On July 1st and 2nd, 2024, the Chelsea Harbour Hotel in London was a hive of recovery-focused activity. Over 300 practitioners and professionals in addiction treatment gathered for the 20th Anniversary of the UKESAD Conference. This year's conference was especially significant as it marked two decades of collaboration, learning, and innovation in addiction treatment. Mike Trace, CEO of Taking Action on Addiction (a campaign ran by The Forward Trust), was honoured to deliver the opening plenary speech.
Origins of UKESAD
Mike Trace shared the humble beginnings of UKESAD, which started at his kitchen table in London around 2003. What began as a conversation with Deidre Boyd evolved into the first UKESAD conference in 2004. After spending seven years working in government, the EU, and the UN, Mike was perfectly placed to join this pivotal conversation about addiction treatment. Their aim was to bring together recovery voices and create an arena where the recovery and harm reduction sectors could work collaboratively. The goal was to promote the idea that both public health measures and abstinence-based treatment were essential elements of the ‘menu’ of treatment services offered in every part of the country.
Mike emphasised that this project was a critical initiative to bridge the gap between the polarised schools of thought around treatment prevalent in the 80s and still lingering in 2004.
Mike paid tribute to Deidre Boyd for her incredible work in bringing together people on a clinical, ideological, and human level. The relationships and connections made at these events have undoubtedly helped hundreds of thousands of people begin their journey to recovery. Deidre's support for RAPt, Action on Addiction, Clouds House, and now the Taking Action on Addiction campaign and Forward Trust has been invaluable.
History of UK State-Funded Treatment Sector in 4 Elections
Mike Trace provided a fascinating overview of how changes in government impacted addiction policy and treatment funding over four election cycles:
In 1997, under New Labour, Prime Minister Tony Blair expressed concern about the impact of illegal drugs, leading to the appointment of a Drug Czar. Although Blair had no strong opinion on addiction, one of his briefs was “Don’t make us look soft on drugs.” Mike Trace was appointed as the government’s Deputy Drug Czar that year.
The good news was that Blair understood some of the societal consequences of addiction, particularly the cost implication for health services, and was willing to “spend to save”. Between 1999 and 2006, the state-funded budget for addiction treatment saw a significant increase, rising from £200 million to over £1 billion per annum. During this period, efforts were made to create a national system with a menu of services, which was largely successful - although, at the scale needed, it became messy and dragged down by bureaucracy.
In 2010, under the leadership of Cameron and Clegg, there was high level political interest in addiction and policy reform, but competing interests and priorities. Cameron had a good understanding of addiction and a desire to create a better support system. However, ideological differences within the cabinet existed. Ian Duncan Smith believed very much in the option of abstinence-based recovery, while Theresa May believed more in controlling the bureaucracy. The civil service resisted various attempts to give Ian Duncan Smith’s ideas a fair trial, and there was no real enthusiasm from the rest of those in charge. Theresa May’s vision won.
This meant that there was no government ‘enthusiast’ for funding addiction treatment. The introduction of austerity following the global economic crisis therefore led to a 35% cut in funding, disproportionately affecting recovery programs and high-cost services. This era is sometimes painted as a recovery-focused period, but this is misleading. It was the opposite.
Despite high demand and good evidentially proven outcomes, many residential treatment centres struggled and closed due to withdrawn or inconsistent state funding. Those with a mixture of clients and enough income from the private sector to balance their books survived to treat more clients - Clouds House being one of them.
In 2019, the Carol Black report highlighted the sector's struggles during austerity. The Boris Johnson-led 2021 spending review led to funding increases, but these primarily replaced lost funds rather than transforming the sector. Residential treatment centres saw the least progress in funding increases.
In 2024, following the confirmation of a Labour government, Mike predicted minimal changes in addiction policy, for now. The focus would remain on competent management and continuing the 10-year strategy. The sector needs to raise the profile of addiction and recovery, calling for public and parliamentary support. Taking Action On Addiction, including our leading annual national campaign, Addiction Awareness Week, is one such initiative, and Mike called on all those present to support it.
Forward Trust's Additional Contribution
In addition to Mike Trace's insightful speech, Forward Trust also delivered a groundbreaking talk at the conference. Matt Thomas and James Hansen presented about the link between addiction and ADHD (read article here). They described how treating ADHD as a co-occurring disorder during an addiction treatment episode can reduce the chance of relapse. James Hansen, an Addiction Therapist and ADHD Life Coach, described how Clouds House has now incorporated treatment for co-occurring addiction and ADHD into their treatment plan, showcasing the innovative approaches being taken to address complex cases of addiction.
Conclusion
Governments may come and go, but the eternal truths about addiction and our service responses remain. While Taking Action on Addiction and The Forward Trust remain committed to collaborating with the government in power to ensure that as many people as possible receive a comprehensive array of services to address their addiction, UKESAD continues to be a crucial gathering for professionals in the field to reconnect, learn, and discuss new developments.
The 20th Anniversary Conference was a resounding success, and attendees left with renewed energy and ideas to continue providing the best possible treatment to their clients.