Gravesham. This indicates significant regional disparities in employment opportunities for young people.

Gender disparities: The data reveals that male youth unemployment is 1.3% higher than that of females, suggesting a need for targeted interventions to support young men in securing employment.

Through our delivery, we understand the challenges faced by young people in the job market, particularly in East Kent. We understand that recognising a lack of confidence, basic skills, and the impact of neurodivergent challenges and learning disabilities is essential for tailoring effective support programmes. At The Forward Trust, we recognise the importance of:

National Careers Week - youth unemployment
Male youth unemployment is 1.3% higher than that of females

Confidence building
The emphasis on building self-esteem, confidence, and resilience is crucial. Many young people struggle with self-doubt, which can hinder their ability to apply for jobs or pursue opportunities. Programmes that focus on personal development can empower them to take the first step.

Skills development
Addressing the lack of basic skills, such as CV writing, and cover letter preparation, is fundamental. Providing practical workshops that guide participants through these processes can significantly improve their employability.

Neurodiversity and learning disabilities
Acknowledging the presence of neurodivergent individuals and those with learning disabilities is vital. Tailoring training programmes to accommodate diverse learning needs can help ensure that all young people receive the support they require.

Mental health considerations
The link between unemployment, mental health, and financial pressure is a significant concern. Providing mental health support alongside employability training can help participants build resilience and cope with the challenges they face.

Recognising talent
We recognise that many young people possess exceptional talents and personalities, which is important. Creating platforms for them to showcase their skills, such as talent showcases or networking events, can help bridge the gap between them and potential employers.

unemploymentWhat are The Forward Trust doing to tackle youth unemployment in Kent?
The services we run are funded by the Department of Work and Pensions, Job Centre Plus, IPS, and the Department of Education. We provide qualifications through our Jobs Pathway, and one-on-one employability support. These services have already supported 450 young adults and equipped them with the skills, behaviours, and knowledge they need to secure sustainable employment, we are helping to bridge the gap between education and the workforce.

Our approach is based on:

Holistic employability support
The emphasis on a holistic approach through the Thanet Restart Scheme and IPS Employability (Medway) is crucial. This comprehensive support system not only addresses job readiness but also considers the overall well-being of the individuals. Our work is always based on the Wheel of Change model – 30% being the effective working relationship between our advisor and the participants, 15% is about giving aspiration and hope, 30% is down to the environment which we can shape, and 15% is down the actual intervention and programme.

Access to vocational qualifications
Providing access to qualifications through the Jobs Pathway training and Multiply courses is an excellent way to enhance the skills of young people, making them more competitive in the job market.

Collaboration with Job Centre Plus and VCSE partners
Working closely with Job Centre Plus and various Voluntary, Community, and Social Enterprise (VCSE) partners strengthens the support network available to young people. This collaboration can lead to more tailored and effective interventions.

The link between unemployment, mental health, and financial pressure is a significant concern
The link between unemployment, mental health, and financial pressure is a significant concern

Engagement with local businesses and employers
By partnering with local businesses to offer training opportunities, apprenticeships, and volunteering positions, Forward is creating pathways for young people to gain valuable work experience and build professional networks. The Forward Trust is also influencing and supporting these organisations to become better employers by creating more sustainable employment and better terms and conditions.

Monthly job fairs
Hosting monthly job fairs (and reverse job fairs) is a proactive approach to connect young job seekers with potential employers. These events not only provide opportunities for interviews but also help reduce the anxiety associated with job searching by facilitating informal introductions.

Empowerment and confidence building
Empowering young people with the confidence and employability skills necessary for job searching and preparing for their first year of work is essential for long-term success.

By focusing on these strategies, Forward can further empower young people in Thanet and across Kent to overcome barriers to employment and build fulfilling careers. Our commitment to adapting training programmes to meet the unique needs of participants will undoubtedly make a positive impact on their lives. We will always aim to foster a supportive environment for young job seekers.

Forward offers lots of employment opportunities for those hiring or looking for work. To find out more, explore our different services or email employment@forwardtrust.org.uk

By Emma Woodward, Operational Manager, Employment Services

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

Glasgow consumption room used more than 1,000 times

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Glasgow consumption roomGlasgow’s consumption room, The Thistle, has been used 1,067 times by more than 140 people since it opened in January, according to the city’s Health and Social Care Partnership (HSCP).

Nursing staff at the facility – the first ever in the UK – have supervised ‘more than 700 injecting episodes, with people injecting cocaine, heroin, or both’ HSCP says. There have also been a number of medical emergencies, it adds, with ambulance support required on some occasions. ‘People using the service who experienced a medical emergency have recovered and been provided with further harm reduction and support from the team,’ it states.

Glasgow consumption room used more than 1,000 times
‘There is no denying how much of a difference The Thistle is making to the lives of those using it’

The facility, which is open every day and is backed by £2m annual government funding, also provides blood-borne virus testing, shower and laundry facilities, and other services. ‘Wound care is the most frequent intervention on site,’ says HSCP.

‘We are really pleased with how things are going at this early stage,’ said city convener for addiction services, Cllr Allan Casey. ‘The Thistle is a new service, unique to Scotland. It is reassuring to know how well it’s running and it’s reaching the population it hoped to. The team have saved lives and are helping greater numbers of people than we ever expected to in the first seven weeks of opening. There is no denying how much of a difference The Thistle is making to the lives of those using it. Lives have been saved, people who have felt marginalised and distant from support are engaging with staff and the early feedback from service users and wider partners is positive.’

NHS Scotland issues alert about ‘sudden collapse’ overdoses

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‘sudden collapse’ overdoses
The overdose has been almost immediate – with reduced breathing and rapid deterioration

An alert has been issued by NHS Dumfries & Galloway over a spate of ‘rapid’ drug overdoses in the region. Although not yet confirmed by local testing, the ‘sudden collapse’ overdoses occurring immediately after injection ‘come amid similar cases elsewhere in Scotland’, the health authority warns.

Testing in the other cases has revealed the presence of powerful synthetic opioids, as well as ‘other combinations of substances’. People who use drugs are being warned to treat all substances with caution, not to use drugs alone and avoid buying from new sources.

‘We’re very keen that everybody is made aware of the current increased risk reflected by these overdose cases,’ said Dumfries and Galloway consultant in public health Chris Allan. ‘In these situations, the overdose has been almost immediate – with reduced breathing and rapid deterioration – and in cases in other areas people have very sadly died. We’re advising people who use drugs to be extra vigilant.’

Due to the potency of synthetic opioids like nitazenes, you may need to administer multiple doses of naloxone

People should also ensure they had ready access to naloxone kits, he added. ‘And due to the potency of synthetic opioids like nitazenes, which might be present, you may need to administer multiple doses of naloxone. Naloxone should only be used if the person is overdosing and unresponsive. Even if you’re not sure if an opioid is present, naloxone can be administered and will not cause harm.’

Meanwhile, a number of people have also been taken ill in Camden, north London, according to local police services. ‘Police are aware and are investigating the circumstances after a number of people have been taken ill in and around the Camden area today (Monday, 3 March),’ said a statement from the Metropolitan Police. ‘We are aware of nine cases and believe that all of these people have fallen ill after taking a substance believed to be heroin. At this time, there have been no fatalities but we continue to monitor the situation.’

Secure environments

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Trauma complex needs

REACH is a multi-agency Housing First project in Scarborough which aims to support people with complex needs to access housing and facilitate change towards recovery – as defined by the person.

Multi-agency working is at the heart of the project, with a team comprising mental health nurses, support officers from both a social landlord and the local authority, and myself – a domestic abuse practitioner. REACH also benefits from the support and guidance of a consultant clinical psychologist, two days a week. By bringing together diverse experience and expertise from a range of professionals, it aims to provide holistic person-centred care to aid recovery.

The project is specifically designed to work with, and provide comprehensive support for, those who have experienced high levels of multiple disadvantages. This means working with a complex interplay of drug and alcohol issues, mental illness, criminality and complex trauma presentations.

complex needs

As a domestic abuse practitioner, I work with those who have experience of domestic abuse, which is almost always a factor in the lives of our clients. Often clients have experienced domestic violence across their lifespans – from witnessing it in childhood to their own intimate relationships. Due to the complex and traumatised attachments people have experienced, victim-perpetrator dynamics are common, and therefore my role is unusual in domestic abuse services. Work with victims and perpetrators is usually strictly separated. However, in my own experience of working with those who are homeless, with co-existing conditions and needs, these areas are closely linked – with people perpetrating abuse within their relationships, and also finding themselves victims of their partner’s abuse.

Homelessness tends to throw people together through necessity, sparking relationships where both parties are often heavily under the influence of substances, and creating situations where each plays out the modelled relationship patterns they’ve been exposed to in their own childhood environments.

Invariably these early traumatising environments are described to me as chaotic, unstable, and insecure – frightening places filled with abuse and neglect. Those with intense experiences of loss, abandonment, and relational trauma can find themselves looking to their partner to fulfil all their emotional needs. But when their partner is unable to provide this, emotions can run high, and – with the disinhibiting effects of alcohol and substances – things can escalate quickly.

trauma

What’s been of interest is that often there’s no recollection of events the next day, due to the high levels of intoxication. This can sometimes lead to a process of minimising the serious nature of what’s occurred, while at other times it can be experienced as frightening or shameful – leading to further substance use to cope. Relationships are often made and broken within weeks or days, and are frequently experienced intensely due to the shared historic experiences of trauma and the need to feel intimacy and connection. So relationships that are craved through the hope of an elusive feeling of care and stability can actually cause further harm.

Homelessness is, of course, a stressful situation for anyone, and this can significantly add to relationship difficulties, further exacerbated by the distrustfulness involved in communal drug use. Limited resources can lead to suspicion, paranoia and altercations that may not be perceived by either party as domestic abuse, but are commonly controlling and coercive in nature.

People’s own internalised beliefs about gender can also be a barrier to recognising themselves as victims of abuse, especially with more subtle forms such as coercion and control. Some men can be reluctant to acknowledge the extent to which their female partner’s controlling behaviour impacts their own wellbeing, or how coercion can negate free will.

complex problems

Overall, the work in this field is both challenging and rewarding – working with a demographic often ignored by society, but who are nonetheless interesting, warm, and funny individuals who have each come to homelessness via unique but all too similar pathways. These invariably involve drug and alcohol use that began as a means of coping and escapism, but became a source of its own trauma along the way.

The wins are amazing – seeing someone who has been street homeless for ten or more years settled into a property and building more secure and respectful relationships is a wonderful feeling. The way the REACH team works in the Scarborough locality is a radical approach. It takes the onus off the individual to make changes to attain a home, and instead provides the home and the appropriate support to overcome challenges.

It’s this that makes my role so fulfilling – knowing we’re tackling things from a person-centred, trauma informed care perspective, and in ways that have the power to heal and change lives.

Emma Locker is a domestic abuse practitioner at IDAS Scarborough and Ryedale

Stand together

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Peer support - Stand Together

In the absence of mental health support from statutory organisations, human resilience shines as people with lived experience form communities on the periphery – where the view is often better anyway. From this vantage point, service users and patients can see where solutions lie and can evidence what is effective as they self-resource within their community.

There are 2m people currently waiting for mental health care in England. The NHS Constitution for England states that patients have the right to access mental health services within 18 weeks of being referred by a doctor, yet statistics published in 2024 show that 10 per cent of those still waiting for a second contact in adult community health services had been waiting at least 116 weeks.

10 per cent of those still waiting for a second contact in adult community health services had been waiting at least 116 weeks

There is silent suffering behind the statistics that we’re becoming desensitised to, as over-stretched, under-performing services become a decades-long norm. Ian, a resident in one of our services recently shared his ideas for reform of community mental health services with his local MP.

INSTITUTIONAL INEQUITY
Ian’s experiences of managing his mental health – sometimes in crisis – over 20 years have given him considerable knowledge of the pathways offered to people by statutory services, and the institutional inequity that allows legislation to be levered against patient choice, even when that strips people of dignity and the hope of recovery.

But Ian has applied what he learned through his experiences of mental health to start bridging the gap in statutory support, through peer-to-peer networks. Ian first experienced a mental health crisis in 2003, and survived several suicide attempts in the following years.

Looking to recover and heal, Ian found that meaningful employment was helpful but the pressures of working long hours for a large firm in the banking industry took its toll on his mental health. From crisis to homelessness, Ian experienced little support from GPs, community mental health teams or psychologists. After two decades, he reached a point where he knew he had to get real help. Though offered only tokenistic support, his perseverance resulted in advice from a professional to voluntarily admit himself to the mental health hospital in his locality.

This was a life changing experience – from entering through the doors and handing over his possessions, to not being allowed out into the community. From beginning to end, the most succinct description of Ian’s time trying to get help in an inpatient mental health unit was ‘just like being in prison’.

