Document Sample
					                                                     25 October 2010

‘It is important to highlight
that the policy proposals
contained within the
consultation paper do not
appear to be underpinned by
any evidence that supports
the policy direction that is
clearly being taken.’

Ex users, professionals and musicians
comment on expected cuts

What will services look like?

Your fortnightly magazine | jobs | news | views | research
                    Families Plus
                    Professional Development
                        “Thinking Beyond the Individual:
                  Working with Families and Substance Misuse”

                   Course dates
                                                   Mon 24 – Fri 28 Jan 2011
                                                   Mon 7 – Fri 11 March 2011
In line with the NTA guidelines “Supporting and involving Carers”,
this professional development focuses on the importance of working
with families and carers and offers training in:

G       Evidence based practice
G       Exploring theoretical models of working with families
G       Involving families/carers in the treatment of the substance misuser
G       Developing services to family members/carers in their own right
With visiting lecturers, Professor Alex Copello (Birmingham and Solihull
Substance Misuse Services & the University of Birmingham)and Lorna
Templeton (Lorna Templeton Research) presenting current research.
This course is accredited by the University of Bath
For details and an application form: Families Plus
Jill Cunningham House, East Knoyle, Salisbury, Wiltshire SP3 6BE
Tel: 01747 832015                    Email:

Action on Addiction, E Knoyle, Salisbury SP3 6BE    Company No 05947481   Registered Charity No 1117988
                                                                                           Editorial – Claire Brown
  Published by CJ Wellings Ltd,

                                                                                           Speak up!
  Southbank House, Black Prince
  Road, London SE1 7SJ

    Editor: Claire Brown
    t: 020 7463 2164
    Reporter: David Gilliver
    e:                                                                Sounding off for policy’s sake
    Publishing asst: Lexy Barber
    t: 020 7384 1477
                                           When the going gets tough the tough get... vocal! With consternation building about the drug strategy,
    Advertising Manager:
    Ian Ralph                              right from the consultation process, we’ve compiled some of the responses (page 6). The picture it leaves is
    t: 020 7463 2081
    e:                  not a satisfactory one. While there is appreciation of a holistic approach, there is also tangible panic about what
    Advertising Sales:
    Faye Liddle
                                           it will mean for those who are not catered for by obvious definitions.
    t: 020 7463 2205
    e:                     At the recent eATA conference, public health minister Anne Milton spoke of the expected cuts to drug
    Designer: Jez Tucker                   services: ‘Many of you will be bracing yourselves.’ But she stressed that government is keen to listen to what
                                           works, and that the goal is greater effectiveness rather than change for change’s sake (page 10). A parliamentary
    t: 020 7463 2085
    e:                 cross-party group earlier this month underlined this suggestion that ministers are willing to learn from the
    Website:                               expertise and experience to be found in abundance in this field (page 9). Many of our readers are fighting on the
    Website maintained by                  frontline of the spending review at the moment; this week there has been no shortage of feedback from
    Printed on environmentally             treatment agencies that sweeping changes to the benefit system could be disastrous (news, page 4).
    friendly paper by the Manson
    Group Ltd                                  With uncertainties hanging over all of us, Carl Stanley puts the questions on everyone’s lips to wider
    Cover montage: JellyPics               consultation, starting with some of his favourite music artists (page 12). Gathering opinions on the effect of
    CJ Wellings Ltd does not accept
    responsibility for the accuracy of     policy changes and spending cuts, he demonstrates that drugs and alcohol are everybody’s business, and
    statements made by contributors
    or advertisers. The contents of this   need to be considered alongside every other mainstream element of society.
    magazine are the copyright of CJ
    Wellings Ltd, but do not necess-           Reports of a successful recovery weekend in Glasgow (page 15) are a reminder of the power and inspiration
    arily represent its views, or those
    of its partner organisations.          of peer support – surely a demonstration of building on what works. And on this note of optimism, this is our
                                           sixth birthday issue since we first published DDN on 1 November 2004, so onwards and upwards! As usual we
   DDN is an independent publication,
     entirely funded by advertising.       want your views on everything that’s going on, so keep them coming.

                                             This issue
         FEDERATION OF DRUG AND                                        6       TOKEN POLL? – COVER STORY
                                                                                       The consultation on the 2010 drugs strategy has been nothing if not controversial, with many in
    SUPPORTING ORGANISATIONS:                                                          the field complaining of lack of both time and detail. DDN casts an eye over some of the responses.
                                                                       9      SAGE ADVICE
                                                                                       Lee Collingham reports on the harm reduction messages at the National Conference on
                                                                                       Injecting Drug Use in Gateshead.
                                                                       9      PARLIAMENTARY BRIEFING
                                                                                       Welfare reforms were among issues debated at the latest meeting of the Cross-Party Group
                                                                                       on Drug and Alcohol Treatment and Harm Reduction, as DDN reports.
                                                                       10     BRAVE NEW WORLD
                                                                                       eATA’s London conference gave delegates a glimpse of what services might look like in
                                                                                       the coming years. David Gilliver reports.
                                                                       12     SOUNDING OFF
                                                                                       An ex service user concerned about potential government cuts, Carl Stanley talks to people in the
                                                                                       field – along with some of his musical heroes – about what the impact might be.
                                                                       15     WEEKEND PASS
                                                                                       Grace Ball, Rowdy Yates and Matthew Kidd report back from Glasgow’s landmark recovery weekend.

                                                                       4      NEWS ROUND-UP: ‘Don’t jump the gun on drug services’ warning • ‘Morally questionable’ Project
                                                                              Prevention pays first UK client • ‘Public inquiry’ demands on parental alcohol misuse • NICE considers
                                                                              incentive schemes for change • Harm reduction ‘should be centre’ of drug strategy • News in brief

                                                                       16     JOBS, COURSES, CONFERENCES, TENDERS                                                                                                                           25 October 2010 | drinkanddrugsnews | 3
News | Round-up

  News in Brief                                 ‘Don’t jump the gun on
                                                drug services’ warning
  Khat out of the bag?
  The Advisory Council on the Misuse of
  Drugs (ACMD) is to conduct a study into
  the stimulant khat, following a request
  from drugs minister James Brokenshire.
  Chewing khat is a widespread practice in
  some Somali, Yemeni and Ethiopian             Commissioners and organisations embarking on ‘slash                    central government to the local level as well as getting
  communities, but heavy use can be a           and burn’ cuts to drug services are ‘jumping the gun’,                 the best possible value for taxpayers’ money’, the
  problem, says the Home Office. It is          according to public health secretary Anne Milton. ‘It is               government says. However, a further £7bn is to be cut
  estimated that around 0.2 per cent of the     not the right response,’ she told delegates at eATA’s                  from the welfare budget in addition to the £11bn
  UK population uses the drug, which is         annual conference (see feature, page 10), adding that                  announced in June’s emergency budget, representing a
  usually sold in bundles of dry leaves – the   savings needed to be made ‘in a way that supports                      ‘dark shadow’ according to Turning Point chief executive
  ACMD will advise on whether to control it     communities rather than abandoning them’.                              Lord Victor Adebowale. ‘There is a danger that in
  under the Misuse of Drugs Act.                     Last week’s Spending Review 2010 saw the health                   removing benefits from vulnerable people, issues such as
                                                sector escape the cuts inflicted elsewhere, with total                 poor mental health, substance misuse and criminal
  Sent to Coventry
                                                spending set to grow ‘by 0.4 per cent over the Spending                activity may spiral out of control,’ he said. ‘It is our hope
  Fifteen packages of the powerful
                                                Review period’. However, the NHS administration budget                 that the poor are not affected disproportionately.’
  hallucinogen dimethyltryptamine, or
  DMT, have been seized by UK Border            would be reduced by 33 per cent and ‘reinvested to support                  The Children’s Society warned that ‘the poor could
  Agency staff at Coventry’s postal hub.        the delivery of NHS services’, the review document states.             become poorer and the disadvantaged more disadvant-
  The packages – totalling around 125                Drug and alcohol services will be financed via a new              aged’, while the combination of cuts to housing benefit
  kilos and worth £13m – had been sent          public health grant to be paid to local authorities, with              and the slashing of the affordable house building subsidy
  from South America. UK Border Agency          funding for public health ring-fenced ‘to improve the health           would be ‘devastating’, according to housing charity
  staff based at postal hubs use                of the whole population’. ‘In order to free up local areas,            Shelter. Homelessness charity Providence Row,
  scanning equipment and intelligence to        funding to local authorities and delivery bodies will be               meanwhile, said the housing benefit cuts could mean
  intercept drugs and other contraband,         radically simplified, giving them greater choice over how to           around 82,000 households facing eviction in London
  says the Home Office.                         use their money to meet the needs of local people,’ says               alone. ‘Many of these people will move to cheap,
                                                the review. The government has also promised that access               crowded accommodation whilst others will face a winter
  Harm reduction at a glance
                                                to psychological therapies will be expanded.                           on the streets,’ said the organisation. ‘Single homeless
  A poster and leaflet setting out the
                                                     As previously stated, the government will abolish                 people are rarely eligible for social housing and rely on
  main findings from the latest Global
  state of harm reduction report has been
                                                Primary Care Trusts and Strategic Health Authorities by 2013           the private rental sector but the lack of affordable rentals
  launched by IHRA. The poster shows            (DDN, 19 July, page 5) – ‘removing whole tiers of NHS                  will see them staying in hostels for longer.’
  which countries support harm                  management, saving money and empowering frontline                           ‘We fear that the universal application of cuts in
  reduction as part of national policy and      professionals,’ it says. ‘The NHS budget will have to stretch          benefits and social housing could hit people at their most
  which     employ     harm     reduction       further than ever before in these difficult times – and so             vulnerable and hold recovery back,’ said WDP chair,
  interventions. Global state of harm           reform isn't an option, it's a necessity in order to sustain and       Yasmin Batliwala. ‘WDP sees people with multiple
  reduction 2010 at a glance available at       improve our NHS,’ said health secretary Andrew Lansley.                problems working hard to get their lives back on track, to                          The review’s priorities are ‘underpinned by radical               become good parents, to learn new skills – all the things
                                                reform of public services to build the Big Society where               society wants. The changes announced in the review
  Counting the cost                             everyone plays their part, shifting power away from                    could set up new obstacles for them.’
  Transform has published an updated
  version of its Comparison of the cost-
  effectiveness of prohibition and regu-
  lation of drugs report to coincide with
  the government’s Spending Review
                                                ‘Public inquiry’ demands on parental alcohol misuse
  2010. The paper compares the costs
  of prohibition with a model for legally       A public inquiry into the effects of parental alcohol misuse on        involved, millions of children are left to do their best in incredibly
  regulated drugs in the UK. Available at       children has been called for by the Children’s Society and             difficult circumstances. A government inquiry must look into all                               Alcohol Concern. More than 700,000 children live with a                aspects of parental alcohol misuse so that we can improve
                                                dependent drinker, according to a new report issued by the two         outcomes for these children.’
  Level licensing                               organisations, while 2.6m live with a parent whose drinking                 Meanwhile, ‘millions of children as young as four’ were
  The government’s proposed changes to          ‘puts them at risk of neglect’.                                        exposed to alcohol marketing during televised world cup
  the licensing laws represent ‘an un-              An inquiry into the scale of harm could improve the                matches this summer, says Alcohol Concern. Live England
  precedented threat to responsible busi-       protection of children by forcing local authorities and other          games shown on ITV featured adverts for Stella Artois, Magners,
  nesses’, according to the Association
                                                organisations to act more quickly, says Swept under the carpet,        Fosters, Carling and WKD, with the total number of children
  of Licensed Multiple Retailers (ALMR).
                                                which also wants to see mandatory drug and alcohol training for        exposed potentially as high as 5m, states the charity’s
  A joint submission from ALMR, British
                                                social workers. Seventy-eight per cent of young offenders with an      Overexposed – alcohol marketing during the world cup report.
  Beer and Pub Association, British
  Hospitality Association, Federation of
                                                alcohol problem grew up in a home with parental alcohol misuse         Alcohol Concern wants to see a 9pm watershed for alcohol
  Licensed Victuallers and others has           and domestic violence, says the report, with alcohol playing a         advertising on TV and a ban on alcohol advertising online.
  been presented to the Home Office,            part in up to 33 per cent of known cases of child abuse.                   ‘Children are affected by alcohol marketing,’ said Professor Ian
  calling for a ‘level playing field’               ‘It’s shocking that in spite of the worrying numbers of children   Gilmore of the Royal College of Physicians. ‘It influences the age
  between the hospitality sector and            affected by parents’ heavy drinking and domestic abuse, so little      at which they start drinking and how much they then drink.
  shops and supermarkets through                is being done to address this,’ said Alcohol Concern chief             Alcohol is a drug of potential addiction and if drinks producers
  either mandatory or voluntary codes.          executive Don Shenker. ‘The whole system sweeps the problem            and retailers won’t stop pushing it at our children then urgent
                                                under the carpet and together with the secrecy and stigma              and tough legislation is needed to protect them.’

