What impact will recent UK government cutbacks have on drug and alcohol counselling? Carl Stanley asked the opinion of a variety of rehab professionals, including a magistrate, drugs counseller, and pharmacist, plus several musicians who have been through the process
The UK’s drink/drug counseling and rehabilitation services are facing cuts in spending and rapid changes due to proposed government plans. Itâ€™s common knowledge cuts are expected in most government spending, but how will our drink/drug services react and cope to, some say controversial, future Government plans. I myself used a local government funded service to deal with my own substance misuse problems. I feel it was essential in me getting myself together and I’m fearing these changes and cuts could prevent other people receiving the same level of help and support that I received.
Therefore I asked several professionals, including a magistrate, drugs counseller, and pharmacist who are all involved in the process of running UK drink/drug counseling services, what they think the results could be regarding the proposed changes and cuts. Several spoke only under condition of anonymity. I also sought out some of the local music artists of whom Iâ€™ve long been a fan, like c, Paul Heaton from The Beautiful South and Black Grape’s Kermit, who agreed to talk honestly about their own experiences of drink and drug misuse and how government services helped them recover.
Part 1: The Drink / Drug Rehabilitation Professionals
The questions are:
Proposed spending cuts of £6.25 billion in Government spending, with out doubt drink/drug services will face cuts. What effects do you feel the cuts will have on the services, service users and society as a whole?
what do you think to the new Government policy of “recovery”, the harder line policy that will focus on drink/drug service users, service users who have not shown much in the way of improvements and rehabilitation, maybe given some sort of time line as to when they have show improvement in their rehabilitation, maybe in order to keep getting the help from their respective service, what are your thoughts and views on this, would it work, is it right….?
In the time of you working, or using a service, or when you started out with your respective band, how have the UK’s drink/drug services changed/improved, what have our services now what they didn’t before…?
Two different reports, one by the UKDPC say their research shows a high level of stigma attached to our drink/drug services and the people who use them, at the same time Drug scope say their on line survey shows 2/3 of their respondents say spending on our services is right and they feel fine with it, whats your view on stigma regarding you and what you have to do with the service…?
Our Governments policy a few years back was to get as many heroin users on a Methadone prescriptions so to maintain them, keep them steady and from breaking the law to support them substance wise, though NICE say while “methadone has a part to play in the rehabilitation of a heroin user, it does not directly address the causes and context of drug dependency”, though other work is done with service users, do our drug services rely on the use of methadone too much, and is there a down side to so many on methadone prescriptions….?
A Chemist/Pharmacist who provides a methadone service and needle exchange
” Well, we can only be as effective as the budgets we receive from the Government, it’s that simple, less of a budget could mean being less effective as our service goes”
” Reducing Methadone users is the next positive step, though to take or stop some ones treatment would with out doubt be the wrong move, and would raise criminal justice issues, as if somebody is taken off their prescription I would think it would effect crime in general, I’m in favor of the right approach to moving meth users off their prescriptions and to the next positive step, reducing them if of course its done accordingly and correct.”
“I have been involved in the methadone/needle exchange for ten years, and the progression of the service has improved so much, I feel our standards are high and we provide a quality service.”
“The correct use of methadone is some thing between the user and the doctor; I feel it has made stable many people with Heroin problems. in a ideal world some one would come off street drugs and go on to the right amount of methadone they would need to keep them stable, then when there life is maybe less chaotic they would start to enter society again as substance free, by reducing their prescription according to there individual needs.”
A Magistrate dealing with drink/drug offenses in court
“I would say we need our services and the standards they give to carry on, as I would say 90% of theft crimes like shoplifting are drug related, I can only use the options I have at my disposal, and drink/drug services are 1 of them which I do access for many, I work on recommendations put before me, so though I do have certain power, I can only work with the services and establishments at my disposal, and I steer people towards them. All I can say is we need correct funding to enable these services to carry on with the work they do. Until I was a magistrate I really didn’t realize the scale of the UK’s drug problem, our drug problem, the amounts of people who make the wrong decisions, and also the numbers of teenagers with substance issues. Sometimes when I’m driving near the local shops for example, and see teenagers vandalizing, smoking drinking and fighting I have this urge to get out my car and talk to them, try and make them realize they can do better things than hanging about, up to no good, give them some encouragement. But I’m all so very aware that my approach wouldn’t work, which is a shame. So we need all our services, Drink/Drug and those services that support teenagers in all aspects.”
“For me to comment on whether a more disciplined approach towards some of the users of drug/drink services would be the right decision or not would not be an answer I would’nt be able to give, as I said I can use the services if its right in that case to do so and if its recommended some one is appropriate for a drink/drug service I will work on these recommendations, I see people going through court and accessing a drink/drug service, but as a magistrate I don’t get much feed back at all on those that I have steered towards a drink/drug service, which in a way is some thing which should happen, some feed back and info on the cases we have delt with would be good.”
” So many improvements over the years I have been a magistrate, I feel things like programmes, talks and training are great, education is so important, to us all, in all aspects. Though we can plainly see a rise in drug related crime over the years, the drink/drug services are always improving, gaining knowledge, more effective, better education, I think our services are very effective, do a great job and we need them in society more than ever.”