Mental Health peer support
The most succinct description of Ian’s time trying to get help in an inpatient mental health unit was ‘just like being in prison’

BASIC PROVISION
Ian found that the basic provision patients experienced once admitted consisted of once-weekly appointments with a doctor and little else, besides medication checks and a TV in a communal area. Patients could speak with each other but many chose to remain in their own rooms, as there was no separate space for those presenting as vulnerable or physically challenging.

Once initially assessed patients were prescribed medication, but there was no explanation let alone discussion about why. Patients learned quickly that trying to initiate a discussion about their treatment plan, share their experiences of medication, or ask for changes, resulted in punishment.

This took the form of being forcibly restrained and given a depot injection of an anti-psychotic medication. Ian found that all the rights prescribed around patient choice – access to his own notes and support plans, discussion around timelines and dosages – were swiftly shut down with the threat of this swift disarming of dignity and autonomy.

RACIAL BIAS
Ian’s observations of how differently black men were treated in the secure hospital are particularly sinister – they were much more likely to be punished with restraint for attempting to communicate their needs. Ian also found a pattern of sectioning black men as an eviction strategy from community settings.

One mental health advocate shared with Ian how a non-verbal patient they knew had been sectioned as their housing provider, the local authority, claimed he was extremely loud and vocal to the point of being classed as anti-social. He was imprisoned and made homeless in one swift application of the Mental Health Act 1983.

WhatsApp group support
Those being discharged from the mental health unit to go out into the community and start again found solace in sharing experiences on the WhatsApp group

This is structural racism 101. As Ian learned to adapt and survive in an oppressive environment, he had to be resourceful and overcome information barriers through a resource he alone had – a short phone charger lead! Accessing the hospital Wi-Fi, Ian started to research the medication he and his fellow patients were on, finding that they were being prescribed doses far higher than what is advised.

Ian began supporting others to discuss this safely in their weekly appointments with the in-house doctor. His phone became a source of hope and resistance and, as more patients conversed and developed relationships, normal joys like humour were revived.

THE LOONY BIN WHATSAPP GROUP
When it was time for him leave, Ian continued to use his phone as a tool of support; exchanging numbers with patients and setting up a WhatsApp group. After discussion, participants decided to name this group after their nickname for the mental health hospital, the ‘loony bin’. The power of humour to overcome, cope, and gain a sense of objectivity and empowerment allowed the men in the group to create meaningful relationships based on their shared experiences.

Those being discharged from the mental health unit to go out into the community and start again found solace in sharing experiences on the loony bin group. They were able to share advice and even arrange meetups, and the group grew organically as people invited others whom Ian would sometimes meet weeks later at social events around London. Smaller meetups included cinema outings and walks that helped to counter the isolation and loneliness many members faced.

The empathy, practical understanding and knowledge that those sharing similar lived experience can offer each other is incomparable but it does not substitute the appropriate support of trained professionals and resourced organisations. Rather, those with lived experience must be supported to train and work in statutory organisations in a variety of roles so that they can influence organisations for the better. It is not just the Mental Health Act that needs reform, but every level of service.

lived experience peer support

CONTRASTING EXPERIENCE
Ian’s experiences in a mental health hospital prove this, and can be contrasted with Jo’s experience of receiving support through one of our services and moving forward to shape and deliver peer mentoring services with Social Interest Group (SIG) in her own community.

Jo’s ability to support people in an effective manner comes from the fact that she is in a permanent post, trained and resourced to advise, support and signpost people into pathways to independence in their local community. SIG’s peer-to-peer community service in Medway is delivered in partnership with the public health service.

This partnership between local statutory and VCSE models a holistic approach that supports people to recover, manage their health and wellbeing, and integrate into their own community.

Integrated services facilitate integrated communities because people can access the different support services they require at any time, in their own locality and on their own terms. Like the ‘loony bin’ WhatsApp group, this offers people a greater sense of ownership and empowerment, providing hope when it is needed most.

Raje Ballagan-Evans is policy and impact manager at the Social Interest Group (SIG)

DDN March 2025

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We’re in it together to improve mental health

DDN March 2025The idea that we may have become desensitised to mental health suffering – even if it’s because we’re overstretched and under intense pressure – is unpalatable (cover story, page 6). So what do we do with this knowledge that patients/clients are being stripped of dignity and hope of recovery, bounced from one crisis to the next – and being made homeless, criminalised, isolated, dehumanised? The lived experience tells a terrible story, but the lesson it offers is invaluable. Through conversation, connection, empathy and humour we rediscover our voices. What better illustration of peer power? And a key point is that it’s not either/or – either peer networks or trained professionals within organisations – it’s a combination of both that galvanises positive change.

With the help of our experts throughout this issue we look at trauma from different perspectives and hope it helps to piece together the complex puzzle of mental health treatment relating to substance use. Much of this lurks under the radar – those suffering from military sexual trauma, people with multiple disadvantage needing targeted support, women whose very specific needs are still treated as ‘gender neutral’. With your help we will open these topics for robust debate.

Read the March 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

Rachel Fantarrow – I am a…

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Rachel Fantarrow is national senior medicine management pharmacy technician at WithYou. We asked her about her career path and role.

Rachel FantarrowWHAT MADE YOU WANT TO WORK IN THIS FIELD?
I really wanted to be a nurse and follow in my mum’s footsteps but I didn’t think I was clever enough for university, then I saw an advert for a dispenser in a community pharmacy which caught my eye.

The pharmacist I began working for was a lady who I always mention and thank for believing in me all those years ago. She encouraged me to enrol at Sunderland University and complete the BTEC in Pharmaceutical Science. I worked my way up from a dispenser to a registered pharmacy technician working in various pharmacy locations and roles. One day I was sitting at lunch reading the ‘Chemist and Druggist’ when I saw an advert for a pharmacy technician working in a prison. I didn’t know much about offender health back then, I had been a special constable for almost nine years and had seen the trauma caused by crime and criminality but had not seen how the rehabilitation of offenders worked or what the inside of a prison even looked like.

I was successful in that role and joined as a senior pharmacy technician. I learned so much working across various prisons, and after I left I saw an advert for a medicine management technician in a drug and alcohol service. After speaking to the lead pharmacist, I came off the phone so excited and I really knew it was something that I had a great passion for and wanted to be involved in.

This role incorporates so many of the transferable skills I have learned in my career as a pharmacy technician and I am constantly learning more each day.

WHAT DOES A TYPICAL DAY LOOK LIKE?
Working in a national role is a mix of home working and working in services, and not one day is the same. One week I may be home all week and the next I may be working in a service three hours away from my home. This variety is great as I get the opportunity to meet so many new people and really see the value our organisation makes to each of our clients, focusing on a patient-centred approach.

TELL US ABOUT YOUR WORK ENVIRONMENT
I work with a wide range of professionals such as medical directors, lead clinical pharmacists, pharmacy technicians, clinical leads and nurses, prescribers (NMPs), heads of services, directors, stakeholders – all with a multidisciplinary approach to positively impact the outcome that someone achieves when accessing support for substance use.

My role is so varied and can range from things like delivering training, writing guides, harm reduction, medicine management, audits, presenting at external events, community pharmacy visits, destruction of CDs, incident management, drug alerts, managing other pharmacy technicians, recruitment and induction.

Rachel Fantarrow WithYou I am a...WHAT DO YOU FIND MOST REWARDING?
For me I feel proud that I can support other pharmacy technicians, clinical staff and non clinical staff to ensure that medication management is carried out safely and effectively, which directly impacts our patients and clients, and their care.

I pride myself on my ability to share knowledge, and help enhance the skills of my colleagues. This not only improves overall quality of care provided but also fosters a collaborative environment where everyone works towards common goals.

I love the sector that I am currently working in and the clients that we support, knowing that the efforts from all the teams working together contribute to safer medication use and better health outcomes.

The role of a pharmacy technician working in drug and alcohol services is vital in ensuring that the healthcare team operates efficiently and that patients and clients receive the best possible support. 

The impact on people supported in a substance use environment can be significant. Our clients often experience improved health outcomes, and they also have access to treatment and support which can lead to reductions in substance use, which in turn decreases the risk of associated health problems, such as infectious diseases or mental health issues.

WithYou really helps to foster a sense of community and belonging for individuals who use our services. Many people struggling with substance use feel isolated and having a supportive environment can enhance their motivation to seek help and stay engaged in their own personal recovery.

Overall, the support offered in substance use environments plays a crucial role in promoting recovery and enhancing the quality of life for those affected, and I’m so pleased to be a part of that.

WHAT WOULD YOU LIKE TO CHANGE?
I would love to see more clients accessing support services, more access to mental health services, job training, housing assistance and more help to address underlying issues that contribute to substance use.

I also want to see an increase in education, offering more awareness around addiction and recovery.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
For any pharmacy technician considering working in a drug and alcohol setting, I would say the role is crucial in ensuring that clients receive the right medications and harm reduction advice while also supporting the individual on their recovery journey.

There are so many transferable skills that can be brought into this sector from community pharmacy, hospital pharmacy and prison pharmacy.

The role requires not only a strong understanding of pharmacology but also a compassionate approach to those dealing with addiction. As a pharmacy technician you are a registered healthcare professional and your ability to communicate effectively and empathise with patients and clients can make a significant difference in the treatment experience, ultimately helping someone on their path to recovery and that is so rewarding to experience.

 

DDN JobsSee opportunities like Rachel’s on DDN Jobs

US overdose deaths down by a quarter

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US overdose deaths down by a quarterProvisional data from the US Centers for Disease Control and Prevention (CDC) for the year to September 2024 is predicting a ‘nearly 24 per cent decline’ in drug overdose deaths, compared to the previous 12 months.

According to the CDC’s National Vital Statistics System, there were around 87,000 overdose deaths between October 2023 and September 2024, down from 114,000 the previous year. The figure is the lowest overdose death total in any 12-month period since the start of the decade, says CDC, and shows a ‘continued steep decline’ in mortalities.

‘Multiple factors’ have contributed to the fall, says CDC, including ‘widespread, data-driven distribution of naloxone’, better access to evidence-based treatment, and shifts in the illegal drug supply. The number of non-fatal overdoses – as measured by emergency department admissions – has also fallen, CDC points out.

US overdose deaths
Overdose remains the leading cause of death for Americans aged 18-44

The US has long struggled with a drug deaths crisis, with almost a million fatalities in the first two decades of this century and opioid overdose first declared a public health emergency almost a decade ago. A study in the journal JAMA Psychiatry also found that almost 322,000 children lost a parent to drug overdose in the decade to 2021.

While the sharp drop in deaths is ‘encouraging’, overdose remains the leading cause of death for Americans aged 18-44, CDC points out, highlighting the ‘importance of sustained efforts to ensure this progress continues’. Although 45 states recorded a fall in overdose deaths, five still saw increases – Alaska, Montana, Nevada, South Dakota and Utah.

‘It is unprecedented to see predicted overdose deaths drop by more than 27,000 over a single year,’ said director of CDC’s National Center for Injury Prevention and Control, Allison Arwady. ‘That’s more than 70 lives saved every day. CDC’s public health investments, our improved data and laboratory systems for overdose response, and our partnerships with public safety colleagues in every state mean that we are more rapidly identifying emerging drug threats and supporting public health prevention and response activities in communities across America.’

Provisional drug overdose death counts available here

Addressing stigma and its impact on families

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families stigma
Families, whether grieving or caring for a loved one, often lack effective support

Substance dependence and its associated stigma are often seen as either a personal issue or a public health crisis. However, families and carers, who bear much of the emotional burden, are frequently overlooked.

The Anti-Stigma Network’s first Accelerator session highlighted the barriers families face when supporting loved ones affected by substance use.

The crisis in family support
Focusing on England, the session explored the growing crisis in family support. Record levels of drug and alcohol-related deaths have left thousands of families grieving, many experiencing disenfranchised grief – where societal judgement leads to unacknowledged grief or even blame. Families, whether grieving or caring for a loved one, often lack effective support.

The stigma they encounter comes from multiple sources – society, within their own families, and self-stigma – keeping their struggles hidden. Additionally, there is no dedicated funding stream for research, best practices, advocacy, or direct support for affected families. As a result, families remain on the fringes of drug treatment, healthcare, and mainstream carer support systems.

Key insights from the session
Led by Viv Evans, chief executive of Adfam, and Amy Dickson, trustee and outreach manager for Nacoa, the session underscored the widespread impact of substance use on families. With one in five children affected by a parent’s alcohol use and one in three families impacted by substance use, the need for dedicated family support is clear.

families and stigma - family support
With one in five children affected by a parent’s alcohol use and one in three families impacted by substance use, the need for dedicated family support is clear

Key themes from the discussion included:

  • Innovative family support approaches: many services when faced with the reality of societal and internalised stigma navigate through those barriers using creative outreach strategies, including online sessions, remote support, and community-based programmes in pharmacies and supermarkets. Family services tend to be very good at considering how they use language and engagement techniques carefully in order to reach families that are marginalised by negative social attitudes.