4 | drinkanddrugsnews | 25 October 2010                                                                                                                
News | Round-up

‘Morally questionable’ Project                                                                                                          News in Brief
Prevention pays first UK client                                                                                                         Marijuana move
                                                                                                                                        Californians are to vote on the legalisa-
                                                                                                                                        tion of possession and cultivation of
                                                                                                                                        marijuana. Proposition 19 would make
Project Prevention, the controversial American organisation         eighth child, psychologically it damages you, particularly if
                                                                                                                                        marijuana a legal, regulated and taxable
that gives drug users cash incentives to undergo sterilisation,     those children go into care because you can’t look after them.      product, with anyone over 21 able to
has paid a 38-year-old British drug user to have a vasectomy.       You have that sense of guilt for the rest of your life.’ In the     possess or transport up to an ounce of
The organisation’s founder and director, Barbara Harris, was        US, Project Prevention has paid more than 3,500 people to be        the drug and cultivate up to 25 square
shown handing £200 to ‘John’ as part of a BBC Inside Out            sterilised or take long-term contraception.                         feet. There have been no criminal
programme broadcast last week.                                           ‘As a drug prevention charity we don’t believe that            penalties for possession of small
      The programme claims that more than 100 British drug          sterilising drug users at their most vulnerable is either ethical   amounts of the drug in California since
users have already called the project’s UK number. ‘John’ told      or effective,’ said Mentor chief executive Paul Tuohy. ‘What        1975, with the state legalising medical
the programme: ‘I wouldn’t be able to support a kid. I’m just       we need as a society are responses that support and nurture         marijuana in 1996. The vote takes
about able to support myself – I’ve just about got it together      the children of drug addicts. We can break the cycle of abuse       place on 2 November.
to do that.’                                                        without resorting to extreme and unpalatable measures.’
      The organisation, which is funded by donations, says its           DrugScope called the organisation ‘exploitative, ethically     Right time
main objective is to raise public awareness about ‘the problem      dubious and morally questionable’, adding that the most             Drink-related hospital admissions for
of addicts/alcoholics exposing their unborn child to drugs          effective and humane approach was ensuring access to good           the under-18s increased by 32 per cent
during pregnancy’. Its plans to establish in the UK were widely     quality treatment and welfare systems. ‘Unlike the United           between 2002 and 2007, according to
                                                                                                                                        a report from Alcohol Concern. Thirty-six
condemned by the drugs field earlier this year, with Release        States, we have a universal, free health and social care
                                                                                                                                        children a day have been admitted for
accusing it of practicing eugenics (DDN, 10 May, page 5).           system available to parents and their children,’ said chief
                                                                                                                                        alcohol related conditions since 2002,
      Harris, who set up the organisation after adopting the        executive Martin Barnes. ‘It is a fundamental principle of the
                                                                                                                                        says Right time, right place: alcohol
children of a drug-using mother, tells the programme: ‘I say        NHS constitution that all treatment should be both
                                                                                                                                        harm reduction strategies with children
one thing to my critics – if you truly believe these women          informed and consensual – we believe that offering cash             and young people, with the London
have the right to continue to have children then step up, get       incentives to often very poor and marginalised people in            Ambulance Service alone responding to
in line and adopt the next one born. To me it’s that simple.’       return for sterilisation runs directly counter to this. The         11,780 alcohol-related call outs
      In the film she visits Kaleidoscope’s drug service in north   premise that people with drug problems should be sterilised         involving under-18s over the last five
London where project director Martin Blakebrough tells her          further entrenches the significant stigmatisation and               years, at a cost of more than £2.5m.
‘it’s something you need to be talking to people about – you        demonisation experienced by this group, making it less              ‘As long as alcohol remains as heavily
need to be advising them and supporting them if that’s the          likely that people will come forward for help and support           promoted as it currently is, young
right decision for them. If you’re on your sixth or seventh or      when they need it most.’                                            drinkers will continue to consume far
                                                                                                                                        more than they might otherwise, leading
                                                                                                                                        to inevitable health harms and wasting

Harm reduction     NICE considers                                                                                                       ambulance and police time,’ said chief
                                                                                                                                        executive Don Shenker. ‘As well as
                                                                                                                                        tackling the ludicrously cheap price of

‘should be centre’ incentive schemes to                                                                                                 alcohol in some settings, we want all
                                                                                                                                        under-18-year-olds who turn up at A&E

of drug strategy   encourage change                                                                                                     to be advised and supported to address
                                                                                                                                        their drinking.’

                                                                                                                                        Death dangers
Harm reduction should be the focus of the forthcoming               Incentive systems such as cash or vouchers could be an              A new briefing on the death penalty for
drug strategy, according to a poll carried out by drug              effective way of encouraging people to change unhealthy             drugs offences has been issued by the
testing provider Concateno at the National Conference               lifestyles, according to a report from the National Institute for   International      Harm       Reduction
on Injecting Drug Use. The strategy is widely predicted             Health and Clinical Excellence’s (NICE) ‘citizen’s council’.        Association (IHRA) in partnership with
to focus on an abstinence/recovery approach.                             The council – made up of members of the public – was           Human Rights Watch and Penal Reform
     Aftercare and housing were seen as the most                    asked to consider whether incentives ‘could acceptably be           International. The briefing sets out the
significant issues for drug treatment, alongside training for       used to help motivate people to live healthier lives’. The          dangers associated with funding drug
drug workers. Nearly 80 per cent of respondents thought             majority agreed, provided certain conditions – including            control activities in countries with
education around bloodborne viruses was inadequate                  effective monitoring and analysis, only offering cash as a last     capital drug laws. Complicity or
while 95 per cent thought that steroid users should have            resort and incentives not being exchangeable for tobacco or         abolition? The death penalty and
access to treatment, despite many not seeing themselves             alcohol – were met. It was also agreed that schemes were            international    support     for   drug
as part of the injecting drug community.                            likely to work best when part of a wider programme of               enforcement available at
     ‘We wanted to see what those in the drug treatment             support and they avoided adding to stigmatisation. They
industry thought should be the focus of treatment                   should also ‘acknowledge the complex factors that motivate          HIV guidelines
                                                                                                                                        New guidelines for testing HIV, viral
provision,’ said Concateno’s account manager for the                people to put their health at risk, such as by excessive eating
                                                                                                                                        hepatitis and other infections in injecting
Midlands and South Wales, Susan Carter. ‘We asked                   or drinking (or) drug taking’, the council said.
                                                                                                                                        drug users have been published by the
delegates whether harm reduction or abstinence should be                 NICE is now holding a public consultation on the issue. The
                                                                                                                                        European Monitoring Centre for Drugs
the focus – several argued that a shift towards abstinence          views of the council did not constitute ‘formal guidance’, said
                                                                                                                                        and Drug Addiction (EMCDDA), including
at the expense of harm reduction could be dangerous for             NICE chair Sir Michael Rawlins, but did ‘advise us about the
                                                                                                                                        a recommended package of prevention
services users. One delegate said that “harm reduction is           social values that should underpin our work’.                       and primary care. Available at
being forgotten in favour of recovery”.’                                 Details at Consultation period ends  
     See conference report page 8                                   26 November                                                                                                                    25 October 2010 | drinkanddrugsnews | 5
Cover story | Strategy consultation

