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More than 60 per cent of people dying a drug-related death in Scotland lived alone

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More than 60 per cent of people dying a drug-related death in Scotland lived aloneSixty-three per cent of people who died a drug-related death in Scotland lived alone ‘all of the time’, according to new analysis by Public Health Scotland (PHS). The agency has published a review of the circumstances of everyone who experienced a drug-related death in the country in 2019 and 2020.

Just under half of the people who died had previously had a near-fatal overdose, the document states, while a third had been discharged from a general acute hospital in the six months before death. Two thirds had been in contact with treatment or harm reduction services in the six months before death, rising to more than 70 per cent of people whose death was opioid-related. More than a third were on an OST prescription, predominantly methadone.

Just over half of the people who died had been living in the country’s 20 per cent most deprived neighbourhoods, with the average age of death 43, and more than 600 children were reported to have lost a parent or parental figure to drugs in 2020.

More than 600 children were reported to have lost a parent or parental figure to drugs in 2020
More than 600 children were reported to have lost a parent or parental figure to drugs in 2020

In the six months before death, 52 per cent of people had a medical condition – primarily respiratory illness, BBVs or epilepsy – recorded, while 46 per cent had a recent psychiatric condition recorded.

Scotland has long had the highest rate of drug-related deaths in Europe, with the total for 2023 standing at 1,172 – a year in which the country also recorded its highest number of alcohol-related deaths since 2008.

‘This report is hugely important for improving our understanding of the individual people who have sadly lost their lives to a preventable drug overdose in Scotland,’ said PHS consultant Dr Tara Shivaji. ‘The scale of the issue is often represented as a statistic, but we know each person represents much more than this. They are mothers, fathers, sons, daughters, siblings, friends and colleagues. Through this report, we can paint a picture of the circumstances that are potentially driving the ongoing drug-related death crisis and recognise high-risk scenarios and trends when people are particularly vulnerable – for example, when a person is discharged from hospital. With this information, we can identify if there is more we can do to intervene and prevent these deaths from occurring.’

Meanwhile, an open letter to the prime minister and chancellor from the Association of Directors of Public Health ahead of this month’s budget – and signed by almost 50 organisations – is calling for more funding to tackle health inequalities, tied to a ‘coherent, cross-government approach’.

We simply can’t meet the city’s needs without increased – and longer-term – funding.
‘We simply can’t meet the city’s needs without increased – and longer-term – funding.’

While praising the decision to re-introduce the tobacco and vapes bill the document points out that the public health grant has been reduced by more than a quarter in a decade, with too many people ending up in hospital ‘because too little is spent in the community’ according to Faculty of Public Health president Kevin Fenton.

‘The staff on the ground in our drug and alcohol treatment services work exceptionally hard and do a fantastic job to provide a safe, non-judgemental environment for people to get help and support,’ said Newcastle’s director of public health, Alice Wiseman. ‘However, they are working at maximum capacity. Take into account that we are currently supporting just 40 per cent of Newcastle’s opiate and crack cocaine users, and only 26 per cent of the people who would benefit from support for alcohol use, and you can see just how difficult the situation is. We simply can’t meet the city’s needs without increased – and longer-term – funding.’

National drug related death database (Scotland): analysis of deaths registered in 2019 and 2020 available here

Open letter available here

Room to live

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DDNWeb
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Camerados

Camerados provides public living rooms for people to find company and connection, with no agenda, no judgement – and no attempts to ‘fix’ them. It’s a model that could have some valuable lessons for other sectors, including the drugs field.

One of the most popular parts of this year’s DDN conference was the ‘public living room’, a space for delegates to relax, chat and connect with each other. It was provided by Camerados, a social movement founded in 2015 by Maff Potts and which now has 250 of these spaces across five countries.

‘There was a real solidarity and camaraderie at that conference,’ says Potts. ‘One of the things that the drug and alcohol space does very well is involve people with lived experience, and if you have a room full of people who’ve been through a lot there’s inevitably a warmer atmosphere.’

The idea for Camerados came after two decades working in the homelessness sector, including as a project manager for Crisis and the Salvation Army’s national director of homelessness services. ‘It was 20 years in traditional institutional organisations, and it doesn’t get more traditional than the Salvation Army – massive warehouses of 150-bed hostels for men on the Clyde or in the East End’, he says.

Camerados being there and listening
One of the key tenets of Camerados is that it’s about a human connection – being there and listening – rather than setting out to ‘fix’ people

Isolation kills
It was here that he became accustomed to his Blackberry regularly buzzing to inform him of another death. ‘Some of the projects were fantastic, but with others I couldn’t find out what was going on, so I’d check myself in as homeless to stay overnight. And of course when you chat to the lads in there you find out everything.’ This led him to investigate all of the deaths that had occurred over the previous year, and he found there was one common denominator – isolation. These were people who’d ‘cut themselves off from everyone’, he says, and he began to grow increasingly disillusioned with the officially sanctioned ways of responding.

‘The single biggest reason for homelessness has always been relationship breakdown, and yet all we ever talked about was housing and benefits. We never focused on what actually mattered. From my very early days when I used to volunteer in shelters, it was obvious that the biggest thing people wanted was companionship.’

One of the key tenets of Camerados is that it’s about a human connection – being there and listening – rather than setting out to ‘fix’ people, he stresses. ‘Institutional models are often predicated on a structure where the board requires a certain amount of data to make decisions. So everyone builds services based on that, and by the time it gets to the beneficiary you’re basically saying, “Can you please have your mental health breakdown between 9.30 and 4.30?” We end up dancing to the tune of the system, and I just got hugely disillusioned with that.’

He decided the answer was to ‘cut out organisations altogether, and go direct to people in their neighbourhoods’. It was also vital not to make it about homelessness, he says. ‘Because the labels were bullshit. These were people exactly like me, it was just that they were having a tough life. That’s why Camerados living rooms are popular in places like hospitals and university campuses. There might be homeless people in them, there might not. It’s just anyone having a rough day who needs a bit of company.’

No agendas
His time in the homelessness sector also taught him precisely how not to interact with people, he believes. ‘My staff would get in people’s faces, ask them deeply personal and invasive questions, and often this was their very first contact – they’d proceed to tell them what they needed to do to turn their life around. We need spaces where that’s not happening, because people feel invaded. Wherever they go they’re defined by their problem, given a label, and told what they need to do to. So it’s about having a space where people aren’t doing that – you can talk about anything, there’s no agenda.’

This can pay huge dividends, even if it’s not immediately obvious. ‘People open up, they relax, the shoulders go down – and eventually they talk in a much more open way about the things that really matter to them, so they are making progress. But if you set out to get an outcome, you close that off. We’d be having a chat about music or whatever, and then I’d turn the conversation around to their support plan, and you could see their expression – they thought we were having a connection, but no. And a lot of these people had way more life experience than me – it was embarrassing.’

Room to live Camerados

Worldwide movement
This is one reason why he’s determined that Camerados never moves to an organisational model, he says. ‘Something happens when you grow over a certain size. You start adopting institutional behaviours.’ That’s not to say the movement isn’t growing fast, however. There are 250 living rooms across the UK, US, Australia, New Zealand and even Sierra Leone, with more now planned for Kenya, Rwanda and Mexico following a successful Camerados side event at the recent UN General Assembly in New York. However, at its core Camerados remains ‘defiantly small’, with just five staff – most of whom are part-time – alongside associate members here and overseas. It works on an ‘open source’ model, where anyone who wants to set up their own living room can get in touch, have a chat over Zoom and then receive a box containing everything they need.

This year’s UK Recovery Walk hosted one, and people ‘really connected with it’, he says. ‘I think that’s because the language in some drug services can be quite jargonistic. If someone comes into drug or alcohol services, the chances are they’re at some point of crisis – otherwise they’d be quite happy just taking their drugs. They’re very anxious, very low in confidence, and they come into places that can be cold and clinical. That’s not all environments, of course, but if you think about the places you’re going to end up in times of crisis – police stations, council offices – they’re not covered in fairy lights and comfy seats like the living rooms.’

Maff Potts CameradosThings like opening times are also often designed to work for the service, rather than the service users, he says. ‘All of it is trying to set up a process to systemise the management of the problem and de-risk it. There’ll always be some new initiative, with a new acronym and a new outcome and all that. But the only thing complex enough to handle the complexity of a human being is another human being. There’s no process system that can fully understand the baggage you bring, which is often incredibly complex and hard to unpick. So many times I’d sit with someone thinking, where do you start? And where you start is by putting the kettle on. Connection has to be the answer, letting the person unravel it for themselves. This notion that you can somehow get a system to do it is kind of absurd, because sorting out one life is a lifetime’s work.’

That’s not to say that that substance services aren’t absolutely vital, he stresses. ‘We’re not the elixir for all ills. My wife works in mental health services – we need mental health services, we need drug services. This is alongside, not instead of. It’s the connection bit, the company bit, and a lot of drug workers probably don’t have time to do much of that.’

It was in a previous project that he’d come across what can sometimes be the intransigent attitude of some services, he points out. ‘Before we hit on the public living rooms, we had this other idea which wasn’t quite sustainable. We’d take a group of ten or 15 people having a very tough time – prison leavers, drug users, homeless people – and we’d start a micro-business in four weeks.’ The idea was to galvanise them and provide the things that underpin Camerados, he says – connection and purpose.

Room to live feature - Camerados

It’s ok to fail
‘In one we were working with people who were active drug users, and we started a business dressed as Christmas elves outside Debenhams where we’d wrap people’s Christmas presents for a couple of quid. One weekend we made £750, which is a lot of presents. People would be handing over their Prada and Gucci stuff to active crack users who’d wrap it for collection a couple of hours later, and obviously they thought this was hilarious – because in their normal life you know what would happen. So it was kind of wonderful. But someone from the local drug service said, “You’re putting lives at risk, because if this business fails these guys will go out and binge and you’ll have blood on your hands.” And I said, “If this business fails what we’ll do is piss ourselves laughing.”

‘So we normalised being a bit shit and failing,’ he says, ‘instead of what they were doing which was to catastrophise failure. When people relapse it’s like the end of the world, just like how I used to evict people because they’d missed a couple of rental payments.’

Keep it human
For anyone tempted to set up their own living room, the best model is ‘alongside, adjacent to’ services, where staff and service users can mix ‘as humans,’ he says. ‘I always say that everything should start with a pizza, because if you arrange a meeting you’ll get people talking like they’re in a meeting. If you order pizza, people are in a different space. You can have a call with Camerados where we’ll talk about the principles and everything else, and we’ll send you a box for free with everything wrapped and handwritten notes. All you’ve got to do is have a space and add some furniture. Just do it once for a couple of hours, and after that you might do it once a week, and so on. Fumble through it – don’t organise the humanity out.’

Camerados living room
The best model is ‘alongside, adjacent to’ services, where staff and service users can mix ‘as humans’

Ultimately the aim is just to be ‘a space in the neighbourhood where people can go when they’re having a rough time and have some company,’ he says. ‘I want it to grow to be a thing where people say, “Get yourself down to the public living room,” because there’ll be one somewhere. If you look at Alcoholics Anonymous, one of the strengths is that there could be ten meetings happening tonight and you could find one. You pass the cup around, you pay for the room, and you’re done. I just want there to be loads of these things around the world run by people in that community. And if four or five people turn up, great.’

It all ties in with one of Camerados’ six key principles, which is ‘it’s OK to be a bit crap’, he says. ‘It stops it becoming too system-y. People connect better and drop their guard – I think it really strikes a chord that sometimes we’re a bit shit.’ One principle that can seem counterintuitive, however, is ‘if you see someone struggling, ask them to help you,’ he says. ‘When I’ve been with someone and absolutely not known what to say – maybe they’ve told me they want to kill themselves – the only thing that’s ever worked is when I say, “I’m really sorry to hear that. Listen pal, can you do me a favour?” And I’ll find something I need. The person comes out of the gun barrel of their own problems, they feel trusted, they feel they’ve got value to add. A lot of services sit in front of people as if they have all the answers, so it’s actually quite nice for someone to hear “I need your help with something.”’

Don’t be alone
But it’s the principle of not fixing people that can be the trickiest for many people to understand, he acknowledges. ‘If there’s no specified outcome they might think, “What’s the point?”

But there is a point. As much as he enjoyed the DDN conference, there was one thing that proved unexpectedly difficult, he says. ‘It was the memorial where you wrote the name of someone who’d died. I wrote the name of a young guy from the early days of Camerados, who was absolutely wonderful. He had so few people in his life because they’d all died from drugs, including his parents. All he wanted to do was outlive his parents, and he didn’t. He was a lovely guy in his mid-thirties and he’d been in and out of prison and was living in a flat with almost no furniture, but he was endlessly charming and sweet and a fantastic artist – we’d get him to do lots of artwork for us. So his death was a huge blow.

‘His name was Rhys and when he died of an overdose I thought about jacking the whole thing in. I was a pallbearer at his funeral – I wasn’t close particularly, but he just had no one. I’d been to a lot of funerals like that, working in homelessness. I remember sitting in the crematorium thinking, “Well, we didn’t help”. And then someone handed out the order of service and there were these pictures of Rhys in the park playing frisbee, having pizza, down by the seaside having fish and chips. And all of them were with the people he’d met through Camerados, him having a laugh in the sunshine – really great pictures. And I thought, “This is the right thing.”

‘Because even if you don’t make it, and you never get out of that hole, while you’re in there you’ve got company. That’s the thing that none of us likes to talk about, that some people don’t make it out. Of course we want people to come through their crisis, but the ultimate fundamental is don’t be alone. And I felt we did that for him.’

Camerados principles

camerados.org

DDN October 2024

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DDNWeb
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A brave, brilliant, yet simple idea for cohesion

DDN October 2024Maff Potts walked into our conference with a sofa over his shoulder. He went back to his van for another, then comfy chairs, standard lamps, beanbags, occasional tables, coloured lights, board games…

When he said he would create a living room we didn’t realise the scale of his vision – the social movement behind Camerados, the brave, brilliant, yet simple idea of enabling social cohesion by providing space to talk and connect. Each of us has the capacity to affect social isolation in a direct way by the simple act of relating to someone else – one thing in a conference setting and quite another when you take it onto the streets. Read about his remarkable journey so far (p6).

Having somewhere to call home; looking after our mental health and wellbeing – it’s about joining up the dots. Our coverage from Cranstoun’s social justice conference reflects things we spend our lives trying to fix – through collaboration we can have our ‘lightbulb’ moments. And we bring you the benefit of experience – Martin Blakebrough’s years at Kaleidoscope (p12) and Mark Gilman’s searching questions for drug treatment in the here and now (p24). Enjoy the issue!

Read the October 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

Celebrating 11 years of Roots: growing community, wellbeing, and recovery together

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As we mark the 11th anniversary of SIG Penrose Roots, Service Manager, Samantha Smith, reflects on the incredible journey of this community-based project and the transformative impact it has had on the lives of so many. Here’s Samantha’s story in her own words.

Penrose RootsOn the 17th December 2012, I joined Penrose, coming from a background in the criminal justice sector. It was my first role on the ‘helping side’ of things, and what I noticed straight away was how grey and isolating life in a large town could be – especially for someone like me, raised in the countryside. The lack of green spaces stood out, as did the disconnection people felt from nature.

It wasn’t long before I observed another trend: many of our participants were creating crises just to have positive human contact. They often asked to meet outdoors, as many didn’t have access to their own garden. These interactions sparked conversations about the healing power of nature and the need for a communal green space. Around the same time, I saw a news story about a gardening project for a drug and alcohol service in Cambridge, and it planted a seed. I asked my manager, Gill, if I could start an allotment project for our members. In her typical supportive style, she said yes.

That’s how Roots began. We started small, loading up cars every Thursday with members and heading to a local allotment in Luton. In this nature-rich setting, the conversations were profound. We weren’t just gardening; we were nurturing wellbeing, reducing isolation, and fostering a deep sense of community. To sustain our project, we even helped other allotment holders in exchange for seeds, tools, or small donations.

A year later, we sought out a space of our own where we could grow the project. After months of searching, we found an unused allotment area on the outskirts of Luton – wildlife had overrun it, but we saw its potential. From there, with the help of amazing supporters like William and Peter, Roots blossomed.

SIG Penrose RootsNow, 11 years on, SIG Penrose Roots is a thriving Community-Based Recovery Service (CBRS). We have a team of 8 dedicated staff, over 90 members, and 5 different projects providing hundreds of kilograms of food to our members and the wider community. We offer 3,200 open hours of support per year, 6 days a week across Bedfordshire, and have become the ‘go-to’ provider for holistic support sought by external services.

SIG Penrose Roots is more than just a garden – it’s a space that fosters mental, emotional, and physical wellbeing. We equip people with new skills, reduce social isolation, and offer a therapeutic growing space where our members, volunteers, and the wider community can thrive. We’re proud to support people with complex needs, from mental health challenges to social isolation, and we’ve even been recognised with awards for our innovative approach. We’re trusted by health commissioners and local authorities as a partner in providing vital recovery services.

Today, Penrose is one of the proud subsidiaries of Social Interest Group, and just as committed to promoting social change and supporting vulnerable individuals through various services as always. SIG Penrose Roots continues to be a flagship project under this umbrella, embodying the core values of holistic support, inclusion, and community building.

But more than any of our accolades, the true magic of SIG Penrose Roots lies in its sense of community. Words can’t quite capture the feeling – so I invite you to come visit and experience it for yourself. I challenge you not to feel the magic that we have been building for the past 11 years.

Thank you for being part of this journey.

Samantha Smith, Service Manager – SIG Penrose Roots

This blog was originally published by Social Interest Group. 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 Social Interest Group

UK’s biggest charity merger promises a Waythrough for people dealing with drug and alcohol, mental health and housing challenges

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Waythrough, which launched 1 October, combines the expertise and resources of Humankind and Richmond Fellowship, two national charities that share values, ambitions and decades of experience supporting people with substance use, mental health, housing and associated needs.

Waythrough

The charity’s vision is ‘to break down the barriers that stop people getting the support they need to live a life they value’ by offering a single point of access for mental health, alcohol and substance use and homelessness services. 

Jacob, who was supported by Richmond Fellowship, became a volunteer and then joined Waythrough’s Heart and Soul group, representing people with lived experience during the merger process, said, ‘Like many others, there have been points in my life where I’ve had mental health and substance use needs at the same time. I have always been baffled by the way these issues are siloed and addressed separately, and that one can pose a barrier to accessing care for the other.

‘Mental health and substance use needs are inextricable, and I hope that the coming together of Richmond Fellowship and Humankind will, in time, lead to innovative service models that support the delivery of person-centred care.’

Ruth, who was formally supported by Humankind and is now a volunteer and member of the Heart and Soul group, added, ‘After living in a state of crisis and being admitted to hospital with liver failure, I went on a three-month Relapse Prevention programme with Humankind. I’m now hitting my 15th month of full sobriety and continue to rebuild my life.

‘I’ve battled with anxiety and depression all my life and have managed to find my way to therapy now, but I have no doubt that an integrated charity would have been better placed to help me access the help I needed faster and with far fewer barriers.

‘What matters to me and the Heart and Soul group is that Waythrough sticks to its promise – something we helped create:

Wherever you are now, we won’t judge or write you off
We’ll help you work out who you want to be and where you want to go
We’ll stick with you until you’re ready to move on.’

Introducing the new charity, Waythrough CEO Paul Townsley stated, ‘For many years it’s been clear that addressing drug and alcohol, housing and mental health support as separate issues ignores the reality and complexity of peoples’ lives, and that a holistic approach is needed. This is why I’m excited about the launch of Waythrough and our ambitions for the future.

‘Today marks a huge step in our journey, and although it’s going to take time, I’m confident that – by working with our partners – we will have the experience, capabilities and determination we need to make our vision a reality.’

This blog was originally published by Waythrough. 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 Waythrough

Celebrating 20 incredible years of The Bridges, Hull

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DDNWeb
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The Bridges, an important drug and alcohol residential rehabilitation facility based in Hull, had a special commemorative event to welcome its 20th year in service.

20 years The BridgesOn Friday 20th September 2024, past and present service users, employees, trustees, and friends of The Forward Trust visited the centre from all over the country to give thanks and pay tribute to the life-changing support delivered by the amazing service.

The event started off with an introductory speech from Mike Trace, CEO of The Forward Trust, acknowledging the background of the service from its humble beginnings to the service it is today – now supporting both men and women in need of residential rehabilitation support for drug and alcohol addiction.

This was followed by The Bridges’ first ever client, Craig Dexter, who’s moving and insightful personal journey really demonstrated the transformative impact of The Bridges.

We were also grateful to have speeches from the local MP for Kingston upon Hull North, Dame Diana Johnson, and the High Sheriff of East Riding of Yorkshire, Colonel Christopher Henson, who both expressed their gratitude to The Bridges for its contributions to help vulnerable individuals to lead lives free from addiction.

An honorary plaque was revealed at the end of the day by Forward’s CEO Mike Trace and Ted Burr, Admissions and Referrals Co-Ordinator at The Bridges, to celebrate 20 years of the service.

The Bridges is a residential rehabilitation centre that provides full-time care for men and women with drug and alcohol addictions aged 18 and over. It has helped hundreds of clients since it first opened its doors in 2004, some of which we were delighted to be joined by at the celebration event, including the very first client of The Bridges, who is now celebrating 20 years of recovery himself.

Charlie-Forbes Adams, a key member of The Bridges Fundraising Advisory Group, also paid his respects to the work of staff across The Bridges and Forward in helping people to seek support for drug and alcohol use.

Julie Muir, Executive Director of Recovery Services at Forward, rounded-off the event with a compelling speech about how much work had gone into the restoration of the new premises – and how much progress had been made in such a short space of time since its purchase only two years ago.

Speaking at the event, Mike said, ‘The Bridges has always been about what the organisation fundamentally tries to achieve: to help people who are struggling, show care and compassion, show practical help, and believe in people so they can make transformational changes in their lives. That has happened hundreds of times at The Bridges over the last 20 years.’

Throughout the afternoon, guests were served with tasty canapes alongside our special 20th-anniversary-branded cupcakes that went down a treat!

We want to say a huge thank you to past and present staff from The Bridges, fundraisers from over the years, and former and current clients for making The Bridges the brilliant service that it is today. Here’s to the next 20 years!

You can visit The Bridges’ website to learn more about the service and the support we provide.

This blog was originally published by 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 Forward Trust

Proportion of current smokers falls to lowest ever level

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DDNWeb
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Proportion of current smokers falls to lowest ever levelAround 6m adults in the UK smoked cigarettes last year, according to the latest figures from the Office for National Statistics (ONS). At just under 12 per cent of the population, this represents the lowest proportion of current smokers since records began.

The highest proportion of current smokers was found in the 25-34 age range (14 per cent), while the biggest drop in smoking prevalence was among 18 to 24-year-olds, where the rate has fallen from more than 25 per cent in 2011 to less than 10 per cent. Meanwhile, more than 5m (9.8 per cent) people currently use e-cigarettes either daily or occasionally.

In England, the highest average percentages of smokers by local authority area were in Fenland and Blackpool at 22.1 and 21.3 per cent respectively, with the lowest in St. Albans (5.7 per cent) and Woking (5.3 per cent).

current smokers
Last year in England 13.4 per cent of men smoked compared with 9.9 per cent of women

The percentage of smokers in each of the UK countries in 2023 was 13.5 per cent in Scotland, 13.3 per cent in Northern Ireland, 12.6 per cent in Wales and 11.6 per cent in England. Last year in England 13.4 per cent of men smoked compared with 9.9 per cent of women, while the prevalence of adults who were ex-smokers was just over 25 per cent compared to more than 63 per cent who had never smoked.

The tobacco and vapes bill – which aims to progressively increase the age at which people can legally buy cigarettes to create a ‘smoke-free generation’ – was included in this year’s King’s Speech after being shelved by the previous government following the announcement of a summer election.