  • Specialised family support services: family support requires unique expertise. Professional skills in treating substance users do not always translate to effective family interventions. Understanding family histories and relationships is crucial, as these dynamics can contribute to shame and isolation. Destigmatising approaches tailored for individuals using substances may not be appropriate for family members, including kin carers or children.

  • Early intervention in schools: schools play a key role in supporting children affected by parental substance use and helping normalise discussions around addiction within families.

Next steps
The session reinforced that stigma is a major barrier to both individual and family recovery. By fostering open discussions, advocating for funding, and driving systemic change, we can dismantle the stigma-related barriers that prevent families from accessing the support they need.

Look out for future activities in our family-focused anti-stigma workstream.

By James Armstrong

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

New growth

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inclusive recovery cities initiative

Based on the idea that recovery is most likely and most contagious in areas where it is both visible and readily accessible, Inclusive Recovery Cities is a movement that celebrates recovery achievements and events. It challenges stigma and exclusion and provides pathways to stable recovery for individuals and families.

There are currently 32 inclusive recovery cities globally, with the UK at the heart of this initiative – ten of them are in England and a further three in Ireland. The network of ten English cities work together and meet quarterly to share ideas and innovations, with the aim of supporting recovery visibility. Towards the end of 2024, the 12 local authorities in the North East agreed to become the first inclusive recovery region, and we are on the verge of agreeing the first inclusive recovery prison in the UK.

There are currently 32 inclusive recovery cities globally, with the UK at the heart of this initiative
There are currently 32 inclusive recovery cities globally, with the UK at the heart of this initiative

At the forefront of this movement has been the wonderful partnership work in Nottinghamshire. Supported by the local authority, Change Grow Live (as the treatment provider), Double Impact (the LERO) and Hettys (the family service) have worked to bring together not only recovery groups and individual recovery champions, but also to engage a diverse range of stakeholders from across the community.

Following a successful launch at Mansfield Town Football Club, we held a second event to focus on innovation and social enterprise for recovery across Nottinghamshire.

The event was opened by Professor David Best who set out his vision for inclusive cities and hoped there would be more such events. He emphasised that the primary aim was to remove stigma associated with people who used substances and their recovery process. A key task for inclusive recovery cities was building a feeling of momentum and making people from across the community proud to be a part of it.

Many respected charities and organisations from our sector were represented at the event, as well as local agencies that were active in the local community. They displayed stalls for their literature, and staff and volunteers were on hand to discuss their organisation with visitors. The event had the feeling of a marketplace, with many things for participants to do and see.

The event in Worksop achieved its aim of showing what support was available for recovery
The event in Worksop achieved its aim of showing what support was available for recovery

The organisations involved included Retina UK, Hettys, New Way, In Sam’s Name, Nottinghamshire County Council, Alcoholics Anonymous, Getting Clean (who came down from Leeds to present), TunTum Housing, Not Saints and Camerados, who provided a living room space for people to mingle and relax during the event.

Speakers from two of the organisations also gave talks about their involvement and future plans. The theme was meaningful activities, and parti­cipants were offered taster sessions, games and workshops. A main aim was to showcase some of the incredible opportunities available in Nottinghamshire, where the IRC Council are building connections with the local recovery community.

A sing-along led by Danny from the Rock Choir brought the event to a conclusion with rousing renditions of motivational songs. Professor Best thanked all present for making the day a huge success.

The event in Worksop achieved its aim of showing what support was available for recovery. Through four events each year we want to create connections that provide opportunities for people to find their passion, develop a sense of belonging, and be a part of something positive that builds hope in the communities where they live and recover.

inclusive recovery cities initiative
What’s happening in Nottinghamshire is a testament to the power of communities and partnerships

IRC intends to keep building on its vision to make recovery accessible, visible and inclusive for everyone while overcoming the stigma attached to substance users and the recovery process.

To that end we’re planning a third event for spring 2025, with the theme ‘new growth’. The intention is to have stalls in the Nottinghamshire area with gardening items and demonstrations to enthuse children, adults and families alike, in the spirit of inclusivity. We hope it will continue the momentum and inspire, motivate and promote IRC’s values and beliefs.

What’s happening in Nottinghamshire is a testament to the power of communities and partnerships, showing that not only is recovery possible but that it has a crucial role to play in community development and wellbeing.

Written by Royce Marshall with the assistance of Prof David Best and Lynne Jaap. Images by Melissa Ward

‘Cuckooing’ to become a specific criminal offence

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‘Cuckooing’ to become a specific criminal offenceThe act of seizing control of a vulnerable person’s home in order to deal drugs, known as ‘cuckooing’, is to become a specific criminal offence under the Crime and Policing Bill, the Home Office has announced. The offence will carry a maximum penalty of five years in prison.

The bill, which is set to be introduced in Parliament this week, will also create another new offence of using a child to commit criminal activity. The standalone child criminal exploitation (CCE) offence will target adults who ‘unscrupulously groom and exploit children into criminal activity’ – such as county lines gangs – says the Home Office, and carry a maximum ten-year prison term.

The new offence will also help to identify more children at risk, the government states. While current estimates show that around 14,500 children were identified as involved in – or at risk of – CCE in 2023-24, this is likely to be an underestimate as many exploited children will ‘not be known to the authorities’, it says.

A 2022 study by criminal justice consultancy Crest Advisory warned that agencies were frequently missing opportunities to respond to the ‘red flags’ indicating that young people were at risk of CCE, and called for better joint working and improved police training. A disturbing report from the University of Nottingham the previous year also found that county lines activity was becoming increasingly categorised by extreme violence and sexual exploitation of both boys and girls.

CCE
‘A standalone crime of child criminal exploitation (CCE) will finally shift the focus onto perpetrators, not victims’

‘The exploitation of children and vulnerable people for criminal gain is sickening and it is vital we do everything in our power to eradicate it from our streets,’ said the home secretary, Yvette Cooper. ‘These bespoke orders will ensure that courts can impose restrictions and requirements on individuals who pose a risk of exploiting a child for criminal purposes, such as limiting their ability to work with children, contact specific people or go to a certain area.’

‘This new offence is a vital step forward that we have been campaigning for over the years,’ said Children’s Society chief executive Mark Russell. ‘A standalone crime of child criminal exploitation (CCE) will finally shift the focus onto perpetrators, not victims. For too long, adults who groom children into criminal activity – forcing them to hold drugs or launder money or commit theft – have evaded accountability. Charges such as drug possession ignore the core truth; these are child abusers exploiting vulnerable young people. To protect the 14,500 children identified at risk last year – and the thousands more unseen – these measures must be backed by three pillars; strong enforcement, training for safeguarding professionals and a statutory definition of CCE to help end the postcode lottery in victim support.’

200,000 people did this year’s Dry January

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Just under 200,000 people took part in Dry January last month, according to Alcohol Change UK.

mocktails
Mocktails are among the growing range of options for people wanting to socialise without drinking alcohol.

Based on previous data almost 70 per cent of Dry January participants continue to consume fewer units for at least six months, the charity says. 

Alcohol Change UK has international partners in France, Austria, Switzerland, Norway and the US, with people from more than 180 countries in total taking part. UK participants saved an average of £124 over the course of the month this year, it says, consuming an average of 100 fewer units of alcohol and more than 7,000 fewer calories, and using the charity’s Try Dry app, daily motivational emails and online support communities. 

This year marked the 12th anniversary of Dry January, with 4,000 people taking part in January 2013. ‘The Dry January challenge is about more than numbers,’ says Alcohol Change UK. ‘It’s about the benefits people feel from resetting their relationship with alcohol for the longer term and the supportive online community that forms with people helping each other to succeed in whatever way works for them. These experiences can be transformative.’

Meanwhile, a WHO report is calling for prominent cancer warnings to be included on alcohol labelling. Public awareness of the link between alcohol and cancer remains ‘alarmingly low’ in Europe, the agency states, with a study across 14 countries finding that just 15 per cent of respondents were aware of the link between alcohol and breast cancer and less than 40 per cent knew of the link to colon cancer. 

The report calls for mandatory labelling, rather than self-regulation, featuring ‘clear and prominent’ health warnings. Ireland became the first country to commit to mandatory labelling for alcohol products in 2023, although they are not due to come into force until next year (https://www.drinkanddrugsnews.com/caught-in-the-act/), with campaigners urging the industry ‘not to cause any further delay’. 

‘Clear and prominent health warning labels on alcohol, which include a specific cancer warning, are a cornerstone of the right to health, because they empower individuals with vital information to make informed choices about the harm alcoholic products can cause,’ said WHO’s regional director for Europe, Dr Hans Kluge. ‘Providing this information does not take anything away from consumers – on the contrary, it arms them with knowledge, and knowledge is power.’

Alcohol health warning labels: a public health perspective for Europe.

Stacey Skilton – I am a…

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Stacey Skilton I am a...

WHAT MADE YOU WANT TO WORK IN THIS FIELD?
I began my career working in custody as a prison officer but felt that the role wasn’t enough for me. I wanted to be able to help people more. In the alcohol and drug field I’ve worked in various different roles – recovery worker, criminal justice recovery worker, and then I moved up to team leader, operations manager, service manager, and head of service. I felt I had something to give to communities, and I had a skill set that would be useful to help people through their recovery journeys. The more I learned about the field, the more my knowledge grew – and the more my interest grew, the more I wanted to do.

I never sat as a little girl thinking, ‘I want to manage a drug and alcohol service’. In fact, I never would have wanted a managerial role. But I had a lot of visible results and could see people in my communities that I supported. So when opportunities arose I thought, ‘If I can manage a service or a team, I can influence more people and help more people become well’. WithYou trusts that its heads of services can run them and make a change.

WHAT DOES A TYPICAL DAY LOOK LIKE?
I cover the full Redcar and Cleveland area. We have numerous hubs covering towns, seaside areas, and rural areas, and I tend to float between the hubs I’m in. I like to spend time with my staff and understand the problems they’ve got, because I can’t support them when they raise their concerns if I don’t understand. On a Friday I tend to keep my diary as light as possible, and the staff will come and have a chat. They’ll ask me for updates, give me ideas, and tell me about client concerns. I like to think that I’m still very much linked to the frontline of the service.

Stacey SkiltonTELL US ABOUT YOUR WORK ENVIRONMENT
A lot of our work includes our partnership service THRIVE, which consists of Harbour (a domestic abuse service), Intuitive Thinking Skills (who provide substance use related educational opportunities), and different elements of the local authority. A big part of my role is representing WithYou to our various partners. I get to influence other local projects and continue to promote our service – challenging the bias and stigma that still exists – and push for wider system change outside of the WithYou world. I enjoy that element.

Working in partnership means we’re in a really good position to be able to challenge each other as stakeholders and better meet the needs of the community, because although WithYou is drugs and alcohol at our core, we are so much more than that.

Recently one of my staff did a home visit to a client that she had huge concerns about because she hadn’t heard from him. He didn’t answer the door so she went to the neighbour, who let her in. It turned out that our client hadn’t been in touch because he had no money and his electricity had been turned off. He was sat in the cold and dark and because he didn’t have money, he couldn’t use his phone. My staff member called the utility company, explained what had happened and got his utilities turned back on.

We do so much more behind the scenes, and that needs to continue to evolve and grow, because people genuinely are in crisis and they don’t know where to go. I think sometimes that we as a service hold that key to reaching out to people.

WHAT DO YOU FIND MOST REWARDING?
I really like to be able to support staff ideas and the changes they want. A recovery worker once said to me, ‘If we sit still, the world will keep turning around us.’ It’s for us to get up and move with that world. I want to foster an environment where people come to me with ideas and say, ‘I think this is needed. Can I do this?’

A staff member came to me and said, ‘Can I swap my caseload round and just have opiates? Because I’m really enjoying working with them.’ If that’s your passion, your interest, go for it. It’s nice to be able to support people in that capacity, because if you make your staff happy, you retain your staff – and if you retain your staff, there’s better relationships with clients and better outcomes. From December ’22 to December ’23 we didn’t lose any members of staff in Redcar. In December ’23 we had staff leave, but those staff members came back to us within eight months and one of them said that returning had been like coming home. I have some incredible staff with amazing stories and loads of skills to give, and I’m in a position to support that.

Stacey WithYouWHAT WOULD YOU LIKE TO CHANGE?
I’d like to change the conversation around drug and alcohol support – for people you pass on the street, shop workers, bus drivers, people who sometimes find it easy to judge the clients who we’re supporting.

