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Global Forum on Nicotine 2025: Quotes and summaries – part 2

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Thursday 19th June 2025

GFN 2025

Michael Russell Oration

Arielle Selya, senior scientist at Pinney Associates, said, ‘There’s a lot of hostility to industry. There are many places I can no longer publish, and there’s criticisms that I’ve seen of industry-adjacent authors, authors who write papers that are cited by industry, or even authors who just make the same arguments as industry.’

‘I want to focus on how academia got this way. From this, I’m going to pull on my decade within academia. My research was on adolescent smoking behaviour, studying things like trajectories, development of dependence and risk factors. When e-cigarettes started to become a big story, around 2014, I initially bought the anti-THR view. I bought the idea that e-cigarettes are gateway products, and that they attract youth, and might lead to smoking. But I changed my mind.’

‘I once wrote what I thought was a pretty neutral and balanced grant, proposing to look at the gateway versus diversion scenarios for youth e-cigarette use. The comment that I got back was that “it would appear inadvisable to encourage a teen to use e-cigarettes because they’re better than traditional cigarettes”. I did not get the grant, obviously, but it goes to show that going against the grain can really work against you when it comes to obtaining this sort of funding.’

‘What drives funding agency priorities? I think a lot of it is honestly naive with good intentions. This aligns with the misperceptions of risk featured in so many sessions at this conference. I think some people genuinely believe that e-cigarettes are harmful, and from that perspective, what they’re doing makes sense to them. There’s also distrust of the profit motive, especially considering the past bad behaviour of the tobacco industry. There’s an emotional objection to recreational nicotine use. And Dr Mike Siegel, I think, was the first to talk about the “not invented here” phenomenon, whereby if e-cigarettes had come from the public health establishment, then they would be touted as a successful solution. Because they came from outside of public health, outside of academia and from industry, they are opposed.’

‘There are other funders of academic research, but at the moment, the major ones all have the same stance on THR – the American Cancer Society, American Lung Association, and, of course, Bloomberg. So the current alternatives to NIH funding would not improve the state of the science. Ultimately, what we need is a range of funders with diversity of thought. I don’t know what to do about this, but possibly it’s a role for grants or contracts from industry. Speaking very optimistically, if this were to become normalised for academic researchers to start relying on grants or contracts from industry, this could help the issue of ostracisation.’

‘One of the biggest challenges for me going into industry was learning how to communicate with lay audiences. Academic journals have almost their own language, and it’s hard to break out of that. I’m still trying to improve my language – and I think that’s a good practice that more academics should have… I think this could even cut down on some of the alarmist media coverage of research.’

‘Lastly, there needs to be more understanding of how someone’s research affects people and consumer voices are invaluable. You have been saying “nothing about us, without us”. In other academic fields that’s been accepted and embraced by the researchers.’

‘For those producing science, keep publishing good science. For those consuming it, keep spreading good science. It’s a quote from Arthur Schopenhauer that “all truth passes through three stages. First, it’s ridiculed. Second, it’s violently opposed, and third, it’s accepted as self-evident”. I think I do see some signs that we’re entering the third stage of truth.’

GFN Warsaw 2025

Workshop

Low and Middle Income Countries: communicating the scientific rationale of tobacco harm reduction

Satenik Muradyan, head of the scientific improvement department at BIL Armenia, said, ‘In many low and middle-income countries, doctors remain very trusted figures to the population. But when it comes to how doctors are approaching the fight against smoking, we have learned that a lot of them only know one way, which is quit or die.’

‘I think it’s very important to educate doctors on the science behind tobacco harm reduction so that they know from root to top what tobacco harm reduction stands for.’

‘Trust me, as a geneticist, it doesn’t matter if you’re Armenian, or French or Chinese, tobacco kills people, nicotine doesn’t and that’s the conclusion that we will always have. If we spend one or two years on researching this topic instead of focusing on making safer nicotine products available, then during that time, thousands of people will be dying because of tobacco. We should focus on countries like Turkey and Iran where these products are banned and make them accessible. Research is important, but if we spend time on research that will only give us the information that we already have, we are losing time and losing people’s lives.’

Hugo Tan, global medical safety officer at BAT, said, ‘There are 1.3 billion smokers, and annually, there are 8 million deaths due to complications related to smoking. COVID amounted to about 7 million deaths. If COVID was a pandemic, if it was a public health crisis, then what about the 8 million deaths from smoking?’

‘Not too long ago, when I was in medical school, we were taught about the harmful effects of smoking, but we learned nothing about the science about alternative nicotine products. How we teach medical students needs to change.’

Sharifa Ezat Wan Puteh, chair of the Malaysia Society for Harm Reduction, said, ‘In Malaysia, as well as in many other low and middle-income countries, tobacco control is very traditional. It’s basically a prohibitionist approach which tries to ban everything under the sun, not only tobacco, but now also alternative nicotine products.’

‘Coming from an NGO, the Malaysian Society for Harm Reduction, we try to educate and advocate, but most of this falls on deaf ears. We are seen as arms of big tobacco, even though the research we produce is not funded by tobacco companies.’

‘I think there’s a lot of failure stories, but there are a lot of success stories as well on the use of alternative nicotine products all over the world that low and middle-income countries can actually emulate, success stories like Japan, the UK or New Zealand.’

Emmanuel Mbenza Rocha, a harm reduction advocate from the Democratic Republic of Congo, said, ‘One of the biggest challenges we have in the Democratic Republic of Congo in particular, and in Africa in general, is the issue of data collection about tobacco use. The information is not really accurate compared to the reality down in different communities.’

‘In the Democratic Republic of Congo, there are 120 million people, but only 25% of them have access to electricity. That means 75% of the Congolese are in darkness, so it’s not really possible to inform them, or campaign to raise awareness about tobacco harm reduction in many parts of the country.’

‘A big challenge we have in terms of introducing the Congolese people to safer alternatives, is the lack of the products we need to show them that there is hope, to show them that there is a way to transition to cessation.’

gfn.events

Watch the day’s proceedings here:

Global Forum on Nicotine 2025: Quotes and summaries – part 1

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DDNWeb
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Thursday 19th June 2025

GFN 2025Opening and Keynote #1

What’s so scary about tobacco harm reduction?

Paddy Costall, director, Global Forum on Nicotine Ltd, said, ‘We chose “Challenging perceptions – effective communication for tobacco harm reduction” as the theme for this year’s event because, whilst the potential of tobacco harm reduction to play a major role in combating non-communicable diseases (NCDs) is becoming more apparent, with science clearly demonstrating this, we face continued challenges from often well-resourced organisations and individuals who remain implacably opposed to it.’

‘Communication is a key issue, and the importance of honesty and accuracy cannot be overstated. Ill-informed and often misleading representations can be seriously damaging to individuals and communities at large.’

‘A balanced and informative approach, rather than a polemic, enables people to make better decisions and thus improve their health. Critical, inquisitive and responsible journalism can play a major role in public understanding and can really help create the conditions where individuals’ decisions are more informed. However, misrepresentation – whether accidental or deliberate – does not serve individual or public health.’

Mark Tyndall, a professor of medicine at the School of Population and Public Health, University of British Columbia, said, ‘I got into harm reduction, not because I took a doctoral degree in harm reduction, but because it became a big part of my work in HIV prevention. I quickly learned that with behaviours and exposures that had inherent risk, the only approach would be to offer interventions that reduce risk, because we couldn’t eliminate the risk.’

‘Most importantly, these interventions are enthusiastically supported by people who will benefit from them. This is not a nanny state type thing that we’re trying to foist on people. This is what people want and what people need. People knowing that they could get HIV are quite happy to use a condom. People injecting drugs are quite happy to use a clean needle. And people using nicotine are generally quite happy to find alternative sources.’

‘I’ve talked about harm reduction interventions as though acceptance should be a slam dunk, but it’s not. It’s not because they don’t work. It’s because of ideology.’

‘The history of harm reduction is controversial mainly because of the people it’s designed to help. Generally, people choosing risky or socially unacceptable behaviours are frowned upon in society. We discriminate against people who are the most vulnerable and most in need of our help. Imagine a scenario where 15% of the richest Canadians, Americans and Europeans were smokers, and they knew it cut 10 years off their lives and resulted in a number of chronic illnesses. Along comes something like vaping that could reverse that. Do we really think we’d be holding this conference? I don’t think so. They would demand that they got a safer product. There’s a lot of discrimination and stigma that’s attached to our responses.’

‘We’ve developed a whole medical system in some countries around smoking, […] around treating these chronic illnesses due to smoking, and nobody’s in a big hurry to change it. Tobacco control organisations aren’t in a big hurry to change things, either. They’ve had decades of working on abstinence-based programmes. I think at the very beginning, when safer products became available, they were cautious. But now, instead of starting to discuss the possibilities of how these could help people and help people’s health, they just continue to double down. And now, 10 or 15 years into it, it’s really hard for these tobacco control organisations to take a big breath and say maybe we were wrong all along.’

‘Tobacco companies are also not pushing hard for change. There’s a lot of new products. The websites of PMI and BAT are very forward-looking, and [they] want to go smokeless, but they seem to be in no hurry. […] In Canada, and I think in many countries, tobacco companies aren’t allowed to say that vaping is safer. And so that’s a huge problem as far as getting the message out there. You would think these companies would have a whole team of lawyers trying to push back on things like that, but it really hasn’t happened. The slow transition these companies will support, but they are not aggressively trying to make this change quickly.’

‘We need to find ways to speed up the transition that I think will inevitably occur. But there are things we can do right now. One is that community activism is extremely important. We need to encourage people who have started to vape to advocate for themselves and have a voice. We can also use people who can speak truth to power. I think we need to do a better job and really get to policymakers – and we need to keep on top of all the false claims and narratives. Finally, we need to use the legal justice system better. With other harm reduction, taking cases to the courts has been very successful. Supervised injection sites, needle exchanges – all have gone to Canadian courts, and they’ve ruled in favour of access to these things. It’s pretty hard from a justice perspective to say that people who want a safer product can be denied.’

‘We should be doing everything we can to increase access, and increase the acceptance of these products, to make them as easy to get as possible so we can get as many people off cigarettes as we can. But that is not what’s happening. I really believe there’s some urgency to this. I think the policies that make vaping and safer nicotine products harder to get for people who smoke is equivalent to denying people HIV treatment.’

Carolyn Beaumont, an Australian GP specialising in rural medicine, and founder of SmokerHealth national telehealth clinic, said, ‘Although we won’t easily get media or politicians on side anytime soon, we must focus on educating health professionals about tobacco harm reduction. It’s simply about offering smokers more solutions, about acknowledging that many don’t want to give up nicotine and they’re sick of being lectured to and judged by doctors. I’m not telling doctors to ignore existing replacement therapies. I’m simply telling them there’s another extremely effective tool in the toolbox.’

‘All I can say about this is three things: innovate, regulate, educate – whatever helps a smoker quit has to be considered seriously and not just dismissed as yet another tobacco industry ploy to addict the next generation. Surely we can remain open to new nicotine technologies and at the same time ensure they remain regulated and as safe as possible?’

GFN Warsaw 2025Panel Discussion #1

Reflections on the Framework Convention on Tobacco Control at 20

Jeannie Cameron, founder and managing director of JCIC International Consultancy, said, ‘When you consider treaty success, you must look at three key things: legal, political and objective effectiveness. The FCTC has achieved much in the first two obligations… For effectiveness, however, the objectives of the FCTC treaty were to reduce the exposure to tobacco smoke and the reduction of death and disease from smoking. And you could certainly say the FCTC has failed in terms of effectiveness.’

‘The Paris Charter Against Cancer has a much more humanitarian approach than the FCTC, although the FCTC does… reference human rights. For example, it draws on Article 12 of the International Covenant on Civil and Political Rights, which outlines that the highest attainment of health is a human right, and also from 1966, the International Covenant on Economic, Social and Cultural Rights. Both have a lot of human rights aspects that are very relevant here. Both of those treaties have what is called an optional protocol. In treaty law, an optional protocol gives individuals or groups affected by their national policy the right to take their case against their government. Most governments in the world are parties to those human rights treaties. A group of individuals who want to vape, and their government stops them from vaping, could take a case as individuals only to those human rights bodies… I did write an article in FILTER magazine last year on it, and no one has yet done that. I think it’s worthwhile to think about.’

‘How do you invoke Article 1d of harm reduction? You would do that in the very same way that all the other articles in the FCTC have been invoked at each COP. For example, Article Eight on environmental smoking bans. During the COP, one country put forward an intervention to say we would like to bring this up for further elaboration and discussion and scrutiny. Another country backed it. The COP is a consensus-making body. No one objected. So hopefully at COP11, one government backed by another one, and there being no objection, could actually bring it up for further discussion, elaboration, presentation of the science and evidence, to actually bring Article 1d out in a practical way.’

Derek Yach, a member of APCO’s International Advisory Board and former executive director for noncommunicable disease at the WHO, said, ‘Success can be looked at with two outcome measures. Do we have more smokers today than we did in the past? Yes – today we have 1.3 billion users of tobacco, a huge amount, and smoking rates exceed 50% in many countries in the world. More importantly, deaths… A billion people will die prematurely this century from tobacco-related disease. Staring us in the face is the obvious way to halt it in its tracks: tobacco harm reduction.’

‘Looking at the objective for the FCTC, if you read the text, it’s very clear that governments would see the FCTC as being successful if it reduced the death and disease caused by tobacco smoke. Each word had incredible meaning. First, it meant that success wasn’t going to be measured simply in smokers no longer becoming smokers. That wasn’t good enough. It had to go all the way through to preventing cancer, cardiovascular disease and respiratory disease. Cancer, of course, was the central one, and we’ve forgotten that. Instead, the debate has moved towards everything to do with kids, forgetting that the real purpose of the FCTC is to show benefits to adults in terms of very specific health outcomes.’

Tikki Pangestu, visiting professor, Yong Loo Lin School of Medicine, National University of Singapore, said, ‘The WHO has a very strong anti-THR position. The main issue is that WHO has huge influence on policies in low and middle income countries (LMIC)… Policymakers there don’t look at research from the US or Japan, they need local research, and that is sorely missing in many of the LMICs. There’s also apathy within governments. If WHO says THR or vaping is as harmful as combustible cigarettes, they will just follow WHO guidance.’

David Khayat, professor of medicine, medical oncologist at the Clinic Bizet in Paris, said, ‘We had 1 billion smokers [in 2005]. We still have 1 billion smokers. In my country, 28 or 30% of adults are smokers. France is a very rich, developed country that put a huge amount of tax [on cigarettes]. And did it work? Not at all. Official data shows that the poorest people either buy illicit cigarettes, about 45% of the cigarettes sold in France, or more important, they spend less money on food, so they have a poorer and poorer diet, to be able to continue what is not just a pleasure, but an addiction. You cannot just say to a drug addict “stop injecting drugs”. It will continue.’

Asa Saligupta, founder and director of consumer advocacy group ENDS Cigarette Smoke Thailand (ECST), said, ‘What Bloomberg is trying to do – or at least the intention – is to reduce smoking rates. But we all know that it’s not working. And what they are also trying to do is to limit access to what we know are safer alternatives, things like vaping or snus or pouches. A lot of countries have bans on less harmful products, like in [Thailand], where it’s illegal to import vapes and it’s illegal to distribute them. But it’s not illegal to possess, it’s not illegal to vape, per se.’

GFN Warsaw 2025

Panel Discussion #2

Nicotine pouches – what’s the real story?

Anna Franzén, clinical & regulatory business development officer, Emplicure, said, ‘I wanted to highlight Sweden, where daily smoking rates have dropped below 5%. This is one of the lowest, if not the lowest, in the world, and according to the WHO meets the definition of a non-smoking country. This is a remarkable public health achievement, with the migration of smokers to Swedish snus being one of the key reasons for that.’

‘There are actually lots of long-term studies on nicotine. NRT [nicotine replacement therapy] was approved as a medicine for smoking cessation over 40 years ago, and it has been used safely for decades. So, when nicotine is separated from tobacco and combustion, the risk profile dramatically decreases.’

‘We have forgotten that 50 years ago Sweden used to have a high smoking prevalence… The Swedish government has only just started to talk about this, sharing the message that the migration of smokers away from cigarettes to Swedish snus (and later nicotine pouches) is a key reason that we have such low smoking levels. This is also the reason why Sweden has the lowest rate of lung cancer in Europe.’

‘So on this continuum of risk, I would say that nicotine pouches and NRT [nicotine replacement therapy] are exactly the same.’

Mark Oates, director of We Vape and the Snus Users Association, said, ‘The real point is that nicotine pouches can be produced very cheaply, at a rate competitive with cigarettes. This is vitally important especially when it comes to low and middle income countries, because vapes are expensive to produce and so can’t be sold to compete with cigarettes at 50 pence a pack.’

Cecilia Kindstrand-Isaksson, director at Swedish Match, then followed with this response, ‘We have published a paper* comparing smokeless tobacco, nicotine pouches, and NRT. In fact, our nicotine pouches contain slightly fewer toxicants than nicotine gum.’ *Back et al. (2023). BMC Chemistry doi: 10.1186/s13065-023-00918-1

Barnaby Page, editorial director of Tamarind Intelligence, said, ‘Looking at it logically, dependency is only a problem if you have large numbers of nicotine naive users coming in, or if you then have a gateway to combustibles. As far as we can see, we have neither. We [Tobacco Intelligence] did a survey of pouch users in the United States, and found about half switched to pouches straight from smoking. Only 5%, one in 20, were nicotine naive. The rest used a combination of smoking, vaping, other oral products and so on.’

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Watch the day’s proceedings here:

Falling through the cracks

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A recent parliamentary meeting examined multiple disadvantage, as DDN reports

The latest meeting of the All-Party Parliamentary Group (APPG) on Drugs, Alcohol and Criminal Justice focused on the service gaps facing people with both mental health and substance use needs – and the personal and system-wide costs of failing to provide coordinated support.

Held during Mental Health Awareness Week (12-18 May), the session – Falling through the cracks: mental health, substance misuse and the cost of multiple disadvantage – brought together speakers from Via, Making Every Adult Matter (MEAM) and the Changing Futures programme, to discuss what needs to change.

multiple disadvantage
There was already good understanding of what could help, including trauma-informed support, housing, peer-led provision and properly coordinated funding

The week was an opportunity to shine a light on issues that often remain hidden, said Via chair, Yasmin Batliwala. Many people with both mental health and substance use problems were still falling between services, with individuals frequently caught in cycles between emergency care, criminal justice and community provision. ‘This comes at significant personal and population-level cost,’ she said.

There was already good understanding of what could help, she pointed out, including trauma-informed support, housing (that isn’t conditional on abstinence), peer-led provision and properly coordinated funding. However, the challenge remained scaling up these approaches. ‘Inaction is a false economy,’ she said. We needed to focus on practical ways to close the gaps between health, justice and social care.

Maud Pedemonte-Ellis, Changing Futures partnership manager at MEAM, talked about the need for system-wide responses rather than relying on the dedication of individual staff. While trusting relationships between key workers and clients were important, they needed to be backed by wider structures that ‘allow for sustained and consistent support’.

She highlighted examples from the Changing Futures programme, which takes a trauma-informed approach across 15 local areas — including work in Nottingham to reduce demand, the creation of an expert citizens CIC in Stoke, and trauma-informed commissioning in Plymouth – examples which offered useful experience. Stressing that long-term, secure funding would be essential to allow the programme to continue and expand, she also called for a shift away from competitive commissioning and towards a more joined-up approach across services.

dual diagnosis multiple disadvantage
An estimated one in four adults experienced a mental health problem each year, with around one in 11 reporting drug use

Dr Matt Liveras, consultant psychiatrist and medical lead at Via, provided figures showing the scale of mental health issues and substance use across the population. An estimated one in four adults experienced a mental health problem each year, with around one in 11 reporting drug use. The wider financial cost of mental ill health was put at £300bn, with drugs and alcohol contributing an additional £30bn.

Liveras shared the case study of a client with a history of childhood trauma, substance use, rough sleeping and repeated contact with the criminal justice system. The man’s experience included physical and sexual abuse, school exclusion, and early heroin use. Despite multiple attempts to access help, services often found it difficult to engage with him when he was intoxicated or displaying challenging behaviour. This underlined the importance of trauma-informed approaches and early intervention, including work in schools and with parents, he said, adding, ‘People in recovery often say it took one person to care.’ While services like Via supported change, they often came into people’s lives after significant harm had already been done.

Lisa McCarthy, a recovery practitioner at Via, gave her perspective as both a worker and someone with lived experience, and shared her journey through long-term alcohol use, detox and residential treatment. It wasn’t until a stay at a women’s rehab that she first received mental health support and began to explore unresolved trauma – which played a key role in her recovery.

stigma
Stigma was a persistent barrier, and the lack of integrated services made it harder for people to access support

Now working with 52 clients, many with a dual diagnosis, she helps with everything from self-care and housing to GP appointments. Stigma – particularly the combined stigma of addiction and mental health – was a persistent barrier, and the lack of integrated services made it harder for people to access support. She also raised practical challenges such as affordable childcare, recalling times when she’d had to leave her children in a fast-food restaurant while she attended appointments.

During the discussion, other speakers and attendees highlighted the importance of trauma-informed systems and the need to keep pace with how young people communicate and access information. Concerns were also raised about school exclusions, the availability of substances online, and the lack of mental health support in prison and probation settings.

One point repeated throughout the meeting was that while service delivery remained fragmented, there was no shortage of knowledge about what worked. What was missing, many felt, was the scale, funding and political will to apply it consistently.

Read previous Drugs, Alcohol & Justice APPG reports here

Arc Hospitality and Restart join forces to fast-track local employment

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Arc Hospitality and Restart Join Forces to Fast-Track Local EmploymentFollowing a successful relationship developed over the past year, Arc Hospitality reached out to The Forward Trust in May with an exciting opportunity. They were organising an induction and interview session at Dreamland on Monday 19 May, and invited Restart to refer as many participants as possible who were interested in bar work. The brief was simple – participants just needed to bring a positive attitude, wear relaxed clothing, and have their Right to Work documentation in hand.

Despite the short notice, the Restart team responded with speed and enthusiasm. Employment advisors were quickly informed and began personally contacting participants, encouraging them to take advantage of the opportunity. Team leader Kirsty Langley coordinated the response, gathering confirmations and arranging to meet the group outside the venue to ensure a smooth and confident arrival.

On the day of the event, Kirsty arrived early and was warmly welcomed by those from Arc Hospitality who were leading the session. She handled sign-ins and stayed for the full event, offering support to participants and observing the level of engagement, identifying those who stepped up with confidence, those who stayed more reserved, and those who left early. This insight has been invaluable in providing tailored feedback to employment advisors to further support participant growth.