‘Today’s figures are further proof that the country is ready to be smokefree,’ said ASH chief executive Hazel Cheeseman. ‘There is cross-party support for ending the sale of tobacco and creating a generation free from the harms from smoking and government should bring forward the bill as soon as possible. Despite the progress there is still much to be done. Our poorest communities continue to pay the price for tobacco company profits, as do our public services and economy. Alongside creating a smokefree generation, the government must maintain the commitment of the last government to invest in support to help the 6m people currently smoking to quit.’

vaping will overtake smoking for the first time
Vaping will overtake smoking for the first time

Meanwhile, a new briefing paper from the Global State of Tobacco Harm Reduction (GSTHR) focuses on the UK’s ‘remarkable shift’ from tobacco to vaping. At current rates, the number of adults who smoke will have fallen to just over 10 per cent by next year while the number of vapers will continue to rise – meaning that vaping will overtake smoking for the first time, it says.

‘The fall in smoking rates in the United Kingdom reinforces just how rapidly situations can improve when people already consuming nicotine by smoking can access a safer alternative like vapes,’ said David MacKintosh, director of K·A·C, which runs the GSTHR project. ‘When vaping overtakes smoking next year in the UK, it will not be simply the consequence of a consumer-led revolution, although this has been significant, it will also be the result of successive governments making pragmatic policy decisions based on the evidence in front of them. Maintaining a clear focus on reducing the use of combustible cigarettes provides an opportunity to achieve the ambitious 2030 “smokefree” target.’

Adult smoking habits in the UK: 2023 available here 

Smoking profile for England: statistical commentary, October 2024 update available here

A smokefree UK? How research, policy and vapes have cut smoking rates available here

A fair exchange

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DDNWeb
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My first real job opportunity felt like a battle against the system – but then something changed for me, says Stuart Lloyd.

Exchange Supplies
Stuart at a reunion with former colleague Scott Robyns (right) and Andrew Preston (left)

‘Same shit, different decade’, was what the badge on my blazer bemoaned the day I was asked to pen this piece. How appropriate, but then again, how untrue. I had worked at Exchange Supplies for ten years and have now been living a different life – several different lives, since I left the fold almost exactly a decade ago.

Exchange Supplies is a social enterprise (their words), meaning (in the government’s words) ‘a business with primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners.’ They are also harm reduction innovators extraordinaire (my words).

In practice, what I saw on the ‘coalface’ was top-quality and innovative harm minimisation products and educational information being developed, produced and marketed. Often left-field, sometimes contentious and regularly ahead of the curve of what was legally acceptable – net result, saving lives and reducing the spread of blood-borne viruses.

It’s often difficult to measure community benefit beyond individual stories. Exchange Supplies, however, has an active policy to employ those whose life has been impacted by drink and drugs – which mine most definitely was.

Smart, passionate, hopeless
I was smart, passionate, political – and a hopeless junkie. At the time I still had pipe-dream fantasies (literally) of taking a master’s degree in a drug-related subject. Seeing a job advert for a harm minimisation company pinned to the notice board in my local drug agency seemed ideal.

I was back living with my parents and my dad was all over me to pull my weight and get work, so I was signed on with a job agency. Despite being a long-term dedicated vegan, I had accepted work at a meat packing plant (I’m not squeamish). After being told I would only be expected to haul boxes, within an hour of arrival – due to the omnipresent moral panic of ‘mad cow disease’ – I was removing spinal fluid from back bones and getting sprayed in the face with blood, marrow and nerve fibres. Needless to say, I leapt at the chance of working in an offal-free environment.

On my first day of employment with Exchange Supplies I was in my element. I had scored my necessary morning fix the night before – and incredibly had resisted ‘doing it in’ that evening. For clarification, in 2004 when Exchange Supplies first employed me, I was a heroin addict and burgeoning alcoholic. Just for the record, when I left ten years later, I was still a heroin addict and a full-blown alcoholic.

You’d think I would be a happy and content worker, safe in the embrace of a tolerant, forgiving, and understanding workplace culture. ‘Allowed’ to have scoring and banging up breaks, flexibility over start times (they were fully aware I couldn’t function without gear and it is a universal truth that dealers are always late). Not having to hide the truth of my situation, surely I was in junkie heaven. Of course I wasn’t.

Exchange Supplies - a fair exchangeSelf cycles
I was a selfish, self-centred and self-justifying drug addict, happy to take the piss at every opportunity, voice my dissatisfaction and sow discord wherever possible. In true drug-addict fashion, I was manipulative and self-seeking. I have deliberately used the word ‘self’ multiple times in this paragraph, just in case you don’t fully appreciate what being an addict is all about. It really is, almost but not entirely, about staving off gear sickness and sourcing your next hit – a relentless and unending self-obsessed cycle.

Being quite intelligent, showing glimpses of charm, and crucially, seldom making errors in my job, I was a picker packer (boxing orders for customers). In this age of Amazon, we all know nothing upsets a customer more than receiving the wrong items. And, of course, I had enough awareness of these qualities to weaponise them whenever and wherever they would serve me best.

So, the game was afoot, junkie vs system, a ‘battle’ Andrew (co-founder and all-round head honcho) has since told me taught him ‘a great deal about managing addicts in the workplace’ – you’re welcome! It was a constant struggle between what could I get away with (not necessarily shirking the work, but having my diverse, demanding and damaged needs met) versus a liberal and understanding business model. It was, however, still a business with procedural needs that had to be met.

Don’t get me wrong, outside of the workplace, I was soooo proud of the company’s ethos and mandate. I lauded the ‘life-saving’ practices and principles we adhered to and sang the praises of those who determined policy. But hey, it’s work and we all ‘hate’ our bosses, don’t we? Picking up petty resentments over decisions that didn’t go my way, feeling my value was under-rewarded, bemoaning ‘they don’t know the job like we do’. I can assure you this is doubled if we also hate the world for dealing us the shitty hand of addiction and the non-stop nonsense that goes with it.

It seemed I was always just good enough, just tenacious enough and just likable enough to keep my job. However, it was very much a battle of will and wits, with me believing these caring and understanding bosses were exploiting my labour. The truth was, I wasn’t fulfilling my potential in life and it hurt. I turned that internal frustration outwards when in reality I had the appropriate job and level of pay for what my capabilities allowed and reliability warranted.

Many days my drunken belligerence was a cause of consternation, and my normal breakfast was a beer (or three) on the train travelling to work. They accommodated this behaviour as best they could but sent me home when necessary – this mostly suited my agenda of more time to drink and use. As caring and understanding employers, full sick pay was the norm – as an addict, I took this as an invite to take days off at will (remember I woke up gear sick every morning).

In an attempt to tackle this, a ratio of eligible sick days per month was implemented. I have since been told our accounts department could accurately anticipate my absenteeism according to this formula. At the time I’m sure I was proud of my ability to manipulate the system, but today I feel embarrassed that I was so predictable.

More than once, I was found asleep on the job (goofing out on heroin a more accurate description). Another time, I stole 200 first class stamps, a clearly sackable offence. Unable to prove it was me, they implemented a procedure to prevent it happening again, another example of their consideration. I’m certain other employers, regardless of the legality, would have terminated my employment on reasonable suspicion. This did lead to an interesting ‘dilemma’ when I approached Andrew to make my amends of whether to return the 2012 price or 2022 cost of stamps – it was a significant amount (I think we settled on 2016 as an acceptable compromise).

Exchange Supplies
Stuart, back in the day at an Exchange event (left in pic)

On a mission
Am I being unfair on myself? Definitely not. All these things and many more happened but I’m probably being a bit selective in the picture I am painting. There was a camaraderie between warehouse workers, and we half joked about the truth that we spent more time together than we did with our loved ones – shared more and knew more about each other too. There was a team spirit throughout (even if the packers did occasionally bitch, scheme and attempt to gang up on management policy). The training and team building opportunities we were afforded were generous and regular – especially in comparison to other workplaces who might have been desperate or ruthless enough to employ an addict like me. However, at Exchange Supplies, there was the sense of being on a mission.

I wasn’t the only junkie working there and part of the Exchange Supplies ‘mission’ was to highlight unjust and dangerous drug laws and policies. As using addicts we faced the impact of these issues daily. The legality and sub-standard quality of our drugs, the dangers of scoring, the risks associated with consumption and the ‘draconian’ enforcement of prescribing practice and drug agency attendance. We were invested in the practical solutions and educational zeal promoted by the organisation because we knew the real-life implications of underfunding, irrational legislation, and often hypocritical implementation. We may have ‘only’ been packing boxes, but we felt like part of the evangelical solution being offered by Exchange Supplies.

Today, I’m clean and sober, but my desperate and disrespectful behaviour during this period was a necessity of addiction – my grateful ingratitude quite natural for an addict stumbling from withdrawals to ‘fix’, encountering the attendant chaos and creating difficulties along the way. However, it also shaped the person I am today – granting me perspective, tolerance and transferable skills all of which were gently fostered and encouraged by the team and policies of Exchange Supplies.

Stuart Lloyd is several years into recovery and has become a writer

MUP increases to 65p

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MUP increases to 65pThe minimum unit price (MUP) for alcohol in Scotland has increased from 50p to 65p from today.

MSPs voted to continue with MUP earlier this year as the legislation was subject to a ‘sunset clause’ when it was introduced, as well as voting to increase it by 15p. Campaigners had long argued that inflation meant that the original 50p rate had become ineffectual.

Despite the introduction of MUP in 2018, however, the latest alcohol-related death figures for Scotland are the highest in more than 15 years, with the death rate more than four times higher in the country’s most deprived areas. Public Health Scotland’s final report on MUP estimated that it had reduced alcohol-related deaths by more than 13 per cent – based on comparisons with England – but also acknowledged that some people with alcohol dependence had been cutting back spending on food and other essentials in order to buy alcohol.

a 70cl bottle of 40 per cent whisky will cost at least £18.20, compared to the current minimum price of £14, while a bottle of 12.5 per cent wine will increase from a minimum of £4.69 to just over £6.
A 70cl bottle of 40 per cent whisky will cost at least £18.20, while a bottle of 12.5 per cent wine will increase to just over £6

The new price means that a 70cl bottle of 40 per cent whisky will cost at least £18.20, compared to the current minimum price of £14, while a bottle of 12.5 per cent wine will increase from a minimum of £4.69 to just over £6.

‘Research commended by internationally-renowned public health experts estimated that our world-leading policy has saved hundreds of lives, likely averted hundreds of alcohol-attributable hospital admissions and contributed to reducing health inequalities,’ said health secretary Neil Gray. ‘However, the Scottish Government is determined to do all it can to reduce alcohol-related harm and as part of that, I am working to ensure people with problematic alcohol use receive the same quality of care and support as those dealing with problematic drugs use. We have also made a record £112m available to Alcohol and Drug Partnerships to deliver or commission treatment and support services locally, as well as investing £100m in residential rehabilitation.’

The increase was a ‘welcome and necessary step to ensure that this life-saving policy remains effective’, said Alcohol Focus Scotland CEO Alison Douglas. ‘The Scottish Government and Parliament are to be commended for implementing this policy in the first place, and for deciding to renew the policy and increase the minimum price. They now need to ensure the price is automatically uprated by inflation going forward, otherwise the positive effects will once again be eroded over time.’

Author of UK drug review visits Darlington drug and alcohol service

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STRIDE partnership in DarlingtonDame Carol Black, author of the 2021 Independent Review of Drugs, recently attended a showcase of the STRIDE partnership in Darlington, a service run in collaboration between WithYou, Darlington Borough Council and Recovery Connections.

Along with Andrew Brown, Head of Drug & Alcohol Improvement Support at OHID, she was shown around both the Tubwell and Conscliffe Road sites by WithYou CEO, Simon Phillips and Dot Smith, CEO at Recovery Connections.

At the Tubwell site she visited the on-site dispensary, heard about the work in relation to harm reduction and met with several teams including the access team and assertive outreach. Then she walked to the Coniscliffe Road site for lunch with clients, staff and Darlington councillors, provided by Recovery Connections Fork on the Road van; a social enterprise which offers opportunities for those out of work to gain valuable skills and experience.

STRIDE DarlingtonBoth Dame Carol Black and Andrew Brown also met with the STRIDE partnership managers to discuss the current issues facing substance misuse services in 2024 and beyond. The final session, led by Recovery Connections, saw members of the recovery community share their powerful, unique journeys with all of those present.

We thank Dame Carol Black, those who shared their recovery journeys and everyone in attendance for joining us for the day and were encouraged by positive and robust discussions about the STRIDE service, the partnership approach, continuity of care and the young persons service.

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

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

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

This content was created by WithYou

Taking Action On Addiction’s Sober Party at the Labour Party Conference 2024

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Sober PartyAs the Labour Party Conference continues in Liverpool, we take a look back at the Sober Party we hosted at the start of the week.

On Sunday 22nd September 2024, Taking Action on Addiction, Forward’s campaign to improve understanding of addiction and end the stigma that surrounds it, hosted its very first Sober Party at The Beatles Story Museum in Liverpool.

Sober Party - LabourThis formed part of the Labour Party Conference and was attended by dozens of MPs, councillors and party members.

There were some brilliant speeches delivered throughout the night, including one from our Patron Tony Adams, ex-captain of England and Arsenal. Tony spoke about his experiences of being in recovery and how he believes we need to reach out to those who need help, not the other way around.

Andy Burnham, the Mayor of Greater Manchester also spoke about his hopes for reform in government in regards to drug, alcohol and prison services. He discussed his plans to reach more young people who might be struggling with addiction and/or homelessness.

We were especially delighted to hear from Navraj Dhesi who leads No More Pretending, a support group which helps Punjabi families who struggle with alcohol use.

Taking Action On Addiction’s Sober PartyThe evening was catered for us by staff from The Brink, the UK’s first-ever ‘dry bar’ based in Liverpool that aims to offer a safe space for those in recovery. They provided a stunning selection of mocktails and delicious snacks – including their famous sausage roll – which went down a treat with those attending.

Musician Lily T also performed a couple of original songs for us, which were brilliant and added to the great atmosphere.

We want to thank everybody who came to support the event, as well as the staff from Forward, The Brink, and The Beatles Story Museum for their time and dedication to making the evening a huge success.

This blog was originally published by Taking Action On Addiction, a part of 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 Taking Action On Addiction

Mike Amesbury MP visits charity giving a voice to vulnerable kids who go missing

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MP Mike Amesbury has visited WithYou’s Missing From Home Service, which supports under 18s who go missing from home and care across Cheshire West and Chester, Warrington, and Halton.

Missing From Home ServiceWithYou caseworkers complete Return Home Interviews with children and young people to understand their stories, the reasons they go missing, and what needs to change to help prevent it happening again. Many of the children they support have experienced a range of traumas and may be distrusting of authority figures.

As an independent charity, separate from the police or social care, WithYou’s caseworkers listen to the young person and act as their voice when working with other professionals to inform safety planning, ensuring what they have to say is heard.

Mike Amesbury, MP for Runcorn and Helsby, says, ‘It was great to meet the team from WithYou’s Missing from Home Service who are doing some excellent work with local children and young people at risk as well as their families and carers.

‘Most youngsters who go missing have complex needs and vulnerabilities, with many having sadly experienced trauma. The disruption caused by the Covid pandemic has undoubtedly also had an adverse impact on the mental health of our youngest generation.

‘I was really impressed, especially by the caseworkers who spoke in terms of their enthusiasm, skills and knowledge – and the positive impact the service is having in helping to keep our young people safe.’

WithYou Missing From Home Service
In 2023/24 the Missing From Home Service saw 1,664 individual children and young people

In 2023/24 the Missing From Home Service saw 1,664 individual children and young people. They worked closely with children, their parents or carers, schools, the police, children’s social care services, residential placements and other young people services. They also delivered Direct Work interventions on relationships, mental health, drugs and alcohol, personal safety, exploitation, online safety, and anger management.

Nikki Thorne, Cheshire Tri-Party Missing From Home Service Manager, says, ‘It was so important to be able to talk to Mike about the vital work we do in the Missing From Home Service.

‘Many of the children and young people we work with are traumatised by experiences that no-one their age should ever have to go through. It can be hard for them to make themselves heard, and some of them may never have felt listened to before. Our specialist caseworkers support them with information and advice to help them keep safe, giving them the confidence to have a voice, and advocating for them in settings with other professionals.’

It’s vital that everyone knows what to do if someone goes missing. You don’t have to wait 24 hours to make a report. If you suspect that a child is missing, contact the police as soon as you have done as much as possible to find them. If a young person or child is in immediate danger, or risk of harm – call 999 now.

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

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

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

This content was created by WithYou

Stick together

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CGL DDN Conf

At Change Grow Live, we were thrilled to be part of the DDN Conference again this year, themed ‘Stronger Together’. We were proud to play a significant role in an event that brought together service providers, national organisations and individuals with expertise and lived experience to share ideas and celebrate the power of collaboration.

The event was a dynamic blend of inspirational speakers, interactive sessions, and engaging debates, along with a variety of other activities that enriched the experience and highlighted the collective passion for improving substance treatment services.

Change Grow Live DDNThroughout the day we handed out information and guidance about our services and harm reduction initiatives, but we also took the opportunity to engage with other organisations and discuss upcoming projects. It reaffirmed our commitment to involving service users at the heart of everything we do, and to bringing together voices from across the sector.

Our own deputy chief executive, Nic Adamson, was a key speaker (see page 17), delivering a powerful message about the importance of meaningful service user involvement (SUI). Nic highlighted that SUI is not just a nice-to-have part of what we do – it’s an essential element of our work.

At the heart of Nic’s presentation was the argument that SUI doesn’t just improve services – it saves lives. One clear example of this is the peer-to-peer naloxone distribution programme. Opiate overdoses remain the leading cause of preventable deaths among users, and by putting naloxone in the hands of those most at risk through peer networks, lives are being saved.

Our commitment to service user involvement goes beyond naloxone distribution. Several other initiatives – such as our veteran support working group – have demonstrated the tangible benefits of working alongside people with lived experience. This group, led by veterans who have experienced substance use, helped us sign the Armed Forces Covenant and develop pathways that have increased veteran engagement with our services by 87 per cent.

Nic CGLAs Nic put it, ‘It’s the right thing to do, it’s the reason for our existence, it should be
our DNA and heartbeat.’ She emphasized how involving people with lived experience improves outcomes for individuals, enhances services, and helps direct scarce resources to where they are most needed.

Nic also paid tribute to Bernie Carr, a passionate advocate for service user involvement who spent 14 years working with Change Grow Live. Bernie was instrumental in establishing our national lived experience group, where he tirelessly supported efforts to make services more inclusive and effective.

The conference wasn’t just a celebration of what has been achieved, but a call to action for what still needs to be done. Looking ahead, we’re committed to doing more. We know that we don’t have all the answers, but we believe that by working together, we can make a real difference.

All of us at Change Grow Live look forward to continuing this journey, and we are already preparing for the next chapter of collaboration and growth in 2025.

We’d like to extend a heartfelt thank you to the organisers and to our dedicated team who attended and supported the event, highlighting the collective effort that made the day a success.

We’re dedicated to ensuring that everyone has a voice, that stigma is challenged, and that lives are transformed – and we believe that the best way to achieve this is through collaboration and partnership. As a sector, we can achieve more together than we can apart.

Change Grow Live DDN ConferenceJinna Sidhu is marketing and communications lead at Change Grow Live

More than half of public backs increase in drinks duty, says Alcohol Change UK

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There is widespread public support to address alcohol-related harm through tax measures, according to Alcohol Change UK. A survey of more than 2,000 adults found that 52 per cent agreed that increasing alcohol duty until it ‘covered the cost’ of alcohol-related harm would have a positive impact on the NHS.

increase in drinks dutyJust under half agreed that increasing alcohol duty in next month’s budget would be the ‘right priority’, says the charity, while more than 60 per cent wanted to see a ban on alcohol marketing in places that could be seen by children. Almost half also supported minimum unit pricing, double the 23 per cent who were opposed.

Increasing alcohol duty at up to 4 per cent above inflation would ‘raise billions’ over the course of the current parliament, says Alcohol Change UK, as well as help to close the ‘alcohol harm deficit’– the gap between the cost of alcohol harm and the income generated by the drinks industry.

While chancellor Rachel Reeves has said she has ‘not ruled out’ a duty increase in the forthcoming budget, industry body the Wine and Spirit Trade Association (WSTA) is calling for a two-year freeze to allow sales to recover from last year’s implementation of a new duty system under which drinks are taxed according to strength. The British Beer and Pub Association (BBPA) added that ‘any additional price increases, on top of the inflationary pressures of the last few years, would tip many beer and pub businesses over the edge’.

More than half of respondents to the Alcohol Change UK survey also supported protecting funding for alcohol and drug services, while almost 60 per cent were in favour of compulsory drinks labelling about calories, ingredients and health risks.

drinks duty
‘Our environment encourages us to drink more while failing to tell us the truth about what we’re consuming’

‘While the government faces some difficult decisions, addressing alcohol harm in the budget is a powerful opportunity that’s popular with voters,’ said Alcohol Change UK CEO Richard Piper. ‘Alcohol harm affects all of us, yet we’re currently spending billions more on dealing with this than we see back in duty.’

Reintroducing a ‘duty escalator’ at 2 or 4 per cent above inflation would ‘start levelling the playing field’, he continued – ‘putting public health and wellbeing above the profits of alcohol producers, largely dominated by massive companies based overseas. Our poll shows that people are connecting the dots, with the vast majority not only wanting to protect our NHS but recognising that changes to alcohol duty are part of the solution. Right now, the system works against us. From the relentless advertising we’re exposed to when going about our lives, to how alcohol is priced, labelled and made available, our environment encourages us to drink more while failing to tell us the truth about what we’re consuming and how this is impacting our health.’

Health and Care Futures Webinar Series

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As part of the programme of activities to mark Turning Point’s 60th year, we are hosting a series of webinars looking at some of the major challenges facing the health and social care sector as we approach the end of the first quarter of the 21st century.

Turning Point webinarsThe series will feature leading thinkers including Professor Sir Michael Marmot, former Labour Health Secretary Rt Hon Patricia Hewitt and broadcaster and academic Tom Shakespeare.

The series will examine some of the key challenges across the sectors in which Turning Point operates with an opportunity to hear from people with lived experience of the issue under discussion as well as what Turning Point is doing.

The webinars are free to attend and open to all. To register for your free place, click on the links below.

Can (and should) charities and social enterprises play a bigger role in the delivery of public services? With former Health Secretary the Rt Hon Patricia Hewitt.
Monday 14th October 2024, 1.30-2.30pm
Link to register: https://t-p.news/healthfutures

The future of social care With writer, broadcaster and disability campaigner Tom Shakespeare CBE.
Friday 18th October 2024, 9-10am
Link to register: https://t-p.news/socialcarefuture

Synthetic opioids – how does the drug and alcohol treatment sector need to work differently to respond to the changing drug supply? With harm reduction and local intelligence systems expert Michael Linnell.
Friday 18th October 2024, 4-5pm
Link to register: https://t-p.news/syntheticopioids

How can we shift the dial on health inequalities? With Director of the Institute of Health Equity, Professor Sir Michael Marmot.
Tuesday 22nd October 2024, 9-10am
Link to register: https://t-p.news/healthinequalities

Mental health services – imagining a better future With co-production specialist and campaigner Isaac Samuels.
Thursday 24th October 2024, 3-4pm
Link to register: https://t-p.news/mentalhealthfuture

Unblocking the system – how can we move more people with a learning disability out of long stay hospital? With Professor Robin Miller from the University of Birmingham.
Friday 25th October 2024, 9-10am
Link to register: https://t-p.news/unblock

How can we reduce alcohol harm? With Dr Richard Piper, Chief Executive of Alcohol Change UK.
Wednesday 6th November 2024, 10-11am
Link to register: https://t-p.news/alcoholharm

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

‘Volatile’ global economy linked to patterns of drug use

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impact of economic downturns on drug useThe impact of economic downturns on drug use is ‘complex and multifaceted’, according to research from the EU Drugs Agency (EUDA). The report highlighted that ‘young people and socioeconomically vulnerable groups are disproportionately affected during times of recession’ and concluded that understanding the effects of recession on illicit drug use remained under-researched. The review aimed to highlight gaps in research and raise questions.