Drug counsellor who provides help and counselling for those with drug-related problems.
1) Spending cuts….?
“I think new Government policy is looking to use more community orders rather than use prison sentences when dealing with people with drink/drug issues, it costs ?35,000 a year to look after a inmate so they could feel it would better, cheaper using more community based orders. I’m hoping there will be sufficient funding to take on the extra numbers coming into the drink/drug services, I’m not sure if the current drink/drug services could cope with more service users with out the right funding, also, would this policy encourage crime, would users think they will probably get a community order instead of a prison sentence if they commit drug related crime…?”
“The new policy of recovery, looking to start moving service users off their medication and council-ling is something that I can see being done with the newer service users, but for those that have been on there medication, for example, Methadone, for some time, large doses over a long period of time, say 5 yrs, and longer in some cases, will be harder to work with, for these people to work to deadlines I don’t think would work.”
“Yes, a few years ago the Governments plans was to maintain every one with a Heroin problem on to methadone, which I feel has been successful, but I also feel there is an issue with amounts that are taken ,some times. Some of the amounts that some people have to take I feel is quite high, and another thing that bothers me is the amount of methadone on the streets, it gives some the people the choice to administrate them selves with the methadone they buy off the black market, together with no council ling this is a problem that has arisen.”
” Of course our services have improved over the years, in lots of ways, but I can say I feel we have more people on Methadone prescriptions then in the past, but less people coming through door, a decline in people needing these prescriptions.”
Comments from Tim Young, chief executive Alcohol and Drug Services (ADS)
“More places and more accessible places, clinical governance has improved, also type of drugs prescribed have changed tremendously from Methadone Grains to ready made Methadone mixture.”
“Its still a problem, but one that is improving, I would say though there is more stigma aimed towards drug service users than alcohol service users.”
” The driving issue in the use of methadone within the drug services has been political not clinical, the way funding is worked out for users gives the services the problem of delivering what they can, but also getting the results. Giving some one a prescription and reviewing them every few weeks is much cheaper than seeing them weekly and working with them through psychological therapies, yet there is loads of evidence to suggest the second provides better out comes.”
4) Spending cuts….?
” I believe some changes are needed, but it’s the speed of these changes that concern me, although we are measured by our results, the funding will be linked to theses changes and we are half way through this year and we have not yet been told how this will happen.”
“I don’t think this is “harder line”, I think it is a value laden word poorly chosen. The recovery agenda for clinicians is about what it means, in terms of treatment delivery.ie, introducing an element that should have been there all along and for which there is substantial evidence. Also if you were to ask some one after some months of treatment they might look for different options with in their treatment, but will make do with what’s there, so the harder line could be seen as offering an option previously denied to service users.”
“At the core of recovery’s the aim of reducing users service dependence on specialist and increase their ability to access/use support from mainstream services, at a time when main stream services are being cut too I fear it will be more difficult at best for some users and impossible for at worst for some of our service users. The holy grail of getting people back into work becomes even more difficult, if stigma and the out of date rehabilitation of offenders act are taken into account it is very difficult indeed for our service users to aspire to anything but the most basic paid employment, if they can get a job at all.”
Methadone user of a local drug provision service
“Well for me I’m asking “what about my methadone script” when I think of cut backs, or the support I get, will it not be what we get now, if I didn’t have this service and prescription I would be left with nothing, if right now my council ling and other help was reduced I would be looking at using Heroin, or prison, I’m still going through rehabilitation and the help I get now I need.”
“If I had to sign up to some recovery agreement I would want guarantees about back up’s, meaning what if I cant stick to some new rehab plan, a harder one, the thought of this “recovery” thing just makes me ask questions about knowing I will be alright, what if it doesn’t work, if it didn’t work, could/would I get another methadone script and the council ling that goes with it…, it makes me feel uncertain about it.”
“I’ve been using heroin for about 13yrs, in the time I have been using drug services I have seen loads of changes, more options, the services allow you to get involved in activities, and the education is good as I didn’t know half the things I do know, about getting clean, trying to stay healthy and also the chance to talk to many different people who can help you, in different ways, yeah I seen a lot of changes.”
Part 2: Artists Talk About Their Experience Of Government Drink / Drug Services
Happy Mondays Bassist and founder member
1) What were services like when you started with the Mondays, improvements…?
“Well to be honest there wasn’t anything that I can remember; people were left to it really. Going into the 80’s the first wave of Heroin hit the streets of Liverpool, close to me and my mates in Manchester, so it didn’t take long for it to make it to our City. Round this time I do remember a little about the 1st anti-Heroin campaign by the Government. So I remember the warning, but I couldn’t see where the help was coming from.”
“It’s needed more than ever, to cut back on these services would only mean less help, but to take any part of the drink/drug services away, and not replace it would be a blow. Its the counseling as much as the medication that’s important, and I feel it would be false economics as it would mean a rise in crime if there’s less help out there.”