Over 25 Restart participants attended, and following the session, Kirsty and the Arc Hospitality team sat down to identify standout individuals who were ready to begin work. With just four days until the Saturday start date, the challenge was clear — but both teams were determined to succeed.

Arc Hospitality Restart The Forward Trust
This collaboration is a shining example of what can be achieved when organisations work together with a shared commitment to empowering people through employment

Participants worked quickly to complete e-learning modules, upload necessary documents, and finalise onboarding. With individuals dropping in and out of the office all week to meet the requirements, the commitment was evident. Thanks to ongoing communication between Kirsty and the Arc Hospitality team, eight participants were successfully placed into roles that weekend, with a ninth joining the following Saturday.

This collaboration is a shining example of what can be achieved when organisations work together with a shared commitment to empowering people through employment. With nine participants now successfully in work and many more opportunities on the horizon, Restart and Arc Hospitality are proving that rapid response, clear communication, and mutual trust deliver real results.

On the collaboration, Emma Woodward, senior operations manager at The Forward Trust, said, ‘We’ve been delighted to support Arc with their recruitment and to support them with suitable, reliable workers for their busy summer ahead at the fantastic Dreamland entertainment park in Thanet. They’re a fantastic employer and advocate for supporting those with long-term unemployment or health-related barriers to return to work. So far, they’ve recruited 11 of our participants.’

The partnership between Restart and Arc Hospitality continues to grow, with both teams staying in close contact to ensure participants are well supported and to meet any future staffing needs. With summer just beginning, this marks the start of an exciting season of opportunity and success for all involved.

This blog was originally published by Forward. 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 Forward

It’s time to seize the opportunity to do better for women in the criminal justice system

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women in the criminal justice system
It’s long been clear that short-term prison sentences rarely lead to meaningful change

We’ve seen a swathe of major policy announcements over the last couple of months, most notably the much-anticipated Independent Sentencing Review and last week’s Spending Review, writes Change Grow Live executive director Vicki Markiewicz. Together, they offer a powerful opportunity to reimagine how we support people with drug and alcohol support needs in contact with the criminal justice system and, in particular, how we do better by women.

For those of us who’ve spent many years supporting people caught in the cycle of drug and alcohol use and offending, it’s long been clear that short-term prison sentences rarely lead to meaningful change. They can turn lives upside down, remove vital support networks, and miss the deeper reasons someone ends up in prison, which so often include trauma, unmet physical and mental health needs, and struggles with drug and alcohol use.

Encouragingly, the Independent Sentencing Review acknowledged this. It put forward a more hopeful vision, one that focuses on rehabilitation in the community, smarter sentencing, and long-term change. At the heart of the review is the acknowledgment that the current reliance on short-term prison sentences, particularly for people dependent on drugs or alcohol, is simply not sustainable. It fails to address the root causes of offending and contributes to the revolving door we continue to see in our justice system.

Change Grow Live fully supports the Independent Sentencing Review’s call to move away from short-term prison sentences and towards greater use of community sentences for low-risk offenders with a treatment need.

We’re also encouraged by the emphasis on expanding Community Sentence Treatment Requirements (CSTRs), which offer a practical and compassionate alternative. These changes could make a real difference, especially for women and people whose offending is driven by drug and alcohol use, offering a stronger foundation for recovery and rehabilitation within the community.

One positive step in the Spending Review to support this shift was the £700 million uplift for probation services – a clear signal that there’s appetite to invest in change. However, we also need to look closely at what’s missing.

Around half of people in prison are living with drug dependence. While women make up just 4% of the prison population, they account for 9% of those receiving treatment for drug dependence in custody.

These figures underline the scale and urgency of the challenge we face, and the need to expand treatment capacity, improve continuity of care between prison and the community, and ensure our frontline teams have the resources they need to deliver consistent support.

It’s time to seize the opportunity to do better for women in the criminal justice system
Women in the justice system are often navigating overlapping challenges: trauma, domestic abuse, poverty, and deep-rooted stigma

Yet there’s still been no dedicated investment for community drug and alcohol treatment, and £7 billion is being channelled into building new prison places. That raises important questions about priorities, especially when we know that funding treatment now will avoid far greater social and economic costs in the future, particularly for vulnerable cohorts like women.

At Change Grow Live, we’ve seen how powerful trauma-informed, gender-responsive treatment can be. Women in the justice system are often navigating overlapping challenges: trauma, domestic abuse, poverty, and deep-rooted stigma. These aren’t new issues, but they remain under-addressed. However, the right approach can help women stay connected to their families, build safety and trust, and support long-term recovery. We’re making progress, and our staff are doing extraordinary work, but ambition has to be matched with investment.

The direction of travel from the Sentencing Review is promising. To realise its ambitions and make long-term change, what we need now is a clear delivery plan and the funding to back it, particularly for the women who have long been overlooked and underserved, but for whom a better approach could make all the difference.

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

‘Ongoing improvements’ in accessibility and choice of treatment, says Public Health Scotland

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The last 12 months have seen ongoing improvements in the accessibility and choice of treatments available to people with problematic drug use in Scotland, says a new Public Health Scotland report on the Medication Assisted Treatment (MAT) standards.
The MAT standards consist of ten evidence-based standards of care designed to widen access to effective treatment

The last 12 months have seen ongoing improvements in the accessibility and choice of treatments available to people with problematic drug use in Scotland, says a new Public Health Scotland report on the Medication Assisted Treatment (MAT) standards.

Local alcohol and drug partnerships have ‘engaged well’ with efforts to make sure that services are ‘psychologically and trauma informed’ and tailored to the needs of their populations, the document states.

The MAT standards, which were introduced by the Scottish Government’s drug deaths taskforce in 2021, consist of ten evidence-based standards of care designed to widen access to effective treatment – both substitute medication and psychological and social support. There has been ‘continued progress’ in the implementation and embedding of standards one to five, reflecting ongoing improvements in accessibility and choice, says the benchmarking document, with ‘substantial progress for the more challenging goals’ in standards six to ten, which cover issues like dual diagnosis, trauma informed care and access to housing and welfare support.

Scotland’s drug death rate is by far the worst in Europe, with the most recent figures recording almost 1,200 fatalities. The death rate is four times higher than it was a quarter of a century ago, with people in the country’s most deprived areas more than 15 times more likely to die from drug misuse. Outgoing Scottish Drugs Forum CEO David Liddell told DDN in 2023 that while the ‘good progress’ with MAT was starting to show an impact the numbers were ‘still colossal’.

The last 12 months have seen ongoing improvements in the accessibility and choice of treatments available to people with problematic drug use in Scotland
There has been ‘continued progress’ in the implementation and embedding of standards one to five, reflecting ongoing improvements in accessibility and choice

Last year also saw a 15 per cent increase in the number of drug-related hospital stays, while earlier this month the Scottish Government appointed Maree Todd as its new minister for drug and alcohol policy.

‘The continued progress in implementing the Medication Assisted Treatment (MAT) standards is a testimony to the enthusiasm and dedication of Scotland’s alcohol and drug partnerships (ADPs) in working with many stakeholders,’ said PHS public health consultant John Mooney. ‘These have included clinical colleagues, third sector partners, and most critically, people with lived and living experience, all working collaboratively to ensure that the ongoing implementation during 2024-25 has been underpinned by a human-rights based ethos. This will also help to embed these same principles in the ongoing sustainability of any service improvements.

‘For the forthcoming year, Public Health Scotland will support ADPs as they continue to make improvements and embed the MAT standards to the justice sector and other non-community settings such as acute care. We must also ensure that MAT standards are adapted to the rapidly evolving drug use landscape, in which opioid drugs are supplemented or replaced by their more lethal synthetic equivalents.’

National benchmarking report on the implementation of the MAT standards: Scotland 2024/25 available here

Cranstoun launches AI harm reduction chatbot

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A new AI chatbot able to provide accurate answers to both ‘basic and complex’ questions about drugs and harm reduction has been launched by Cranstoun.

Cranstoun launches AI harm reduction chatbot
Drugbot can give accurate information on issues like safer behaviours, dosage and aftercare

Drugbot, delivered in partnership with technology-based harm reduction social enterprise Substancy, can give accurate information on issues like safer behaviours, dosage and aftercare, says the charity. The bot has a safety filter which is able to detect any questions that could ‘encourage or assist’ illegal activities such as buying drugs, Cranstoun adds. People are also urged to contact professional drug workers when any ‘particularly risky’ behaviour is identified.

The bot’s responses to more than 20,000 questions were tested as part of its pilot programme, with all the responses rigorously checked by drug service professionals. Drugbot will continue to be improved via user feedback, says Cranstoun, and there are plans to further enhance it with additional features.

The government has previously backed a range of AI-based harm reduction pilot projects, including the use of wearable AI to detect overdoses and alert responders.

‘The Drugbot database draws on a diverse array of trusted sources, from crowdsourced information to insights written by domain experts,’ said Substancy founder Dr Ivan Ezquerra Romano. ‘Each record is rigorously curated and prepared for the AI system. The information is overseen by a dedicated team whose combined decades of experience in the substance use and harm reduction field ensure that every user receives the most accurate, up-to-date guidance to reduce risk and save lives.’

With more and more contaminants appearing in a rapidly changing drug market it was ‘essential that we can reach more people and provide them with accessible information that could save their lives,’ added Cranstoun’s director of services, Megan Jones. ‘We’ve invested and partnered with Substancy to launch this service so we can support people in a unique way – as we know that for many people it can take a lot of confidence to come and speak to someone in one of our drug and alcohol services about their drug and alcohol use. The Drugbot is seeking to break down some of those barriers and will be able to suggest that people do seek in person face-to-face help too.

‘It’s really important that our drug and alcohol services aren’t left behind by the rapidly changing technology landscape, and the ways in which many people communicate. Drugbot will help to provide meaningful drug related education and advice to many people who would struggle to access or talk about their drug use.’

More information here

Market forces

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Regulating drugs will save lives and reduce misery, says Dr Alison Bedford Russell.

Regulating drugs will save lives and reduce misery, says Dr Alison Bedford Russell.

My eldest son George was one of many who needlessly died of a heroin overdose in 2016. Social status and education do not protect from drug use and dependence, and mental health problems. I was a medical director of an acute NHS trust at the time, and he had just graduated from university. The multiple system failures which contributed to his death nine years ago have not improved sufficiently to prevent the same happening again today, and drug-related deaths are at unacceptably high levels in the UK.

That is why I’ve joined Transform and the Anyone’s Child campaign group. A network of families, like mine, whose lives have been destroyed by current drug policies and are now calling for a new approach – the legal control and regulation of the drug market.

Dame Carol Black published an excellent review in 2021 which highlighted the disjoint between NHS-run mental health services and council-run addiction services as major barriers to good quality care. The Royal College of Psychiatrists (RCPsych) recently published a report warning that people who have a co-occurring substance use and mental health disorder (CoSUM) are being failed by a system that is not designed or equipped to meet their complex needs (see news, page 5), as was the case for George.

George was found dead in June 2016, the result of a heroin overdose. He’d been refused access to mental health services earlier that year.
George was found dead in June 2016, the result of a heroin overdose. He’d been refused access to mental health services earlier that year

RCPsych is calling on the UK and devolved governments to provide substance use and mental health services with the training, staff, and funding they need to address these difficulties. The college is also calling on all health and local authority commissioners to ensure the number of people with CoSUM disorders, and their outcomes, are routinely monitored. This will help improve understanding the scale of the issue while supporting better resource allocation and strategic planning. The college’s report is aimed at helping the general public, healthcare professionals and commissioners to better understand CoSUM, and has recommendations for how people can be better cared for.

What is omitted from the Carol Black and RCPsych reports, however, is the need to revise the very outdated and not fit for purpose UK drugs laws. Punitive drug laws exacerbate the problems by driving them underground, and stigmatise those affected. Drug-related deaths are rising year on year and have such devastating impacts on family and friends.

Approximately 50,000 children in the UK are frontline dealers for heroin and cocaine as part of ‘county lines’ activity. Using children to sell illicit drugs is an unanticipated adaptation by organised crime in response to police activity and does not feature in legally regulated markets.

Anyone using unregulated recreational drugs may be harmed from ingesting substances of unknown dose and purity, including ecstasy. Most users of illegal recreational drugs are not addicted and do not have mental health problems – they are seeking similar social enhancements to alcohol.

Alcohol is a risky but largely regulated recreational drug: an uncomfortable fact. Addiction to alcohol can result in illness or death. Regulation versus prohibition provides harm mitigation: consumers make reasonably informed decisions about consumption and are not criminalised. Producers and suppliers are regulated and held accountable.

Regulating drugs will save lives and reduce misery, says Dr Alison Bedford Russell.Anyone’s Child lobby Parliament in 2023.
Anyone’s Child lobby Parliament in 2023. On 24 June Anyone’s Child will once again be returning to Parliament

The UK criminal justice-led ‘war on drugs’ strategy should be replaced by a focus on public health and legal control and regulation of the market. Regulation of the drugs industry and all it encompasses would save lives by mitigating direct harms. Regulation of suppliers would reduce the collateral damage linked to the illegal drug trade.

Successive governments have avoided implementing the evidence-based solutions outlined by the Global Commission on Drugs Policy, because of insecurity that the solutions could be unpalatable to the voting public. It is vital that members of Parliament as well as the general public receive good quality, evidence-based information on drugs and drug policy.

This year marks Anyone’s Child’s ten-year anniversary and on 24 June we will once again be returning to Parliament to show the public and politicians that we stand for better drug laws. To achieve change, we need you there.

Change is possible when all stakeholders unite, consider all the available evidence and work together to prevent further unnecessary deaths through implementation of an effective, evidence-based drug strategy. So join us on 24 June, speak out on the need for reform and help us to protect more young people like George.

More details here

Dr Alison Bedford Russell is a consultant neonatologist

A partnership to save lives

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A partnership between Turning Point, Leicester City Council and Leicestershire Police that trains officers to administer a lifesaving antidote to opiate drugs won a national award on Wednesday.

The judges said they were 'wowed by a partnership solution that is both innovative and pragmatic'
The judges said they were ‘wowed by a partnership solution that is both innovative and pragmatic’

The initiative sees police officers trained to use naloxone, which reverses the effects of an opiate overdose – if given quickly enough. In the first 12 months, officers administered naloxone on 14 separate occasions, in situations where people were likely to have otherwise died, before calling for ambulance back-up.

The success of the scheme was recognised with it winning in the Public Partnerships category at the Local Government Chronicle Awards, held at the Grosvenor House Hotel, London. The awards recognise excellence in local government across the whole of the UK.

The judges said they were ‘wowed by a partnership solution that is both innovative and pragmatic’.

‘The clarity on the role of each partner and the way they overcome challenges was truly impressive. We could see how all places could apply this model to save lives and strengthen services,’ they added.

Approval for the pilot scheme was given by Leicestershire Police in 2023, after Turning Point and the city council’s public health team had found funding and established pilot sites. Initially, small groups of police officers were given training in overdose awareness and administering naloxone, and as a result almost 200 officers voluntarily agreed to carry it.

New recruits to Leicestershire Police are now trained in administering naloxone as part of their core training and offered the chance to carry at that time. Since this was introduced, every new recruit has volunteered to carry it.

A partnership to save lives
‘We could see how all places could apply this model to save lives and strengthen services,’ the judges said

Leicester’s director of public health Rob Howard said, ‘In the event of an opiate overdose, administering an immediate dose of naloxone by nasal spray reverses respiratory arrest and allows time for emergency medical services to be called.

‘Police officers are most likely to be the first on scene at such incidents, and thanks to years of hard work by all involved, we believe that the Leicestershire police service is now the first in England and Wales to commit to enabling all front-line officers to carry naloxone.

‘This incredible partnership work has not only saved lives, and will save lives in the future, but is also supporting a broader understanding of the challenges faced by people who use drugs.’

James Edmondston, Leicestershire Police’s substance misuse team leader, said, ‘The most important duty of a police officer is to preserve life and naloxone gives officers a simple, safe and effective way of doing so. This initiative reflects a strong and robust partnership commitment to saving lives and supporting people into long term treatment.

‘It is fantastic to see its use being celebrated – it really does save lives and we are looking to expand its use across the force and into custody.’

Julie Bass, Turning Point chief executive, said, ‘Winning this prestigious award is testament to the power of partnership. We have been delighted to work with Leicestershire Police and Leicester City Council on this initiative, which genuinely has saved lives and also strengthened joint working across our organisations.’

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

‘Longest standing’ dark web drug market shut down by police

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European law enforcement authorities have shut down the world’s longest standing dark web drug market, Europol has announced. ‘Archetyp Market’, which had more than 600,000 global users, was one of the few darknet market places to allow the sale of fentanyl and other potent synthetic opioids, ‘contributing to the growing threat posed by these substances in Europe and beyond’, says Europol.

The site had over 17,000 listings and a transaction volume of ‘at least’ EUR 250m

The site, which had been operating for more than five years, had over 17,000 listings and a transaction volume of ‘at least’ EUR 250m. The police operation involved 300 officers across six countries and saw coordinated raids last week in Germany, the Netherlands, Romania, Spain and Sweden.

Police took the platform’s infrastructure offline and arrested its administrator, a 30-year-old German national. Measures were also taken against six of the platform’s biggest vendors, with almost EUR 8m of assets seized, the authorities state.

The action was the result of ‘years of intensive investigative work’ to trace financial flows, analyse digital forensic evidence and map the platform’s technical architecture. Archetyp Market’s longevity, scale and reputation in the criminal community put it in the same category as famous dark web markets like Silk Road, says Europol, which was first shut down in 2013.

‘With this takedown, law enforcement has taken out one of the dark web’s longest-running drug markets, cutting off a major supply line for some of the world’s most dangerous substances,’ said Europol’s deputy executive director of operations, Jean-Philippe Lecouffe. ‘By dismantling its infrastructure and arresting its key players, we are sending a clear message: there is no safe haven for those who profit from harm.’

US alcohol-related liver disease deaths double in two decades

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Age adjusted mortality rates for alcohol associated liver disease in the US doubled between 1999 and 2022, according to new analysis published by JAMA Network Open. The death rate increased from 6.71 to 12.53 per 100,000 with a ‘significant acceleration’ around the COVID-19 pandemic.

US alcohol-related liver disease deaths double in two decadesResearchers studied almost 440,000 alcohol associated liver disease deaths and found there were also ‘disproportionate’ increases among women, young adults aged 25-44 and Native American and Alaska Native populations.

These trends were ‘particularly concerning’ the researchers state, highlighting the ‘urgent need for targeted public health interventions and enhanced surveillance’. This was especially the case given the sustained impact of pandemic-related changes in consumption patterns, which were ‘more severe and enduring’ than previously documented. Many countries have seen increases in alcohol-related deaths in recent years, with the UK experiencing record-high deaths every year since the pandemic.

Although the US has also been in the grip of an opioid crisis since the late 1990s – officially declared a public health emergency in 2017 – provisional data for the year to September 2024 shows an almost 24 per cent fall in overdose fatalities compared to the previous year, thanks to factors such as data-driven distribution of naloxone and improved access to treatment.

Alcohol-associated liver disease mortality available here

Scotland appoints new drugs minister

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Maree Todd has been appointed as the Scottish Government’s minister for drugs and alcohol policy, following the death of Christina McKelvie earlier this year. Todd is the MSP for Caithness, Sutherland and Ross.

Maree Todd
Maree Todd

The Scottish Drugs Forum (SDF) said the appointment was to a ‘crucial role’ at a pivotal time. ‘We look forward to working with the minister to improve the lives of people affected by substance use across Scotland,’ it stated. ‘We are committed to supporting evidence-informed policy and ensuring that people with lived and living experience are central to shaping services and strategy.’

The latest provisional figures from Police Scotland show there were 308 suspected drug deaths between January and March this year – a 33 per cent increase on the previous quarter, but just under 5 per cent fewer than the same period last year. More than 60 per cent of the suspected drug deaths were of people aged between 35 and 54, with men accounting for almost 80 per cent of the total.

The quarterly figures are compiled from reports of police officers attending scenes of death, and are different from the accredited official statistics published annually by National Records of Scotland. The numbers can ‘fluctuate from quarter to quarter’ the Scottish Government stated, adding that care should be taken not to interpret changes between quarters as indicative of long-term trends. ‘Suspected drug deaths in Scotland remain at a high level,’ it stated.

The latest figures from Public Health Scotland showed that the number of drug-related hospital stays was up by 15 per cent in 2023-24, with the agency issuing a warning earlier this year about an increase in overdoses characterised by ‘sudden and rapid collapse’ and linked to a ‘nitazene-type opioid’ identified in heroin samples.

Suspected drug deaths in Scotland: January to March 2025 available here

Make tobacco firms pay for increased NHS spend, say campaigners

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Anti-smoking charity ASH has renewed its call for a ‘polluter pays’ levy to be imposed on the tobacco industry as part of its response to the government spending review earlier this week.

Anti-smoking charity ASH has renewed its call for a ‘polluter pays’ levy to be imposed on the tobacco industry as part of its response to the government spending review earlier this week
‘An additional investment of £97m per year would ensure that there are 2m fewer smokers by the end of this Parliament’

While the review ‘rightly acknowledges’ the importance of smoking cessation for disease prevention and the long-term sustainability of the NHS, the £80m annual figure for cessation and enforcement is less than the current spend, the charity states.

‘The government should ensure that all current spending commitments are maintained – including swap to stop, financial incentives for pregnant women and mass media campaigns,’ said ASH CEO Hazel Cheeseman. ‘There is an opportunity, alongside the tobacco and vapes bill, to accelerate progress towards a smokefree future. An additional investment of £97m per year would ensure that there are 2m fewer smokers by the end of this Parliament.’ A polluter pays levy on the tobacco industry would mean that this is ‘not funded by the taxpayer’, she added.

A recent survey commissioned by the charity found that almost two thirds of the public back the ‘smokefree generation’ policy in the tobacco and vapes bill, with nearly half of the 11,000 respondents agreeing that the government ‘isn’t doing enough’ to tackle smoking. The government’s ban on single-use, disposable vapes came into force at the beginning of this month.

Peter Krykant dies aged 48

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Peter KrykantScottish police have confirmed the sudden death of drugs campaigner Peter Krykant, aged 48. Krykant was a passionate advocate for drug consumption rooms, and became a well-known figure after setting up an unofficial mobile consumption room facility in a converted van. Police Scotland say that his death is being treated as unexplained, pending a post-mortem.

