If not now, when?

A new drugs strategy offers the chance for the Government to right the wrongs of disinvestment by funding Dame Carol Black’s rigorous, costed policy programme. The necessary resource must be provided to bring a new generation of people in need into recovery, save thousands of lives, reduce crime and make major savings for the public purse. The time to act is upon us. If not now, when?

For the drug and alcohol treatment and recovery field, 2021 has been a year of massive challenges – and one significant, as-yet-unrealised, opportunity.

Years of disinvestment have left their mark, however committed our workforce is to delivering life-changing (and in many cases life-saving) support. And after 18 months of the stress and upheaval of Covid-19 it’s no surprise that many services are now under enormous pressure. From peer support and key-workers, to service managers and local authority commissioners, our workforce is at risk of exhaustion without an increase in resource to build capacity across the board.

Recent treatment statistics have provided further evidence – if it was needed – that major, sustained investment is needed to build resilience back into the system to enable it to cope with the challenges of tomorrow.

Where are we now?

Multiple ministers have publicly noted the government’s commitment to “turning the tide on drug related deaths” and the role treatment and recovery have to play in this.

They now have at their fingertips – in the form of the Black Review – a high-quality, costed plan to achieve that goal, as well as bring thousands more people into treatment and prevent millions of crimes, all at a saving to the public purse. A £80m Universal Grant earlier this year was welcome but, with its one-year accelerated timeframe, could only ever feel like a life-raft on a stormy sea.

The Autumn Budget and Spending Review did not contain the good news we hoped for following the publication of the Black Review in the summer. The Public Health Grant, the primary source of funding for drug and alcohol services, will remain stable over the next three years, but this is perhaps little comfort in the context of a 24% cut in real terms since 2015/16. And while an additional £42m is pledged for “new programmes that reduce crime and drugs misuse” there is little detail on this commitment.

Hope on the horizon

The Government’s initial summer response to the Black Review was clearly a step in the right direction, but must now be built on. It has committed to a new cross-government drugs strategy published by the end of the year. We expect it to see the light of day very soon. It will represent a once in a generation opportunity to transform both the mechanics and the ambition of our country’s treatment and recovery system. All now rests on its contents and the funding we hope is announced alongside it.

Dame Black has costed the programme of policy interventions in her Review, offering huge gains at all levels from the individual to the family to the community. The investment needed is substantial, but it must also be sustainable (over the three-year span of the Spending Review), protected (so hard pressed local authorities cannot simply make corresponding savings in other areas) and tapered upwards (so the resource doesn’t overwhelm a battered system).

As a drugs strategy (rather than a treatment and recovery strategy) the document will cover the full range of state activity directed towards the harms presented by drug use. The political realities of the day mean that crime will once again be the policy lens through which drug treatment is primarily considered, treatment and recovery remaining effective tools in reducing crime. The risk we must avoid as a field is allowing this focus to inadvertently stigmatise those who need help. Stigma harms people, prevents them asking for help and can worsen the help that is provided. The strategy must have a human face, recognising the toxic combination of poverty, social exclusion and trauma which underpins a huge amount of addiction.

The cross-cutting nature of addiction, and addiction policy, has always been hard to resolve. In order for this to be a truly cross-government strategy, it must unite the six key department of states, focusing their common energy and intent via the crucible of the Joint Combatting Drugs Unit. Structures to enable both clear lines of accountability for implementation and a shared sense of purpose will be necessary.

Finally, the strategy must articulate how these structures will connect effectively with local and regional systems and ensure a national cross-government approach is mirrored at the local level with effective partnerships between the treatment and recovery field and criminal justice, mental health and housing.

The change we all want to see will not happen overnight, and so we must recognise an effective strategy and robust settlement would only mark the start of a new chapter. But if these conditions are met, 2021 may yet be looked back on as marking a shift in fortunes for people with drug and alcohol problems. Dame Carol’s vision of a transformed, renewed treatment and recovery system lies tantalisingly within reach.

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