Collective Voice, the voice of the drug and alcohol treatment sector, have formulated a position which details where they stand on drug consumption rooms.
Drug consumption rooms are facilities where illicit drugs can be consumed under the supervision of trained staff and have been proven to reduce overdoses, drug related deaths, risky injecting practices, drug litter, public injecting and improve engagement of hard to reach groups.
CEO of Collective Voice Paul Hayes states that their “overwhelming priority… is addressing the increasing toll of drug-related deaths in a context of ever dwindling resources.” Figures released yesterday by the Office for National Statistics show the UK is again breaking records by hitting the highest level of drug related deaths since 1993, with deaths related to fentanyl also on the rise.
To address this alarming rise in drug related deaths, he highlights that “being in contact with treatment services is the most powerful factor protecting opiate users from overdose.” Thus, “the single most important step that can be taken to mitigate the increase in deaths is to maintain investment in drug treatment and harm reduction services.”
The Government has recently announced that local authorities will receive £84 million less from the government for public health in 2017/18, which has followed a £77 million reduction in 2016/17, and a £200 million cut in 2015/16.
These cuts leave difficult questions of where the funding for a drug consumption room would come from. Though Collective Voice have recognised for the first time that drug consumption rooms “may be able to make a contribution to reducing deaths by providing safer places to inject and also by initiating contact between health services and drug users currently outside the treatment system,” their concern is that “in an era of austerity, it is naive to assume that additional resources will necessarily be forthcoming to initiate such services.”
Collective Voice’s position calls on commissioners not just to demonstrate that “they have the potential to be a valuable addition to their treatment system, but that the resources they would absorb represent the most cost-effective way to achieve this outcome.” What they are asking is, though a drug consumption room may benefit 50 people, will that come at the expense of 150 people not being able to access a treatment service?
We would highlight though that these considerations are nothing new to local commissioners who will always need to judge the opportunity cost when investing in new services. What benefit would be lost from taking one course of action over another? And is this loss of benefit greater than any projected gains the other action could offer? These are the inevitable questions, though they undoubtedly play a more prominent role when budgets are stretched and where the opportunity cost is potentially loss of life.
Encouragingly, Collective Voice conclude that in the areas where these challenges can be overcome, they would be “keen to work with commissioners to ensure these services are integrated into existing provision in a way which maximises their potential.” The Collective Voice and NHS Substance Misuse Providers Alliance publication ‘Improving Clinical Responses To Drug-Related Deaths’, adds that “in an area where the conditions appear to be right for a drug consumption room all local partners, including criminal justice, would need to be involved in considering and enabling a proposal to develop one”.
Our key takeaway from Collective Voice’s position is that commissioners need to get more creative with funding. Treatment budgets are already under significant strain and the savings that would come from a drug consumption room can be clearly traced to other services, such as emergency call outs and clinical waste disposal. It is possible that drug consumption rooms may pave the way for more integrated funding as, like with many other services, its benefits cannot be categorised into one neat silo. By raising necessary questions of cost effectiveness, Collective Voice are initiating these conversations.
Please scroll down to read the full position statement.
COLLECTIVE VOICE STATEMENT ON DRUG CONSUMPTION ROOMS
“The overwhelming priority for the drug treatment sector is addressing the increasing toll of drug-related deaths in a context of ever dwindling resources. The ACMD, PHE and the Local Government Association all recognise that being in contact with treatment services is the most powerful factor protecting opiate users from overdose. They therefore all recommend that the single most important step that can be taken to mitigate the increase in deaths is to maintain investment in drug treatment and harm reduction services.
In CVs view the issue of investment in drug consumption rooms cannot be decoupled from this challenging reality. Although there is good reason to believe that drug consumption rooms may be able to make a contribution to reducing deaths by providing safer places to inject and also by initiating contact between health services and drug users currently outside the treatment system, in an era of austerity it is naive to assume that additional resources will necessarily be forthcoming to initiate such services. The challenge facing commissioners who might consider using their resources to fund drug consumption rooms is therefore to demonstrate not that they have the potential to be a valuable addition to their treatment system , but that the resources they would absorb represent the most cost-effective way to achieve this outcome.
In those areas who conclude that drug consumption rooms offer a cost effective route to reducing overall levels of drug related harm including deaths CV members will be keen to work with commissioners to ensure these services are integrated into existing provision in a way which maximises their potential.”
Paul Hayes
CEO
Collective Voice August 2017.
Words by Lizzie McCulloch
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