Most people have a story about someone they know who died from alcohol, or someone who used too many prescription drugs after an operation. But for some reason, the disparity between everyday conversation and the conversation about our client group is quite vast. There’s a big gap there, and I’d love to be able to bring it closer together.

I also want to continue developing the service to intervene and reach out to people before they need our help – before they fall into the river and need pulling out. Our young people’s service attends schools and colleges and speaks to children as young as nine and ten about healthy relationships and substance use, in an age-appropriate manner. If we educate young people, they’ll be able to tell their parents/carers and other children, and as they’re teaching and spreading the word, they’re retaining the information more, and it’s going to have more of an impact on them later in life.

They may still go on to try a substance, but if they’re aware of the risk, it might only be a try and not become a dependence. They might then know how to keep their mum and dad safe if they find tablets, and if their friends or other teenagers get into trouble with alcohol they’ll know to phone 999. If we’re not having the conversations and not giving them the knowledge, we’re not giving them the opportunity to use it. And I do think that as drug and alcohol service, we have to be accountable for that harm reduction within our community. It’s our responsibility.

If we empower commun­ities to have the knowledge and the skills to know where to go for help when they’re ready, and know what that help looks like, that would be job done for me. I could retire happily with that legacy.

 

DDN JobsSee opportunities like Stacey’s on DDN Jobs

Youth vaping research project to track 100,000 young people

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A research project to study the long-term health effects of vaping on children will track 100,000 young people aged eight to 18 over the course of a decade, the government has announced. 

Teenager vaping
The research will give the most comprehensive picture yet on youth vaping.

Data will be collected on behaviour and health records to understand ‘what affects young people’s health and wellbeing, including the impact of vaping’, the Department of Health and Social Care (DHSC) states. While vaping is a proven tool to help adults successfully quit smoking, rates of youth vaping have ‘skyrocketed’ in recent years, says the department, with a quarter of 11 to 15-year-olds now having tried it. 

The long-term impacts of youth vaping are still ‘not fully known’ and the research will give the most comprehensive picture yet, the government says, as well as providing health professionals and policymakers the ‘robust evidence they need to protect the next generation from the potential health risks’.

A study by Brighton and Sussex Medical School published earlier this month, however, found that many young people still mistakenly believed that vaping is ‘as bad for you or worse’ than smoking, and called for action to address these ‘pervasive misconceptions’ (https://www.drinkanddrugsnews.com/misinformation-deterring-young-people-from-switching-to-vaping/). 

The government’s tobacco and vapes bill, which is currently making its way through Parliament (https://www.drinkanddrugsnews.com/tobacco-and-vapes-bill-introduced-to-parliament/), contains plans to tackle youth vaping by tightening the legislation around packaging, flavouring and displays designed to appeal to children. Disposable vapes will also be banned from June this year under separate legislation (https://www.drinkanddrugsnews.com/government-to-ban-disposable-vapes/), further reducing vaping’s appeal to young people, the government states. 

public health minister Ashley Dalton. 
Public health minister Ashley Dalton.

‘With vaping on the rise among young people, it is crucial that we develop a solid evidence base to better understand its health impacts, and help ensure we protect and support the next generation,’ said CEO of the National Institute for Health and Care Research and chief scientific adviser to the Department of Health and Social Care, Lucy Chappell. ‘By investing in important research such as this we give young people, parents, and policymakers the knowledge they need to make informed decisions and safeguard long-term health.’

‘We know that vaping can be a useful tool to quit smoking, but it’s crucial we have clear evidence on the long-term health harms, especially for young people,’ added public health minister Ashley Dalton. 

Changing the nitazene narrative

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Changing the nitazene narrative

We can all agree – the presence of nitazenes in the heroin supply is a problem. It’s a problem that has more than likely caused more than 400 people to lose their lives in the UK, with many more overdoses on the cards.

Their emergence should also have come as no surprise – the rise of potent synthetic alternatives to ‘traditional’ drugs has been a familiar trend ever since the early 2000s and the advent of ‘legal highs’. Very quickly, the UK decided to gift these compounds to organised crime, with tragic and predictable outcomes.

When it comes to nitazenes there seems to be a prevailing view that they can’t be managed or controlled by the people using them. This can easily morph into the belief that the only way for people who currently use heroin to ensure they don’t suffer a nitazene-related overdose is to abstain. However, there are many people with powerful reasons why they can’t or won’t stop, and they may be left feeling hopeless and at the mercy of these compounds.

nitazenes
When it comes to nitazenes there seems to be a prevailing view that they can’t be managed or controlled by the people using them

At the same time, in the face of the fearsome potency of some nitazenes, services have understandably retreated to familiar ground, offering slightly tired advice like ‘don’t use alone’ or ‘look after your friends’, while rightly calling for effective but distant systemic change like the introduction of overdose prevention centres and expansion of drug testing facilities.

Of course, the introduction of evidence-based, low-threshold harm reduction should be a priority for the UK, and we should continue to promote it at every opportunity. However, there is a problem staring us in the face – currently these life-saving transformative interventions are NOT the priority for policy makers. These changes will take time and money to implement, and we’re in danger here of letting the perfect be the enemy of the good – of concentrating on future developments while doing little or nothing to intervene in the present.

As for most individual users of heroin, they’re left in a very familiar space. That is, feeling powerless waiting for these distant remedies while facing the real and present prospect of dying – at the mercy of the invisible monster in their bag of gear. We’re in urgent need of simple practical harm reduction advice that individuals can implement easily while the country waits for large evidence-based approaches to be introduced.

harm reduction adviceThe idea of ‘batch cooking’ could be an example of just such a small change in the preparation of heroin (with clusters of nitazene present) that could marginally lower risk. The idea came from a chance discussion with an anaesthetist and pain specialist, someone who was no stranger to using powerful synthetic opioids on patients

The conversation turned to the nitazene threat and I asked him what techniques were used to administer a safe dose of anaesthetic. Among other things, he simply replied ‘dilution’. Dilution of a substance can of course have the benefit of both lowering the strength of a dose but also of evenly distributing the drug through a solution – clustering of nitazene within a batch of heroin has been cited as a particular threat.

For some people who use drugs, this is not a new idea. There are examples of people who prepare a number of doses of heroin in advance and then use the solution over the day or sometimes longer. Put simply, if the user were to dissolve a number of doses of heroin/nitazene mix in a larger amount of water with some added citric, the nitazene would be better distributed throughout the liquid and the dose of nitazene would be both more diluted and more evenly distributed. If the user then ‘tasted the hit’ and found it to be effective, they would have a store of ready mixed liquid solution that they could use with reduced risk.

heroin overdose risk nitazenes
The basic concept of ‘batch cooking’ may be a useful, easy and pragmatic way for people who use heroin to lower the risk of overdose

There are a number of important issues to be thought through here – detailed in my discussion paper – but the basic concept of ‘batch cooking’ may be a useful, easy and pragmatic way for people who use heroin to lower the risk of overdose. We need to keep thinking of novel harm reduction practices like this and sharing them with people who use drugs to see if they find them practical and useful to implement, while doing all we can to ensure that any new ideas do indeed reduce risk and don’t increase harm.

Clearly, with drugs like nitazenes there comes a point where the potency of the drug is fatal regardless of harm reduction practices. But we should not stop thinking creatively about how people can survive this latest threat on a day-by-day basis.

Renato Masetti is training co-ordinator, drugs and alcohol, Health Outreach NHS

Contact him for his original paper at renato.masetti@nhs.net

VITAL CLUES
The detective work on nitazenes is a vital tool in harm reduction, as DDN reports.

Of 37 samples found to contain nitazenes, 29 of them were submitted as oxycodone
Of 37 samples found to contain nitazenes, 29 of them were submitted as oxycodone

WEDINOS was a network unlike any other, a monitoring system that reflected national drug markets, trends and threats, project manager Dean Acreman told the RCGP/AP conference.

Through examining con­sumer level samples since 2013 the system had identified drugs quickly and effectively, showing that many substances contained substitutions that people had no idea they were buying. Since attracting Welsh Government support, it had become integral to harm reduction in Wales over the past ten years and had analysed more than 45,000 samples.

More recently it had become a vital tool in tackling the nitazene crisis, with more than 250 samples profiled as containing nitazenes since April 2021. ‘We can turn around results very quickly,’ said Acreman. ‘Are you getting what you think you’re getting?’ he added. For example, of 37 samples found to contain nitazenes, 29 of them were submitted as oxycodone.

The journey over the past few years reflected the ‘changing face of nitazenes’ as WEDINOS started to find them in heroin. ‘We put out a leaflet and gave reassurance around using naloxone,’ he said. The service had also played a key role in prison safety – HMP Parc reported spice deaths but the blank pieces of paper being sold were found to be laced with nitazenes. An information sheet for staff and easy-to-read document for prisoners swiftly followed.

With an expanding list of drugs found to include nitazenes, the ongoing challenge was ‘how do we get the message out?’ he said.

drug deaths nitazenes
The situation could be ‘even worse than we know’ as testing threw up some ‘weird things’ that could indicate that deaths could be being missed

The UK was responsible for a third of all drug-related deaths in the EU in 2019, said Dr Caroline Copeland, director of the National Programme on Substance Use Mortality. ‘They’re glad we’ve left.’ She later added, ‘There are many different answers to why they’re so much higher in the UK – maybe some countries may not test so well. Also, Scandinavian countries have much greater investment in healthcare.’

Her national programme involves using data to understand more about the pharmacoepidemiology of drug-related deaths. Coroners voluntarily send reports from England, Wales, Northern Ireland, the Channel Islands and the Isle of Man, amounting to 60,000 reports to date.

The high volume of detailed data, including demographics, meant ‘we can do an awful lot of analysis,’ she said. Data on 230 fatalities related to nitazenes between June 2023 and 2024 revealed large clusters around the Birmingham area and south coast of England.

She shared concerns that the situation could be ‘even worse than we know’ as testing threw up some ‘weird things’ that could indicate that deaths could be being missed – nitazenes had been detected in post-mortem urine but not in post-mortem blood; drugs had been detected in post-mortem blood in quantities not usually associated with fatality. The service was working as fast as possible to find answers to questions that were a vital part of the picture.

Change Grow Live: our call for sustainable funding for community drug and alcohol treatment

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Funding for residential drug treatment
Without sustained, ring-fenced funding, these hard-won gains are perilously close to being undone

Every pound invested in drug and alcohol treatment services delivers extraordinary returns: saving lives, reducing crime, easing NHS pressures, and breaking cycles of disadvantage.

At Change Grow Live, we have rebuilt our workforce, expanded access to care, and helped hundreds of thousands of people to achieve the stability they deserve. Without sustained, ring-fenced funding, these hard-won gains are perilously close to being undone.

Disinvestment would set our country back and jeopardise the very safety of the communities we support, as emerging threats – like the growing danger of synthetic substances – multiply. Withdrawing funding will cost more in the long run than any short-term savings can justify.

This is why we are calling for continued investment in these services.

sustainable funding Change Grow Live
Drug and alcohol treatment services have been demonstrated to reduce offending by 33%

We know that:

1. Drug and alcohol services deliver value for money
The harm related to illicit drug use in England costs an estimated £19.3 billion. Adult drug treatment reflects a return-on-investment of £4 for every £1 invested in the short term – potentially increasing to £21 over 10 years.

2. Drug and alcohol services help keep people economically active
With sufficiently funded services, we have seen 52% of people who use Individual Placement and Support services successfully obtaining employment within 18 months – compared with just 16% prior to receiving this funding.

3. Drug and alcohol services break down barriers to opportunity
Drug and alcohol services open up life-changing opportunities for young people. In the past year, 85% of young people who finished treatment with Change Grow Live were no longer self-harming, and 53% reduced or stopped offending behaviour.

4. Drug and alcohol services make our streets safer
Drug and alcohol treatment services have been demonstrated to reduce offending by 33%, playing a crucial role in keeping streets safe and easing pressures on already overwhelmed criminal justice services.

5. Drug and alcohol services ease pressure on an already strained NHS
For illicit opioid users, there are 3.8 million avoidable healthcare appointments associated with primary care and secondary care. This costs the NHS an estimated £414 million per year. The cost of alcohol to the NHS and healthcare is estimated at £4.91 billion.

6. Disinvestment would undo hard earned progress at the worst possible moment
New synthetic drugs present an unprecedented public health threat. They have already contributed to the deaths of almost 200 people, and in 2024 our testing strips detected synthetic opioids in 482 samples.

To sustain the life-changing progress we’ve made, continued investment in drug and alcohol treatment services is essential. Any reduction in funding would reverse the significant progress and risk the lives and safety of many people who use our services. The case for continued investment has never been clearer.

