In the UK, Spending Cuts Leave Addicts with Nowhere to Turn

By The Fix staff 10/09/18

“Many community service providers are simply turning to harm reduction measures such as needle exchanges and opiate substitution medications just to keep their clients alive.”

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Getting treatment for drug and alcohol addiction can be lifesaving, yet in America only 5 percent of people experiencing substance use disorder report getting the treatment that they need. Americans often lament our system of treating substance abuse, but we’re not the only country where people with substance use disorder are left without a lifeline: In the United Kingdom, nearly 20 percent of spending on addiction treatment services has been cut since 2013, leaving people with nowhere to turn.

“It’s absolutely no surprise that addiction services have been hit hard, particularly given the lack of sympathy and stigma associated with addiction,” says Oliver Clark, founder of Rehab Recovery, a UK addiction treatment helpline. “This is particularly shameful given the number of new drugs hitting the street such as spice and other synthetic drugs.”

Despite the fact that the UK has a public health system, the Conservative Party that has been in control since 2010 has pushed for austerity, cutting funding to programs that are essential for getting people into recovery. The result has been fewer people getting into recovery and increased costs for addiction-related social problems, including theft.

“These cuts are clearly depriving vulnerable people of vital services,” Clark says. “The cuts mean the needs of vulnerable addicts are being left unmet.”

The Cost of Austerity

In the past, the funding for addiction services in the United Kingdom fell under the budget for the National Health Services (NHS), which is protected. However, in 2012 the responsibility for addiction services were moved to the local councils, which allowed the government to trim spending on addiction services. Although that may help balance budgets on paper, it does not show the full story, Clark says.

“These cuts are really just short-term fixes,” he says.

Because fewer people are able to access treatment, they often don’t get help until they are in crisis — which increases the cost of treating them. 

“[The cuts] only serve to put pressure on the NHS down the line, which ultimately has to pick up the pieces when vulnerable people require hospitalization,” Clark says. Since the cuts, both emergency room visits and inpatient hospitalizations related to addiction have increased dramatically.

The cuts to addiction treatment aren’t just driving up healthcare costs — they’re also leading to an increase in crime as people try to fund their addictions.

“If you have a £500 a day crack-cocaine addiction, then that money has clearly got to come from somewhere,” Clark says.

Each year, drug misuse costs the UK £15 billion, most of which is caused by drug-related crime. In 2014, the National Treatment Agency estimated that drug-related crime cost the UK £13.9 billion, while the NHS spent £0.5 billion treating drug misuse. Much of this cost could have been prevented by investing in treatment up front.

“A report published by Public Health England said that for every pound spent on drug treatment, £2.50 is saved in costs to society,” Clark points out. “It thus makes sense to invest in addiction services.”

The Human Toll

Of course, talking about addiction treatment shouldn’t just be a numbers game: cutting addiction services has a real toll on people’s lives.

The cuts to spending have meant that fewer people are willing to work in community treatment programs. The workers who are left are stretched to their limit, meaning that the programs are often overwhelmed and unable to effectively deliver treatment services.

In addition, because addiction services are bid on, the community providers change often.

“Service users become frustrated when their service provider is changed and staff members become demoralized by having to constantly change employer,” Clark says. “Many people simply leave the sector because of the burn out this process causes.”

Because of this constant shifting, the most vulnerable people — those with co-occurring mental illness, trauma, criminal backgrounds or homelessness — are often underserved by community treatment programs.

“Community service providers are thus faced with an array of intractable problems they simply are not qualified to cope with let alone solve,” Clark says. “Unfortunately, these services are not qualified or capable of treating serious mental health problems that often come part and parcel with addiction.”

Some programs have recognized that they are unable to keep up services, and changed their mission from helping people get sober to helping them stay alive.

“Many community service providers are simply turning to harm reduction measures such as needle exchanges and opiate substitution medications just to keep their clients alive,” Clark says. “In truth, most of these people have very little chance of beating their addiction.”

Treating Addicts as People

So, why are governments on both sides of the Atlantic able to so grossly underserve people with substance abuse disorder? Stigma around substance use disorder is still prevalent in the US and the UK, making it easier for politicians to slash funding without worrying about alienating their voters.

“Society is slow to change in this regard,” Clark says. “It may take many years until addiction is finally considered to be a ‘disease’ and not a choice by the wider public. Sharing recovery stories doesn’t seem to help remove the stigma and general lack of sympathy that is unfairly directed to people suffering from an addiction.”

People who don’t have addiction in the families are more likely to hear the negative stories about crimes caused by people with substance use disorder than they are to hear about people who overcame addiction to live healthy, productive lives.

“Sadly, whilst addiction often makes headlines, recovery seldom does,” Clark says.

Clark said that just like in the United States, the only effective way to change the system in the United Kingdom is by voting for governments that have policies that support spending on treatment services. That way everyone — regardless of their socioeconomic status — can have some hope for recovery.

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