Krykant was a ‘fearless and compassionate campaigner whose work has helped change the landscape of drugs policy in Scotland and beyond’, said the Scottish Drugs Forum (SDF). ‘Peter’s unwavering commitment to the health and dignity of people who use drugs was driven by his own experiences. He will be remembered most prominently for taking direct action to highlight the urgent need for safer drug consumption facilities – courageously operating an unsanctioned mobile drug consumption van in Glasgow. In doing so, he challenged outdated laws and helped to raise the profile of the life-saving potential of these services.’

He was ‘an incredible campaigner for the rights of communities that use drugs’, added Release. ‘Peter placed himself at great personal risk doing this work, and his work will have a lasting impact in the UK and beyond.’

Turning Point Leicestershire’s initiative shortlisted for national award

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Turning Point Leicestershire's initiative shortlisted for national awardTurning Point Leicestershire’s Substance Use service have been shortlisted for a national award, after introducing a lifesaving initiative that allows for front-line police officers in Leicestershire to carry and administer naloxone, an antidote that reverses the effects of an opioid overdose.

The city council’s public health team worked in partnership with the police and local drug and alcohol treatment service Turning Point to develop the initiative, which has potentially already saved 14 lives in its first 12 months of operation.

It’s now in line for a Public Partnerships award, as part of the 2025 Local Government Chronicle’s Awards, which recognise excellence in local government across the whole of the UK.

The partnership was developed in response to a national rising trend in drug deaths. Many of these could have been avoided with the use of the antidote naloxone, which reverses the effects of an opiate overdose – if given quickly enough.

Leicester’s director of public health Rob Howard said, ‘In the event of an opiate overdose, administering an immediate dose of naloxone by nasal spray reverses respiratory arrest and allows time for emergency medical services to be called.

‘Police officers are most likely to be the first on scene at such incidents, and thanks to years of hard work by all involved, we believe that the Leicestershire police service is now the first in England and Wales to commit to enabling all front-line officers to carry naloxone.

‘This incredible partnership work has not only saved lives, and will save lives in the future, but is also supporting a broader understanding of the challenges faced by people who use drugs.’

Turning Point Leicestershire's Substance Use service have been shortlisted for a national award, after introducing a lifesaving initiative that allows for front-line police officers in Leicestershire to carry and administer naloxone, an antidote that reverses the effects of an opioid overdose.
The initiative has potentially already saved 14 lives in its first 12 months of operation

Approval for a pilot scheme was given by Leicestershire Police in 2023, after Turning Point and the city council’s public health team had found funding and established pilot sites.

Initially small groups of police officers were given training in overdose awareness and administering naloxone, and as a result almost 200 officers voluntarily agreed to carry it.

James Edmondston, Leicestershire Police’s substance misuse team leader, said, ‘The most important duty of a police officer is to preserve life and naloxone gives officers a simple, safe and effective way of doing so. This initiative reflects a strong and robust partnership commitment to saving lives and supporting people into long-term treatment.

‘It is fantastic to see its use being celebrated – it really does save lives and we are looking to expand its use across the force and into custody.’

Julie Bass, Turning Point’s chief executive, said, ‘Being shortlisted for this prestigious award is testament to the power of partnership. We have been delighted to work with Leicestershire Police and Leicester City Council on this initiative, which genuinely has saved lives and also strengthened joint working across our organisations.’

In the first 12 months of the scheme, police officers administered naloxone on 14 separate occasions, in situations where people were likely to have otherwise died, before calling for ambulance back-up.

New recruits to Leicestershire Police are now trained in administering naloxone as part of their core training, and offered the chance to carry at that time. Since this was introduced, every new recruit has volunteered to carry it.

The winners of the LGC Awards will be announced at a ceremony on 11 June 2025, at Grosvenor House, London.

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

Alcohol companies using LGBT branding for ‘superficial inclusivity’

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Alcohol companies using LGBT branding for ‘superficial inclusivity’The alcohol industry is using rainbow branding as a marketing tactic for ‘superficial inclusivity’, according to a new report from Alcohol Focus Scotland. Some brands had even used the legacy of events such as the Stonewall riots for promotional purposes, which many people found ‘inappropriate and offensive’, says Community, not a commodity.

The report is based on a series of workshops with LGBT+ people that explored how alcohol marketing affected them, and how the industry’s presence at events like Pride was perceived by the community itself. Participants were asked if they’d seen alcohol marketing that specifically targeted LGBT+ people, and what tactics they thought were being used. Many thought the marketing strategies frequently commodified LGBT identity, using it as a ‘tool to drive sales while glossing over the realities of alcohol consumption.’

Alongside the ‘commercialisation of queer history’ the main concerns included increased social pressure to drink and unrealistic portrayals of the community. Alcohol advertising was ‘seen to reinforce the idea that drinking is a necessary part of queer social life, contributing to pressure and exclusion – especially for those in recovery or who choose not to drink’, says Alcohol Focus Scotland.

The presence of drinks companies at Pride events was a ‘particular point of discomfort’, with people questioning whether partnerships with the industry were aligned with ‘the values Pride is meant to represent’. Many people were also concerned that LGBT+ venues were too centred around alcohol, with few non-alcoholic alternatives available. ‘The reliance on alcohol-focused venues raises concerns about the lack of inclusive, alcohol-free spaces where people can socialise without feeling pressured or surrounded by drinking culture,’ says the report. Research has consistently found that rates of binge drinking tend to be higher in the LGBT+ community.

‘The intersection of alcohol marketing and the LGBT+ community raises significant concerns about the impact of targeted advertising on a population that already experiences higher rates of harmful alcohol use,’ the report states, and calls for tighter marketing regulations, especially for spaces where young people are likely to be present.

Report available here

Rough sleeping to be decriminalised after 200 years

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The government has confirmed it will formally scrap the 200-year-old Vagrancy Act by next spring, meaning that rough sleeping will no longer be a criminal offence in England and Wales.The government has confirmed it will formally scrap the 200-year-old Vagrancy Act by next spring, meaning that rough sleeping will no longer be a criminal offence in England and Wales.

Although use of the act, which was introduced in 1824 to deal with rising rates of homelessness after the Industrial Revolution and Napoleonic Wars, has ‘significantly declined’ in recent years it remains legally enforceable. The government is repealing the act to ‘ensure rough sleeping is no longer a criminal offence, as it concentrates its efforts on getting to the root causes of homelessness, backed by major funding’, it states.

While repeal of the act was approved by Parliament in 2022, no formal timetable had previously been set to remove it from law. New legislation will be introduced to target organised begging by gangs and trespassing with the intention of committing a crime, the government says, both of which were previously included in the 1824 act. A cross-government homelessness strategy will be published later this year.

The number of people estimated to be sleeping rough in England on a single night was 4,667 in autumn 2024, according to the most recent figures – 20 per cent up on the previous year and the third increase in a row. When the 2023 total was released Shelter pointed out that the numbers were likely to be an underestimate, as ‘people who sleep in less visible locations can be missed’, and Crisis called the figures ‘a source of national shame’. ONS figures from 2022 showed that almost two in five deaths of people either sleeping rough or using emergency accommodation were drug-related.

rough sleeping
A cross-government homelessness strategy will be published later this year

‘We are drawing a line under nearly two centuries of injustice towards some of the most vulnerable in society, who deserve dignity and support,’ said deputy prime minister Angela Rayner. ‘No one should ever be criminalised simply for sleeping rough and by scrapping this cruel and outdated law, we are making sure that can never happen again.’

‘The repeal of the Vagrancy Act, which criminalises rough sleeping, cannot come soon enough,’ added St Mungo’s chief executive Emma Haddad. ‘Right now, we are supporting thousands of people who are rough sleeping; everyone facing this issue has their own heartbreaking story to tell of how they ended up on the streets – from complex mental and physical health issues to an increasingly unaffordable housing market. The answer is not to criminalise people for living on the streets but instead to focus on tackling the health, housing and wider societal issues that are causing homelessness in the first place.’

Support services frequently report that criminalisation discourages people sleeping rough from seeking help, said Homeless Link. ‘The homelessness support services we represent, many of whom work every day with people who regularly sleep rough, know the focus needs to be on supporting people into a secure home while addressing their other needs, not sanction and prosecution,’ said its chief executive Rick Henderson. ‘We welcome the government’s delivery on a long-standing promise to repeal the Vagrancy Act. We also salute campaigners, activists and politicians from all parties who have backed the Scrap the Vagrancy Act campaign over the years. Ministers’ explicit pledge that there will be no equivalent powers criminalising rough sleeping in the new crime and policing bill is also welcome. However, we will carefully analyse the amendments announced that focus on rough sleeping, and assess how these may impact on those sleeping rough and the services who support them.’

Celebrating recovery through a lens

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On 3 June, Chester Picturehouse hosted the launch of Beauty in the Everyday, a powerful photography exhibition created by people in recovery at local drug and alcohol support service, Via – New Beginnings, Cheshire West & Chester. 

Beauty in the Everyday
Pictured left to right: Jodie Roddy, Umarah Choudhary (Cheshire West & Chester Council); Dave Targett, Jane Murphy, Matt Flegg, Craig Middleton, Jennifer McWhirter (Via); Jason Kelvin (photographer)

The exhibition brought together participants, their families, staff, local partners, and professionals from the wider community to reflect on recovery, creativity, and the beauty found in everyday moments. The showcased work is the result of weeks of collaboration and storytelling through photography — a medium that provided space for reflection, connection, and growth. 

The evening featured inspiring speeches, including a personal story from a peer mentor, followed by a vibrant performance from Fallen Angels dance group. Attendees then had the opportunity to view the exhibition up close. 

Beauty in the Everyday is part of a Via project led by photographer Jason Kelvin. Previous exhibitions have taken place at Via services in the London Borough of Redbridge and at residential detox and rehab, Passmores House in Essex, each time showcasing the voices and visions of people in recovery across different services. 

Lisa, who took part in the project, shared her experience, ‘I wasn’t sure what to expect embarking on this project. I thought it would be a great way to rediscover my creativity. It has challenged me to stop hiding my shadows and embrace them, as they are part of who I am and what makes me, me.’

Steve, another contributor, said, ‘Instead of walking past the everyday, I now stop and pause to take in the beauty around. Capturing it inspires me to create. The project also brings me a calmness of mind, a great feeling of achievement, and the chance to make good friends.’

Via Beauty in the EverydayPhotographer and project lead, Jason Kelvin, shared, ‘It’s been a real pleasure working once again on the Via photography project, Beauty in the Everyday. The staff and clients in Cheshire West and Chester have been incredibly warm and kind. Once again, I’m hugely overwhelmed by the absolute genius, beauty, and creativity of their photography.

‘As a recovering addict and alcoholic myself, I really feel that the times we’ve worked together — printing and framing the photos — have enhanced my connection with others and prevented me from feeling isolated. I’m so happy that I’ve been given this opportunity once again.’

Councillor Lisa Denson, Cheshire West and Chester Council’s Cabinet Member for A Fairer Future (Poverty, Public Health and Mental Health), said, ‘This exhibition is amazing, really inspirational, and you can see all the hard work and passion that’s gone into it. We want residents in our borough to flourish, be happy and healthy, and to live in supportive communities – something that was 100 percent evident through this project.’

Anna Whitton, CEO of Via, said, ‘Beauty in the Everyday puts the right people at the very heart of the project. It brilliantly documents beauty in the everyday and celebrates connections to the world that we live in. The project has been and continues to be thought-provoking and inspiring. It should make us all stop and reflect on what is possible.’

Dave Targett, area director for Cheshire West and Chester, said, ‘People often see recovery as just removing what’s harmful, but it’s just as much about building something hopeful. It’s not only about letting go, but also about what we grow into. This project captures that. It’s honest, creative, and rooted in everyday life. You’ve shown what recovery can look like when we focus on the whole journey, person and future.’

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

In the pipeline

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Ahead of his presentation at this year’s DDN conference, executive director of Boston-based Smoke Works, Jim Duffy, talks to DDN about pipe distribution and the future direction of harm reduction.

‘I worked at a fantastically well-funded needle exchange, and we might see 100 to 150 people a day,’ says Smoke Works executive director Jim Duffy. ‘But we’d walk out the door through a crowd of 20 or more people smoking crack. These were people that we didn’t know – and it was our job to know people.’

The reason they weren’t coming through the door was because they didn’t think there was anything relevant for them at the exchange, he says – which meant they were missing out on all the add-on services it offered. ‘I myself never went into a needle exchange when I was using drugs heavily,’ he states. ‘I smoked, and had something brought me in I would’ve found free and anonymous HIV testing, I would’ve found bad coffee and good people, and all the things that make a welcoming environment – somewhere to bring problems that usually don’t get answered elsewhere.’

Smoke Works FAQNO EASY ANSWERS
It was while working at Boston’s AHOPE exchange that he and co-founder Nate got the idea for Smoke Works, a harm reduction organisation that provides pipes and other smoking equipment, alongside training, technical assistance and advocacy. ‘With stimulant use at the time, it was almost like people were afraid of it,’ he says. ‘There was a perception that it was easier to work with people on opioids, whereas the presentation alone with stimulants made people nervous.’ There were also ‘no easy answers’, he adds – ‘no silver bullet in case of emergencies, like naloxone.’

Another disincentive to incorporating services for people who used stimulants was that it meant redefining job roles, he says. ‘We were serving people who use opioids, and that’s a specific demographic, but we needed to be serving the entire community of people who use drugs. That’s a challenge for a lot of folks. But obviously most of our people were already on more than one substance, and we just couldn’t address it with them – we didn’t have the tools.’

BUYER’S CLUBS
They began sourcing and distributing pipes on their time off from AHOPE, and in 2020 developed the first of their ‘buyer’s clubs’ where different harm reduction organisations would pool their resources to get more pipes for a lower outlay. As the demand continued to grow, they also began to channel the profits back to underfunded harm reduction groups to help them provide food, shelter and care to their clients.

‘In the early days, when there was less structure, if somebody that we worked with was trying to find housing for someone after an emergency, or a bail fund, abortion fund, or healthcare drive, we could just throw some money,’ he says. ‘And that was a cool thing to do, because all that was based on pipe sales.’

crack pipe

MUTUAL AID
This evolution from buyer’s clubs to a mutual aid model happened ‘really organically’ he says. ‘I can’t say enough that it’s at the behest of the community we serve.’ Previously, when AHOPE had obtained private funding to start distributing some pipes in 2020 his job had ‘got easier, because I had something to offer more people when I went out to meet them’, he says. ‘And we learned quickly that as much as we thought we knew everything, we didn’t realise that not everybody wants to inject. So the effect was immediate, and the effect was huge.’

In the first three months of pipe distribution at AHOPE, people brand new to the exchange were coming in ‘just for pipes – nothing else, no injection supplies’ and 50 per cent were leaving with naloxone, he states. ‘These were communities that we weren’t getting naloxone to, and this was during the period of fentanyl being found in stimulants.’

Smoke Works at Harm Reduction 2025, #HR25 in Bogota.
Smoke Works at Harm Reduction 2025, #HR25 in Bogota

FENTANYL CONTAMINATION
When he’d started working in needle exchange two years previously it was ‘just at the point that fentanyl contamination in the local drug supply was becoming a major issue’, he says. ‘It was turning into saturation – arguably a safer place to be, because there was less mystery about what people were ingesting. But I saw the injection rates increase dramatically – from three to five times a day for heroin to 15 to 20 for fentanyl – and it seemed like we just weren’t addressing that. There were other, less risky, options than injection, but we weren’t offering them. And that seemed like a disservice to people, letting their needs go unmet.’

He and Nate began distributing pipes from a basement in evenings and on their days off from the exchange. ‘I’d take a personal day to take receipt of a pallet, and hopefully it would show up,’ he says. ‘We’d clock out of the needle exchange and start packing up pipes. And eventually the larger institutions started calling, because people had been talking about the need endlessly.’

HOSTILE ENVIRONMENTS
Before long they’d managed to find pipes ‘at the right price point, so that we could get them out to people for less’ he continues. ‘So when we started buyer’s clubs, we just got on Instagram and the people who responded were the folks doing this work in some of the most hostile environments, without any institutional funding.’ Many were working at full-time jobs to fund the distribution they did ‘out of the trunk of their car on the weekend’, he says. ‘Here we were at this well-funded exchange in Boston, and the inequity of services was just so stark.’ It was this that made him determined that ‘everything we built was to support those smaller groups’, he states. ‘It was one less thing that those folks with no money had to struggle to find.’

Smoke Works

They partly achieved this through selling a range of Smoke Works merchandise – t-shirts, badges, even COVID masks – to cover the shipping costs, and eventually ‘stumbled into this system of prioritising those smaller, independent groups working where there’s no other services.’ The larger institutions would pay, allowing them to keep sending out free supplies to the smaller organisations. ‘That’s developed over the years, but it’s still the core mission,’ he explains. ‘To sell pipes so we can also give them away.’

By early 2022 he was able to quit the needle exchange – ‘a tough decision’ – and turn Smoke Works into a full-time operation. It has since moved fully beyond the earlier mutual aid model and concentrated its efforts exclusively on pipes, understanding that while there’s ‘no end to any need, we’re best if we stay in our avenue. So now everything we do is specific to free pipes.’

PUBLIC PERCEPTIONS
When it comes to public perceptions and media reporting – and obviously the two are very closely linked – it seems that while most people probably now regard traditional needle exchange as something beneficial and relatively uncontroversial, pipe distribution can seem a step too far. Why is that?

‘Sometimes I think that if we’d had pipe distribution for the last 30 years and were just now introducing syringes, it would be the same,’ he says. ‘But I’m going to point the finger towards ourselves. For decades we’ve been advancing access to harm reduction services in general, and we’ve gotten to people having at least a passive acceptance of the value of needle exchange by pointing to HIV prevention. That justifies the work they might not otherwise see the value in, and that’s completely valid – it’s the foundation of harm reduction internationally. But we failed to evolve the definition of harm reduction over time to really illustrate what’s offered in a needle exchange. If we had a more robust definition, people would see the value of safer smoking as well.’

Xylazine Wound Care

Since pipe distribution can’t be as straightforwardly linked to HIV prevention – ‘you can, you just can’t do it as quickly’ – people won’t necessarily see the same tangible benefit. ‘But in reality when there’s a headline about needles in the park or an outcry over public injection, I just want to say “let’s get more pipes into the community!”. And when there’s a financial argument I want to say, “let’s get something that’s reusable, compared to an immediate biohazard, into the community”.’

Is he hopeful that it will all become less controversial in time? ‘Wouldn’t that be nice? But if ten, 15 years ago we were able to sit down and see the overdose numbers that we see now we’d also optimistically have said that access to services would rise as well – and it hasn’t necessarily. There’s been expansion based largely on naloxone distribution and incorporating that into existing frameworks, but there’s a backlash to everything too – where people see harm reduction as the enabling movement in a time when we should be pushing people towards recovery.’

UNDER THE RADAR
Their relationship with the city and state authorities has been mostly supportive, however, he points out. ‘Maybe we’re a little spoiled in Massachusetts. Our early goals at Smoke Works were to affect paraphernalia laws and be heavy into advocacy, but we realised there’s a quieter path that can have better results – because all of those avenues require House and Senate support, as well as headlines. What we got in Massachusetts was some passive state support and an allowance to spend money on injection alternatives.’

The value of that was more important than ‘changing the paraphernalia laws, that most people didn’t know how to interpret anyhow’, he says. ‘So those have been some of the larger wins for us – a handshake deal with a sheriff somewhere, or the board of health saying “we see the value”. The laws will always lag behind harm reduction, but Massachusetts has been really supportive. They see the effect – I just wish that were replicated everywhere.’

In 2021 the Innovation in Harm Reduction Coalition awards recognised Smoke Works for ‘pioneering creative and nontraditional approaches to dismantle systems, fight toward equitable policies, and promote harm reduction’.
In 2021 the Innovation in Harm Reduction Coalition awards recognised Smoke Works for ‘pioneering creative and nontraditional approaches to dismantle systems, fight toward equitable policies, and promote harm reduction’

That’s not to say there haven’t been challenges, including being blocked by the company processing their payments and having $5,000 worth of equipment impounded by customs officials and never returned. He remains philosophical, however. ‘Some of what we’ve encountered is probably par for a small business. We’re pretty insulated overall – I just wish we could act in a way that would shield the programmes we work for, because they’re the ones who end up taking the majority of the heat.’

Smoke Works always ensures that it works closely with client organisations to equip them with the conversation points that help to illustrate the benefits, he says. ‘We try our best to make leading research available, and when we have a new customer one of my first questions is “who in your organisation is on board? Who isn’t? And would you like us to come in and talk about the larger picture?” Because if ten years ago you’d told me about pipe distribution I don’t know where I would have been on it.’

CRANK CALLS
While there’s been some inevitable negative press coverage, they’ve mostly ‘dodged it by a hair’, he says. ‘But that might not last forever, and we’re kind of prepared for that. A few years ago our URL was visible in a picture on the front page of the New York Post, but just ever so slightly obscured. We got some crank calls, but frankly they were funny. The brunt of it, unfortunately, is taken on the local level by the organisations doing the outreach and actually connecting with people.’

Is he worried that things could start to get very uncomfortable with the current administration? ‘We’re concerned, I can’t lie,’ he says. ‘We know this is on the radar of some folks in the administration, and it seems like things move very quickly from a local headline to Fox News to the president’s desk these days. That’s not lost on us, which is why we really value the silence around our work because it means we can move quicker.’

But that inevitably also presents a problem when it comes to advocacy, he points out. ‘If the New York Times called us tomorrow and said “we want do a cover story on how awesome pipe distribution is”, I’d think twice. Which is a really shitty place to be in, right? But the advocacy really comes down to the folks on the front lines. They’re doing the heaviest lifting.’

Jim Duffy Smoke Works

Jim Duffy spent several years working in outreach and syringe service programmes in the Boston area, before turning his focus to promoting novel harm reduction interventions through Smoke Works.

He is one of the speakers at this year’s DDN Conference in Birmingham on 10 July. For more information and to book your place visit drinkanddrugsnews.com/ddn-conference-2025/

Roots Community leads clean-up efforts across Blackburn

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Roots Community leads clean-up efforts across BlackburnThe Roots Community Clean Up group has been making a visible difference across Blackburn through a series of community-led litter-picking events. Volunteers have been out regularly, working together to keep the streets and public spaces clean and inviting for everyone.

In one week alone, the team filled over 20 bags of rubbish, with other sessions seeing more positive results thanks to the continued dedication of the group.

‘Good job, community clean up,’ one member shared. ‘It’s been a great morning working together, let’s keep it up!’ The shared effort and sense of pride among the volunteers have helped build momentum for future clean-ups.

