State of the Nation: One of the day’s lunchtime sessions heard delegates debate the current state of English drug policy
‘The subtitle of this session is “have we lost our duty of care”, and that’s something that really worries me,’ Chris Ford told delegates. Many services now had a ‘one size fits all’ agenda, or ‘to be more accurate, one size fits nobody,’ she said. ‘They’re concerned about their PbRs or whatever. As the Archbishop of Canterbury said, the way a society is measured is by how we care for our most vulnerable’.
The ‘deafening silence’ around the fact that drug-related deaths had risen by more than 60 per cent in two years was a ‘real indictment’, agreed Alex Boyt. ‘Imagine if that was in any other part of society. I’m not anti-recovery, but I am worried that it pulls some people forward but leaves others behind. Service users in Camden, where I work, create newsletters that have now become just pages and pages of obituaries.’
Wales and Northern Ireland had actually seen death rates fall in the last two years, he pointed out, while Scotland had experienced an increase and in England it varied according to region. ‘Naloxone by itself is not going to reverse the trend.’ When people arrived at services now they were ‘shattered, tired, broken’, he said. ‘They need to be held by services, but increasingly they’re subject to recovery-based criteria. One service manager said to me recently that, “These days we have to get them in and out before we even get to know them”.’
Recovery also now meant so many different things to so many different people that ‘it seems to me that when we use it we’re not communicating properly’, he argued. ‘I think it’s important that when you celebrate recovery you’re aware that what works for you may not work for other people.’
Indicative of the overall problem was that one current target was for hepatitis C testing, he said. ‘So you can say you’ve offered testing to 99 per cent of your clients, but only 1 per cent are treated, which is obscene.’
‘Thirty years ago I started going to a drug service in Paddington, and my main feeling was fear,’ Beryl Poole told the session. ‘Now those elements of fear are creeping in again, and I never thought they would. You have drug workers talking to you about recovery with these fixed, rictus smiles. We used to diss the NTA but now that we don’t have them we miss them. Who’s going to advocate on our behalf now?’
‘A lot’s been said about service user involvement having a voice, but it’s lost its way,’ said Steve Freer. ‘In the days of the NTA it was statutory, but service users are feeling totally disillusioned now, and they’re being crushed underfoot.
On the key question of how to create a meaningful voice for service users it was vital that ‘we should all be on the same side’, said Ford, but one delegate argued that ‘we have lost our voice. It’s all being muddied by money, and we’re losing our passion.’
Organisations had a vested interest in not promoting service user involvement, argued another. ‘It’s a bit of a monster once it’s let out of the cage – they don’t want service users to have that power. I’m a service user representative but I’m not listened to, not really. Once you let that monster out of the cage how do you control it, what do you do next?’
What it amounted to was a ‘divide and conquer’ process, said another delegate. ‘What we have to do is be fighting this top-down inequality. There’s too much arguing about the minutiae.’ Poverty was by far the biggest driver of drug-related deaths, said Ford. ‘In the 1980s, the most deaths were in the North East and the North West. It’s poverty.’
While there was undoubtedly a need for a social movement, it shouldn’t be based around drugs, argued Alistair Sinclair. ‘We need to be talking to people in mental health, in homelessness.’
‘When the service user voice has really been heard, it works well,’ stated Ford. ‘It’s a win-win situation. I think this the beginning of a rallying call. We have to get together – united we stand, divided we fall.’
Throughout the conference, Philippe Bonnet gave practical training sessions on administering naloxone. Distributing kits made an important difference, he told DDN
Another year, another DDN SU conference in sunny Birmingham. This year, however, I was allowed to not only train people but give them take-home naloxone kits too!
The legislative changes made in October 2015 have made a real difference in kit distribution – to some parts of the country at least. Although I trained around 45 individuals last year, I could not provide them with kits there and then. This year everyone left with a kit.
This year was also a reminder of how blessed we are in Birmingham. To date, we have issued around 3,000 kits and we witness successful reversals on a monthly basis. My organisation’s national naloxone strategy, launched last year the day after the DDN conference, has had a tremendous impact. Naloxone sure saves lives.
Phillippe Bonnet is an outreach worker and activist