‘Recent global events, including the COVID-19 pandemic and Russia’s invasion of Ukraine, have caused volatility in the global economy,’ it stated. Against this backdrop, it looked at 25 studies up to 2020, mainly relating to Europe and the US, and produced a general picture of young and already vulnerable populations appearing to be most affected. Riskier patterns of use, such as switching from smoking or snorting drugs to injecting, were more likely during an economic downturn, and there were also signs of increased cannabis use.

This year’s European Drug Report confirmed overdose as being the leading cause of avoidable death among people who use drugs – around 6,400 people in the EU in 2022, or 7,000 including Turkey and Norway. Most were in their late 30s and early 40s and four out of five were male.

Opioids, mainly heroin – and usually combined with other substances – were the most commonly implicated drugs, linked to more than 80 per cent of overdose deaths. Other opiates, including methadone and (to a lesser extent) buprenorphine were also linked to high statistics in some countries, along with pain relief medicines containing opioids and synthetic opioids.

economic downturn - cannabis use
Riskier patterns of use were more likely during an economic downturn, and there were also signs of increased cannabis use

Highly potent synthetic opioids, mainly nitazenes, were identified in many recent overdoses – around half of the deaths in Estonia and a third in Latvia. Cocaine was identified in polysubstance use in an increasing number of drug-induced deaths in some countries.

The type of drug used and route of administration were identified as risk factors, alongside disruption of treatment provision. People recently released from prison with reduced opioid tolerance were particularly vulnerable.

The report gave special attention this year to suicidal intent, with a higher proportion of women than men suffering drug-induced death from this cause. ‘These findings highlight the need for more targeted interventions addressing self-harm and suicidal behaviour among people who use drugs, particularly women,’ it said.

Overdose statistics were highlighted across the world as part of Overdose Awareness Day, held each year on 31 August.

Strong suit

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Service user involvement SUIT

At the Service User Involvement Team (SUIT), we’re always looking to make an impact and raise awareness of our service and the people who engage with it. Many of our clients and volunteers are marginalised and stigmatised, and getting their voice involved is core to our values of lived experience.

Our team understands that people exposed to addiction come with an extra, often creative, sensitivity. Our exhibition stall at this year’s conference showcased powerful visual art, created by our clients and volunteers, and it was fantastic to witness so many of the delegates drawn in by the impressive work.

Included in SUIT’s wraparound support offer is a recognition that the creative arts can release emotions and frustrations, and at the same time create beauty, change perception, and resist stigma and judgement.

SUITSUIT was founded in 2007 and has since become a platform service for some of the most vulnerable people in Wolverhampton. We deliver prevention, treatment and rehabilitation services, both through the criminal justice system and within the community, and we believe that vulnerable people with drug and alcohol problems should be treated fairly, have access to services that focus on recovery, and be able to engage with service providers that will support them individually.

In early 2024, we became recognised as a LERO, which means that SUIT can connect with similar organisations creating peer-led support. This has opened a variety of new pathways for lived experience co-creation and for our services to grow and develop. Our volunteers and staff all come with lived experience and work to reduce barriers between clients accessing healthcare, welfare, employment, in criminal justice settings, and also in areas considered inaccessible to people on the sharp end of society.

service user involvement - SUITRight now is the most exciting time in SUIT’s 17-year history. Early this year, we received funding for core staff, including a creative arts and research lead and Punjabi-speaking and Polish-speaking project workers. Support and engagement need is increasing within South Asian and Eastern European communities in Wolverhampton, and we now have the resources to tackle this. Our increased outreach provision and exciting creative projects should also bring a unique focus and more referrals into the service.

We also have a new data illustrator role, which is allowing us to provide robust evidence
for peer-led support. For the first time since our service began, our lived experience is not just anecdotal but is being brought to factual real life. Our team is proving its value, passion, and dedication to a wider audience, and with deeper meaning, and we are now living and breathing our own air – giving clients a powerful voice and the opportunity to resurrect their lives with buddy support from a team who have lived that lifestyle and climbed over the other side.

DDN Conf SUITAt the DDN Conference our team were able to connect with a diverse group of experts, policymakers, and individuals directly affected by substance use, and it was great to meet so many of you in person. We took part in insightful workshops, including essential naloxone training from Cranstoun, panel discussions, and networking sessions, all aimed at enhancing the support and resources available to those battling addiction. Harm reduction, holistic therapies, and community-based support systems were all discussed and there was such a feeling of dedication and togetherness, especially surrounding policy changes, how we tackle drug deaths, and the nitazenes and fentanyl crisis.

Hearing success stories and challenges from other lived experience recovery organisations reinforced the importance of our mission at SUIT. The team feel renewed and ready to implement new strategies and continue advocating for an even more inclusive and effective approach to addiction. We extend our thanks to the organisers of the DDN Conference for hosting such a valuable and inspiring event.

SUIT service user involvementChristiane Jenkins is creative arts and research lead and Marcus Johnson is project manager at SUIT

‘Unforgettable’ event honours achievements of people in recovery

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Renfrewshire recovery eventHundreds of people in recovery from drug and alcohol addictions have attended a special event in Renfrewshire to celebrate their achievements with friends and family.

Around 300 people came together at Abbeycare’s annual Recovery Gathering on Sunday, September 8, at the Glynhill Hotel and Spa in Renfrew, marking the start of National Recovery Month.

The event is organised and hosted by Abbeycare Scotland, which runs a residential drug and alcohol addiction recovery clinic in Erskine.

The idea behind the gathering is to bring together Abbeycare’s community of existing and former clients and their families, making the process of recovery more visible.

This year’s event was held less than three weeks after official figures showed that 1,172 people in Scotland died as a result of drug use in 2023, an increase on the previous year.

Statistics published last week also showed that 1,277 people died from alcohol-specific causes in 2023, the highest number for 15 years.

Renfrewshire recoveryAll previous and existing clients of Abbeycare were invited to the Recovery Gathering, giving them a chance to share experiences of their ongoing recovery journeys, reconnect with those who have supported them, and celebrate their achievements.

Collectively, those attending the event had accumulated 933 years of ‘clean time’ between them, demonstrating that recovery is both possible and can be maintained.

The keynote speaker at the event was Eddie Gorman, who previously worked for Abbeycare and now manages the Harbour recovery service in Ayrshire. He is in long-term recovery from addiction himself.

The audience also heard speeches from Ross Carrick and Emma Harrison, both former Abbeycare clients, who talked about their own issues with addiction and the impact it had on their lives.

Another speaker was Barbara Calderwood, whose son Andrew sought help for his addiction to alcohol from Abbeycare. There was also a performance from local choir Voice of the Town.

Paul AbbeycarePaul Bowley, Chief Executive of Abbeycare, said: ‘This year’s Recovery Gathering was truly unforgettable. It was a privilege to listen to some of our former clients reflecting on their journey back to health, surrounded by the love and gratitude of their families and friends.

‘Events like this make me incredibly proud of the Abbeycare team and the work they do every single day in helping people recover from addiction and giving them their lives back.

‘Recent figures show that Scotland continues to be in the grip of a drugs and alcohol crisis, with thousands of people tragically dying last year alone.

‘Services such as ours have never been more important, and we are determined to be part of the solution in changing this narrative in the months and years ahead. We must stand together and stand up for recovery.’

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 provided by Abbeycare

Client of local drug and alcohol charity completes skydive to raise awareness

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charity skydive withYouSusie, a client at WithYou in Cornwall, took on the ultimate challenge on Sunday 15 September, by completing a charity skydive in Perranporth to raise money and awareness for WithYou.

She first approached WithYou for help in 2019 due to the challenges she was facing with drugs and alcohol. Susie has raised £383 so far. The money raised will go to both WithYou and the True Butterflies charity.

WithYou in Cornwall provides free, confidential support to individuals and families living across the county. The charity offers outreach services and support for those experiencing issues with drugs or alcohol.

Charity skydiveSusie, WithYou in Cornwall client, said: ‘I’ve always wanted to do a skydive and the day itself was just perfect. Everything was as it was meant to be, great weather and a rainbow around the sun.

‘I’ve been inspired to do this by my daughter, and the support I’ve received from WithYou, after struggling with alcohol and drugs for the last 20 years. They really are ‘WithYou’ every step of the way. I wanted to give back to them and help others.

‘WithYou are like family because there is no judgement – everyone is in the same boat, and everyone is there to help you make a positive change. Their support has made a huge difference to my life.’

Vicki Eslick, Employment Specialist at WithYou, said: ‘I have been honoured to get to know Susie during her time at WithYou, and to watch her confidence grow. She is a strong and caring lady and the efforts she has gone to raise money for WithYou is just incredible.’

For more information and to support Susie’s fundraising efforts you can visit her fundraising page

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 provided by WithYou

Help us fight stigma – support our Early Day Motion (EDM)

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We are excited to announce that we have tabled an Early Day Motion (EDM) asking MPs to support our mission to take action on stigma. We hope this will draw attention to the network and encourage MPs to support our work.

Early Day Motion (EDM)To progress the EDM to a parliamentary debate, we need you to encourage your MP to support it.

It’s very simple to do. Follow the three basic steps below:

  1. Visit writetothem.com
  2. Enter your postcode and select your MP from the list
  3. Write your own letter to your MP explaining why you think they should support the EDM and the work of the network, or copy and paste the text below:

Dear [MP’s Name],

I am writing to draw your attention to Early Day Motion (EDM) 62483, which addresses the crucial issue of stigma and discrimination against people affected by drugs and alcohol. Stigma is one of the most significant barriers to treatment, support, and broader healthcare for those who use drugs and alcohol.

Stigma costs lives, shames people, and limits society’s progress. We must end stigma because the harms are too great, and because, collectively, we can.

The EDM highlights the work of the Anti-Stigma Network and its mission to take action on stigma. I urge you to support this Early Day Motion and join the Anti-Stigma Network at antistigmanetwork.org.uk.

Your support will be instrumental in bringing about meaningful change and raising awareness about the importance of challenging the stigma and discrimination of one of society’s most vulnerable groups.

Thank you for your time and consideration. I look forward to hearing from you and hope that you will stand with us in this vital cause.

Yours sincerely,

[Your Name]
[Your Address]
[City, Postal Code]
[Email Address]

Anti-Stigma NetworkShare our work and support us!
By amplifying our message, sharing our work, and encouraging people to join us, you help expand our reach. The more people we can reach, the more Anti-Stigma conversations we can have, and the more we can bring about meaningful change to people affected by the stigma of drug and alcohol use.

Anti-Stigma Open Forum
We have created two open drop-in sessions with no fixed agenda. These drop-ins are meant to be an informal space for you to meet with other network members, exchange ideas, ask questions, or simply listen to others talk about their anti-stigma work.

Please join us on

Thursday October 3rd at 12:30–1:30 on Teams: the joining link is here

Or

Tuesday 22nd October at 10:30–11:30 on Teams: the joining link is here

Thank you for your continued support!

The Anti-Stigma Network Team

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

WithYou responds to the National Records of Scotland report on alcohol-specific deaths

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The National Records of Scotland published its annual report on alcohol-specific deaths. The report finds that:

  • There were 1,277 alcohol-specific deaths registered in Scotland in 2023, an increase of one death from 2022.

  • This is the highest number of alcohol-specific deaths registered in a year since 2008.

  • Alcohol-specific deaths were 4.5 times as high in the most deprived areas of Scotland compared to the least deprived areas in 2023. This compares to a ratio of 1.8 times for all causes of death. This ratio has decreased over time.

WithYou Scottish alcohol deaths
‘The Scottish Government must pursue alcohol-specific deaths with much greater urgency, determination and innovation’

Statement from WithYou
Louise Stewart, Director of Service Delivery at WithYou, says: ‘The Scottish Government must pursue alcohol-specific deaths with much greater urgency, determination and innovation.

‘Minimum unit pricing is often held up as an example of forward-thinking policy-making because we were the first country in the world to introduce this measure. But it could and should work much harder.

‘Currently, the funds raised go to retailers and the alcohol industry itself. This revenue could make a real difference if it was instead directed towards improving and increasing the availability of alcohol support services – because these services will ultimately help to save lives.

‘To demonstrate its commitment to reducing alcohol-specific deaths, we believe that the Scottish Government should update, resource and reinforce treatment standards that ensure people receive a choice of treatment, as well as access to support and harm reduction measures, wherever they are in Scotland.

‘To anyone who is worried about their drinking or that of a loved one, please get in touch. As well as delivering services in communities, WithYou offers a free and confidential webchat. This is a great first point of contact for anyone who is worried about their alcohol use or that of a loved one. Visit wearewithyou.org.uk today.’

WithYou Scot alcohol deaths
‘I’d lost myself as a person. I didn’t know who I was. I had suicidal ideations every day’

Graeme’s story
Graeme, 36, lives in Glasgow. He started drinking heavily when his ‘granda’ died 10 years ago. His family tried to help him, but at that time Graeme didn’t think he had a problem.

He says: ‘As soon as I had a drink in me, I didn’t care about anything else. I didn’t care about my family. I didn’t care about my friends. I didn’t care about my health. I didn’t care about anything.

‘If I didn’t drink, I would have the shakes. I would hallucinate, severe stomach pain, constipation, headaches, dizziness, vomiting.’

Graeme explains that his grandad, who had always been his hero, had stopped drinking after he developed pancreatitis. At the age of 34, Graeme was shocked to receive the same diagnosis.

He continues: ‘My mum and my granny always told me, you’ll end up with this, you’ll end up with that. I was like, ‘Cool, I don’t really care’. But I did care once I got it, believe me, it was the worst pain of my life.’

Graeme approached WithYou for support in June 2024 and has been abstinent from alcohol since May.

He says: ‘I’d lost myself as a person. I didn’t know who I was. I had suicidal ideations every day. Sometimes I used to get annoyed when I woke up in the morning.

‘It was not a nice place. The world was dark. Now I see the sun’s brighter, the grass is greener, the birds cheep a wee bit louder, and things are just a lot better.

‘I never ever thought that I would be able to stop because I had always had this feeling that I was leaving something behind, when in reality, I was actually going to gain something much more valuable than what I’d ever had. But the life I had, it wasn’t a life, it was an existence.

‘I’ve got more friends now than I’ve ever had, because when I was drinking I didn’t have friends, I had acquaintances, I had drinking buddies. Whereas now I’ve got actual meaningful friendships with people that just want the best for you.’

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

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

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

This content was created by WithYou

Cranstoun response to Scottish drug deaths: evidence must prevail to prevent tragedy

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National Record for Scotland’s latest data revealed that drug deaths in Scotland are tragically on the rise once again, after two years of decline. The increase of 12% represents a shocking 1,172 lives lost to drugs last year. Each one of these deaths may have been preventable, and Scotland retains the shameful tag of being the drug death capital of Europe by rate – around three times higher than the next country on the list. 

Each one of these 1,172 lives lost in just a year will have impacted thousands beyond those who died – sons, daughters, partners and loved ones. The trauma and suffering through generations is unthinkable, and action must be taken immediately to alleviate the suffering and stop the deaths. 

nitazene
Nitazenes were involved in 23 deaths, up from 1 from the year prior

The data worryingly revealed that synthetic benzodiazepine bromazalam was involved in 426 deaths, with testing for this substance unreliable for years prior, making a comparison on prevalence in the market difficult.  

Nitazenes – a family of potent synthetic opioids – were involved in 23 deaths, up from 1 from the year prior. There should again be hesitancy around such comparisons given the veracity of testing. 

People from the most deprived areas in Scotland were a shocking 15 times more likely to die from a drugs death than those from the least deprived areas. Increases in deaths related to cocaine are also on a sharp trajectory upwards highlighting the complexity of the crisis. 

Context
Cranstoun work closely with Scottish Government and local councils to find solutions to the shameful level of drug deaths and there is sincere will to tackle the problem, but action is happening too slowly and attempts to find solutions have been knocked back at each turn. 

Whilst the problems specific to Scotland are multi-faceted, with issues including poly-drug use, significant prevalence of novel and highly potent benzodiazepines, increased cocaine injection in recent years, and disproportionate levels of poverty – there is simply no excuse for the sheer number of deaths and lack of immediate action. 

Positive work by campaigners, policy professionals, charities and Councilors are bringing us closer to implementing measures – such as an additional Overdose Prevention Centre in Edinburgh in addition to Glasgow – which will save lives but much more action is required to turn the tide.  

OPC
The first sanctioned OPC in Scotland will finally open in October but one centre alone is not nearly enough

The first sanctioned overdose prevention centre (OPC) in Scotland will finally open in October but one centre alone is not nearly enough. Now the go ahead has been given by Westminster, exploration of different models for delivery too must be considered as well, given the cost of the NHS delivering a highly medicalised model. 

It is not just OPCs, but issues related to treatment numbers, deprivation and poverty, increased prevalence of potent synthetic drugs, medical assisted treatment (MAT) standards, a reticence to try alternative evidenced measures, and the continued criminalisation of people who use drugs which are causing preventable deaths to remain near record levels.  

DAT (Diamorphine Assisted Therapy)
One example of missed opportunities relates to the further opening of a DAT facility in Dundee. A recent report published by the Alcohol and Drug Partnership for Dundee recognised the benefits of diamorphine assisted treatment, yet they declined the opportunity for such a facility to exist, giving reasons such as poly drug use. Poly drug use is undoubtedly an issue but DAT remains an effective tool in ensuring that the most at risk are being seen by a health professional daily. If someone overdoses in an OPC or DAT facility due to poly drug use, it is likely that their chance of survival is significantly higher than if they were alone. 

Furthermore, a recent report by Professor Andrew McCauley for Public Health Scotland shows that whilst cocaine injections are reported as surging, heroin is still the most injected substance in Scotland. This compounds the need for services including same day prescribing of opioid substitutions (such as methadone or buprenorphine), DAT, and provisions for access to naloxone.  

Medical Assisted Treatment standards & delays
It is with great relief that the first sanctioned overdose prevention centre in Scotland will open in just a few months, with an October 21st date finally set. Whilst this is encouraging news, the time it has taken to reach this is of enormous concern. It is not just OPCs that are taking longer than anticipated too.

Key targets set by the government are being missed (despite improvements in several areas), with no immediate plan on how to solve them and updates seemingly scarce. For example, mandatory Medical Assisted Treatment (MAT) standards for treatment providers were announced over two years ago and the April target set has now long passed, with Scotland still no closer to reaching this target. 

Cranstoun Scottish drug deaths
Scotland has a significantly lower number of people in Opiate Substitution Therapy who would benefit from it compared to England

This is one of several issues likely hindering people who use opiates from accessing treatment at the earliest point. Scotland has a significantly lower number of people in Opiate Substitution Therapy who would benefit from it compared to England – around 40% compared to 60%. Furthermore, research in The Lancet highlights how those who are not on Opioid Substitution Therapy (OST) are around three times more likely to die from drugs, than those who are receiving OST. This demonstrates the importance of same day prescribing and quick, easy access to such programmes for those who would like it. 

Opportunities to engage more people in treatment are being missed. Solutions should include smarter use of the criminal justice system, more outreach programmes to reach those who would benefit from treatment and more harm reduction measures. 

Additionally, the third sector in Scotland is unable to prescribe opioid replacement therapy. This leaves prescribing in the hands of the NHS alone, which given the strain it is under, may explain delays in getting people onto an opioid prescription. Delayed prescribing discourages people who use opiates from seeking treatment and is at least partly culpable for the issues in Scotland related to opioid deaths. 

Criminal justice
Data provided by the Scottish Government shows that whilst more drug warnings are being issued by the COPFS, there are still scores of people being proceeded against for drug possession offences. This is despite the Scottish Government announcing in 2021 that it would essentially ‘de facto decrimalise’ the possession of controlled substances.  

The SNP’s party position is aligned with this, however full decriminalisation of possession would require amendments to the Misuse of Drugs Act with powers reserved to Westminster.  

The use of diversion schemes, namely pre-arrest schemes that do not require legislative change. The ability to issue drug warnings without sign off from the COPFS or whether pre-arrest schemes are in place is not immediately clear given contradictory information on the Scots Gov website. 

Cranstoun drug deaths
The number of people dying from drugs is even more concerning given the increased prevalence of synthetic drugs contaminating the drug supply

Synthetic opioids and novel benzodiazepines
The number of people dying from drugs is even more concerning given the increased prevalence of synthetic drugs contaminating the drug supply, namely potent opioids such as nitazenes as well as novel benzodiazepine analogues (such as etizolam and bromazolam) and sedative xylazine (believed to be used to elongate the effects of synthetic opioids but which make propensity for overdose more likely).  

Our CEO, Charlie Mack, recently returned from a visit to Vancouver in Canada, one of the epicenters of the synthetics drugs crisis. The teeth marks of the crisis remain incredibly visible, after an explosion of potent synthetics such as fentanyl wreaked havoc in various parts of Canada and the US. Both the US and Canada have called public health emergencies, and drug deaths have risen exponentially over the past few years. 

We can take lessons – across the United Kingdom – for the lack of preparedness ahead of the crisis in North America, by adopting measures which will mitigate the level of crisis. Last year, Cranstoun published an 8 point plan in light of rising prevalence, though time is running out to implement measures which will save lives. 

Thus far in response, the Scottish Government have taken steps for a multi-locality drug checking service pilot scheme, which should act as an evidence based measure to reduce the harm of synthetic opioids and the presence of other adulterants which may be contaminating the drug supply. It is additionally welcomed that a proposed site in Glasgow for testing will be in the same hub as the soon-to-open OPC. This joined up approach is what other areas, and the rest of the UK should be working towards, and there is great hope the evidence emerging from this pilot will result in a more cohesive approach across the country. 

Over-medicalisation and lack of provision with third sector
Lastly, in addition to MAT standards improvements, the Scottish Government should further embrace the role of the third sector in treatment provision and service delivery. NHS-led delivery models for services such as DAT and OPCs are viewed by some as overly-medicalised, lacking the trauma-informed approach that is somewhat at odds with medical delivery of such services. 

A comparison of third sector delivery against NHS delivery could be developed. A social model OPC in Edinburgh, and third sector delivery of DAT elsewhere in Scotland would provide an evidence base for which to evaluate and determine the best course of delivery. 

Additionally, there is a significant difficulty in delivering MAT standards given prescribing restrictions for the third sector in Scotland. Given this is wholly in the hands of the NHS, there is unfortunate delays to prescribing which may explain the lower take up of treatment for people who use opioids. 

strategy Cranstoun Scottish drug deaths
The Scottish Government must do everything within its power to turn the tide

Recommendations
Cranstoun believes that the Scottish Government must implement Cranstoun’s 8 point plan in response to rising drug deaths, and assist in preparations for a potentially worsening crisis. 

There are green shoots of encouragement for action that is being taken, with pilot schemes for an OPC and drug checking set to open, whilst DAT in Glasgow is operational. There is still work to be done in developing a better framework for pre-arrest diversion schemes, improvements for MAT standards to ensure same day prescribing is available everywhere and mechanisms for encouraging more people into treatment. 

Despite some good work and a clear positive will from the Scottish Government to tackle the issue, last week’s tragic figures lay bare the need for more action, quicker. The Scottish Government must do everything within its power to turn the tide, and until it is doing everything within the realms of its devolved powers, it is simply not good enough to point the finger at Westminster or anywhere else. 

