Closed call for evidence

Independent review of drugs: part 2 ‒ prevention, treatment and recovery (call for evidence)

Published 2 July 2020

Applies to England

Introduction

In February 2020, I was asked by the government to lead the second part of an independent review of drugs misuse, focused on prevention, treatment and recovery. This coincided with publication of part one of the review, sponsored by the Home Office, which focused on the complex and overlapping markets for illegal drugs. I took a market approach because only by understanding the illicit drug market and the drivers behind it can the government hope to disrupt it and address the harms caused.

Part 2 of the review has been commissioned by the Department of Health and Social Care (DHSC). It will make policy recommendations to the government – including what level of service provision is required and what commissioning and accountability mechanisms should be put in place – to make sure that these services are effective in preventing, treating and supporting recovery from drug problems. Addressing regional variations in performance and outcomes is also critical to the government’s ‘levelling-up’ agenda.

Further information about the scope of the review and its terms of reference can be found here.

This call for evidence forms part of the information-gathering phase of my review and I would encourage all interested parties to share evidence, and their insights and experiences to increase our understanding of challenges involved in drug treatment, prevention and recovery and opportunities for improvement. I am also particularly keen to hear the views of people using services and people in recovery. As well as inviting as broad a range of people as possible to respond to this call for evidence, I will be working with organisations with existing forums for people with lived experience and also with Dr Ed Day, the government’s ‘recovery champion’, who has established networks with recovery communities.

Professor Dame Carol Black

About this call for evidence

The responses to this call for evidence will be used with other sources such as official statistics, visits, research reports and academic literature, to:

• build a detailed, up-to-date picture of drug treatment, prevention and recovery
• inform recommendations on how the government can support improved provision

Responses will be read carefully and assessed in terms of the strength and quality of evidence they contain. Respondents are therefore encouraged to provide the detail of sources and references wherever relevant.

Only evidence which falls within the scope of the review will be considered. In particular, changes to the legislative framework are out of scope, and the review itself will apply to England only although we are interested in learning about best practice across the whole of the UK.

How to respond

Respondents should feel free to answer as many or as few questions as they wish to. They should not feel they have to comment on every area but to focus on where they have a strong evidence base for their response. When responding to a question, please:

• give specifics (for example, types of intervention being referred to, over what time period, among which groups of people, as relevant)
• reference any sources of data and provide evidence where possible
• keep responses as concise as possible

Responses to this call for evidence should be submitted online here

If, for exceptional reasons, you are unable to use the online system (for example because you use specialist accessibility software that is not compatible with the system) then please contact independentreviewofdrugs@dhsc.gov.uk and we will work with you to find a different way of responding.

Deadline for responses

The closing date for written submissions is 6 August 2020.

Confidentiality

Information you give in response to consultations may be subject to publication or disclosure under the Freedom of Information Act 2000 or the Environmental Information Regulations 2004.

The review will only process any personal data it receives as part of this consultation (for example, any identifying material) according to data protection law. This means your personal data will only be used for the purpose of the call for evidence. It will not be disclosed to third parties unless the law requires it, and you will not be identifiable from any published reports.

Questions

About you

To evaluate responses fully we need to ensure we reach a wide number of people from diverse backgrounds and experiences.

The following set of questions will help us better understand who is responding to this survey and in what capacity.

• What is your first name?
• What is your last name?
• If you want all, or any part, of your response to be treated as confidential, please explain why you consider it to be confidential.
• Is it OK for the Department of Health and Social Care to contact you in relation to your response?
• A small team of people from the Department of Health and Social Care will be looking at the responses received to this call for evidence so that we can write a report to summarise the findings. If you answer ‘No’ - your wishes will be respected and we will not contact you.
• What is your email address? *
• In what capacity are you responding? *
  • as an individual
  • as a representative of an organisation
• Which of the following best describes you or your organisation’s sector? *
  • young people’s drug prevention and/or treatment
  • adult drug treatment
  • academic/research
  • lived experience, mutual aid or peer support
  • health or social care
  • education or children’s services
  • homelessness, housing or employment services
  • local authority drug treatment commissioner
  • local authority (including public health)
  • criminal justice
  • member of the public
  • member of the public with lived experience of drug/alcohol dependence
  • a carer or family member of someone with lived experience of drug/alcohol dependence
  • other
• What is your job role or title
• Which country are you/your organisation based in?
  • England
  • Scotland
  • Wales
  • Northern Ireland
  • other (please specify)
• Which region(s) in England do you or your organisation work in? *
  • national
  • London
  • south-east
  • south-west
  • north-west
  • north-east
  • west midlands
  • east midlands
  • east of England
  • Yorkshire and the Humber
  • other

Prevention and harm reduction

1) What interventions are the most effective at preventing problematic drug use? Answers can relate to universal or targeted interventions for both adults and young people. Please include any good practice examples

i. What helps to implement them?

ii. What makes implementation difficult?

