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AFAR
people from Adfam, Lifeline and (I’m delighted to say) The Alliance. Their report
appears to safeguard access to treatments like methadone and buprenorphine
while rejecting compulsory detox or time-limited scripts, but there were also
some ambiguities that could be the devil in the detail.
If I’m honest, prescribing kept me alive when I needed it, but at times it was
touch and go. In late 1980, I overdosed and nearly died trying to chase a buzz
with Palfium in the bathroom of a Shaftsbury Avenue hotel. I was lucky enough
to come round, but after that I couldn’t convince myself any longer that a script
was my only option and I entered rehab smartish. The 15 months I spent in an
’80s therapeutic community was full of hard work and challenges but it also
helped me learn essential lessons of self-control and deferred gratification that
users need to learn to stay alive. I never returned to injecting.
Nowadays, I’m less of a die-hard supporter of any one treatment over another,
especially when it comes to opiate dependency. I want people to get the
treatment that they want. I understand that some people want to work to
‘extinguish’ their drug dependency and it’s great when this happens.
I don’t actually have a problem with reminding patients on methadone scripts
that an exit is available as long as no one is arbitrarily drop-kicked through it.
Compulsion to come off methadone should have no place in our treatment
system. This is particularly egregious if the person is doing well and not using
street drugs. People must consent to such a change in their care because they
are the ones who have to live with the jeopardy of a relapse.
The best defence to arbitrary policy change is a strong and united service
user movement. It is everyone’s interests to stick together to oppose any
attempt to turn the treatment clock back to the bad old days.
Do write to me through
DDN
or at billnelles@telus.net if you have questions
or comments.
Look out for Bill’s occasional columns in future issues of DDN
BE THE CHANGE…
The sixth national service user involvement conference will take place on 14
February 2013 in Birmingham. To be a part of the consultation process on the
programme please email conferences@cjwellings.com
Activism|
Policy scope
September 2012 |
drinkanddrugsnews
| 11
www.drinkanddrugsnews.com
‘If I’m honest, prescribing
kept me alive when I
needed it, but at times
it was touch and go.’
POLICY SCOPE
The government will introduce new guidance on
the conduct of public consultations in September.
The Cabinet Office minister Oliver Letwin says that
‘the aim is to replace potentially unproductive
process with real engagement with those affected’.
Most controversially, the government says that
the principle that consultations should be held over
12 weeks is too restrictive, and suggests this could
vary from two to 12 weeks, depending on the kind
of consultation and the nature of the issues.
My sense is that there is frustration with
consultation processes on both sides. For government, the volume of responses
can be challenging (for example, there were 1,850 responses to the consultation
on the
2010 drug strategy
) and may appear disproportionate to the opportunities
to exert influence and add value. From the perspective of the drug field, there is
scepticism that the government is always giving sufficient attention to what we
say, and therefore about opportunities to influence policy.
It is important for both sides to channel these frustrations into a shared
commitment to developing consultation processes that work for everyone,
rather than to disengage from constructive dialogue.
Public consultations are one of the main routes through which providers
and users of drug and alcohol services can influence local and national
government. They provide an opportunity to have a say on policies that have
an impact on our services and communities. And that benefits government
too. Neil Cleeveley, director of policy and communications at the National
Association for Voluntary and Community Action, comments that consultation
‘isn’t done as a favour to the voluntary sector; it’s done because talking with
service users and organisations delivering services leads to better services and
more efficient public spending.’
Currently, the risk is that ‘bureaucratic’ consultation practice is creating a
relationship between government and the drug field that puts me in mind of
the old Soviet quip directed at Nikita Khruschev’s nomenklatura: ‘they pretend
to pay us and we pretend to work’.
The Cabinet Office’s new consultation principles declare that the aim
should be ‘real engagement rather than following bureaucratic process’. This
commitment could provide a basis for reinvigorating consultation practice. It is
also encouraging that the new principles explicitly say that the terms of the
Compact between government and community sector organisations – revised
and relaunched in 2010 – will continue to be respected, as this includes an
expectation that any departures from a 12-week consultation timeframe will
be publicly explained and justified.
The risk is that a more ‘flexible’ framework will legitimise ‘quick and dirty’
consultations on key policy issues where formal consultation guided by
established best practice would be most appropriate. The bottom line is that
DrugScope and organisations like us generally do need 12 weeks to consult
with members or service users, identify good practice, review the evidence and
prepare responses that can really help to make better policy.
Marcus Roberts is director of policy and membership at DrugScope, the
national membership organisation for the drugs field, www.drugscope.org.uk.
The
new
cabinet
office
consultation
principles
are
at
www.dft.gov.uk/mca/consultation_principles.pdf
New rules introduced this month could
reinvigorate the public consultation
process, says
Marcus Roberts
MAKING IT REAL