Our deepest sympathies and thoughts are with those who lost a loved one to a drug death in the past year.  

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

Radical acts

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drug user unions

‘In order for people to liberate themselves from external controls, they have to know about these controls,’ said Black Panther activist Huey Newton. ‘Consciousness of the expropriator is necessary for expropriating the expropriator, for throwing off external controls.’

For this issue, we are departing from our usual case studies about drug treatment and instead turning our attention towards RATS, a drug user union. RATS (‘radical acts to survive’) offers an alternative vision of care practices to that currently on offer through mainstream services. Our purpose in highlighting RATS is not to suggest that this organising model replaces those services. Rather, we hope that it serves as a useful comparison point, and inspires further change in favour of self-determination and community care.

RATS is a budding drug user union set up primarily by migrants, sex workers, and queer and trans people. Union members share experiences of otherisation, pathologisation, and the denial of agency and care – conditioned by their particular relations to multiple and intersecting systems of oppression.

RATS members are not willing to quietly sit back and allow fellow drug users to be punished, imprisoned and killed

Recognising this interplay, RATS understands all liberation movements to be deeply intert­wined. While their work focuses on experiences faced by people who use drugs, they embrace a politics of radical solidarity. For instance, the union centres the needs of sex workers and combats tropes around ‘drug using sex workers’, highlighting their use to justify harm against both drug users and sex workers. RATS believes in a shared project of liberation and seeks to build collective power through dismantling harmful structures while also building a stronger, diverse, and connected drug user community.

RATS members are not willing to quietly sit back and allow fellow drug users to be punished, imprisoned and killed, and so they are ready to take ‘radical action to survive’ in order to dismantle the structures that harm, resource a more resilient community, and build power amongst people who use drugs.

RATS was instrumental in establishing the Harm Reduction Hub at Release’s offices. The hub is a low threshold drop-in harm reduction centre that offers a welcoming non-judgemental environment, safer use materials, harm reduction literature, and pathways toward further support. The union continues to steer the development of the hub through delivering the Harm Reduction School training programme, staffing out-of-hours hub shifts, and fundraising.

As a drug user union, RATS rejects the service-client dichotomy, instead working towards a shared liberatory project. Their aim is for the hub to be a space for co-production, where people who share overlapping experiences of marginalisation can build community and better meet each other’s needs.

At the same time, RATS continues to politicise the need for the hub in the first instance. The hub would not be as necessary in a world which was kinder to drug users. Prohibition means that people’s basic needs – such as knowing what’s in the drugs they use – are systematically denied. RATS makes these points clear and invites other drug users to similarly create pockets of solidarity and resistance.

Through its emphasis on building grassroots community power, RATS embodies a radical reimagining of care by and for people who use drugs

People who use drugs and other groups impacted by the ‘drug war’ are made vulnerable to premature death through their interaction with systems that restrict and diminish life. To better understand their functioning, in view of dismantling them, the Harm Reduction School is required training for all potential hub volunteers.

The training politicises harm reduction, tracing harm back to its root causes. Sessions cover topics such as racial capitalism, disability justice, and sex worker liberation. At the same time, the school equips participants with skills to meet the immediate needs of their communities. This includes practical workshops on harm reduction techniques, mental health safety planning, and de-escalation skills, among others. By sharing and building on each other’s skills, whilst collectively sharpening structural analysis, RATS aims to build more resilient communities, better capable of sustainably responding to the harm they experience.

Through its emphasis on building grassroots community power, RATS embodies a radical reimagining of care by and for people who use drugs. Where healing does not result from individualised and top-down decision-making, but from practices that nurture collective resilience, connection and solidarity.

The ‘drug war’ continues, maintaining racial and social control across the globe. RATS offers a vision of grassroots resistance by cultivating power together as people who use drugs. By fostering an autonomous and politicised health and community space, the work of RATS gestures towards a future where everyone can experience greater safety, autonomy, and wellbeing.

Shayla Schlossenberg is drugs service coordinator at Release

Client of local drug and alcohol charity skydives to raise funds and awareness

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Susie, a client at WithYou in Cornwall, is set to take on the ultimate challenge of completing a charity skydive to raise money and awareness for WithYou.

She approached WithYou for help in 2019 for the challenges she was facing with drugs and alcohol. Thanks to the support and guidance she received, Susie is now sober. She has now turned her attention to giving back to the charity that helped her by taking to the skies over Perranporth on Sunday 15 September.

charity skydiveSusie has been preparing rigorously for the skydive and is excited to take on the challenge. She is hoping to raise as much as possible for WithYou and the True Butterflies charity and is calling on the public to support her efforts.

WithYou in Cornwall provides free, confidential support to individuals and families living across the county. The charity offers outreach services and support for those experiencing issues with drugs or alcohol.

Susie, WithYou in Cornwall client, said, ‘I’ve always wanted to do a skydive and I’m really looking forward to raising as much money as possible.

‘I’ve been inspired to do this by my daughter, and the support I’ve received from WithYou. I want to show her that once you get over the fear of overcoming a challenge in your life, you can go on to accomplish anything.

‘I had previously struggled with alcohol and drugs for the last 20 years, and the greatest support I have received is from WithYou – they’ve been there for me every step of the way.

‘WithYou are like family because there is no judgement – everyone is in the same boat, and everyone is there to help you make a positive change. Their support has made a difference in my life today.’

Vicki Eslick, Employment Specialist at WithYou, said, ‘I have been honoured to get to know Susie during her time at WithYou, and to watch her confidence grow. She is a strong and caring lady and to see the efforts she is making to raise money for WithYou is just incredible. Good luck, Susie, we are with you all the way.’

For more information and to support Susie’s fundraising efforts you can visit her fundraising page

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 provided by WithYou

Alcohol deaths continue to rise in Scotland

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alcohol deaths ScotlandThe number of alcohol-specific deaths in Scotland continues to rise, according to figures released today by National Records of Scotland. The total of 1,277 deaths in 2023 is one higher than the previous year and is the highest figure since 2008.

Around two thirds of the people dying were male, increasing by 25, while female deaths decreased by 24. Alcohol-specific deaths were 4.5 times as high in the most deprived areas of Scotland compared to the least deprived areas, with the council areas of Inverclyde, Glasgow City, North Lanarkshire and Dundee City all showing higher rates than the Scottish average.

‘The rate of alcohol-specific deaths peaked in 2006 and then fell until 2012. Since then it has generally risen,’ commented Phillipa Haxton, head of vital events statistics. ‘Those aged 45-64 and 65-74 continue to have the highest mortality rates. If we look at the average age at death, that has risen over time. The mortality rates for those aged 65-74, and 75 and over, were at their highest since we began recording these figures in 1994. At the same time, for age 25-44 the mortality rate has been fairly stable over the last decade.’

While awaiting data to be released for the rest of the UK, Scotland continued to have the highest alcohol-specific death rate of the UK constituent countries, using figures from 2022 – although the gap had narrowed over the last two decades.

Billy Henderson
‘There must be a renewed national focus on preventing people from drinking to hazardous levels”

‘It’s heartbreaking that three people are losing their lives every single day in Scotland specifically because of alcohol, and that the death toll is showing no sign of falling,’ said Billy Henderson, service engagement manager at the Abbeycare Group, which runs a specialist residential detox and rehab service in Erskine. ‘Our staff see first-hand the terrible impact that excessive alcohol consumption can cause, not just on people’s health but on their families, careers and wider relationships.’

Pointing out that minimum pricing had been in place since 2018, with the level due to rise from 50p to 65p per unit at the end of this month, he added: ‘We believe that raising the sale price of alcohol will only have a limited effect. There must be a renewed national focus on preventing people from drinking to hazardous levels. We would like to see more money put towards harm reduction and treatment services for alcohol, as well as a review of drinks marketing and a wider education programme.’

Support
‘Better access to support for substance use outside normal hours is essential and will save lives’

The Salvation Army voiced concern about barriers preventing people from accessing the help they needed. Through its Breaking the Cycle report, the charity highlighted the lack of specialist substance use support at weekends and evenings – more than 80 per cent of Scottish drug services, many of which included support for alcohol use, were closed from Friday afternoon until Monday morning. It also identified the need for adequate mental health support alongside treatment.

‘Behind today’s alcohol death figures are yet more avoidable deaths and a call to action for government and health providers,’ said Lee Ball, director of addiction. ‘To tackle problem alcohol use we need the Scottish Government, local authorities and health and social care partnerships (HSCPs) to work together to deliver a wide range of specialist support services. Better access to support for substance use outside normal hours is essential and will save lives. We must also ensure that no one is denied support due to mental health issues, which can be exacerbated as a direct result of long-term problem drinking.’

Frame of mind

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Mental health and wellbeing practitioners (MHWP)

Mental health and wellbeing practitioners (MHWP) can play a significant – and vital – role in addictions treatment, says James Varty.

In recent years the psychological professions have seen significant change. The NHS Long Term Plan set out ambitious proposals to rapidly expand access to psychological therapies and interventions in England. This transformation required significant workforce expansion, leading to a psychological professions workforce growth of 65 per cent between March 2020 and December 2023. Growth ambitions continue, with a further 24,000-26,000 posts projected by 2037, almost doubling the size of the current workforce.

This transformation has included the creation of a variety of new roles across the three workforce groupings (psychologist, psychological therapist and psychological practitioner) designed to deliver different levels of treatment intensity and psychologically informed interventions in a range of settings.

Mental health and wellbeing practitioner (MHWP) is one new ‘practitioner’ role, introduced in 2022. Although intended to work in secondary care adult community mental health services as part of the national Community Mental Health Transformation programme, spare capacity on MHWP training courses was offered to NHS drug and alcohol services for the second cohort in 2023.

Course fees and 12-month training salary were met by NHS England as part of the training offer, conditional on the post being maintained post-qualification. Further pilots have since commenced in the West Midlands gambling harms service and in some prisons.

MHWP

Great fit
Dr Luke Mitcheson, consultant clinical psychologist for Lambeth Drug and Alcohol Service (working for South London and Maudsley NHS Foundation Trust – SlaM) first heard about the roles through training places being offered across secondary care mental health provision within his trust.

‘The interventions delivered seemed a great fit for drug and alcohol services,’ he says. ‘There’s undoubtedly a real need to meet the psychological needs of our clients – roughly 60-70 per cent have underlying mental health problems, largely depression, anxiety or mood disorders. Our client group often do not meet entry criteria for NHS talking therapies for anxiety and depression, or for secondary care mental health services.’

SLaM recruited one trainee MHWP into their Lambeth service, a post secured by Vincent Heavey, who was among the first MHWPs to complete training. Coming from a lived experience background, after entering recovery Vincent progressed from volunteering to working as a recovery worker. ‘I did a master’s in addiction psychology and counselling while still working as a recovery worker,’ he says. ‘Then this opportunity attracted me, because it was pulling me into psychology but still within a substance misuse context. From recovery worker to a mental health worker, there were a lot of changes.’

‘Vincent carries a caseload, but each client also has a keyworker,’ explains Luke. ‘He has a specialism – it’s an adjunct to keyworking. The keyworker might lean back a little while Vincent leans in. Vincent has been a catalyst for us slightly flexing our model by delivering psychological wellbeing workshops that are skills-based, dealing with low mood, emotional regulation, and loss. Clients trust us.

‘Getting mental health support while they’re here is very helpful to their recovery,’ he continues. ‘It might be sufficient for their needs, or it might get them to a point of stability where they are then able to access mental health services. Even with Vincent, we’re a small psychology resource, but addictions services have to do some mental health work. Sending everyone to mental health services is unrealistic and service users won’t go. Mental health services should be equally pragmatic.’

MHWP

Inclusion
‘Inclusion’, part of Midlands Partnership University NHS Foundation Trust, deliver services across the UK and took on a number of MHWP trainees as part of the drug and alcohol pilot.

Kieran Doherty, head of quality and governance, states ‘I very much see the value of talking therapies within drug and alcohol services. There have been challenges accessing talking therapies for people who use our services who may need clear, structured interventions to help with their mental health needs. We were taking a financial risk with this project as there were start-up costs, supervisory costs and the need to make workforce changes, but it had strong support from Inclusion’s leadership team. We recognised that we need to build people with these skills into our workforce. Developing supervisory networks was possible internally because we already deliver talking therapy services. It’s our aim that MHWPs become part of the mixed treatment economy within our services.’

While there’s still work to do to improve links between mental health and drug and alcohol services it can be life-changing, says Kieran. ‘People who wouldn’t have received a talking therapies intervention are now getting one. It’s having a profound impact on people who use our services.’

Debbie Hart and Karina Cichocka both qualified in the first trial cohort at different Inclusion drug and alcohol services. ‘The focus of our sessions is mental health,’ says Karina. ‘Recovery workers also work within a CBT model, but the tools that we use are very different, and the goals that we work on are very different. We work in parallel for joint outcomes for the client, focusing on different areas that the client is struggling with. My line manager has been very specific about protecting my job role and not getting it confused with the recovery worker’s role.’

‘At the start it was a struggle for everybody to understand where we fit within the service, as the role was so new,’ adds Debbie. ‘Now I feel like we’re embedded. We’re getting more referrals from recovery workers who understand more about what our role is.’

MHWP

Gambling harms
The West Midlands Gambling Harms clinic, also delivered by Inclusion, offers self-referral with rapid access to a formulation-based assessment process. Clients are allocated to one of three pathways: ten-week group, one to one, or an online/blended support programme. Elective psychological therapies are offered in parallel based on need, and this is where trainee MHWP Ela Osei Williams comes in.

‘I assess purely mental health and wellbeing,’ says Ela. My role is fluid; I might come in at the beginning of someone’s treatment journey, or midway, when low mood, depression or anxiety are an issue, to do some structured work. There’s a benefit in having an MHWP who solely focuses on mental health support. The rest of the team can focus on the gambling treatment.’

MHWP

Learning curve
Operations manager Andy Ryan states ‘We rely on the insight of therapists working on the gambling side to bring Ela in when mental health issues arise. Ela’s interventions are invaluable in supporting people and keeping them engaged. We can build a scaffold around the person, drawing on the multi-disciplinary team. We’re one of 15 gambling clinics, and we are all experimenting with different methods and care pathways. We’re on such a learning curve.’

Dr Sarah Stacey, consultant clinical psychologist and professional lead for psychology at Inclusion, has been leading the pilot cohort of MHWPs in prisons, which commenced in April 2024.

‘We started having conversa­tions about the feasibility of this in autumn 2022,’ she says. ‘Our leadership team already had experience from the drug and alcohol pilot, and insights that practitioners like Karina and Debbie helped us think about how this might work in prisons. Inclusion run psychosocial substance use services in over 20 prisons.

‘We decided to pilot the roles in prisons where we’ve got integrated mental health and substance use teams, so that the practitioners could have the experience of working with substance use, but could also be part of an established mental health team where they’d have support from senior practitioners. We chose sites with practitioner psychologists in post too – it’s a really nice fit.’

In the trainee’s sites, there’s an integrated primary and secondary care mental health service while for the secondary care population, there’s been a treatment gap with psychological interventions, and the MHWPs ‘slot in really nicely’, she says. ‘The interventions they’re being trained to provide will definitely meet a need. It’s early days, but our hope is that we can provide interventions that support people to manage distress and difficulty in prison. They can get on with doing other things in prison that will give them a better chance of the life that they want on release.’

MHWP

Making a difference
Across these three settings, MHWPs are clearly making a difference and improving mental wellbeing. Inclusion and SLaM both deliver mental health services, bringing existing governance infrastructure for supervision and appropriate clinical escalation which have been vital to these new roles.

So what can we take away from the mental health and wellbeing practitioner pilots so far? NHS England’s Workforce, Training and Education Directorate are currently finalising their evaluation, but early indications seem positive. A challenge will be to navigate the frequent tendering and remodelling of services through commissioning cycles, often moving from NHS to third sector provision, and vice versa. NHS innovation within the psychological professions workforce must be recognised and understood by commissioners, with the value of MHWP and similar roles built into service specifications. Psychological interventions work, as demonstrated by a body of evidence.

MHWPs – and potentially other new roles emerging within the psychological professions’ taxonomy – represent a move towards designated psychological practice capacity for mental health and wellbeing within drug and alcohol services, as well as gambling, prison healthcare, and other specialist settings.

James VartyJoin the free network to receive a fortnightly bulletin at www.ppn.nhs.uk 

James Varty is programme manager, Psychological Professions Network (Midlands)

Hidden children: what happens when a parent is imprisoned?

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Parent in prisonThe Ministry of Justice (MoJ) recently published statistics estimating that nearly 200,000 children have a parent in prison each year, based on combined data from multiple reporting systems that are used across government departments. 

We now need strategies and processes being instigated by the government in line with Labour’s manifesto commitments to create national guidelines to identify and support children at the point of sentencing to stop them from falling into cycles of deprivation leading to crime.

The loss caused by a parent being imprisoned cannot fail to impact a child. The impact can be measured emotionally and psychologically as children try to make sense of the confusion and stigma they face personally and socially. The economic impact can exacerbate the loss and plunge children into poverty and desperation.  

This combined effect is reflected in the statistics evidencing that children of prisoners are more likely than others to also be involved in crime themselves. One 1996 landmark study (Farrington et al.) that is still often quoted stated that 63% of male children of prisoners go on to be imprisoned too. 

However, less emphasised but even more concerning is that these children are victims of crime and trauma. When a parent is incarcerated for a crime, the immediate and long-term impact of children victimises them as a result of their parent’s offence. Going on to perpetrate crimes is not disconnected from being a victim of it, and this recognition is key to changing the trajectory of hundreds of thousands of lives.

Children of prisoners / Parent imprisoned
Children of prisoners are more likely than others to also be involved in crime themselves

Many studies have found ‘a golden thread’ of positive trends and outcomes based on supporting those imprisoned to maintain contact and relationship with their families. Lord Farmer’s influential 2017 review highlighted reduced recidivism for those able to maintain relationships but also pointed out that much of the work being done to support familial relationships is carried out by charities, including SIG Safe Ground. 

Ministry of Justice analysis of our Father’s Inside programme shows that those who participate in developing relationship skills through our 4-week arts-based course are significantly less likely to re-offend. They are able to develop a sense of self and purpose that correlates with their identity and responsibilities as a parent. Working with fathers at a grassroots level in prisons, we hear more than just their determination to not commit crimes but also their joy at developing skills that allow them to parent their children:   

‘Knowledge is power. I’ve got more tools to prepare me for many roles I will face as a father. I can be the father I’ve always been, but now I can give more of myself whilst I am home. I can now turn up present, ready to listen, ready to do new things with my girls and be a productive family member.’ 

Head of SIG Safe Ground, Emma Hulme, states, ‘The staggering statistics in the MoJ’s report clearly demonstrate the ripple effect being in prison has on families. SIG Safe Ground provide vital and innovative support to families. Fathers Inside is the first of its kind to be delivered across prisons nationwide. Facilitating an arts-based methodology, Safe Ground supports the participants in better understanding themselves, their lived and parental experience, and the impact this, and being in custody, has on family relationships. Men and their families need this work!’ 

Raje Ballagan-Evans, Policy and Impact Manager

This blog was originally published by Social Interest Group. 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 Social Interest Group

DDN conference 2024: session three

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DDN Conference session three

The afternoon session saw lively, interactive discussions on three crucial topics – the ongoing fight against hep C, ensuring user involvement is genuine and at the heart of services, and getting the sector’s key issues into the in-trays of our new crop of MPs.

DDN Conf 3HEPATITIS C – THE RACE FOR ELIMINATION
The conference theme of ‘Stronger Together’ summed up the fight against hepatitis C, Deborah Moores of Humankind told the conference. Her organisation was part of the Hep C Drug Treatment Provider Forum, which was hosted by Gilead Sciences and also included NHS England, the Hepatitis C Trust, and the hep C leads from the country’s main treatment providers. ‘We’ve all got the same goals, so we’ve pooled our resources, our expertise, our methods, our policies and our ways of doing things so we can do it stronger together. We all have that passion and we’re all very vocal, so sometimes we need NHSE and the Hep C trust to calm us down a bit.’

Streamlined pathways
Sharing, integration and equality were the key themes when working together, she told the conference. Other organisations involved included the operational delivery networks (ODNs) who were trying to get as many people as possible into treatment, and other pharma organisations, said Deanne Burch of Hep C U Later. ‘We’re trying to get as much coverage as possible and streamline those pathways, so if you go into one drug service you’re going to get the same level of care around your hep C as you would anywhere else.’

DDN ConferenceLast year the forum won the Health Service Journal’s best healthcare analytics project award for its work with data, said Moores, thanks to its focus on developing shared solutions to common problems. ‘We’ve all got the same challenges. We’re trying to test everybody so what we need to know now is where are the places we’re missing and what cohort should we be talking to? It’s all about collaboration and networking.’

The forum had established elimination criteria to make sure that everyone accessing services who’d put themselves at risk was offered, and received, a test. ‘And if that test is positive and they need treatment, for us to be able to facilitate that treatment for them as effectively as possible.’ It had also developed a set of elimination standards for all treatment providers, she added. ‘They’re not easy to achieve, and they’re not meant to be. We don’t want something that’s just throwaway – we want something that people have striven hard to get to.’ Around 84,000 people had been treated since the middle of the last decade, with a 37 per cent reduction in deaths. Eighty per cent of the treatment provided was to the most deprived half of the population, she added, and there were now 15 prisons that had achieved micro-elimination.

‘We have a shared set of beliefs that we try to live with as much as possible,’ said Burch. ‘And we’re in this because we do believe it’s possible to eliminate hep C as a public health threat in England.’ There was still a real issue of reaching people who were not coming into drug services and offering them a test, however. ‘We need to make sure they’re aware of the risks. So tell us where we need to go, and what we need to do.’

The Hepatitis C content was supported by Gilead’s sponsorship of the event.

DDN Conference threeMEANINGFUL ENGAGEMENT
User involvement should be the ‘DNA and the heartbeat’ of services, said Nic Adamson of Change Grow Live. ‘It’s just the right thing to do. But it also improves outcomes – there’s a raft of evidence that shows people have a better experiences and outcomes when they feel heard, are directing their own care and are given the opportunity to make things better.’

It also helped to improve service delivery, she stressed. ‘Speaking to those who know best what they need, what’s worked well and where there are shortcomings is a far faster route to better service provision than anything else.’ It was vital to direct scarce resources to the right places, she pointed out. ‘The level of need is only likely to go one way, and that’s up. So we have to ensure those resources are going to what works and what matters. It’s not only the right thing to do, it makes a difference – so my ultimate question is why would you not do it?’

While it was rare in the field to meet anyone who didn’t agree with doing it, at the same time it ‘hadn’t significantly grown since the days of the NTA’, she said. ‘I want to hear about the practical things we can do to support it to flourish and become more meaningful throughout the sector.’

Be the change
All recruitment processes at Change Grow Live included a service user panel, up to and including the most senior positions, she told delegates. ‘It isn’t lip service. If our service user panel says they’re not right for us, then they’re not right for us. And I’m really proud of that.’

ConferenceThe organisation also supported people to move into its employment, with strong training and volunteering pathways, and staff surveys suggested more than 40 per cent of the workforce had lived experience, she said. ‘We all know that overdose is the leading cause of preventable death for opiate users, and we all know that half of those who die have never been in treatment. Peer activism helps us get life-saving treatment, support and harm reduction advice into the hands of the people most at risk. It changes minds, and it changes lives.’

Challenges remained, however. ‘Everyone wants to do this and believes in it, but everyone’s really busy. So we often find that without that passionate local champion it doesn’t reach the top of the list.’ There were also criticisms that voices were not representative enough. ‘I hear that, but it shouldn’t be an excuse for doing nothing,’ she said. ‘We have to start somewhere, and only by showing the difference that can be made can we encourage the other voices to get involved.’

