User Centred Drug Services

Project briefing

Drug users are one of the most vulnerable and stigmatised groups in the country. While current treatment services are reaching around half of users, they often fail to meet the chronic condition of drug dependency and the nuances of individual needs.

Compelling evidence demonstrates that services can deliver better outcomes if shaped by users themselves. In particular evidence from adult social care services shows that individual budgets - schemes for self-directed support, centred on personal budgets - show improved outcomes.

This project aims to make the case for and test a range of new solutions to aspects of these problems.  The work builds on the recommendations of the RSA Commission on Illegal Drugs, Communities and Public Policy, exploring whether drug users can be included in the government's current drive towards providing more personalised public services.

What is the problem?

The RSA Drugs Commission report, Drugs - facing facts (March 2007), highlighted a number of important issues about the effect of illegal drugs on communities and users.  This work, along with other research in the field, shows us that the challenges to public policy concerning illegal drugs are critical.

Drug services are still largely centralised, standardised and stigmatised and as such they are failing to help more than a small proportion of problematic drug users to make the changes in their lives they want and need. High numbers of service users fail to enter or complete treatment, suffer relapses or drop out.  Evidence suggests that tailoring treatment to specific groups or individual needs can address some of these retention problems as well as increase the level of engagement in treatment and so meet government targets of increasing the number of problematic drug users in treatment.

Some of the most vulnerable people in society face particular problems:

• Various groups of young people have been categorised by the Home Office as particularly vulnerable to problematic drug use: those who have been in care, in trouble with the police, excluded from school, or homeless
• One in three problem drug users is homeless or in need of housing support and a large proportion of homeless people are drug users
• In one 2005 study, nearly two-thirds of female drug users contacting treatment services had been physically abused and more than one-third sexually abused by a family member or family friend
• Refugee communities are targets for drug dealers. Young people within them are vulnerable as they commonly experiencing depression, loneliness, isolation and racially-motivated  bullying
• Unemployed people are more likely to have problems with drug use than the employed or economically inactive.

Personalised care

The drive towards personalised care is gathering momentum. In December 2007 the government's "Putting People First" Concordat proposed a radical transformation of care services, with a grant of £520 million earmarked for the introduction of personal budgets over the next three years. On 8th January 2008, Gordon Brown suggested that personal budgets might be extended to health care with the introduction of individual allowances for people with chronic conditions.

The government will soon be looking for other areas in which to try out self-directed support and drugs treatment is a key target for this kind of approach. Individual motivation is crucial to help people stay in treatment and change their lives.  Giving people more control over the services they use is a powerful incentive to persevere.

Our response

Drug users have not forfeited their fundamental rights as citizens and we want to make sure they are included in the planned revolution in health and social care.

Personalised care is already producing results in other areas of social care, and we aim to explore the strengths and weaknesses of such a strategy for helping drug users. The project will work with the West Sussex Drug and Alcohol Action Team and local partners to design and test user centred services.  A user reference group will be developed and trained to carry out parts of the research that will inform the early work and test the services as they are developed.

This is an ambitious project that will put into practice ideas developed in research and ultimately find out whether drug users can be included in the government's drive towards providing more personalised public services.
 
Email drugs@rsa.org.uk for more information.