Paul Hayes looks at the challenges local government faces in relation to drug treatment in the latest issue of Local Government Chronicle.
Read the article online here - This is a subscription site. The text of the article is available below.
Going back to the future on drugs
A decade ago, councils and the local NHS commissioned treatment services spent £200m and Whitehall £50m. Then central government took over and pumped in extra resources. Whitehall now spends £600m a year, three times the local investment, and this is paying dividends.
The numbers requiring treatment are falling, and record numbers are recovering from dependency. Soon responsibility will pass to local authorities again, through directors of public health working alongside health and well-being boards.
In such circumstances, a cash-strapped town hall might be tempted to take the money and run. It could cite localism to justify spending its share of a ring-fenced public health budget on alternative priorities.
I believe this would short-change voters and taxpayers. The number of problem drug addicts is relatively small, but the cost of drug addiction to society is huge – and the impact on local communities is incalculable. Drug addiction goes hand-in-hand with poor health, homelessness, family breakdown, and offending.
Although addiction is rare, there are still 306,000 heroin and crack users in England, often concentrated in deprived areas: for example, urban Middlesbough has proportionally six times more than rural Wiltshire. About 1,200,000 people in poorer communities are directly affected by drug addiction in their families. Whole neighbourhoods can be blighted by discarded needles, drug-dealing, street prostitution, and fear of crime.
It makes sense to invest in drug treatment to make communities safer, as well as help users overcome their addiction. Treatment protects public health, by preventing drug-related deaths and restricting the spread of blood-borne viruses like HIV and hepatitis C.
It also cuts crime. Most heroin and crack addicts steal to fund their habit. Drug-related crime – burglary, robbery, fraud and shoplifting – costs society almost £14bn a year. Research shows that treatment reduces this level of offending by about half. That means millions fewer crimes every year, and thousands fewer victims.
The National Audit Office endorses Home Office estimates that every £1 spent on drug treatment saves £2.50 in costs to society. Without this investment, disease would spread, drug deaths rise, welfare dependency increase, and crime rocket.
The public instinctively knows this. Opinion polls say the vast majority believe drug treatment makes communities better and safer places to live, and represents a sensible use of public money. IPSOS Mori told us that two-thirds fear crime would increase without it.
Local authorities ignore this challenge at their peril. Nevertheless there are positive reasons for councils to engage with this agenda, too. They hold the key to enabling even more people in treatment to sustain their recovery. Since 2006, 255,000 people were treated for drug addiction in England, and 28% overcame dependency. Yet treatment on its own is never enough.
Mutual aid from friends and family is vital, in partnership with local services like the police and probation, family doctors and mental health, and family and parenting support. In particular, we know recovery is more likely to happen when users are in stable accommodation and get support through education and training to boost their employment skills.
Under the leadership of local councils, we now have the chance to fully integrate drug treatment and recovery services so they work for individuals, communities and society alike.
Paul Hayes, chief executive, National Treatment Agency