It was also essential to harness the experience of the people not in treatment, she stressed. ‘I don’t believe they don’t know where we are. I do believe they’re making legitimate choices to not come through our doors, and I’m really interested in hearing the reasons why. So we can do something about it.’ But it was also vital to celebrate more, she told the conference. ‘All of the changemaking activities that are happening are an inspiration, and I still don’t know the half of it. So we need to tell the stories, we need to share the practice, we need to work as one and we need to be open and honest with each other about where we’re struggling. And we need to be ambitious and relentless.’

DDN Conf session three afternoonPOLITICAL PERSUASION
‘One of the good things about being around for a long time is you don’t get too excited about politicians,’ Forward Trust CEO Mike Trace told the conference’s final sessions. ‘I’ve seen an awful lot of ministers and governments come and go. But it also means you don’t get too depressed when things are a bit rough.’

To provide some perspective he could ‘tell you that no one in the Labour leadership, in Keir Starmer’s office, or any other ministerial office is coming into government saying, “My priority is to reform drug policy” – or to open consumption rooms or change the Misuse of Drugs Act. But in a way that’s a good thing. It’s a blank sheet of paper, and it’s why it’s important for us to be getting our voice out there to these people.’

The new set of ministers coming into their jobs would want to do the right thing, however. ‘They’ve got a lot of problems to solve, but they’re approaching that with a problem-solving mindset. That fits with our world and our sector – so we’ve got a much more open ear than we’ve had for a number of years.’

While home secretary Yvette Cooper was a pragmatic, competent problem solver and health secretary Wes Streeting had ‘good instincts about this issue’, neither had hard and set opinions on the subject – which made it all the more important to try to influence them. Justice secretary Shabana Mahmood had also said encouraging things about the drugs issue, but perhaps even more interesting than the cabinet ministers were those ‘on the edges of that’, he explained. These included people like Angela Rayner, Jess Phillips and the new prisons minister, James Timpson – a ‘very smart, very impressive guy. So it’s going to be very interesting and I’m very hopeful that some of the rubbish policy, rubbish funding and rubbish way of managing prisons might actually turn around.’

Usually when new prime ministers gave their first speech it was all ‘motherhood and apple pie’, he said. ‘You definitely don’t talk about prisons. But Keir Starmer did, and that I’ve never seen before. So we’ve got a prime minister who’s saying the prisons crisis has to be solved and we’re going to confront it, rather than pretend it’s not happening and try to stay out of the Daily Mail.’

DDNCMake your voice heard
The fact that very few of these new ministers were saying ‘this is the manifesto commitment, we’re going to do this, this and this’ was what provided the vital opportunity to influence what Labour’s problem-solving, pragmatic policies on these issues would be over the next few years, he said.

The drugs market was the main reason that prisons were currently ungovernable, he told delegates. ‘If you don’t address the drugs market in prisons you’re not really going to get on top of it. They know that – what they do about it, we’ll wait and see. We also have a drug-related deaths outrage in this country, which is getting worse as we speak. I’ve been trying to say to any politician who’ll listen for the last six months, “This is something you’re not going to be able to brush under the carpet – or you morally shouldn’t be able to”. So I’m hoping that we may be moving into a period where some of that squeamishness around harm reduction gets out of the way, and some good practical life-saving policies are supported. That’s going to be a tougher call, and that’s what a lot of you are going to have to be pushing for.’

DDN Subs
Subscribe to receive DDN updates and suggestions on how to lobby your M.P.

The new parliament had 650 MPs, 330 of whom were there for the first time, he pointed out. ‘It’s first day at school for over half of them. They’re all excited but they’ve no clue what’s going on, so it’s a great opportunity for advocates. The ones who have an interest in homelessness policy, criminal justice policy, drug and alcohol policy – they’re a new generation and they’re open to be interested in your subject. So, particularly if you’re part of a LERO, a local community group or a local service, this is the time to get out and engage with your new MP. Get to those surgeries, talk to them about what you do, invite them to your projects and events, and get their support. Get in there before everybody else.’    

Watch the video footage of session three here:

DDN’s 2024 conference was dedicated to harm reduction activist and DDN conference team volunteer Lee Collingham

WORDS FROM THE FLOOR

‘I got tested for hep C in prison and had a bit of paper through the door saying “you’re positive”, then the door slammed again. It didn’t bother me because it was something I thought everybody got. I’ve been in this field for a long time and I know all about the percentage testing rates, the increasing – but still not perfect – levels of treatment delivered, but something that’s missing is information about what happens when you get hep C. In the drug-using community nobody says, “This will knock 20 years off my life” or “I’ll probably die of this.” There was always very little information about the consequences of hep C.’ Alex Boyt

‘Our local MP is fantastic – she’s taken what we’ve said and quoted it in Parliament. So I do recommend that people get connected.’ Delegate

‘Devolution in the English context seems to be big theme, in terms of bringing the mayors together, so would it also be useful for drug agencies to think how they can influence a more devolved England?’ Martin Blakebrough, Kaleidoscope

Delphi Medical: a leading provider of alcohol and addiction treatment in the UK

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There’s no quick fix for substance dependency, but it’s important to understand that you don’t have to struggle alone – it’s treatable and with the right support and professional guidance you can start your journey towards a healthier, substance-free lifestyle.

Delphi Medical works alongside local authorities, community organisations, and across the criminal justice system to help people through each step of their recovery journey.

Our focus is on ensuring we provide effective addiction recovery services as part of an integrated recovery pathway, which supports and facilitates patients to engage in genuine recovery.

Our services include:

The ARC in Manchester
The ARC in Manchester

The ARC in Manchester – a safe and welcoming community hub in Manchester where multi-agencies have the space to work together by providing services and support both in the community and within the criminal justice system.

Horizon in Blackpool – funded by Blackpool Council, Horizon provides a wide range of drug and alcohol support for all Blackpool residents. We offer information, health screenings, treatments (including opioid substitution therapy), and counselling.

Horizon in Blackpool
Horizon in Blackpool

Spark in Blackburn – Our Spark partnership helps individuals, families, and communities create a life beyond drugs and alcohol. Our diverse team provides an effective, confidential, and judgement-free service you can rely on.

Work in prisons – We provide life-saving clinical and psychosocial programmes in a custodial setting, supporting anybody dealing with drug and alcohol addiction in prison, alongside their family and friends.

Psychosocial Services for Young People – We are working to support vulnerable children and young people who are living in secure accommodation by delivering drug and alcohol services which include education, awareness, 1-1s, and group work.

Get in touch
Talk to one of our friendly and professional experts today.

Delphi MedicalEmail us on contact@delphimedical.co.uk or click on the local service link for a local telephone number.

All enquires are handled with total confidentiality.

Recovery Month – a time to celebrate everyone’s journey from addiction to recovery

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Now in its 34th year, Recovery Month (September 2024) celebrates the success of those in recovery from all addictive behaviours.

Recovery MonthThrough our campaigns, and in the work we do in over 70 community-based services and 25 prisons, the Forward Trust is dedicated to making recovery possible in all its forms.

Since 1991, we have been empowering people to break the cycles of addiction or crime to move forward with their lives. We believe that anyone is capable of lasting change, as celebrated in our Taking Action on Addiction campaign. Our services have supported thousands of people to make changes to create better lives in recovery.

We are proud to stand with our recovery community and celebrate with you!

We’re kicking off this year’s Recovery Month with an all-important reminder that addiction can happen to anyone at any point in life. It is nothing to be ashamed of and getting help – whether it’s for you or a loved one – can save and transform your life.

Everybody Knows Somebody impacted by addiction. We all know friends, neighbours, work colleagues and family members who have experienced or are living with addiction. Yet, despite this, when addiction touches people in a directly personal way, people find it difficult, almost impossible at times to find ways to talk about their experiences.

Last year, our national campaign, Taking Action on Addiction’s lead campaign – Addiction Awareness Week – created a powerful new film, ‘Everybody Knows Somebody,’ giving voice to 42 people impacted by addiction.

The full-length feature of ‘Everybody Knows Somebody’ – a powerful film of 42 participants talking about their experience of living with or someone else’s addiction and recovery.

Throughout the month, we’ll be celebrating the successes of our recovery community. Join us in sharing the message that recovery is possible for everyone!

  • 13th September – FAVOR Recovery Conference
  • 14th September – Recovery Walk Crystal Palace Park
  • 15th September – Switch Off Sunday

Stay tuned for more events and listings.

This blog was originally published by 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 Forward Trust

Local drug and alcohol charity micro-eliminates hepatitis C ahead of NHS target

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Drug and alcohol charity WithYou, partnered with Gilead Sciences, has achieved micro-elimination of hepatitis C across its North Somerset services – a huge step towards NHS England’s target to eliminate the virus by 2025.

micro-eliminates hepatitis C

Hepatitis C is a bloodborne virus which can cause liver cirrhosis and cancer. Early testing is vital, as quick detection and treatment reduces the likelihood of serious liver damage. More than 90% of people who are treated can be cured.

Working with their partners, Bristol and Severn Operational Delivery Network and Bristol Royal Infirmary NHS Foundation Trust, the charity has been actively raising awareness of the importance of testing and treatment, which includes taking testing right to people’s doorsteps.

Gill Flanagan, WithYou’s Head of Service Delivery in North Somerset, says, ‘If left untreated hepatitis C can cause serious and potentially life-threatening damage. But we’ve made so much progress in recent years, and now 90% of people who are treated can be cured.

‘It’s really important for us to do what works to help our clients. It’s been a whole team effort from testing new clients straightaway, testing people when they’re visiting, setting up stalls at the hospital, and going to meet people in their own homes.

‘I’m so proud of the North Somerset WithYou staff who have put so much dedication and commitment into supporting our clients to get tested and achieve micro-elimination of hep C.’

hep c
‘We’re playing our part to stamp out this virus in the UK, and the whole world’

One of WithYou North Somerset’s healthcare assistants, Hannah Ritchie, was appointed as the charity’s hep C Champion. Hannah has spearheaded the work – boosting the confidence of staff, and supporting clients. For those who test positive, she helps them through the whole process, ensuring they get the right treatment and checking in on how they’re progressing.

Rickie Bartlett, WithYou’s Clinical Lead in North Somerset, says, ‘Every successful treatment, every person who is now free from hepatitis C is a direct result of the relentless efforts and hard work of our staff.

‘Some of our clients were hesitant to get tested for a long time. We spoke to them all and explained how important micro-elimination is. This isn’t just about helping people in North Somerset – we’re playing our part to stamp out this virus in the UK, and the whole world.

‘This milestone is just the beginning. We have proven what is possible when we come together with a common goal. Our next step is full elimination.’

Emma Lamond, Director of Integrated Treatment at WithYou, says, ‘As an organisation, we are committed to — and passionate about — eliminating hepatitis C and supporting NHS England and partners to achieve and sustain our shared ambition. We recognise that clients may not always disclose their past injecting history or other risk factors; that’s why we want to challenge the stigma that surrounds hepatitis. Through these interventions, we have an opportunity to bust those myths, raise awareness, and empower people to stay safe and make informed decisions.

‘There is of course still work to be done — we must continue our comprehensive testing programme to sustain micro-elimination status and strive towards complete elimination of hepatitis C going forward which includes strengthening our harm reduction provision and reaching more people.

‘I would like to thank the North Somerset team and our partners who have achieved micro-elimination; the impact they’ve had is extraordinary. Their hard work means our clients have a greater chance of receiving timely, appropriate and successful treatment.’

Hepatitis C testMicro-elimination is defined as:

  • 100% of clients in structured treatment are offered a hepatitis C test
  • 100% of those with a history of injecting have been tested
  • 90% of current and previous injectors (at risk) have a hepatitis C test date within the last 12 months
  • 90% of clients who’ve tested positive for hepatitis have commenced treatment

Most hepatitis C infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions and some sexual practices, but the virus can also be shared through tattoos, sharing razors and even toothbrushes.

Across the world, around 58 million people live with chronic hepatitis C, and there are around 1.5 million new infections each year. The NHS have committed to eliminating hepatitis C before 2025, and through achieving micro-elimination, the service has played a key part in helping the NHS to achieve this target.

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

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

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

This content was created by WithYou

Government announces plans to ban xylazine

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ban xylazine
Xylazine is increasingly being used in combination with opioids as a ‘cheap means of stretching out each dose’

The government is to ban the powerful non-opioid sedative xylazine, along with 21 other substances, it has announced.

A statutory instrument has been laid in Parliament to control the substance as a class C drug, following a recommendation from the Advisory Council on the Misuse of Drugs (ACMD) earlier this year. While xylazine is approved for use as a sedative, muscle relaxant and analgesic in veterinary medicine, it is increasingly being used in combination with opioids as a ‘cheap means of stretching out each dose’ the government states. It will continue to be legally available for veterinary prescribing.

Known in the US as ‘tranq’ or ‘tranq dope’, especially when mixed with fentanyl or heroin, xylazine has been associated with dangerous side effects such as large skin ulcers. As it is not an opioid its effects cannot be reversed by naloxone in the case of an overdose, with the years 2018 to 2021 seeing the number of US xylazine-involved overdose deaths increase from just over 100 to almost 3,500. A recent report from King’s College London warned that the substance had now infiltrated the UK’s drug market and was no longer ‘limited to heroin supplies’.

The government press release announcing the ban – headlined ‘Britain takes decisive action to ban “zombie drug” xylazine’ – has come in for criticism, however. ‘While aimed at addressing public health concerns, [the decision] has been accompanied by deeply troubling rhetoric, labelling the substance as a “zombie drug,”’ said advocacy organisation VolteFace. ‘This kind of stigmatising language is a significant departure from responsible policymaking and is more typical of sensationalist media coverage than official government communications.’

Government announces plans to ban xylazine
Among the other drugs covered by the forthcoming legislation are variations of nitazenes

Among the other drugs covered by the forthcoming legislation are variations of nitazenes, while the statutory instrument will also introduce a new generic definition of nitazenes to stop drug gangs from ‘attempting to use minor adjustments to their synthetic compound’ to get around the law, the government states. The changes are expected to come into force either later this year or in early 2025.

In addition to xylazine, the following drugs will be classified as class C substances: bentazepam, bretazenil, 4’-chloro-deschloroalprazolam, clobromazolam, cloniprazepam, desalkylgidazepam, deschloroclotizolam, difludiazepam, nflubrotizolam, fluclotizolam, fluetizolam, gidazepam, methylclonazepam, rilmazafone, nthionordazepam. Six substances will also become class A substances: AP-237, AP-238, azaprocin, para-methyl-AP-237, para-nitroazaprocin, 2-methyl-AP-237.

‘We have seen what has happened in other countries when the use of these drugs is allowed to grow out of control, and this is why we are among the first countries to take action and protect our communities from these dangerous new drugs,’ said policing minister Dame Diana Johnson. ‘The criminals who produce, distribute and profit from these drugs will therefore face the full force of the law, and the changes being introduced this week will also make it easier to crack down on those suppliers who are trying to circumvent our controls.’

If Labour is serious about prevention it needs to commit to the continuation of the drug strategy

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labour drug strategy
Wes Streeting stated that ‘the NHS is broken’

Turning Point’s Clare Taylor discusses the need for continued government support for the 10-year drug strategy and the role of the sector in supporting an NHS fit for the future.

In his first statement as Secretary of State for Health and Social Care, Wes Streeting stated that ‘the NHS is broken’ with record waiting lists, overcrowded emergency departments and a discontented workforce. Day to day spending has increased over the last parliament although not in line with inflation.

How then, can the Government succeed in its mission, to build an NHS fit for the future, when its own economic forecasts conclude there is limited opportunity for serious investment in public services?

At Turning Point, we believe that better prevention and early intervention is key. NHS funding dwarfs the amount invested in public health services (£164.9 billion compared to £3.6 billion in 2024–25). Streeting himself, identifies strengthened prevention measures as an integral part of modernising the NHS.

According to the Institute for Alcohol Studies, the economic burden on the NHS of alcohol harm now stands at £4.9 billion, enough to pay the salaries of nearly half the nurses in England.

labour drug strategy funding
In 2021, the previous government published a 10-year drug strategy, backed with investment

In 2021, the previous government published a 10-year drug strategy, backed with investment, aiming to address rising alcohol and drug harm and reduce strain on the NHS and wider health systems.

The new funding, coming on the back of 10 years of disinvestment, has increased the number of treatment places available and enabled services to step up outreach activity. For example, Turning Point now has mobile FibroScan equipment available in all its services. We run FibroScan clinics in GP surgeries, enabling us to identify poor liver health ensuring people get the treatment they need at an early stage and also helping build people’s motivation to address their drinking. Data from an early pilot showed around 20% of patients who were drinking at ‘harmful and hazardous’ levels, were successfully referred for treatment.

John (not his real name), was ambivalent about his alcohol use when he first came to Turning Point. Despite beginning each day with a drink at around 10am and regularly cancelling social engagements in order to continue drinking, John maintained his drinking was not problematic. However, a FibroScan showed that his liver was beginning to fail. This served as a wake-up-call regarding the real damage alcohol was causing to his body and served as motivating factor behind his application for detox and rehab.

Substance use is fundamentally a public health issue. An NHS that is ‘fit for the future’ requires a shift in resources to public health initiatives focussed on prevention and early intervention. Despite the progress that has been made in the first three years of the 10-year drug strategy, there is still much more to be done if we are to reduce the strain placed on the NHS as a result of alcohol and drug use. This is why it is vital that the new government uses the Budget and the Spending Review to commit to continued investment in the drug and alcohol treatment sector. Re-building the drug and alcohol sector means building towards a stronger, more resilient NHS.

Clare Taylor is Chief Operating Officer at Turning Point and Interim Chair of Collective Voice, the sector body representing third sector drug treatment providers

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

MPs need to ‘wise up’ to alcohol industry lobbying tactics, say campaigners

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MPs need to be careful to ‘avoid conflicts of interests’ with drinks industry lobbyists, says a report from the Alcohol Health Alliance (AHA), ASH and the Obesity Health Alliance (OHA).

drinks industry
71 per cent of respondents felt that all government policy should be ‘protected from the influence’ of the drinks industry

This means adapting transparent principles for engagement with ‘health harming industries’, rejecting corporate hospitality – such as free tickets to sporting or cultural events – and equipping themselves to ‘challenge common industry arguments that undermine public health’, says Killer tactics – how tobacco, alcohol, and unhealthy food and drink industries hold back public health progress.

In a recent YouGov poll of more than 13,000 people, 71 per cent of respondents felt that all government policy should be ‘protected from the influence’ of the drinks industry, the report states, with 78 per cent feeling the same about the gambling industry.

MPs – especially those newly elected – need to familiarise themselves with common industry lobbying tactics, the report urges, and prioritise the ‘health of their constituents above the profits of unhealthy industries’. MPs and members of the House of Lords are allowed to accept gifts, benefits and hospitality under the Code of Conduct, provided they declare anything above £300 in value. However, businesses often provide gifts ‘strategically valued’ just below the threshold, the document says, meaning that the register of members’ interests may only represent ‘a fraction’ of the gifts received. ‘This raises concerns about conflicts of interest, particularly when MPs are tasked with making policy decisions that may impact these industries’, the campaigners state.

While there are strict rules on government engagement with the tobacco industry under the WHO’s tobacco control treaty, similar regulation does not apply to the drinks industry, which the document says is ‘a cause for concern’. The Institute of Alcohol Studies and other campaigners recently issued a set of guidelines for promoting transparency and protecting policy making from drinks industry interference.

‘For too long, previous governments have worked hand in glove with these industries, leading to policies that prioritise private profits over public health’

‘Alcohol, tobacco and unhealthy food are the three biggest killers in our society, with alcohol alone claiming 10,000 lives in 2022 — the worst on record,’ said AHA chair professor Sir Ian Gilmore. ‘For too long, previous governments have worked hand in glove with these industries, leading to policies that prioritise private profits over public health. MPs are expected to make decisions based on the best interests of their constituents, but we know that lobbying tactics such as receiving gifts and benefits from these industries can lead to a conflict of interest and impartiality being compromised. If the new Labour government is serious about health as a key mission, and about cleaning up standards in Westminster, embracing the principles outlined in this report would be a good place to start.’

Meanwhile, a report from the London School of Economics (LSE) is calling for a new standalone service along the lines of NHS Talking Therapies for people with drug and alcohol issues. ‘One group of mentally ill people receiving little psychological therapy at present are those suffering from addiction – whether to alcohol, drugs or gambling,’ states Value for money: how to improve wellbeing and reduce misery.

From a purely economic point of view, a person who has recovered is 20 per cent more likely to work and would therefore be paying tax and receiving more than £9,000 less in benefits, it says. The report estimates the average cost of the service at £1,122. ‘A recovered addict costs the NHS £2,024 a year less,’ the document states. ‘A recovered addict costs the government £946 a year less in criminal justice. Thus the benefits are substantial and the net cost is negative.’

AHA report available here

LSE report available here

DDN September 2024

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The ideas flow… things feel possible

DDN Magazine September 2024‘We already knew what works.’ This statement referred to peers mobilising with urgency around nitazenes – but it came up again and again throughout the DDN Conference. As each individual or team stepped forward we heard the passion, the evidence and the impact of people with lived/living experience being the lifeblood of services.

This is what happens when you bring peers together from all over the country. The ideas flow, inspiration is generated and things feel possible. By the afternoon session we were in full flow, debating effective campaigns, meaningful service user engagement and political persuasion – and how we could make sure that the enthusiasm for being involved and the appetite for change could translate into expertise and a valuable contribution to policymaking. Why wait for others to decide what’s best for you? Inform, educate, influence – see page 19 for how to get involved.

Visit our website for more pics and videos. It’s more than a conference – it’s a reminder of the team spirit we share, whether you were at the event or not. Let us know what you’re doing in your area to keep this spirit alive and kicking.

Read the September 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

DDN conference 2024: session two

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DDN Conference session 2The day’s second session heard from three different organisations who were putting lived experience at the heart of their activities.

DDN Conf session 2 Gareth‘The people who work for us are from the communities we work with,’ Gareth Balmer of the Fife With You team told the morning’s second session. ‘Some of our staff have even used with those people in the past, and they know their families. We’re a large organisation but we’re very proud of delivering a local service.’

A mostly prosperous and rural area of Scotland, Fife also had pockets of severe deprivation – among the worst in the country – along with high levels of problematic drug use and drug-related deaths. ‘We had seven deaths in ten days a couple of weeks ago,’ he said.

This meant multiple challenges for his harm reduction-based service, he said, including ‘huge’ levels of non-fatal overdoses, ‘benzo use through the roof’, high levels of femoral injecting and increasing crack use. Sixty per cent of clients were over the age of 40, he said.

Session 2 a DDN

Meeting people where they’re at
More than 50 per cent of his team now had lived experience of substance use issues, he said, with the service using vans to provide food, phones, sim cards and an access point for treatment and BBV testing. There was also a take-home naloxone programme and home-delivery service. ‘Unlike with fixed sites, we actually get into people’s homes, which makes a difference. A lot of our work is supportive – one guy we visited 42 times in a month, because he needed a lot of support. That was invaluable.’

The service also had a team of peer naloxone champions, and carried out extensive street-level outreach. ‘We’re not here to judge – drug use is part of our society. But it’s not all about harm reduction – we’re also a stepping stone to services.’ Although the situation had improved in recent years, there were still some high-threshold statutory services locally, he said. ‘So I see us as the fuzzy edge – because we’re super-flexible.’

DDN Conference 2024 session 2 StellaHuman connection
‘When I was thinking about what I was going to talk to you about today I decided I’m not going to talk about harm reduction or the deaths I’ve experienced among my clients – I’m going to talk about a human connection and what it really means to support people effectively,’ said Stella Kityo, founder of the women’s brand Soulgetic. ‘Change happens faster and deeper when we drop the “change” agenda. A lot of the work we do is based around trying to get people to change, and usually it’s the narrative of the services – not the individual and looking at what really works for them.’