Read the full Change Grow Live Representation to HM Treasury Spending Review Phase 2 here

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

The Laurel Centre: the UK’s only dedicated residential course for sex and porn addiction

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The Laurel Centre provides support and treatment for sex and porn addiction through individual therapy, couples therapy, online treatment programmes, and the six-day Residential Recovery Course.

Dr Paula Hall, the Laurel CentreEstablished by Dr Paula Hall, the Laurel Centre is the UK’s largest therapy organisation that specialises in working with clients struggling with compulsive sexual behaviour disorder (commonly known as sex or porn addiction) and their partners. What began as one therapist’s mission to provide a treatment service to an under­represented and often misunderstood client group has now grown into a 20 plus strong team of specialist, trained therapists based all over the UK with over 500 clients currently using the service, five different client courses available, and an accredited therapist training programme.

The beating heart of the Laurel Centre is the six­-day Residential Course in Leamington Spa, the only residential course in the UK that is exclusively for those struggling with compulsive sexual behaviours. It is also the only residential treatment programme of its kind in the world to be scientifically evidence­-based with proven results published in a peer­-reviewed research journal.

Laurel Centre residentialLimited to a maximum of eight attendees, the residential has been designed to get clients away from their usual environment and focus all their attention on overcoming compulsive sexual behaviours. Offering the equivalent of 56 hours of therapy, it provides an environment that overcomes the shame, isolation and secrecy that often fuels addiction.

By the end of the course, clients can:
1. Understand the biological and psychological causes of their addiction.
2. Recognise and manage triggers.
3. Establish relapse prevention strategies to secure and maintain recovery.
4. Identify and overcome potential future blocks to recovery.
5. Develop long term strategies for re-establishing personal integrity and a healthy lifestyle.

transformative experience

The cost of the residential course includes bed and breakfast for five nights, lunch, refreshments, all treatment materials, a personalised aftercare plan, and a follow­-up day three months after the end of the course. Upon completion, attendees are also invited to an aftercare group to receive continued support throughout their recovery.

 

Laurel Centre contact

To find out more, please contact us on 01926 339594 or email info@thelaurelcentre.co.uk
Visit our website at www.thelaurelcentre.co.uk

Pivotal Recovery

For those who cannot afford or don’t have access to traditional therapy, we recommend an affordable, online, therapy-based programme – Pivotal Recovery.

Based on over a decade’s research and experience with thousands of men and women, Pivotal Recovery is a recovery course that will change your life, not just your habits. A sex-positive, inclusive solution for problematic sexual behaviours.

“This was a well-structured, informative, and pragmatic course that represents great value for money.”

www.pivotalrecovery.org

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Prison system came ‘dangerously close to collapse’, says interim sentencing review

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Prison system came ‘dangerously close to collapse’, says interim sentencing review
Measures to ease the ‘great strain’ on the probation system could include wider use of ‘drug, alcohol and mental health treatments’

Capacity pressures on the prison system brought it ‘dangerously close to total collapse’ last year, says the interim report of former justice secretary David Gauke’s Independent sentencing review.

The prison population has grown rapidly over the last 30 years, says the document, largely the result of prison sentences being ‘lengthened substantially by successive governments’. The review’s final report will be published in the spring and will set out recommendations to ensure that the demand for prison places does not exceed supply and is ‘sustainable in the longer term’.

Mandatory minimum sentences were introduced in 1997 for a range of offences, the report points out, including a mandatory minimum of seven years for a third class A drug trafficking offence. The document includes case studies from places where the prison population has significantly fallen in recent years, including Spain, the Netherlands and Texas, all of which have reformed their drug sentencing policies.

Prison system
The review’s final report will be published in the spring and will set out recommendations to ensure that the demand for prison places does not exceed supply

In an op ed column for the New Statesman Gauke writes that measures to ease the ‘great strain’ on the probation system could include wider use of ‘drug, alcohol and mental health treatments’, while there is ‘encouraging evidence that problem-solving courts are effective in rehabilitating offenders – but we have very few of them. Relatively small sums of money (compared to the prison budget) could do much more to reduce reoffending.’ A report from the Prison Reform Trust earlier this month found that less than half of prison leavers had settled accommodation on their release.

‘This is not simply a crisis of prison capacity,’ said director of campaigns at the Howard League for Penal Reform, Andrew Neilson. ‘Our overcrowded and violent prisons are breeding grounds for crime, while probation services are overstretched and under-resourced within the community. We welcome these findings from the Review and look forward to proposals to reset the system. Action cannot come quickly enough if we are to achieve a sustainable and more effective course for prisons and probation in the future.’

‘We have waited a long time for such a clear and brave analysis of the factors that have led to the overcrowding and financial crises in the prison system,’ added chief executive officer at Forward, Mike Trace. ‘We now call on the inquiry team to be similarly clear and brave in recommending, and quickly implementing, measures to get more offenders into employment, mental health, and addiction recovery programmes.’

Independent sentencing review – history and trends in sentencing available here

Deadly disparities

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Social injustice

Late last year Professor Sir Michael Marmot, a leading expert on health inequalities, delivered a keynote speech at the Drugs, Alcohol and Justice All Party Parliamentary Group (APPG), which is co-sponsored by Waythrough alongside Via and WithYou.

Professor Marmot has spent decades examining the root causes of health disparities, which are outlined in his landmark 2010 review Fair society, healthy lives alongside evidence-based strategies to address them. A decade later his Health equity in England: the Marmot review 10 years on report found that health inequalities in England had in fact worsened, with drug and alcohol use remaining a key driver.

Social injustice - housing
Addressing health disparities demands systemic change to tackle the underlying social determinants of health, such as education, housing, and employment opportunities

Professor Marmot framed health inequality as a profound issue of social justice and stated simply that ‘social injustice is killing on a grand scale’. Addressing health disparities requires more than investments in healthcare systems, he said – it demands systemic change to tackle the underlying social determinants of health, such as education, housing, and employment opportunities.

Professor Marmot’s core message was that deprivation directly correlates with poor health. Wealth acts as a protective factor, regardless of location, but for those in deprived areas – especially in the North West and North East of England – health disparities are particularly stark. A lack of social mobility and rising rates of child poverty also create intergenerational cycles of ill health that are difficult to break.

Professor Marmot didn’t hold back in criticising how political decision-making drives inequalities, and singled out the reduction in public sector expenditure during the austerity years as a key cause. Between 2010-11 and 2020-21 the total spending power for local authorities fell by 26 per cent, and government-funded spending power fell by more than 50 per cent in real terms. His research also found that, perversely, areas with shorter life expectancy experienced the most severe funding cuts during austerity. ‘The sicker the community, the more money the government takes away from it,’ he said.

‘Deaths of despair’ is a phrase popularised by economists Professor Angus Deaton and Anne Case, referring to deaths caused by drugs, alcohol and suicide. Each often has a link to inequality and deprivation.

Deadly disparities APPG
While public discourse often blames individual people for substance use or poor mental health, environments and systems perpetuate these issues

Professor Marmot noted that while public discourse often blames individual people for substance use or poor mental health, environments and systems perpetuate these issues. We have all seen evidence of this only too clearly – in 2023, there were 5,448 drug-related deaths, with the North East being disproportionately impacted with 441 deaths. This was the eleventh consecutive year the area had the highest rate of drug-related deaths.

Despite the scale of the challenge, Professor Marmot expressed cautious optimism. The new government has said it will focus on prevention and is committed to tackling the social determinants of health to reduce inequalities, with public health minister Andrew Gwynne publicly stating the aim of making England a ‘Marmot country’.

While these steps alone won’t reverse the devastating impacts of hollowed-out public services and falling life expectancy, Professor Marmot emphasised the need to take action and called for others to do the same. We at Waythrough will continue to work with the parliamentarians in our APPG to urge the government to act on its commitments to reduce deprivation and inequalities and ultimately save lives.

Elsa Corry-Roake is external affairs manager at Waythrough

Call to action - social injustice

Turning Point: supporting you to make a positive change

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Turning Point has been providing residential detox and rehab for over 30 yearsTurning Point has been providing residential detox and rehab for over 30 years. Using evidence-based therapies and peer support, we’ll support you to improve your physical and mental wellbeing, and gain a level of independent living that will stand you in good stead to achieve lasting recovery.

Our three CQC rated “Good” locations are at Smithfield Detox Unit in Central Manchester, Leigh Bank Therapeutic Community Rehab in Oldham, and Stanfield House Rehab in rural Cumbria. Our professional, qualified staff are a trusted part of the community, creating tailored recovery plans designed by experts for each individual struggling with drugs or alcohol.

Drugs and alcohol rehabilitation (rehab)
The idea of entering residential rehabilitation can feel scary, but changing your behaviours and habits will support you in staying alcohol or drug free.

Turning Point rehabOur residential treatment programme offers a structured environment where you’ll learn the skills and behaviours to maintain long-term recovery from substance use. This includes access to the wrap-around support needed to get you back on your feet.

About residential community rehab
Residential rehab programmes are bespoke in terms of their specific approach to individual needs, but there is a focus on providing a supportive and therapeutic environment that encourages personal growth, self-awareness, and positive change.

Our programmes incorporate evidence-based practices such as cognitive-behavioural therapy (CBT), dialectical behaviour therapy (DBT), and motivational interviewing (MI), and typically range from 12 weeks to 6 months in length.

TP rehabAs community support is important in facilitating change, we create a safe environment where you can embrace support and challenge from the peer group, participate in structured daily activities, independent living and engage with the community in a substance-free setting.

Support plans are put in place for aftercare as well as care co-ordination between our services and the local community.

Drug and alcohol detoxification (detox)
With a combination of compassionate care and effective treatment, we can support you to a more positive future by no longer being physically dependent on a substance.

Turning Point detoxWhen you undertake a detox, the focus is to improve physical, emotional, and mental wellbeing so your long-term recovery can be achieved. While detox can be challenging, our professional team are on hand 24/7 to support. They’ll manage your withdrawal symptoms and help give you confidence in taking the next step.

Our recovery orientated service
Our approach is very centred around the needs of each individual but typically, alcohol detoxes are 7 days and opiate detoxes are 21 days, with detoxes for other substances and respite from regular use of other non-addictive substances also being available.

TP detoxTo ensure that withdrawal symptoms are managed effectively, the units are staffed by mental health nurses and support workers 24 hours a day.

With symptoms being managed, a key aspect of recovery is in discovering who you are now and who you want to become. Peer mentors and volunteers ensure there are also activities aimed at creating a support network, building independence, and growing confidence for ongoing recovery.

Turning PointFor more information, visit turning-point.co.uk/support-we-offer/drugs-and-alcohol

 

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Broadway Lodge: transforming lives

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Proudly treating addiction & transforming lives for over 50 years

Broadway Lodge is one of the leading and most respected abstinence-based addiction treatment centres in the UK.

Broadway LodgeReturning lives addiction has taken away
We know that the prospect of staying in rehab can feel daunting. But as the UK’s longest established abstinence-based addiction treatment centre, we understand addiction and how to treat it. We love what we do and we are passionate about helping people to begin a new journey in recovery.

Since 1974 our multidisciplinary team has helped to transform the lives of thousands of people, supporting them in their recovery from:

  • Alcohol addiction
  • Illicit drug addiction
  • Prescription drug addiction
  • Gambling addiction
  • Sex addiction
  • Gaming addiction
  • Co-dependency

We work with clients compassionately using a wide range of interventions, counselling approaches and specialist treatments to help them to understand their addiction, address underlying causes, explore other presenting issues and to build confidence, self-worth and self-esteem along with healthy coping mechanisms for challenges faced.

Treatment philosophy
Broadway Lodge is a residential, abstinence-based and compassion focused treatment centre for adults. Clients are immersed in a programme that provides a healthy mix of challenge and support, enabling them to develop a daily routine and to improve mental, emotional and spiritual wellbeing.

Our comprehensive integrated treatment schedule includes one to one counselling, daily group therapy sessions, holistic therapies and psycho-educational lectures and workshops, not to mention the 24/7 medical and peer support. Clients begin to work through the 12 Steps too, which has supported millions of individuals across the globe to continue a beautiful process of change and growth for many years after treatment.

Clients work with counsellors both individually and in a group setting to explore their addictive behaviours and to address their underlying issues. Clients learn to develop healthy coping mechanisms in a safe environment, without resorting to alcohol, drugs or other harmful behaviours.

Broadway LodgeReferrals & admission
We accept referrals from individuals who self-fund their treatment and from drug and alcohol services who have secured funding for their service users. We also work with organisations who fund their employees’ treatment for addiction.

A stay at Broadway Lodge can be from two weeks up to six months. We recommend a 12 week stay as the ideal duration to gain a solid foundation to recovery.