With the continued work of Roots Community Clean Up, Blackburn is benefitting from cleaner spaces and a stronger sense of community spirit. The team even had a helping paw from a four-legged friend, who joined in the fun and boosted morale during one of the clean-ups.

This blog was originally published by Red Rose Recovery. 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 Red Rose Recovery

Solid support

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In the UK, more than 180,000 children are raised by kinship carers

In the UK, more than 180,000 children are raised by kinship carers – relatives or close family friends caring for children when their birth parents are unable to do so. Kinship carers play a vital role raising children and keeping them connected to their families. While kinship families form for a variety of reasons, parental substance use is one of the most common factors behind these arrangements.

According to the Kinship charity’s 2022 Cost of loving annual survey, 40 per cent of kinship carers cited substance misuse as the primary reason the children in their care were unable to live with their parents. This statistic highlights a widespread yet often overlooked reality: when parents struggle with drug or alcohol dependence, it is frequently family members who step in to provide stability and care for affected children.

Drug and alcohol treatment providers regularly witness kinship care arrangements being put in place as families rally together to support a loved one through treatment. While these arrangements are often informal, they come with immense emotional and financial demands.

Many kinship carers experience feelings of isolation and judgementIn 2020, Dame Carol Black’s landmark Independent review of drugs estimated that the indirect costs for kinship care resulting from substance misuse amounted to £73m. However, the true cost – including direct financial expenses – is likely far higher. Many carers take on the role suddenly or unexpectedly, bearing considerable financial costs – including basic necessities such as food and clothing – often without adequate support. Beyond the financial toll, carers also endure intangible emotional and psychological strain, including through increased stress and anxiety.

Through Adfam’s many years’ experience working with kinship families affected by substance use we know that these carers face unique and complex challenges. One of the most difficult is the stigma surrounding substance use, which often extends to both the children and carers themselves. Despite their selfless dedication, many kinship carers experience feelings of isolation and judgment for raising a family member’s child under such circumstances – making their already demanding role even harder.

Despite the vital role they play in children’s lives, kinship carers often lack the recognition and support they deserve. Vital reform is needed to recognise the value of kinship carers, including those affected by substance use and the challenges they face, and to ensure their unique needs are addressed.

Charities like Adfam are committed to championing kinship families, and helping them navigate the complex realities of caring for a child affected by parental substance use. In addition to our work supporting kinship carers affected by substance use, Adfam is a member of the Kinship Care Alliance, which campaigns for kinship families to receive the right support and help in order for them to thrive.

kinship family services
Children raised within their family network typically experience better education, health, and labour market outcomes than those placed in local authority care

Adfam recently held an online forum event featuring Jahnine Davies, the government’s national kinship care ambassador, alongside Sue Nash, from the Peterborough Kinship Care Group, and Lindsay Reid, a kinship care support and development coordinator for Adfam. During the event, attendees heard about Jahnine’s ambassadorial role in raising awareness to advocate for kinship carers and children, and to improve local practices and support. Sue and Lindsay also shared powerful insights into the challenges faced by kinship families affected by substance use and the essential support they provide to these families.

Adfam is also currently working in partnership with the Kinship charity to deliver a series of free training sessions for kinship carers across the country and online, made available through a grant from the Department for Education. These workshops focus on the effects of substance use, offering practical strategies to better support children while also offering kinship carers the chance to meet others in similar situations, to connect and learn from each other.

Kinship carers play a crucial, yet often overlooked, role in providing stability and care for children affected by parental substance use. Research indicates that children raised within their family network typically experience better education, health, and labour market outcomes than those placed in local authority care. The commitment, dedication, and support provided by carers can have a lasting, positive impact on a child’s life. However, much more must be done to ensure that kinship families affected by substance use receive the recognition, support, and resources they undoubtedly need and deserve.

Robert Stebbings is policy and communications lead at Adfam

Comfort zone

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ketamine use disorder (KUD)

KUD ketamine treatment ketamine use disorder (KUD)In the UK, ketamine use disorder (KUD) is rising in prevalence and disproportionately affecting a younger demographic compared to substance use disorders more generally. Earlier this year, the government commissioned an updated harm assessment for ketamine, prompted by a 231 per cent increase in reported use among 16-to-24-year-olds since 2013 and growing concerns about the severity of harm it’s causing.

Physical symptoms associated with ketamine use include bladder and kidney damage, incontinence, impaired sexual function, and infertility. These can emerge within just two years of use, and in the case of bladder damage can contribute to the ongoing cycle of ketamine misuse given the drug’s analgesic properties.

Depending on the severity of the KUD, healing is possible following cessation. In the worst cases, however, the damage is chronic and irreversible, which is devastating for a young adult. Compounding the issue is the psychological impact, which is exacerbated by the deterioration in mental health typically seen with addiction. There’s little doubt, therefore, of the urgency with which services ought to respond – whether by implementing preventative initiatives or providing appropriate treatment and recovery options. Determining what works for the evolving needs of an emerging population within addiction services, however, requires careful consideration to ensure that it’s effective.

AGE DISPARITIES
According to UK government statistics, the average age a person engages with addiction treatment services for alcohol use disorder is 46, and 44 for opiate dependence. This highlights the age disparity that services are increasingly seeing, with people with KUD typically presenting in their early twenties. It’s reasonable to conclude that the needs of emergent groups will be different based on factors such as age, lived experience and symptomology. Finding ways to make treatment accessible and relevant for a shifting client demographic is as important as continuing to serve the existing and better understood populations that continue to access services.

Co-producing treatment solutions that work for those they are there to help places value on respect and collaboration, empowering individuals to take an active role in their care to ensure that services are relevant, inclusive and responsive.

Given the young population affected by KUD and the rapid onset of its physical symptoms, this presents services with an opportunity to learn from client experience, and to embed ways of working that are consumer informed, adaptable and hospitable, both immediately and as a model to accommodate future populations. Perhaps it’s the greatest respect services can show their clients – to listen without notion of applied expertise, but rather with the intent of learning to be better.

This is the approach Acorn Recovery Projects has adopted in response to the growing demand they were seeing for residential rehabilitation placements for people with KUD – choosing to speak directly to service users to better learn how they can support them.  In doing so, clear themes emerged – for example, the acute embarrassment clients experienced due to bladder issues, which impacted their dignity and self-confidence.

NEW PRACTICES
In response, Acorn introduced new practices to offer discreet solutions, such as providing waterproof mattress protectors and extra bedding, facilities to discreetly dispose of incontinence products, and a change in group structure so that comfort breaks were no longer scheduled but taken as needed. Ensuite room allocation was prioritised when possible, and transport arrangements were altered to accommodate the use of service facilities without having to openly request them.

Another prominent topic was the physical discomfort experienced by clients. As a result, hot water bottles were provided to ease abdominal cramping, adaptable work schedules were accommodated, and medical appointments pre-planned for client reassurance.

Cushions and more comfortable seating options were introduced, which not only helped ketamine clients participate in lengthier groups but made the therapeutic environment more welcoming for all service users. The importance of hydration was recognised, as well as how caffeine is an irritant to the damaged bladder. This knowledge was shared with new ketamine clients, and refreshment options were expanded to include a variety of non-caffeinated options. Another important theme was the limited opportunities for individuals to connect with others facing sensitive KUD-related health issues.

NEEDS RECOGNITION
This observation was not a criticism of existing mutual support groups, but rather a recognition of the need for a new solution where people could openly discuss problems with their contemporaries in areas such as their social lives, intimate relationships and personal hygiene, without fear of shame or embarrassment. 

In response, and with direct input from their ketamine service users, Acorn established a ketamine support hub, providing the resources – including a safe environment and staff assistance – for this to operate. This is the first ketamine-specific community resource in Stockport, and has empowered one service user to create a dedicated ketamine service with extended outreach, including an online channel, support for families, and education services for prevention.

Acorn Recovery Projects has demonstrated an effective model of adaptation, centred on engagement with clients to inform practical, dignified, and responsive service provision. Initiatives including discreet symptom management and innovative support structures demonstrate how services can adapt to meet the specific needs of emerging client groups.

If services are to provide inclusive treatment that delivers effective recovery outcomes for all populations it’s vital that they adopt flexible, consumer-informed approaches that prioritise co-production, respect, and accessibility.

Dr Lisa Ogilvie is a psychologist working for Acorn Recovery Projects

DDN Conference 2025The Acorn Recovery Projects team will be presenting on peer support for ketamine use, with young people’s insight, at the DDN Conference on 10 July.
For more information visit drinkanddrugsnews.com/ddn-conference-2025/

From robbery to recovery

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From robbery to recovery

I work as a sustained recovery volunteer two days a week. My role is to encourage people coming into our hub in the city centre to access ongoing support after they become abstinent – either through our 5 WAYS centre, the Leeds hub for people in recovery, or other local support.

I think it’s a key role because stopping using is tough, but staying stopped can take just as much effort. It’s so important people know about the help that’s out there in Leeds.

My role is really rewarding. It’s what’s keeping me abstinent. It’s like Professor David Best says – give a recovering addict a purpose and watch them thrive. I’ve got purpose now, and I feel that what I’m doing is amazing.

I’m nearly four years drug-free but I had 40 years in addiction and 24 years in and out of prison. I was not a nice person. My speciality was armed robbery. I started sniffing glue aged nine to cope with a really traumatic childhood. Soon I was using heroin and crack. Everything spiralled.

I’ve had so much tragedy in my life and every time it just led me to going and getting off my head. But not anymore. I don’t ever want to be that person ever again. This version of me is a hell of a lot better than I used to be when I was in addiction. I’m a lot less angry with everyone and everything.

What I love most about what I’m doing is spending time just chatting to people in the reception and waiting room areas. I know if I went back to using I wouldn’t be able to come down here, and I wouldn’t be able to see everybody. I’ve got a real connection with everyone here. And they say when I’m not here, I’m missed. This is what’s keeping me motivated. I’ve got a role, something I feel is important – and that keeps me going.

It’s so great seeing people coming in, looking just like how I looked, so unwell, and then later on they’ll come in and tell me, ‘Tommy, I’m off to rehab’. Seeing their journey is what’s so rewarding.

I always try to make people feel special. I let everybody know that I see them, that they matter. Because I know what it’s like. You feel invisible and that everybody looks down their nose at you. I’m all about trying to put a smile on people’s faces when they come in, and that’s another part of the volunteering role that I love.

robbery to recovery Waythrough Forward LeedsI’m visible recovery for people. So many of the people coming in I know from my past life and – this may sound arrogant – I know I can inspire people. ‘If Tommy can do it, so can I.’ There are people I was homeless with coming in for support, and there’s someone I used to live in a lift shaft with. They’re seeing the new me, and I hope that’s helping them to feel that recovery is not only achievable but desirable too. That they can have a better life.

I’ve discovered so much as well. The Waythrough volunteering programme offers so many opportunities for learning. I do BBV testing now. You can do all the same training the paid staff can do, alongside them, which is incredible. Like last week I did some neurodiversity training.

I’m connecting with other Waythrough staff and volunteers up and down the country as well. My friends from rehab are now volunteering or working in other areas like County Durham and Calderdale for other Waythrough services.

The personal support I get here is massive as well, especially from Carys our volunteer manager and from my supervisor Becky Walker. Nothing’s too much trouble. I’m back here alongside Sarah Miller, the worker who helped me off the drugs. I’ve even had a high five from the Waythrough CEO Paul Townsley.

My physical health is poor from smoking crack for so many years, and that really restricts what I can do. So it’s unlikely I’ll be able to get into paid employment. But I don’t want to do anything other than this. It’s incredibly fulfilling.

Tommy Kearns is a sustained recovery volunteer at Forward Leeds

The Wellbourne Clinic: a holistic approach to recovery

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The Wellbourne Clinic

Private One-to-One Therapy Room
Private one-to-one therapy room

Recovery can sometimes seem an intimidating challenge, however it is really one of the most meaningful and heroic decisions you can make. This vital step marks the beginning of your journey to a healthier, addiction-free life. At The Wellbourne Clinic, near Birmingham, we specialise in drug detox and alcohol detox as well as personalised drug rehab and alcohol rehab services to support you through every stage of recovery.

Situated in the tranquil suburb of Kenilworth, near Kenilworth Castle and Abbey Fields, our clinic offers a rare chance to connect with nature and history while you heal. Whether you are seeking a drug rehab or alcohol rehab, our caring team of experts will guide you through every stage of recovery. We deliver high quality, person-centred care customised to your personal needs.

Our skilled counsellors and addiction support workers provide both one-to-one therapy and group therapy, plus a range of alternative therapies which aim to tackle not only the addiction itself but also the causes behind it and the associated patterns of behaviour. We take a holistic approach to addressing your needs, so that together we can meet whatever challenges may lie ahead.

https://thewellbourneclinic.co.uk/

rehab Wellbourne
A comfortable and supportive environment

Why choose detox or rehab at The Wellbourne Clinic?
The Wellbourne Clinic is a unique private residential addiction treatment clinic offering comprehensive detox services and rehabilitation. Our clinic was created by experts in the field of substance misuse, ensuring the highest standards of care. We provide a high-quality, supportive environment that is ideal for those taking their first steps toward recovery from alcohol or drug dependency.

We have established a team of experienced doctors, therapists and specialist support staff who are dedicated to designing rehab programmes around the unique requirements of each person in their care. With a focus on person-centred care, The Wellbourne Clinic limits treatment to just six people at a time, ensuring that every client receives the attention and support they need.

At our clinic, we treat the whole person, not just their substance misuse, being sure to adapt for any unique circumstances. Based in the heart of West Midlands, we pay attention to health, nutrition and a positive experience, assisting people on their journey towards lasting recovery.

residential rehab
Private and comfortable accommodation

Comprehensive support for every stage of recovery
At The Wellbourne Clinic, we understand that addiction recovery is a journey. That’s why we provide a complete range of care, designed to be there for you through every step of the process. From detoxification to rehabilitation and beyond, we’re here to ensure you receive the highest level of care.

  • Medically supervised detox: We design your detox to fit your specific needs, allowing you to safely rid your body of substances while under the supervision of our experienced medical team.
  • Residential rehab programme: Our private residential rehab programme provides a secure and supportive space to work on your recovery, away from the triggers of everyday life.
  • Treatment tailored for you: Everyone’s recovery journey is different. That’s why we work with you to build a treatment plan that’s unique to you. We blend therapy with a whole-person approach to tackle both the physical and emotional sides of addiction.
  • Ongoing aftercare and support: Recovery doesn’t end after treatment. We provide aftercare services to help you maintain sobriety and prevent relapse, ensuring long-term success.
  • Holistic therapies: Beyond traditional treatments, we offer alternative therapies like meditation, yoga and nutrition counselling to help heal the mind, body and spirit.
Wellbourne drug and alcohol rehab
A warm and inviting living space

A healing environment: the power of our location
Located in the tranquil town of Kenilworth, Warwickshire, our clinic is near Kenilworth Castle and the serene Abbey Fields, making it an ideal place to focus on your path to sobriety. The peaceful, natural surroundings help ease stress, boost mental well-being and create a relaxing atmosphere that’s essential for healing.

Our private residential facility offers a secure and distraction-free haven, so you can fully engage in detox and rehabilitation. With our modern, comfortable accommodations and our caring team, you’ll feel safe, respected and supported throughout your treatment journey. Along with our holistic therapies, this nurturing environment helps you regain balance and well-being as you work toward a lasting recovery.

You don’t have to go through this alone. Take that courageous step and let us be your trusted partners on the road to recovery.

The Wellbourne ClinicWeb: thewellbourneclinic.co.uk
Email: info@thewellbourneclinic.com
Telephone: 0330 043 1715
Address: 43 Waverley Road, Kenilworth, CV8 1JL

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

Dehumanising language rife when discussing homelessness, say researchers

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The language regularly used when discussing homelessness is perpetuating and reinforcing stigma, according to a Centre for Homelessness Impact report by researchers at King’s College London.The language regularly used when discussing homelessness is perpetuating and reinforcing stigma, according to a Centre for Homelessness Impact report by researchers at King’s College London.

People experiencing homelessness were ‘assumed, implied or described to be different from others on the basis of appearance, hygiene, personal shortcomings, poor life choices and substance abuse’ the document states, with descriptions also suggesting they ‘lacked human qualities’.

Researchers looked at more than 4,500 Twitter posts by UK users as well as almost 1,000 sentences featuring phrases ‘commonly used’ in the UK press and in the homelessness charity sector. The material was reviewed by a panel of people with lived experience of homelessness working in pairs, with almost 1,000 examples deemed to be stigmatising or negative by both members of a pair. Public conversations about homelessness are also ‘often reduced to rough sleeping’, the report adds, overlooking the large numbers of people either living in temporary accommodation or ‘sofa surfing’.

language homelessness
‘Joking that someone “looks homeless” isn’t harmless’

The authors have compiled a checklist for people writing or talking about homelessness, including focusing on the person rather than their housing status, steering clear of negative stereotypes about appearance or behaviour, and respecting people’s dignity. Homelessness should only be mentioned when relevant, it states. ‘We often add that a person is homeless even when this detail is not pertinent – for example, “A homeless man was questioned by the police in relation to the incident”.’ People should also avoid implying that homelessness makes places dangerous or undesirable through statements that reinforce negative stereotypes rather than address the ‘real challenges of homelessness’.

It is also important to recognise that substance use ‘may be a coping mechanism rather than the root cause of homelessness’, the document urges. ‘In many cases, people may have started a problematic use of alcohol and drugs to cope with their homelessness.’

‘Stigma is created and sustained through communication,’ said co-author Dr Apurv Chauhan of King’s College’s Institute of Psychiatry, Psychology and Neuroscience. ‘Joking that someone “looks homeless” isn’t harmless. While unintentional, it subtly perpetuates the incorrect and stigmatising belief that people experiencing homelessness are all dishevelled or unkempt. Our research shows that stigmatising ideas about homelessness often hide in plain sight and perpetuate through everyday comments, humour and casual remarks. We all need to play a role in being careful in our communication and challenging the everyday normalisation of prejudice.’

Homelessness and the language of stigma available here

Volunteers’ Week 2025: connecting communities through compassion and action

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As Volunteers’ Week 2025 unfolds, The Forward Trust celebrates the incredible dedication of volunteers who play a vital role in transforming lives and strengthening communities.

As Volunteers' Week 2025 unfolds, The Forward Trust celebrates the incredible dedication of volunteers who play a vital role in transforming lives and strengthening communities.This year’s theme, Connecting Communities, perfectly reflects the heart of our work by bringing people together to support recovery, build resilience, and inspire hope.

At The Forward Trust, volunteers are at the heart of our mission. From mentoring individuals overcoming addiction to supporting educational and wellbeing programmes, our volunteers create powerful connections that change lives. Their commitment not only uplifts those we support but also fosters a sense of belonging and shared purpose within the wider community.

Many of our volunteers working across a range of services have lived experience of addiction or the criminal justice system. This means they are best-placed to support those going through tough times, as they have been there themselves. We are proud of the dedication that our volunteers dedicate on a daily basis to Forward’s mission.

This Volunteers’ Week, we honour the spirit of connection that volunteers bring to The Forward Trust. Their work highlights how coming together – whether through listening, guiding, or simply being present – can create lasting change.

Join us in Connecting Communities
Are you inspired to make a difference? Explore volunteer opportunities with The Forward Trust and become a vital part of our community. Whether you have a few hours or more to give, your time can transform lives and build stronger, healthier communities.

Visit our volunteer vacancies page today and take the first step toward meaningful connection and impact.

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

Click here to see the latest volunteering opportunities on DDN Jobs.

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

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Almost 90 new synthetic opioids on European market since 2009

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Almost 90 new synthetic opioids on European market since 2009
More than 20 nitazenes are now being monitored across Europe

A total of 88 new synthetic opioids have appeared on the European drug market in the last 16 years, according to the latest European drug report from EUDA. ‘These are often highly potent, creating risks of poisoning and death,’ it states.

All of the new synthetic opioids formally notified to the EU’s early warning system last year were nitazenes, with more than 20 nitazenes now being monitored across Europe. A recent study by EUDA found that nitazenes accounted for a ‘significant share’ of overdose deaths in Estonia and Latvia, with the substances appearing to have ‘filled a vacuum following the decline of fentanyl and heroin, highlighting the adaptability of local drug markets’.

There has long been speculation that the Taliban’s 2022 opium ban could lead to gaps in the heroin market being filled with highly potent synthetic drugs. ‘Given the potential negative consequences of this, Europe needs to improve its preparedness for the harm reduction and other challenges that such a market shift could bring,’ the report states. Seizures of nitazenes in Europe have risen rapidly, with the quantity detected in powder form tripling to 10 kilograms in 2023.

Fake medicines containing nitazenes which ‘typically mimic’ legitimate prescription drugs like oxycodone and benzodiazepines are also an increasing problem, raising concerns about them being used by a ‘broader range of consumers, including young people’. Earlier this week The Loop warned about a batch of drugs resembling oxycodone pills that instead contained nitazenes, and were linked to two deaths in London.

Meanwhile the availability of cocaine in Europe ‘remains high’, with record amounts of the drug seized by EU member states for the seventh year in row. Belgium, the Netherlands and Spain accounted for nearly three quarters of the total quantity seized, with the latter recording its largest ever seizure in a single shipment last year – concealed in a shipment of bananas from Ecuador.

new synthetic opioids
Cocaine was the most frequently reported substance by those presenting to European hospital emergency departments in 2023

Cocaine was the most frequently reported substance by those presenting to European hospital emergency departments in 2023, and is now the second most common drug for those entering treatment services for the first time – with both cocaine injection and use of crack cocaine reported ‘in a growing number of countries’. Competition in the hugely lucrative cocaine market is also driving gang-related violence and homicides, the report states.

There have also been ‘unprecedented’ seizures of synthetic cathinones, with the market evolving ‘significantly since the 2014-15 “legal highs” phenomenon’ and the drugs becoming established ‘as replacements for stimulants such as amphetamine and cocaine in some parts of Europe’.

Rapid shifts in the drug market are ‘creating new health and security risks’ and challenging the region’s capacity to respond, the document states. The consistently evolving situation is seeing both suppliers and consumers adapting to ‘geopolitical instability, globalisation and technological advances’, it says, alongside risks to public health from ‘an increasingly diverse range of substances’ – often of high potency. Growing rates of polysubstance use also present a challenge, ‘complicating the delivery of effective prevention, treatment and harm reduction services’.

‘Amid global instability and fast-changing drug trends, Europe faces multiple challenges that put its citizens at risk,’ said EUDA’s executive director Alexis Goosdeel.