Twenty years of working in housing support services had taught her that often women had ‘no narrative of their own’, she said. ‘The narrative they have has been built for them. Seventy per cent of women selling sex describe themselves as homeless. We have a woman who told us recently that her only way off the street was death, jail or a hospital. If that’s your life and that’s your viewpoint, it’s hard to move forward.’

Hidden homelessness was a huge issue, she said. ‘Sofa surfing, staying in A&Es, transport terminals, 24-hour establishments and engaging in survival sex-working. I’ve done outreach in Brixton for the last five years, and our women get through what they need to get through with drink and drugs.’

Session 2 b DDN

After leaving home at 16 because of a ‘toxic relationship’ with her parents she’d found herself homeless, the told the conference. ‘I found myself rough sleeping, sofa surfing and in situations I never thought I’d be in. And I wonder if I’d approached services at that time would they have deemed me a “complex needs” woman?’

When she’d first gone on outreach in areas with high levels of street sex work she’d asked her colleague where are all the sex workers were. ‘I said, “I can’t see anybody”. I was expecting the lady from Pretty Woman with a short skirt standing on a street corner. Instead what I saw was women in tracksuit bottoms and jeans. And you couldn’t connect with them, because they were so used to people like me coming in and out of their lives talking about how they were going to change their life. It doesn’t work that way.’

Endless cycle
The lives these people lived were indeed complex, but that ‘doesn’t take away from who they are’, she said. ‘We have women who have issues accessing healthcare, barriers, stigma, judgment, mental health issues, dual diagnosis. Sometimes they have to walk in front of traffic to get the help they need, and even then they’re released back out to repeat the same cycle again. I get tired of referring women to places that are not going to support them effectively. We create the narrative for people – “difficult”, “aggressive”, “manipulative”, “uncooperative”, “non-compliant”, “high risk” – that’s a big one on referral forms. So we’re not really listening, are we?’

She’d seen numerous clients die over the years and witnessed the same cycle again and again, she said. ‘Have we really listened to what the client wants? We get so wrapped up in arguments about things like abstinence and maintenance that we’re missing the human standing in front of us. Have we examined our own biases?’ Co-production needed to be genuine, she said. ‘Is it for our organisation, or the people we’re supporting?’ Safer environments designed by and for women were vital, and collective energy was powerful. ‘All of us have a voice, and all of us can make a change – through being human.’

DDN Conf session 2 Red RoseTrust and respect
‘If you can name it, you’re pretty much going to find it in our staff and volunteer team,’ said Sarah Omara of Red Rose Recovery. ‘Out of 120-plus staff, 97 per cent have lived experience of multiple disadvantages. That’s because we believe in people and their capacity to change. We’ve built a community where every voice is heard.’

It was a community where people seeking treatment had a say in how it was developed and how it worked, she said, and where learning was shared. ‘We’ve formed excellent relationships with our commissioners, and it’s built on trust and respect.’ It was also a model that was sustainable and could be replicated elsewhere. ‘I wouldn’t be alive today if someone before me hadn’t reached out a hand and shown me the way. It’s our responsibility to pass on what we’ve learned to empower other communities, and we have a responsibility to invest our resources in other grass-roots organisations.’

‘When I heard the word “leader” I always thought of people like Stalin or Hitler, but a leader is really somebody who serves the people they lead,’ said her colleague Rolonde Bradshaw. His team had started picking up litter, ‘serving our community’, he said. ‘That’s what we did in the beginning – we picked up litter and tried to be nice to people. It’s gone from being a once-a-week litter pick to nine regular activities every week – cooking groups, gardening groups, guerrilla gardening. It’s developed, and people have seen value in what we do.’

After recently mending some fishing platforms on the local river, a community group got in touch. ‘I went to see them to tell them what we do and they asked me to leave the room for a few minutes. I thought they were going to give us a couple of hundred quid, but they called me back in and said, “We want to give you £4,700.” So demonstrate the value, and the resources will come.’

Session 2 c DDN

Watch the video footage of session two here:

DDN conference 2024: session one

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first session

The first session of Stronger Together explored how people could unite to address the ever-increasing risks from nitazenes and other potent synthetic drugs.

Session one A‘In 2021 when I first joined Turning Point there was a series of overdoses from something that we all called ‘iso’, because nobody could pronounce it,’ Turning Point’s national safer lives lead Deb Hussey told the morning session of Stronger Together. ‘Maybe naively, we thought it had gone away.’

Isotonitazene hadn’t gone away, however, and by 2023 nitazenes had fully entered the UK’s drug supply. ‘They’re being found in everything – they’re crossing genres,’ she said. ‘We don’t really know the statistics of how many people have actually died, so getting those effective messages out is key.’ Turning Point had begun distributing more naloxone and warning people, she said. ‘And we kept warning them, until there were so many warnings that it just became white noise and people weren’t hearing them anymore. So how can we really get those messages across?’

Pragmatic advice
It was decided that what was needed was ‘really pragmatic advice’ that was applicable no matter what drug the person was using, she said – and with the same message coming from all treatment providers. The organisation brought several other providers onboard, and made sure that everyone was posting the same messages on social media in the run-up to International Overdose Awareness Day. ‘We knew these messages had been developed with people who use drugs, and we really thought they would land. But actually we were just talking to each other – not the people who really needed to hear this stuff. And the overdoses continued to happen.’

A survey carried out by the organisation’s Somerset service found that three quarters of respondents had witnessed an overdose, with more than half witnessing five or more. ‘These were the people we needed to get sharing those messages, the people who could really have an impact,’ she said. ‘And we already knew what works.’ An ACMD review looking at a peer project in Wales had found that for 70 per cent of people receiving naloxone it was their first kit, and almost half were not in treatment at all. ‘These are the people we need to be getting the harm reduction messages about nitazenes to.’

A fifth had even refused naloxone, she added. ‘I don’t know why that is, but maybe it’s because of who offered it. Maybe if they were offered it by a peer they’d be more likely to take it. Is that going to be the same around advice for reducing the overdose risk from nitazenes? I suspect it is.’

Her colleague Jude Duncan, however, had witnessed first-hand what happens when nitazenes get into the drug supply. ‘We had 18 non-fatal overdoses hospitalised and four fatal overdoses in 24 hours,’ she said. ‘Nitazenes were linked to all of them.’ But the actual number of overdoses was likely to have been far higher, she told delegates – ‘we were being told about people who’d been saved by their peers and weren’t going to hospital.’ On the streets that night with a homelessness outreach team she found people were ‘shocked, stunned, worried, scared,’ she said. ‘What I saw was complete devastation and fear.’ It reinforced the vital need to ‘work alongside, and be led by – not do to – people,’ she said.

Session one BMarket vacuum
‘I was raised in the synthetic opioid crisis and I’ve administered naloxone 48 times,’ said drug service coordinator at Release, Shayla Schlossenberg, who uses they/them pronouns. ‘We’re two years into a Taliban ban on opium production in Afghanistan and the market reacted really quickly to that before the actual supply had been hit.’ The cost of heroin had risen and the purity had fallen, creating a vacuum for synthetic opioids and other adulterants to fill. ‘So our drug supply is poisoned – not just heroin but benzo supplies and other opiate pill supplies.’ Nor was it just limited to nitazenes – there was also the synthetic non-opioid xylazine (known as ‘tranq’ in the US), along with fentanyl and its analogues.

‘The number of people dying continues to rise, and half of these people are still not in contact with treatment. In England we don’t have a national naloxone campaign and we don’t have a click-and-deliver service.’ Coverage was piecemeal and dependent on your postcode and who was commissioned in your area, they said. ‘And we don’t have a functioning early warning system.’

Drug-related deaths in the UK were already an emergency before synthetic opioids became a significant concern. ‘We’re already awash with problems in the way we deal with drug-related harm in this country. We know things have got to change but what do we start with? The metaphor I like to use is that we both widen and deepen our toolbox.’ This meant returning to the tools we already had and improving them to maximise their effectiveness – along with expanding the range of tools available. ‘I see “harm minimisation” used synonymously with needle and syringe provision, but I don’t see the ethos of harm reduction in many of those programmes – non-judgmental and non-coercive, and honouring the agency of people currently using drugs. That’s not necessarily happening.’

Co-production
The arrival of nitazenes meant that all of this would need to be done ‘super-quickly’, and one example of making the toolbox deeper was services being delivered and led by people who were current drug users – ‘genuine community involvement’. Drug treatment often wasn’t attractive, with the barriers ‘too high, and the wait times in many areas too long. People are not empowered to partake in treatment because it’s not co-produced with them to be about what will work for their individual lives.’

Promoting and supporting drug user unions could also help to deepen harm reduction work, they said. ‘A union is not the same as a service user feedback form. It exists for and of itself, not to improve a service.’ An example of widening the toolbox, meanwhile, would be opening an overdose prevention site (OPS). These were already ‘hugely evidence-based’, with more than a hundred around the world, and many offering housing support, trauma support, health support and more. In terms of the oft-cited legal liabilities around having an OPS, many were already shared by current NSPs – ‘and we already manage them.’

Nothing would work without real community involvement, however. ‘You can’t do the grassroots mobilisation and buy-in and the changing people’s minds and bringing people with you if you don’t have real people who are impacted by these things at the centre. We might win OPSs and we might win drug checking, but we could lose it if we don’t do the people building along with it.’

Session one CPeople power
‘We’ve always been about empowering our members,’ said Radha Allen of the peer-led B3 organisation in Brent – through training, education, volunteering and more. ‘Even all but one of our board of trustees have lived experience.’ B3 was based in both of the treatment hubs in its borough, and keyworkers would get in touch if their clients needed support with ‘literally anything’, she said.

Colin McMahon had initially come into contact with B3 as it was based in the same building as his treatment provider Addaction, he said, and he’d become a B3 ambassador last year. ‘My addiction took me to the gates of insanity and hell. It destroyed me. I came into recovery in 2015 and all I had was a bin liner full of clothes. My life revolved around police, prison and criminality. My life was black and white but when I came into recovery it changed into colour and I started living again. I’ve gone on to do so much.’

B3 emphasised training and volunteering skills and getting people back into the community, said staff member Nadil. ‘When I first started as a volunteer I had nothing, no qualifications. We want people to be able to gain qualifications that take them to wherever they want to go.’

The organisation also ran recovery champion schools, added B3 volunteer Nitsu – ‘a very well-structured programme delivered through a series of workshops and lessons.’ Be Safe was yet another B3 volunteer-run service, said volunteer Sue. ‘We help each other and give each other support and confidence and growth. I’m no longer in survival mode – I’m enjoying life. And living.’

Watch the video footage of session one here:

A social space

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Cranstoun Conference 2024

With drug-related deaths on the increase, Peter Krykant looks ahead to Cranstoun’s Social Justice Conference 2024.

Drug deaths and harms are increasing, the cost-of-living crisis is impacting families and young people, homelessness is rising, prisons are overflowing and cases of domestic abuse are at appalling levels.

Cranstoun’s three-day Social Justice Conference will cover the five key areas of domestic abuse, young people’s services, criminal justice, housing and homelessness, and of course substance use. The theme is ‘innovation and collaboration’ – coming together to learn, share and be inspired by each other.

Cranstoun Social Justice ConferenceAt Cranstoun we believe in empowering people, meeting people where they’re at and delivering services that are designed by the people they’re there to serve. At this conference we’ll hear from leaders in the field, from those with living experience and those who challenge outdated laws and stereotypes.

While we all work as hard as we can as individuals to support people often experiencing multiple forms of disadvantage, we believe our combined knowledge, expertise, compassion and voice can drive the wider policy changes needed for real meaningful change. This is exactly why this conference is so critical – to steal the theme of this year’s DDN conference, we really are ‘Stronger Together’.

So who should attend? Anyone with an interest in social justice – third sector, drug services, prison, police and probation services, housing associations, social workers, commissioners, health services, night-time economy, community safety teams.

When last year’s inaugural Cranstoun Social Justice Conference took place in Brighton, we were joined by delegates from all over the world – Aamer Anwar the Scottish human rights lawyer, renowned Canadian activist Zoe Dodd and author and reader in law Dr Kojo Koram were among a wide range of speakers covering topics like drug decriminalisation, racial justice, sex work, civil disobedience, overdose prevention sites and heroin-assisted treatment.

Social Justice Conference

After amazing feedback we’re ready for #SocialJustice24 which will take place from 18 to 20 September at the Birmingham Conference and Events Centre. Much has changed since last year’s event, with the drug supply in the UK becoming increasingly toxic – which makes the need to scale up harm reduction services crucial.

‘It’s imperative now that we use spaces like the Social Justice Conference to find our people and team up to prevent further drug deaths, given the rise in adulterants like nitazenes and xylazine,’ said keynote speaker and Release’s service coordinator, Shayla Schlossenberg. ‘I’m grateful for the chance to speak and look forward to finding accomplices interested in taking action against the toxic drug supply.’

Alongside Shayla, we’re delighted to welcome other keynote speakers including Judy Chang from the International Network of People Who Use Drugs, outgoing executive director of Harm Reduction International and Cranstoun board member Naomi Burke-Shyne, our very own director at Cranstoun Meg Jones, Hannah Boyle and Claire Longmuir from Simon Community Scotland, Anna Millington from HR M2M Network, Deb Hussey from Turning Point and Aura Roig Forteza from Metzineres in Barcelona.

We’ll also have poster displays and an exhibition space, and the conference registration will include free-flowing tea and coffee. There’ll be a full lunch each day, and a social evening with a drink included on arrival for each delegate.

Last year we brought together individuals and organisations (that are often competing for contracts and tenders) to share ideas in a safe space, a space where we could be honest and open with each other about some of the challenges we faced as drug deaths continue to rise. Our challenges now are even greater. The Social Justice Conference will give everyone attending enhanced knowledge and expertise so we can meet them head on.

Peter KrykantFor further information and tickets click here

For group rates, exhibition spaces and student rates email pkrykant@cranstoun.org.uk and events@cranstoun.org.uk

Peter Krykant is events and campaigns lead at Cranstoun

Running a marathon with a broken leg

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Running a marathon with a broken leg - residential treatment provision
Karen Biggs, Phoenix Futures

Team GB’s Rose Harvey ran the Paris Olympics marathon with a broken femur. Headlines talked of her extraordinary achievement, her resilience and her courage not to give in, writes Karen Biggs, Chief Executive of Phoenix Futures.

I was discussing the difficulty people experience moving from prison straight into residential treatment with a colleague from another organisation this week. They said they felt much of the processes created by the sector to allow access to residential treatment were like asking someone with a broken leg to run a marathon before they were given the medical intervention they needed to mend the break.

Phoenix Futures delivers a range of psychosocial interventions across the prison estate and the community, as well as housing and homelessness services. We are also the largest charitable provider of residential treatment. Residential treatment is an effective evidence-based treatment option and yet thousands of people are being excluded from accessing it.

Residential placements have been in severe decline since 2014 despite increasing need. This means people with multiple and complex needs aren’t getting the treatment that would support them to recover, including women who have experienced trauma, people with co-occurring mental health conditions and people leaving prison.

This in turn exacerbates pressures elsewhere in the system, including NHS services such as A&E and mental health provision, police and the wider criminal justice system, and other parts of the health & social care system.

residential treatment provision - marathon with a broken leg
Residential placements have been in severe decline since 2014 despite increasing need

As such there is huge potential to leverage residential treatment as a community asset to create significant social benefit through a straightforward solution. I have been working for some years to ensure on a system level, appropriate pathways to recovery are available and equitable for all.

Over the last decade, the operational responsibility for accessing residential services in most local authorities has been given to community services. They establish the processes and agree the funding. Community providers are absolutely a core and very important stakeholder in residential treatment pathways but shouldn’t be the sole stakeholder. We need a broad-based partnership approach to maximising the potential of residential treatment.

Residential treatment and certainly the specialist residential treatment services aren’t commissioned. They are still spot purchased through short term individual placements.

Despite promises in the drug strategy to review the funding arrangements for residential treatment we are still in a strategic no mans land. With the significant risk that progress made in the drug strategy doesn’t impact residential treatment. As an example:

  • None of the 2,500 additional drug and alcohol workers nurses, psychiatrists and psychologists recruited through the additional funding have gone to residential services.
  • Responding to the instability created within the sector through 3-year contracts for community services those contracts are increasingly commissioned for 8-10 years. Residential funding is still spot-purchased for each individual for a 3-month placement.

Of the 290,635 people in treatment in 22/23 only around 1% were able to access residential treatment, in 41 local authority areas fewer than 4 people managed to access residential treatment and in 6 areas, not a single person was able to navigate the system.

residential treatment provision
We need to create strategic ownership of residential treatment provision at a national and regional level

What does all that feel like for people who want to access this form of treatment?
After 17 years in my role, you can imagine I have many people’s stories in my head (and my heart). Many of them inspiring, all of them fraught with trauma, too many with sad endings.

Recently I heard of a man who had joined us in our residential treatment service in Glasgow this month. He had come to us through the prison to rehab pilot the Scottish Government fund. He was from the NE of England and had stayed there for a long time. Recently he moved to Glasgow, frustrated that he couldn’t access residential treatment from his hometown. He had worked out if he spent some time in a Scottish prison, he would have a better chance of accessing residential treatment. The plan worked. His own traumatic sole destroying marathon paid off. It’s the stuff of fables but I assure you it’s true.

What is the alternative?
There are a few options but at its core we need to create strategic ownership of residential treatment provision at a national and regional level to maximise their value to the full range of stakeholders (NHS, mental health, social services, prisons and wider justice services). That would include:

  • Commissioning residential services on a basis that allows access by the full range of stakeholders.
  • Broadening access, creating pathways to all stakeholders.
  • Longer term funding for residential provision that recognises the same instability issues that have impacted the rest of the sector.
  • Not viewing residential treatment as outside of the sector.
  • Treatment durations to be individually assessed as appropriate to need, not time limited contrary to evidence.

If you extend the trajectory of the current declining access to residential treatment, we will cease to have a residential treatment sector by the end of the life of this drug strategy (2031).

We know that this would be a tragic loss and I can point to thousands of people who would agree with us. People across the country that have indeed ‘run that marathon with a broken leg’ and showed real resilience and bravery to access a treatment option they should have been entitled to.

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

How the drug strategy can support Labour’s growth agenda

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Turning Point’s Clare Taylor explores how the drug strategy can support Labour’s growth agenda.

How the drug strategy can support Labour’s growth agenda
Those struggling with drugs or alcohol can face significant barriers in getting and keeping a job

The rise in long-term sickness in the wake of the pandemic and increasing numbers not working nor actively seeking employment is a hotly debated topic. If the new Labour government is to achieve their headline mission to kickstart economic growth, they need to tackle economic inactivity.

This no small feat. There may be a number of inter-related underlying issues at the root of economic inactivity, but this is rarely reflected in the media. Few subjects stir up the popular press quite like people claiming benefits.

Employment issues related to drug or alcohol use can range from ‘absenteeism’ which might be the first sign that someone is developing a problem with alcohol to chronic unemployment. Previous estimates suggest 80% of people struggling with substance use are estimated to receive benefits, with little success of getting back to work.

Employment is an essential part of recovery, both for financial stability and to offer meaningful activity. Yet those struggling with drugs or alcohol can face significant barriers in getting and keeping a job. Dame Carol Black, in her landmark review on drugs, noted how employer-focused employment support inside treatment centres has shown promising results.

Investment linked to the subsequent drug strategy has enabled the sector to increase the number of treatment places, to strengthen the workforce and we are beginning to see a rise in the number of people accessing support. This includes progress on a central aim of the drug strategy, which is to provide holistic support through “employment opportunities, accommodation and their mental health”.

drug strategy Labour
It is essential the Autumn Spending Review commits to continuing drug strategy funding

At Turning Point, we know the value of employment in promoting good health and wellbeing. Last year we supported 1,241 people to access new education, training or employment opportunities. This includes the establishment of Individual Placement and Support schemes offering targeted support to people recovering from drug or alcohol issues.

We also recognise the essential role played by peer mentors and volunteers within our services. They have lived experience of the recovery process, and are well placed to offer guidance, friendship and hope to those experiencing similar issues. Many of our peer mentors have been out of work for a long time and peer mentoring can be the first step towards gainful employment.

Gaining employment can be truly transformative for someone in recovery. Tammy is well on her way to opening her own therapy business. The confidence she gained as a volunteer peer mentor enabled her to go back to education and gain the qualifications that will allow her to open an alternative therapy business to support people’s physical and mental well-being.

Looking back on her time working as a peer mentor with Turning Point, Tammy said: “It really helped me with my long-term recovery, giving back to the community by supporting other people who were struggling. I really learnt a lot about myself. I learnt that I was more confident than I thought I was. It made me realise that I can interact with people because I always thought that I was kind of introverted.”

We are now 3 years into a 10-year drug strategy, but future funding to realise the ambitions of the strategy remains uncertain. If the government continues to invest in building up skills and capacity in the sector, we can turn the tide, enabling people previously struggling with substance use to thrive within their community and workplaces.

It is essential the Autumn Spending Review commits to continuing drug strategy funding – ensuring the substance use sector and wider public services are fit for purpose in supporting people’s health and achieve their career ambitions.

Clare Taylor is Chief Operating Officer at Turning Point and Interim Chair of Collective Voice, the sector body representing third sector drug treatment providers

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

Glasgow consumption room to open in October

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consumption roomThe UK’s first official drug consumption room will open on 21 October, according to the BBC. This week’s announcement of the latest Scottish drug death figures – showing an increase of 121 on the previous year – made it clear that ‘we are in a public health emergency and one that requires radical action’, Glasgow City Council’s Allan Casey told the broadcaster.

The new facility, located on Hunter Street in Glasgow’s east end, will include injecting booths and medical rooms and operate from 9am to 9pm, seven days a week. Up to 30 service users will be able to access it at any time.

Earlier this month Glasgow City Health and Social Care Partnership (HSCP) announced that feedback from engagement sessions with people with lived experience had led to some late changes to the layout of the service, including the addition of a shower room, clothing store and secure outside area. ‘We also consulted with lived and living experience groups on a name for the new service,’ HSCP added – the facility will be known as ‘The Thistle’.

Glasgow consumption room
The facility will be known as ‘The Thistle’ (pictured: a German overdose prevention centre)

‘Following a successful recruitment process – with the support of lived experience reference group members within our interview panels – we’re now creating a fully comprehensive training and induction plan for all staff members,’ said the facility’s operational manager Dan Daly. ‘We look forward to working closely with all services, promoting collaboration and inclusivity for all.’

Scotland’s latest drug death figures showed a 12 per cent increase on the previous year, with 1,172 drug misuse deaths registered in 2023. Opiates and opioids – including methadone – were implicated in 80 per cent of the deaths, benzodiazepines in 58 per cent, cocaine in 41 per cent and gabapentin and/or pregabalin in 38 per cent. People in the most deprived areas of Scotland are more than 15 times as likely to die from drug misuse compared to people in the least deprived, the report stated.

Share your history!

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Working with EveryoneWorking with Everyone are compiling a fascinating history of drug user involvement.

April Wareham and the team from Working with Everyone have embarked on tracing the path of drug user involvement that takes them from the harm reduction pioneers of the 1980s with a backdrop of the HIV/AIDS epidemic, through the rise of the recovery movement, to the here and now. Some of the campaigning groups have grown and evolved into services; many, sadly, are just a memory of a newsletter or logo.

From galvanising to provide immediate support and harm reduction services, the drug-using community became involved in tackling the BBV epidemic, with members campaigning for support services, research, good medical treatment and the right to be part of policy decisions. Black Poppy magazine and The Methadone Alliance were among those fighting for appropriate treatment and OST.

