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T
he opening question was on an emerging tension in the wider drugs
strategy – what did the rights of the individual, and person-centred
treatment, mean now that the stated goal of treatment was abstinence?
‘The only conflict is the one we allow the field – and critics of the field –
to have,’ said Hugo Luck. Seventy per cent of users wanted to get out of their
lifestyle and needed support, he said. ‘There’s no dichotomy – only the one that
critics exploit. We need to move on from abstinence versus harm reduction towards
concentrating on effective treatment.’
People should have a choice and not be pushed into abstinence, said Chris
Ford. ‘A diabetic on insulin doesn’t get excluded from a job. Why should someone
on a script? Drug users should be employed everywhere if they have the confidence
and abilities to do the job.’
On the question of the NTA’s definition of effective treatment, Andy Stonard said
that there was a criminal justice driven agenda that meant drug users were seen
as a criminal class, while on the subject of needle exchanges, Erin O’Mara said it
was essential that services moved with the times. There was also a significant
issue around outreach workers not reaching a range of people who were ‘below the
radar’, she said.
Many delegates felt strongly about use of the word ‘choice’ when it came to
treatment. ‘How can you give a service user a choice and say ‘this is your choice?’
asked one. ‘The key term is ‘evidence base’,’ replied Hugo Luck, urging delegates
to ‘get informed’. ‘Knowledge is power,’ he said. ‘Effective treatment is evidence-
based, humane and individual.’
Another question was on the potential reluctance of providers to put forward
individuals to be part of a service user group. ‘They often get rid of the most vocal
individuals and keep the ones who don’t give much trouble,’ said Erin O’Mara, while
Chris Ford stressed that ‘services should not be deciding who is in a service user
group’. On the issue of how to start a user group, meanwhile, Hugo Luck said
everyone’s experience was different. ‘Funding is important,’ he said. ‘No one ever
said user involvement was easy. But service user groups don’t need the NTA.’
On the question of whether there existed a clear policy on needle exchange provision
for the under-18s, Hugo Luck said that NICE had ‘not gone down the young people’s line’
in its guidance. ‘There’s a clear absence there that needs to be addressed,’ he
acknowledged. There was also the highly charged issue of needle exchanges in prisons.
‘They definitely should be in prisons,’ stressed Chris Ford. ‘Needles are already in
prisons, and they’re the contaminated ones,’ commented one delegate.
23 March 2009 |
drinkanddrugsnews
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Involvement |
Service user conference 2009
www.drinkanddrugsnews.com
‘It was good to see what is possible and it has inspired
me to carry on with service user involvement.’
Tim Archbold, Heads Together, Luton.
‘It was a very interesting and informative day... there
was so much going on.’
Nigel Calvert, SUST, Gloucester.
‘I really got a lot out of it. It made the training I've
been doing make sense and seem worthwhile, and
energised me to carry on in service user involvement.’
Jean Ayers, PAST, Barking.
‘Great to catch up with colleagues and friends and
meet new people involved in the user involvement
movement... same old rhetoric from the NTA.’
Dave Stork, service user coordinator, Gloucester.
‘The event was great for networking with other
service user groups and even though we're an
established group we still learned a lot.’
Tracey Gibbs, Hi's & Lows, Walsall.
‘This year’s event was as real as last year’s. Everyone
loved the alcohol presentations and Mick Webb’s
naloxone slot seems to have re-energised the subject.
We brought 12 service user reps from Bristol and two
felt really heard when they grabbed Paul Hayes –
though his lecture on responsibility and benefit
reform met with disappointment, especially since,
down our way, DWP are already telling people in
structured treatment to “get back to work”.’.
Alex Boyt, service user coordinator,
Bristol Drug Strategy Team
‘No one ever said user
involvement was easy.’
When it came to provision of specific services for stimulant users, Andy
Stonard said that there was undoubtedly a lack of both services and recognition.
‘Services don’t look at harm reduction issues around stimulants, like the
sharing of straws and pipes,’ he said. ‘They always end up looking at needles.’
Most services were opioid based and had been for 40 years, said Chris Ford,
but services needed to respond to people as individuals, with individual issues
and problems. Some delegates felt that those in recovery for stimulant use only
were not given consistent medication and treatment, it being done instead on
an ad hoc basis. ‘A lot of people with stimulant issues are in jail or mental health
facilities,’ said one.
On the controversial issue of the welfare reform white paper and the
increasing overlap of drug treatment with the criminal justice agenda, Erin
O’Mara thought that treatment services were only now emerging from '20 years
of the dark ages’. ‘There are a lot of snappy phrases in the document,’ she
commented. Referring to the new JobCentre Plus coordinator posts (
DDN
, 26
January, page 4) she said there was ‘£9m of training for staff, but what kind of
training will they have? There’s nothing in the document about the psychological
impact of returning to work. It’s terrifying for people.’
It was also felt that the NTA’s stated aim of keeping families together could
be a hollow promise when the funding was not available. Hugo Luck
acknowledged that for the last two or three decades services had been geared
towards white male opioid users in their 20s and 30s, but commissioners would
now need to meet their targets around childcare. ‘There’s nothing that stops
funding for childcare,’ he said. ‘It’s down to the local DAT, so it’s up to service
user groups to lobby for this.’