Health secretary Sajid Javid has announced the creation of a cross-government unit to deal with the nation’s drug crisis in the wake of a damning report that says the current system for prevention, treatment and recovery is no longer fit for purpose.
The Joint Drugs Combatting Unit will bring together the Department of Health and Social Care; the Home Office; the Ministry of Housing, Communities and Local Government; the Department for Work and Pensions; the Department for Education; and the Ministry of Justice, among others.
Its is one of 32 recommendations made by Prof Dame Carol Black in the second part of her review into the misuse of drugs in the UK. Black’s review was commissioned by Javid in 2019 when he was home secretary. Part one looked at the challenges around drug supply and demand, and was published last year.
Black’s report said there are now an estimated 300,000 opiate and crack users in England and around a million people using cocaine, while drug-poisoning deaths are at a record high. The most recent Office for National Statistics figures record that there were 4,393 drug-poisoning deaths in England and Wales in 2019.
Black said the current prevention, treatment and recovery system for people with drug problems is “not fit for purpose and urgently needs repair”. She said departments must work together to improve treatment, employment, housing support and the way the criminal justice system treats people with addictions.
Her report recommends addiction be recognised as a chronic health condition, requiring long-term follow-up, and says there is an “urgent need” to reinforce the treatment workforce to raise standards and restore morale.
Black said that increased funding is “necessary, but not sufficient” and reform of central government leadership will be vital in tackling the demand for illegal drugs because responsibility for the agenda spans multiple departments.
She warned ministers not to expect a reduction in demand for class-A drugs without “reversing the recent disinvestment” in treatment and recovery services. She also suggested that patterns of drug use in more-deprived areas indicates that dealing with the issue will be critical for the government’s levelling-up agenda.
“People with drug dependence are a small part of the much wider populations that departments serve, so tend not be prioritised in policy and funding decisions,” she said.
“There is no systematic way for departments to coordinate plans so that they cohere when implemented on the ground.”
Black said the new unit needs “clear ministerial sponsorship” and should take the lead in setting clear objectives and targets for the rest of government.
She also said ministers need to invest more in drug treatment and wider recovery support – identifying an additional £552m needed by DHSC over the next five years to provide a “full range” of high-quality treatment services and an extra £15m needed by DWP to help divert opiate users away from the criminal-justice system.
Black added that MHCLG needs to work out how much will be required to improve its housing support for people in drug treatment as part of its Spending Review submission.
“The government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences,” she said. “A whole-system approach is needed and this part of my review offers concrete proposals, deliverable within this parliament, to achieve this.”
Urgent action
Javid said he knew the sale and use of drugs drove serious violence and homelessness when he commissioned Black’s review in 2019, but that her phase-two report has shown the health implications of the industry are just as devastating.
“Tackling this issue requires strong collaboration across government and the new specialist Joint Combating Drugs Unit will help us to do just that,” he said.
“I would like to thank Professor Dame Carol for her dedication to this critical work and for producing this accomplished review.
“We will look closely at these recommendations and publish an initial response shortly on the urgent action we can take to turn the tide on drug-related deaths and get more people access to higher quality services.”
£19bn annual cost of drug misuse
In addition to the cost in human life and health, Black said the financial cost to society of the drug crisis is also high. Supporting documents to her report said it is estimated that the costs associated with illicit drug use are more than £19bn year.
The report said drug-related crime is the main driver of the costs, accounting for £9.3bn, with harms from drug-related deaths and killings making up the next largest cost, at £6.3bn.
The estimated annual bill for adult family and carers of drug users is £1bn, and the cost of enforcement £700m. The report said the government’s current annual spending on drug treatment and prevention is £600m.
Black said the overwhelming majority of the £19bn annual price tag relates to users of crack and opiates.
The report said the estimated 300,000 people using either crack, opiates or both cost society an average of £58,000 a year each, compared with an average annual cost of less than £1,000 each for the three million users of other drugs.
Black’s other recommendations include a call for the MoJ to ensure that everyone leaving prison has ID and a bank account and that those who cannot claim benefits online get the opportunity, from the day of release, to access DWP’s telephony service.
She also urged DHSC to commission Health Education England to devise a comprehensive strategy to increase the number of professionally qualified drug treatment staff and set occupational standards, competency and training requirements for drug workers and peer-recovery workers.
The report found that the drug-treatment and recovery workforce has “deteriorated significantly in quantity, quality and morale” in recent years and that services are increasingly reliant on drug workers with minimal – or no – professional qualifications.