                 hen is a consultation not a consultation, asks Release on its             it states, adding that harm reduction should be ‘an explicit priority’ of the
                 website, calling the government’s consultation on its forthcoming         strategy.
                 drug strategy ‘narrow in scope, thin on policy and short on                   Almost all respondents welcome the consultation’s proposal for a more holistic
                 timing’. Indeed, the limited time frame for responses – at little         approach – tackling drug use alongside other relevant issues – but many also
  more than a month – even prompted an Early Day Motion from Green Party MP                express concern at the consequences for harm reduction in the shift towards
  Caroline Lucas (DDN, 27 September, page 4), which was also critical of the lack          abstinence-based models. ‘The consultation paper completely fails to properly
  of policy detail.                                                                        acknowledge the need to reduce drug harms and as such fails to tackle many
     As well as offering limited time for people to respond – the Cabinet Office’s own     aspects of both problematic drug use and non-problematic drug use,’ says Release.
  code of practice on consultations recommends a minimum of 12 weeks – the 30              ‘The term harm reduction is not mentioned once.’ The charity also expresses
  September closing date for input into a strategy to be published before the end of       disappointment at the paper’s failure to consider alternatives to a criminal justice
  the year surely also leaves little time for any genuinely meaningful evaluation of       based approach, warning that abstinence-based treatment orders would lead to
  responses.                                                                               higher rates of relapse and ‘people breaching their community orders’.
     Release points to the lack of scope for respondents to ‘really interrogate’ policy        ‘There is no doubt that drug treatment has improved significantly over the last
  proposals, some of which, it adds, have already found their way into the NTA’s           decade, and we should be careful not to throw the baby out with the proverbial
  business plan (DDN, 5 July, page 9) – ‘approved by ministers without public              bathwater,’ Release continues, expressing surprise that the concept of benefit
  consultation’. ‘It is also important to highlight that the policy proposals contained    sanctions for those who fail to comply with treatment is still being considered.
  within the consultation paper do not appear to be underpinned by any evidence                Turning Point adds that while it is supportive of proposals that encourage
  that supports the policy direction that is clearly being taken,’ states the charity.     more people to enter treatment, care would need to be taken to make sure that
  ‘This lack of evidence is central to why this consultation process is not sufficient.’   any benefit sanctions did not ‘further marginalise hard to reach and vulnerable
     Transform also expresses ‘serious concerns’ about both the process and the            groups’. ‘It must also be considered that cutting benefits for those who refuse to
  document, pointing to the lack of impact assessments for – as well as research           seek help will only work if there are appropriate treatment places available,’ said
  in support of – the proposed policy shifts and going so far as to call for the           the organisation’s director of substance misuse services, John Mallalieu. ‘If we are
  consultation process to be reviewed by the Cabinet Office ‘pending a relaunch’.          to move more individuals on a path to recovery and make communities safer, the
     Calling for ‘a move from misplaced moralising and outdated (but entrenched)           government may wish to concentrate on ensuring investment for rehabilitation and
  drug war ideologies’ to a pragmatic public health approach, Transform also               integration is preserved and ring-fenced.’
  attacks the document for the omission of key policy issues such as harm                      DrugScope echoes the call for ring-fenced treatment budgets to be
  reduction. ‘The adoption of harm reduction approaches by the Conservative                maintained, adding that the government would need to make sure that its
  government in the 1980s has been an overwhelming public health success,’ adds            ‘localism’ and ‘payment by results’ agendas were developed on the basis of
  the UK Harm Reduction Alliance (UKHRA) in its response. ‘Any response which              careful assessment of potential risks and benefits, with an ‘integrated, cross-
  emphasises drug-free outcomes for individuals must also acknowledge and                  governmental recovery programme’ developed alongside a clear harm reduction
  reduce the harms faced by those who are unable or unwilling to stop using drugs,’        strategy. It welcomed the focus on recovery and social reintegration but said its

The consultation on the 2010 drugs strategy has been nothing if
not controversial, with many in the field complaining of lack of both
time and detail. DDN casts an eye over some of the responses


6 | drinkanddrugsnews | 25 October 2010                                                                                                     
Cover story | Strategy consultation

members wanted to see the ‘promise of continued improvements to drug and                ‘The number of people accessing treatment doesn’t represent real change unless
alcohol treatment matched by a commitment of energy and resources to a                  these people are making improvements in their overall life situation,’ states
genuinely ‘joined up’ approach to prevention and early intervention’.                   Adfam’s response. ‘Someone in treatment is not simply a ‘patient’, but someone
    The organisation calls for ‘a balance between consolidation and change’ –           in need of a broad range of support measures to help them back on their feet.’
stressing the importance of building on past achievements – and for the government          Adfam also warns that any form of payment by results should ‘take care to
to ensure that the NTA’s key functions are successfully incorporated into the new       minimise the risk such a system could create in terms of services not taking on the
public health service, as well as ensuring ‘a balance between policy momentum and       people who are most in need of support’. There would be a potential for services
stakeholder engagement’ in the form of ongoing, constructive consultation.              paid according to narrow outcomes to cherry-pick those they think they had the best
    DrugScope also wants to see a balance between respect for evidence and support      chance of helping, it says, ‘and neglect those with more entrenched and complex
for innovation, calling on the government to make sure that services are supported      problems because the positive result – and therefore the accompanying money –
by the ‘same clinical and evidential standards as all other NHS provision, including    would be harder to reach’. Structured whole family interventions require a high level
implementing appropriate NICE guidance’ and for it to work ‘constructively and          of skill and expertise and therefore investment in training, it adds.
transparently’ with the ACMD and other independent advisory groups.                         A family-focused approach should be ‘gold standard’ for all treatment, says
    Any vision of problematic drug and alcohol use should focus on the most harmful     Addaction, which also encourages the government to reconsider the role of
drugs but be responsive to new problems, it continues, with families and carers at      substitute prescribing, urging a shift away from long-term ‘parking’ on substances
centre stage. It also wants to see a review of the Misuse of Drugs Act, with the        like methadone towards community-based support and peer-led recovery groups.
majority of low level drug offences dealt with outside the criminal justice system, a   It also wants to see an ‘open and honest debate’ about subjects like
view echoed by WDP which calls for a ‘full public debate’ about drug use and the law.   decriminalisation, consumption rooms and a minimum unit price for alcohol.
    ‘The law as it stands is adding to the damage done by drugs by criminalising            ‘The coalition government should not back away from these issues,’ said chief
people for the use and possession of small amounts of drugs,’ said WDP chair            executive Simon Antrobus. ‘There is an opportunity to engage the country in what
Yasmin Batliwala. ‘It is also muddling up drug use with crime in people’s minds,        happens next, to push the boundaries, to leave no stone unturned to prevent
when actually drug addiction and misuse is a health problem. The government must        further addiction and support those addicted into recovery.’ The charity also
show leadership now. We believe that this is the time and opportunity to turn the       suggests designating certain prisons to specialise in drug treatment, with
nation’s drug and alcohol problem around. The government’s recovery agenda can          offenders encouraged to attend treatment ‘by way of flexible sentencing’,
be the catalyst to change the way society thinks and talks about addiction.’            alongside ‘more multi-agency help for resettling ex-offenders in the community
    Many in the field are worried about the potential impact of spending restrictions   when released’.
(see feature, page 12) and fears have been expressed that family services could             Overall, however, Transform seems to some up the feelings of many in the
bear the brunt of cutbacks (DDN, 11 October, page 12).                                  field in the conclusion to its submission. ‘Sadly this consultation falls short on
    Both DrugScope and Adfam want to see a renewed focus on families, with              almost every front,’ it says. ‘It is tokenistic, politicised, and entirely inadequate.
Adfam stating that it is ‘of paramount importance that families and the services        It is more than a missed opportunity; it is entirely unacceptable as a basis for
that support them are involved as key partners’ in the delivery of the new strategy.    developing a new drug strategy.’                                                                                                                   25 October 2010 | drinkanddrugsnews | 7
Comment | Letters

                                                investment. In my experience too many        lost due to pollution from a factory. Or       intended to break down such misinter-
                                                offenders in prison were being left          scale up the furore over the tabloid           pretations whilst increasing our
                                                without support unless they could claim      staple of the denial of an expensive           understanding of the risks.
                                                to have an additional drug problem, and      cancer drug to one person whose life it            Alcohol problems are not confined

