This is a highly anticipated report that arrives at a critical time for the many thousands of people directly affected by substance use problems and the millions indirectly affected as a family member, friend or carer.
Substance use dependency and addiction is a complex health condition but with personalised care delivered in the right setting it is treatable and many of the associated harms can be avoided. However, left untreated in an underfunded and poorly connected health and social care system those harms can be life threatening. With drug-related deaths and harms at record levels it is vital we take this opportunity to realise the huge potential of investing in improving and saving lives.
The report has identified the fault lines in our treatment system and provided a whole system approach to fixing them. Dame Carol Black has given a robust business case for the changes, including additional funding, and set out a clear narrative for why we can’t get it wrong.
There is much to support in this report.
At Phoenix we have been campaigning for many years for improved access to, and funding for, the vital health and social care services for people with substance use problems. People who use, or have used drugs, despite our knowledge of the personal and social drivers of addiction, are some of the most marginalised and stigmatised people in society. Despite these efforts, and those of others, we have a long way to go to address this life-threatening inequality.
In particular the report highlights that high-cost low-volume services like residential treatment and inpatient detox have been starved of funding and should be commissioned on a regional basis.We support the recommendation that DHSC, NHSE and the Office for Health Promotion review commissioning and funding mechanisms by the end of 2021/22.
We believe this is a once in a generation opportunity to redress the inequality faced by people from all walks of life. In particular to focus on how we can all work together to create genuinely effective, inclusive, connected and caring services and support that lead to sustainable recovery.
Phoenix, as a specialist in psychosocial provision for more than 50 years, know it is essential that the meet the holistic needs of people, families and communities. It is the potential of good health, housing and employment that makes recovery sustainable.
On psychosocial interventions the report highlights that these interventions are critical, we support the recommendation that every local authority area enables access to has a programme of psychosocial interventions, led by trained professionals.
Furthermore, as we have focused on investing in and developing our own approaches to supporting people with co-existing mental health and substance use we welcome the understanding that these are co-morbidities rather than separate problems for a ‘dual diagnosis’. Too many people fall between the cracks in services and we believe there are some areas of excellent practise in this areas that we have experienced as providers, led by progressive commissioning approaches. We hope this practise can be spread more widely across the country.
As charity that supports whole-person needs we know that no one department, agency, or charity can do that alone. To achieve our shared aims of helping and empowering people to access support and recover from substance use addiction, we must recognise that everyone has a role to play.
The report highlights the need for reform and repair of the system can only be solved through coordinated action by multiple departments including the Home Office (HO), Department of Health and Social Care (DHSC), Department for Work and Pensions (DWP), Ministry of Housing, Communities and Local Government (MHCLG) and the Ministry of Justice (MoJ).
It will take improved coordination between national and local government departments, the NHS and voluntary sector and many others, including the media and business worlds, to realise this opportunity. This is an opportunity not just for inclusive, effective services but to realise the potential of an inclusive society that works for everyone.
The report references the corrosive impact on stigma that limits access to healthcare and employment. Phoenix believes every organisation should work towards an anti-stigma policy so that we can end the discrimination faced by people in addiction and recovery. We will be releasing our guidance on anti-stigma approach this autumn.
Investment in prevention, harm reduction and treatment, and a concerted effort to end stigmatising and discriminatory attitudes wherever they limit the potential for recovery, will save us all from the long term human and economic cost of substance use addiction.
Finally, for now, as there is much more to say in the future. At Phoenix we want to thank our staff and volunteers who have worked tirelessly, and will continue to do so to support and empower people to recover within a system that is in urgent need of repair. We have great hope for change and that hope comes from the fact so many people do get better in spite of our current treatment system. This is a testament to our staff and volunteers.