Broadway LodgeMake a treatment enquiry today by:
Calling 01934 815515
Emailing hello@broadwaylodge.org.uk
Visiting www.broadwaylodge.org.uk

 

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Misinformation deterring young people from switching to vaping

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Misinformation deterring young people from switching to vapingMany young adults ‘inaccurately believe that vaping is as bad for you or worse than smoking’ according to a study led by Brighton and Sussex Medical School. Young people were more likely to give up smoking and switch to vaping instead if they properly understood the reduced harm of vaping, says the report, which is published in the journal Nicotine and Alcohol Research.

Using data from the Avon Longitudinal Study of Parents and Children, the researchers found that a perception of vaping as less harmful among smokers aged 23-24 was associated with switching to vaping six years later. ‘To the best of our knowledge, this is the first study among young adults in England to assess whether vaping harm perceptions are longitudinally associated with vaping and smoking behaviours,’ says the report.

The findings highlight the need for interventions to tackle the ‘pervasive misperceptions’ about vaping, the researchers stress. Chief medical officer Chris Whitty has stated that  ‘The key points about vaping can be easily summarised. If you smoke, vaping is much safer; if you don’t smoke, don’t vape’.

While repeated studies have shown e-cigarettes to be an effective quitting tool for smokers, media reports on vaping frequently repeat ‘misconceptions as conventional wisdom’, and present ‘opinions as facts’, anti-smoking charity ASH warned in 2023. A study carried out by the charity last year found that almost 3m people in the UK had used vapes to successfully quit smoking in the last five years.

switching to vaping
‘Vaping is much less harmful than smoking and can help people successfully quit smoking’

‘There is a lot of misinformation circulating that vaping is as bad as smoking or even worse,’ said lead author of the Brighton and Sussex Medical School study, Dr Katherine East. ‘While vaping is not without risks, the evidence is clear that vaping is much less harmful than smoking and can help people successfully quit smoking. Unfortunately, misperceptions of vaping harms continue to increase, and we have found in our study that this could deter young adults who smoke from switching to vaping, a less harmful behaviour. In England in 2024, 85 per cent of adults who smoked inaccurately perceived that vaping is equally or more harmful than smoking or did not know the relative harms, an increase from 59 per cent ten years before.’

‘Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet most people who smoke do not know vaping is less harmful and can help them to stop smoking completely,’ added co-author and Professor of Tobacco Addiction at King’s College London, Ann McNeill. ‘Our study shows the importance of addressing vaping misperceptions among people who smoke.’

Perceived harm of vaping relative to smoking and associations with subsequent smoking and vaping behaviors among young adults: evidence from a UK cohort study available here

Less than half of prison leavers have settled accommodation

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prison leavers

Just 45 per cent of people released from prison in 2023-24 had settled accommodation on their release, according to the Prison Reform Trust. Thirteen per cent were either homeless or sleeping rough, says the trust’s Bromley briefings prison factfile: February 2025, ‘undermining efforts to support people away from crime after prison’.

Research by the Nacro charity and the Independent last year revealed that the number of people finding themselves homeless on release had increased by 30 per cent in 12 months, partly the result of the ‘chaotic’ early release scheme to free up prison space and risking a ‘revolving door back into custody’. The likelihood of a drug-related death in the first two weeks after leaving prison is also estimated at more than seven times greater than at any other time.

More than one in five women and almost a third of men said it was easy to get drugs in prison, the Prison Reform Trust briefing states, with 22 per cent of men and 12 per cent of women reporting that it was easy to get alcohol. Seizures of drugs were up by 44 per cent last year – to more than 21,000 occasions – and 2023 saw 1,155 prison staff investigated for supplying drugs. Almost 10 per cent of men surveyed by inspectors reported that they’d developed a drug problem while in prison, while naloxone provision for people on release also remains inconsistent.

More than one in five women and almost a third of men said it was easy to get drugs in prison
More than one in five women and almost a third of men said it was easy to get drugs in prison

Almost a third of women and just under a quarter of men reported having a drug issue on entering prison, with 17 per cent of men and 15 per cent of women who were serving a prison sentence there for drug offences. However, 66 per cent of women and 38 per cent of men said they’d committed offences to get money to buy drugs, and almost half of women said they’d committed offences to support someone else’s drug use. Seventy per cent of people ‘with a self-identified alcohol problem’, meanwhile, said they’d been drinking when they committed the offence they’d been jailed for.

The prison estate is once again facing the risk of running out of places, the report warns, with an increase in the number of people being recalled after release posing a ‘significant headache’. There were almost 32,500 admissions to prison following a recall in the year to September 2024, nearly 30 per cent up on the previous year and an issue ‘particularly affecting people serving short prison sentences of less than 12 months’.

The majority of recalls are for non-compliance rather than suspected re-offending, the document points out. In the year to September 2024, 76 per cent of recalls were for non-compliance, of which more than a third involved ‘failure to keep in touch’ and almost a quarter ‘failure to reside’ – frequently ‘exacerbated by the difficulties in securing stable accommodation on release’, it states.

Less than half of prison leavers have settled accommodation
‘The growing use of recall is trapping people in the criminal justice system rather than supporting them out of it’

Former justice secretary David Gauke is currently leading a review of sentencing for the government. Last month Professor Dame Carol Black told DDN that ‘what we haven’t achieved yet is enough diversion from prison, but I’m hoping David Gauke’s forthcoming sentencing review will help that’.

‘The evidence is clear, short prison sentences are less effective than other community sentences at reducing crime, and the growing use of recall is trapping people in the criminal justice system rather than supporting them out of it,’ said the trust’s chief executive Pia Sinha. ‘Further measures are needed if the government is to avoid another prison overcrowding crisis. These should include the abolition of the use of short, fixed-term recalls of 28 days or less; the removal of post-sentence supervision for people serving short sentences; and a transition towards more effective community-based solutions through the introduction of a presumption against short prison sentences.’

Report available here

Castle Craig: it’s time to leave addiction behind

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Residential rehab facility in the heart of the Scottish Borders treating people suffering from addiction since 1988.

ISO 9001: Rated ‘Outstanding’

Castle CraigCastle Craig is an HIS registered hospital for people suffering from addiction to alcohol and drugs, alongside other complex conditions, like gambling and gaming addiction, depression, anxiety, ADHD, trauma, relationship issues, eating disorders, and more.

Set on 50 acres of a private estate in Scotland, Castle Craig offers primary and secondary care programmes, comprehensive assessments, and medically managed detox. Our multidisciplinary team is psychiatrist-led, enabling us to effectively treat dual-diagnosis. We have 24/7 doctors and nurses onsite, to ensure a safe environment for patients.

Castle Craig residential rehabWe offer comprehensive treatment for addiction that is tailored to each individual. Our programmes, based on the 12 Steps, offer each patient the opportunity to engage in different therapies such as CBT, DBT and EMDR, alongside complementary therapies, such as reflexology, acupuncture, and aromatherapy massage to help them engage with their wellbeing while following their bespoke plan. We also have a fitness centre and freshly-cooked food so that patients feel well-cared for and can concentrate on their journey to recovery. There are a variety of accommodation options, from shared/private en-suite rooms, to women-only/male-only houses.

Making a referral:
In order to provide the highest quality of care for patients, Castle Craig works closely with the referring professionals such as social workers, medical staff, probation officers and other personnel. We develop a personalised treatment plan for each patient in our care, based on patient history, our own medical and biopsychosocial assessments and discussions with the referring prison service departments.

Castle Craig rehabFast admission process:
Our Admissions Team ensure your patient enters rehab quickly and safely. We offer sober transport services if needed.

Dedicated point of contact:
Our Development Manager is a dedicated point of contact for all service referrers in the pre-admission phase. Once a patient is admitted to our care, a focal therapist is appointed as the main contact.

Communication:
Our knowledgeable treatment staff can walk you through our treatment programme and answer any questions you might have. We are happy to keep in contact with you if required.

 

Castle Craigwww.castlecraig.co.uk
info@castlecraig.co.uk
0808 134 9739

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Phoenix Futures residential services

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With over 50 years of experience delivering residential rehabilitation in the UK, Phoenix Futures are dedicated to helping people, families and communities overcome substance use.

Phoenix Futures Rehab Spotlight

We have seven residential services across the UK each with their own specialism and unique features including an enhanced therapeutic community offering a blended approach to treatment for co-occurring mental health and substance use, a trauma responsive female-only service and specialist family services that support parents, their children and pregnant women.

All of our residential services offer:

  • Flexible 3-6 month programmes
  • Comfortable, homely and compassionate environments
  • Separate male and female accommodation, single en-suite rooms available at most locations
  • Support from a highly skilled multi-disciplinary staff team
  • One to one sessions with our trained therapeutic team
  • Individualised care plans placing the community member at the centre of their rehab journey
  • Onsite counselling or access to community-based counselling services
  • Mental health support via our clinical team
  • Offsite leisure activities for example swimming, cinema, bowling and day trips
  • Access to our evidence-based bespoke group programme
  • Access to our Recovery Through Nature programme
  • Option of moving into Phoenix recovery housing services on completion of programme
  • Medically monitored detox available, please contact us for more information

RESIDENTIAL SERVICES

OPHELIA HOUSE, OXFORDSHIREOphelia House, Oxfordshire
– Trauma responsive residential treatment for women with single en-suite rooms
– All female multi-disciplinary staff team
– Onsite counselling and psychologist led interventions
– The Freedom Programme offered onsite

NATIONAL SPECIALIST FAMILY SERVICE, SHEFFIELDNational Specialist Family Service, Sheffield
– Residential support for families including single parents or couples and their children or pregnant women
– Evidence-based parenting skills development
– Ofsted registered nursery – rated Outstanding with childcare and child development support provided by specialist childcare staff

NEW OAKWOOD LODGE, DERBYNew Oakwood Lodge, Derby
– Individualised care with a blended approach to substance misuse and mental health
– Psychologically informed environment with single en-suite rooms and onsite counselling
– Recovery Through Nature programme delivered within the extensive gardens

WIRRAL RESIDENTIALWirral Residential
– A spacious, Edwardian building provides the setting for one of our longest established therapeutic communities
– Specialist recovery move on supported accommodation
– Established graduate pathway from peer support to volunteering through to employment

SCOTTISH RESIDENTIAL, GLASGOWScottish Residential, Glasgow
– Psychologically informed environment with single en-suite rooms
– Specialist recovery move on supported accommodation
– Established graduate pathway from peer support to volunteering through to employment

NATIONAL SPECIALIST FAMILY SERVICE, SCOTLAND (HARPER HOUSE)National Specialist Family Service, Scotland (Harper House)
– Residential support for families including single parents or couples and their children or pregnant women
– Evidence-based parenting skills development
– Regulated child daycare service with childcare and child development support provided by specialist childcare staff

Rae House, ScotlandRae House, Scotland
– Newly refurbished building with a trauma informed environment
– Single en-suite ground floor rooms
– Access to our specialist recovery housing and day services
– Recovery Through Nature programme delivered onsite

Phoenix Futures Rehab GuideWe have trained and experienced staff available to speak to you at all our services who can support you to explore treatment options and answer any queries or concerns. Find out more on our website www.phoenix-futures.org.uk

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Ark House Rehab: “A Bridge To Recovery”

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Ark House Rehab

For over three decades, Ark House Rehab Ltd in Scarborough has been a beacon of hope for individuals seeking to overcome addiction and reclaim their lives.

With a rich history of trans­formation and healing, Ark House Rehab Ltd is committed to providing a full and comprehensive 12­-step programme and offers a full and free aftercare service for as long as it is needed. Ark also has an extensive network of graduates to offer other essential aftercare and ongoing peer support.

A LEGACY OF SUCCESS
Ark has become a trusted name in the treatment of addiction since its establishment over 30 years ago and has garnered a reputation for excellence and innovation. Our long­-standing commitment to helping individuals break free from their addiction has given back hope to countless individuals and their families.

THE POWER OF THE 12-STEP PROGRAMME
At the heart of Ark’s success is its unwavering dedication to a 12­-step programme, taking people through all the 12 steps. This time­-tested approach has helped people find their way to recovery through a structured and supportive framework for healing.

ArkThe whole team at Ark House have created an environment, where it is hoped everyone can flourish. Whatever their background or personal circumstances, clients at Ark can embark on a transformative journey toward sobriety, self­-discovery, and personal growth.

Ark House’s 12­-step programme goes beyond simply treating addiction; it addresses the root causes, helps individuals build resilience, and fosters a sense of community. The programme encourages self­-reflection, accountability, and spiritual growth, providing a holistic path to recovery. Clients at Ark not only break free from the chains of addiction but also emerge stronger and better equipped to face life’s challenges.

A LIFELINE OF AFTERCARE SUPPORT
Recovery doesn’t end when treatment does; it is a lifelong journey. Ark understands this and the importance of ongoing support that is needed to maintain sobriety.

