Oliver Standing, from drug and alcohol treatment charity Humankind, says the cuts to services have been devastating. But he has hope the sector could be on the right track – and being in local government should stand services in good stead.
To understand the challenge facing drug and alcohol treatment services the coming years, Humankind Director of Communications and External Affairs Oliver Standing likes to use a plant analogy.
“Imagine if you haven’t watered the plant for a long time. The soil is dry and cracked and the plant is shrivelled. When you pour the water in some of it is going to run straight through. It takes time and care to restore the soil and nurture the plant back to health.
That is what we are facing with drug and alcohol treatment services – we now have money going in, but we have a lot of rebuilding work to do. We have to build back and recover from the lost decade.
The ‘devastating’ cuts
He said the cuts to public health funding had been “devastating” on the sector and are a big reason why drug-related deaths and those linked to alcohol have hit their highest levels on record.
Mr Standing, who led the drug treatment umbrella group Collective Voice until last year, said: “The cuts have been massive – and some of the impacts have been scary. Caseloads have gone up - if you are looking after more clients you cannot provide the same amount of care to any single person. It is as simple as that.”
Not that he blames local government for the cuts. Mr Standing said: “When you look at the changes to central government department funding during the austerity years it’s really disappointing to see how massively local government was affected and it’s local government that commissions those public health services that are essential for all our communities.”
The reasons to be optimistic
But Mr Standing is now cautiously optimistic. The reason why is the Dame Carol Black Review – and the impact that has had on government thinking. The two-part review which was published in 2020 and 2021 set out a clear diagnosis and recovery plan for the sector.
It called for immediate reversal of the disinvestment in treatment and recovery, saying substance misuse needed to be treated like a chronic health condition.
The review recommended a multi-pronged approach involving not just treatment but support with housing, work and mental health. These are all things Humankind, which supports over 90,000 people across the country, is involved with.
And vitally the review led to the new drug strategy From Harm to Hope and was accompanied by more money, said Mr Standing.
“With the massive inflationary pressure at the moment, it doesn’t make up for the money that has been lost completely, but it gives services a platform to tackle some of the problems that have become all too apparent,” Mr Standing said.
We have seen outreach work cut. And the thing with addiction is not everyone is just going to walk in and ask for help – you have to work hard to engage people and that takes time. Some people have chaotic lives and you cannot just open a service and expect them to knock on your door.
‘We’re seeing lots of collaboration’
And given the need for joined up approach, Mr Standing said there is a real benefit to local government holding the purse strings.
“Before the move of public health commissioning to local government, councils had some input in decision-making through the joint drug and alcohol teams, but the NHS was the lead voice.
Council commissioners are well placed to a focus on the needs of their local populations through a lens of ‘place’ and are used to working with charities. As a result, we have seen some really positive, inclusive and sustained partnerships with voluntary sector providers emerge.
“And I think that puts us in a good position in terms of developing the services that we need to meet the challenge. As the Dame Carol Black Review noted there are still too many people we could help out of treatment. Charities are well placed to focus on those wider issues. Addiction is an ‘everything issue’ – it is about meaning, jobs, relationships and housing as well as structured treatment.
“So what we are seeing is a lot of collaboration. Bigger charities partnering with smaller charities, local government and NHS trusts. Humankind is one of the biggest charities in the sector. In Bradford, for example, we have led a local partnership working with local groups to offer a full range of structured treatment, health and wellbeing support and peer mentoring.
“This will be a big focus for us under our new ‘Being Human’ strategy. We are thinking much more about localism, about place. The solutions for a rural area are going to be different from an inner-city area.”
Mr Standing said while it will take time to nurture the sector back towards full heath, services need to be ready to respond quickly to changes in demand.
“We don’t live in isolation – the cost-of-living crisis is having a huge impact on the day to day running of services - and has driven an increase in demand for support.
“Stresses of this kind can lead to people using more drugs or alcohol to cope. Those on cusp could tip into more hazardous behaviour. Meeting that need is going to be challenging, but as long as the drug strategy funding continues beyond the initial three-year spending review settlement we are in the right place in local government to respond.”