‘The rise of highly potent substances and more complex patterns of drug use is placing health and security systems under strain. We must design a comprehensive European and national preparedness framework to respond effectively, scaling up prevention, treatment and harm reduction services and adapting them to today’s realities.’

European drug report 2025: trends and developments available here

Is there such a thing as ‘good’ stigma?

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Is there such a thing as ‘good’ stigma?
Stigma involves ‘spoiling’ a person’s identity, not just violating a social norm

As drug-related deaths continue to rise across the globe, debates about what can be done to tackle society’s addiction problems continue. Although stigma is generally recognised as a major barrier to addiction recovery, arguments can sometimes be heard that stigma – or at least societal ‘disapproval’ – towards substance use is, in fact, a ‘good’ thing, writes Dr James Morris.

This view is of course controversial, but the argument essentially goes that the extent society accepts or disapproves of substance use or ‘addiction’ has an important influence on how likely people are to use drugs (or gamble) in the first place, or how incentivised they may be to pursue recovery. Intuitively, the premise makes sense and it is well established that people’s behaviour is influenced by social norms (i.e., what people think is ‘normal’ or acceptable). People tend not to litter in public, in part because they know others will disapprove, and in turn people may feel a sense of guilt, regret, or shame if they act in ways that are frowned upon by others.

Despite this, people obviously still engage in behaviours which they know are deemed anti-social or illegal, but the reasons for this are complex. Most actions (such as taking a drug) come with potential costs and benefits. Some of these are more certain or immediate, whilst other consequences are unknown. Indeed, ‘addiction’ itself is partly characterised by cognitive biases in which immediate benefits (e.g., feeling good or alleviating pain) are heavily valued over later costs (e.g., health effects, or rejection from others). As such, how societal attitudes influence behaviour is highly dependent on the individual, the behaviour and the context in which it takes place.

‘Stigma’ is bad, but can ‘disapproval’ be good?
Whether society can use types of social signalling to influence addiction-related behaviours is therefore a question that requires careful empirical attention, as myself and colleagues set out in the journal Addiction Theory & Research. This largely follows from an argument that societal disapproval can be separated from stigma, and that it should be used to reduce addiction. That is, whilst stigma is a harmful practice of unfair treatment and social devaluation (and therefore can’t be ‘good’), it is suggested that society has become too lenient towards harmful substance use. In turn, it is argued anti-stigma campaigns are unintentionally removing an important disincentive towards addiction – society’s ‘disapproval’ of it.

In the first case, it is certainly true that idea of stigma as a force for good is a contradiction in terms and should be rejected. Stigma experts agree that stigma itself is fundamentally harmful since dehumanisation, social devaluation and discrimination are hugely damaging to individuals and society. Stigma can exist in many harmful ways, and as history shows us, stigmatising narratives serve to dehumanise the ‘other’, in turn facilitating mistreatment, oppression and even genocide.

good stigma
Stigmatising narratives serve to dehumanise the ‘other’

Recognising the role of ‘norms’ in shaping substance behaviour
Stigma is of course a major barrier to addressing addiction problems, not only via the discrimination and devaluation people experience, but via self-stigma, when people internalise negative stereotypes to themselves. This process of ‘self-stigma’ is particularly harmful through reducing people’s sense of self worth and belief in their capacity to recover, and in turn potentially increasing feelings of guilt, shame, and more harmful use.

However, cultural attitudes and norms can also shape behaviour in ways which are not inherently stigmatising. Social norms are beliefs about other people’s actions or attitudes towards certain behaviours. Such perceptions can therefore influence us as we tend to consider – including subconsciously – whether others will ‘approve’ or ‘disapprove’ of our actions. For example, generally people think one should wash their hands after using the bathroom. So if we see someone leaving a bathroom without washing their hands, we might ‘disapprove’ of this as violation of hygiene-related norms. We might even feel a sense of disgust and instinctively give them a ‘dirty look’, or tell others what we saw in an attempt to strengthen the norm of handwashing. However, whilst someone who doesn’t wash their hands might get individually shamed, ‘non-handwashers’ are not a labelled group in society and therefore are not stigmatised in the way people labelled as ‘addicts’ are. Stigma involves ‘spoiling’ a person’s identity, not just violating a social norm.

So for many behaviours, people might adhere to norms, or loosely to ‘follow the crowd’, but without being stigmatised if they don’t. Indeed in certain contexts, drug and alcohol use is influenced by social norms without stigmatisation. For instance, in university settings hundreds of studies have shown how perceptions of other people’s drinking behaviours and attitudes shape how and why students drink. Sometimes, drinking can be reduced by correcting student’s beliefs if they overestimate heavy drinking or approval of it amongst students in general (a type of ‘nudge’). It would therefore be a mistake to suggest societal attitudes hold no influence on these behaviours, but the crucial question is can norms be deliberately changed to reduce addiction without causing harm (e.g., inadvertently increasing stigma)?

Can ‘disapproval’ reduce addiction?
The appeal of ‘disapproval’ then is that society can curb ‘unwanted’ behaviours via changing or strengthening social norms. Indeed, in a broader context, some advocate for more use of shame to incentivise better behaviour, although generally advise this should be targeted at corporations or policy makers rather than individuals. What about in the case of substance use and addiction?

Stigma involves ‘spoiling’ a person’s identity, not just violating a social norm
Of crucial importance is recognising the societal drivers of addiction, including inequalities, poverty and weak drug and alcohol policy

We argue this is a question that needs more research first, although some important evidence exists. For example, some studies suggest guilt-prone people may be less likely to engage in addictive behaviours, thus social disapproval may have some preventative value (although the studies are limited in proving cause and effect). However, there is another important catch. These patterns only seem to apply to groups who do not have ‘addiction’. In fact, amongst people with addiction, higher levels of guilt or shame have been proposed to be counter-productive. Simply put, whilst permissive attitudes might increase the likelihood of uptake or use of drugs in some contexts, shaming people with addiction is harmful. Whilst cliché, addressing addiction problems is most effective when coming from a place of compassion, social support and building people up.

The importance of resisting stigmatising blame
This is not to argue there should be no consequences for people’s actions just because they may be experiencing ‘addiction’. There is a crucial distinction between responsibility (e.g., to not harm others) and blame (‘it’s their own fault’) often motivated by anger or contempt. Of crucial importance, however, is recognising the societal drivers of addiction, including inequalities, poverty and weak drug and alcohol policy. Placing too much responsibility on individuals for ‘addiction’ is itself a harmful practice which feeds blame and stigmatisation, distracting from the need for evidence-led drug policy and compassion towards people who so often have histories of severe trauma or abuse.

Addiction does not result from a lack of disapproval or judgment from society. It is a complex problem for which society places too much emphasis on individuals as making a ‘choice’, rather than recognising the complexity of the issue. We must tread very carefully before putting people at risk of more stigma in the name of ‘disapproval’.

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

Northern Reunion: the magic of recovery reveals itself in Hull

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An inspiring, moving and heartwarming daytime event brought the Forward Trust’s recovery community together for its annual event in the north on 24th May.

Forward Trust Northern ReunionDespite the wind and rain outside, Forward saw rays of sunshine indoors welcoming over 150 attendees to the Jubilee Central conference venue in Hull city centre.

Our community travelled from all over – Margate, Ashford, Liverpool, Norwich – and of course Hull!

Donuts, hot drinks and sweet treats were available throughout the event, with stalls advertising a number of Forward services – both in the region (The Bridges residential rehabilitation and ReNew, a CGL and Forward co-delivered service), and nationwide (Forward’s digital and hub services).

Kicking off at 11am, the event was opened and hosted throughout by Josh Thetford, Forward’s incredible recovery support team leader and event organiser bringing light, humour and colour from the stage throughout this vibrant event.

Josh was followed by Forward’s CEO, Mike Trace, who explained the importance of Forward’s mission to help anyone impacted by addiction, crime, homelessness, mental health or long-term unemployment to turn their lives around to achieve both mental and physical wellbeing.

Mike explained the key component to Forward’s work is our ‘caring’ ethos. His speech neatly reinforced our charity’s goal which is to support people through addiction (alcohol, drugs or gambling), break the cycles of criminality and prison, and help those wanting the opportunity to live a positive life that fulfils their potential.

Northern ReunionWe then heard a trio of inspiring shares from Laura, Sarah and Liam – each with their own unique story and challenges – that eventually led them to recovery through a Forward drug and alcohol treatment service.

While their individual stories all varied enormously – different places, upbringings and family dynamics – each shared the same common elements of chaotic lifestyles, denial, shame and ultimately recovery. We’re extremely grateful to Laura, Sarah and Liam for accepting the invite to share their journey with everyone.

This was a fitting segway into a demonstration of how to use naloxone effectively. This life-saving medication helps to revive anyone in the case of accidental drug overdose. We’re proud that we could use this event to not only show the correct way to use but also hand-out a batch of free naloxone kits.

Lunch was an incredible array of curries for all tastes and preferences (served with all the essential extras including bhaji’s, naan breads, poppadom’s and pickle tray) – needless to say this was a big hit! Our thanks to the incredible catering team for a restaurant-level taste experience!

The event then included two further shares by Chris and then Alan, who both provided moving accounts of supporting their respective sons through addiction. Their emotional stories unpacked the complex challenges of supporting loved ones but also the barriers in gaining access to addiction services within the health system. Both related their gratitude in finding Forward support services and our recovery community.

Forward Northern ReunionThese poignant family shares also highlighted the ripple effect of addiction; all too often family members, children, friends, work colleagues and significant others of individuals in active addiction can be affected. Forward is pleased to be able to also provide more support for this community through Reach Out confidential online chat and also our new specialist programme, Recovering Families UK (RFUK) – now accepting self-referrals.

The final part of the day culminated in live acoustic performances, a raffle and the Serenity Prayer.

Our thanks to everyone that made the journey to Hull and our gratitude to the staff at Jubilee Central. Special thanks to our team of event organisers and live event technicians – here’s to next year!

Finally, do keep an eye out for videos from the event – including shares – in the coming weeks!

If you are interested in more stories about addiction and recovery, you can find these on our campaign site, Taking Action on Addiction, where we help to share the message that Addiction Affects Everyone BUT Recovery Is Possible.

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

Claudine Evetts – I am a…

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Claudine Evetts is a lead clinical nurse at WithYou. We asked her about her career path and role.

Claudine EvettsWHAT MADE YOU WANT TO WORK IN THIS FIELD?
If I’m brutally honest, I fell into it. Many, many years ago, my role was looking after clients in custody, going from cell to cell. I was the only one on full time work, everyone else was on part time, so I was getting all the really rubbish shifts and I’d be given 40 minutes to get from Walsall to Wolverhampton, to get into the cell custody suite to take someone’s blood. I was literally run ragged all over the West Midlands.

Someone I knew at WithYou (when it was previously called Addaction) asked if I’d be interested in a bloodborne viruses nursing role. I asked, ‘Well, what does it entail?’ She told me, and I thought it sounded interesting, so I applied, got the job, and realised that that’s where my passion lay.

I stayed in that previous role at WithYou for seven years as the BBV nurse. I implemented so many different things when I was there. I shouted the loudest about policies and practice standards, and I ended up being the first lead nurse for the organisation. I did that for three years, and then, because I’d had my daughter and she had specific needs, I left to look after her and went into general practice. I had an eight-year break, and then I came back to WithYou.

My passion for this sector has never died, and I don’t think it ever will. When I was in general practice I didn’t wake up on a Sunday morning, see something in the news and think, ‘We could implement that for our clients.’ General practice is held firmly by the senior partners, you don’t get the opportunities for innovation in the same way. Whereas we’ve got innovation here, we’ve got a chance to create better care for our clients. 

WHAT DOES A TYPICAL DAY LOOK LIKE?
I haven’t got a typical day. Today, for example, I’ve looked at a competency framework for a volunteer who’s a nurse that is offering to do low level health interventions for our clients. We need to make sure that their governance and their indemnification is seen too. I’ve also looked at a workbook for our residential rehabilitation centre Chy, in Cornwall, because I’m going down there to train staff.

I collaborate with other members of the team. I run the ‘Communities of practice’ for all the north west clinical staff, whereby we get together once every three months to to be able to share best practice, to discuss case studies that may be worth thinking about, to discuss innovations and proactively look at how we can actually embrace those innovations and shape them. I support clinical supervisors and clinical leads in their services.

Finally, in the midst of all that, once a month I go to Shropshire to do a clinic where I still go and see clients, I still vaccinate, I still prescribe for clients as needed, and do assessments and give out health advice.

I am a... Claudine Evetts
‘For me, everything is about the client. They are marginalised but don’t deserve to be, they deserve access to healthcare in exactly the same way as anyone else.’

WHAT DO YOU FIND MOST REWARDING?
The innovation to push new practices forward that will benefit our clients in the long run. I am very client-focused and client-driven. For me, everything is about the client. They are marginalised but don’t deserve to be, they deserve access to healthcare in exactly the same way as anyone else. Sadly they have often been through experiences that have caused trauma which impacts on their ability to access healthcare in the same way as the general population. That shouldn’t mean that access is cut off. So it’s about us facilitating innovative, new referral pathways in collaboration with a variety of health colleagues.

In simplicity, some have early childhood trauma, their brain synapses and neurology then form differently, and the pathway in the brain becomes atypical. Well, that’s what we need to do with health pathways/interventions. They just need to be accessed in a different way, not the same way, as everybody else.

WHAT WOULD YOU LIKE TO CHANGE?
My vision all those years ago when I was a BBV nurse was to have a ‘one stop shop’ for healthcare. We are a little bit nearer, but we’ve still got quite a way to go to have that ‘one stop shop’, though it is the way forward, that’s what I want to keep pushing – as should others. I want to help facilitate more skills for our nurses to be able to ensure that our clients are looked after holistically. I just want parity for our clients, and currently, they haven’t got the parity they deserve.

I also want to see more innovation and bravery in the sector. I do understand we need to have certain boundaries, policies and procedures, but I do think that we trip ourselves up and we create more barriers, rather than just test bed at a pilot site and if it works… repeat.

It’s actually about remembering why we’re here in the first place, forming the best practices, and doing away with our own egos.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
The clients are wonderful – embrace their lessons because they have so much to teach you. Trust in yourself, and ensure that you’re doing it for the right reasons. Be innovative, bold and brave.

 

DDN JobsSee opportunities like Claudine’s on DDN Jobs

The Loop warns about deadly nitazene pills

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Drug-checking charity The Loop has issued a warning after pills confirmed to contain nitazenes were associated with two recent deaths.

Drug-checking charity The Loop has issued a warning after pills confirmed to contain nitazenes were associated with two recent deathsAn investigation is underway after a man and a woman in their 20s died in Southall, west London, on 26 May. ‘This is following reports that the individuals allegedly passed away after taking an illicit substance in the form of a green pill,’ a Metropolitan Police spokesperson told the BBC.

According to The Loop, two pills tested by the Eurofins laboratory were found to contain the highly potent synthetic opioid N-Pyrrolidino isotonitazene as well as ‘trace element’ ketamine and MDMA, while another pill tested by The Loop and the University of Bath also contained N-Pyrrolidino isotonitazene and trace element MDMA.

While the drugs resemble oxycodone pills, the ‘purchase intent’ for the pills is unknown, says The Loop, meaning it is unclear what people thought they were buying. The charity is urging people to test their drugs before use – with either nitazene testing strips or a professional drug checking service – and to always carry naloxone. ‘Don’t take drugs alone,’ it states.

Earlier this year Public Health Scotland (PHS) issued a warning after an increase in ‘sudden collapse’ overdoses – some of them fatal – with a ‘nitazene-type opioid’ identified in heroin samples linked to the overdoses. The Home Office recently issued new recommendations to help police and local councils address the threat posed by synthetic opioids, including better information sharing and fast-tracked drug testing when suspected synthetic opioids are seized.

Last year saw the highest ever number of new nitazenes reported to the EU’s early warning system, according to EUDA’s European drug report.

Free time

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Project FREE is a lived experience recovery organisation that supports adults with substance-related offending behaviour in Bury and Oldham, Greater Manchester.

Project FREE is a lived experience recovery organisation that supports adults with substance-related offending behaviour in Bury and Oldham, Greater Manchester.

As a group they empower individuals leaving prison, using lived experience and credible role models to help people break free from addiction and criminal behaviour and create lasting change.

The project was launched in 2023 by Bernard Shaw, following his own experiences with addiction after leaving prison in 2017. Now more than eight years into his recovery journey, Bernard is working to help men aged over 25 who are going through a similar situation.

The programme not only addresses substance misuse but the underlying issues driving criminal behaviour, offering participants guidance, support, and practical tools to build a future free from addiction. ‘I wanted to start Project FREE and just went for it,’ says Bernard. ‘Two years down the line it’s started to take off. It’s my role to get people through the programme and into volunteering, so they can go on to inspire other people. It’s a ripple effect that keeps growing and growing.’

Project FREE is a lived experience recovery organisationThe team of volunteers at Project FREE is comprised of individuals who are walking the path of recovery themselves, creating a strong connection with those who participate. By drawing on their own experiences, volunteer role models offer genuine understanding and motivation to help others break the cycle of addiction and offending.

‘We connect with people at the prison gate,’ he continues. ‘If they don’t get that lived experience support, the chances are we’re going to lose them back into a cycle of substance use and reoffending.’

Project FREE hasn’t been commissioned directly, but has been supported financially by a number of organisations, including The Calico Group, Red Rose Recovery, Turning Point, Bury Council, GMCA and Greater Manchester Mental Health NHS Foundation Trust via the Achieve Bury Recovery Fund. They also work in partnership with other recovery organisations to deliver services, including Acorn Recovery Projects, Gateway Floating Support, Action Together and more.

Many of the group’s activities and sessions are held at Red Door in Bury, which is run by homelessness charity Caritas. The building offers a warm space for anyone struggling, providing regular meals, laundry facilities and showers to those in need.

After seeing the good work Project FREE do for the community, Caritas generously gave office and activity space for the team to have a base. ‘It’s a huge help,’ says Bernard.

At the back of the building, nestled between St Joseph’s Church and local stores, is a garden space that’s being transformed from an ‘unloved jungle’ into a thriving community space – thanks to the volunteers at Project FREE and the generosity of their neighbours. It’s their first big project as a team, and so far, it’s going great…

The garden space was overgrown and abandoned. Previously a church garden, it had been taken over by climbing ivy, unkempt plants and mounds of discarded litter. The rotten gate leading into the space allowed anyone walking past to throw their rubbish or dump drug paraphernalia – but thanks to the hard work of the Project FREE clean-up squad, it’s now been cleared.

The team of volunteers at Project FREE is comprised of individuals who are walking the path of recovery themselves
The old church garden next to St Joseph’s in Bury was overgrown and abandoned and had become a dumping ground for litter. It’s the first big project for the team and, with the help of material donations from the local community, has been turned into a welcoming community garden that is accessible to all

Lee, who was released two years ago following a 19-year period behind bars, is one of the volunteers who has helped transform the area. ‘It’s great for the mind, body and soul,’ he says. ‘I feel great and I’m giving back. It’s great to see people’s expressions. I’ve been at the project for nearly two years. Just after leaving custody, I heard about Bernard, and I’ve been here ever since. It’s a lifeline for me. It’s brilliant how everyone is coming together.’

Now the space has been freed from the years of neglect, the team have big plans to transform the area into a space for everyone to enjoy. On the agenda so far are colourful flower beds, picnic benches and a large mural to brighten up the exterior wall.

Their hard work hasn’t gone unnoticed either. Their neighbour from Fired Paint a Pot Café has been inspired by their efforts and wants to help the team achieve their goal.

‘She wants to support us with funding for a new gate and benches as she’s been trying to get something happening with this space for years,’ says Bernard. ‘She wants to help to create a space we can both use and enjoy.’ Nearby building materials supplier Jewson has also generously donated gravel to help the team neaten up the space even further.

Talking about the success of the group’s first big project together, Bernard says that the impact it’s having on the community ‘is really touching. It’s been a great project; everyone is really enjoying being a part of it. Everyone putting their own bit in and doing their part. It’s all about the result at the end.’

Alan has also been volunteering his time on the project, after probation reduced his risk assessment level so that he could engage with the project. ‘It’s turned my life around,’ he says. ‘ All I’ve known was in and out, like the hokey cokey. Now I come here twice a week, every week. And it’s given me a totally different change of pace. I’m 60, I’ve no time to be wasting. It’s a good thing for me, it keeps me grounded and surrounds me with like-minded people. Without being here, people would be back in and taking drugs. The positivity and connection make us like a tight-knit family on the same page and it really helps.’

Karen Baggaley is a support worker at Project FREE. Talking about what volunteering on projects like the garden clean-up does for the recovery community, she says that it gives people a purpose. ‘It promotes connection and gives people the confidence and brings friendships together and gets them close,’ she states. ‘They’ve all worked as a team. It’s been amazing seeing them work together and create something to be proud of. They’ve all done it so quickly – it’s all been done in about 12 hours so far.’

 ‘It’ll help the community a lot,’ adds her colleague Emma Sharkey. ‘It’s going to make the street look better and gives us space to deliver our sessions – wellbeing and mindfulness and outdoor groups, relaxation.’

Finalising his thoughts on the garden, Bernard concludes: ‘This is our first big project as a team, but how much it’s inspired the community has inspired us to do more. This street has had a big issue with drugs in the past, so it’s great to finally start turning it into something good. A lady walking by even told me, “You guys are all being talked about in the church. What you’re doing is absolutely amazing.” It’s great to hear such good feedback.’

Project FREEFind out more about Project FREE here or get in touch by emailing: project.free@redroserecovery.org.uk

Emma Marsden is senior communications officer at The Calico Group

DDN June 2025

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What better way to show things will be ok?

DDN June 2025‘The ripple effect that keeps growing and growing.’ Bernard describes the ethos of a programme that’s helping people through the difficult stages after leaving prison (p6). That connection at the prison gate can be transformative – an introduction to peers and partnerships that can open up a world of opportunity. ‘It’s a lifeline for me,’ says Lee, a volunteer working with the project after 19 years behind bars.

This positivity, connection and confidence shine through Tommy’s story as he emphasises the value of the two-way exchange (p8). Not only is he gaining much from his role after a life dominated by drug use, homelessness and prison, he’s also offering the hand of friendship and reassurance to people coming through the service’s doors for the first time – including someone he used to live with in a lift shaft. What better way to show someone that things will be ok?

Our stories in this issue remind us that we all have a vital role in successful rehabilitation. And with the final report of the Independent sentencing review indicating a shift towards more community sentences (p4), it’s clear that our volunteers and peer support workers will play a more valuable role than ever.