There was little or no coordinated central strategic involvement outside of HIV prevention and treatment until the National Treatment Agency (NTA) was established in 2001 and promoted service user involvement groups funded by local drug action teams.

The dynamic shifted as local groups focused on service user delivery and organisations such as NUN and INPUD campaigned for human rights issues on a national or international level.

The rise of the recovery movement from around 2010 led to the promotion of abstinence-based recovery, and positive changes to many lives – but at what cost to those for whom abstinence was not realistic or desirable?

The history brings us up to the present day to look at the varied patchwork of groups striving for meaningful involvement with a value on lived experience. There is much still to explore and everything to fight for.

Can drug users, service users, people in recovery, patients, advocates, activists… take the lead on everything that affects them? Where do services fit in? How can everyone be heard? How can we make sure the opportunity, the passion and the action come from the grassroots?

Read the evolving history at workingwitheveryone.org.uk where it can be downloaded and printed. It’s a ‘live’ document where readers can add recollections, comments and opinions.

Scottish drug deaths up by more than 120

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There were 1,172 deaths as a result of drug misuse in Scotland last year, according to the latest figures from National Records of Scotland (NRS) – 121 more than in 2022. Opiates and opioids were implicated in 80 per cent of the fatalities.

Scottish drug deaths - Glasgow
Glasgow and Dundee saw the highest rates of deaths

Almost nine out of ten of the deaths were accidental poisonings, with 7 per cent classified as intentional self-poisonings. People in Scotland’s most deprived areas are more than 15 times more likely to die from drug misuse compared to those in the least deprived, NRS points out, with men twice as likely to die a drug-related death than women. Glasgow and Dundee saw the highest rates of deaths, while East Renfrewshire and East Dunbartonshire recorded the lowest.

While the overall figure is up on the previous year it is the second lowest total since 2017, with 2022 recording the lowest. However, Scotland’s drug-related death rate is four times higher than it was in 2000.

‘Today’s statistics show an increase in drug misuse deaths over the last year. The longer-term trend shows that drug misuse deaths are still much more common that they were over two decades ago,’ said head of vital events statistics at NRS, Phillipa Haxton. ‘In the medium term, today’s figures represent the second lowest number of deaths in the last six years.’

The level of deaths remained ‘hugely concerning’ and underlined ‘why we will continue to do all we can to reduce harm and deaths caused by drugs’ said health secretary Neil Gray. ‘We’re taking a wide range of actions through our £250m national mission on drugs, including opening a safer drug consumption facility pilot, working towards the opening of drug-checking facilities and widening access to life-saving naloxone. We will also continue to improve access to residential rehab, where we’re on track to meet our target for additional placements, and drive the rollout of medication assisted treatment (MAT) standards to make treatment and support available more quickly.’

The government would also intensify its efforts to respond to the growing threat from ‘highly dangerous, super-strong synthetic opioids like nitazenes in an increasingly toxic and unpredictable drug supply’, he added.

Scottish government Scottish drug deaths Scottish funding
Extra money will be available for residential rehab places

The Scottish Government announced this week that extra money would be available for residential rehab places for local alcohol and drug partnerships facing high levels of demand. However FAVOR UK’s Annemarie Ward branded the announcement ‘pathological spin’ and a ‘superficial gesture’ in anticipation of the increased drug death total. The government confirmed to the Scottish Sun that officials had had access to the new figures since 13 August.

Meanwhile, the Scottish Drugs Forum (SDF) has published a new report on MAT, Medication assisted treatment – evaluation of current practice across eight health board areas in Scotland, based on extensive interviews with people in drug treatment in Scotland. The report found that some people faced delays in getting an appointment of several months, with further delays in accessing a prescription. Travel distances and costs were also a barrier, the interviewers found, as were stigmatising attitudes from GPs and pharmacists.

‘The examples of stigma and discrimination were painful to observe during the project and are difficult to read now,’ said SDF CEO Kirsten Horsburgh. ‘People’s expectations of services are often very low yet even the basic standards of care and human decency can be sorely lacking. The primary aim of all treatment should be the empowerment of people in treatment. This would be achieved by successful implementation of all ten MAT standards – of which there is some way to go.’

Drug-related deaths in Scotland in 2023 available here

Medication assisted treatment – evaluation of current practice across eight health board areas in Scotland available here

Taking drugs has never been more dangerous, warns NCA

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Taking drugs has never been more dangerous‘There has never been a more dangerous time to take drugs’, the National Crime Agency (NCA) has warned in its annual assessment of serious and organised crime.

There has been a ‘significant escalation in the criminal use of nitazenes’ as a cheap way of increasing the strength of drugs – particularly heroin – and users often ‘simply do not know what they are consuming’, the report states. More than 280 deaths have been linked to nitazenes since June last year.

In the majority of cases ‘these substances were consumed unintentionally alongside other drugs such as heroin and/or benzodiazepines, with very small quantities capable of leading to overdose and death,’ the document says.

Global production of cocaine is up

Alongside the growing availability of synthetic opioids, global production of cocaine is also up, with UNODC highlighting a 35 per cent increase between 2020 and 2021 in last year’s Global report on cocaine. Not only has the number of drug-related deaths in the UK tripled in the last 30 years, illegal drugs are also a ‘key driver of serious and organised crime that blights communities across the UK’, the NCA document says.

‘While overall crime figures have fallen over the last decade, the scale and harm of serious and organised crime has increased,’ said NCA director general Graeme Biggar. ‘As we outline in our latest assessment, it is clear that serious and organised crime still causes more harm, to more people, more often, than any other national security threat.’

Meanwhile, the Scottish Government has announced that local alcohol and drug partnerships (ADPs) experiencing high demand for their services will be able to access extra funding from the £2 million Scottish Government Residential Rehabilitation Additional Placement Fund (APF). The fund will be able to support more than 100 residential places, the government states.

‘Those working in ADPs have helped design this approach, which complements a range of other residential rehabilitation projects supported by the Scottish Government,’ said drugs minister Christina McKelvie. ‘This demand-led fund will allow ADPs that need the greatest number of placements to draw down on additional funding for these when they need it – helping ensure funding is targeted at those areas which face the biggest challenges in meeting demand and where help is needed the most.’

‘We welcome this extra funding from the Scottish Government, which will give hard-pressed councils the option of referring people with drug and alcohol issues to residential rehab services like ours,’ said chief executive of the Abbeycare Group, Paul Bowley. ‘For some people, residential rehabs are the best option and can end up saving their life. They can play a key role in reducing the number of people dying due to drugs and alcohol, working alongside other specialist crisis and stabilisation services.’

National strategic assessment of serious and organised crime available here

Services to support people away from drug and alcohol dependencies will help break the cycle of offending

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A new county-wide service to reduce problem substance use and re-offending has been commissioned by Warwickshire Police and Crime Commissioner Philip Seccombe.

help break the cycle of offending

National drug and alcohol specialist support provider Cranstoun has been awarded the contract to deliver drug and alcohol support to those over the age of 18 who are in contact with the criminal justice system in Warwickshire. The contract award is for an initial period of three years from 1 April 2024.

It’s the latest example of the Commissioner’s commitment towards early intervention among people struggling with substance use.

Darren Nicholas, Assistant Director for Criminal Justice Services at Cranstoun, says, ‘We know how effective making interventions in police custody are to supporting people into treatment and to finding the right support for them.

‘We’re pleased to be expanding our work with the Warwickshire PCC and Police as we work together with partners across the county to give people options and opportunities when they leave police custody to get access to further alcohol and drug services and opportunities to live safer lives.’

Warwickshire Police and Crime Commissioner Philip Seccombe says, ‘Drugs and alcohol are identified as two of the key drivers of crime and disorder, with strong links between substance use and an increased likelihood of committing a range of offences, from acquisitive crime to violent crime and re-offending.

help break the cycle of offending
‘Ultimately, these services are vital to helping break the cycle of re-offending that people can find themselves spiralling into’

‘I’m pleased to be able to confirm the new arrangements for this commissioned service, which follows a competitive tendering process. I’m looking forward to working with Cranstoun, who have more than 50 years of experience in supporting people to rebuild their lives and empower positive change.

‘Ultimately, these services are vital to helping break the cycle of re-offending that people can find themselves spiralling into. I remain committed to funding a range of services that support people to overcome their dependencies, reduce their offending behaviours and ultimately live healthy and crime-free lives.’

Cranstoun have worked with the Office of the Police and Crime Commissioner and former service provider Change, Grow, Live to ensure a smooth handover and continuity of service. Change, Grow, Live will continue to deliver separate community drug and alcohol support services across Warwickshire.

Meanwhile, services to deliver drug and alcohol interventions to young people across Warwickshire will be provided by health and wellbeing charity Compass, whose existing contract has been renewed by the OPCC to at least 2027.

Dedicated workers will be providing services to young people already in the criminal justice system. Educational and outreach work will also continue to raise young people’s awareness more generally of the consequences of substance use.

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

New Lived Experience Campaign Network

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Adfam is setting up a National Lived Experience Campaign Network, to remotely bring people together with lived experience of a family member’s substance use, to campaign, raise awareness and influence change.

Lived Experience Campaign Network
The survey is open until Monday 2nd September 2024

Free online training opportunities will be available to members of the network, to help develop new skills around storytelling and campaigning. Specific topics may include areas such as how to engage with local services, politicians, print media and social media.

We would like to hear from family members with lived experience about whether you would be interested in being involved in the network, what you think the network should look like in practice, and which kind of opportunities you would find most valuable.

If you would like to express an interest in the campaign network, or would like to share your views, please take part in our five minute survey.

This survey will be open until Monday 2nd September 2024.

Please note this survey is specifically for the family members and loved ones of people affected by substance use (this can be both current or previously).

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

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

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

This content was created by Adfam

Stronger Together – Via at the DDN Conference 2024

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L-R: Gary Gemmell (Capital Card Manager), Max Griffiths (Service Manager) and Rick Rutkowski (Recovery Communities Coordinator) from our Via – New Beginnings in Brent service

The DDN (Drink and Drugs News) service user conference took place this year on 11 July in Birmingham, and our Via colleagues from Brent, Cheshire West and Chester, and Surrey hosted a stall. 

This annual event provides an invaluable and inspirational space for sharing knowledge, fostering partnerships, and highlighting essential services and programmes offered across the UK. 

Max Griffiths, Service Manager at Via – New Beginnings – Brent, says, ‘This year’s theme was ‘Stronger Together’, and we attended alongside Brent’s Service User Council, B3. B3 ran a session at the conference, showcasing the impactful work they do in Brent, including their collaboration with our New Beginnings team to deliver a peer-to-peer naloxone programme.

The GLOVES programme is a 6-week initiative using boxing skills to aid recovery

‘Our Reintegration Coordinator, Andreas Kavalierou, also attended with boxing gear, demonstrating our innovative and inspiring GLOVES programme to attendees.’

Our stall featured a variety of initiatives and topics, including the Via Capital Card, the Re-new enhanced brief intervention programme, and our upcoming women’s detox facility in Gloucestershire. Visitors were also invited to participate in a survey on improving service collaboration. 

‘Overall, the day was a fantastic opportunity to hear from guest speakers and engage with other providers and companies in the field,’ says Max.

Andreas Kavalierou, Reintegration Coordinator, says, ‘I thoroughly enjoyed the DDN conference with Via colleagues – connecting with others in the field and being able to talk with pride about the work Via does.

‘Peer mentors, volunteers and people who use our service in Redbridge who attended told us that they felt very lucky they were invited and they felt ‘inspired and blessed’.’ 

Another peer mentor said that, ‘It was a lovely experience and very educational.’

Via DDN ConferenceDave Targett, Area Director at Via, says, ‘It was great to attend the DDN Conference, to hear from the speakers, see some exciting work being presented and to be able to talk about the delivery of our own commitment to the theme of the conference. Via strongly believes in the importance of working together with all stakeholders, and most importantly our clients, to provide the best health and wellbeing support to as many people as possible, helping them to change their lives for the better. There will be a number of exciting initiatives focussed on working together with our clients coming in the future. If this is something of interest, please do reach out.’

About B3
B3 aims to raise awareness of drug and alcohol issues through information and education, provide a voice and support for service users, and improve services in Brent through community feedback, partnership work, training, and service user involvement. Established in 2008 as a small service user group, B3 has grown significantly, eventually running courses, conducting outreach and education, and setting up BSAFE, a weekend service, in 2010.

About GLOVES
The GLOVES programme is a 6-week initiative using boxing skills to aid recovery through boosting responsibility and resilience. It features two sessions each week: a group strategy session and a one-to-one boxing session with a personal GLOVES trainer. The programme helps build and sustain a winning mentality, improve fitness, and develop a personal plan for sustained recovery. Through boxing, GLOVES offers new strategies and a fresh perspective on overcoming challenges, ensuring continuous support and motivation.

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

Seeds of change

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Volunteering in a tranquil natural setting provides fertile ground for challenging stigma

Stigma is well known to people affected by drugs and alcohol. It creates barriers that marginalise, and breeds discrimination and prejudice. It causes exclusion, limits opportunities, and negatively impacts health and wellbeing. People that use substances know inequality well and the shame that accompanies reaching out for support in a stigmatising society. The marginalisation of people affected by drug and alcohol use is also perpetuated by the media and exploited by politicians for political gain.

Seeds of change - challenging stigmaYet, amidst the tranquil backdrop of green leafy spaces and lush vegetables carefully planted in neat rows lies a powerful antidote. Phoenix’s Recovery Through Nature (RtN) programme brings people together to volunteer on a range of hands-on conservation and horticultural projects in natural spaces across the country. For many, the sense of community and belonging found on the programme stands in stark contrast to the othering experienced in wider society. RtN offers participants fertile ground in which to nurture new narratives that disrupt and undermine the stereotypes that have often been internalised.

stigma

The benefits of RtN reach far beyond the people taking part in the programme. The work that the participants do positively impacts the environment, local wildlife, ecosystems, and the communities that live, work, and visit the areas. Nestled among the vegetation, enveloped in the sounds of nature, the solidarity and social cohesion of the RtN community is almost palpable.

Since 1994 when RtN first began the concept of encouraging team-working in ‘the outdoors’, producing positive and tangible results has proved to be an extremely powerful therapeutic tool. The key to the success of RtN is in creating stigma-free, safe spaces that facilitate enjoyable and safe learning environments. The strength of the programme lies in its capacity to encourage genuine bonding and team-working with peers, and positive change is bought about by people listening and sharing their stories and experiences and learning from and supporting one another.

Challenging stigma

Peer-to-peer support is an integral part of positive change. For the people taking part in RtN, drawing on their community through voluntary work can be seen as an act of resistance that helps to dismantle powerful and harmful narratives. When we talk about RtN and the people that take part we’re conscious not to inadvertently play into and reinforce the redemption narrative. It’s well understood some of the stigma people who use substances face is based on moral judgments. There is an implicit expectation of expressions of regret, apology and actions aimed at ‘redeeming’ and ‘giving back’ to the community. We want to be absolutely clear that RtN is not this.

We know stigma is a complex issue, and so are the systems and policies that help to create and compound it. It’s not just a by-product of an unequal society – it’s orchestrated and used as a weapon to deliberately create division and political gain. Stigma-free spaces where inclusion and empathy are the norm help us start to disarm the power of stigma politics and see them for what they are.

Whilst a stigma-free society might seem like a distant goal, spaces like RtN help to make the vision more tangible, help us to have more hopeful conversations and support the reality of a society where everyone feels valued and accepted for who they are.

Jon Hall, Phoenix Futures

To find out more about RtN and how you can partner with us visit Recovery through Nature | Phoenix Futures (phoenix-futures.org.uk)

Jon Hall (left) is commissioning and development manager at Phoenix Futures

JACOB’S STORY

‘My first day of RtN was daunting – being around so many people felt quite overwhelming, and I had become used to being isolated. But, coming from such a low place mentally, feeling suicidal, depressed and ashamed, I was ready to try anything. I couldn’t talk to anyone about my using, and hiding it reinforced the shame and guilt I felt. Through RtN I met people with similar experiences and that’s why the community aspect of it is so integral, because it works. This is one of the best things I’ve done. I’m surprised as initially I wasn’t sure if it was for me. I’ve learnt to love myself again and stop apologising for who I am. Rationalising and being myself is becoming more natural to me. I am not afraid of who I am anymore. Volunteering is a leveller, it transcends social and economic status – it’s like being a beacon of hope to others who feel excluded and isolated, and the people who usually get the most out of it are those who are resistant in the beginning.’

Peer power

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Turning Point’s peer mentoring programme gave Tammy another chance at life. Zahra Paine tells her story.

Turning Point’s peer mentoring programme

Former Turning Point service user and peer mentor Tammy Doyle is well on her way to opening her own therapy business – a remarkable turnaround for someone who just four years ago was left with a 30 per cent chance of survival due to complications from binge-drinking. 

Peer mentorTammy, who spent two years at Turning Point’s City and Hackney service, said the social enterprise’s peer mentoring programme provided her with the platform to turn her life around. ‘I started the peer mentoring programme with Turning Point after I was six months sober. It really helped me with my long-term recovery, giving back to the community by supporting other people who were struggling. I really learnt a lot about myself. I learnt that I was more confident than I thought I was. It made me realise that I can interact with people because I always thought that I was kind of introverted.’

Tammy is using the skills she learnt as a peer mentor to go back to education and gain the qualifications that will allow her to open a business that utilises different therapeutic techniques to support people’s physical and mental well-being – she’s already completed courses in Indian head massage and reiki.

‘In September I’m going to start a level 3 diploma in massage at City Lit,’ she says. Her goal is similar to the one she had as a peer mentor – to help others who are struggling with difficulties with substance use. ‘I want to help women in recovery,’ she says. ‘I know a lot of people who need support in things like domestic abuse. But I want to use this form of therapy for whatever people need healing from.’

Tammy’s own alcohol issues spiralled out of control in her late 20s after the break-up of her relationship with her partner. There were periods where she would regularly consume up to five bottles of wine a night and could drink three quarters of a bottle of gin in one go. The pandemic exacerbated the problem and she was hospitalised, needing a five-hour emergency operation to repair her liver.

‘After all of this I was sent another lifeline,’ she says. ‘I spoke with my psychiatrist and he informed me of Turning Point. I referred myself online and received a call back. From the moment I received the phone call my life began to change. I was assigned a support worker called Lauren who was amazing. I finally felt listened to and understood.’

By September 2021 her liver function was close to normal. ‘Doctors were stunned, and I cried with happiness. I put my recovery down to eating a low-salt, low-sugar diet, no alcohol, exercising and losing a stone in weight.’

Volunteer / peer mentoring
Tammy received an Inspired by Possibility award in November 2022

With the help of her support worker Tammy was able to take part in a mindfulness relapse prevention course, which taught her coping mechanisms to manage her cravings and urges. She also set goals for herself, including raising money for a charity and studying business and administration.

‘When it came to the end of my course and I was no longer in need of support after six months, Lauren asked about my plans for the future. I told her I’d love to become a support worker like her and help people the way she helped me. Not long after I received a message from her for training to become a peer mentor.’

After completing the peer mentor and volunteer training course, Tammy started escorting clients to rehab and detox centres and co-facilitating programmes. ‘My confidence began to grow and I was learning to become more sociable without having to use any substances. I had a great sense of control and freedom back. The course not only taught me about the work we would be doing and the information required, it also helped me to understand my own addiction which in turn made me even stronger in my sobriety.’

Tammy travelled to other services, meeting and listening to inspiring women who were doing well on their own journey. She also co-facilitated in the managing alcohol programme and introduced and co-facilitated the 5 Ways to Wellbeing group with her supervisor at Turning Point’s City and Hackney service.

She completed a four-week course for the service user involvement forum, where she met with other users to discuss and come up with ideas for the service and community. She also shared her story with medical students at the Royal London Hospital to help reduce the stigma surrounding addiction.

Tammy’s work at Turning Point was recognised when she received an Inspired by Possibility award in November 2022. ‘I’ve been given a second chance at life and feel so lucky,’ she says. ‘I won’t waste a second more.’

Zahra Paine, Turning PointZahra Paine is partnerships manager at Turning Point’s City and Hackney Integrated Recovery Service

Mother who nearly died of alcohol dependency volunteers at rehab clinic that saved her

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A mother who nearly died of alcohol dependency last year is rebuilding her life by volunteering at the same Scottish rehabilitation clinic where she was treated.

Emma Harrison, 43, from PaisleyEmma Harrison, 43, from Paisley, was admitted to hospital three times at the start of 2023 after her drinking spiralled out of control and isolated her from her family. At her lowest point, she had developed alcohol-related neuropathy which left her barely able to walk, and was suffering from hypothermia.

She turned her life around after being admitted to Abbeycare, a residential drug and alcohol addiction recovery clinic in Erskine, Renfrewshire. She spent 12 weeks at the facility after arriving in March last year, and later completed its comprehensive aftercare programme, which helps to reduce the risk of a relapse.

Emma now spends 14 hours a week volunteering at the clinic and is on track to gain an SVQ in health and social care, which could lead to full-time employment. She is one of the first people to take part in Abbeycare’s new peer volunteering programme, which gives those in recovery from drug and alcohol addictions the chance to help others who are going through the same thing.

‘I didn’t know if it was 10 o’clock in the morning or 10 o’clock at night’

‘I was killing myself with alcohol, drinking myself to death. I was drinking in the house on my own, and my children had been removed from my care,’ Emma recalls. ‘I got to the stage where I didn’t know if it was 10 o’clock in the morning or 10 o’clock at night. I was admitted to hospital with hypothermia and my family thought I was going to die.

‘One day Gordon, the admissions manager at Abbeycare, and the nurse from my local addiction service came to my hospital bed and asked if I wanted to come in.

‘When I started rehab I was really, really poorly. I was severely underweight, I’d lost a lot of my hair. But I had a willingness to change and I did everything that they asked me to do. I had one-to-one therapy and group therapy, and started learning all about addiction, as well as the triggers to look out for and things from my past that I didn’t know still affected me.’

Mother who nearly died of alcohol misuse volunteers at rehabilitation clinic that saved her
‘Helping others is all part of our recovery’

Six months after completing her stay at Abbeycare, Emma joined its peer support programme, being assigned as a contact for people who were about to leave the clinic. This led to a position on its volunteering programme, where participants are given the chance to work in the clinic, learn from other staff and complete training courses. Around half of Abbeycare’s existing staff are in recovery themselves, and the aim of the programme is to build up volunteers’ skills so they can eventually get a permanent position.

One of Emma’s responsibilities is to do ‘check in calls’, where staff contact clients who have recently left the clinic to make sure they are not overwhelmed by returning to normal life. She has also taken a first aid course and has undergone suicide prevention training. Now more than a year sober, she has also rebuilt her relationship with her three children.

‘It gives them hope straight away, because they see that recovery is possible’

‘It’s been a beautiful journey,’ she says. ‘I learn so much from the staff in here and from the new clients who are coming in. Helping others is all part of our recovery, that’s how we stay sober. I think the clients can relate to us, because it’s not that long ago that we were in their position ourselves. It gives them hope straight away, because they see that recovery is possible.

‘Abbeycare saved my life. If I hadn’t come in here, I wouldn’t be here today. I would’ve gone out, lifted a drink again, and I wouldn’t have survived it. It’s given me a life to live and I feel like I’ve found my calling.’

Eddie Clarke, outreach manager at the Abbeycare Group, said: ‘We hope Emma’s story will act as an inspiration to those who find their lives devastated by alcohol addiction, which unfortunately continues to affect too many people in Scotland.

‘She has been on a remarkable journey that began in her hospital bed when she was offered the chance to begin her recovery with us, and we are so glad that she said yes. She is now a valued member of Abbeycare staff, who uses her own experiences to put people at ease when they first arrive at the clinic and support them when they move on.

