https://publichealthmatters.blog.gov.uk/2017/07/20/the-government-drug-strategy-tackling-the-complex-issue-of-drug-misuse/

The Government Drug Strategy - tackling the complex issue of drug misuse

The new Government Drug Strategy sets out how the Government will tackle the complex issue of drug misuse. We have made progress in recent years but challenges remain, including the increasing rates in drug related deaths.

We supported the Home Office in developing the prevention and recovery strands of the strategy, informed by the findings of our drug treatment evidence review published earlier this year.

The strategy is important because it signals the Government’s continuing commitment to the drug misuse prevention and treatment agenda, along with the expectation that local authorities will continue to ensure access to treatment and to improve outcomes for those in their communities.

We welcome the strategy’s emphasis on evidence based interventions. We see it as a progressive evolution of previous strategies, with more emphasis on people and their circumstances, as opposed to just their drug use.

There are number of key themes in this strategy which I would like to highlight:

A focus on resilience based prevention

The evidence tells us that education-only approaches, which focus on scare tactics, mass media campaigns, ex-users and police visits in schools are not effective on their own at reducing drug use and harm.

What does work is a broader approach which builds resilience and confidence among young people, giving them the skills and motivation to resist risky behaviours and recover from any setbacks. The drug strategy reflects this.

PHE will play its role in supporting young people by continuing to develop our Talk to FRANK drug information and advice service and the Rise Above digital hub, which helps young people to make positive life choices and build resilience; as well as continuing to commission Mentor UK’s Alcohol Drugs and Education and Prevention Information Service (ADEPIS).

The importance of housing, employment and other support

A key strength of the strategy is its focus on addressing the wider health and social inequalities often faced by those with drug problems. One of the biggest challenges is ensuring that treatment works as part of a wider response to recovery.

Recovery is so much more than just helping people overcome their dependency. It’s about supporting them in all aspects of their life.

We are pleased the Government is putting evidence into practice and calling for action to ensure that drug users are supported in gaining access to employment support at all stages of their recovery, as well as help in securing decent housing.

The importance of working in partnership

Drug misuse does not happen in isolation but is a complex issue. Successful recovery is only achievable through local organisations working together, which is why the strategy focuses on coordinating treatment with employment, housing and children’s services as well as health and social care.

PHE will continue to work closely in partnership with local areas, supporting them to understand and identify their local needs and the services required, as well as what works best and the cost effectiveness of interventions. For example, we know that every £1 spent on drug treatment yields a £2.50 saving on the social costs of drugs, including crime.

And it’s not just about local partnerships. These partnerships need to work across Whitehall, hence the strategy’s commitment to introduce shared indicators relating to issues like housing and employment.

The new Home Secretary-chaired board which will oversee the implementation of the strategy and be attended by all the relevant Secretaries of State, is also an important development. It demonstrates a cross government commitment, and a partnership approach.

Responding to new threats and challenges

Services have already had to deal with the emergence of new psychoactive substances (NPS). There is also increasing evidence of widespread NPS use among vulnerable adults such as prisoners and homeless people. It’s vital that local treatment and recovery systems are flexible and able to respond to any new and emerging challenges and threats.

Specialist services usually respond well to NPS, but the harms are often poorly understood in frontline healthcare services. We hope that our pilot of the new Report Illicit Drug Reaction (RIDR) intelligence system will provide the insight needed to reduce the length of time between new harms emerging and developing effective clinical responses.

Services also need to respond to the challenges posed by the recent rise in drug-related deaths, which is in part related to the risks faced by an older group of heroin users who are suffering a range of health issues.

There have been a number of recent deaths involving fentanyl, which we are now using our networks to lead further investigations. As with all emerging threats we need to be vigilant, understand what is happening and then act.

Updating our indicators

Lastly, it’s really important we understand whether the interventions we put in place are having the impact we want. We need to use a range of indicators that measure, health harms, social integration and recovery. In future, we will track progress against a broad range of measures including:

  • prevalence
  • treatment access rates
  • drug related death, hospital admissions and blood borne virus rates
  • homelessness and housing
  • crime and offending
  • mental health
  • employment
  • treatment outcomes for different cohorts

This should give us a much better picture of whether we are meeting need, reducing harm and supporting recovery. They give us all the opportunity to show the impact of our work and drive improvement.

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