I was recently asked what I consider to be the critical issues that, given the opportunity, I would raise with our political masters. My list would be:
Removing the ring fencing from the Pooled Treatment Budget, when it moves in under Public Health England, should be delayed for up to three years to give time to allow recovery-oriented approaches to treatment to bed down locally. Otherwise the localism agenda with its competing priorities will undermine the objective of a recovery-oriented treatment system.
Given the millions of families affected by addiction and its costly impact on their physical and mental health, the needs of families in this situation should be viewed as a major public health issue. Accordingly investment should be made without delay in cost-effective interventions and support.
A high priority is to ensure that commissioning standalone detoxification is avoided and that detoxification is commissioned only when it is integrated into recovery-oriented treatment
The government must find more money to fund research into how recovery is achieved. We spend far too much on medically based research and next to nothing on psycho-social interventions and change processes.
We are committed to achieving outcomes, but the Payment by Results approach to addiction treatment is flawed because recovery is a process influenced by many factors, not an event achieved through mechanical repair. Let us get the system pointing in the direction of recovery. We can then evaluate effects which will in turn tell us how to tweak the system. We should not underestimate the costly bureaucracy that will be needed for PbR.
We need to move away from measuring outcomes as they relate to a relationship with a particular substance and consider recovery from addiction. Recovery from dependence on heroin for instance doesn’t necessarily mean recovery from alcohol dependence.
CEO, Action on Addiction