A lot has changed in drug treatment in the past twenty years. Countless contracts have come and gone, entire providers have gone out of business, several drug strategies have significantly changed the focus of treatment, and funding has plummeted. Amongst this flux one thing has always remained of vital importance; the voice of service users needs hearing.

The best way to connect with this voice is to attend the DDN’s annual conference, this year entitled ‘Keep on Moving’ in Birmingham. The title correctly suggesting that a level of resilience is required for anyone passionate about this space. In the morning Tim Sampey’s ‘Big Conversation’ talk summed it up well when he said ‘I am really tired of death. I know so many people who have died, I can’t even remember all their names and faces’.

Yet, despite the tiredness and countless drug-related deaths, he continues to run an inspiring weekend based mutual aid service in London called Build On Belief. And Tim is not alone in this resilience and commitment to advocating for the rights of service users. Comments throughout the day highlighted the passion that exists for service users involvement and the need for it to remain at the forefront of delivery.

Despite the passion, attending the conference gave me the impression that everyone in the sector is feeling frustrated. The cuts to treatment services have been nothing short of brutal, with little investment from Government even in the context of record levels of drug-related deaths. Mat Southwell from the European Network of People who Use Drugs (ENPUD) gave a fantastic presentation which was full of difficult questions for those in Government.

Early on in his presentation Mat asked ‘How on earth have we had an outbreak of HIV in 2018 in Glasgow, the home of harm reduction?’. A good question, the answer to which is likely to lie in the lack of investment and funding in the sector. He also asked why is the UK seeing so many drug-related deaths compared to other parts of Europe? He stated that it can’t just be due to an ageing population, highlighting that changes to the way in which treatment services work could play a key role.

Despite the latest Government drug strategy referencing the importance of harm reduction it sounds as though treatment services are still heavily monitored on drug free outcomes. Several comments were made throughout the day with members of the audience stating that if treatment services didn’t pressure people to stop taking drugs so much more people would attend for support.

On several occasions the question was asked ‘How do we make sure those who don’t access services are represented?’. This is an important question, especially considering most drug-related deaths are those who are not in treatment services. As pointed out by Rosanna O’Connor, Director for Drugs, Alcohol, Tobacco and Justice from Public Health England, alcohol presentations in drug treatment have reduced by 19% in three years, which is significant when you consider all other drugs have dropped by just 5%.

Alongside the tension and frustrations there was no doubt a great deal of passion and commitment at the conference. The afternoon session felt far more personal with speakers sharing their own stories and experiences of drug use. There is a great amount of positivity around service user involvement despite the pressures treatment is under and it is inspiring to hear of the hard work which is taking place across the country to support service users in treatment.

The voice of service users is more important than ever, and the conference highlighted both the great work and the clear frustrations which exist. On the way back down to London I spent a lot of time reflecting on Tim’s quote, trying to remember all the names and faces of the people I knew who died in nine years whilst working in treatment. Like Tim, I couldn’t remember them all and the process of reflecting was tiring, difficult and draining. Yet it reminded me how important this issue is, and spending a day surrounded by people who, despite the sadness, won’t ever stop championing for service users was, and always is, a privilege.

Paul North is the Director of External Affairs at Volteface and tweets at @Paul__North

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