   LETTERS                                      this typifies the imbalance of priority in
                                                much of past political and social
                                                                                             may increase by six weeks.
                                                                                                 Clearly, not everyone who drinks will
                                                                                             experience problems, but generally
                                                                                                                                            to the small proportion of drinkers with
                                                                                                                                            dependency – so of course no one is
                                                                                                                                            suggesting we are ‘all addicts in need
                                                    Let us be clear that alcohol in itself   speaking as the amount of alcohol              of state management’ if we drink more
  COMPLEX IMPACTS                               is not the disease but the impact of it      consumption increases in a population          than the recommended guidelines.
                                                is – we need to recognise this reality       the problems associated with it increase           It is as important as ever to debate
  I am writing in response to the alcohol       and invest in programmes that better         – whether town centre weekend                  what role the government should play in
  debate (DDN, 11 October, page 10).            educate and support maintenance and          problems or long-term health problems          public health whilst respecting individual
  The two articles illustrate both the          recovery. People’s lives depend on it        across the population who, despite what        choices. But misconstruing the data and
  defensive nature that often perpet-           and that remains indisputable.               they may believe, are not protected from       painting a sensationalist picture of a
  uates the debate and the dangers of           Rev Martin Batstone, chaplain                harms by drinking at home and not being        ‘war on alcohol’ will get us nowhere – no
  relying on statistics, which can present                                                   one of ‘them’. People need to take             one is calling for prohibition.
  such a confusing picture.                                                                  responsibility for their behaviour and         James Morris, AERC Alcohol Academy
       The debate also highlights how a         A LEVEL PLAYING FIELD                        services should encourage this. Brief
  purely punitive approach both                                                              interventions can be carried out by non-
  alienates and stigmatises and fails to        I read with interest the (presumably)        alcohol specialist workers. As an              WHAT COERCION?
  get to the heart of the matter. What          deliberately contrary piece by Suzy          approach it is at the population level,
  concerns me most is the impact that           Dean (DDN, 11 October, page 10). I           rather than with individuals with severe       I have worked in this sector for 15 years,
  alcohol abuse has on society, ordinary        have taken the bait and responded.           alcohol problems. It seeks to allow            and rarely have I experienced a reaction
  families and upon the individuals who             I personally believe people should be    people to make an informed choice              to a letter as I did to ‘Methadone: who
  slowly slip into alcoholism. This impact      able to make their own choices but have      about their alcohol use. If they choose to     cares’ (DDN, 27 September, page 10).
  goes far beyond the potential dangers         the right to do so in an environment that    reduce use it involves discussing how              As a project worker at a prescribing
  to personal health and the financial          encourages healthy ones. (I endorse a        this might occur but relies on harnessing      clinic, I work closely with clients and GPs
  cost to the NHS – important though            move towards decriminalisation of drugs      their skills to carry it out. The evidence     and have to strongly disagree with Bri’s
  such considerations are.                      for example).                                suggests a worthwhile number of people         comments. Our aim in the first instance
       Having worked in the criminal justice        The drinks industry makes a great        will change their drinking following a         is to stabilise a client so that there is no
  system, it is clear that where alcohol is     deal of money from selling alcohol, yet      brief intervention, so it is surely valid to   need to ‘use on top’. This eliminates the
  involved the impact of criminal activity is   takes no responsibility for the external-    afford them the opportunity to do so.          danger of using unreliable street drugs
  likely to be devastating, particularly in     ities inevitably resulting from their            I’d go so far as to argue that if health   and lessens the need to commit crime.
  the levels of violence. Suzy Dean rightly     pursuit of profit. The environment we        professionals do not seek to intervene         Yes, harm reduction.
  argues that alcohol should not be seen        live in has a high frequency of alcohol      on this matter then they are tacitly               Always the client is very much at the
  as some kind of justification for the         vendors, be they pubs, clubs, off-           approving of the damaging status quo.          centre of the discussion around their
  crime, and that ultimately the offender       licences or supermarkets. Music              This means a significant proportion of         treatment and as for using ‘the big stick
  has to take responsibility for their          festivals and venues as well as sports       the people they see are going to die           of harm reduction’, nothing is further
  actions. However, it strikes me that          competitions and teams are sponsored         early because of their drinking – but at       from the truth. Clients have a choice
  there is a real danger that this falls back   by alcohol firms. Drinking is seen as        least they won’t have had to suffer the        and welcome the opportunity to be in
  into a rather smug ‘if you can’t handle       part of life on soap operas, and a high      indignity of discussing the conse-             control of their using. No client is forced
  your drink then that’s your problem’.         proportion of TV adverts and billboards      quences of their actions and whether           or coerced into reduction of their
       The reality is that the alcohol          are replete with fun, sexy images of         they might wish to alter them.                 medication.
  consumption denies the ability to take        drinks and drinkers.                         Niall Scott, Wigan IBA Project                     My experience has shown that a
  responsibility at the time of the criminal        Any attempt to redress the balance                                                      majority of clients do want to be drug free
  action because the individual is out of       is seen as a sour micro-management                                                          and not become ‘legitimate’ drug
  control and post action – in many cases       of people’s lives. It may seem to relate     OWN GOAL                                       addicts. Once the chaos stops and
  – they genuinely cannot remember. It is       to nanny-statedom, but are there not                                                        stability begins and – with appropriate
  hard to deal with the underlying issues       clear parallels between this issue and       I welcome debate on the role of alcohol        interventions such as key work, counsell-
  of anger management, domestic abuse           a parent attempting to encourage             policy, but Suzy Dean’s call to ‘challenge     ing and support groups – clients express
  and victim awareness when their body          largely boring healthy eating up against     the war on alcohol’ seems like an own          a desire to be free from all drugs.
  and mind is being poisoned and                the might of confectionery and fast          goal in arguing that alcohol problems              The views expressed in Bri’s letter, in
  deluded by alcohol. Nor can you say to        food companies?                              are over exaggerated. The flawed state-        my view, are what keeps people in
  the mother whose daughter has been                I am currently working on an alcohol     ments and jumbling of data only serve          bondage. If a client is not given a choice,
  killed by their boyfriend in a drunken        brief intervention project in Wigan. I do    to demonstrate the common misunder-            how will that client ever know that there
  frenzy that alcohol wasn’t to blame,          not think this can reasonably be seen as     standings about alcohol problems and           is a choice?
  when their daughter might well be alive       ‘treatment’ and always balk at terms like    possible responses to them.                    Mandy Stevens, Slough
  if the drink factor had not colluded with     ‘binge drinking’ (judgemental yet diluted)       For example, to say ‘according to
  the anger and violence.                       and ‘alcoholic’ (I don’t find labelling or   the official standards we are all binge
       The point is, the personal and social    the disease model helpful). I do, how-       drinkers’ appears to be a deliberate
  impact of alcohol does have to be taken       ever, believe this to be worthwhile, as      distortion of the data in order to              We welcome your letters...
  seriously at every level. Instead of          the average male in Wigan is expected        discredit it. The data the Department           Please email them to the editor,
  arguing about whether alcohol purchase        to lose a year of his life due to alcohol.   of Health uses (General Household      or post them to
  and consumption is increasing or de-              This is surely a significant issue       Survey) indicates about 18 per cent of          the address on page 3. Letters may
  creasing, let us recognise that there is      that we should try to do something           us are ‘binge drinkers’. Indeed these           be edited for space or clarity – please
  still a real and imminent problem that        about. Imagine the scandal if a year of      definitions can be unhelpful, but new
                                                                                                                                             limit submissions to 350 words.
  requires immediate attention and              life for every male in an area was being     terminology around levels of risk was

8 | drinkanddrugsnews | 25 October 2010                                                                                                              
Events | Policy

