As the UKDPC wraps up its work, Roger Howard looks back on six years of helping drug policy become ‘fitter for purpose’ and considers what the future might hold.

After six years of looking at the evidence for what works to tackle drug problems, the UK Drug Policy Commission (UKDPC) has come to the end of its work, although we will still be doing some limited activities this year to ensure our legacy continues. Our demise has been long planned – we were set up to run for a fixed period – and in anticipation we have spent much of our last year developing our final conclusions. The result is our report, A fresh approach to drugs (DDN, November 2012, page 4) which sets out our view on the current state of drug policy in the UK and our recommendations about where improvements could be made. 

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So what have we learned? Our findings split into two parts– our conclusions about the policies themselves, and what we have concluded about the processes of policy making. While there is much that can be improved about drug policies, we should not lose sight of the fact that the UK does some things very well. Harm-reduction policies, like needle and syringe exchanges, have saved many lives and kept blood-borne diseases like HIV at an internationally low rate among injecting drug users.

The great expansion of treatment and recovery services over the last 15 years has also reduced deaths and helped many more people to recover from drug dependence and move on with their lives. The evidence is clear that such services provide value for money. At the same time, fewer people are using drugs – particularly among younger age groups – although we should be wary about any claims of credit for this, given similar trends are seen in several countries with quite different drug policies.

Sheffield service users had a chance to celebrate their sobriety in fine style this Christmas, ending the year on a genuine high. Olivia Adams reports

It began as an ambitious idea from local charity Sheffield Alcohol Support Service (SASS) just seven weeks earlier, but on 17 December 250 sober people walked down the red carpet for Sheffield’s first Celebrate Recovery Ball. The evening was held in honour of those in recovery from drug and alcohol addiction and was planned for the potentially difficult festive period with the temptation of alcohol everywhere. There were high expectations of this first inclusive entertainment event of its kind – a sell-out event thanks to united effort from all the alcohol and drug services in the city.

Why should you be at the national service user involvement conference this year? DDN answers your questions  

What is ‘Be the Change’?

Be the Change is the theme of this year’s annual national service user involvement conference. Created in 2007 by DDN, in partnership with The Alliance, the event has grown each year and now also partners with the National Users Network (NUN) and the UK Recovery Federation (UKRF) to make sure it’s truly representative of all service users, whatever their current circumstances. It is the biggest one-day conference in the UK drugs field and dedicated entirely to improving the treatment experience, aftercare, welfare, employment opportunities and rights of people who use drug and alcohol treatment services.

Why should I be there?

The conference brings crucial issues to the table, addresses your concerns and invites you to question the speakers and have your say. This year, more than ever, service users need to know what’s happening as drug and alcohol treatment becomes part of the public health landscape. We cover the entire event for a special issue of DDN, seen by politicians and policymakers, and make your voice count. 

The programme also features practical workshops, sharing essential skills and knowledge, and a highly popular service user group exhibition, where groups can display material about themselves and their activities. We also have live music, therapy rooms, Tai Chi and an enterprise zone. Perhaps above all, the event has become known as a superb networking opportunity for colleagues all over the country, inspiring new service user groups and initiatives. 

Where is it?

DDN hears from four winning entrepreneurs – whose success was made even more remarkable by their challenging journeys overcoming addiction.

At a glitzy ceremony in London, four entrepreneur finalists competed for a prestigious business award. Their final task was to pitch their business idea to a panel of judges led by award-winning businessman Will King, founder of the £60m company, King of Shaves, alongside chairman of Youth Business International, Sir Malcolm Williamson.

Twenty-one-year-old Chris Adams pitched his mobile hairdressing business, Baseline. Christine Dore, aged 45, presented her Caribbean catering operation, Mix & Blend, serving up a feast for the high-profile judging panel. David Howell, 41, made the case for his cleaning and catering enterprise, Servants-r-us. And Kirsten ‘Fifi’ Imrie pitched her dog-walking business, Walkies with Fifi and Friends, securing first place, a cheque for £1,000 from sponsors Fujitsu, and a year’s support with advertising and marketing from successful marketing agency AnAbundance

All four finalists had been selected from more than 50 people who had completed the E=MC2 programme over the past year – an initiative run by award-winning social enterprise and charity The Small Business Consultancy (TSBC), whose chief executive and founder, Amar Lodhia, writes DDN’s Enterprise Corner.

And this is where the story becomes truly remarkable; for not only had the entrepreneurs started successful businesses, they had transformed their histories of substance misuse problems into character-building experiences. Referred to the programme by their local London DAATs – Southwark, Barking and Dagenham and Haringey – they grasped the opportunity to relegate negative experiences to the past, learn from their mistakes, and bring their business ideas to life.