Our network of graduates is a testament to Ark House’s enduring success. These individuals have not only conquered their own battles with addiction but have also become dedicated advocates for others seeking recovery. They offer invaluable insights, guidance, and mentorship to current clients, providing a lifeline of support during the early stages of sobriety and beyond.

We sign post people into local peer support groups and offer free weekly access to virtual meetings, groups and lectures.

FAMILY SUPPORT
Ark has identified that if you involve the family in the treatment of the addicted person, they are more likely to succeed in their recovery journey. To that end we offer not only treatment to the affected individual but also free family support groups to their family members.

Ark House

JOIN US ON THE PATH TO RECOVERY
Ark is more than just a treatment centre – it’s a place where transformation happens. Our legacy of success, commitment to the 12­-step programme, and extensive network of graduates set us apart as a trusted and proven partner in an individual’s journey to sobriety.

If you or a loved one is struggling with addiction, don’t wait to take the first step toward a brighter future. Reach out to us today and unlock the path to recovery. You don’t have to face addiction alone – Ark House is here to guide you toward a life of sobriety, purpose, and fulfilment.

Join us on this journey of hope, healing, and transformation. Together, we can build a brighter future, one step at a time.

Ark House Rehab Logot: 01723 371869
e: info@arkhouserehab.co.uk
w: www.arkhouserehab.co.uk
Ark House Rehab, 15 Valley Road, Scarborough, YO11 2LY

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Acorn: compassionate care for recovery

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Located in Stockport and Burnley, Acorn Residential Rehab Services provides a safe, welcoming, and CQC-regulated environment designed to help individuals and families overcome addiction.

Acorn Residential Rehab ServicesWith evidence-based programmes and a dedicated team of experienced counsellors qualified to at least Level 4 diploma, we are committed to guiding you through every step of your recovery journey.

Our team draws on both personal and professional experience, challenging stigma, inspiring change, and instilling hope – because we’ve been there too.

A THERAPEUTIC PROGRAMME THAT WORKS
At Acorn, we understand that addiction is complex, often rooted in past trauma or adverse experiences. That’s why our therapeutic programme focuses on helping clients uncover and address the underlying causes of their addiction. Participants gain a deeper understanding of how trauma and Adverse Childhood Experiences (ACEs) have influenced their thinking and behaviours, leading to unhealthy patterns.

Residential Rehab ServicesThrough group work and assignments, clients challenge these self­-defeating behaviours and learn healthier ways of cop­ing. They also gain insights into building and maintaining healthy relationships by recognising how their attachment styles impact interactions. Our programme equips clients with the tools to foster resilience, better manage their thoughts, and adopt strategies for relapse prevention.

By the end of the programme, clients leave with a renewed sense of self and improved recovery capital, supported by a strong foundation for long­-term recovery. The positive outcomes we see in clients’ wellbeing and resilience are a testament to the CORE programme’s effectiveness.

TAILORED AFTERCARE SUPPORT
Recovery doesn’t end with completing the programme, and neither does our support. We offer a tailored aftercare plan to suit individual needs, ensuring that clients continue to feel connected and supported as they transition into life beyond residential treatment.

As part of this support, all residential clients are invited to attend our weekly aftercare group, facilitated by our lead counsellor. These sessions provide a vital space for ongoing recovery protection, fostering connections within the community, and encouraging peer support. For those unable to attend in person, digital options are available to ensure accessibility.

Acorn Residential RehabImportantly, there’s no time limit on aftercare access – it remains available as long as abstinence is maintained. This flexibility allows clients to build a sustainable recovery at their own pace.

MOVE-ON HOUSING OPTIONS
For clients with no fixed address, Acorn offers move­-on housing options to provide a stable foundation for recovery. Subject to availability and housing history, clients can transition into our community housing after completing the programme.

These shared properties offer individual bedrooms and dedicated support from housing workers who assist with key areas such as securing tenancies, managing wellbeing, and accessing local resources. Residents are also expected to participate in weekly aftercare groups and maintain regular contact with their support workers, creating a structured and supportive living environment.

Additionally, we work closely with local housing providers to prioritise long­-term tenancy opportunities for those in our care, ensuring a smoother transition to independent living.

Acorn RehabEDUCATION FOR A FRESH START
Empowering clients with new skills and knowledge is a cornerstone of our recovery approach. Acorn’s in­-house learning academy offers a range of Ofsted­-approved courses designed to help clients regain confidence and build a brighter future. The courses include: group facilitation training, counselling skills, peer mentoring, and workshops on independent living and tenancy management.

While classroom­-based courses are currently available only to local residents, we encourage all clients to explore educational opportunities as part of their recovery journey.

VOLUNTEERING AND COMMUNITY ENGAGEMENT
Finding purpose and giving back can play a vital role in sustaining recovery. Our volunteer coordina­tor helps clients explore oppor­ tunities within Acorn or similar organisations across Greater Manchester and Lancashire.

For those relocating, we provide support in identifying volunteering roles closer to home, ensuring clients remain engaged and connected within their communities. These opportunities offer structure and a sense of purpose, which are key to maintaining long­term recovery.

Acorn Residential Rehab Services

AcornTo learn more about our services, visit acornrecovery.org.uk

 

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Supply & demand

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OST medications

When we discuss the barriers to accessing OST medications, most often it’s the barriers of making it to the clinic, through the clinic’s hoops, or the pharmacy. Money, transit, and the stigma associated with walking through the doors of a drug service or being spotted on supervised consumption all come to mind. Much less commonly spoken about are the ways in which modern global supply chain dynamics can produce shortages. These impact a great many things in our lives, but unlike most – and even most other medicines – OST medications are subjected to the sort of regulations that make overcoming shortages significantly more challenging.

Supply chains are likely to be disrupted more and more regularly as a result of things like climate change-related extreme weather events, and while many of us will find workarounds to these disruptions as part of our new ‘normal’, what happens when we’re powerless to do so?

Release OST

Anna is a Release service user who was recently impacted by a medication shortage that meant her prescribed methadone tablets became unavailable. She was originally prescribed injectable methadone, but transitioned to tablets as that was deemed safer by her prescriber. When the tablet shortages impacted her, her service swapped her back to injectables but reduced her dose significantly from what would have been the equivalent dose to her tablets, citing overdose risk as the reason. This is despite the fact that leaving Anna suddenly under-dosed would increase the odds she would resort to the illicit market after a long time away from it – increasing her overdose risk.

In this case, to stay well, Anna supplemented her dose with some leftover oral methadone so that she could get through the Christmas period with her family. Sadly, this has caused her to worry about whether the service would ever reinstate her earlier dosage or if they would punish her for ‘topping up’.

Unfortunately, Anna’s situation is not unique. As a result of medication shortages, Release has been contacted by a number of people – some of whom had been stable on their medication for years only to be thrown into a state of sudden uncertainty and put onto regimens they were unhappy with or even properly consulted about. In other cases, people have contacted us because their service simply would not get involved promptly to help resolve their medication shortage through the provision of an alternative script, leaving them sick and in distress.

Release OST medication
Release has been contacted by a number of people – some of whom had been stable on their medication for years only to be thrown into a state of sudden uncertainty

The systems of medication manufacturing and distribution to pharmacies are not straightforward to understand or navigate. Pharmacies order medications via different wholesalers who have rules for ordering and distribution – such as not stocking or supplying medicines within a set number of months of their expiry date. Getting information from wholesalers on whether they still have stock of different medicines is often impossible for normal citizens trying to solve their own shortages. This is also true for advocates at Release, who are not privy to intel from wholesalers and have to work with allied professionals in the drugs sector to find solutions for people whose medication is unavailable.

For every person contacting us, and who we were able to support, how many didn’t have Release’s number, or an allied key worker, or a kind pharmacist fighting their corner? Even in cases such as Anna’s – where people have self-advocated but been offered subpar treatment plans as a result – how many are left more vulnerable after each supply disruption?

It’s not an answerable question. We don’t know how many people are prescribed various different forms of OST, as there’s no breakdown of prescription type in NDTMS and there’s no public entity keeping track for us to make FOI requests to. This means it’s hard to strategise much beyond the firefighting we do already.

We need a system overhaul which rejects the current allowance for OST patients to be treated as second class citizens

Ultimately, we need a system overhaul which rejects the current allowance for OST patients to be treated as second class citizens, especially OST patients who do not fit the mould and require less common forms of OST medication to live well. Services should offer and protect medicine choice and not view shortages as an opportunity to permanently alter the treatment plan of a patient. We also need services and systems to become more responsive to patients, in an environment where disruptions are becoming more commonplace and the illicit market evermore dangerous.

Finally, for people who commission services, we ask: what mechanisms are you incorporating to make services accountable to service users? These mechanisms must suit people actively on OST in all their diversity (by which we mean diversity of medications, of class, of race and ability status, and of gender and sexuality) and not prioritise those people working towards abstinence alone.

Shayla Schlossenberg is head of drugs services at Release

Riley Johnson is drugs support advisor and NSP specialist at Release

Park House: supporting recovery in Birmingham

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CGL Park HouseLocated in Birmingham and operated by Change Grow Live, Park House offers an inpatient drug and alcohol detox. With a focus on collaborative working, holistic care, and effective aftercare pathways, the service plays a vital role in helping people achieve lasting recovery.

Service manager Cortney Henry says the Park House philosophy is ‘to get people well, quicker’. This simple yet powerful mission drives everything the team does, from providing clinical detoxification to ensuring clients are supported during and after their stay.

Park House accepts referrals from services across the country, working together to ensure a smooth transition for clients and planning treatment pathways following their stay. Henry emphasises the importance of continuity: ‘While clients are here, it can feel like they’re wrapped in bubble wrap, but it’s what happens when they leave that really matters. That’s why we focus on ensuring there is strong aftercare in place.’

Park HouseHOLISTIC CARE IN A SAFE SETTING
Park House provides a structured, clinically managed detox programme in a non­-hospital environment. This includes the use of vitamin therapies such as intravenous Pabrinex; Park House is the only non­-hospital based service to provide this.

Taking a holistic approach to treatment, Park House recognises that recovery is about more than just physical detoxification. Clients are treated as individuals, with their unique needs and circumstances carefully considered.

‘Recovery isn’t just about stopping substance use – it’s about helping people rebuild their lives,’ Henry explains. ‘We aim to give clients the best chance of success by supporting them emotionally, physically, and practically.’

CGL residential treatmentNATIONAL SERVICE WITH A LOCAL TOUCH
A key focus at Park House is preparing clients for life after their stay. The team ensures pathways are in place for continued recovery, including connections to housing support and local services.

This comprehensive approach helps reduce the likelihood of relapse and supports long­ term success.

Park House is making a tangible difference in the lives of its clients, offering a safe space to begin recovery and the tools to continue it.

JEROME’S STORY

I had an extremely dysfunctional childhood in Liverpool, and losing my dad at a young age hit me hard. By 38, I was relying heavily on alcohol and cocaine to cope. Things only got worse when my mum was diagnosed with cancer. I had to give up my childhood dream of becoming a jockey to care for her full time.

CGL Park House Jerome

I ended up on the streets the day after my mum’s funeral, and my dependence on alcohol and drugs deepened. A friend who was in recovery saw me and gave me a place to stay. He introduced me to AA meetings and took my phone so I couldn’t call my dealer.

After a relationship breakdown, I relapsed and moved to Birmingham to stay with my cousin. When my cousin left, I ended up in short-term accommodations and fell deeper into addiction. I was drinking a bottle of vodka, 24 cans of lager, and using cocaine daily. My GP referred me to Change Grow Live, who helped me reduce my intake and prepare for detox at Park House.

Walking through the doors of Park House was terrifying – I wanted to turn back, but the staff were lovely. They sat me down, gave me a cup of tea, and made me feel welcome. I completed a two-week medically assisted detox and attended group sessions that helped with my anxiety and gave me tools to cope. Change Grow Live then arranged a 12-week stay at Lindale Recovery, where I gained confidence and moved into follow-on housing.

Now, I volunteer at Park House and other community organisations, and I’m studying plumbing at college. I can’t believe the change – I’m so happy, blessed, and grateful.

 

CGL Park Housewww.changegrowlive.org
www.changegrowlive.org/park-house-inpatient-treatment-service-birmingham

 

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

TLC Rehab: Truly Life Changing

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TLC Rehab is a London-based residential service, offering medically managed detox and an eclectic approach to addiction treatment.

TLC Rehab LondonFrom heartfelt beginnings, TLC Rehab is redefining residential rehab with compassion, innovation, and a holistic focus that empowers clients to rebuild their lives.

