IF I RULED THE WORLD…Ten things I would do

(A conference session in which Chief Executives gave their views on how drug treatment could be improved)

Ten Things I would do if I Ruled the World.
 

1. Stop Criminalising Drug Users

I would stop criminalising and punishing drug users and to this end I would remove all crimes of possession from the statute.

2. An Integrated Classification and Policy Framework for All Drugs

I would move towards integrating alcohol, tobacco and illicit substances into a common classification as per the recommendations of the 2006 Report of the House of Commons Science and Technology Committee, ‘Making a Hash of It’.

3. Greater Candour about the Failure of the Global Strategy to Control Supply and Cultivation.

I would be more candid about the global failure to control the cultivation and supply of illegal drugs.

4. Drug Testing only when Public Safety is the Paramount Issue

I would encourage drug testing only where issues of public safety were of paramount importance.

Coming on to the Drug Treatment Industry.

5. The Role of Nice and The Health Care Commission.

I would continue to support the work of NICE in developing guidance for commissioners about research validated interventions of proven efficacy. People talk about NICE in the context of its rationing role and also the strict criteria it uses concerning admissable research.

In respect of the recent NICE guidance on the Psychosocial Management of Drug Misuse there have been concerns expressed about too much reliance being placed on random control trials, most of which were conducted in the United States.

Notwithstanding these concerns, however, one of the most interesting things the Guideline Development Group identified was a number of different kinds of success achieved as a result of positive reward via Contingency Management. Following on from these findings, The National Treatment Agency is already moving towards the early introduction of Contingency Management programmes in this country. This major piece of innovation is moving quickly and that is encouraging.

I would also support the developing work of the Health Care Commission in monitoring standards of assessment and care. Despite having much to be proud of in terms of our achievements during the 10 year lifetime of the first National Drug Strategy, the Health Care Commission, in their joint review with the National Treatment Agency, has pointed to the worrying fact that a significant minority of our services are just not very good.

6. We need a new Independent Research Foundation to Evaluate the Impact of our Industry.

To augment the work of these two bodies I would create a third body. This would be an independent research foundation whose role was to determine the impact and effectiveness of the UK National Drug Strategy and the Drug Treatment Industry. For too long we have escaped independent evaluation of this kind.

7. A National Developmental Programme to raise standards of Governance in Our Sector.

I would resource a national developmental programme designed to raise standards of governance in the non-statutory drugs treatment sector. This programme would emphasise the role of trustees in strategic leadership on a sector-wide basis.

I think improvements in governance and trusteeship would bring a greater independence to large and small drug treatment charities. It would, more than any other single change, facilitate a shift from short-termism to a longer-term perspective. It would go someway towards guaranteeing that drug users were re-installed as the major and proper beneficiaries of our industry and broad strategic planning.

It would enable trustee bodies to look outward and to speak each to the other, organisation to organisation, thus strengthening our sector and certainly enhancing our ability to mount more effective campaigns.

8. Plan Young People’s Drug Services around a Broad Health and Well-being Agenda

I would encourage the integration of young people’s drug services into local area services designed to address and respond to the broad range of young people’s health needs.

9. An Ongoing Series of Health Need Assessments designed to identify the Invisible Populations.

I would commission, via a range of research methods, an on-going series of health need assessments, designed to identify those groups and populations that the current National Drug Strategy renders invisible.

10 A Major Programme of Health Literacy built from the ground up.

I would resource a major programme of Health Literacy developed in close association with service users, drug users not in treatment, drug information services and public health professionals. These campaigns would utilise an early warning system comprised of a national network of volunteer respondents. It would be a barefoot version of Frank.

Everything we have learned about health literacy at Lifeline indicates that the most empowering public health campaigns are those which involve most thoroughly the target audience for whom the messages are intended.

Ian Wardle

12th October 2007