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The Failure of the NTA

The first calls for the NTA to be scrapped were in 2006 when it became clear their efforts were designed to prolong drug use and not end it.

Health Minister Agrees:
NTA to be abolished.

But Kathy Gyngell, chair of Addiction Policy at the Center for Policy Studies Think Tank has other concerns, 'the decision has left the NTA operating as usual, with control over spending by Drugs Action Teams and Primary Care Trusts. For both are still required to submit their drugs treatment budget/spending and care plans for approval to the NTA in January 2011. 

These plans are due to be passed in March, yes by the NTA, for the year to come. This will most likely block any real change till the end of 2012.

By then, as one concerned colleague commented to me last week, 'no doubt the NTA hierarchy will have embedded themselves in the DH and still be able to destroy and wreck lives by putting whatever spanners in the works of treatment reform they disagree with'.

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In Feb 2010 Iain Duncan Smith called for the National Treatment Agency for Substance Misuse to scrapped and replaced by an Addiction Recovery Board, now as Work and Pensions Secretary he said 'it was unacceptable that only 4% of addicts in treatment ever get “clean” and accused the agency of “pushing aside” proper rehabilitation'.

The NTA will spend £1.2billion in 2009/10 on treatment which is a 50% increase in budget on the previous year from £800million but they have the worst success rate in treating addiction and dependency problems, they reported a success rate of just 4.3% [8,980] in 2009 which equates to just 1 in 23 people 'in treatment' quitting drugs but the reality could be far worse.

The numbers leaving treatment 'drug free' are disputed as the terms ‘treatment complete' or ‘treatment complete, drug free' are not clinical terms/definitions, cirtics say 'it does not mean the person is actually drug free – the terms essentially just record entry into and exit from the NDTMS reporting framework and have no clinical value at all, they are intentionally misleading'.

No Relapse Figures
Also startling is the absence of any relapse figures as the NTA considers addiction and dependency to be a 'chronic relapsing disease/disorder' but they make no mention of how many of the 4.3% 'exit rate' relapse straight back into drug use.

No Provable Clinical Effect
The reality is, NTA 'treatments' have a 0% success rate or 'no provable clinical effect'. This was also confirmed by two studies published in The Lancet, one of the world's leading medical journals:

  • [October 09] NTA claimed 'around two-thirds of people stopped using these drugs within six months of treatment initiation' but in reality they treated 14,656 addicts over 6 months and not a single person left the program 'drug free'.
  • [June 10] NTA claimed heroin trial was a 'success' and wanted it rolled out nationally but 38 out of 43 clients - who received a 450 mg of legal heroin twice a day plus a nightly oral methadone supplement over a 26 week period - still failed to get off 'street heroin' after 6 months of treatment at a cost of £15,000 per annum per person - all 43 were still drug dependent.

In fact, more than 66% of all medical research is wrong with 'two in every three conclusions published in medical journals later found to be wrong or fraudulent' the two NTA Lancet studies been prime examples.

Even though both studies were a complete failure, the NTA presented them as a success, as they do with all their statistics.

Critics say 'the NTA will have to distort their figures even further when the focus changes to 'outcomes and results' rather than the 'numbers in limbo/treatment' which are meaningless, as Health Minister Andrew Lansley said 'It is vital that we focus on the results and the outcomes of patients'.

Ten Days
'It's a simple fact, the 'evidence based clinical treatment methods' used by the NHS to treat addiction and dependency do not work and the methods which do work and can help people get off drugs or alcohol in ten days have been 'pushed aside' by the NTA.

The NTA will continue to deliver these disastrous results until they introduce our treatment options to help with addiction and dependency problems to:

  • stop dependency
  • or reduce the level of harmful use by significant levels
  • and provide effective ongoing support

Abolish the NTA to cut drug use
But critics say, 'it's too late for the NTA, they have to go. Their treatments don't work and their funding [£1.2bn] is not sustainable, they received an extra £400million in funding last year and their supposed success rate improved from 3.6% to 4.3%, if they and the 150 DAT's were scrapped tomorrow, roughly four to five per cent of addicts would still quit anyway'.

No Treatment
Critics says 'the NTA constantly mention the word 'treatment'..'we have over 200,000 people in treatment'...'we have retained more people in treatment'...'we want more people in treatment'...but it's a meaningless statement, there is NO treatment in the medical sense to help people stop taking drugs as per the two Lancet Studies.

