For the last decade or so there has been a dismal lack of interest shown in the UK towards drugs policy. We have had the annual wringing of hands when updated drug related deaths figures have been released. There have also been the same ritualistic responses to crimes associated or perceived to be linked to drug use. But at the same time front line services and those who deliver them have been starved of resources and support. Much of the progress made in the UK from 1995 onwards has been lost or undermined.
So, the announcement earlier this year that the government was going to provide an additional £148m investment in drugs work was something I welcomed. Inevitably the press release and much of the coverage was spun towards law and order. It is an unwritten rule that you have to talk about cracking down on crime or dealing with criminal kingpins, rather than talking about improvements in drug treatment. It is also considered a great thing if you can come up with a good, tough sounding, acronym. For 2021 we have Project ADDER, which is seeing £28 million provided to pilot approaches targeting prolific offenders with drug problems. In case you are wondering, the acronym stands for Addiction, Diversion, Disruption, Enforcement and Recovery. Sounds a lot like something we used to call the Drug Intervention Project (DiP), but I acknowledge that naming it after the UK’s only poisonous snake sounds more hard hitting. It will also look better on a t-shirt.
But putting all cynicism and mockery aside, it is good to see a clear acknowledgement of the need and benefits of adopting a system wide approach. This was one of the things the UK learnt in the 1990’s but has increasingly seemed to forget. No one agency or service alone can turn around a community’s drug problems. Most individuals require a range of support to help them overcome their issues. That this has, once again, been recognised by central government is to be welcomed.
Of course, to be truly effective, all services are dependent on their staff to reach out and engage with people. Well-motivated, trained and supported individuals are an essential component to successfully engage and work with people who are using drugs problematically. In the UK many drug workers are employed by voluntary sector groups/NGOs. This has posed challenges for providing access to emerging research and developments, and many of the organisations which were active in this area haven’t survived the years of austerity. Around the world there is huge variation in the availability of resources to support delivery and professional development. Much of what does exist is often targeted at a narrow, specific professional group. This ignores the fact that other professionals also need access to good quality and relevant information, including social workers, nurses, doctors, youth workers and those working within the criminal justice system.
GPHN is committed to sharing knowledge and experience about substance use alongside other public health issues. This is one of the reasons we are so pleased to be involved in helping deliver the SOLID-EXCEED programme, which looks to boost the capability of social workers in Asia to help prevent and treat problematic drug use. It does this by bringing together academic expertise from a range of universities with the experience of front-line practitioners. Building capacity, while also developing networks, helps not only to boost improvements in outcomes in the here and now, but also provides a foundation for future cooperation.
Drug issues are not great respecters of national boundaries, and the lessons learnt about how to reduce harms and improve responses can and should be shared. Of course, there are substantial social, economic and cultural differences between countries, but there are great gains to be had by supporting the development of shared interest groups. All of those working in this field have useful lessons to be shared and can support colleagues around the world.
One of the lessons I think the UK can share is that you take your eye off drug problems at great cost. This can be measured in terms of drugs related deaths, which themselves are the tip of an iceberg of the avoidable harm and misery which disproportionately affects the most vulnerable members of society. It is also measured in the cost of rebuilding structures and going back through the process of educating policy makers and others about the benefit of partnership, and system wide approaches. Much of this new investment will be required to re-establish the architecture and understanding which we have allowed to disintegrate over recent years.
As the Scottish poet Robbie Burns said in one of his most famous poems, the best laid plans of mice and men often go awry. Let us hope that, ADDER, and other drugs related work currently underway, will help embed the understanding that to tackle complex problems you need a broad based, partnership approach. That way we in the UK will not have to relearn all this again another ten years down the track. Working together, GPHN seeks to share knowledge and experience so that we can help improve the delivery of services and support and limit the amount of time spent relearning things we already know.
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