Something old, something new ...
Wednesday/27/Feb 2008 Filed in:
Info - CommentaryJust a few quick thoughts about the new drug strategy.
Get yourself a copy at
New ten-year strategy: 'Drugs: protecting families and communities'
Its an interesting structure - good to see the strategy being supported by a three year action plan. Not only should this add meat to the rhetoric of the actual document it also could provide greater accountability - and link up our expectations with the investment. Many of the actions really need fleshing out however before we can be clear how they will deliver the outcomes identified. Its a fairly easy to read document - well organised despite the obvious multiple authors. It reminds me more of the 1995 strategy than the either the 1998 one or the 2002 update. Harm reduction as a concept is not mentioned at all and there is a sense of cold showers and healthy morning runs about the document that was absent from our previous strategy. Having said that the overwhelming thrust of the document is towards a community approach to drug use with a recognition throughout of the clear links between social exclusion and drug related problems
The emphasis on mainstreaming and local delivery and planning is encouraging, however given the dearth of levers available to DATs and other local partnerships to drive engagement locally this could be problematic. Its good to see PSAs 16 and 8 (promoting social inclusion and regeneration) getting a mention in here. Presumably new indicators to look at specific reporting about drug users to these PSAs will follow shortly - though there isn't any mention of it in the action plan. Without this of course, progress towards inclusion and employment can't be measured - and while the intent may be to make these things happen, we know that mainstreaming needs robust outcome measurement to stand a chance of success.
I'm very happy to see a reinvigoration of employment initiatives for people in treatment - and pleased too that housing and accommodation is being prioritised. However unless I'm mistaken there are no new resources to support this either within the PTB or the mainstream so local engagement could be very tricky. In terms of increasing access to employment, one of the issues that comes up repeatedly is the difficulty of finding employers willing to take on ex problematic drug users. This is a hard issue to tackle as so much of it is about the stigma and discrimination many people who have experienced problems with drugs face day in and day out. It would be good to see some more emphasis in the communications section of the strategy on tackling that.
There is no mentions of initiatives to reduce drug related deaths or tackle blood born viruses beyond public information campaigns. This alongside the statement that -
"The goal of all treatment is for drug users to achieve abstinence from their drug – or drugs – of dependency"
- is most worrying. After all, the goal of drug treatment must be to alleviate the suffering related to drug use, to enable the individual to live a full active and law abiding life and to protect the public and the community from harm. Sometimes abstinence will be the route to this, but at others it will not. Are we now to consider a failure that drug treatment that doesn't focus on abstinence? If so then the past ten years must have been a disaster. We know that some progress has been made through the Harm Reduction Strategy (though we have yet to see a clear implementation plan or set of SMART targets for that work so its hard to know exactly how much progress) however to find no mention of initiatives to tackle drug related death and blood born viruses in our new national drug strategy is alarming. Could this be a resurgence of the moral rather than the rational at the heart of our drug strategy?Or is it simply about the palatability of the strategy to the general public, the media and politicians?
Public spending on drugs is shown as pretty much flat-lining over the next three years, which given inflation, is actually a reduction. Some of the ambition - particularly around reintegration and employment will be hard to live up to if no new resources are available in the mainstream to support it. The only area to see increased resources - so far as we can tell from this document - is work in and around prisons. Here the intention to do something to address what the BMA called a national disgrace is obvious. There are a number of action identified for the next year - the inclusion of prison data in NDTMS reports and the roll out of IDTS are positive moves - but the current state of the secure estate, the level of overcrowding and the frequent movement of prisoners round the country will prove challenging. There is a clear signal about the quality of care in prisons too - with prison clinical care to be brought to a "minimum evidence based standard" by 2011. This may seem a less than lofty ambition, however, when you think about it its probably a realistic goal - and one that will require considerable work, but that will be hugely important. An initial inspection - maybe by the healthcare commission - into this area would provide a useful baseline against which progress could be measured. I'm afraid there's probably going to be a lot of rocks to look under here - but its hugely overdue and very welcome.
It seems a shame that Drug Courts will only be extended over 4 more areas in the next three years - after all, this is an initiative we have known for some time generates positive outcomes. The further roll out of intensive DIP to other areas on a self funded basis may go some way towards appeasing those who have described problems with a drift of crime from intensive to non intensive areas.
The focus on piloting new approaches to commissioning, including individual budgets is encouraging. Its a shame these pilots seem only going to look at aftercare and not treatment itself, but its a start. One interesting aspect of this may be how these approaches can be made to work alongside not just following treatment - and obviously how brokerage will operate.
The National Audit Office examination of Drug Action Teams - their work and the cost efficiency of their operation is a really positive move. Hopefully some of the difficulties relating to multiple funding streams and diverse reporting mechanisms can be ironed out - at last.
On enforcement there's not much that's new. The greater engagement of communities is welcome - but care must be taken to ensure we don't see a resurgence in vigilante activity. There's a new focus on tackling doping in sport - though this seems to mainly be about reassurance for the international sporting community. Anyone would think we had an olympics coming up or something ....
More undoubtedly as it all sinks in later this week ... haven't had a chance to look at all the young people's stuff yet.
(thanks to David Mackintosh at the LDPF for sharing his reading of the strategy with me)
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Tags: New Drug strategy, Home Office, uk drug policy, reintegration