Whatever the 'treatment' is, [if not taking methadone] it's NOT working and explains why NTA results are the same as 'doing nothing', because they are - doing nothing' they have NO effective means to help end dependency.

For example: the clinical guidlines for 'Drug misuse and dependence 2007' mentions the word 'treatment' 701 times but does NOT state what that treatment actually is.

Critics say 'if you substitute the word 'limbo' for treatment, it makes much more sense, 'we have 200,000 people in limbo'...'we want more people in limbo'...'we have retained more people in limbo'. Others have accused the NTA of rewriting the dictionary to give the impression of successsful results.

Basically, 'NTA treatment' means 'we are keeping the NTA quango rolling at a cost of £20million per annum, spending £1.2bn on meaningless 'maintenance' programs and keeping 11,000 drug works in a job but it has nothing to do with actually ending dependency and getting people off drugs quickly and successfully'.

Costly Failure
The Center for Social Justice said 'During a decade of Labour drugs strategy, policy itself has become an intrinsic part of the problem. It has been a costly investment in failure. The combination of centralised targets and a ‘medical management' approach to treatment has further entrenched addiction, adding to intergenerational cycles of substance dependency'.

The Tory's have said they will abandon Labours failed addiction policy and David Cameron said 'we urgently need reform to make our whole health service more efficient'.

Some have called for the 'NTA to be dismantled when the Tory's return to power as they continually block change and better treatment options'.

Graham Lettington DAT Co-ordinator also said "During the 8 years working in the delivery of local drug and alcohol strategies I increasingly despair at the direction the NTA has led addictions treatment. In my view their abolition is essential to remove an unneccesary layer of bureaucracy including the burdensome data collection systems they have imposed on treatment providers, which serves no useful purpose and is only utilised to justify the continued need for the NTA".

The National Treatment Agency is a failed health quango started in 2001 to improve the availability, capacity and effectiveness of drug and alcohol treatment in England however critics say 'it is an overwhelming failure arguing that these bodies 'are used by ministers to avoid taking responsibility for failures in public service delivery'.

Results of NTA Treatment

  1. UK is the worst in Europe
  2. 1 in 23 'exit' rate?
  3. Alcohol deaths up 40%
  4. Drug deaths soar by 12%
  5. Drug deaths at 8 year high
  6. Cocaine five-fold increase
  7. £10bn spent on treatment
  8. Only 2% referred to rehab
  9. 4.3% 'success/exit' rate?
  10. Misleading Lancet studies
  11. Meaningless statistics
  12. Block 'change & innovation'
  13. Failed treatment options
  14. Harm Reduction a disaster
  15. £39billion cost to society
  16. No Actual Treatment
  17. No New Treatments

Critics say 'year on year the NTA fails to deliver success as the numbers of addicts emerging from Government treatment programmes are at the same level as if there had been no treatment at all'.

Empty Pledge
The now disgraced ex-Health Secretary Patricia Hewitt in 2006, pledged to help families affected by drug abuse. She said: 'We will continue to reduce the effects damage caused by the most dangerous drugs by ensuring effective treatment is available.'

But 5 years on, no new treatments have been commissioned to help with addiction and dependency problems.

After 8 years of failure even the NTA are beginning to recognise the need for success and so published a number of studies in the Lancet medical journal.

The Lancet Study
In 2007/08 the NTA recorded success rate was just 3.6% however in 2009 they published an article in the Lancet medical journal in (October 09) claiming 'around two-thirds (66%) of people stopped using these drugs within six months of treatment initiation'.

0% Success
The truth is, they treated 14,656 addicts over 6 months and not a single person left the program drug free, they were simply put on methadone (heroin substitute). In effect the Lancet study is 'evidence based' that NTA treatments do not work and any success is attributed to either the 'natural rate of remission' or 'exiting' the reporting framework.

Professor David Clark Director, Wired In said 'this whole agenda was about protecting the so-called integrity of the NTA (and the government-supported treatment system), rather than caring whether we are actually helping people whose lives have been so badly affected.

This is a disgraceful matter and should be looked into further. The implications for the future of drug treatment are potentially very serious'.

Critics suggest the Lancet should retract the 'meaningless and irresponsible' study as it did with the MMR paper.

The NTA Dodgy Dossier
Addiction Today have called the Lancet study 09 a dodgy dossier. 'We must all be very careful about data taken from agencies which are potentially under threat if they are not seen to be getting good outcomes. At the end of the day, these findings will be used to continue with the same ineffective system of non-treatment and denying patients, their families and society the promise of improved lives'.

