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PCCs back call for huge investment in drug treatment

The government must invest in helping illegal drug users quit or face the consequences, its adviser has warned. PCCs have backed Dame Carol Black’s findings.

Police and Crime Commissioners have backed calls for a whole system response to illegal drug use and its multi-billion pound cost.

Reducing illegal drug demand rather than focusing on arresting people with dependency issues is the only way to reduce the UK’s drug problem, a government-ordered review has found.

In the second part of her report, Dame Carol Black said central government had to lead a radical change of approach to problem drug users that viewed them as having a chronic health problem that needs long-term treatment.

And to do this, Dame Black said the whole of the public sector would need to be brought together.

“Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences. A whole-system approach is needed, with demand reduction a key component, to drive down the profitability of the market,” she warned.

The report also revealed the huge numbers of people involved: 300,000 opiate and crack users and a million cocaine addicts.

But there was also a blunt warning that achieving the objective would not come cheaply. Services cut in the austerity era would need to be rebuilt and additional investment would be needed on top of that.

“We cannot expect a reduction in demand without reversing the recent disinvestment in treatment and recovery services,” she said. “To achieve and sustain recovery people need, alongside treatment, somewhere safe to live and something meaningful to do.”

Work across all the major Whitehall departments would be needed to achieve this – and the current spending review structures would need to change.

A dedicated government minister would be needed and councils given a legal duty to work with other agencies – similar to the new duty about to be placed on forces.

The report calls for the system to see the underlying issues of addiction and tackle them, to break the cycle of use and offending.

And the current treatment targets needed to be abandoned.

“It must be recognised that addiction is a chronic health condition, and like diabetes, hypertension or rheumatoid arthritis, it will require long-term follow-up,” the report said.

“Discharge after short-term treatment is currently used as a measure of success, but should be stopped, as it ignores the fundamental relapsing and remitting nature of the condition.

“Trauma (physical, sexual or psychological) and mental ill-health are the drivers and accompaniment of much addiction. They are co-morbidities rather than separate problems for a ‘dual diagnosis’. Commissioners of substance misuse services and NHS mental health services must ensure that individuals do not fall between the cracks.

 “Too many drug users are cycling in and out of prison. Rarely are prison sentences a restorative experience. Our prisons are overcrowded, with limited meaningful activity, drugs easily available, and insufficient treatment. Discharge brings little hope of an alternative way of life.”

There was also a warning to wider society that the impact of ‘middle class’ or ‘weekend’ users couldn’t be ignored.

“We can no longer, as a society, turn a blind eye to recreational drug use. A million people use powder cocaine each year and the market is worth around £2 billion, the report warned.

“They are causing considerable harm to others through the supply chain, both here and abroad."

For every £1 spent on rehab and support, there is a £4 saving on the health and criminal justice systems

“The vast majority of users do not see themselves as having a drug problem and they are unlikely to come forward for treatment,” the report said.

“This is a difficult group to influence but, as the COVID-19 pandemic has so clearly shown, behavioural and attitudinal shifts in health behaviour are possible. We need to invest now in an innovation fund to test out which marketing and behavioural interventions could work in the UK, building on evidence from abroad.”

But the report got unanimous support from Police and Crime Commissioners who had fed evidence from their forces into the review.

The Association of Police and Crime Commissioners said forces were already working to improve the services being commissioned. But they also wanted to ensure work to break the supply chain was not impacted.

The joint leads for Alcohol and Substance Misuse, Joy Allen and David Sidwick, said: “We believe that Dame Carol is right to place an emphasis on addressing the health issues related to drug taking. It’s vital that there’s investment in evidence-based treatment services and support for those recovering from addiction to help get them out of crime and into recovery.

 “Drugs, however, are not just an issue for the health sector. It’s important to recognise the important role played by police forces, the National Crime Agency and Border Force in disrupting supply lines and investigating traffickers.”

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