2) What interventions are most successful at reducing harm, particularly within vulnerable groups? Please give examples of what has worked well and which vulnerable group they relate to.

i. What helps to implement them?

ii. What makes implementation difficult?

3) What do you think the government could do to support the implementation of harm reduction interventions?

i. What do you think the government could do to support drug prevention initiatives and interventions?

Young people

4) What do you think has caused the recent increase in drug use amongst children and young people?

i. What do you think can be done to reduce drug use among children and young people?

5) Please tell us about any types of drug and alcohol services or inventions for young people that work well. We’d particularly like to hear about services or interventions for types of drug and alcohol use which are increasing such as alprazolam (Xanax), cocaine or Ketamine

6) What are the gaps in interventions and services for young people using drugs and alcohol?

7) How well do specialist drug and alcohol services for young people work with wider children’s services and mental health services?

i. What stops them working well together?

ii. How could this be improved?

8) What could the government do to help improve specialist drug and alcohol services and interventions for young people?

Treatment and recovery

9) What are the barriers to implementing evidence-based drug treatment guidelines and interventions? Answers can relate to specific interventions or services, such as in-patient detoxification or residential rehabilitation.

10) What could the government do to better support the implementation of evidence-based guidelines and improve the effectiveness of drug treatment and recovery interventions to help it realise its ambition to ‘level-up’ communities?

11) What are the best models for commissioning and providing drug treatment and recovery services?

i. What are the best ways to secure effective accountability for those services across different organisations at a national and local level?

ii. What levers or mechanisms could be introduced to ensure that services are effective and respond to the needs of local populations?

12) What are the most effective ways of commissioning, designing, and providing integrated services for people with multiple and complex needs?

Particularly for those who experience rough sleeping and co-occurring substance misuse and mental health conditions

13) How does the way the drug treatment market, in terms of the tendering of services and contracts, impact on outcomes for people and effective service delivery?

i. What measures could improve how the market works?

14) Why do some drug users who need treatment not access it?

i. What can be done to address this?

We’d particularly like to hear answers about specific groups such as black, Asian and minority ethnic (BAME) communities and women

15) How well do drug treatment and recovery services meet the needs of parents who are drug users and their children?

i. How could this be improved?

16) How could the capacity and competence of the drug treatment and recovery workforce (both providers and commissioners) be improved?

17) What are the most effective ways of meeting the physical health needs of people in drug treatment?

i. What can prevent their physical health needs being met?

18) What are the most effective ways of meeting the mental health needs of people in drug treatment?

i. What can prevent their mental health needs being met?

19) What current approaches are effective in meeting the employment and housing needs of those in treatment, include of people experiencing rough sleeping?

i. What barriers are there to good practice?

20) How can peer support/mentoring, mutual aid and recovery communities be better supported and improved?

21) What other barriers are there to people achieving and sustaining recovery?

i. How could they be addressed?

22) What needs to be done to help those in custody address their drug misuse and continue their recovery?

i. How can we improve the pathways between prison and community-based drug treatment, including ‘through the gate’ services when people are released?

23) How can treatment work better with the criminal justice system? Including through diversion by police using out of court disposals and community sentence treatment requirements as an alternative to custody?

Cross-cutting issues

24) What lessons can be learned from the way that drug prevention, treatment and recovery services have responded to coronavirus (COVID-19)?

i. Looking to the future, how do they need to respond to the impact of the pandemic?

25) How effective are drug treatment and recovery services at meeting the needs of black, Asian and minority ethnic (BAME) communities?

26) The Public Sector Equality Duty requires public bodies to help make society fairer by tackling discrimination and providing equality of opportunity for all. How effectively do the commissioners and providers of drug prevention, treatment and recovery services do this and what improvements could be made?

Responses can address any of the protected characters, specified in the duty, which are: race, religion or belief, sex, sexual orientation, age, disability, gender reassignment, pregnancy and maternity.

27) Is there anything we have not asked that you would like to include?