1. PLUS PROJECT: SUBSTANCE
Policy update
PLUS PROJECT: SUBSTANCE
MISUSE FORUM
Vivienne Evans CE
@AdfamUK

2. Overview Home Office Drug Strategy DH Clinical Guidance (Orange Book)
State of the Sector 2016
4. Dame Carol Black review
5. Psychoactive Substances Act 2016
6. Life chances strategy

3. Drug Strategy 2017?
Strategy is overarching policy document – important but not binding
Drug policy is owned by Home Office but lots depts. have interest – DH, DCLG, DWP
Indications new strategy will be similar to 2010 version
Was supposed to be published about a year ago, indication it may be February 2017 – but who knows!
Brexit has snarled up policy making of government massively

4. Drug Strategy 2010
“We are determined to protect the public from the harms that drugs can cause to individuals, their families and society as a whole by reducing demand, restricting supply and supporting individuals to lead lives free of dependence.” Home Sec
3 priorities:
Recovery
Restricting supply
Reducing demand

5. Clinical Guidance (Orange Book)
Current version published 2007
intended for all clinicians, especially those providing pharmacological interventions for drug misusers as a component of drug misuse treatment.
Assessment should include “Identifying social problems, including housing, employment and domestic violence, and offending.”
Newer issues such as NPS and naloxone will be covered more extensively in new doc.

6. Clinical Guidance (Orange Book)
PHE have run the consultation which has included service user and carer “pods”
Draft version has been released.
Has been a bit delayed but should be published soonish.
Lots of stuff to be updated, to cover NPS and naloxone for instance.
Going to be hard for services to implement the gold standard in climate of sustained cuts.

7. State of the Sector 2016
Fourth annual snapshot survey of England’s drug and alcohol treatment system.
Being carried out by Adfam on behalf of the Recovery Partnership
This year focusing on qualitative research, lots of in-depth interviews with local areas – Newham, Essex, Lancs and Greater Manchester – and CEs of national orgs
Published end of March

8. Dame Carol Black review
“An independent review into the impact on employment outcomes of drug or alcohol addiction, and obesity”
“Long-term conditions such as drug addiction and alcohol dependence, or obesity, can seriously affect people’s chances of taking up and remaining in rewarding employment.”
“7. What are the legal, ethical and other implications of linking benefit entitlements to take up of appropriate treatment or support?”

9. Dame Carol Black review
NHS constitution: patients can “accept or refuse treatment that is offered to you, and not to be given any examination or treatment without valid consent.”
Published in December 2016.
Rejected the idea that substance users could be “coerced” into treatment through benefit sanctions

10. Psychoactive substance act 2016
Came into force May 2016 in response to “legal highs” / Novel psychoactive substances (NPS).
The law defines as a "psychoactive substance" anything which "by stimulating or depressing the person’s central nervous system ... it affects the person’s mental functioning or emotional state".
Exemptions made for alcohol, tobacco, caffeine, poppers
Criticised for definition above and for breadth ‘ “banning pleasure”, un-enforcability

11. Psychoactive substance act 2016
Has been criticised – ACMD pointed out was unworkably broad, and often impossible to prove psychoactivity
Anecdotal evidence indicates harms concentrated in populations of vulnerable people (offenders and homeless)
Spice (now generic name for synthetic cannabinoids) by far most common form of NPS use by these cohorts
Around 500 headshops have closed, so penetration of NPS in wider population probably has been reduced

12. Life chances strategy
PM’s speech in Jan 16 launched the idea, 4 priorities
Early neurological development
Development of character and resilience
Social connections
Specific drivers of poverty such as D&A, mental health
“It starts with that fundamental belief that people in poverty are not liabilities to be managed, each person is an asset to be realised, human potential is to be nurtured.”

13. Life chances strategy
This now not being released as was Cameron’s baby
However some if being picked up in a a wider Social Justice Green Paper “in the new year” (ie soon)
There is a £80m Life Chances Fund still open for social investment on a payment-by-results basis

14. Questions
Q & A