   SAGE ADVICE                                                                                       PARLIAMENTARY BRIEFING

                                                                                                     WELFARE REFORM
                                                                    Lee Collingham
                                                                                                     The latest meeting of the Cross-Party Group
                                                                    reports on the
                                                                                                     on Drug and Alcohol Treatment and Harm
                                                                    harm reduction                   Reduction, chaired by Lord Ramsbotham,
                                                                    messages at the                  considered the impact of forthcoming
                                                                    National                         welfare reform and aimed to raise the
                                                                    Conference on                    quality of alcohol services for ex-service
                                                                    Injecting Drug                   men and women. DDN reports
                                                                    Use in Gateshead
                                                                                                     A PAPER prepared by Harry Fletcher, assistant general
   AT THIS YEAR’S NATIONAL CONFERENCE ON           success with in the 1990s.                        secretary of NAPO, raised the issue of inadequate service
   INJECTING DRUG USE (NCIDU), held at                  On the second day, service user advocate     provision for ex-service men and women with alcohol and
   Gateshead’s Sage Centre, professor of           Tony Lee explained about getting the right        drug problems. There were large numbers of these clients,
   sociology at the University of Plymouth,        harm reduction messages across to injecting       mainly with alcohol-related issues, presenting at services
   Ross Coomber, told delegates about work to      clients, such as using as small a gauge needle    throughout the country – people with complex needs which
   involve drug dealers – especially user-         as possible and injecting with the direction of   were not being addressed by relatively untrained staff.
   dealers – in harm reduction.                    blood flow. The morning plenary saw                   The group’s representatives from treatment agencies
        They often gave out clean injecting        research fellow from the London School of         supported the idea of collecting data from clients to try and
   equipment and provided a clean                  Hygiene and Tropical Medicine, Magdalena          gauge the level of need with the aim of improving services.
   environment to use for those they supplied,     Harris, describe research she’d carried out       David Burrowes MP drew members’ attention to work being
   who were usually friends, he told delegates.    with a group of long-term injectors from          carried out by Andrew Murrison MP and the veterans’
   Engaging with this group would allow harm       different countries who had remained free of      minister: ‘This area is in the zone of government – it’s
   reduction messages and practices to be fed      hepatitis C by using clean equipment in a         important you don’t reinvent the wheel.’
   through to injecting drug users who may not     clean environment.                                    Niamh Eastwood of Release gave a detailed briefing on
   be in contact with services. Training and            Research scientist for Public Health         the potential impact of welfare reform, highlighting the
   support should be offered to the dealers, he    Wales, Noel Caine, told delegates about the       ‘rhetoric’ and the ‘usual thing of being tough on drug users’.
   stressed, at the same time as giving out harm   Welsh BBV action plan, while senior lecturer      She highlighted the risks of unfair benefit sanctions, argued
   reduction advice and signposting users to       from the London School of Hygiene and             the need for a treatment allowance on the grounds of human
   relevant services.                              Tropical Medicine, Peter Vickerman,               rights and urged the group to put pressure on the
        Martin Chandler of Liverpool John Moore    discussed how antiviral therapy for HCV           Department for Work and Pensions. Some members of the
   University’s Centre for Public Health told      could be a prevention tool for active             group expressed the view that DWP did not want to do the
   delegates about issues around anabolic          injecting drug users. The morning was             ‘wrong thing’, but that it needed more information, so a
   steroids. Steroid users usually began with      rounded off with parallel sessions on             briefing session would be arranged.
   sport supplements and were often                influencing choice of needle size in needle           Discussion of government drug and alcohol strategy was
   introduced to steroids through other people     exchanges, heroin prescribing and femoral         dominated by criticism of the way in which the consultation
   at the gym, he said. What was clear was that    injecting, among others.                          was conducted, particularly its inadequate timeframe, which
   the majority of steroid users were poly drug         The final plenary session saw DrugScope      Release would be challenging through legal action (see feature,
   users, often using a whole range of             chief executive Martin Barnes look at what        page 6). Niamh Eastwood said it had ‘very little scope and
   substances to target different areas of their   the future might hold for drug treatment.         clarity’ and, among other flaws, broke statutory requirements
   body. Use was typically in cycles, depending    This was followed by Claire Cole of Liverpool     on race and disability. Release was also concerned at the paper’s
   on training regimes, with substances taken      John Moore’s University on the adulteration       content – specifically that it ‘did not mention harm reduction
   to counterbalance the effects of other drugs.   of illicit drugs and senior lecturer in           once’ in focusing on a principle of drug-free recovery.
   There was also a growing group of younger       pharmacy practice at the University of Bath,          ‘There has been a need for a more ambitious, less fatalistic
   injecting users who were unaware of the         Jenny Scott, on appropriate harm reduction        approach to drug treatment,’ said David Burrowes MP. He urged
   damage they were doing to themselves.           advice based on laboratory analysis of crack      the group not to shoot down initiatives too early, but to look at
        Specialist nurse at NHS Islington, David   cocaine adulteration.                             opportunities for work to improve outcomes. He cautioned
   Robertson, told delegates about the                  Speaking with service users, it was felt     against ‘putting up fences too early’.
   phenomenon of neck injecting, while             that a number of speakers could have been             Steve Hamer, chief executive of Compass, was optimistic
   parallel sessions looked at bloodborne          more forthcoming with their answers to            that the dialogue with ministers was a positive one and
   viruses, groin injecting, setting up harm       delegates’ questions. It was also agreed that     commented ‘everything is to play for.’ Alex Boyt, representing
   reduction suites and the global state of        the presentations by ex or current service        service users, said this was reassuring to hear but cautioned
   harm reduction. John Derricot of Exchange       users had proved to be the most informative       that many service users were worried about the punishing
   Supplies and Amsterdam-based HIV and            and helpful, dealing with issues that             rhetoric of the drug strategy and the NTA’s recent business plan.
   harm reduction consultant John-Peter Kools      professionals are perhaps sometimes
   looked at ways of promoting the transition      reluctant to tackle.                                  The cross-party group is organised by the Conference Consortium.
   from injecting to smoking drug use,                                                               For more information visit
   something the Dutch had experienced great           Lee Collingham is an ex service user                                                                                                               25 October 2010 | drinkanddrugsnews | 9
Treatment| Policy

                                              NEW             any of you will be bracing yourselves’ public health minister Anne
                                                              Milton told delegates at eATA’s conference, Aiming high for drug
                                                              and alcohol treatment. ‘But we need to make savings in a fair way,
                                                              and in a way that supports communities rather than abandoning
                                           them.’ Those local authorities and commissioners that had already embarked
                                           upon ‘slash and burn’ cuts to drug services were ‘jumping the gun’, she stressed.
                                           ‘It’s not the right response’.
                                                ‘You’ll have heard plenty of talk about the Big Society,’ she told delegates, ‘and
                                           I know some doubts remain about what it means.’ It was about moving power out
                                           of Whitehall into the hands of frontline professionals – ‘a bit of a leap of faith’. ‘I
                                           have a pretty simple philosophy – what matters is what works. What I’m
                                           interested in is effectiveness.’ The abstinence versus maintenance debate was
                                           ‘sterile’, she told the conference – what was important was putting people on a
                                           path to a stable life for them and their families and addressing issues around
                                           problem drug use like family breakdown, poor housing and education and low self-
                                           esteem. ‘Neither methadone nor abstinence will break someone free – it’s about
                                           joining it all up, with integrated support from different agencies.’
                                                The new Public Health Service would be locally led, with directors of public
                                           health playing a key role, she said. It would be ‘unified, evidence based and
                                           outcomes focused’, but organisations would not be penalised for taking on harder
                                           cases. ‘There’ll be no cherry picking. Outcomes is the watchword – what matters
                                           is “did the person get better?”’ There would be a national alcohol strategy
                                           separate from the drug strategy, but in some areas there would be ‘a lot less
                                           money’, she acknowledged, meaning a clearer focus on effectiveness.
                                                The government’s localism agenda provided an ‘interesting dilemma’, she said. ‘If
                                           you believe in localism then you believe in handing over authority, but you will still be
                                           held responsible centrally.’ The government’s role would be to provide ‘frameworks’.
                                           ‘The drug strategy will be about a framework, about how we define what we want and
                                           on what basis we’ll pay people – it won’t be about how you do it. You’ll need local
                                           solutions.’ There would be no ‘big bang approach’, she stressed. ‘It’s about growing
                                           things bit by bit. A lot of money gets wasted on rolling things out too quickly – there
                                           are different ways of working in different areas.
                                                ‘I know there may be concerns about change and how this may affect you,’ she
                                           told delegates, adding that programmes would be piloted and ‘grow organically’.
                                           ‘Nothing’s set in stone.’
                                                ‘A lot of money’ was being spent ‘very ineffectively’ across the public sector,
                                           she said – ‘one pound of taxpayer’s money is going to have to buy one pound’s
                                           worth of services’. The question was how to get best value for each pound against
                                           a background of structural change and a changing drug landscape, said NTA chief
                                           executive Paul Hayes. ‘We need to make sure we carry on doing what we get right.’
                                                The drug treatment spend had increased from £250m to £800m since 2000, he
                                           said. ‘You cannot invest as much as has been invested over the last ten years and be
                                           certain that every pound is well spent. The system has grown too quickly for there not
                                           to be better ways of spending money.’ Cuts would lead to a ‘ruthless’ focus on what
                                           works, but payment by results would be rolled out gradually, he promised. The direction
                                           of travel from government to commissioners had been set, and now had to be set from
                                           commissioners to providers, ‘in a way that focuses on what works for individuals’.

10 | drinkanddrugsnews | 25 October 2010                                                       
Treatment| Policy

                                                                                              to be difficult to persuade the community if jobs are hard to find.’
                                                                                                  The recovery movement, however, had been increasingly under attack, said
                                                                                              reader in criminal justice at the University of Western Scotland, David Best. ‘We’re
eATA’s London conference gave delegates                                                       regularly criticised that it’s based on aspiration and wishful thinking without an
                                                                                              evidence base. But that’s not the case – it just doesn’t make sense to use the
a glimpse of what services might look like                                                    same narrow medical models.’ Definitions of recovery were also unhelpful and
                                                                                              had led to bickering about issues like abstinence, he said. ‘There’s no diagnostic
in the coming years. David Gilliver reports                                                   measure of de-addiction. Not only do definitions of recovery vary from person to
                                                                                              person, they vary within that person over the course of their recovery journey.’
                                                                                                  Another controversy was the perceived ‘anti-treatment’ agenda, he said. ‘For