Since recovering from drug and alcohol addiction in 2004, it’s been Jitesh Sanghani’s dream to run a rehab. Inspired by his counsellors, he regularly revisits the rehab centre where he received treatment, to stay connected to his recovery family. When he met James Peacock, who has worked in the addiction sector for over two decades, their passions collided – and TLC Rehab was born. ‘Our shared goal was to create a service that stands out from the crowd,’ says James. ‘By using an innovative and holistic model, we could incorporate a range of psychotherapeutic interventions to deliver truly inspirational treatment.’

TRANSFORMATIVE APPROACH
Moving beyond the traditional 12­-Step model, TLC focuses on deep therapeutic work, including schema therapy, which helps clients identify and heal unhelpful patterns formed early in life. ‘We also integrate Dr Gabor Maté’s “compassionate inquiry” approach,’ says James. ‘It helps uncover the connection between trauma and addiction, fostering self-­awareness and emotional healing.’

TLC

‘Recovery here is about transformation, not just abstin­ence,’ emphasises Jitesh. ‘Our goal is to address the underlying emotional pain the addiction has masked and in doing so help clients reconnect with their “authentic self”.’

TRANQUIL ENVIRONMENT
Located in the leafy London suburb of North Finchley, the facility boasts a serene, 100­foot garden providing a tranquil space to relax, unwind, or engage in outdoor yoga, breathwork, or light exercise. ‘Every morning, we go for a daily wellbeing walk to Friary Park at the end of the road,’ explains Jitesh. ‘The walk­-and­-talk activity is a great way to start the day – it’s good for both the mind and body.’

The weekly schedule also includes yoga sessions, art therapy, and support from a nutritionist, with every client receiving a minimum of two one­-to-­one counselling sessions per week.

TLC residential rehab

24-HOUR MEDICAL CARE
TLC’s 24­-hour nursing support sets a critical standard for safe detox and holistic health management. ‘Having medical professionals onsite around the clock assures our stakeholders that while someone is in our care, all of their healthcare needs will be met effectively,’ says James.

COMMUNITY BUILT ON TRUST
TLC’s relaxed and compassionate approach fosters a sense of trust and community. ‘We focus on striking the right balance between the intensity of the counselling programme and the freedom clients need to rediscover themselves and do things that truly matter to them,’ explains Jitesh.

By providing a safe, supportive environment, TLC empowers clients to rebuild their lives with clarity and purpose. ‘Most clients tell us it’s the best rehab they’ve been to – with a genuinely person­-centred approach, we help them develop autonomy and independence.’

TLC Rehab

TAILORED THERAPIES FOR LASTING RECOVERY
For clients staying three months or longer, TLC offers additional therapeutic options, including photo therapy and equine therapy, delivered locally by experts. ‘If these aren’t the right fit, we’ll work with clients to explore other options, such as EMDR and hypnotherapy, to tailor a package of care to their individual needs,’ says James.

SUPPORT BEYOND REHAB
Being based in London, TLC benefits from excellent transport links, making aftercare accessible for graduates. ‘Ongoing connection is fundamental to successful long­-term outcomes,’ says Jitesh. TLC provides weekly follow­-up calls to complement their aftercare group – ‘We want to be part of people’s journey, guiding them through challenges and celebrating their achievements along the way.’

TRULY LIFE CHANGING
‘We spent a long time coming up with a name,’ says James. ‘TLC initially stood for The London Clinic, but we soon decided a more accurate reflection of what we represent is Truly Life Changing. That’s what we want this service to be for everyone connected to us.’

TLC RehabIf you’d like to learn more about TLC Rehab, please call 0203 098 7007 or email connect@tlcrehab.co.uk – we can’t wait to hear from you.
www.tlcrehab.co.uk

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Via rehab revitalised

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DDNWeb
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Via residential expansion set for 2025 launch

Kings Acre Via Passmores HouseWe are excited to announce that Passmores House will be expanding its rehab facilities with an addition of a single storey building with six modern en-suite rooms amongst beautiful grounds.

Set to open in Spring/Summer 2025, this significant development is part of our ongoing commitment to providing high­-quality, tailored support for individuals seeking help with their substance use.

Kings Acre

KINGS ACRE
The new building, called Kings Acre, will serve as a ‘stepping stone’ for people in rehab who are nearing graduation but need to develop greater independence before returning to the community.

Located next to our existing detox and rehab residential house, Passmores House, this dedicated space will support individuals as they transition from structured rehabilitation to more independent living, providing an environment where they can practice essential life skills while still benefiting from the centre’s support.

By creating this transitional housing, Passmores House ensures its residents are better prepared for life beyond rehab while freeing up space in the main facility to accommodate more individuals needing complex residential rehabilitation.

Via

A MILESTONE FOR PASSMORES HOUSE
The launch of Kings Acre marks a significant milestone in Via’s residential mission to provide accessible, high­-quality recovery services. By increasing our capacity and optimising care delivery, we can continue to be a leading provider of detox and rehabilitation services in the region.

We are deeply grateful to our staff, partners, and community supporters who have made this expansion possible. Together, we are taking an essential step toward addressing the growing need for recovery services and ensuring that more individuals have the opportunity to rebuild their lives.

LOOKING AHEAD
We look forward to welcoming people to our expanded facilities and supporting even more individuals on their path to recovery. If you have any questions about the new rehab facility or our services, please don’t hesitate to contact us. Together, we can make recovery possible.

MEETING THE GROWING NEED FOR COMPREHENSIVE CARE
Passmores House has always strived to meet the needs of our community by offering evidence-based, compassionate care. With the demand for detox and rehabilitation services continuing to grow, this expansion enables us to:

Increase capacity
The new facility will create additional space in the rehab centre, allowing more individuals to benefit from our residential rehabilitation programmes.

Facilitate independent living
By offering a dedicated ‘stepping stone’ facility, those nearing the end of their rehab journey can develop the skills needed for independent living before re-entering the community.

Support holistic recovery
The new building will work in tandem with the main facility, ensuring a seamless transition for people as they progress from structured rehab to greater independence.

WHAT TO EXPECT FROM THE NEW REHAB FACILITY
The purpose-built rehab facility has been designed with comfort and safety as a top priority. Features of Kings Acre include:

Enhanced group programmes
A revised group programme featuring practical topics like financial management and other activities to support a smooth transition to independent living. Developed by our consultant psychologist and supported by dedicated staff.

Specialised medical support
On-site medical staff trained in substance use recovery, ensuring 24/7 care.

Psychologically informed environments
Quiet and calming spaces for reflection and recovery, alongside access to group and one-on-one therapy sessions.

Via contact

To find out more about the care and treatment we offer and how to refer someone, please contact us on 01279 634 200 or email passmores@viaorg.uk
Visit our website at www.viaorg.uk/services/passmores-house

DDN Rehab Guide 2025

Rehab spotlights

Finding the appropriate treatment option can be challenging.

In partnership with rehab facilities across the UK, 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.

Read more rehab spotlights here

Global State of Tobacco Harm Reduction

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DDNWeb
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GSTHRSwitching to safer nicotine products could be a life-saving intervention for millions of people currently using high-risk tobacco products like combustible cigarettes.

Global State of Tobacco Harm Reduction (GSTHR) maps the global, regional and national availability and use of safer nicotine products, regulatory responses to them, and the public health potential of tobacco harm reduction (THR).

THR reports
Global State of Tobacco Harm Reduction 2024: A Situation Report was published in November 2024. GSTHR’s fourth biennial report uses the latest evidence and new data projections to assess the current global THR situation as well as its potential to rapidly reduce tobacco-related disease and mortality.

View all THR reports here

Briefing papers
The latest briefing paper, How snus is replacing smoking in Norway: a revolution led by consumers and product innovation, was published in January 2025 and is now available to download.

View all briefing papers here

The GSTHR is a project run by Knowledge•Action•Change (K•A•C), a company dedicated to the promotion of harm reduction to improve health.

Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers

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DDNWeb
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The comparative health implications of e-cigarette use versus traditional cigarette smoking remain a critical focus in public health research. This cross-sectional study examined differences in self-rated general health between exclusive e-cigarette users and exclusive cigarette smokers, using data from the 2017–2019 Scottish Health Survey.

Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers

A total of 2484 adults (aged 16 and above) were included and categorized as exclusive e-cigarette users (n = 565) or exclusive cigarette smokers (n = 1919). Self-rated health was assessed using a single-item measure with five response categories: “very bad,” “bad,” “fair,” “good,” and “very good”. Generalized ordinal logistic regression models were used to estimate the association between nicotine product use and self-rated health, adjusting for age, sex, Scottish Index of Multiple Deprivation, marital status, ethnicity, alcohol consumption frequency, physical activity, presence of longstanding physical or mental health conditions, and age of smoking initiation.

In the fully adjusted model, exclusive e-cigarette users had higher odds of reporting better self-rated health compared to exclusive cigarette smokers overall (OR = 1.26, 95% CI 1.05–1.51, p = 0.012). A graded relationship was also observed in the fully adjusted model, with progressively lower odds of reporting better self-rated health as smoking intensity increased, using exclusive e-cigarette users as the reference group. Heavy smokers (≥ 20 cigarettes/day) had the lowest odds of reporting better self-rated health (OR = 0.63, 95% CI 0.49–0.80, p < 0.001), followed by moderate smokers (10 to < 20 cigarettes/day) (OR = 0.81, 95% CI 0.66–0.99, p = 0.047). In contrast, light smokers (< 10 cigarettes/day) showed no significant difference in self-rated health compared to exclusive e-cigarette users (OR = 0.94, 95% CI 0.75–1.18, p = 0.614). These findings indicate that exclusive e-cigarette use is associated with better self-rated health compared to exclusive cigarette smoking, particularly among moderate and heavy smokers.

Additional analyses revealed no significant differences in self-rated health among exclusive e-cigarette users based on prior smoking history (OR = 0.94, 95% CI 0.43–2.08, p = 0.882) or among exclusive cigarette smokers based on prior e-cigarette use (OR = 0.87, 95% CI 0.69–1.09, p = 0.219). These findings suggest that prior use is unlikely to explain the observed association between exclusive e-cigarette use and better self-rated health compared to exclusive cigarette smoking.

Given the subjective nature of self-rated health, these findings should be interpreted with caution. Future longitudinal studies incorporating objective health measures are essential to assess the long-term impacts of e-cigarette use and inform evidence-based harm reduction policies.

Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017–2019 Scottish Health Survey

West Berkshire’s drug and alcohol service packs a punch with local community event

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DDNWeb
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On 30 January, drug and alcohol support charity Via welcomed local partners and community leaders to an open day at its Newbury hub. The event celebrated the service’s impact in West Berkshire and highlighted the vital drug and alcohol support available to local people.

West Berkshire’s drug and alcohol service packs a punch with local community eventThe event was opened by Matt Pearce, director of public health for West Berkshire Council, who emphasised the power of partnership in supporting local communities. Anna Whitton, CEO of Via, followed with a speech on the importance and impact of accessible, high-quality services in supporting people on their recovery journey.

Dani Cawsey, service manager for Via West Berkshire, provided an insightful overview of the service, explaining how it helps people through structured treatment, a wide range of support options, and dedicated programmes such as the family and friends group.

A particularly moving presentation came from Andreas Kavalierou, Via’s reintegration coordinator, who introduced the GLOVES programme – a unique 6-week initiative from Via that draws parallels between the 12 rounds of boxing and the 12 steps of recovery. He spoke powerfully about how the programme gives people determination, focus, and a sense of purpose beyond their usual treatment. By enhancing responsibility, resilience, and fitness, GLOVES helps develop a winning mentality for sustained recovery. Attendees were also treated to an impressive boxing demonstration by a GLOVES graduate, showcasing the programme’s impact in action.

Jason Kew, public health strategist, spoke passionately about the local Combatting Drugs Partnership, highlighting the importance of collaboration between organisations to tackle stigma, promote harm reduction, and enhance education and prevention efforts.

Via West Berkshire
Jason Kew highlighted the importance of collaboration between organisations to tackle stigma, promote harm reduction, and enhance education and prevention efforts

The day concluded with a delicious lunch and networking session, where attendees connected and explored future collaboration opportunities.

Eleanor Lyden-Vieten, area director at Via, said, ‘I’m really proud of the whole Via team and the impact they have every day in the lives of the people we support. The success of this event is a testament to their hard work, enthusiasm and passion. We were happy to see so many local partners in attendance and look forward to continuing to build even stronger working relationships with them.’

Craig Middleton, executive director of services at Via, said, ‘It was great to see so many partners from West Berkshire at the event. The strong interest in the service’s work was clear from all the people who attended. The team shared some wonderful examples of the support and help they offer to people who use our service and positive impact it has had.’

Matt Pearce, director of public health, West Berkshire Council, said, ‘We’re proud to partner with Via. The work they do is a game changer. They become an integral part of people’s journeys with alcohol dependency and drug use and help them to take a better path.’

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

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