2. The cost of problem substance use Cost of illicit drug use £3.5bn Cost of alcohol misuse total £2.25bn

3. Treatment for substance use £173 million on drug and alcohol services in Scotland  £84 million specifically on drugs services  £30 million specifically on alcohol services.  £59 million spent on joint drug and alcohol services. 68% spent on treatment and care 6% spent on prevention 0% spent on protecting the investment in treatment

4. Treatment for substance use £22,827,123 cost of drug treatment for problem drug users  Problem drug users not in treatment £35,069  Problem drug users in treatment <1yr £15,025  Problem drug users in treatment >1yr £3,072

5. A Life Course Approach 13 problem drug use GP Prescribing Prison Methadone programme Residential Treatment Programme Prison Residential Treatment Programme Methadone programme Non-residential Treatment Programme 34 3 years abstinent 2 nd year at Uni 3000+ hours volunteering £13 k £2 k £20 k £161 k £20 k £8 k £5.7 k £3 k Hospitalisations Crime ££££

6. Recovery from addiction No reliable national information on outcomes of treatment (Audit Scotland) 3 % achieve abstinence in prescribing programmes (DTORS) 65 % achieve abstinence in services with abstinence as a goal (LEAP) But, relapse rates in all forms of treatment are high 60% relapse after one year (NIDA, USA) Cost of relapse?

7. Cost of problem substance use Cost of treatment Continuing improvement of outcomes Contribution to society Relapse Cost of treatment to achieve abstinence is offset by savings 3:1

8. Preventive Spend “Prevention” Treatment and care Relapse prevention

9. The Power of Recovery Time Potential Lessons from the USA

10. Recovery Capital Recovery capital is the strength of internal and external resources that can be drawn upon to initiate and sustain recovery from severe alcohol or drug problems – Hope in recovery – Supportive relationships – Secure and stable housing – Learning and personal growth – Connections to a community – Making a contribution to the community

11. Impact on outcomes of Recovery Capital Determines the success or failure of recovery Increases in recovery capital create turning points It may take several years to accumulate recovery capital Sustained recovery is harder for disadvantaged groups who lack recovery capital

12. Learning from the Serenity Cafe Year 3 By people for people in recovery 30 volunteers 200 ‘customers’ Cafe-club nights Social networking Sport, leisure and recovery-oriented activities Peer mentors Recovery coaches Links with treatment services and education/training providers

13. What will it take? 1%