Today’s release of two important Public Health England 2019/20 datasets – substance misuse treatment in secure settings, and young people’s substance misuse treatment – underline the urgent need for political commitment to the reform and renewal of England’s drug and alcohol treatment system.
Whilst the immediate picture presented is one of relative stability, a longer lens reveals significant, and worrying, trends in the availability of treatment for prisoners and young people.
Despite the prison population remaining fairly static since 2015 (notwithstanding the sharp drop in 2020 due to the Covid-19 pandemic), treatment numbers have decreased by 12 per cent, with the numbers starting treatment down by 18 per cent. This is despite a lack of evidence indicating substance misuse has decreased, signalling a clear, increasing, unmet need. Particularly concerning is what happens on release – in 2019/20 just a third of adults successfully started community treatment within three weeks of release. More could also surely be done to ensure opioid dependent people leave prison with naloxone (just 17 per cent in 2018/19), given the well documented risk of fatal overdose in the immediate post-release period.
Similarly, while there was just a three per cent drop in 2019/20 in the number of young people in treatment, this number has fallen a staggering 42 per cent since 2008/09 – while substance use prevalence rates among children and young people have actually increased. Young people’s treatment services have also experienced massive cuts – a 28 per cent reduction in funding between 2013 and 2018 that coincided with a decimation of wider young people’s services, and increasing complex support needs for those young people.
The recent £80m cash injection, which is framed squarely around the link between drug use and crime, brings some rays of hope. It can be used to meet the pressing needs of people experiencing multiple disadvantage, caught in the revolving door of substance misuse, crime, homelessness and mental ill health.
However, a longer-term vision of an effective drug and alcohol treatment system that meets the needs of everyone, including people in prison and young people, is still not guaranteed.
The recent funding announcement is a vital life-raft for a field still suffering from years of disinvestment, and a welcome sign of political intent. But the shortfall in life-saving support highlighted by today’s statistics only adds urgency to our position that the second part of Dame Carol Black’s review must be published imminently, and its recommendations responded to with the political focus and the financial backing they will surely merit.