                                                                                              most people community drug treatment means case management, scripting and
                                                                                              chatting, but it doesn’t have to be like that’ – a major challenge for workers was to
                                                                                              effectively link people to community groups. ‘There were more than 1,500 people
                                                                                              on the recovery walk in Glasgow (DDN, 13 September, page 13) – recovery is
                                                                                              happening. Our big challenge is to document, chart and learn from this.’
                                                                                                  While figures from the US Center for Substance Abuse Treatment (CSAT)
                                                                                              showed that 58 per cent of people with a lifetime dependence would achieve
                                                                                              lasting recovery, the perception of drug workers had become a ‘huge problem’, he
    The objectives of payment by results included simplification, incentivisation,            continued, ‘breeding hopelessness and learned failure’ that was transmitted to
innovation and joining up treatment, said head of the Department of Work and                  clients. ‘We as a field need to raise the bar significantly, and we don’t make
Pensions’ (DWP) drug and alcohol policy unit, Colin Wilkie-Jones. ‘The principle is           enough of success.’ The challenge was to make recovery champions ‘visible’, he
that if high level outcomes are not delivered, providers won’t get paid.’ The                 said. ‘It’s not hard to find these people, but the system loses them’.
government would release money in the form of loans to ‘pump prime’ the system                    Paul Hayes said it was essential that the system was optimistic and did not
– offset against future delivery payments – and make evidence available rather than           write people off, but there remained ‘a real political issue around inclusion – how
prescribe activities, he said. ‘The market will be encouraged to determine the                far society will accept people,’ with stigma a major issue. Language was ‘incredibly
appropriate mix of provision to maximise outcomes.’                                           important’, said Charlie Lloyd of York University, who was carrying out research on
    Proposed ‘high level outcomes’ included employment, stable housing, reduced               the subject for UKDPC. ‘Media invective’ could not help but be influential in terms
offending, improvement in mental and physical health and exiting treatment free of            of the ‘unconscious process of language influencing the way people think’.
dependency, with the government allocating funds to local authorities via public                  Stigmatisation involved complex social interaction, which made it hard to
health budgets. The DWP would also invest benefit savings ‘in return for
employment outcomes’, while local government’s role would be to develop local
markets and partnerships, decide the spend from public health budgets and make
sure pilots were appropriate to local circumstances. It would also be encouraged              ‘If people are going to sustain recovery
to join together CARATs, DIPs and aspects of tier 2.
    There would be pilots in ‘a few areas’ from this autumn, pathfinders from 2013
and nationwide implementation before the next election, he said, with alcohol
                                                                                              they need a stake in society... There’s
services following on a ‘less aggressive’ timescale. ‘We’ll learn the lessons from
implementing pilots in the drug sector,’ he said.
                                                                                              real political oomph behind this, but it’s
    ‘What we won’t have any longer is dictat from the centre saying “thou shalt not
do that” – that’s not how the political game will be played over the next five years,’        going to be difficult to persuade the
said Paul Hayes. The Public Health Service offered an opportunity to bring the
alcohol and drug agendas together, he said, with recovery as the ambition.                    community if jobs are hard to find.’
‘Recovery that in large measure will have to be self-defined. Different individuals
are not starting from the same place and their end destinations won’t be the same,
but we need to be ambitious on their behalf. We’ve got to collectively say to people          influence, he said, but more could be done, such as campaigns to ban words like
“you can get better” and allow them the space to take up that challenge and                   ‘junky’ in media reporting. ‘Stigmatisation matters – it’s felt strongly and deeply.
become fully functioning citizens.’                                                           Humans are social animals and we care what people think.’ The UKDPC was also
    People should be in treatment ‘for as long as they need to be but no longer’, he          looking into ‘institutional stigma’, said director of policy and research Nicola
told the conference, but with the confidence that they could come back if they                Singleton, such as contract clauses excluding people with criminal records and
relapsed. ‘That doesn’t mean arbitrary time limits but neither does it mean “you              ‘two-year drug free’ rules – ‘things that have become commonplace.’
come in, you’re scripted and forgotten about”. That’s far from what happens in the                The media’s influence extended far beyond stigma, said DrugScope chief
best services but it is what happens if you take your eye off the ball.’                      executive Martin Barnes, often directly shaping the agenda, as had been the case
    There would be a renewed emphasis on effective care management, said FDAP                 with cannabis reclassification, the sacking of David Nutt and, most recently,
chief executive Carole Sharma, as well as on psychological treatments.                        mephedrone. ‘The intensity and sense of urgency in the coverage meant it
Practitioners would need to be qualified to deliver these, and better at seeing               inevitably became an issue for government,’ he said.
clients as parts of systems. ‘Our practitioners need to be skilled with regards to                The national media was a ‘difficult nut to crack’, but there were opportunities for
child protection – we have not been good enough.’ This would mean working with a              organisations to get their message across at local level. The localism agenda meant
broader group of partners from other agencies, she said. ‘Our partners will be as             that local media would have even more influence, especially given the frequent
harassed and worried as we are, and may not want to think about our client group              unpopularity of drug services. ‘New forms of activism at community level will need to
too much because they’re perceived as trouble.’                                               emerge,’ he said. ‘In the uncertain and difficult days ahead the voices of service users
    The focus would go beyond clinical needs to include things such as life skills, said      and their families will need to be heard, and savvy communication will be key. It’s an
Paul Hayes, but communities would also need to allow people to ‘take up the                   opportunity to look at the local media as a friend rather than the foe it often is.’
challenge’ of becoming fully functioning citizens. ‘If people are going to sustain                Unlike disabled people and the mentally ill, problem drug users were not widely
recovery they need a stake in society,’ but jobs and houses would inevitably be a             seen as ‘unfairly stigmatised’, said Charlie Lloyd. ‘If the government is serious
challenge in the current climate. ‘There’s real political oomph behind this, but it’s going   about recovery, then it needs to be serious about stigma.’                                                                                                                          25 October 2010 | drinkanddrugsnews | 11
Treatment | Vox pop

   An ex service user concerned about                                                                                                       ‘Each time I got to
   potential government cuts, Carl Stanley                                                                                                 that stage of main-
   talks to people in the field – along with                                                                                                taining myself and
                                                                                                                                          being stable I would
   some of his musical heroes – about                                                                                                    also feel totally lost,
   what the impact might be...                                                                                                           like an empty shell...
                                                                                                                                      There’s so much more

   Sounding                                                                                                                            work to be done when
                                                                                                                                      you get to that point –
                                                                                                                                              making the right
                                                                                                                                        decisions, using your

                                                                                                                                            time with the right
                                                                                                                                      people... The counsell-
                                                                                          Paul Ryder                                           ing is essential.’
                                                                                          Bassist, Happy Mondays

                                                                                          Spending: ‘Well it’s needed more than ever – to cut back on these services
                                                                                          would only mean less help. To take any part of the services away would be a
           ive years ago I got over a heroin addiction with the help of a                 blow – it’s the counselling as much as the medication that’s important. I feel
           government-funded drug service. Now those drug and alcohol services            it would be a false economy as it would mean a rise in crime if there’s less
           are facing spending cuts and new directions in policy that could have          help out there.’
           a huge impact, so I decided to ask people who work in the services,
   those who use them and some of my favourite music artists for their thoughts.          Recovery: ‘Being more disciplined towards service users is one thing but any
                                                                                          thought of timelines for users to rehabilitate to would just not work. It’s about
   The questions I asked are:                                                             the individual and their problems – it’s complicated because there are normally
   Spending – what effects do you feel cuts could have on services, service users         many reasons why someone would have a drink or drug problem. No one can
   and society as a whole?                                                                work to a deadline as far as rehabilitation is concerned, that’s daft.’
   Recovery – what do you think of the ‘recovery’ policy? Is it right that service
   users who have not shown much in the way of improvement may be given some              Improvement: ‘To be honest there wasn’t anything that I can remember when I
   sort of timeline to demonstrate their rehabilitation, in order to keep getting         started with the Mondays – people were left to it, really. In the ’80s the first wave
   support?                                                                               of heroin hit the streets of Liverpool, close to me and my mates in Manchester,
   Improvement – since you have been you working in – or using – services, how            and it didn’t take long for it to make it to our city. Around this time I do remember
   have things changed or improved?                                                       a little about the first government anti-heroin campaign – I remember the
   Methadone – NICE says that while methadone ‘has a part to play in the                  warning, but I couldn’t see where the help was coming from.’
   rehabilitation of a heroin user, it does not directly address the causes and
   context of drug dependency’. Do services rely on methadone too much?                   Methadone: ‘Well I have used several methadone prescriptions, and even
                                                                                          though I went through it a number of times, at the time they did work as far as
                                                                                          bringing me off street drugs. Methadone’s staple use is to maintain someone,
                                                                                          to keep them from using heroin, which it did for me, but there was no follow-up
   The chemist                                                                            work – you saw a doctor and went through the process of getting on a
   A pharmacist providing a methadone service and needle exchange                         prescription but each time I got to that stage of maintaining myself and being
                                                                                          stable I would also feel totally lost, like an empty shell. That’s where I could
   Spending: ‘Well, we can only be as effective as the budgets we receive from the        have used some follow-up counselling, but it wasn’t there. There’s so much
   government – it’s that simple. Less of a budget could mean being less effective.’      more work to be done when you get to that point – making the right decisions,
                                                                                          using your time with the right people, depression, changing your lifestyle. The
   Recovery: ‘Reducing methadone use is a positive step, though to stop someone’s         counselling is essential.
   treatment would be the wrong move and would raise criminal justice issues. I’m in
   favour of moving methadone users to the next positive step, if it’s done correctly.’   Personally I would like to see more beds provided for detox patients. One time
                                                                                          when I went to Salford hospital for detox there were 25 beds but only two beds
   Improvement: ‘I have been involved in methadone and needle exchange for ten            for people from Manchester – I had to wait eight weeks. I live in LA now and have
   years, and the service has improved so much – our standards are high and we            been clean three years. Though it’s great living here, like Manchester you see
   provide a quality service.’                                                            the drug problems all the time – it’s a place where plenty run away to hoping for
                                                                                          a good life, yet loads of them end up on the street. I see it when I go downtown
   Methadone: ‘The correct use of methadone is something between the user and             – these are people I can relate to.’
   the doctor. In an ideal world someone would come off street drugs and go on to
   the right amount of methadone they need to keep them stable, then when their
   life is less chaotic they would start to re-enter society substance free, reducing
   their prescription according to their individual needs.’

