Within days of the publication of the government’s new drugs strategy, Rebecca Daddow assesses the landscape.
The speculation about the content and direction of travel of the drugs strategy seems to balance out fairly evenly between excitement and deep anxiety. If the rumours are to be believed, it will be high level with the nuts and bolts missing. This is not entirely surprising and is consistent with the localism agenda and the government’s Big Society narrative, which sets some framework but leaves much room for local authorities to determine implementation.
Whatever the reality, the drugs strategy needs to grounded in the reality of how different groups will engage and cope with the reforms being suggested as well as the wider implication of cuts to services. Setting aside the biological features of addiction and dependency that can affect us all, the reality is that if you are poor, homeless, unemployed, have a relatively unsuccessful education history, and live in a deprived area with little by way of opportunity, then you are more vulnerable to problematic drug and alcohol use. And once you start using, you are less likely to be able to free yourself from the multiple problems once they occur.
The concentration of problematic drug use and high levels crime within areas suffering from multiple social difficulties means that despite the prevalence of drug use across social groups, the issue is too often seen as one ‘belonging’ to the poor. While not wishing to ignore individuals’ ability to resist social trends, the expansion of drug markets within deprived communities, together with the normalisation of drug and criminal lifestyles, means young people, for example, are more likely to see these behaviours as acceptable.
But what came first, the problem drug user or the environment conducive to problem drug use? And whose responsibility is it to sort it out? A lot is pinned on the new drug strategy: we are currently deeply reliant on public services in trying to address the challenges presented by problem drug use. The good news is that the strategy is likely to expand the number of government departments responsible for delivery, recognising the complexity of the issues. It is also likely to emphasise recovery.
However, what is not yet clear is how the different departments will work together and whether the strategy will begin to engage whole communities: taking a truly big society approach.
We have already seen the re-emergence of discussions about a ‘deserving’ and ‘un-deserving’ poor; the re-moralising the welfare debate. If local agendas and priorities are going to be driven by local people then these kinds of discussions will not bode well for those trapped in cycles of addiction or struggling to recover from the complex problems associated with drug and alcohol misuse. Who is more ‘undeserving’ than the jobless heroin addict? Given reliable and objective information, the public are known to take a more sensible standpoint in regard to criminal justice issues. Unfortunately, this information is usually lacking or buried in the complexity of ‘criminal justice speak,’ which leads to the promulgation of misleading perceptions.
For example, there is a perception in some significant quarters that treatment doesn’t work at the local level. This is not surprising when local level criminal justice agencies are in contact with the same people year after year: some 206,889 adults are in contact with treatment services but only 23,680 adults have successfully completed treatment. This can lead to fatalism. So, amongst practitioners, we hear about the ‘relapsing condition’ as if this were an absolute rule and that there is nothing that can be done about the high levels of incomplete treatment journeys. Not very empowering to the service users or staff.
The popular media does little to help. Aside from vilifying real-life problem drug users, they perpetuate an unrealistic notion of recovery. “Eastenders‘” Phil Mitchell can go from being a heroin junkie one week to a reformed drug free person the next. Ta-da!
The natural reaction of most people – whether they have a drug or alcohol problem or not – is to distance themselves from the ‘problem’. Unfortunately this means that most don’t engage with the realities of recovery.
What is required now is an injection of realistic optimism at all levels. When it comes to tackling drugs and alcohol problems, the government will need to temper its vision of the Big Society with pragmatism in its application. Meanwhile, practitioners need to overcome their inertia and deeply embedded assumptions. Of course, this would be more likely to occur if the media could be persuaded to present a fairer portrayal of drug use and user, and if the public would recognise the role they could play in preventing the development of problem drug use and in addressing it once it occurs.
The RSA Whole Person Recovery project begins to address these challenges. It suggests that by empowering and enabling problem drug and alcohol users to take greater responsibility for their recovery, and by supporting others by engaging them in the design, development and delivery of services, recovery becomes more accessible.
The projects’ Whole Person Recovery System offers a high-level structure that we believe can hold multiple levels of complexity and feature various delivery agents in generating the overall outcome: recovery for all. Adopting such an approach would ensure that the various departments expected to be involved in delivering the new national drug strategy will be working together.
Crucially, in doing this work, the RSA has engaged a wide variety of community stakeholders that goes beyond the ‘usual suspects’. By creating Recovery Alliances, we have generated a shared understanding of recovery and what it entails at every level of the community: from elected cabinet members, local Fellows, to the police, the service providers and the service users.
This project demonstrates how to translate ambition into practical action at a local level. It provides the nuts and bolts and should be used as a platform from which to build on.
Rebecca Daddow is a researcher at the RSA and co-author of Whole Person Recovery: a user-centred systems approach to problem drug use