‘
We do not
underestimate
the scale of the
transformation
from a system
that has
concentrated on
engaging and
retaining people
in treatment to one that is capable of
delivering recovery outcomes.’
Lord Henley
‘We have grave
concerns about
the impact
of the
government’s
change of
direction on
HIV amongst
injecting drug
users in this country.’
Yusef Azad
The government’s cross-departmental
Putting full recovery
first
document (
DDN
, April, page 4) outlines its ‘roadmap for
building a new treatment system based on recovery’,
following on from the 2010 Drug Strategy and guided by
‘three overarching principles’ of wellbeing, citizenship and
freedom from dependence.
The document reiterates the coalition’s stated aim of challenging the ‘status
quo’ and bringing ‘an urgent end to the current drift of far too many people into
indefinite maintenance’, which it describes as ‘a replacement of one
dependency with another’. The creation of Public Health England will allow
‘clearer leadership and vision-setting’, it says, while payment by results (PbR)
will shift the focus of providers ‘from process and output to delivering tangible
personal and social outcomes’ and value for money.
‘We do not underestimate the scale of the transformation from a system that
has concentrated on engaging and retaining people in treatment to one that is
capable of delivering recovery outcomes,’ says chair of the inter-ministerial
group established to take it forward, Lord Henley. What he may have
underestimated, however, is the sheer strength of feeling against the document.
Last month the UK Harm Reduction Alliance (UKHRA), UK Recovery
Federation (UKRF) and National Users Network (NUN) wrote to him enclosing a
public statement,
Putting public health first
, that forensically takes the
government’s plans apart, accusing it of setting ‘arbitrary, unethical and
ineffective’ treatment goals, willfully ignoring ‘decades of evidence’ and
endangering the wellbeing of clients. The roadmap, it continues, will ‘waste
scarce resources’ and constitutes a threat to public health in the UK.
The 40 signatory organisations and individuals include some heavy hitters.
While the government would probably say it expected some resistance from
Release, Transform, Harm Reduction International, SMMGP, NUN and the
Alliance – all present and correct among many others from the field – it will be
less easy to dismiss the Terrence Higgins Trust, National Aids Trust and the
London School of Hygiene and Tropical Medicine as ‘the usual suspects’.
‘The UK has one of the lowest HIV epidemics amongst injecting drug users
thanks to early introduction of such harm reduction measures as opioid
substitution treatment,’ said the National AIDS Trust’s Yusef Asad. ‘We have
grave concerns about the impact of the government's change of direction on
HIV amongst injecting drug users in this country.’ In fact, the encouraging thing
about the document,’ says NUN volunteer Alan Joyce, is the ‘unanimity of the
response by virtually every organisation with any expertise in the area’.
If the government was hoping for unqualified support from the UK’s recovery
organisations it was wrong on that score too. ‘Recovery is much bigger than
abstinence and we believe that a treatment system founded on notions of “full
recovery” will fail to meet the needs of many, put people at risk and generate
greater stigma and discrimination,’ says UKRF director Alistair Sinclair.
‘Abstinence is just stopping something,’ he tells
DDN
. ‘We have difficulty
with the notion of “full recovery”, as do many others, including people active
within the fellowships. Recovery is a process, not an end state.’
Does he feel the document fundamentally misunderstands recovery? ‘The
interesting thing is it’s 27 pages long and, from memory, has about eight
references – I’ve never seen anything like it,’ he says. ‘From the point of view of
evidencing and referencing it’s deeply disturbing – there are no references to the
Organisations have been voicing their opinions of
Putting full recovery first
– the
government’s ‘roadmap’ for the creation of a recovery-based treatment system.
And they’re not positive, reports DDN
6 |
drinkanddrugsnews
| May 2012
www.drinkanddrugsnews.com
News focus |
Analysis
ROADMAP FOR PEACE?