12 | drinkanddrugsnews | 25 October 2010                                                                                                   
Treatment | Vox pop

                                                ‘I think people need                                                                       ‘I’m fine paying 40
                                                      to wake up and                                                                         per cent tax if it’s
                                              realise it’s a disease                                                                         going to the right
                                              – I can’t imagine the                                                                              cause, but the
                                                government saying                                                                                  cutbacks in
                                                 to a cancer patient                                                                            spending are to
                                              “you have two years                                                                              pay for the next
                                               to get better”. It’s a                                                                            banking crisis,
                                                 disease and should                                                                                  that’s all.’
                                                  be treated as one.
                                                       I feel strongly
                                                           about this.’

Mani                                                                                      Paul Heaton
Bassist, Primal Scream, Stone Roses                                                       Singer/songwriter, The Housemartins, The Beautiful South

Spending: ‘In the industry I’m in we pay 40 per cent tax – I contribute my fair           Spending: ‘I’m fine paying 40 per cent tax if it’s going to the right cause, but the
share so from that point of view I would rather see my government spend money             cutbacks in spending are to pay for the next banking crisis, that’s all.’
on drink/drug services than war. People today rely on these services so much –
what a negative impact it would have to cut back on them, what’s that saying?             Recovery: ‘Deadlines are no good for people with addictions – I can’t imagine it
But no one is going to help you if you don’t make that first move to help yourself.’      works like that.’

Recovery: ‘I think people need to wake up and realise it’s a disease – I can’t            Improvement: ‘I have no idea but I see an increase in people trying to fend for
imagine the government saying to a cancer patient “you have two years to get              themselves. I had no dealings with drink/drug services during my Housemartin
better”. It’s a disease and should be treated as one. I feel strongly about this.’        days, though I did consult a group called DART while I lived in Hull – they were
                                                                                          great but closed under the last government. I can't tell someone when is a good
Improvement: ‘When I started out with the Stone Roses there was nothing like              time to consult professional people, but they won’t come searching for you.’
today’s services – people were basically left on the streets, or in prison. It was
scary and the way things are going we could be looking at a similar situation to
the old Tory government, because that’s when it all happened – heroin and the             The drug worker
crime that went with it. There was no help at all.

Personally, I had an issue with alcohol so I booked myself into a rehab – I’m lucky
                                                                                          Spending: ‘I think new government
                                                                                          policy is looking to use more
                                                                                                                                              ‘Another thing
to have the means. Going through rehab was like I’d been walking around most of           community-based orders rather than               that bothers me
my life with a rucksack full of bricks, weighing me down physically and mentally. The     prison sentences when dealing with               is the amount of
counselling in rehab allowed me to one by one take out the bricks – baggage from
not talking about things I had stored up over the years. So I talked to the counsellors
                                                                                          people with drink/drug issues – it costs
                                                                                          £35,000 a year to look after a inmate.
                                                                                                                                         methadone on the
and detoxed and now I can say my life is so much better – my relationship, my home        I’m hoping there will be sufficient              streets – it gives
life, I get much more work done musically and everything is much clearer.’                funding to take on the extra numbers             some people the
                                                                                          coming into services as I’m not sure
                                                                                          services could cope. There’s also a
                                                                                                                                       choice to administer
The magistrate                                                                            question of whether this policy could        themselves... off the
                                                                                          encourage crime – would users think         black market, with no
Spending: ‘We need our services to maintain their standards, as around 90 per
cent of theft crimes like shoplifting are drug related. I can only use the options I
                                                                                          they will probably get a community
                                                                                          order instead of a prison sentence if
have at my disposal, and drink and drug services are one of them, which I do              they commit drug-related crime?’
access for many. I work on recommendations put before me, so although I do
have a certain power I can only work with the services and establishments at my           Recovery: ‘The policy of recovery – looking to start moving service users off their
disposal and steer people towards them. All I can say is we need correct funding          medication – is something that I can see being done with newer service users, but
to enable these services to carry on with the work they do.’                              for those that have been on their medication for some time, maybe large doses over
                                                                                          a long period, it will be harder to work to deadlines. I don’t think it will work.’
Recovery: ‘I see people going through court and accessing services but as a magistrate
I don’t get much feedback at all on those that I have steered towards a service – some    Methadone: ‘A few years ago the government’s plan was to maintain everyone
feedback and information on the cases we have dealt with would be good.’                  with a heroin problem on methadone, which I feel has been successful, but
                                                                                          there is sometimes an issue with amounts taken. Some of the amounts people
Improvement: ‘There have been so many improvements over the years I have                  have to take are quite high and another thing that bothers me is the amount of
been a magistrate. The services and training are always improving – I think our           methadone on the streets – it gives some people the choice to administer
services are very effective, they do a great job and we need them more than ever.’        themselves with methadone off the black market, with no counselling.’                                                                                                                    25 October 2010 | drinkanddrugsnews | 13
Treatment | Vox pop

                                                       ‘I believe some                                                                                ‘We’re living in a
                                                 changes are needed,                                                                               society where new
                                                 but it’s the speed of                                                                           drugs hit the streets
                                                  these changes that                                                                           every month – with all
                                                         concerns me.                                                                              the legal highs our
                                                     Although we are                                                                                drug services will
                                                    measured by our                                                                              be overrun with new
                                                     results, and the                                                                             problems. As far as
                                                funding will be linked                                                                         spending goes, it’s not
                                                to these changes, we                                                                           just funding for drink/
                                               have not yet been told                                                                            drug services but all
                                                how this will happen.’                                                                           the other issues like
   The drug service boss                                                                        Paul Leveridge (aka Kermit)
   Tim Young, chief executive, The Alcohol and Drug Service (ADS)                               Rapper, Black Grape, Ruthless Rap Assassins

   Spending: ‘I believe some changes are needed, but it’s the speed of these                    Spending: ‘We’re living in a society where new drugs hit the streets every
   changes that concerns me. Although we are measured by our results, and                       month – with all the legal highs our drug services will be overrun with new
   the funding will be linked to these changes, we have not yet been told how                   problems. As far as spending goes, it’s not just funding for drink/drug
   this will happen.’                                                                           services but all the other issues like housing and so on that people need
                                                                                                help with when they have a drug problem.’
   Recovery: ‘The recovery agenda for clinicians is about what it means in
   terms of treatment delivery, introducing an element that should have been                    Recovery: ‘I think it’s ignorant to use a one size fits all – drink and drug
   there all along and for which there is substantial evidence. However, at the                 issues come down to the individual. I can’t see the recovery policies
   core of recovery is the aim of reducing service users’ dependence on                         working.’
   specialist services and increasing their ability to access support from
   mainstream services, at a time when mainstream services are being cut too.                   Improvement: ‘Back in the day help was scarce – there were hardly any
   I fear it will be more difficult at best – and impossible at worst – for some                services, GPs only dealt with a select number of people with drink or drug
   of our service users, as the holy grail of getting people back into work                     problems and methadone prescriptions were nowhere near as widespread
   becomes even more difficult if stigma and the out of date Rehabilitation of                  as they are today. In the early days I used recreational drugs – the music
   Offenders Act are taken into account. It’s very difficult indeed for our service             industry has always been associated with drink and drug use and my story
   users to aspire to anything but the most basic paid employment, if they can                  is pretty much the same as everyone else’s. I’ve been there with substances
   get a job at all.’                                                                           but I’m older now and having a good time doesn’t mean messing yourself
                                                                                                up. My thing will always be music.’
   Methadone: ‘The driving issue in the use of methadone within drug services
   has been political, not clinical. The way funding is worked out for users gives
   services the problem of delivering what they can, but also getting the results
   – giving someone a prescription and reviewing them every few weeks is
   much cheaper than seeing them weekly and working with them through
   psychological therapies, yet there is loads of evidence to suggest the
   second provides better outcomes.’
                                                                                                                                                 ‘What if I can’t stick
   The service user                                                                                                                               to some new rehab
                                                                                                                                                  plan, a harder one?
   Spending: ‘For me, I’m asking “what about my methadone
   script?” when I think of cutbacks, or the support I get –
                                                                        doesn’t work – could I get another methadone script and
                                                                        the counselling that goes with it? It makes me feel
                                                                                                                                                  The thought of this
   will it not be what we get now? If I didn’t have this service        uncertain.’                                                               recovery thing just
   and prescription I would be left with nothing. If my                                                                                        makes me ask what if
   counselling and other help was reduced I would be looking
   at using heroin, or prison – I’m still going through
                                                                        Improvement: ‘I’ve been using heroin for about 13 years
                                                                        and in the time I’ve been using drug services I’ve seen
                                                                                                                                                     it doesn’t work –
   rehabilitation and the help I get now, I need.’                      loads of changes – there are more options, they allow you                 could I get another
                                                                        to get involved in activities and the education is good as I           methadone script and
   Recovery: ‘If I had to sign up to some recovery agreement I
   would want guarantees about back-ups – meaning what if I
                                                                        didn’t know half the things I do now about getting clean and
                                                                        trying to stay healthy. Also there’s the chance to talk to
                                                                                                                                                 the counselling that
   can’t stick to some new rehab plan, a harder one? The                many different people who can help you in different ways –             goes with it? It makes
   thought of this recovery thing just makes me ask what if it          yeah, I’ve seen a lot of changes.’                                         me feel uncertain.’
   Pictures: Paul Ryder – Barry Tomes, BTMG; Mani – David Fisher, Rex Features; Kermit – Roger Sargent/Rex Features

