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The Dame Carol Black review is a major opportunity to revitalise how we support people who use drugs

Part two of the review provides ambitious recommendations for a treatment system in need of a boost.

Photo by Ming Jun Tan on Unsplash.

The long-awaited part two of Dame Carol Black’s Independent Review of Drugs has finally been published and it is a candid, bold and thorough analysis of where the drug treatment system currently finds itself. It is clearly designed to have an impact and presents a unique opportunity to reform and improve a drug treatment system that is very much in need of a boost.

The scope and ambition of the review is to be applauded. It is wide-ranging and addresses many of the issues we hoped it would. It makes a strong ‘invest to save’ case for drug treatment, calling for improved Government leadership and accountability, reforms to commissioning and more integrated services. There is a welcome focus on trauma-informed service delivery, stronger partnership working and investment in the skills of our workforce. This review holds the potential for long-term, meaningful change.

We are pleased to see the review highlight the link between drug dependency and mental health. These services must work better together and the review provides a timely, welcome challenge to the sector to develop our approach in this area. Mental health and drug dependency are so often inextricably linked and our sector’s understanding of these issues through the lens of ‘dual diagnosis’ has to change. We are using our experience and insight of delivering mental health services to improve our understanding of these linkages, and exploring this issue will be a priority for us going forward.

The review is also right about the need to improve the services provided to non-opiate users. As a sector, we need to do more. We need to diversify the services we offer, which means more than just offering a mix of digital and in-person treatment. We’ve created new online advice and guidance on how to use drugs more safely, developed the UK’s first ‘find a needle exchange’ service, have new online groups, and new overdose prevention illustrated guides such as on how to use naloxone, ensuring people can access harm reduction information without having to come into a service. We must continue to explore new innovative ways to reach more people.

Diversifying our services also means designing services that are inclusive and tailored to the needs of specific groups. We are currently doing this by providing veterans with veteran-specific services, offering women-only drop-in times and female key-workers, web-chat services for LGBTQ+ and a helpline specifically for older drinkers. Though these cohort specific services are improving access and engagement in treatment, they also show how much more we can do. Our services need to evolve to become more flexible and meet people where they are at, offering support beyond the confines of fixed buildings.

How we work together as a sector can also be improved. Services can sometimes be siloed, working in isolation, and competing commercial interests can undermine the potential for partnership working. Improving how we work in partnership with other organisations and sectors, including housing, domestic violence, mental health and NHS services is essential if people are to get the support they need in a joined-up way. Our experience delivering the Blackpool Fulfilling Lives programme showed just how important effective partnership working with a range of statutory and voluntary agencies, and people with lived experience can be. An evaluation of the programme showed a saving of almost £10k for each person engaged in the programme over a 12-month period.

And of course, the review’s recommendations around investment are also vital to its success. It is clear that in order to provide the support that people deserve, addressing long-term disinvestment is essential. The Government must now match the ambition of this review, responding to these recommendations with an appropriate financial settlement in the upcoming Comprehensive Spending Review and serious political backing.

Though meeting the ambition of the review will be challenging for both Government and service providers, this is a major opportunity to revitalise our whole approach to supporting people who use drugs. There are many reasons to be hopeful about the long-term impact of the review. There are lots of innovative and exciting ideas coming from our sector, and we have all learnt a lot from the past year that we can use to enhance the services we provide. We now need to keep up the momentum and demonstrate that we’re able to do things differently and come up with new solutions in an ever challenging environment. We as providers need to rise to the challenge and play our part.

As such, the review should not be seen as an end in itself, but rather the start of a journey. As we look forward to developing our next three year strategy, the recommendations will be invaluable in providing clear focus and helping to shape our support offer into the future.

If you would like to learn more about how With You will be responding to the Review, you can email us at pressoffice@wearewithyou.org.uk

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With You

We are one of the UK’s leading mental health, drug and alcohol charities. We provide free, confidential support with drugs, alcohol and mental health.