DRUG TREATMENT STATISTICS: ONLY 1.2% OF ADDICTS GET REHAB
The National Treatment Agency for Substance Misuse today issued a statement on drug treatment statistics claiming that Addiction Today, published by the Addiction Recovery Foundation charity, was inaccurate in one sentence of its four-page cover story. The sad fact is that the NTA prefers to expend its resources on semantics in order to avoid addressing issues of becoming drug free.
At issue is that few people get truly drug free, no matter how much they need it, because only 1.2% of problem drug users in contact with the drug-treatment system under the NTA enter rehab. In 2008/9, it was 4,711 out of 202,000 users, or 2.3%. In 2009/10 numbers fell to 3,914 out of 320,000 users.
The figure could be lower. For, last week, Jon Hibbs of the NTA gave us a list of ‚Äúrehabs‚ÄĚ which appears instead to be a medley of organisations which do not fit neatly into other categories: first- and second-stage units, quasiresidential, detox and other setups which we would not define as rehabs.
A related serious concern is that the NTA intends to pay for the author of its failed TOP measurement tool to measure rehab outcomes ‚Äď using this list?
The NTA calls for and approves plans from local areas and purchasers of treatment and boasted recently about ¬£570million funding. Where are the drug-free outcomes under its regime?…
- Gloucestershire has a treatment budget of ¬£6million; there are 1,000 clients on maintenance prescriptions and 6 (yes, six) in abstinence programmes
- A procurement manager in St Helens writes that ‚ÄúTier 4 interventions [rehab] will not be provided… it is not envisaged that this will be a subsequent requirement‚ÄĚ
- Another area handed over its total commissioning to a single organisation which has been fined ¬£1million for not referring addicts to rehab in over a year
- Camden has 1,200 clients on maintenance prescriptions; it has ¬£300,000 to spend before the end of its budget year this month but ‚Äúno one to refer to rehab‚ÄĚ
- Nottingham has ended its contracts with 12-step-based organisations.
‚ÄúThere is no evidence rehab works,‚ÄĚ claim NTA senior managers, despite empirical research ‚Äď and despite their own research by Dr David Best who interviewed people in true long-term abstinent recovery and found that the only effective treatment episode was rehab.
When Hibbs asked us to clarify the ‚Äúdrug free‚ÄĚ statement last Friday, we were happy to help and proffered an olive branch. We explained that calling addicts ‚Äúdrug free‚ÄĚ when they are still using psychoactive drugs means that cross-addiction (swapping one drug for another) is rife, resources are spent on symptoms rather than causes, and thus destructive addictive behaviours continue apace.
Illicit or licit, psychoactive drugs incur harms which continue throughout families and generations. For example, in a catch 22, methadone is supposed to replace heroin but is more addictive and harder to withdraw from, and is the second-greatest drug killer in the country ‚Äď so some prescribers now want to issue pure heroin legally to replace this substitute. In this Alice in Wonderland world of NTA redefinitions, people can then be called ‚Äúdrug free‚ÄĚ while still on heroin. Incidentally, the heroin trials were many times more expensive than rehab which, unaccountably, was not offered nor even considered as a control.
‚ÄúAny individual on a methadone prescription is by definition still in treatment, and cannot be discharged or claimed as ‚Äėdrug free‚Äô,‚ÄĚ the NTA website states. We are confused: the categories "retained in treatment" seem to overlap with successful discharge from treatment "drug free" (ie, free only of illicit drugs). These and similar sentences also contradict its reverie of ‚Äúmedically assisted recovery‚ÄĚ. How can can this exist when the person is ‚Äústill in treatment‚ÄĚ (sometimes for decades), dependent rather than having moved on?
‚ÄúAn individual who has overcome a drug dependency but shows signs of addiction to other substances (including alcohol or cannabis), or is at risk of relapse, should not be discharged but referred on to an appropriate service,‚ÄĚ the NTA website states. It begs the question of whether this "appropriate service" is logged by NDTMS. The 1.2% annual rehab access figure suggests that these "appropriate" other services cannot be rehab, as do the above examples refusing to commission rehab leading to recovery.
As for next year… well, the last sentence of the NTA website states it has no plans to improve the NDTMS dataset.
Key in ‚Äúdodgy dossier‚ÄĚ 1 or 2 or 3 in the search box to the left for more analyses of NTA figures.