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Be careful what you wish for…
At several conferences over the last few years, including at least twice at DDN service user involvement conferences, I have had the pleasure of hearing NTA chief executive Paul Hayes speak. At these events he has been challenged on why funding for drug treatment has been made available to tackle perceived drug related-crime, and several times faced impassioned pleas that drug use should be seen as a health issue, not dealt with by the criminal justice system. On each occasion Mr Hayes has agreed with the questioner, but urged them to take a pragmatic approach, pointing out the competition that budgets would face within a wider health and social care context.

I came across a ‘conference special issue’ of DDN from 2008 and Mr Hayes says: ‘Service users as a group are unpopular with the public, compared to old ladies who need hip replacements or babies in incubators. You are seen as the authors of your own misfortune – there is no way we can hide from that.’

Mr Hayes impressed on delegates that while the NTA was working to transform the negative image of drug service users and challenging attitudes towards them, its main business was to use criminal justice-led funding to improve treatment.

‘We are in the business of doing good by stealth. Reject the victim label, but also the fantasy that if everyone would stop stigmatising you everything would be alright,’ he urged. This view was so deeply unpopular that on several occasions what he was saying was drowned out by loud booing from the audience.

Fast forward four years and the UK’s visible recovery movement has made great inroads into challenging stigma and having substance misuse recognised for the health problem it undoubtedly is. This will culminate in April of next year when responsibility for drug treatment will be administered by the new Public Health England. Surely this is being hailed as a major victory within the field, and there is much rejoicing across the land?

It would seem not. All I currently hear is concern that drug treatment budgets will be plundered by other areas of public health, and how the future removal of ring fencing will lead to vast reductions of the amount spent on treatment, with local directors of public health diverting the money to old people’s services or child welfare. I don’t wish to hail Mr Hayes as a great visionary, but on this occasion maybe he did get it right. Is there a chance that by winning an important moral victory, we will have lost the battle to maintain the high levels of funding the field has been enjoying. Is it a case of be careful of what you wish for? I hope not.

T Small, by email



In our last issue, the article Joint Forces, (DDN, October, page 15) was attributed to Cinzia Altobelli. It was in fact written by her colleague Cat Payne, therapeutic practitioner/tutor at Action on Addiction’s Families Plus team.