Innovation Partner Stephanie Otuoacheampong reflects on the recent Dame Carol Black Independent Review of Drugs (part 2) published this month, and considers how our own evidence correlates with its findings. She explores what this means for people experiencing multiple disadvantage and describes some of the actions we are already taking.
Around 30,000 people are currently using opiates and crack in the UK, and the problems caused by overusing drug and alcohol are not limited to substance use disorders, but include many other health and safety problems that can result from over-using substances. For example, there is a strong link between substance use and individuals experiencing multiple disadvantages such as mental health disorders and homelessness.
The recent Dame Carol Black review sought to increase access to treatment and recovery support for people misusing drugs, ensure that treatment and recovery packages include evidence-based drug treatment, and reduce the demand for drugs and prevent problematic drug use.
Joined up approach required
The review revealed the need for high-quality treatment and recovery services pathways into treatment which are separate from the criminal justice system and shone a light on the fact that reducing the demand of drug use is not linear. The Review noted that “the solutions span into many government departments, local governments and different organisations”. The Review also observed the need for collaboration between professionals in the same field but with different specialities.
Understanding the impact of multiple disadvantage
Based on the evidence gathered by Fulfilling Lives LSL – which was submitted to the Carol Black review last year – we strongly believe that responses must also recognise the interactions of multiple disadvantage.
For example, the Review highlighted the link between other health issues and drug use saying:
“Many drug users have poor overall health. The NHS is poor at engaging with the wider health needs of drug users with medical co-morbidities … many of whom are ill-equipped to navigate complex pathways, and feel stigmatised. Department of Health and Social Care and National Health Service England should work together to develop an action plan on improving access to physical healthcare.”
The review also highlighted the need to rebuild services that offer treatment and recovery support saying:
“DHSC and the Office for Health Promotion should support local areas to ensure that thriving communities of recovery are linked to every drug treatment system, working to standards on quality and governance developed by the government’s Drug Recovery Champion and the Office for Health Promotion”.
Our actions to improve drug services
The feedback we collected from local people in south London who use drugs, which was submitted as evidence to the national review, explored many themes which are reflected in Dame Carol Black’s conclusions.
To address these concerns, we are introducing a number of innovative practices to improve outcomes for people experiencing multiple disadvantage and drug use in Lambeth, Southwark and Lewisham. These include:
- Building an evidence base
Women being supported by Fulfilling Lives LSL report barriers to accessing drug and alcohol treatment in Lambeth, including the structure of assessments, waiting periods, and the male dominated environment.
We have dynamically engaged with the women we support to find out more about their experiences in accessing drug and alcohol treatment in our local boroughs as well as engaging in women-only spaces.
- Co-designing a specialist pilot to improve women’s access to drug and alcohol treatment
We have also worked with a group of experts by experience and a local drug service to co-design a specialist pilot. The proposed design has been led by the experiences of women accessing the services, and seeks to remove barriers to access experienced by women in the area. We will be working with the coproduction group and the service to set up this new pilot, in line with the proposal.
- Enabling partnership working
We have facilitated several shared-learning forums with key stakeholders including commissioners and practitioners from across the boroughs. These forums have explored how we could work collectively to co-produce improved access routes into treatment that would promote positive outcomes for people experiencing multiple disadvantages in our boroughs.
- Increasing understanding and supporting challenging transitions
We are working with stakeholders across London boroughs to strengthen knowledge and understanding around supporting individuals who experience multiple disadvantages. In addition, we are providing support for people through transitions such as transitioning living spaces or from prison, for example, including supporting people to access drug treatment.