‘We hope that Emma will be the first in a long line of former patients who go on to achieve great things after taking part in our volunteering programme.’

Nearly 3m people used vapes to quit smoking in last five years

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Nearly 3m people used vapes to quit smoking in last five yearsVapes are now the most popular stop-smoking aid among those who have successfully quit, according to new analysis from ASH.

Around 5.6m adults in the UK – roughly 11 per cent of the adult population – currently vape, more than half of whom have stopped smoking. Among people who have successfully quit in the last five years, around 2.7m people used vapes to do so, the charity points out. Of the 5.6m vapers, 39 per cent are still smoking and 8 per cent have never smoked.

The survey also found that half of adults mistakenly believe that vaping is just as – or more – harmful than smoking, representing ‘high levels of public misperception’. For smokers who had never vaped, 60 per cent believed that vapes were as harmful, or more harmful, than smoking, compared with 24 per cent of ex-smokers who had quit in the last five years.

The data is based on analysis of YouGov’s annual survey of e-cigarette use, which has been carried out since 2010 and updated to include results from 2024.

ASH is calling for a new tobacco and vapes bill to be introduced urgently to address high levels of teen vaping, but wants to ensure that the new regulations don’t ‘undermine the value of vapes for those smoking’. Although the bill was shelved by the previous government it was included in the King’s Speech in July this year.

Vapes are now the most popular stop-smoking aid
Hazel Cheeseman, ASH deputy chief executive

‘Millions of people have used vapes to successfully stop smoking in recent years, increasing healthy life expectancy,’ said ASH deputy chief executive Hazel Cheeseman. ‘Tougher vape regulations are urgently needed, but it is important they are calibrated to address youth vaping while not deterring use of vapes as quitting aids. Smoking is still the country’s biggest preventable killer and vaping is one of many tools needed to help smokers quit if we are to create a smokefree country for current as well as future generations.’

There was also an urgent need to tackle the increase in ‘dangerous misperceptions’ around vaping, added professor of addictions public health at King’s College London, Leonie Brose. ‘More than half of people who smoke long-term will die prematurely due to smoking. Alarmingly, half of those who smoke think vaping is just as harmful or more harmful and almost as many are unaware that nicotine-containing medication is less harmful than smoking. These misperceptions are costing lives and we need continued focus on reducing the harms from smoking.’

Survey results available here

University of the West of Scotland

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As a UWS graduate, you’ll be work-ready and feel prepared to contribute both locally and globally.

Your learning and teaching experience will be student-centred, personalised and distinctive – preparing you for a rewarding future. Our cutting-edge courses are career-focused and will help you develop advanced knowledge and understanding in your chosen field.

The PGCert / Postgraduate Diploma (PgDip) / MSc in Contemporary Alcohol & Drug Studies adopts a critical social science perspective to explore the interplay between psychoactive substances and society.

You will be introduced to a range of cross disciplinary theories, concepts and evidence to analyse:

  • the use and effects of psychoactive substances
  • patterns of consumption differentiated across social groups
  • responses to drug and alcohol-related harms from a range of perspectives, such as criminal justice, treatment, harm reduction, public health, and health inclusion

We critically examine substance-related harms for individuals, families and communities and how harms are mediated by gender, class, race and ethnicity. We pay particular attention to the social, economic and political contexts of inequality and risk environments and how issues such as housing, homelessness and welfare state reforms may contribute to harms.

We also assess the influences of the alcohol industry; the drugs economy; and prohibition on policy and practice, and engage with current debates on alcohol and drug law reforms nationally and internationally.

Website: www.uws.ac.uk/study/postgraduate/postgraduate-course-search/contemporary-drug-alcohol-studies/

Largest ever trial of ketamine-assisted therapy underway

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Largest ever trial of ketamine-assisted therapy underwayThe largest ever trial to investigate if ketamine-assisted therapy could help people with alcohol problems to stop drinking is recruiting participants, the University of Exeter has announced.

The trial will initially be delivered at eight NHS sites across the country, with the first patients now being screened for eligibility. The £2.4m Multicentre investigation of ketamine for reduction of alcohol relapse (MORE-KARE) is being led by the University of Exeter and co-funded by the National Institute for Health and Care Research (NIHR), the Medical Research Council (MRC) and Awakn Life Sciences.

Early research in the 1980s found ‘promising’ reductions in alcohol relapse rates following ketamine treatment, with more recent studies also showing that the drug has a ‘fast-acting anti-depressant’ effect, the university says. The latest phase III trial builds on the positive initial findings from an earlier phase II investigation, which showed that ketamine was ‘safe and tolerable’ for people with severe alcohol use disorder.

Participants who had a combination of ketamine and therapy in the earlier trial were found to go from daily drinking to remaining sober for almost 90 per cent of the time over a six-month period. However, the researchers made it clear that they were ‘certainly not’ advocating taking ketamine outside of a clinical context.

‘Street drugs come with obvious risks, and it’s the combination of a low dose of ketamine and the right psychological therapy that is key, as is the expertise and support of clinical staff,’ said Professor Celia Morgan at the time. A recent pilot study by the KARE team found that ketamine may make people more receptive to mindfulness therapy, increasing engagement and improving treatment outcomes.

ketamine-assisted therapy
The participants’ alcohol use will be monitored via drink diaries and self-breathalysing

Participants in the current trial will be randomly allocated to receive a different dose of ketamine infusion via drip along with psychological support sessions with a therapist. Both the ketamine dose and type of psychological support will be randomly assigned by computer, with neither the participant nor the research team knowing who has been assigned what. The participants’ alcohol use will be monitored via drink diaries and self-breathalysing, which will be followed up in person at three and six-month intervals.

‘Alcohol problems affect not only the individual but families, friends and communities, and related deaths have increased still further since the pandemic,’ said consultant psychiatrist Professor Rupert McShane. ‘Alcohol-related harm is estimated to cost the NHS around £3.5 bn each year, and wider UK society around £40 bn. We urgently need new treatments. If this trial establishes that combined ketamine and therapy works, this will be a step closer towards seeing it used in the NHS, to help people turn their lives around.’ 

Full details here

Free your mind

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Psychedelics in Recovery - free your mindLast December, I attended my first Psychedelics in Recovery (PIR) meeting, where people are following a 12-step programme. They ‘may or may not use’ various psychedelic plant medicines to help them get off and stay off drugs, not to mention address ‘treatment-resistant’ depressions, and long-standing trauma.

A part of PIR’s preamble notes the potential risk of taking them too often, and although there’s much enthusiasm there for ‘journeying’ and ‘ceremonial use’, it’s very unusual that peers start using plant meds the way we drank or shot dope. I don’t know about you, but I’d likely end up in a secure unit if I took them the way I used heroin.

The group sprang out of a US drug policy event years ago, when it turned out there were around 50 psychonauts present with past addiction issues. It seemed beyond coincidence that they should all be in the same space together, so they grabbed the moment, and leapt bravely into growing PIR.

To contextualise – the US gave birth to the 12 steps in the 1930s, and Bill Wilson, who co-founded AA, took a couple of different psychedelic medicines to help him out of prolonged depressions. So for those of you wondering how a group can call itself 12-step while occasionally taking these meds, the answer, as ever, is written into the implicit search for healing.

PIR friends regularly share how folk originally from AA and NA either don’t tell their fellows that they’re using plant medicines, or the ‘mixed’ responses when they do. Until fairly recently, sharing about taking any drugs in such fora was thought to be unwise, but slowly-slowly our communities are changing.

Psychedelics in RecoveryThe AIDS Coalition’s (ACT UP) slogan ‘Ignorance = Fear’ became imprinted upon my consciousness decades ago, and it reminds me that the psychedelic renaissance is relatively new. Not everyone knows these medicines can stop depressions or reduce the ongoing impact of trauma, and so I don’t get preachy about it.

Ketamine is being used to treat alcoholism but is dependency-forming itself, so some PIRers are unsure about it. Also, people must be free of opiates and SSRIs before they would be considered in most psychedelic research protocols, including for ibogaine. This raises questions for me. Around 2000, I took an ibogaine trip that had me immobile for six hours. I was on SSRIs at the time but the outcome of that journey was ten of the calmest months of my life – the peace and stability I’d craved since childhood. So no adverse affects, though I understand how researchers are currently treading carefully and are reticent to include people on other currently-contraindicated drugs, the potential danger being serotonin syndrome.

If a person’s primary mental health challenge were only suicidal ideation, you might be lucky and find yourself on a psychedelic research protocol. But if you’ve ever been diagnosed with bipolar or schizophrenia, forget it. When I first worked that out over years of chats with friends at Breaking Convention and the Multidisciplinary Association for Psychedelic Studies (MAPS), I wasn’t delighted.

Anyways, I did my first community detox from opiates and SSRIs, arguably a dumb thing to do given I live in chronic/severe pain. My conclusion so far is that it was definitely a good idea to stop the SSRIs. Not sure about the low-level opiates, as I’m always struggling with physical pain, acute or not.

As for the million-dollar question about whether microdosing psilocybin will stall decades of depression, I would answer yes, though you’d better have the money to afford them. Just like medical weed, they’re not cheap, but if you shop around you may find a reasonable price.

Moreover, I am not yet personally convinced that psilocybin is more successful at treating depression than some SSRIs, but I haven’t spent the last decade of my life empirically researching this. What I will say is that it can only be a good thing to have increased medicinal choices on this planet, in this historical period where war-related trauma and the climate emergency are creating high levels of mental health trauma and associated illnesses.

Andria Efthimiou-Mordaunt is an activist, who visited PIR as an observer

One in three people on prescribed opioids showing signs of dependence

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One in three people on prescribed opioids showing signs of dependence

Problematic pharmaceutical opioid use ‘appears to be common’ in chronic pain patients treated with opioid analgesics, according to a new scientific review, with one in three ‘showing signs and symptoms’ of dependence and opioid use disorder.

Researchers looked at almost 150 studies, covering a total of 4.3m participants who had non-cancer pain for three months or more, with the review providing a ‘more accurate and more concerning rate of opioid misuse than has previously been calculated’. The studies were predominantly from North America or other high-income countries, and were mainly carried out since 2010.

The researchers divided the studies into four categories – ‘dependence and opioid use disorder’ (a formal diagnosis), ‘signs and symptoms of dependence and opioid use disorder’ (craving, tolerance, withdrawal), ‘aberrant behaviour’ (repeated dose escalations, seeking early refills, ‘lost’ prescriptions), and ‘at risk of dependence and opioid use disorder’ (characteristics that might increase the risk of dependence in the future).

While nearly one in three patients in the studies fell into category 2, almost one in ten were in category one, with one in five showing aberrant behaviour says the research, which was led by the University of Bristol and is published in the journal Addiction.

Health professionals need to regularly discuss prescriptions with their patients – including the potential risks

NHS England published a framework for prescription drugs last year, setting out that health professionals needed to regularly discuss prescriptions with their patients – including the potential risks – and that services for people experiencing withdrawal symptoms should be built into service specifications. A Public Health England review from 2019 found that some people were being prescribed opioids – along with other potentially addictive drugs such as benzodiazepines – for up to three years at a time.

‘Clinicians and policy makers need a more accurate estimate of the prevalence of problematic opioid use in pain patients so that they can gauge the true extent of the problem, change prescribing guidance if necessary, and develop and implement effective interventions to manage the problem,’ said lead author Kyla Thomas, professor of public health medicine at the University of Bristol. ‘Knowing the size of the problem is a necessary step to managing it.’

Turning Point’s clinical director, Dr Martyn Hull
Turning Point’s Dr Martyn Hull

‘Despite good progress in reducing the prescribing of these drugs in primary care in England over the last few years, there are currently limited options for people with severe chronic pain and there is a clear need for improved access to both multidisciplinary pain clinics and evidence-based non-pharmacological treatment options such as physiotherapy,’ added Turning Point’s clinical director, Dr Martyn Hull. ‘Additionally, psychological therapies for those with chronic pain should be more widely available. There is also a very obvious gap in provision for those dependent on prescription opioids, many of whom have a complex mix of physical and mental health issues.’

While there were pockets of good practice in England, community drug and alcohol services were generally not commissioned to provide support, he said. ‘For those patients who have developed a dependency on prescription opioids, we need to take a more joined-up approach with specialists in the areas of pain, addictions and mental health working together to provide dedicated support for this group.’

Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain: A systematic review and meta-analysis available here

Sharp rise in homelessness among prison leavers

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homelessness among prison leaversThe number of people finding themselves homeless after being released from prison has increased by 30 per cent in a year, according to research by social justice charity Nacro and the Independent. The situation risks a ‘revolving door’ back in to custody, it states, despite a government scheme being in place to house people on release.

More than 9,200 people were released into homelessness or rough sleeping in the year to March 2024, according to analysis of Ministry of Justice figures – up from just over 7,000 the previous year. The number of people leaving prison overall rose from 62,345 to 70,040, meaning that more than 13 per cent of prison releases are now resulting in homelessness, while the number of women being released into homelessness is up by almost 40 per cent.

Much of the rise is the result of the ‘chaotic’ early release scheme, which has seen more than 10,000 prisoners released up to 70 days early to free up prison space. A report from the Prisons and Probation Ombudsman (PPO) published last month found that more than 30 per cent of people who died within two weeks of release were released homeless. ‘Those who are the most vulnerable due to experiencing mental health and substance misuse issues made up many of those released homeless,’ it stated. ‘Our cases showed that some individuals were worried about being released into accommodation that might lead them back to substance misuse.’

The ombudsman investigation into 137 post-release deaths between September 2021 and December 2023 found that more than half of the people had died within the first four days of release, with more than 70 per cent of the deaths drug-related. Twenty of these drug-related deaths occurred on the first day of release, the report adds. ‘We know that prison leavers often have multiple risk factors,’  ombudsman Adrian Usher commented at the time. ‘However, more must be done by HM Prison and Probation Services and community service providers to ensure that vulnerable prisoners have the right support in place so they are released with suitable accommodation and to protect them from substance misuse on release.’

homelessness prison leavers
The number of people leaving prison into homelessness has increased significantly

The government’s scheme to find accommodation for prison leavers housed 12,205 people between July 2021 and March this year. However, the Independent ‘understands that, due to difficulties finding beds in the private rental sector, the rollout was slower than hoped – with the scheme having only reached 70 per cent capacity in December and 85 per cent this month’.

‘The number of people leaving prison into homelessness has increased significantly in the past year,’ stated Nacro chief executive Campbell Robb. ‘This is on average 800 people a month who go straight from prison to homelessness, most of those are rough sleeping. The increase in homelessness is likely to be driven in part by the former government’s early release scheme, which saw people coming out early, too often without enough time to prepare.’

The data was a ‘clear warning’ to the new government ‘not to repeat the mistakes of the past’, he stated. ‘Immediate steps to tackle the prisons overcrowding crisis are necessary, but they must put in place special measures to house the thousands of extra people coming out of prison early in the autumn. Otherwise, they risk swapping the prisons crisis with a homelessness crisis. People are 50 per cent more likely to reoffend if they are homeless, so it is likely many people released early into homelessness will return to prison and the opportunity to free up space in the prison system will be wasted.’

Number of prisoners released into homelessness rises by a third in a year, despite new government scheme available here

Learning lessons bulletin issue 19: Post-release death investigations 2 available here

DDN Conference – in pics

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DDN Conf pics

Did you attend the DDN Conference 2024? Did our roving camera snap you? Take a look at a selection of photos from the big day and see if you can spot yourself!

DDN Conference photos

DDN CONFERENCE 2024 PHOTOS

ddn conf 24 photos

Stay tuned for more conference coverage coming very soon!

If you have any feedback, photos or video clips of the day, we’d love to hear from you. Please share on social media using the hashtag #ddnconf or send to us directly via DM or by emailing carly@cjwellings.com

Herefordshire recovery service launches Click & Deliver programme for naloxone kits

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Turning Point’s Herefordshire recovery service has introduced a delivery service for naloxone kits in Herefordshire. Naloxone is a critical first aid medication that can reverse the effects of an opioid overdose, potentially saving lives in emergency situations.

click and deliver naloxoneThe Click & Deliver programme by Turning Point’s Herefordshire drug and alcohol recovery service offers individuals the convenience of having naloxone kits delivered to a location of their choice. This service comes as a solution to the challenges of accessing naloxone kits, which were previously available only through select drug treatment providers and pharmacies, posing barriers for many in need.

Understanding the necessity for accessibility, Turning Point recognised the diverse needs of individuals, including those with mobility issues, residents in rural areas with limited service availability, and family members of individuals at risk of overdose who may face stigma concerns.

The success of a similar postal naloxone service in Scotland and Wales inspired Turning Point to pilot the Click & Deliver programme in England, starting at the Somerset Drug and Alcohol Service. The initiative proved highly successful, with over 140 kits distributed and at least three instances reported of naloxone being used to reverse overdoses and save lives.

Highlighting the impact of this initiative, Michael*, an experienced first aid volunteer, shared his experience of administering naloxone to an individual in need. Through Click & Deliver, individuals like Michael* can access naloxone training and kits easily, enabling them to respond effectively during overdose emergencies.

‘I regularly deliver basic first aid to people in need but had never been able to access naloxone training. In October, I placed the Click & Deliver order for naloxone through Turning Point and received training on how to administer it over the phone.

‘In March this year, I made a second Click & Deliver order as I needed to replace the kit as I had used it on someone who had overdosed. I had been out and came across someone who was unresponsive. Recognising the signs of an opiate overdose, I called an ambulance and administered naloxone and the person was taken to hospital.

‘When I ordered the replacement naloxone, I requested a carry case to make sure the kit was always at hand if I needed it again.’

The ambition is to expand the Click & Deliver programme across all its services by the end of the year to ensure broader access to naloxone.

click deliver naloxone
‘This will save lives’

Deb Hussey, Turning Point’s National Safer Lives Lead, emphasised the importance of making naloxone easily accessible to combat the rising risks associated with synthetic opioids.

‘With the increasing risk from potent synthetic opioids, it’s never been more important to make it as easy as possible for people to access naloxone. By removing the barriers experienced by some, Click & Deliver helps us raise awareness and make sure we’re getting naloxone into the hands of the people who need it. This will save lives.’

If you are in the Herefordshire area, click to find out how to order your naloxone kit.

*real name changed

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

The drug market is at the centre of the prisons crisis – here is what we can do to tackle it

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Mike TraceOn 2 August, CEO of the Forward Trust Mike Trace attended the latest graduation event at the ‘Y Bont’ programme in HMP Swansea. Read his thoughts here…

This intensive 12-step drug/alcohol recovery programme aims to equip prisoners (whose offending is addiction-related), with the strength and skills to live a drug and crime-free life.

It’s one of seven prison-based addiction programmes that Forward Trust operates. Amazingly, the only ones that receive dedicated funding are in three Welsh prisons – funded by the Welsh office of HM Prisons and Probation.

The drug market is at the centre of the prisons crisis
Most prison-based addiction programmes were closed down as funding was withdrawn between 2012 and 2015

This is in contrast to 10 years ago, when there were almost 100 prison-based addiction programmes across the country; with 14 of the largest operated by Forward Trust. While many were of poor quality, they represented a foundation for the creation of an anti-drug culture on prison wings. But sadly, most were closed down as funding was withdrawn between 2012 and 2015.

The austerity era policies saw a significant increase in the prison population, while massively reducing prison budget and staffing levels. This, combined with the closure of the addiction programmes, has had the effect we all predicted. We now see most prisoners held in unsafe and insanitary environments, with little opportunity or incentive to engage in positive activities, and every incentive to try to make money in the drug market, or to block it all out in a drug-induced haze.

The excellent Chief Inspector of Prisons, Charlie Taylor, has repeatedly detailed this problem in his reports on individual prisons, and there are signs that prison leaders are waking up to the need to reverse a decade of decay:

  • The Ministry of Justice is in the process of rolling out an initiative to create locations in every prison where prisoners can choose to live free from drugs, and if necessary, get the treatment they need to recover from addiction. The clumsily named ‘Independent Substance Free Living (ISFL)’ units currently vary in quality and scope. However, the idea is a good one: if implemented with enough determination, it has the potential to be a game-changer in prison discipline.
  • Dame Carol Black, who authored the standout review of the community-based drug/alcohol treatment system, has been working on a similar analysis of the prison-based system. She expects to submit her recommendations to Ministers this month. If her analysis and vision are as clear as her previous report, this could be a turning point for services that have been underfunded and poorly targeted for many years.
  • Finally, the Prime Minister himself was brave enough to acknowledge the poor state of prison policy that he inherited from the previous government and has made the inspired appointment of James Timpson as Prisons Minister. We can see from James’ CV, and his first speech in parliament, that this is someone who understands prisons and prisoners, and is determined to turn things around.
drug market prisons
We have been frustrated to see the deterioration in control of drug dealing and consumption in our prisons

At Forward Trust, we have been frustrated to see the deterioration in control of drug dealing and consumption in our prisons over the past 10 years. We had a successful blueprint for tackling drug supply and demand many years ago, but have struggled to be heard, as cost savings and other initiatives have pushed tackling drugs down the agenda. Our advice remains the same – every prison should have:

  1. A drug strategy coordinator, and multi-disciplinary committee, to ensure the necessary interventions are widely and well implemented.
  2. An intelligence-led anti-smuggling and dealing plan to isolate those bringing drugs in and root out corruption.
  3. Designated wings for prisoners who commit to staying away from the drug market, and to engage in treatment and other purposeful activities.
  4. Incentives regimes that encourage prisoners to move to these wings, to comply with drug testing and other rules, and to make progress in activities that reduce their risk of reoffending.
  5. Easy availability of addiction recovery programmes, that confront prisoners’ reasons for becoming dependent, and that give them the tools to live a life after release free from drugs and crime.
  6. Early release programmes that allow prisoners who have completed the first phase of their treatment in prison to engage in a second phase on release.

All of these proposals are deliverable under a smarter strategy and better prioritisation of resources – this is not about big new investments. Indeed, they are highly cost-effective ‘spend to save’ measures that will lead to reduced future costs and pressures, as the rate of reoffending comes down.

We have good people in charge of prisons policy – and now, an opportunity to make a generational difference. Let’s hope we can grasp that opportunity.

This blog was originally published by 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 Forward Trust

Keep industry out of alcohol policy, say campaigners

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Keep alcohol industry out of policyThe government needs to establish governance processes that promote transparency and ‘protect health-focused policymaking from alcohol industry interference’, according to guidance developed by the Institute of Alcohol Studies (IAS) and other campaigners.

It also needs to acknowledge the ‘essential conflict of interest’ between its public health goals and the industry’s economic objectives, the document adds, and reject partnerships with industry bodies. Any interactions should be minimised, with those that do occur restricted to ‘information exchange to support policy implementation’. Previous plans to reduce alcohol-related harm – such as the long-delayed implementation of minimum unit pricing in Scotland – had been subjected to ‘interference’ from the industry, says the guidance, which is published in the Guardian.

alcohol industry
‘…alcohol companies have a long history of disrupting and delaying health policy’

‘Just like tobacco companies, alcohol companies have a long history of disrupting and delaying health policy, which is why the World Health Organization advises governments to protect against undue influence from the alcohol industry,’ said IAS chief executive Dr Katherine Severi. ‘Alcohol companies, trade bodies and industry-funded front groups should be treated in a similar way to the tobacco industry, with all interactions a matter of public record and discussions limited to implementation of policies that have been developed in the public interest.’

However Portman Group chief executive Matt Lambert labelled the guidance a ‘narrow-minded suggestion put forward by an organisation funded by the temperance movement’, and one that failed to take into account industry-funded initiatives to encourage moderation, reduce harms and promote responsible marketing. ‘It is vital to listen to a range of voices on these important issues and it would be counterproductive to exclude the expertise of the alcohol industry and self-regulatory bodies which do a huge amount to encourage responsible consumption,’ he said.

Report available here

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