Select Committee on Home Affairs Memoranda


Submitted by Addaction


  Addaction is a leading national provider of community drugs and alcohol treatment services. We saw approximately 40,000 clients last year. Founded in 1967 by a parent whose son died from a drugs overdose, we have grown rapidly in the last decade. We run community-based services, Day Programmes for arrest and referral, operate DTTOs, offer harm reduction services, and also run several Therapeutic Communities within HM Prison Service.

  We expect our clients to examine themselves honestly and openly, and so must we if we are to meet their needs. Our aim is continual self-improvement through the delivery of quality services. We are the only charity in the field with a Directorate for Development and Improvement and an Audit Committee who regularly evaluate the quality of service provision.


  The Government's Drugs Strategy set high targets for success, and consequently has raised high expectations. The strategy, rightly, has placed tackling drugs misuse high on the political agenda. Since June 2001, responsibility for Government policy has moved into the Home Office. We believe this move is a significant reflection of the commitment of government to deliver a successful strategy and implement effective policy.

  1.  The change in departmental responsibility following the last election came in the wake of an intense and critical media campaign arguing for de-classification of cannabis and a change in legislation regarding medical prescription of heroin.

  2.  The relationship between the Government's Policy on poverty and social exclusion and policy on drugs is not clear, yet, it is clear to us as a treatment provider, that there is a clear connection between poverty and drugs misuse.


  (a)  From a drug treatment perspective, Addaction believes there is not enough clear evidence on cannabis use in relation to patterns of addiction, which could underpin with confidence a liberalisation or relaxation of the law, however, the law needs to be consistently applied which would suggest that cannabis be classified to category "C" schedule of the Misuse of Drugs Act,

  (b)  The media rarely does justice to the subject of drugs misuse. The media find the subject too complex. Rarely do we see stories focusing on success in treatment. In the arguments put forward to support de-classification and new legislation, addiction itself has been pushed out of the picture.

  (c)  The vast majority of the most problematic drugs misusers bring with them other problems such as a history of abuse, neglect, poor education and social deprivation. Unless other problems are dealt with at the point of entry into treatment, these problems will continue to trigger repetitive drug using behaviour. Treatment providers have a key role to play not only in evaluating need, but in making constructive interventions and offering real help with the whole range of social problems.

  2.  Our guiding principle in campaigning on drugs policy and issues is to only comment on issues we know something about and to argue for more treatment and better treatment, planned in a unified geographical strategy. Our views are encapsulated in the following statement:

  The provision of treatment services that work has to become embedded in every locality, and every relevant institution, so that no one with problematic use faces a postcode lottery, and where no one who wants to address their drugs misuse is allowed to fall through the net.

3.  There are profound weaknesses in both current accessibility to services and in the quality of many services.

Addaction's response:

    (a)  We welcome the establishment of the National Treatment Agency as the prime opportunity to introduce clarity and cohesion into a geographically un-coordinated and disparate field of service provision. We want to see the NTA establish comprehensive standards for service delivery and monitoring of service quality.


    (b)  a clear and well-publicised directory of drug services and clear information on how to access these services;

    (c)  a reduction in the over-emphasis on methadone regimes at the expense of abstinence-based programmes;

    (d)  far greater resources spent on treatment;

    (e)  a far greater emphasis on appropriate "throughcare". Currently throughcare programmes are so minimal as to pose a threat to the genuine long-term success of prison-based drugs services;

    (f)  a change in the way treatment services are commissioned. Commissioning is often too short-term and bureaucratic. Insecurity militates against achieving continuity of staffing and constrains service provision;

    (g)  a dilution of the plethora of umbrella groups and a reduction in the confusing array of policy bodies which currently promotes mystification not clarity;

    (h)  an end to the denuding of residential centres. More are needed, not less;

    (i)  a standardised data-set including activity and outcomes enabling the delivery of clear strategic management information;

    (j)  greater incentives to encourage more drug workers into the field;

    (k)  an increase in the availability and accessibility of quality staff training;

    (l)  a co-ordinated strategy building on the key role parents have to play in combating drugs misuse;

    (m)  clarification of the role of DPAs which has a budget of £9 million;

    (n)  greater understanding of role of relapse in recovery by the judiciary;

    (o)  principles of Harm Reduction services re-directed to become a platform to move towards abstinence;

    (p)  Waiting lists at statutory drugs services are unacceptable (up to 12 months). These services do not need more money but redesign, reconfiguration and modernising. Methadone maintenance should be episodic, not for life.

4.  We particularly want to see intervention at an early stage with Young People who either misuse drugs or are at risk of misusing drugs.

  High on the list of priorities in our view is the need to deliver early intervention for Young People who misuse drugs or are at risk of misusing drugs integrated into prevention and education strategies. In particular, approximately 60,000 children in care in England and Wales who are at high risk of drug misuse, crime and prostitution, and require special tailored programmes in prevention and rehabilitation. Currently, only a handful of specialised services exist.

5.  Assessment of evidence and recommendations for application in the UK, on the increasing positive outcomes in the USA, where every rehabilitation service has maintained strong links with Alcoholics Anonymous and Narcotics Anonymous.

  It is true that treatment is a two-way street—people have to want to be treated, and in that sense, they "treat" themselves. No statutory service can expect to provide life-long maintenance and support to individuals, AA and NA are programmes for change. They are well-established, and offer a maintenance programme that may be used by individuals at no cost, as little and as often as they wish, taking from the programme as little or as much as they feel necessary for the rest of their lives.

6.  Drug Action Teams vary widely in terms of effectiveness and knowledge of the field, yet ultimately, the power to commission and fund treatment services lies with them.

  Commissioning of services need a thorough review and should be based on needs analysis and evidence based treatment and care. Quality of commissioning varies enormously from DAT to DAT.

October 2001

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