Clinical & Policy Updates:
SMMGP Policy Update November 2007
|Download the PDF version of this Update here! (PDF*, 42K)|
SMMGP were invited to a preview of the direction of travel for the new drug strategy following the recent consultation. Here we present the details to members. If anyone has any burning comments to make we would be happy to submit them to the government, comments will still be considered from stakeholders until January.
The key messages from the consultation were:
- Real Progress has been made but this is not reflected by public perception.
- There was widespread support for treatment and the Drug Interventions Programme.
- Weaknesses were identified as: Non-heroin and non-criminal justice treatment, prevention, wraparound services, links to alcohol, inconsistent commissioning, services for at risk groups and the evidence base.
Priorities should be:
- More to help young people avoid problems with drugs.
- Fast track referral for those most at risk.
- Increased focus on local drug supply.
- Streamlined administration.
3 packages of action were proposed:
- A new approach to Young People and Families.
- Better treatment with a focus on reintegration.
- Disrupting drug supply and seamless Criminal Justice System interventions.
In terms of treatment:
- Major focus on improving the quality and effectiveness of treatment, in particular with regards to value for money.
- Wider use of new treatment approaches (yes contingency management was mentioned).
- Radical new focus on drug users re-establishing their lives.
- Major change in prison treatment with services brought into line with those in the community.
We raised a concern that the "wider use of new treatment approaches" should be allied with caution regarding non or poorly evidenced treatments and should avoid implying that present treatments do not work.
In terms of young people and families:
The aims as ever are to reduce usage, with a focus on preventing the associated school failure, crime and disorder, poor mental health and developmental risks. Also a specific emphasis is to be pit on protecting children of drug using parents. Young people and families most at risk will be focussed upon. The proposed package will include:
- Maximising the protective role of families to protect young people through better communication support and guidance.
- Pregnant substance misusers to receive better pre-natal and early years support.
- Parents in treatment helped with being better parents and to receive better access to wraparound services.
- Early identification of families at risk (e.g. prison) with better access to family support.
The prevention agenda is to be mainstreamed with clear lead roles for directors of childrens' services who will include substance misuse in their strategies. These strategies will include:
- High quality substance education for all children starting primary school.
- Identifying and supporting children at risk.
FRANK is to continue.
In terms of supply:
- Increase identification and 'grip' on drug missing offenders/dealers.
- Target local drug supply.
- Focus on community sentences where most impact can be made.
- Improve prison interventions.
- Increase risks and penalties to organised gangs.
- Engage and empower communities.
- Final drafting: January 2008.
- Implementation: discussions February 2008.
- Implementation: April 2008.
For a thoroughly thought out response to the consultation see the ACMD's response on www.drugs.homeoffice.gov.uk.
It was quite critical calling it "self congratulatory and generally disappointing" as well as saying it concentrated too hard on "trying to convince the reader on success and progress". However they did agree with the general aims and many of their concerns seem to have been addressed in the present form of the strategy outlined above.
Another interesting research report from the Joseph Rowntree Foundation explores the use of "street policing" of drug users and finds a high level of contact between officers and street dug users. Whilst this sometimes perceived as a threat by drug users and can lead to displacement, the contact is usually informal and does not prioritise making arrests for class A drug possession. An interesting conclusion is that this is an under utilised resource in terms of getting information to street dug users about services, in particular treatment services. Read the report summary on www.jrf.org.uk. The full report will be published online in 2008.
For a round up of all the major issues explored at this years International Harm Reduction Conference read this interesting report written by a delegation of users who attended it on behalf of the NTA and have reported back on it from an English user perspective in a report entitled Nothing About us Without us at www.nta.nhs.uk.
For members who want to increase their knowledge on alcohol this conference still has places and we would recommend it looking at the programme, if you can make it at short notice. Alcohol Treatment Effectiveness: are we providing treatments which have an evidence base and if not, why not? Village Hotel, Bury, 11 December 2007. Contact Helen.Macklin@bstmht.nhs.uk, tel 0161 772 3782. Workshops on relapse prevention; detoxification; dual diagnosis & psychological interventions/ITEP.