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December 2013 |
drinkanddrugsnews
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Policy |
DrugScope conference
‘Whatever viewspeople takeof
theprosandconsof the times
we’re in, what everyonecan
agreeon iswe’rechartingvery
newwaters in turbulent seas.’
MARCUSROBERTS
ATE THE POSITIVE
authorities for all their resources and for the public health grant, and I’m well
aware that there’s widespread redesign and retendering,’ Public Health England’s
director of alcohol and drugs, Rosanna O’Connor, told the conference. However,
there were fewer adults in treatment than ever, she said (see news story, page 4),
and the number of people starting new treatment journeys had also gone down.
‘Cannabis is the only primary-presenting drug that has any kind of increase and
there are now more non-opiate clients than opiate clients,’ she stated. However,
there were still increasing numbers of over-40s coming into treatment for the first
time and the number of successful completions had ‘pretty much plateaued’.
‘The existing health gains and recovery ambition need to be maintained and
strengthened, the sector needs to be championed and strategic partners
engaged,’ she said. ‘You must ask for the investment you need. We do expect for
there to be appropriate local services and for them to be properly invested in.
The task in terms of making sure every service user gets a half-decent chance of
successfully completing treatment is not the same across the country, and that’s
not good enough.’ PHE was offering enhanced support to more than 40 local
authorities that were performing less well, she stressed.
The political interest in the sector was there, she emphasised, as recovery
continued to be a key measure in national outcome indicators, closely monitored
by ministers and PHE. Drugs recovery would also be priority indicator of the
government’s proposed ‘health premium’ if it went ahead, she said.
Particular challenges were the number of entrenched heroin users, for whom
lasting recovery was often much harder to achieve, and the emergence of new
psychoactive substances at an ‘unprecedented’ rate. Although the number of
people seeking treatment for the latter remained small, ‘the ability of all of us to
keep abreast of this is a challenge’, she said. Mephedrone presentations had
almost doubled in the last year but should be seen against falling numbers of
people seeking treatment for ecstasy, she added.
‘What on earth do we call these things?’ said toxicologist at St George’s
Hospital medical school, John Ramsey, of the new drugs. ‘New psychoactive
substances doesn’t really trip off the tongue, and legal highs doesn’t work either
so I choose to call them new and emerging drugs of abuse.’ The new compounds
fell outside legislation with the consequences that people were being exposed to
an ‘ever-changing list’ of chemicals. ‘What do we do? If kids are having medical
problems then you can’t ignore it, but when you ban them you just get a whole lot
of new ones.’
‘There are genuine opportunities with Public Health England,’ said outgoing
DrugScope chief executive Martin Barnes, as he summed up both the event and his
ten years at the organisation. ‘But despite genuine high-level commitment to drug
treatment and recovery, the government has created a situation where funding is at
risk. Whatever your view of the NTA, it was effective at holding DAATs and providers
to account. The pendulum of localism may swing back, but at the moment what
ministers think is increasingly less important.’
Further local government perspective came from cabinet member for health and
wellbeing at Birmingham City Council, Steve Bedser. ‘There is a huge risk of
disinvestment,’ he acknowledged. ‘“Severe” is an understatement when it comes to
the pressures on local authorities, and we are, of necessity, looking at the
commissioning portfolios and practices we’ve inherited. Some of the services we’ve
inherited have been very poorly commissioned indeed. We have to make sense of
the money and find interventions that are cost-effective. We face hard choices on
the use of public money and you will have to work hard to engage politicians.
‘But if there’s a sliver of a silver lining in the whole austerity agenda, it’s that it
does give us an opportunity to do integration properly. Have faith in health and
wellbeing boards. They’re good things, so make sure you influence them.’
DDN