  NDTMS data set J could mean more than just a new way of saying the same thing, argue Jan Hernen and Dr Christopher Whiteley

We all recognise that moment when we find out we need to provide a bank of new data to those on high, although drug and alcohol workers might ask ourselves why we can’t just be left to get on with the ‘real job’ – helping service users to improve the quality of their lives.

So what drives the latest version of the data we are being asked to submit – data set J of the National Drug Treatment Monitoring System (NDTMS)? What does it have to do with real and enduring recovery? Why are modalities being relabelled as interventions, and what is the point of having sub-interventions? And what was wrong with the old system anyway?

Anyone using or working in UK drug and alcohol services will be aware of the impact of the recovery agenda on expectations of what drug treatment is really about, with the focus now not only on achieving reduction of drug use or abstinence from it, but on recovery in a much wider sense. 

Who Benefits? 

Benefit reform, long a thorny topic, seems set to become one of the year’s defining policy issues. DDN looks at the truth behind some of the government rhetoric.

Welfare reform is one of the government’s flagship policies, and this year will see the much-touted ‘universal credit’ replace a range of benefits including income support and jobseeker’s allowance, while disability living allowance will be replaced by a ‘personal independence payment’. The measures were set out in the Welfare Reform Act 2012, one of the key aims of which was ‘creating the right incentives to get more people into work’. 

Changes to the benefit system have loomed over service users since before the coalition came to power, however, with Labour’s own controversial green paper, No one written off: reforming welfare to reward responsibility proposing the withholding of benefits from problematic drug users who failed to enter treatment. 

The first Adfam/DDN conference for families affected by drug and alcohol use urged carers from all over the country to make their voices heard. DDN reports

 ‘You know how much stigma gets in the way of your lives. It’s that stigma we have to challenge,’ 

said Vivienne Evans, Adfam chief executive, opening the inaugural Families First conference. ‘This annual event is the start of a movement for family members,’ she said, before handing over to the first speaker, a mother asked to give her personal perspective.

 ‘I’m standing here because my family was affected by drug use,’ said Christine Tebano. ‘I’m a mum of four and I didn’t know for a long time. There was odd behaviour from my daughter and I knew something wasn’t right. It hit home when she didn’t sit her final exam. We found drugs in her handbag, had calls from her school and then the police started arriving at our door. We didn’t know what to do.’

Drugscope’s recent conference focused on how the sector could deliver high quality services in uncertain times. DDN reports.

The drug and alcohol treatment sector was in a period of profound change, DrugScope’s director of policy, Marcus Roberts, told delegates at the organisation’s A question of balance: delivering an inclusive treatment and recovery system conference. DrugScope had been broadly supportive of the notion of ‘recovery’, he said, in terms of individually-focused journeys and community support, ‘but I wonder if the high tide of recovery as an organising definition for our times has already been passed, as we find ourselves in this new environment’.

 Issues of crime prevention were already moving rapidly up the agenda, he told the conference. ‘While that’s certainly a lever for investment, how does it balance with the more positive message of recovery?’ The sector was now in a position of having to ‘talk to different audiences’ locally – directors of public health and police and crime commissioners – and there was also the question of how the vision of recovery set out in the Drug strategy 2010 translated into local action. ‘The broader message from government is that it’s not in the business of providing guidance, as that goes against localism.’

While the frequently hot-tempered harm reduction/abstinence debate that had characterised previous years finally appeared to be morphing into something more measured, 2012 still saw the sector negotiating upheaval on all sides and dramatic shifts in patterns of drug use.

JANUARY

 Perhaps fittingly for early January, 2012 begins with a call from the cross-party science and technology committee to review the government’s sensible drinking guidelines, including a recommendation for at least two alcohol-free days a week. The government launches its controversial ‘troubled families’ agenda and, in what is to become one of the year’s defining characteristics for policy debates – celebrity endorsements – Sir Richard Branson writes in the Telegraph that it’s time to end the ‘failed drug war’.

 FEBRUARY

 The UK has reached an ‘alcohol death tipping point’, warns the Royal College of Physicians’ special advisor on alcohol, Professor Sir Ian Gilmore, with the next 20 years potentially seeing more than 200,000 avoidable deaths. Meanwhile, the fifth national service user conference, Together we stand, sees another day of vibrant debate and vital networking at its brand new venue, Birmingham’s NEC. 

Public Health England chief executive Duncan Selbie describes how his organisation will work with the treatment sector, and promises that it will deliver ‘a marked improvement’ in the public’s health within three to five years

 Public Health England takes over the functions of the NTA next year, when decisions about local drug and alcohol services will become the responsibility of regional directors of public health. 