Read the June 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

PCCs reject call for cannabis decriminalisation

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PCCs reject call for cannabis decriminalisationThe Association of Police and Crime Commissioners (APPC) has rejected the call to decriminalise small amounts of cannabis for personal use contained in the recent report from the London Drugs Commission. The APPC represents police and crime commissioners (PCCs) and police, fire and crime commissioners (PFCCs), as well as deputy mayors in England and Wales.

While acknowledging that cannabis ‘can be addictive’ – and that more dedicated support services were needed – the London Drugs Commission report, which was published last week, said that controlling it as a class B drug was ‘disproportionate’. The sentencing options – especially for personal possession – could ‘not be justified’ when balanced against the impact on the individual, it added. Cannabis policing also disproportionately affected ‘particular ethnic communities’, it said, creating ‘damaging, long-lasting consequences for individuals, wider society, and police-community relations’. Although fully legalising the drug would boost tax revenues and reduce ‘criminalisation’, the ‘extent of harms, particularly with respect to public health, as well as personal and societal costs, take longer to emerge and are not yet well understood’.

‘It is clear that a fundamental reset is required,’ said the commission’s chair Lord Charlie Falconer – but full legalisation was not the answer. ‘The criminal justice system response needs to focus only on the dealers and not the users. Our report provides detailed recommendations on how the law needs to change to reflect a new focus for the criminal justice system, and how the response of the public and other sectors can better support those damaged by cannabis use.’ Although the report’s conclusions were endorsed by London mayor Sadiq Khan, the government has stated that it would not be changing its position on the drug’s classification.

PCCs cannabis decriminalisation
‘Cannabis is a harmful drug that has serious adverse effects on its users’

‘While we recognise that this is an issue where some PCCs may take different views, we disagree with the commission’s recommendation that possessing a small amount of cannabis should be decriminalised,’ said the APCC’s addictions and substance misuse leads, Joy Allen and David Sidwick. ‘As this report recognises, cannabis is a harmful drug that has serious adverse effects on its users. It also rightly concludes that legalisation, as we have recently seen in other jurisdictions, would increase the availability of this harmful drug and could significantly amplify the health and mental health risks.’

Decriminalisation could risk making people more likely to use cannabis, they added, as well as create confusion around what constituted ‘a small amount’ and the difference between ‘natural’ and ‘synthetic’ cannabis. ‘We have previously argued for a more robust approach to policing the possession of cannabis and other drugs, but not a narrowly punitive one,’ they stated. ‘The focus should be on referring people who are using harmful drugs onto education and support programmes that can reduce their risks of future harm, and requiring them to attend. This approach is in line with the three-pillar approach combining enforcement, treatment and prevention to tackle illegal drug use, which has rightly been at the core of government policy.’

 London Drugs Commission report available here

 

Almost 70 per cent back ‘smokefree generation’ policy

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Sixty-eight per cent of the public back the ‘smokefree generation’ policy, as contained in the government’s tobacco and vapes bill, according to new polling from ASH.

Sixty-eight per cent of the public back the ‘smokefree generation’ policy, as contained in the government’s tobacco and vapes bill, according to new polling from ASH.The bill, which was first introduced by the previous government and then re-introduced by the current administration, contains measures to phase out the legal sale of tobacco to anyone born after 2009. It is currently entering its final stages in Parliament.

The results of the ASH polling show a ‘major shift’ in the attitudes of smokers themselves, says the charity, with more than half backing the policy.

More than 11,000 people were surveyed, with 45 per cent overall agreeing that the government ‘isn’t doing enough’ to tackle smoking, and 65 per cent saying they ‘want to live in a country where no one smokes’. Support spans ‘all age, income and regional groups’, says ASH. ‘Despite the extensive media coverage of the tobacco and vapes bill, and the introduction of legislation that will make the UK the first country to introduce a generational smoking ban, 45 per cent of surveyed adults feel that the government is not doing enough to limit smoking, with 31 per cent saying that what they are doing is about right,’ the document states. ‘Only 10 per cent feel that the government is doing too much.’

smokefree generation
‘Every day we delay, 200 lives are lost and this cannot be ignored’

Three quarters also wanted to see a ‘big tobacco’ levy, with the money going to smoking cessation and youth prevention services, while 59 per cent supported a smoking ban in the outdoor areas of pubs, cafes and restaurants. ASH is now calling on the government to publish a ‘roadmap to a smokefree country’, setting out how it will deliver ‘rapid reductions’ to smoking rates.

Figures released by the Office for National Statistics last year showed that 6m UK adults were currently smokers, the lowest proportion of the population since records began.

‘This isn’t about a nanny state, it’s about a public mandate,’ said co-chair of the APPG on Smoking and Health, Bob Blackman MP. ‘People from all walks of life want action. They’re not just asking for a bill, they’re calling for a movement toward a smokefree future and parliament must now match the public’s urgency. Every day we delay, 200 lives are lost and this cannot be ignored.’

Public support for a smokefree society available here

Learning curve

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DDNWeb
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The National Substance Misuse Non-Medical Prescriber Forum teamed up with Addiction Professionals to host the latest in a series of peer-to-peer educational days. DDN reports.

Co-use of benzos and opioids

Why do people co-use benzodiazepines and opioids? Opening the question to the forum, Bristol Medical School’s Dr Jenny Scott said it was important to try to understand motivation, particularly when looking at care of vulnerable people – and because most drug-related deaths involved polydrug use. A study involving 48 people who had overdosed in Glasgow, Bristol and Teesside had given insight.

On one hand benzo use could be called functional – to feel calm or give confidence, rather than to deliberately feel intoxicated. The other scenario was more experimental – to feel a buzz, a warm glow, a feeling of intoxication: ‘Benzos took them into oblivion, away from all their problems.’

Many people were bingeing, using handfuls of street benzos in uncontrolled quantities, and often using opioids and benzos together, she explained. The changing patterns of co-use could be triggered by prescribing decisions or the change in availability of illicit drugs, and could veer from controlled use to a much more chaotic situation.

So what was the perception of overdose risk? ‘People were acutely aware of consumption roulette, where they’re not sure what they’re going to get,’ said Scott. ‘At times they were asking “how can I keep myself safe?”.’ Attempts to try to do so included taking one dose every five minutes, then another – not failsafe as the effects could take longer to kick in – but it was at least evidence of a strategy, she said. Others experienced hopelessness and inability to change – ‘it’ll probably kill me’ – particularly if they had been severely affected by trauma.

Lack of care could make people feel ‘horrible’ about themselves and give them a sense of not being able to go anywhere for help. And while some people felt able to do things to keep themselves safe, others were made additionally vulnerable by their lack of stability and inability to manage triggers such as arguments with family members. The findings pointed to a ‘huge unmet need for mental health support,’ said Scott.

People’s understanding of street benzos was found to be ‘quite limited’, especially where there was co-use with other drugs. As most overdoses were unintentional, there was a clear need for consumption rooms and drug-checking initiatives, she said. Furthermore, the different cohorts and uses relating to street benzos and prescribed benzos needed very different interventions.

Safe space for working women

‘When you come to work you don’t know what you’re going to deal with that day,’ said a member of the Sheffield Working Women’s Opportunities Project (SWWOP), represented by Shelley Jackson, Sophie Golland and Lydia Flower. What was clear was the group’s success in providing a safe space and trauma-informed support in a red light district of Sheffield – ‘a vital link between marginalised women and wider health and social support services’. The SWWOP staff had realised they were uniquely placed to see opportunities for early intervention, especially as the women they came into contact with ‘often fall down the gap of care’.

The team was proud to collaborate on a holistic trauma-informed health care model, and there was a sense of ownership and pride to be part of the project from all involved. ‘It’s a safe space and it’s important for us to feel that trust,’ said Rosie, one of the women who attended the service, in an audio clip. It was a refuge ‘from the chaos’ and gave opportunities to improve physical health and enhance wellbeing, as well as having a long-term impact on integrated healthcare.

A pilot scheme offering long-acting buprenorphine had given hope to those who might have struggled to maintain their script because of irregular hours. It had given the team the chance to signpost them to other services, including respiratory health (especially COPD), overall health and wellbeing, sexual health and harm reduction interventions.

Key to progress had been partnering with the Wicker Pharmacy in Sheffield, which was in the right location – a space where the women felt safe and secure. Supported by a drug worker and a GP, they were able to focus on five key aims – easier access to drug treatment, sexual health support, scripts, mental health and wellbeing interventions, and easier access to healthcare. ‘We wanted to improve physical health, enhance wellbeing, and have a long-term impact on integrated healthcare,’ said Lydia Flower.

Feedback from the long-acting buprenorphine trial was showing very positive results so far: ‘It’s changed my life massively – it’s calmed me down,’ LJ, a visitor to the service, had told the team. ‘I’m already making plans for the future. Even that bit of itchy pain you get afterwards is worth it for what you get from it.’

‘It’s changing my other drug use,’ said another, Jo. ‘It’s gone down to two days now. I’ll put it this way – I haven’t been drug-free since the age of 11… If this is normal, I love it.’

Understanding ARBD

What is alcohol-related brain damage (ARBD), what does it do and how does it present? Julia Lewis from the University of South Wales looked at what could be done for patients who might be drinking heavily – from the first stages of their treatment onward.

‘Umbrellas, spectrums and syndromes’, the subject of a chapter in the forthcoming alcohol guidelines, explained how a collection of neurocognitive syndromes overlapped ‘because people normally have more than one of them’. The biggest group happened in the frontal lobe.

So what caused ARBD? ‘Booze gets into the bloodstream and into the brain quickly,’ she explained. ‘The immune system mounts its attack on its own tissue.’ Glutamate caused damage to brain cells – the areas of white matter and the insulation around brain fibres. ‘You need lots of thiamine to repair it.’ If the insulation was damaged, you could do something about it – but once the axiom was damaged you couldn’t do much.

The body turned thiamine over quite quickly and needed it to replenish, she said. Alcohol stopped this from happening. Damage could be repaired if there was enough thiamine, and in withdrawal it was needed acutely – without it at this stage there was risk of acute brain damage.

Classic symptoms of ARBD ranged from short-term memory impairment to retrograde amnesia. Confabulations were commonly experienced – when the brain tried to make sense of the situation the person was in by constructing a situation that might be far from reality, but trying to make sense of the information it had.

‘Memory impairment and dementia – we’re used to talking about this,’ said Lewis. ‘But dysexecutive syndrome gets overlooked’ – this could involve poor motivation, difficulties with planning, goal-setting, control, flexibility and thinking. A lot of doctors didn’t know much about ARBD, she said, while getting a good social worker who was interested in it could be ‘a godsend’.

A study of 300 consecutive cases showed that drinking more than 50 units for men and 35 units for women for more than five years put you at risk of ARBD. ‘You can stop cognitive decline if you come off the booze,’ she said. ‘If you’ve drunk enough to damage your liver, you’ve probably drunk enough to damage your brain.’

Gradual decline could be reversed to become gradual improvement over three years. Alongside medication, the other aids to recovery were cognitive programmes, family and friends, and the right accommodation and support. A transition phase – at home with support – required assessment and reassessment throughout, which was why ‘you need a good social worker onboard’.

Managing the situation involved all aspects of routine – the right nutrition, a regular bedtime, developing relationships and bringing family and friends into the therapeutic process. ‘A lot of what we need is out there – we’re just not used to working with ARBD,’ she said. ‘We need to look at what services are out there and how they could work together.’

Creating a scene

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Recovery Street Film Festival

The theme of this year’s Recovery Street Film Festival is creative healing. The festival’s new creative director shares her vision for the competition, and how it reflects her own recovery journey.‘I believe in the power of film to drive social change and empower under-represented groups and individuals in society,’ says the new creative director of the Recovery Street Film Festival (RSFF), Maddie Kitchen. ‘I use my skills as a filmmaker and my lived and living experience to champion people in recovery from addiction, mental ill health and trauma.’

The theme of the 2025 festival is ‘creative healing’, exploring the ways in which artistic expression can ‘nurture the soul’ – ‘from painting to poetry, theatre to dance, music to meditation, creativity serves as a powerful holistic tool for recovery,’ says RSFF.

Kitchen says she wants to take the festival ‘back to the streets, where it belongs. This is about challenging stigma by opening it up to the public and creating a vibrant, inclusive event that celebrates recovery out loud and in the open,’ she states. She’s also the founder of Sobriety Films UK, which focuses on recovery-oriented storytelling and has collaborated with organisations including Change Grow Live, Waythrough, the NHS Addictions Provider Alliance, Phoenix Futures and Turning Point – holding screenings and running filmmaking workshops to help challenge stigma and raise awareness of recovery.

The theme of this year’s Recovery Street Film Festival is creative healing

Kitchen herself has been in recovery from alcohol addiction for nearly 20 years. ‘Along the way, I’ve experienced two relapses, but I’m now 13 years sober,’ she says. ‘I always highlight that because it’s important for others to know – you can come back from relapse. My recovery has been abstinence-based, which is what has worked best for me. I experienced my first episode of major depressive disorder at the age of 19 and to cope with overwhelming anxiety I began using alcohol to self-medicate.’ Over time this became a ‘horrible and harmful cycle’, she says.

Getting sober, however, was the best thing she did for her mental health, she states. ‘As someone with a dual diagnosis I know how challenging it can be to separate mental health issues from addiction. But I also know that recovery is absolutely possible.’ While many people still fall through the cracks in the system – presenting with substance problems that stem from underlying mental ill health issues, only to be told they need to be abstinent before receiving any mental health treatment – the conditions are ‘deeply connected and must be treated together, at the same time’, she stresses.

‘I believe everyone’s recovery journey is different,’ she says. ‘There are a variety of methods and treatment choices – it’s up to the individual to find what works for them. I know that recovery is possible, because I’m alive to live it every day.’

RSFF

It’s this belief that also underpins her vision for the festival. ‘This is a festival for the whole of the UK, and for anyone whose life has been touched by drug or alcohol use,’ she says. ‘That includes individuals in recovery, family members, friends, and professionals. Everyone’s story matters, and everyone should feel welcome. At its core, this festival is about education, awareness, and connection.’

Recovery Street Film FestRecovery is often misunderstood, she says, ‘and I want to help demystify it. What does it look like in real life? How is it achieved, and how does it evolve? Through bold, personal storytelling and the creative power of film – across genres, styles, and voices – we can open minds, ignite conversations, and stir imaginations. I want to nurture emerging talent, nurture new voices, and give people in recovery a platform to express their truth.’

One of her biggest hopes is to see lived experience filmmakers collaborating with others in the recovery community, she says – ‘supporting individuals and groups to tell their stories on screen. My dream is to see independent creative hubs across the UK, where people with lived experience come together, learn from one another, share filmmaking skills, and create raw, powerful, dynamic films that reflect the richness and diversity of our recovery journeys and beyond. This is more than a festival. It’s a movement – one rooted in honesty, creativity, truth and hope. Join us!’

Maddie Kitchen

Born and raised in Camden, Maddie Kitchen has a BA in media studies from Westminster University, specialising in TV production. She is also a graduate of the School for Social Entrepreneurs and a fellow of the Royal Society for Arts.

With a career spanning broadcast news, charity media, and independent filmmaking, she’s worked with organisations including ITN and the Media Trust and as a freelance producer/director for on Channel 4, ITV Anglia and Channel 5. Her short films have been shown at international festivals including the Reel Recovery Film Festival (USA) and the Northern Ireland Mental Health Arts Festival.

Maddie has also served as a film judge for both the Athens Short Film Festival and the Dublin Independent Film Festival. She is the founder of Sobriety Films UK and is creative director of RSFF.

 

Meet the RSFF team and see last year’s winning films at the DDN Conference on 10 July

Community connections

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DDNWeb
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When LEROs work in real partnership with established local providers, great things can happen says Jon Roberts.

Finding space amongst jostling perspectives and competing priorities is an ongoing challenge for the humble LERO. With daily funding pressures and strains on capacity (more than 3,000 individuals came through our door last year and we’re a micro-organisation) day-to-day working life is never dull. Yet we need to be operating effectively as a calm antithesis to active addiction, not running around appearing to mirror its stresses and strains. How is this achieved?

In a field seemingly willing to ultra-process basic ingredients, it can be helpful for LEROs that are growing up in a sometimes-frightening world to remember core values, beliefs and skillsets. Broadly, these values include maintaining a belief in the wisdom of community – having a faith that often, with the right setting and oversight, people coming together voluntarily in the social setting will unlearn addiction’s teachings of helplessness.

The emphasis on supportive social processes within positive networks is a belief system also known by another name – mutual aid.

LEROs’ understanding of the importance of setting the social scene comes with good reason. We know most of us learnt to start taking drugs and alcohol in a social environment, so why not start learning to stop in one? Adhering to a focus on the psychologically informed environment – which, in less convoluted talk, means generating recovery from the living room – is a valuable LERO USP.

When LEROs work in real partnership with established local providers, great things can happen
Most of us learnt to start taking drugs and alcohol in a social environment, so why not start learning to stop in one?

RETAIL RECOVERY
This leads on to acknowledg­ing the importance of creating an independent home for recovery in the community, offering open access and high street visibility – retail recovery! Based in a home-grown community rehab, LEROs build a social, principled space where anyone can walk in and immediately sit down to talk with someone with lived experience of services, addiction, harm reduction and recovery. LEROs can offer a warm welcome, independent space and a sense of belonging.

Operating this way in the community – away from burgeoning bureaucracy, the more extreme examples of stifling risk-averse practices and the umbilical cord of bigger providers – the independent LERO remains free to talk truth to its members, and truth to power.

The ABCD approach is a further, articulate example of how LEROs, as freelance frontline providers, can remain nimble, responsive (and entrepreneurial), staying one step ahead by harnessing available assets within local community networks – assets, for some reason, which seem beyond the reach of more established services. The willingness and ability to expand into cross-sector networks will add further dimensions and opportunities for LEROs to establish themselves and help more people. We work with the University of Leicester for example, sourcing apprenticeship funding for staff development and accessing other benefits for development, such as participating in their insightful growth accelerator for social entrepreneurs programme.

PARTNER ACCESS
LEROs are clearly in strong positions to advance social care within the community. During our ‘Dridays’ – beside the graduations, music, written word and shares – we offer eye tests, fibro scanning, smoking cessation, BBV tests and more, provided by our partners. Working in partnerships provides access to people, places and things you’d be hard pushed to reach on your own.

The forging of productive working relationships within our shared arena – the pooling of thinking, perspectives and other resources – is not only sensible, pragmatic and often cost effective, it can establish the transformative change that users of statutory services so deserve.

lived experience
Embedding within successful partnerships is a key tactic for allowing LEROs to survive, prosper and grow

Coming from the lived experienced perspective, this means building on the cooperation process and tapping into useful networks so many of us found helpful when addressing the crushing consequences of our own addictions. The same assets applied to build our personal recovery capital are scaled up in the professional capacity to build the improved infrastructure across service delivery that’s so sorely needed. Embedding within successful partnerships is a key tactic for allowing LEROs to survive, prosper and grow.

Of course, espousing the benefits of effective partnership work is nothing new. But where the recovery city landscape is ever more mapped with different contributors and locations, what’s become essential now is how these organisational relationships come together to present a cohesive whole. Limiting harm happens when working alliances orientate towards supportively navigating recipients’ pathways through an often-bumpy terrain. This navigation is achieved through increased liaison and understanding of the different roles, including who is where and who does what, creating a streamlined momentum towards improved outcomes.

Maturing LEROs can play an active role in this work, advocating, as always, from the service user’s perspective. This model might still be a way off from effective personalised treatment plans, but does create a joined-up infrastructure which supports a more tailored approach. Attaining capacity for the LERO to be a leading contributor in this role is vital if we’re serious about progressing lived experience and improving outcomes.

SMALLER PARTNERS
Participating in partnerships where members are eager to learn from each other has allowed us – as the relatively new kids on the block – to become better understood and influential. We can now learn from the master’s table, or at least the status of being invited to properly sit down has been attained.

It’s empowering for us to know we’re getting somewhere, albeit for now as a smaller partner. It’s a huge responsibility. However, establishing such working partnerships can form a vital part of the LERO journey towards what is slowly becoming parity of esteem with the bigger, more established players.

Partnerships have certainly been a cornerstone of our community build. The partnership between Turning Point and Dear Albert has evolved to become multifaceted and well-integrated, providing good examples of how LEROs can work alongside the main provider and how established providers can support the LERO.

LEROs Dear Albert Turning Point
Turning Point and Dear Albert work together in Leicester on a daily basis, sharing data, venues and expertise

Turning Point and Dear Albert work together in Leicester on a daily basis, sharing data, venues and expertise. Turning Point holds overall control of the Leicester substance use contract, enabling Dear Albert to perform targeted lived experience roles and lead on certain initiatives. Locally, Turning Point provides regular training to Dear Albert members including naloxone distribution and needle exchange, so there’s increased opportunity to spread support across a larger area.

SHARING WORKSPACE
Dear Albert manages Turning Point’s aftercare caseload and leads on service user involvement, as well driving significant initiatives, such as establishment of Leicester’s community rehab. The partnership includes the sharing of workspace, co-facilitation of groups and attending each other’s meetings. This might be Turning Point accompanying our morning ‘huddles’ or popping into the senior lead meeting, or giving us access to training portals and conducting extensive audits – I’m now aware of expiry dates of bandages in the first aid boxes! More seriously, our Turning Point partnership has created buy-in and an urgency that we must get up to speed.

Whether appointing a designated safeguarding lead, or rewriting our standard operating procedures, the partnership has allowed us to become more professional. They want us to do well, and we want to show we can.

Close collaboration on event planning, such as Alcohol Awareness Week and September’s recovery festival, creates convergence on messaging and tangible unity across the contract. We contribute to Turning Point’s ARC (alcohol resolution clinic) and MAP (managing alcohol programme) based at our Community Rehab Stairway Project.

Dear Albert’s lived experience practitioners contribute to needle exchange at a local Turning Point hub, with Turning Point workers conducting 1-2-1s at one of our consultation rooms. We work together with ongoing feedback and alongside commissioners on such things as future city-wide strategies to combat harms.

LEROs lived experience Dear Albert
We’re thrilled and grateful to be sharing what works well with a wider audience

We also deliver the recovery and community session as part of Turning Point’s peer mentor training, and we employ Turning Point peer mentors – playing our part in providing real paid employment to those with lived experience of addiction. This commitment to working together towards common objectives and leveraging the strengths of each other while mitigating weaknesses and blind spots creates effective teamwork – a synergy to enhance opportunities for those we serve.

Having a partnership that works well in Leicester and Leicestershire has provided a secure base on which to understand what works well and then share with other areas – we’re thrilled and grateful to be sharing what works well with a wider audience.

