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‘We seem to be living in an
increasingly pinched and mean
society, a political climate of
intolerance towards marginalised
groups,’
said DrugScope’s director of
communications, Harry Shapiro, as he
introduced
Access all areas: equality
and diversity in drug and alcohol
treatment,
the charity’s annual
conference.
The UK’s treatment system had
been shaped by the heroin epidemic of
the 1980s and ‘90s, said chief
executive Marcus Roberts, ‘and I’d
argue that we’re in the long tail of that
now’. An estimated 300,000 problem
drug users was ‘still a lot, but
significantly less than the 450,000 at
the height of the epidemic’, and while
the 2010 drug strategy was still built
around a notion of dependency
inextricably linked with deprivation, this
no longer fitted ‘with emerging issues
such as drug use among men who
have sex with men, or use of image and
performance-enhancing drugs’, he said.
These shifts were against a
backdrop of an estimated 40 per cent
reduction in local authority funding
over the course of this Parliament, he
pointed out. According to DrugScope’s
State of the sector 2013
research,
there were signs of disinvestment in
services but ‘no sense yet that we’ve
reached a cliff edge’, while the political
debate was also entering a new
terrain. ‘On the one hand there’s an
increasing focus on the millions of
people who take drugs without
experiencing any significant harm, and
another discourse focused on the role
of drugs in deprived and marginalised
communities.’ There were left wing
and right-wing versions of both, but
the fact remained that in terms of
public perception, addiction was seen
as the primary cause of child poverty,
and it was likely that this was where
the focus would be in the run-up to the
next election.
‘UK drug policy is in many ways a
success, and at a time when we’re
asking people to invest in it, it’s
important to focus on that,’ he
stressed. ‘Discourses around winning
and losing the “war on drugs” are not
helpful. What happens next is partly
dependent on what we say and do.’
Another issue that would be in the
news ‘a hell of a lot’ before the election
was immigration, said CEO of the
Refugee and Migrant Forum of Essex
and London (RAMFEL), Rita Chadha.
Although access to treatment was a
vital issue for her clients there were
significant barriers, including difficulties
with language and registering with GPs,
fear of the authorities, and stigma,
something that was also an acute issue
with people involved the commercial
sex trade, said team manager at
Blenheim CDP, Maggie Boreham. ‘What
biases do we as practitioners hold?’
she said. ‘Do we know how to ask the
right questions? What training do we
need for our staff?’
‘Many staff assume that a “white
middle-class” culture is neutral, and
appears nice and friendly to everyone,’
echoed strategic director for addiction
and offender care at CNWL NHS
Foundation Trust, Annette Dale-Perera.
‘It isn’t. We need to match services to
local needs, so you’ll need “teams
within teams”, and local needs
assessments are particularly important
– if you don’t look you won’t see.’
Stigma and ‘nimbyism’ were the risks
that went alongside the opportunities
presented by the localism agenda in a
climate of ever falling per capita spend
on health and social care.
‘One of the things we’ve rather
belatedly realised is that the way the
state is structured – centralised, in
silos – isn’t designed to respond well
to complex issues like people with
multiple needs,’ said associate
director for public service reform at
IPPR, Rick Muir. ‘We need to end this
fragmentation, and we need to ask
people what they want – what will
enable them to lead the lives they
want to lead.’
Drug use was about three or four
times higher in the LGB population,
said Alastair Roy of the University of
Central Lancashire, partly associated
with ‘significant self-esteem issues’
but also changing patterns of use
linked to ‘chem sex’ and injecting.
‘Localism might be the name of the
game in drug treatment now, but these
agendas only move forward with
national leadership,’ he said.
‘We need a model that better
understands and mobilises the social
resources available to us in the
community,’ said the RSA’s director of
research, Steve Broome. This could
mean more diverse partnerships or
more co-commissioning, he said, as
substance use was a ‘collective, social
inclusion’ issue, with the ‘constant
cycle of re-commissioning arguably
not helpful in this respect’. More
investment was also needed in mental
health, he stressed, where the gap
between rhetoric and reality was
‘shockingly large’.
‘If you can’t ensure that the most
vulnerable and marginalised are going
to be looked after, is the cost of
localism to society too high?’ asked
Karen Biggs of Phoenix Futures.
‘Decision making at a local level is
generally better than a state,
monolithic model,’ said Rupert
Oldham-Reid of the Centre for Social
Justice, ‘but marginalised groups tend
to be less good at advocating for
themselves. A statutory requirement
for recovery champions on local
health and wellbeing boards could be
one answer’.
‘We have a world-class treatment
system and a lot to be proud of,’
Marcus Roberts told the event’s
closing session. ‘But we also have a
lot to do and a lot to build.’
DDN
DrugScope’s annual conference looked at equality and
diversity in the sector at a time of shrinking budgets
News focus |
Analysis
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drinkanddrugsnews
| December 2014
www.drinkanddrugsnews.com
‘Discourses around winning and losing
the “war on drugs” are not helpful.
What happens next is partly dependent
on what we say and do.’
Marcus Roberts, chief executive, DrugScope