 The chief executive of the organisation, Duncan Selbie, has spent more than 30 years working in the NHS and Department of Health, including stints as chief executive of a mental health trust, a strategic health authority and, most recently, Brighton and Sussex University Hospitals. He tells DDN about how the new body will work with the treatment sector, and how services will need to adapt.

The UKDPC’s final conference saw politicians, policymakers, commentators and media representatives gather to discuss where next for drug policy. DDN reports

‘We need a new conversation about drugs,’ UK Drug Policy Commission (UKDPC) chair Dame Ruth Runciman told delegates at the commission’s final conference, New generation, new problems, new drugs, last month. The UKDPC had been set up in 2007 to ‘provide objective analysis of the evidence for drug policy and practice and improve public understanding’, she said, publishing its final report in October (DDN, November, page 4). ‘The wider social and economic issues around drug use are at least as important, if not more so, than polarities around the legal status of drugs,’ she told delegates.

 Policy had not worked over recent decades, chair of the all-party group on drug policy reform, Baroness Meacher, told the conference. ‘In 1971, when the Misuse of Drugs Act was passed, the government of the time believed that the drug problem would have been solved by 2010, but there has been a phenomenal increase in drug use over that time. The situation is out of control, and all the money is going to terrorists and drug barons.’ 

The first Adfam/DDN conference for families affected by drug and alcohol use urged carers from all over the country to make their voices heard. DDN reports

 ‘You know how much stigma gets in the way of your lives. It’s that stigma we have to challenge,’ said Vivienne Evans, Adfam chief executive, opening the inaugural Families First conference. ‘This annual event is the start of a movement for family members,’ she said, before handing over to the first speaker, a mother asked to give her personal perspective.

 ‘I’m standing here because my family was affected by drug use,’ said Christine Tebano. ‘I’m a mum of four and I didn’t know for a long time. There was odd behaviour from my daughter and I knew something wasn’t right. It hit home when she didn’t sit her final exam. We found drugs in her handbag, had calls from her school and then the police started arriving at our door. We didn’t know what to do.’

Fewer young people than ever are entering treatment for heroin and crack problems, and more people of all ages are successfully completing their treatment, says the NTA. What’s behind the trends, and can they be maintained? DDN reports

Figures released by the NTA last month (see news story, page 5) show that the number of young adults entering treatment for heroin or crack is now at its lowest recorded level. In 2011-12, 4,268 18-to-24-year-olds came into treatment for heroin, down from 5,532 the previous year and from more than 11,000 in 2005-06.

Overall drug use – problematic or otherwise – among the young also appears to be falling, with 19 per cent of 16-to-24-year olds reporting using drugs in 2011 compared to 25 per cent in 2005. Fears that large numbers of young people would start to experience problems with substances like mephedrone also appear – so far – to be unfounded. 

‘While the number treated for mephedrone has risen in recent years, this has been offset by a corresponding decline for similar substances, such as ecstasy,’ says the NTA’s report, with the actual numbers remaining ‘small compared to other drugs’. The total number of 18-to-24-year-olds coming into treatment for the first time for any drug fell from 18,500 in 2005-06 to 12,655 in 2011-12, a trend that’s ‘particularly encouraging’, says the agency. 

As the report states, the only age group where the numbers entering treatment are going up is the over-40s, who now make up almost a third of the entire treatment population. However, there’s ‘no evidence of swathes of people in their 40s and 50s starting to use heroin and crack’, says NTA chief executive Paul Hayes. ‘It’s a population that started using 20 or 30 years ago.’

With its Voyage of Recovery just completed, David Gilliver talks to Phoenix Futures chief executive Karen Biggs about overcoming polarisation and embracing change

When Phoenix Futures won ‘best employer’ at the recent Third Sector Excellence Awards, one of the reasons cited – alongside the organisation’s commitment to volunteer involvement – was that 11 per cent of the staff and 10 per cent of management had graduated through the service themselves. ‘That’s part of who we are,’ says chief executive Karen Biggs. ‘We came from a self-help origin, and the fact that graduates of our services and service users are deeply involved in the culture of the organisation we take for granted. You forget that that’s impressive to other people.’

She’s been chief executive since 2007, overseeing 700 staff and nearly 90 services across community, prison and residential settings, following a 17-year career at Stonham Housing Association. Much of her time there was spent running supported housing services for prolific offenders, and a feeling that she was ready for a change coincided with being headhunted for the Phoenix Futures job. ‘When I saw the other candidates I thought I didn’t have a chance,’ she says.