CAN-DO ATTITUDE
Partnerships incorporating independent LEROs – who can often bring a fresh can-do, solution-focused attitude to the table, with genuine lived experience and community credentials – working alongside those with robust clinical excellence, the required safeguarding standards and the lived experience of actually running services, will bring about the transformative change we all know needs to come.       

Whether the independent LEROs will remain forever the smaller partner and lived experience becomes better represented by being absorbed into the main providers’ personas, or LEROs thrive to become serious, rounded competitors on their own merit, time will tell.

In the meantime, if LEROs are truly going to reach second-generation status, pull away from the founder’s image, learn from mistakes and help more people, then remaining true to our core values and strengths, while integrating our skillsets into wider partnerships, is a strategy that might just work. I truly hope so. We’ve got scaffolding going up for a new roof, and I’ve just signed a five-year lease.

Jon Roberts is director at Dear Albert

Cranstoun response to the London Drugs Commission

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The independent London Drugs Commission has published its long-awaited report which focuses primarily on cannabis use in the capital, making 42 recommendations.

Response to the London Drugs Commission
The Commission was tasked with considering the impact of cannabis laws on crime, public health and economic outcomes

The Commission, established by London mayor Sir Sadiq Khan in 2022, was tasked with considering the impact of cannabis laws on crime, particularly violent crime, public health and economic outcomes.

The recommendations include removal of the criminal sanctions for those in possession of personal amounts of cannabis (excluding synthetic cannabis), its removal from the Misuse of Drugs Act 1971 (to bring it under the Psychoactive Substances Act), and the opening of a drug testing (checking) service.

We broadly welcome the recommendations, in particular the emphasis on diversion schemes to reduce the number of people of colour entering the criminal justice system, as well as the focus on education for young people to warn them of the potential harms of cannabis. We also welcome the recommendation for a drug checking facility in London, which was previously put forward by the London Assembly.

It is particularly encouraging to learn that the Metropolitan Police Service (MPS) and Mayor’s Office for Police and Crime (MOPAC) have considered our pre-arrest diversion scheme, DIVERT, and the report highlights the ‘significant benefits’ that this approach could bring in London. We urge both bodies to consider implementing the scheme in London, at least on a trial basis.

London Drugs Commission
Black people are 3.1 times more likely to be stopped and searched than white people

The report states that black people are 3.1 times more likely to be stopped and searched than white people and this may be partially leading to decreased trust in the police among some communities. It is noted that our work with West Midlands Police and Crime Commissioner, where people are diverted on the street, can take ‘some of the conflict out of Stop & Search encounters’ and we believe that diversion could improve relations between communities – who are disproportionately stop and searched – and the police.

Furthermore, we believe that MOPAC and the MPS should go further in considering a diversion-focused whole system approach to managing drug use, like the model deployed by the Police and Crime Commissioner in the West Midlands. Our data shows that nearly 9 in 10 DIVERT referrals are for cannabis and we receive around 400 referrals a month in the West Midlands alone. With conservative estimates showing that each referral saves over four hours of police time, this could save thousands of hours of precious time, empowering the police to tackle other serious issues in the capital including violent crime and violence against women and girls.

Unfortunately, the report did not expand into other areas of drug harm in the capital – namely the rise of ketamine use among young people, and the increased prevalence of clusters of potent, synthetic opioids. London should consider a whole system approach to managing all levels of substance use by focusing on solutions which address the root cause of social issues related to controlled substances.

Cranstoun response to the London Drugs Commission
The report is ‘an acknowledgement from the Commission that the current approach is failing the people of London’

We hope that both the Commission and the London Drug Forum will continue to consider these issues and engage with providers in finding potential solutions which will reduce harm and protect Londoners.

Meg Jones, director of new business and services, said, ‘Today’s report is a step in the right direction and an acknowledgement from the Commission that the current approach is failing the people of London. It also serves as a good opportunity for us to have a grown up conversation about drugs.

‘The removal of criminal sanctions, increased use of pre-arrest diversion, a drug checking facility and additional education for young people would help to tackle the harms associated with cannabis, but the report could go further in following established global and national evidence.

‘We will be reaching out to the mayor’s office to offer further information on our DIVERT scheme and how this would work in London. We stand ready and waiting to work with the MPS and MOPAC, should they wish to trial any of our innovative approaches which have been proven to reduce racial disproportionality, cut reoffending and save police time.’

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

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

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

This content was created by Cranstoun

Harper House – a centre for learning

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Since opening Harper House in November 2022 we’ve been keen to develop the service into a centre for learning about the impact of substance use on the whole family, writes Rhia Walton, research manager. Harper House in Scotland builds on the work we started in England through the National Specialist Family Service in Sheffield.

Since opening Harper House in November 2022 we’ve been keen to develop the service into a centre for learning about the impact of substance use on the whole family
Child removal was likened to a bereavement, but with little or no formal grief support offered to mothers

I was keen to kick-start that process by hosting a conference to bring together research, practice, and lived experience to explore holistic, trauma-informed, and evidence-based approaches to supporting families, particularly parents with substance use issues, within family-centred residential services.

We held the conference in April and it included evaluative findings, comparative international perspectives, and reflections from mothers and specialist practitioners.

We’ll be developing further work around the key themes of the conference over the next few years.

Some of the key themes that emerged were the description of a fragmented system that is stacked against mothers who use or have used substances. Child removal was likened to a bereavement, but with little or no formal grief support offered to mothers. The expectations of mothers were unclear or unachievable. In summary, mothers seemed to be set up to fail.

The conference heard from Dr Claire Smiles about the lived experience of mothers. Common themes of child loss through the care system were loss, shame, fear of surveillance, need for emotional safety, and lack of holistic support. Mothers express a deep value placed on motherhood and desire to be better parents than their own were.

Harper House – a centre for learning
Common themes of child loss through the care system were loss, shame, fear of surveillance, need for emotional safety, and lack of holistic support

Most notable perhaps, was the experience of loss of identity in child removal.

We also heard from Dr Miriam Boeri who has been developing an international comparison between Scotland and New Jersey. We were interested to learn that Scotland offers more comprehensive services but with more intense surveillance, whilst New Jersey provides less support but also less procedural intrusion. However, common to this research and our wider discussion, mothers in both settings report stigma, trust issues, and a lack of clear expectations in child protection systems.

To address this lack of trust in the system Edinburgh Council have developed a Specialist Support Pathways – PrePare. The PrePare programme provides integrated perinatal support for mothers using substances. Its non-judgemental approach builds trust with mothers in order to support mothers to stay with their children in a safe environment.

We were also keen to hear Dr Lynda Russell, who presented on the topic of mothers with experience of addiction, child removal and support services.

Dr Russell’s research focuses on the lived experience of mothers with substance use issues who have had one or more children removed from their care. The work draws from routine data, service staff input, and in-depth interviews with 12 mothers, revealing complex, emotionally charged themes that have deep implications for practice and policy.

In future blogs we’ll define the recommendations that emerge from this conference and our work across the UK supporting families.

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

The connection between substance use and mental health

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DDNWeb
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Substance use and mental health are deeply intertwined. For many, turning to drugs or alcohol isn’t about chasing a high – it’s a way to cope with emotional pain. But why does this happen? How does substance use begin as a form of relief and turn into a deeper struggle?

In this blog, we’ll explore how emotional distress can lead people to use substances as a coping mechanism, the cycle of self-medication, the impact of stigma, and how we can offer meaningful support, especially through our compassionate, community-based services.

The connection between substance use and mental health
Self-medicating can quickly become a cycle

Life can be extremely tough. For some, the weight of trauma, loss, or ongoing stress can feel unbearable. Many people who use substances are not doing so to chase a high – they’re trying to cope with emotional turmoil, or struggling with clinically challenging issues like anxiety, depression, PTSD, or unresolved grief. Drugs can offer a temporary escape – a way to numb intense feelings or silence intrusive thoughts. They can be seen as a way to provide relief in the short term, even though they often create more challenges in the long run. While they can take the pain away temporarily, substance use can also compound existing mental health issues, making them harder to navigate over time.

Using drugs to self-medicate
When someone feels overwhelmed, they may use drugs to self-medicate, to dull the pain or ease distressing emotions. But self-medicating can quickly become a cycle. The more a person uses substances to cope, the more they may need them to function. And as tolerance builds, they may need higher doses to achieve the same effect, increasing the risk of dependency.

This cycle can be incredibly difficult to break, especially if the underlying emotional pain remains unaddressed. It’s not a lack of willpower, it’s a response to distress. Running alongside this is often a physical dependency caused by symptoms that occur when you ‘withdraw’ or reduce the drug intake. This can be extremely difficult to move past.

The impact of stigma
Society often views drug use through a lens of judgment rather than empathy. This stigma can prevent people from seeking help or even admitting they have a problem, creating further isolation and emotional distress. But the reality is that the reasons behind drug use are often complex, and drug use spans all demographics, cultures, and socio-economic statuses. Mental health challenges can occur for anyone and drug and alcohol use can seem like a soothing option.

The connection between substance use and mental health
Ask open-ended questions and be willing to hear their story without interrupting

Supporting people who use substances
If you have a loved one who is using drugs, it can be difficult to know how to help. Start by listening without judgment. Ask open-ended questions and be willing to hear their story without interrupting. Show them that you care and are there to support them, whether that means helping them find professional support or simply being a compassionate ear.

Encourage them to explore resources that can help them address both their mental health and their substance use. Turning Point provides comprehensive support for people struggling with both issues, offering non-judgmental advice and pathways to recovery.

In Hammersmith & Fulham, Kensington and Chelsea we provide individually tailored support for people dealing with substance use. This includes access to a huge range of services to help deal with whatever challenges they might be facing. We can provide access to trained recovery workers in group sessions or one-to-one support, and we have a full programme of informal, supportive opportunities such as park fitness, coffee mornings, and friends and family drop ins. Our regular ‘Supporting emotions’ sessions help individuals to better understand and cope with emotions and handle distress with self-compassion.

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

Back to reality

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DDNWeb
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Prolonged-release buprenorphine could be a game changer when it comes to supporting prison populations, says Claire Illingworth.

Delphi were one of the first community drug services in England to offer a flexible-dose, prolonged-release buprenorphine (PRB) solution for subcutaneous injection. In 2021 Delphi proposed to introduce a PRB trial at HMP Manchester and HMP Buckley Hall – the trial began with an expectation of ten clients maximum, shared across two groups.

PRB has multiple advantages within prison settings. Firstly, the subcutaneous injection route allows for completely supervised administration, with a NICE evidence review for PRB finding no risks for diversion. Additionally, the prolonged release formula­tion allows for long-term in­jec­tions which reduces the frequency of dispensing and thus also supervision. The weekly or monthly doses also remove the daily administration requirements necessary for oral methadone and sublingual buprenorphine – this supports future recovery by allowing individuals to attend work in prison regimes and may facilitate easier transition post-release.

The HMP Manchester and HMP Buckley Hall trial was led by the head of medicines management within the DARS (drugs and alcohol services) team. The proposal and costings were approved by Greater Manchester Mental Health NHS Foundation Trust and Delphi proposed to complete case studies for each PRB client to measure qualitative and quantitative data.

INCLUSION CRITERIA AT INITIAL PROPOSAL

Prolonged-release buprenorphine PRB
PRB has multiple advantages within prison settings

Group 1 maintenance option (three clients)
•  Currently maintained on buprenorphine tablets
•  Sentenced for more than six months and not likely to be transferred or released
•  Actively engaging with DARS psychosocial interventions

Group 2 detox option (seven clients)
•  Currently prescribed methadone, maximum of 30mg
•  Sentenced for more than six months and not likely to be transferred whilst on treatment
•  Actively engaging with DARS psychosocial interventions
•  Looking to be abstinent from OST within four weeks

IN THE PRISONS DELPHI INTRODUCED PRB:

•  To offer services that mirror the community
•  To provide choice in detox options
•  To support plans for future recovery
•  To allow clients to attend work in prison regime
•  To remove the daily requirement for methadone
•  To reduce diversion chances

In June-July 2021 preparations began and the DARS team started speaking to clinical clients who met the criteria. The head of prisons shared information about the trial with governors across both prisons, the commissioner, and the regional drug strategy lead, and the PRB trainer delivered an administration session to all staff.

Following the information session 16 clients in HMP Buckley Hall expressed interest and the head of medicines management reviewed their records to plan 1-1 sessions. In November 2021, a delivery test order was made to HMP Buckley Hall with a start date of December. The maintenance clients were prioritised at this point, recognising their previous feedback about detox over Christmas with January for detox options.

A smaller number of clients at HMP Manchester were identified as ready for review and change. PRB officially started at HMP Buckley Hall on 1 December 2021 with two doses successfully delivered. The prison governors and commissioner were updated, and the numbers increased to five clients by 17 December.

CLIENT FEEDBACK FROM THE INFORMATION SESSIONS

•  ‘I found it interesting and want to change over.’
•  ‘I love the idea of this. It will be a game-changer, I just hope I can get on it.’
•  ‘I think this will be great for being released. I also think it will help break the cycle.’
•  ‘Very good that you can have this from an injection and I want this for myself and the trial run.’
•  ‘I found it very helpful and informative. All questions and worries were answered. I feel completely at ease after the talk and would definitely go on [it] if I was given the opportunity.’
•  ‘Very important. A shame it’s not everywhere in the community.’
•  ‘It was very good. I want to go on it as soon as possible. It sounds something I’d like to continue when I come out.’

For the clients who commenced PRB, the key workers supported them with a review within the week to assess any issues and identify solutions – for example around occupying their time or distraction techniques.

The plan now is that prescribers will attend weekly and review as needed, and PRB will be an agenda item on drug strategy meetings. New starters are reported on a spreadsheet so we can keep a continued record with feedback and the prescriber attends the service once a week to review prescriptions and administer doses. This is then followed up as required and as per prescription via the prescriber and nurses on site.

Prolonged-release buprenorphine could be a game changer when it comes to supporting prison populations
Emerging evidence supports the economic viability of PRB usage in correctional contexts

There are some clients who state they are feeling great, while another who had mental health issues before the transition feels the change of medication while accessing mental health medication has been a challenge.

The outcome in both prisons was favourable and the following recommendations were made: At Buckley Hall it was proposed to have treatments as an agenda item at drug strategy meetings, allowing the prison to be involved in the work and raise awareness of progression in the DARS service; to improve awareness of PRB as an option of treatment with HMP service providers; and for clients to be reviewed on a regular basis in addition to the prescriber clinic.

Emerging evidence supports the economic viability of PRB usage in correctional contexts. Cost estimates from 2020 demonstrated that switching just 50 incarcerated individuals, in a standard English prison, from methadone to PRB would reduce overall costs by £8,665 and save more than 3,000 hours of staff time. A recent Canadian cost comparison between PRB injections and sublingual buprenorphine/naloxone identified that whilst PRB did cost more than buprenorphine/naloxone, the reduction in staff time in preparing, administering, dispensing, and monitoring meant that PRB was more cost-efficient.

Currently Scotland and Wales recommend, based on evidence of previous trials, switching over to PRB if cost-effective within the prison. While it is now standard practice within Wales to prescribe PRB as part of release planning, NHS England have not recommended it because of operational and continuity of care challenges.

Our non-randomised multicentre mixed-methods trial of PRB with psychosocial intervention adjuncts aims to assess the treatment outcomes of both maintenance and detoxification options in incarcerated populations in England. Delphi will continue with PRB in HMP Manchester and use the lessons learnt from Buckley Hall to improve client care on PRB.

Prolonged-release buprenorphine outcome and feedbackClaire Illingworth is head of operations central at Delphi

Government accepts majority of sentencing review recommendations

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Government accepts majority of sentencing review recommendations
Around 60 per cent of people receiving sentences of 12 months or less go on to reoffend within a year

The government has accepted most of the recommendations in David Gauke’s Independent sentencing review, the Ministry of Justice has announced. ‘The majority of the recommendations have been accepted today in principle – with a sentencing bill due in the coming months,’ it says.

The recommendations amount to a comprehensive overhaul of sentencing policy, with a move away from short sentences – except in ‘exceptional circumstances’ – towards more use of suspended sentences and community punishments. The review was commissioned by the government after the prison system came ‘dangerously close’ to collapse last summer.

There will now be a ‘presumption against custodial sentences of less than a year’, the ministry states, in favour of ‘tough community sentences’ as around 60 per cent of people receiving sentences of 12 months or less go on to reoffend within a year. There will also be more intensive supervision courts, to ‘tackle the root causes of crime such as alcohol and drug abuse – forcing repeat offenders to take part in tough treatment programmes or face prison’.

Dame Carol Black’s Independent review of drugs pointed out that many people in prison were serving short sentences for mostly acquisitive crimes related to drug use, with little opportunity for effective treatment.

The government has accepted most of the recommendations in David Gauke’s Independent sentencing review, the Ministry of Justice has announced
Prisoner release dates will be ‘more dependent’ on their behaviour, to try to ensure more prisoners engage with education and employment activities

The justice secretary will ‘go further’ than the sentencing review’s recommendations, the government states, including ‘developing new ways in which offenders can undertake tough, unpaid work.’ This could potentially include street cleaning and filling in potholes, it says.

Prisoner release dates will also be ‘more dependent’ on their behaviour, to try to ensure more prisoners engage with education and employment activities. Most offenders on standard determinate sentences will be released after serving between a third and a half of their sentence. The government has also announced an increase in probation funding, alongside a ‘massive expansion’ in surveillance of offenders through increased use of tagging.

‘Our prisons are, once again, running out of space and it is vital that the implications are understood,’ said the lord chancellor, Shabana Mahmood. ‘If our prisons collapse, courts are forced to suspend trials, the police must halt their arrests. Crime goes unpunished, criminals run amok and chaos reigns. We face the breakdown of law and order in this country. The prison population is now rising by 3,000 each year and we are heading back towards zero capacity. It now falls to this government to end this cycle of crisis.’

DDN Conference 2025: programme

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DDN Conference programme

Read speaker bios here

8.30 am Exhibitors set up

9 - 10 am Registration

10 - 11.20 am Session one

Jamie Poole, Changing Futures

Levelling the field: How lived experience is proving a lifeline to those affected by multiple disadvantage.

Zack Haider, Intuitive Thinking Skills

New prospects: Changing the course of your future through the individual placement and support (IPS) employment programme.

Jon Roberts, Dear Albert and Andrea Knowles, Turning Point

LEROs at large! How do you work in partnership with providers while maintaining your independence?

Andrew, in conversation with Hannah, Social Interest Group

From the outside in: A personal journey from homelessness, showing how the right support is crucial.

 

DDN Conference programme Tea coffee networking

11.50 am - 1.00 pm Session two

Grahame Morris, MP Chair of the All Party Parliamentary Group on Drugs, Alcohol and Justice

Power in our hands: Politics starts with you – how we can all be agents for change.

Syncora/Acorn Recovery/Delphi

The ketamine challenge: How can we tackle the rise in ketamine use and provide appropriate support – with young people’s insights.

Kim Moore, Blossome

The ripple effect: Looking at how you can use self-compassion and self-care for yourself and your family – a story told from a very personal perspective.

 

DDN Conference programme Lunch networking

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

DDN Conference lunch sessionsHalf Measures is the one-man street-folk project of Arthur Perez. Launched in 2024 just after coming out of rehab, Arthur’s music unpacks the chaos of addiction, recovery, mental health, relationships, and the fragile process of rejoining society. ‘If I can make someone go “huh, I needed to hear that” and maybe laugh in the process, then I’ve done my job,’ he said.

Also due to take the stage is The Detox Factor, who said their ‘primary purpose is to inspire the addict who still suffers’. Click here to see The Detox Factor performing one of their tracks live.

Be sure to catch the craft and music sessions at lunchtime!

2.00 - 3.45pm Session three

Jim Duffy, Smoke Works, Boston

Feel the need, be the change: An exciting and innovative peer-led harm reduction initiative from across the pond!

An interactive session led by Mark Gilman from Harm Reduction Research, Policy and Practice

Bringing it back to you: Organising, mobilising, influencing… how do we get the right treatment and support for every one of us?

Conference close

DDN Conference programme National Motorcycle Museum

Easy access to crack ‘driving addiction’ in deprived communities

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The widespread availability of crack cocaine is ‘driving addiction, mental health struggles and homelessness’ in England’s deprived communities, says a new report from Birkbeck, University of London and the University of York
Many of the participants in the northern town felt that the easy availability of crack meant that it was ‘impossible’ to avoid

The widespread availability of crack cocaine is ‘driving addiction, mental health struggles and homelessness’ in England’s deprived communities, says a new report from Birkbeck, University of London and the University of York.

This is especially the case in the north, the document states. Researchers interviewed people with crack, opioid and alcohol dependency in two towns – one in the north and one in the south – who had been out of treatment for more than a year. Many of the participants in the northern town felt that the easy availability of crack meant that it was ‘impossible’ to avoid. The ‘ubiquity’ of the drug had been a ‘key feature in their initiation and inability to stop’, the report states.

Almost half of the untreated participants in the northern town were using crack, compared to just 4 per cent of those in treatment, ‘highlighting a major gap in support’. Three quarters of those not in treatment were also in urgent need of housing, while 85 per cent had serious mental health issues. People using crack reported spending up to £500 a day on the drug, ‘often relying on benefits, begging, or shoplifting’, the report states. ‘Service providers across England confirmed high numbers of untreated users and the challenges of supporting them,’ it adds.

Easy access to crack ‘driving addiction’ in deprived communities
Participants in the northern town using crack were much younger than in the southern town

While heroin users in the UK are an ageing population, there is ‘growing evidence of new cohorts of younger crack cocaine users’, the document says. Participants in the northern town using crack were much younger than in the southern town, whether in or out of treatment. ‘Crack users are also highly marginalised, making abstinence an ambitious goal,’ it adds. ‘There is no “gold standard” for treatment and no accepted form of substitution therapy. Rapid response and dedicated services may be most effective.’

‘Violence, poor physical and mental health, severed relationships, bereavement and homelessness were common among the participants we interviewed in both locations,’ said Professor Charlie Lloyd from the University of York. ‘Crack and opioid use were part of their extreme marginalisation and formal drug treatment meant little in this context, when the fundamentals of safety and warmth were in such short supply.’

‘Our empirical research across the two study sites has highlighted that those who are dependent on crack, opioids and alcohol face a myriad of complex and multifaceted needs: substance use being one unmet need among many others,’ added Dr Bina Bhardwa from Birkbeck’s Institute for Crime and Justice Policy Research. ‘This has led us to question – both conceptually and practically – ultimately, how we understand and respond to those with unmet needs in this area.’

