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Government policy on drugs

The coalition has released their strategy on drugs last week that at first glance sounds quite exciting.
Under the last administration drug and alcohol services were rewarded for the number of people in treatment. Unfortunately they didn’t specify the goals of the treatment and so a lot of people were left with repeat prescriptions of drugs that qualified them as “being in treatment”.
Thankfully the new coalition have tried to correct this by starting to use a new terminology including the term “recovery”, normally only associated with abstinent and twelve step treatment. Of course a lot of commentators are unclear exactly what “recovery” is meant to mean and definitions are hard to come by but a reasonable working definition would be that recovery involves being abstinent from mood altering chemicals and is an holistic treatment incorporating not just a medical treatment process but also a social and even a spiritual one (however people want to define that).
A lot of this is very exciting for us. We have been advising these broader goals for recovery for some 25 years now and so you might expect us to be feeling rather as if our ship has come in! In fact we are receiving this news with a tinge of anxiety.
People may remember a prior Conservative government policy called “Care in the Community” from some 20 years ago. For those of you who don’t, it had the laudable intention of taking people out of mental health institutions who didn’t really need to be there and instead, helping them live a more integrated life in their local communities. Clinically and morally it was a fantastic idea. Many people had been locked up in institutions for years and years whose problems were really rather slight, and who posed little or no risk to society but who may have simply appeared a little “odd” to the “normal” population.
Unfortunately the aspect of “Care in the Community” which seemed to be catch the eyes of the Conservatives was the misguided notion that a small fortune could be saved by moving these people out of expensive institutions and into conventional social housing. In reality, to do this correctly would in fact be a more expensive process rather than a money saving one as monitoring and support in the community is less efficient than keeping people all in one place.
As a result, people were sent out into the community with very little support or management and we started to get a number of cases where people were managed badly and the public became afraid of this policy.
I have a sneaking suspicion that the current governments agenda is going to go the same way. We are hearing a lot of talk about the savings that will be made by prescribing less methadone, for example, but there is precious little talk about the extra funding that would need to be found to help this group then deal with their underlying psychological and social issues. As a result I fear that once again the correct clinical treatment is going to be discredited by being used as a justification for cuts.
I hope I will be proved wrong in this but the signs so far are not looking good.
Robin

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