Drink and Drugs News DDN 1804 - Page 17

We welcome your opinion: www.drinkanddrugsnews.com If treatment is to survive it needs to make a more convincing case and reach out to new groups, argues Paul North heroin cohort dies and leaves treatment, so does the money to support them. The challenge that treatment must confront, and a surefire way of creating funding, is to connect public need with public concern – raising awareness of an issue to attract new referrals, whilst at the same time educating society on the benefits of doing so. This is no small task for treatment and requires innovative outreach. The truth though is that if treatment does not find treatment-naive groups and make a convincing case for supporting them, the government is unlikely to give out funding on the off-chance of success. There needs to be a clear justification for funding, and concern to match it. Creating public concern often requires a good narrative, and these narratives must also be backed up by data and evidence. The first step then is to prove the need, by evidencing that there are hundreds of thousands of people who require support. All these people who would benefit so much from treatment need to walk in through the front door – these stats then need to find themselves on the desks of commissioners as well as the local press. At a local level, let people know the great work the treatment service is doing and encourage others to get support. Identify a group and prepare them for treatment, get them on NDTMS and prove treatment still has a use outside of the heroin cohort. he first group that treatment could target is an easy win. Last year, 23.8m opiate prescriptions were dispensed in the UK. Use of painkillers has risen by 80 per cent in ten years and is costing the NHS billions of pounds – there are no doubt hundreds of thousands of people using opiates problematically on prescription. They are easily accessible, in every community across the UK, and reducing their use would save the NHS millions of pounds. Furthermore such an approach would bring significant health benefits, as it is estimated that up to 90 per cent of prescribed opiates are ineffective at addressing chronic pain. Treatment services are essential if such a reliance is to be reduced – without a planned therapeutic intervention a situation similar to that in the US could emerge where those taken off ineffective prescriptions simply seek out illicit opiates. It is clear that a very strong economic and health argument could be made for engaging this group. Save money, put some of it into treatment and reduce the vast numbers of people on poorly managed opiate prescriptions. The next key group is the hundreds of thousands of cannabis users that do not enter treatment. Last year we showed in Liz McCulloch’s report Black sheep that cannabis presentations have risen by 55 per cent in ten years. My report Street lottery estimated that this equates to 200,000 cannabis users in the UK. Cannabis represents both the fastest growing cohort of drug users, and the most commonly used drug among young people and adults. As outlined in Black sheep treatment has not yet made a convincing case for engaging this group as we are ignorant of the health and economic benefits of doing so. This group require bespoke outreach interventions and campaigns to engage. Without any effort at all the group has doubled in size in ten years. Imagine what it would look like if treatment made a more concerted effort. If services around the country looked up from managing the heroin cohort and engaged treatment-naive groups then the money would emerge – the T www.drinkanddrugsnews.com national press would have a story, further educating the public on the changing face of treatment and encouraging others to seek support. The issue of funding services would then likely receive far more public support. Such a strategy would unite public concern with public support, thereby validating funding. This is not about ditching the important service that treatment provides for the heroin cohort. It is about ensuring i n years to come it can continue to do so effectively. Treatment needs to stay well funded and healthy to support heroin users at a time when overdoses are at an all- time high. Those on the frontline of drug treatment know full well the importance of continued support for this group. This is an exciting proposition for those working in treatment. The chance to explore a new frontier and engage groups who have historically avoided support. A chance to show government the innovation that the sector is capable of and share the life-changing work that has been going on in key-work rooms up and down the UK for years. To those who are sat with overwhelming caseloads, complex clients and demanding targets, the only way out of that picture is to adapt. The heroin cohort created treatment but if services don’t act they might also spell the end of it. They are no doubt a vulnerable and difficult cohort to work with who need bespoke support, but they are not the key to future funding. If treatment does not grasp this opportunity quickly and make a convincing case for more money then it will disappear into irrelevance, and only have itself to blame. Paul North is head of communications at Volteface, @Paul_North Graph data from Beyond the tipping point at www.recovery-partnership.org April 2018 | drinkanddrugsnews | 17