Unmet need for substance misuse treatment available here

Gauke review signals shift away from short prison sentences

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Custodial sentences of less than 12 months should only be used in exceptional circumstances and use of community punishments should be increased, says the long-awaited final report of former justice secretary David Gauke’s Independent sentencing review
The review was commissioned after the prison system came close to collapse last year

Custodial sentences of less than 12 months should only be used in exceptional circumstances and use of community punishments should be increased, says the long-awaited final report of former justice secretary David Gauke’s Independent sentencing review. Suspended sentences should also be allowed for up to three years, the document states, including for low-risk offenders with substance use issues.

The review was commissioned after the prison system came close to collapse last year, with demand for places exceeding supply. The aim of the review is not only to reduce the prison population but also to address ‘other related challenges to the criminal justice system that will reduce future pressures’, Gauke says in the document’s foreword – including reducing reoffending.

The three ‘foundational principles’ of the review are to ensure that sentences ‘punish offenders and protect the public’, that they ‘encourage offenders to turn their backs on a life of crime’ and that greater use is made of ‘punishment outside of prison’. However, if more offenders are to receive community sentences these need to be ‘effective and properly enforced’, Gauke states.

The review supports more investment in community sentence treatment requirements (CSTRs) ‘which will be particularly important for prolific offenders with drug and alcohol addiction needs’. While out of court resolution and diversion were outside the scope of the review’s terms of reference, the evidence ‘indicated that the government should also consider whether earlier intervention, entirely outside the criminal justice system, in services such as housing, substance misuse and employment, may be more appropriate for low-risk offenders’, it adds. ‘This would require a cross-government effort.’

Professor Dame Carol Black highlighted in the first part of her Independent review of drugs that more than a third of the people in prison at the time were there for – mostly acquisitive – crimes related to drug use, and serving short sentences that gave little time for any kind of effective treatment. This created a situation where drug users were ‘cycling in and out of our prisons at great expense but very rarely achieving recovery or finding meaningful work’, she said, and meant they were consequently ‘very likely to re-offend’.

Gauke review signals shift away from short prison sentences
The review supports more investment in community sentence treatment requirements

‘What we haven’t achieved yet is enough diversion from prison, but I’m hoping David Gauke’s forthcoming sentencing review will help that,’ she told DDN earlier this year.

The problem, however, was that diverting people meant having somewhere to divert them to, she said  – ‘high-quality treatment in the community where you can hold people carefully and appropriately, and that has not been easy to achieve. The workforce is simply not there.’

Less than half of people released from prison in 2023-24 also had settled accommodation on their release, according to a report from earlier this year, with 13 per cent either homeless or sleeping rough.

The sentencing review was a ‘once in a generation opportunity to reset the sentence framework so that it is more focused on reducing reoffending and keeping the public safe’, said Prison Reform Trust chief executive Pia Sinha. ‘Proposals to expand the use of effective community alternatives and limit pointless short spells in custody will not only free up limited prison capacity but also lead to better outcomes for victims and wider society. We hope the government will accept and implement the majority of measures in this review and we look forward to its response.’

‘This is a watershed moment for a prison system which has been pushed to the brink of collapse,’ added Nacro chief executive Campbell Robb. ‘The government has a rare opportunity to turn the tide on escalating prisons sentences that have fuelled the prison overcrowding crisis. We are glad to see a recommendation of a presumption against prison sentences of less than a year. Restricting the use of short prison sentences has the potential to reduce reoffending, save money and give people the best chance of a second chance, something we will all benefit from.’

Independent sentencing review: final report available here

DDN Conference 2025 exhibition details

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DDN
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Thank you to everyone who has booked an exhibition space at the DDN Conference! The details for exhibitors are below.

If you have not yet confirmed your booking it’s not too late! Please contact ian@cjwellings.com today.

QUICK LINKS:

Timings, venue details, accommodation and set up

Information for stand deliveries 

Delegate names 

Invoicing

Contact for questions: Ian Ralph: ian@cjwellings.com – 07711 950 300

Timings, venue details, accommodation and set up

Date and timings
The conference is on Thursday 10 July. The conference programme will run from 10am – 4pm with breaks for refreshments and lunch. Registration will be from 9am.

Venue
The event will be held at the National Conference Centre (The National Motorcycle Museum), Birmingham, B92 0EJ. The venue is easy to reach by both car and public transport and offers free parking. Full details on location, accessibility and other information on the venue can be found here.

Accommodation
The DDN team are staying in the Arden Hotel which is close to the conference venue. The conference room allocation has now been released but you can find hotels close by here or on booking.com  (other hotel websites are available..) The DDN team will be having a small get together in the bar the night before the event, it would be great to see you there.

There are other hotels close by in the NEC, or Birmingham city centre is only 20 minutes away.

Exhibitor set up
Exhibitors will have access to set up stands from 8:30am on the morning of the conference. There will be limited availability to drop stands and materials off at the venue between 2-4pm the afternoon before (Wednesday 9 July) but you will not be able to set your stand up until the morning of the event. Please let Ian know if you are dropping off material the day before.

Exhibition space
You have an exhibition stand which will be a tabletop and chairs with space for pop up banners and stands. Please email if you have specific requests such as power or need extra space for stands etc.

As those of you who have attended before will know, this is a vibrant area at the heart of the event and interactive stands and giveaways are incredibly popular.

Information for stand deliveries 

Delegate bag inserts and information for couriers
The deadline for sending inserts for delegate bags is Thursday 3 July. The bags are being packed by volunteers at Better Together.

We are expecting 500 delegates. Please send all inserts to:
C/o Nicky Dwyer
Better Together
21 Warwick Grove
Olton
Solihull
B92 7JL

Email and phone contact for couriers:
nicholas.dwyer@bettertogether-src.org.uk
07480 463 179

Please label all deliveries DDN Conference.

Deadline for delivery is Thursday 3 July.

—

If you are sending your stand via courier a day or two before the event, please send it to the details below.

If you are popping it in the day before, please go to reception and ask for Michelle Cruise. She will store your materials and it will be waiting for you in the exhibition area on the day of the event. Please note, you will not be able to access the venue itself the day before as another event is taking place.

Stand delivery/drop off
Attention Michelle Cruise, Events Planner, MichelleC@nationalconferencecentre.co.uk, 01675 444149.

The National Conference Centre (at the National Motorcycle Museum)
Coventry Rd
Bickenhill
Hampton in Arden
Solihull
B92 0EJ

Please ensure all stands are clearly marked DDN Conference 10 July.

Please email Michelle in advance and copy in ian@cjwellings.com.

DDN cannot take responsibility for delivery or pick up of stands from the venue.

Delegate names

We will be issuing delegate badges at the event in the same customisable format as last year, so there is no need to supply a list of names! We just need the number of people attending.

Invoicing

You will be emailed an invoice for your booking to be paid in advance of the event by either BACS or credit card. If you have any questions regarding the invoicing, please contact accounts@cjwellings.com.

We hope this helps you prepare for what should be a fantastic, interactive, energetic and inspiring event. If you have any questions or would like to discuss the event or DDN magazine, please contact ian@cjwellings.com – 07711 950 300.

 

Details of the event, speakers and programme coming soon.

European teens taking fewer drugs but vaping more

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Substance use among European 15-16-year-olds is continuing its ‘long-term decline’ but there are growing concerns over ‘new behavioural and health risks’, according to the latest findings from the European school survey project on alcohol and other drugs (ESPAD).

European teens taking fewer drugs but vaping more
‘New behavioural and health risks’ include increasing e-cigarette use, non-medical use of prescription drugs and a ‘sharp uptick’ in online gambling

These include increasing e-cigarette use, non-medical use of prescription drugs and a ‘sharp uptick’ in online gambling, the report says. Almost 114,000 young people across 37 countries participated in the survey, which is based on anonymous online questionnaires.

While fewer European teens are drinking alcohol or smoking traditional cigarettes, e-cigarette use is on the rise, the report states. Lifetime alcohol use among 15-16-year-olds stood at just under 90 per cent 30 years ago but has now fallen to 74 per cent, while use in the last 30 days fell from 55 to 43 per cent. Reported binge drinking in the last 30 days also fell to its lowest rate, at 30 per cent.

However, current e-cigarette use is up from 14 to 22 per cent since 2019, with more girls reporting lifetime use than boys – 46 compared to 41 per cent. Around one in eight school students reported ever having used an illegal drug, with lifetime prevalence falling from 19 to 14 per cent over the last decade. Lifetime use of cannabis has fallen to 12 per cent, while 3 per cent of students report having used NPS. Reported use of amphetamines, MDMA, cocaine and LSD were all around 1 to 2 per cent.

Substance use among European 15-16-year-olds is continuing its ‘long-term decline’ but there are growing concerns over ‘new behavioural and health risks’, according to the latest findings from the European school survey project on alcohol and other drugs (ESPAD)
Non-medical use of pharmaceutical drugs was a ‘growing concern’

Non-medical use of pharmaceutical drugs was a ‘growing concern’, however, with lifetime use now at 14 per cent. This was more common among girls (16 per cent, compared to boys’ 11 per cent) with tranquilisers and sedatives the drugs most frequently misused. ‘The perceived ease of obtaining these substances — one in five students say tranquillisers are easy to access — underscores the need for targeted prevention and monitoring of prescription drug misuse among teens,’ says the report. Online gambling rates, meanwhile, have almost doubled in the last five years, to 14 per cent.

‘Despite long-term declines in substance use, emerging trends raise new concerns,’ says the document. ‘Cigarette smoking has decreased markedly over the past decades, with lifetime prevalence halving over the period 1995–2024. Early initiation persists, however, particularly among girls, whose daily smoking rates at age 13 or younger have increased in recent years. Meanwhile, e‑cigarette use has risen sharply among adolescents, with rising rates of early initiation and daily consumption, fuelling concerns over the dual use of traditional and electronic cigarettes and reflecting a broader shift toward alternative nicotine products.

Alcohol consumption has also declined over time, with overall use and binge drinking decreasing. However, this reduction is more pronounced among boys, with girls showing a more stable trend. Despite this progress, alcohol remains widely accessible, and early initiation and heavy episodic drinking remain significant concerns in some regions.’

European School Survey Project on Alcohol and Other Drugs (ESPAD): 30 years available here

Drug deaths taking toll on UK life expectancy

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DDNWeb
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Drugs, violence and suicide are contributing to rising death rates in under-50s in the UK, says new analysis from the Health Foundation – in contrast to other wealthy countries.

Drugs, violence and suicide are contributing to rising death rates in under-50s in the UK, says new analysis from the Health Foundation – in contrast to other wealthy countries
While drug-related death rates in peer countries have continued to decline, in the UK they have risen sharply

The briefing document compares trends in mortality both within the UK and with more than 20 other high-income countries, based on new research by the London School of Hygiene and Tropical Medicine. ‘The findings are stark, underlining deep inequalities in health between different parts of the UK and a worrying decline in UK health compared with international peers,’ it states.

The 2010s saw improvements in UK mortality rates slow significantly across all UK nations and regions, more than in ‘most other countries studied’. As of 2023, the UK mortality rate for women was 14 per cent higher than the median for peer countries while the male mortality rate was almost 10 per cent higher. Scotland, Wales and Northern Ireland all have higher mortality rates than England, with Scotland performing ‘particularly poorly’.

People aged between 25 and 49 have seen a ‘particularly pronounced’ relative worsening of mortality rates, the briefing says, with UK female mortality rates for this age group almost 50 per cent higher than the peer country median. While mortality rates for cancers and circulatory diseases improved for this age range between 2001 and 2019, death rates for ‘external causes’ went up. While drug-related death rates in peer countries have continued to decline, in the UK they have risen sharply.

There were almost 5,500 drug-related deaths in England and Wales in 2023, up 11 per cent on the previous year, while Scotland has long had the highest drug-related death rate in Europe. Of all the countries studied for the briefing, the only country with a higher overall mortality rate than Scotland was the US.

There are also ‘stark’ geographical inequalities in drug-related mortality within England, the report stresses. In the North East, drug-related mortality rates increased by nearly 300 per cent for women and 120 per cent for men between 2001 and 2019, and in the West Midlands by 156 per cent and 96 per cent. ‘On the other hand, rates barely changed in London and the East of England’, it states. For alcohol-related deaths, meanwhile, mortality rates are three times higher in the North East than in London. While mortality rates for suicide and ‘deaths of undetermined intent’ also went up, the increases were lower than for drug-related deaths, it points out.

Drugs, violence and suicide are contributing to rising death rates in under-50s in the UK
A wide range of evidence shows that the UK’s health is ‘fraying’, the report states

A wide range of evidence shows that the UK’s health is ‘fraying’, the report states. ‘Improvements in life expectancy have stalled, a growing number of people are expected to live in ill health, and deep inequalities in health persist between the poorest and wealthiest communities.

‘With the UK comparing poorly with many other high-income countries, improvement is both possible and urgently needed,’ it continues. ‘This will require long-term action for economic recovery in areas of long run industrial decline; a strong focus on prevention; investment in public health services and action to address risk factors such as smoking, alcohol and poor diet; and a concerted effort to tackle drug-related deaths. These actions should be brought together in a clear strategy for tackling health inequalities. The UK government’s health mission promised just such an approach, but progress so far has been slow. This needs to change or the UK’s health will fall further behind its international peers.’

‘Many drug overdose deaths are preventable,’ added chair of the Local Government Association’s Community Wellbeing Board, David Fothergill. ‘Ensuring robust practices are in place, along with the policies or protocols to support those at the greatest risk, can prevent overdoses and subsequent fatalities. As well as this, we must support and expand the provision of naloxone, a drug that can reverse the effects of an opiate overdose and provide overdose training for drug service users, drug users not in treatment, family and friends, hostel residents and others.’

UK mortality trends and international comparisons available here

From small acorns

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DDNWeb
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Acorn Recovery Projects

Acorn housing

Acorn Recovery Projects has been helping people break free from drug, alcohol, and other addictions since 1997. Over the last three decades, it has utilised the power of lived experience to help people across Greater Manchester and Lancashire work towards lifelong recovery.

As a pioneering LERO, Acorn has a variety of housing options available to help people seeking sustainable recovery to move towards fully independent living. These services include residential rehabilitation, community programmes – and supported housing.

For six years, Acorn Recovery Projects’ supported housing project has been quietly revolutionising the lives of those who need it most. This unique initiative is giving a fresh start to individuals who have faced the toughest barriers to accessing help – people whose lives have been shaped by homelessness, addiction, and involvement in the criminal justice system.

Supported housing provides a safe environment for people who are looking for a place to stay and rebuild their independence following substance misuse and homelessness. Acorn works in close partnership with prison services, probation, local housing and substance misuse providers to make sure that we take the right approach for people’s needs and recovery.

Acorn’s team understands that lasting change requires more than just housing – it demands holistic care
Acorn’s team understands that lasting change requires more than just housing – it demands holistic care

Their innovative and compassionate approach begins with a flexible assessment process that focuses on the individual’s needs, supported by a network of collaborative partnerships – including Lancaster City Council, Manchester City Council, Delphi Medical, Walter Lyon Trust and Rochdale Borough Council.

Acorn’s team understands that lasting change requires more than just housing – it demands holistic care. Using a person-centred approach, they identify past barriers and work with clients to build the skills and resilience needed to maintain their own tenancy. By collaborating with partners, Acorn connects residents to community resources that foster stability and growth.

‘Our goal is not just to provide a roof over someone’s head,’ explains a member of the Acorn team. ‘We’re here to empower people to rebuild their lives and thrive in their communities.’ One shining example of Acorn’s impact is their Manchester project where, as well as high quality housing, residents can access programmes like the dependency emotional attachment programme (DEAP).

DEAP is an intensive therapy course, delivered by professional counsellors, that helps clients confront and heal deep-seated emotional challenges. It supports people in long-term recovery by exploring their personal experiences with addiction and addressing any unresolved emotional or attachment issues. During the 12-week course, individuals develop skills and strategies for maintaining abstinence and building a new life in recovery.

Every property within Acorn’s portfolio has its own identity, designed to cater to the diverse needs of residents. During the intake process, the team carefully matches clients to the most suitable project, taking into account the dynamics of current residents and the resources available in each location. The result is a network of housing solutions where values remain consistent, but support is personalised.

Steven Riley started using drugs and alcohol at 13 – it destroyed his relationships and health. After living on the streets and years of prison sentences he reached out to Acorn
Steven Riley started using drugs and alcohol at 13 – it destroyed his relationships and health. After living on the streets and years of prison sentences he reached out to Acorn

Steven Riley’s story is a testament to the transformative power of Acorn’s approach. ‘I started using drugs and alcohol at 13, beginning with cannabis and moving on to crack and heroin,’ he says. ‘My addiction destroyed my relationships, my health, and my ability to manage a home. I ended up living on the streets, unable to see a way out.’

After years of prison sentences and drug abuse Steven hit rock bottom, and during his last sentence he reached out to Acorn. Upon release, the team provided supported housing, giving him the stability and care he desperately needed.

‘Acorn changed my life,’ he says. ‘I received one-on-one counselling, group therapy, and training courses, all through their programmes. Today, I’m in low-level supported housing, volunteering, and looking forward to a brighter future.’

Acorn’s commitment to empowerment doesn’t stop with housing, however. Over the past two years, eight former residents have transitioned into employment – either with Acorn or one of their partner agencies.

This emphasis on personal growth creates a ripple effect of positive change, not just for individuals but for the communities they serve. It also shows the value of lived experience by empowering and inspiring clients using the insights of people who have had similar life experiences.

Acorn’s dedication to delivering high-quality support is unwavering. Their team’s hard work and belief in the power of community make them a beacon of hope for those in need.

Through compassion, collaboration, and creativity, Acorn proves that change is possible – even for those society has often overlooked.

To find out more about Acorn Recovery Projects, visit acornrecovery.org.uk

Darren Lang is team leader at Acorn Community and Prison Services. Gary Mills is service manager at Acorn Community and Supported Housing

Stop weaponising stigma

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We have seen again this weekend a shocking example of stigmatising, offensive and counterproductive media reporting 'zombie drug horror', writes Phoenix Futures Chief Executive Karen Biggs.
Phoenix Futures Chief Executive Karen Biggs

We have seen again this weekend a shocking example of stigmatising, offensive and counterproductive media reporting ‘zombie drug horror’, writes Phoenix Futures Chief Executive Karen Biggs.

I’m not encouraging you to read it, not least because the media outlet concerned shouldn’t be rewarded by high click rates for these offensive articles. But needless to say it contains derogatory language, dehumanising images and videos and othering of people.

The trigger for the article is the release of a report from government on a multi agency response to preventing deaths, Local Preparedness for Synthetic Opioids in England.

The report shows good multi agency working between government, public health and the police. The government’s release was balanced and non-stigmatising – an improvement on previous releases and I like to think in part as a result of the adoption of our Anti-Stigma Language Guide.

We know the government share a commitment to taking an anti-stigma approach and that they see it as a necessary underpinning of all approaches to reduce drug-related deaths.

We have seen again this weekend a shocking example of stigmatising, offensive and counterproductive media reporting 'zombie drug horror'
The irony is clear – in reporting on a life-saving initiative our big media are increasing the risk of people dying

We have plenty of research that shows the impact of language informing society’s views and policy approaches.

More specifically recent research led by Harry Sumnall into the use of the zombie trope concluded: ‘Our study is the first to show that dehumanising “zombie” framing frequently used in news reporting is associated with higher public stigma towards people who use drugs. News media is an important source of public education on drugs, so to avoid reinforcing stigma the use of dehumanising language and framing, such as “zombie” metaphors, should be avoided. Organisations working to reduce stigma towards people who use drugs should encourage news outputs and journalists to avoid this type of representation.’

So we have awareness, education, evidence base and a commitment to take a non-stigmatising approach to preventing death – so why do we have to still see the most dehumanising images in our national media?

The irony is clear – in reporting on a life-saving initiative our big media are increasing the risk of people dying. One could be justified in thinking it was a purposeful attempt to undermine the initiatives that will prevent people from dying.

The Anti-Stigma Network analysed the comments below this most recent article to get a sense of how the piece landed with the public. This is what we found:

  • Many responses advocate for harsh punitive measures, including in the most extreme, death penalty for dealers, withdrawing NHS treatment, euthanasia or abandonment of people who use drugs.
  • There was frequent use of dehumanising language (e.g., ‘junkies’, ‘scum’, ‘halfwits’) and metaphors (e.g., ’round them up’, ‘dump them in the sea’) reflecting the deep stigma and moral judgment directed at people who use drugs.
  • Several comments express distrust in government, belief that authorities have lost control and criticism of public health messaging.
stigma - zombie drug horror
There was frequent use of dehumanising language (e.g., ‘junkies’, ‘scum’, ‘halfwits’)

You could argue that the below the line comments on these articles are always the extreme but they are still part of the article. This is an online news outlet with one of the biggest reaches of all mainstream newspapers. I am sure its reach makes it an attractive first stop for launching initiatives. But is it really the best way to launch good initiatives to save lives when it works counter to that aim? When it increases stigma, discrimination, distrust of government agencies providing the support. When it makes it harder for people to seek life-saving treatment and the consequence will inevitably be an increase in preventable deaths.

As others have expressed this week it does feel like all roads lead to the media. Not all media, some of the reporting on this topic was compassionate and balanced. But it’s easy to feel powerless and frustrated.

I would urge us all to be more cognisant of the media we engage with – whilst we might identify an opportunity to get our point across – not all press is good press and what might look like an opportunity might indeed be working against the points we are trying to make.

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

Stigma, grief and love: a conversation with my mum

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

 

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

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

 

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

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

Fern.

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

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

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

This content was created by the Anti-Stigma Network

Healing together: the power of peer support in mental health

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

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

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

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

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

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

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

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

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

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

This content was created by the Forward Trust

Irish campaigners keep up alcohol health labelling pressure

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

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

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

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

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

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

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

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

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

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

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

Provisional drug overdose death counts here

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

Home Office issues new synthetic opioid guidance

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

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

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

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

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

Local preparedness for synthetic opioids in England here

Record-breaking cocaine seizures ‘now the norm’ globally

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

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

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

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

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

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

InSight Crime 2024 cocaine seizure round-up here

First… do no harm

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

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

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

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

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

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

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

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

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

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

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

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

Sign up for Understanding Tobacco Harm Reduction here

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

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

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

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

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

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

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

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

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

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

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

From lived experience to leadership

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

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

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

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

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

Essex Recovery Foundation - lived experience

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

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

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

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

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

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

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

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

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

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

From lived experience to leadership

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

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

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

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

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