RIOTT Trial
The NTA then did another study, in May 2010 also published in the Lancet of a heroin prescription trial which was widely promoted as a success. But 38 out of 43 addicts who received a 450 mg of legal heroin twice a day plus a nightly oral methadone supplement failed to get off street heroin after 6 months of treatment.

Despite being a complete failure the NTA promoted the heroin trial as a success and wanted it rolled out nationally at a cost of £15,000 per addict per annum but critics said 'if any further proof was needed that NTA treatments just do not work, the RIOTT prescription heroin trial is it. They claim 5 out of 43 addicts who managed to stop the use of 'street heroin' is a successful result but they were ALL still drug dependent, it's old thinking, failed treatment, totally unaffordable and irresponsible in the current climate'.

The RIOTT trial cost £645,000 and not a single person was drug free, we could have changed the lives of 185 clients for this amount and provided 'real treatment'.

One expert said, 'the Lancet studies show the level of spin employed by the NTA to prop up their failed regime, their results are a complete failure but are promoted as a success and sucked up by the media, it's shameful as their statistics lack credibility'.

Meaningless Statistics
For example: statistics from the National Drug Treatment Monitoring System 2008/09 state 'Of the 210,815 clients aged 18 and over in treatment contact in 2008/09 194,572 were in treatment for 12 weeks or more or exited treatment free of dependency before 12 weeks (92%)'.

This clearly gives the impression 92% of addicts leave treatment free of dependency, the actual figure for 08/09 was just 4.3% and of course this figure is disputed as the term 'treatment complete drug free' is not a clinical term or definition and does not mean the individual is actually drug free, they are just accounting terms.

Critics say 'the NTA has no credibility as their figures are pure fiction and spin' one expert said, 'if they told me it was raining, I would have to go and check for myself'.

No Hope
Experts agree 'addicts have 'no hope' of getting off drugs with current NTA treatment options' as rehab doesn't work and the Lancet studies confirm other treatments do not work either, this explains why so few addicts stop their drug use and the ones that do, are those who would have quit anyway, just 4.3% or 1 in 23, if that.

NTA U-Turn
In January 2010 The NTA launched a dramatic U-turn less than 3 months since The Lancet study claimed '66% of drug user stop using drugs due to their treatment methods'.

New Buzzword - Recovery
The objective is to now 'communicate the NTA shift in policy towards recovery and explain the recovery concept to tier 3 prescribing drug workers to facilitate a shift in thinking and a change of culture across the NTA/DATs, and demonstrate how to make recovery relevant and accessible to serious drug users'.

Critics have said this is just 'lipservice and a desperate bid for survival' before the next government, who have questioned the need for the NTA. 'New rhetoric, same old treatments' said one critic.

Nick Barton, Joint CEO Action on Addiction said ‘The targets are about people into treatment. It doesn't tell you what treatment, whether that treatment is any good, all it is, is about numbers…[they] can say, oh, we've got 185,000 people in treatment. To me that's a meaningless statement, what I want to know is how many people have you managed to get drug-free or reduce their level of harmful use by significant levels.

That's the only thing that matters, and that hasn't happened…how many people since they started their work have become drug-free?"

Critics say 'there's a culture of inertia and inefficiency that is rife throughout the public sector. In the public sector there is no competitive edge; no incentive to cuts costs or improve efficiency, it's clear the state are not the best resource to help with addiction and dependency problems and this area should be handed over to those in private sector who achieve the best results'.

The government has said 'there's a once-in-a-generation chance to examine what services the government should provide and whether there are ways to do it more efficiently involving the private and voluntary sectors.'

New Government Pledge
'We are committed to the continuous improvement of the quality of services to patients, and to achieving this through much greater involvement of independent and voluntary providers.

We will give every patient the power to choose any healthcare provider that meets NHS standards, within NHS prices. This includes independent, voluntary and community sector providers', so now the addiction services should be able to use our treatment services.

The Way Forward
We can help solve these problems and detox patients or reduce their level of harmful use by significant levels in 8 to 10 days on an out-patient basis and provide effective ongoing support if required, but the NTA ignored our efforts to help those people who are in need of real treatment.

The NTA could have saved themselves by implementing our treatment methods but it is now too late as they are to be scrapped due to their poor outcomes and the tax-payer can not continue to fund a quango which wastes £1.2billion per annum with a 1 in 23 success rate or worse?

