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The Black Review: A shared mission for transformational change

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As organisations which see the impacts of drugs and alcohol on people, families and communities on a daily basis we have come together to advocate collectively for change.

We welcome the scope and ambition of Dame Carol Black’s Review which represents the best chance to reset and renew our treatment and recovery system in over a decade. Dame Carol has engaged with our field with admirable rigour and heard the many challenges brought about by the profound disinvestment of recent years – as well as the passion, skill and tenacity used to support thousands of people every year into recovery.

It offers an evidence-based, person-centred response to drug and alcohol addiction, laying out the full array of challenges facing people with drug and alcohol problems. We commend the author’s wide focus on the inter-connected systems which support people with drug and alcohol problems. Efforts to address ‘addiction’ without work with partners in criminal justice, health, homelessness and mental and physical health fields are futile. The recommendation of increased funding for young people’s services is welcome however, we do believe there should be wider recognition of the harms to others, including children, drug and alcohol problems can bring. Families deserve recognition as a vital source of recovery capital but, equally, require support in their own right.

We wholly endorse the Review’s call for strong, sustained local and national political leadership. The proposed Drugs Unit should be created as soon as possible and used to bring together the six key departments of state with a crystal-clear structure of accountability and action. This must be mirrored at the local level through the health, justice and crime partnership mentioned.

Compassion and political leadership are essential ingredients – but so is funding. Our field has lost more than one pound in every four since 2013 with a proven association with falls in numbers entering and completing treatment. Real impact requires real investment – Dame Carol is right to make a call for major, sustained and protected investment over the next five years. With the right resource we can together support many more people (and their families) into recovery and help deliver the Government’s commitments to levelling up our poorest areas.

We believe a ‘whole system’ approach based on accountability, collaboration and partnership is essential. The Review’s recommendation for a local government led joint approach with health, housing and employment support, and criminal justice is welcome, as is the suggested for closer working between the Ministry of Justice and NHS England over prison-based treatment. The recommendation of sustainable regional or sub-regional commissioning of inpatient detoxification and residential rehabilitation is a positive step in restoring this vital form of provision.

The Local Outcomes Framework and Commissioning Quality Standard could both be useful approaches to drive quality and partnerships – but must be developed in consultation with experts in the field. Both must enable and assure integrated working between organisations that meet the often complex needs of the citizens they serve.

A renewed, confident and competent workforce remains our most potent weapon in the fight against addiction. Dame Carol’s suggestion that Health Education England take a leadership role in developing a strategy for the workforce is welcome, as is the focus on co-existing mental health problems and drug dependence.

The time for political action is now. Following years of disinvestment and a lack of political leadership, we are now experiencing a drug death crisis. We implore the new Health Secretary to urgently respond to the report’s recommendations – to reduce the harms caused by drug use, stem the flow of deaths, and enable thousands more citizens – and their families – to recover.

As a sector, we stand ready to work together with government and wider partners – both local and national – to make the most of this vital opportunity. The hundreds of thousands of people touched by addiction in this country are counting on us all to get this right.

Vivienne Evans, CEO Adfam
Oliver Standing, Director Collective Voice
Chris Lee, Chair English Substance Use Commissioners Group
Danny Hames, Chair NHS Addictions Provider Alliance



Adfam is the national charity for families affected by drug and alcohol use.

Collective Voice is the national alliance of drug and alcohol treatment and recovery charities.

The English Substance Use Commissioners Group is the representative voice for commissioners of alcohol and drug services.

The NHS Addictions Provider Alliance is an alliance of NHS Trusts who work within the addictions field, including within drug, alcohol, gambling and gaming – providing treatment services and recovery support.

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Collective Voice is the national charity working to improve England’s drug and alcohol treatment and recovery systems