“Being more disciplined towards drink/drug service users is one thing, but any thought of time lines for users to rehabilitate too, would just not work, its about the individual and their problems, its complicated because there are normally many issues why some one would have a drink/drug problem, its complex stuff some times. To what extent the new more disciplined Recovery policy will include I don’t know, but no one can work to a dead line as far as rehabilitation is concerned, that’s daft.”
“Well I have used several methadone prescriptions, and even though I went through it a number of times, at the time they did work as far as bringing me off street drugs, like now with the methadone, its staple use is to maintain some one, to keep them from using Heroin, which it did for me, but there was no follow up work, no councilling, you saw a doctor and went through the process of getting on a methadone prescription. But each time I got to that stage of maintaining myself on methadone, being stable, I would also feel totally lost, like an empty shell, not much in the way of feelings or thoughts, that’s where I could have used some follow up councilling, but as I said it wasn’t there. Methadone can keep you stable, but there is so much more work to be done when you get to the point of maintaining your self on your medication. The councilling is essential.”
“Personally I would like to see more beds provided for detox patients, one time when I went to Salford hospital for detox, there were 25 beds but only 2 beds for people from Manchester, and it was made up of people from towns and places outside MCR. I also had to wait some time before getting the help, I waited 8 weeks for a bed, and when I was finished detoxing in the Hospital I was signed over to the doctor, I would just turn up every so often ,and go through the motions, but again, no follow up work, and again I’m left feeling empty, once you get stable a whole load of other issues start, ….making the right decisions, using your time right with the right people, depression, changing your life style, all these things have to be dealt with, and most of these things require help and council ling.””I live in LA now, and I have been clean 3years, though its great living here, like Manchester you see the drug problems all the time, its a place where plenty run away too hoping for a good life in what ever they do, yet loads of em end up on the street, I see it when I go down town, these are the people I can relate to, the people I feel I could help. The council ling I get out here is one reason why I’m here, along with all the other great things about LA, but I’m happy and the council ling works for me.””At the moment the kids are on holiday, I’m currently working with Tina Waymouth (Talking Heads, Tom Tom club) who I have known and worked with since the early 90’s, always been a big fan of her work, so yeah.things are great.”
Stone Roses/ Primal Scream
“Comparing today’s drink/drug services to when I started out with the Stone Roses, well there was nothing, people were basically left on the streets, that or prison, and there were a lot of people left to it back then, it was scary, way things are going we could be looking at a similar situation to the old Tory Government, because that’s when it all happened, Heroin and the crime that went with it, and there was no help at all.”
“As far as recovery goes, I think people need to wake up and realize it’s a disease, I can’t imagine the Government saying to a cancer patient “you have 2 yrs to get better” you know what I mean, it’s the same for addiction, it’s a disease and should be treated as one. Feel strongly about this, and whether people like it or not, it needs to be treated the same as any thing else that makes you feel as ill, it’s a disease.”
“In the industry I’m in we pay 40% tax, I contribute my fair share so from that point of view I would rather see my Government spend money on drink/drug services than war. People today rely on these services so much, what a negative impact it would be to cut back on them, what’s that saying. Under this Government it could be like going back to the old Tory Government, in the way of these services, so if you think you need the help the drink/drug services can offer, getting in there, no one is going to help you if you don’t make that first move to help your self.”
“Me personally, I had an issue with alcohol, so I booked my self into a rehab, I’m lucky to have the means to do so but obviously not everyone can. to sum up what it was like for me going through rehab is…; like I have been walking around most of my life with a ruck sack full of bricks, weighing me down physically and mentally and going through the councilling in rehab allowed me to one by one take out the bricks, baggage from not talking about things I had stored up over the years.So I talked to the councilors and detoxed, the councilling was effective for me and now I can say my life is so much better, my relationship, my home life, I get much more work done musically and everything is much clearer, a good living.”
The Beautiful South / The Housemartins
“I have no idea but i see a increase in people pubically trying to fend for themselves.”
“Deadlines are no good for people with addictions; I can’t imagine it works like that.”
“I’m fine paying 40% tax if it’s going to the right cause, the cut backs in spending are to pay for the next banking crisis, that’s all.”
“I had no dealings with drink/drug services during my Housemartin days, though I did consult a group called DART while I lived in Hull, they were great but have now closed (under the last Government). I can’t tell someone when is a good time to consult professional people but that’s what they are and there trained for moments and people like you and they wont come searching for you.”
aka Kermit, Black Grape.
“Back in the day help was scarce, hardly any services, GP’s only dealt with a select number of people with drink/drug problems, and methadone prescriptions were no where as near as wide spread and used as they are today.”
“Were living in a society where new drugs hit the streets every month, never mind hard drugs, with all the legal highs about our drug services will be over ran with new problems, not just the old ones, and as far as spending goes, its not just funding for drink/drug services but all the other issues like housing and such that people need help with when they have a drug problem, we need more than just drink/drug services.”
“I think it’s ignorant to use 1 size fits all, drink/drug issues come down to the individual, cant see the recovery policy working.”
“In the early days I used recreational, and no hard drugs, the music industry has always been involved in drink/drug use, my story is pretty much the same as every one else, I’ve been there with substances, but I’m older now and having a good time does not mean messing your self up, At the moment I’m in the studio and my thing will always be music.”