14 | drinkanddrugsnews | 25 October 2010                                                                                                       
Recovery | Conference

    Grace Ball, Rowdy Yates and Matthew Kidd report
    back from Glasgow’s landmark Recovery Weekend

    inaugural Recovery Academy conference on Friday 24 September, the ‘Big
    Welcome’ on Saturday morning and the UK Recovery Walk in the afternoon. The
    whole weekend has been heralded as a success, partly as a result of the
    pervading sense of warmth and enthusiasm that did much to promote the
    reality of recovery.
         The two overarching themes of the conference were ‘recovery starts with
    understanding’ and celebrating recovery in the UK by examining the evidence
    base. Community safety minister Fergus Ewing commended the conference and
    told delegates to be inspired in their belief that recovery can and does happen,
    a theme reflected throughout the day.
         The filled-to-capacity conference was a ‘rainbow coalition’ of academics,
    service users, those in recovery, commissioners, service providers, politicians and
    strategic planners, all learning from each other and appreciating different
    points of view in a way that felt quite different to most events in the field.
    Professor Phil Hanlon of the University of Glasgow told delegates about the
    impact of deprivation on health and the ‘Scottish effect’, but said that while
    deprivation – and its association with addictive behaviour – was one element of
    a wider complex picture, deprivation itself did not explain the higher levels of
    mortality in Glasgow compared to Manchester or Liverpool. The numbers of
    deaths attributed to alcohol and drugs in Glasgow were significantly higher,
    despite comparable levels of deprivation, he said, showing how detrimental
    alcohol and drugs could be to a population.
         ‘Addiction is a disease of exposure – a collision between personal
    vulnerability and social opportunity,’ said William White in an article prepared
    for the conference. ‘That opportunity is often bred within psychological and
    social circumstances that made picking up again and again an attractive
    choice… a process of spiritual awakening.’
         Stephen Bamber told delegates that spirituality was not to be confused
    with religion – rather spirituality and recovery were framed by principles of
    healing, self-transcendence, wellbeing, growth and personal development – an
    anthropological dimension of all human life. He outlined the evidence
    promoting spirituality as a proponent for good health and recommended the
                                                                                          ‘What the Recovery Academy does
    implementation of locally based spirituality care policies.
         David McCartney focused on the correlation between successful recovery
                                                                                          now is paramount, as expectations
    journeys and links to supportive non-using networks and peer groups, using the
    LEAP project as an example. The importance of treatment setting was expanded
                                                                                          are raised in terms of the support it
    on by Rowdy Yates as he explained the value of therapeutic communities, and
    the supportive and empowering role service providers have in providing the            can give to individuals, communities
    right set of circumstances for the initiation and sustaining of recovery. David
    Best, meanwhile, looked at how to assess recovery capital at an individual and        and services.’
    community level. ‘Long-term prediction of recovery is more strongly predicted
    on positive strengths and resources,’ he told the conference.
         Recovery capital should be assessed using asset-based tools to measure and       delegates challenged to consider the application of recovery in their own areas.
    demonstrate change, said Dr Teodora Groshkova of the Institute of Psychiatry,         Many people found the workshops hugely valuable to debate their point of view
    who told delegates about the values placed on a successful recovery                   and found that the ambiance of the event lent itself to open and honest dialogue.
    assessment. A change in how people are assessed was necessary in order to                  The objective of the conference was to promote the ideals of recovery, taking
    focus attention on both strengths and threats to recovery, she said. This ‘deficit    into consideration other viewpoints and presenting academic evidence of
    vs asset’ concept was developed by Mark Gilman of the NTA, who emphasised             effectiveness. What the Recovery Academy does now is paramount, as
    the empowering nature of recovery-based systems, echoing the theme of care            expectations are raised in terms of the support it can give to individuals,
    systems assessing and supporting the person, their family and the wider               communities and services. In the words of Alexandre Laudet, director of the Center
    community into long term recovery.                                                    for the Study of Addictions and Recovery: ‘Our task as clinicians, researchers, policy
         Conference workshops were designed to consolidate the learning from the          makers, funders and concerned individuals is to help people who have substance
    presentations and looked at how recovery can be developed and researched              use problems get the resources and strategies they need to improve their lives,
    through community-based networks and recovery focal points, as well as more           because that is really what constitutes, and also what promotes, recovery.’
    strategic planning forums to support individuals’ recovery journeys, with                  Grace Ball, Rowdy Yates and Matthew Kidd are directors of the Recovery Academy                                                                                                                      25 October 2010 | drinkanddrugsnews | 15
SEIZE THE DAY          Thursday 10 February 2011
                       Holiday Inn, City Centre, Birmingham

                                   DDN and The Alliance are pleased to
                                   present the 4th annual service user
                                   conference, Seize The Day. This is YOUR
                                   chance to speak up and speak out about
                                   issues around service user involvement.
                                   Service users, drug and alcohol workers and treatment
                                   service providers are invited to the must-attend event of the
                                   year. The latest and hottest topics will be discussed – with
                                   plenty of time to ask questions and share your views.

                                   With a new government and an increasingly difficult
                                   economy, what can service users do to ensure their voice
                                   continues to be heard? Budget cuts mean that services are
                                   looking to make ‘efficiency savings’ – and it is up to service
                                   users to make sure that your views are not lost in the fight
                                   for survival. We will look at innovative ways to keep your
                                   service user group going, as well as how service users,
                                   drug and alcohol workers and treatment services can work
                                   together to make sure that support does not suffer.
                                   Full conference details, programme and online booking:

                                   If you would like to exhibit in the service user or service
                                   provider exhibitions, please telephone 020 7463 2081 or

To register your entry, or for more information:
Classified | Services and events

      Drug and Alcohol Teams, Social Services
     Look no further!
      No waiting lists – immediate beds available

      LUTON                                     Chelmsford
      G   24hours, 7 days a week care           G    24 hours, 7 days a week care
      G   24 beds quasi – residential primary   G    24 beds quasi – residential
          care – £450 per week                       primary care - £495 per week
      G   12 week primary care and 12 week      G    12 week primary care and 12 week
          secondary care                             secondary care
      G   Detox facilitated                     G    Detox facilitated
      G   12 Step and holistic therapy          G    Luxury Accommodation
      G   EATA member                           G    12 step and holistic therapy
      G   Weekly reporting to NDTMS             G    EATA member
      G   Block contracts available             G    Weekly reporting to NDTMS
      G   Client weekly reports                 G    Block contracts available
                                                G    Client weekly reports

      CALL FREE 08000 380 480
    Email:                      Web:                                                               25 October 2010 | drinkanddrugsnews | 17
Classified | Services

18 | drinkanddrugsnews | 25 October 2010
Classified | Recruitment and services

  More jobs online from Phoenix Futures, ADS, Turning
  Point, Sagitta, Street Scene and Foundation 66                                   

                                 Sagitta Recruitment is a leading specialist
                                 agency delivering both temporary and permanent
                                 professionals into Drug & Alcohol Services

               We regularly recruit nationally for the following niche areas:
    •   Arrest Referral                        •   Hostels, Mental Health & Dual Diagnosis
    •   Commissioning & Service Managers       •   Pre-scribing and Needle Exchange
    •   Drug & Alcohol Action Team (DAAT)      •   Specialist Drug & Alcohol Practitioners
    •   Drug Interventions Programme (DIP)     •   Supported Housing
    •   Ex-Offenders & Resettlement            •   Youth Offending Teams (YOT)

               For an initial discussion please contact Dan on 0844 504 2325
               or email your CV to

                                                                                        25 October 2010 | drinkanddrugsnews | 19
       Hull Drugs Strategy Team –
   NHS Hull, Hull City Council, HMP Hull,
  Humberside Probation, Humberside Police

The Hull Drug Strategy Team, on behalf of its partners, is in
the process of redesigning the substance misuse
treatment system in line with the recovery and
reintegration agenda, and are seeking tender submissions
from experienced organisations, who can demonstrate the
knowledge, ability and innovation to provide a new model
of adult substance misuse services in Hull.

The tender will be divided into:
• Criminal Justice Substance Misuse Service – providing
  services across Hull Prison and the Community
• Open Access and Harm Reduction Service
• Community Based Prescribing Service
• Assessment and Case Management Service

Prospective providers are invited to tender for one or all of
the services. Consortia tenders will also be considered.
Contracts will be awarded for 3 years with the opportunity
to extend up to two years. All Services will be expected to
start on 1st July 2011.

Interested organisations are invited to apply via an initial
PQQ process followed by a formal Invitation to Tender. The
procurement will be advertised on
on 27th October 2010.

It is proposed to hold a Bidders Information Event on the
morning of 10th November 2010.

       If you require further details please contact
             Paul Robinson on 01482 612395.

            Do you provide
         training in the field?
  From universities to individual practitioners, the
Summer 2010 Training and Development Directory
featured over 160 training opportunities in the UK.
           Did you miss out?
 The Winter 2010 edition will appear as a pull out
and keep section in the 22 November issue of DDN.
   To make this the most comprehensive training
 listing available, make sure you don’t miss out on
                    your free listing.
              CALL FAYE NOW...
       020 74632205 or

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