Evidence not Ideology must prevail

While statistically flawed, recent revelations from the BBC have raised doubts as to whether the taxpayer has been getting value for money from the treatment system.

Many of the dedicated people who work in drug treatment will have plenty of stories of people who have been helped to the point where they have re-established relationships, found a job and somewhere to live and have something to look forward to.

But the government has failed to communicate these successes and not only laid the system open to criticism, but also allowed the fault lines in the treatment debate to widen.

Talk is good and we need much more open debate about treatment effectiveness (see below), but nobody should believe they have come down from the mountain with the stone tablets of treatment truth.

You have to be in severe crisis to present yourself to the treatment system. You are admitting to yourself and others that you have hit rock bottom, you need help, your situation cannot continue. If somebody shows you a door marked ‘treatment’ you will go through it, apprehensive about what is on the other side, but certain in the knowledge that something has to be done. And ask any user at that point what they want and they will say that they want to get back some control of their lives.

But here the commonalities end. Drug addiction is not like diabetes: the gold standard treatment for diabetes is insulin. Nothing like that exists for drug treatment. Indeed some will find their way back from the brink without any official intervention at all.

So one-size does not fit all. It never has done and never will. And so, it is fine for different services to be offering different approaches – that’s called patient choice – and proper assessment and care planning will help people navigate their way along the twisted paths of the treatment ‘journey’.

But critically, what is delivered has to be based on a forensic examination of the evidence – and if the evidence isn’t there or isn’t robust enough, then it behoves the government to make sure it is – and if it is, then it must over-ride all other considerations. Just believing something to be true does not make it so.

The next issue of Druglink features a major article by Mike Ashton deconstructing the evidence base around treatment. As a follow-up, DrugScope and Conference Consortium are planning three half-day debates in three locations across the UK on the issues raised by the article. This is still in the early planning stage, but places are going to be limited and on a first-come, first-served basis. There will be a modest charge. If you would like to register your interest please e-mail consultations@drugscope.org.uk putting "treatment debate" in the subject box. We will be in touch in due course.