Late last year the government announced their new drug strategy with a best forgotten dramatic flourish that sent a clear message to the country - we’ll not tolerate drugs. Its sounder pledges were reminiscent of the drug-war rhetoric we know to be harmful. To announce record investment in drug treatment and a guaranteed treatment place for every offender with an addiction from a clearly staged drug raid was a bit of an oxymoron and potentially not the best thought through long term messaging. Continuing to play out this ‘us vs them’ narrative risks keeping the UK firmly out of step with countries treating their drugs policy more progressively and achieving promising results.
The underlying connection between stigma and resistance to getting help needs to be acknowledged and dealt with. Continually promoting a negative image of people who use drugs reduces the pathways available to change their lives. All drug users, no matter their background fit the profile of real complexity and vulnerability, requiring a human rights-based approach that tackles inequality, poverty, addiction, and abuse from a trauma-informed perspective.
It was promising to see that funds will be better directed at improving treatment services, albeit with a focus on abstinence over harm reduction. I believe our focus should be on reducing harm and tackling inequality, tailoring programmes to reach young people at increased risk of developing serious addiction issues. Drug addiction is complex, particularly when a substance plays into a set of existing circumstances, pain and trauma. If we move away from the stigma and fear that surrounds drug use, perhaps we can begin a cascade of change, where misconceptions about people who use drugs, the policy that governs them and the treatment they receive are transformed. There will be no touting of a single treatment approach, and the interventions offered will be as wide-ranging as individual experience. For the unfortunate third that develop a serious addiction a co-production approach will offer choice as the order of the day. For some that may mean Buvidal, for others methadone, for others heroin-assisted treatment. Determining what works for the individual is critical, and depends on their aspirations for life going forward. For some that might never be abstinence, and that’s okay too.
The Government is too fixated on drugs being a lifestyle choice. It’s a fantasy that becoming trapped in the criminal justice system, or suffering punitive action such as the denial of a passport, will force people to make better choices. In the main, people do not choose drugs as is often portrayed, they are more often people who society has failed to protect.
It was a ground-breaking moment indeed at the Taking Action on Addiction campaign launch in October last year when the Duchess Of Cambridge spoke the words “Addiction is not a choice.” Finally, there is a glimmer of hope that following the example set by The Duchess, mainstream thinking around this is going to change.
To their credit, the government will provide a boost to drug treatment after years of cuts, totalling 900 million over the next 3 years. Investment in a health-based approach is key, although the drugs crisis is a consequence of the decimation of treatment budgets and a decade of austerity. This investment will go some way to repairing that damage. It is worth noting, however, that treatment agencies have vested interests in these debates and are not impartial voices. Treatment agencies, including Kaleidoscope, will do all we can to ensure funds are directed at improving treatment outcomes, but we must still campaign for the complete overhaul required to tackle the drugs crisis – regulation of the market and the scrapping of the Misuse of Drugs Act 1971. Many treatment providers oppose the act privately but are unwilling to publicly call for its repeal. This highlights the lack of an independent voice for the substance use sector more generally.
We need to hear from people who are directly impacted by drugs, to involve them in the design, delivery and review of services. The strategy has a target to prevent 1000 needless drug deaths and I believe the rollout of overdose-reversing Naloxone is beginning to make a difference, not least because people who use drugs are central to its provision, distributing the kits through peer networks.
Our Peer to Peer Naloxone Pilot, co-produced with Welsh Government and George Charlton, saw Mick, Leighton and Kim deliver 237 lifesaving kits into the hands of those who need them most. That’s 237 more people on the streets of Newport trained to reverse overdose with a kit at their disposal. The target for the pilot was 60, yet the group delivered four times as many in just two months. George Charlton’s conviction and the power of our peers should see Wales become the first county in the world to offer cross country peer-to-peer Naloxone next year.
In Cardiff, alongside our partner Recovery Cymru, we have set up Voices Action Change. This project raises the voices of those not engaged with services, or who have had negative experiences navigating the system for either themselves or their loved ones. People are willing to engage, and we must take their wants and needs seriously.
Punishing people for using the only way they know to deal with their emotional pain and trauma is not the way forward. We’re better than that. Let’s make 2022 the year it really starts to show.
Martin Blakebrough, CEO Kaleidoscope
For more information on Kaleidoscope and its services click here.
This space is to enable more conversation around the topics discussed. The opinions expressed and clinical practices described in this article are those of the author and do not represent the opinions of Forward Trust or the other partners in the Taking Action on Addiction campaign.