We would welcome the opportunity to work with new The Public Health Service who take over responsibility for real treatment to help those with drug or alcohol addiction and dependency problems.

We also look forward to the implementation of real patient choice so the patient can decide which detox service they wish to attend.

Click here for client comments.





'Only 1 in 23 manage to quit illegal drugs'

It's a simple fact, the 'evidence based clinical treatment methods' used to treat addiction and dependency do not work'.

Addiction: Estimated No of Addicts: Treatment Budget Success Rate
Illicit Drugs 320,000 £1.2billion per annum 4%
Alcohol Dependents 1,100,000 small % of above 1% to 2%
Smoking Cessation 17,000,000 £300million per annum 12%

Annually the NHS costs the tax payer £1.5billion for drug, alcohol and smoking treatments which 'do not work, have poor outcomes and bad results' as targets have focused on the 'numbers in treatment' rather than the outcome of that treatment, this is wasteful and irresponsible at any time, especially in the current economic climate.

But now the coalition Government plans to move to outcome targets rather than process targets. Health Minister Andrew Lansley said "I want to free the NHS from bureaucracy and targets that have no clinical justification and move to an NHS which measures its performance on patient outcomes'.

Doctors, Lies & Addiction Bureaucracy
Dr. Dalrymple, author of 'Doctors, Lies & Addiction Bureaucracy' argues that 'his profession has totally misunderstood addiction & continues to perpetuate the myth to protect its own existence, the addiction services have grown so massively they have developed a survival instinct and are not looking for a cure, in short, the bureaucracy of addiction needs addicts far more than addicts need the bureaucracy of addiction. As a result, a self-serving, self-perpetuating and completely useless medical/drug bureaucracy has built up to deal with the problem'.

'The propaganda, assiduously spread for many years now, is that addiction is an "illness". This view serves the interests both of the addicts who wish to continue their habit while placing the blame for their behaviour elsewhere, and the bureaucracy that wishes to continue in employment, preferably for ever and at higher rates of pay. Since the bureaucratic solution to waste is to waste even more, you don't have to be Nostradamus to predict that funding in Britain will continue to rise'....until now.

Flawed Disease Theory
You will find when the addiction services are eventually called to task over their poor performance for the last decade they will justify their failure on the theory, addiction is a disease, which of course it is not. Those who use this excuse represent 'old thinking' and lack credible treatments to help people stop and so blame their failure on a wider less tangible concept that addiction or dependency is a disease, however the disease myth or theory has been popularised but never 'proven'.

One will find that the disease theory is played down/abandoned once financial pressure is brought to bear on treatment services and outcomes become the new measure of success rather than those maintained 'in meaningless/non-existent treatment' perpetuated by the 'old disease model of addiction', patients will now be told, 'you don't have a disease, you can get better and stop' as the new addiction mantra.

Critics argue 'having a disease used to mean an 'involuntary condition' such as leukemia or cancer, over time the definition of a disease expanded to be more inclusive and capture personality traits or behaviors, being a drug addict is hard work, there is a lot of time and effort required to acquire the drugs and then use them and a lot of financial planning required to buy them, it is certainly not an involuntary action and therefore does not fit the original definition of a disease'.

Critics say 'the whole field of addiction treatment is wrong as it was designed to prolong the addiction problem rather than ending it. Individuals with alcohol or drug problems need the positive empowerment of psychology rather than the negative connotations of psychiatry in order to make real changes. But since 2001 the NTA promoted 'addiction maintenance' as 'treatment' which did nothing to end the cycle of drug use'. The NTA was abolished in 2010.

And now a leading think tank agrees there needs to be a real change in policy to make any real headway with addiction and dependency, the UK Drugs Policy Commission says 'policy shift to abstinence-based approach for treating problem drug users won't work unless prejudice is tackled. Colin Blakemore, professor of neuroscience at Oxford University says 'we need to inform the public about the true nature of addiction so that addiction is no longer a lifelong handicap'. The drugs minister, James Brokenshire, confirmed a clear shift in the rhetoric surrounding official drug policy with the ultimate aim of helping the 210,000 problem drug users currently in treatment to achieve a drug-free life.

As with all areas of healthcare, addiction and dependency 'treatment' needs radical reform.

Treatment v Limbo
The definitions of the word treatment are 'the management of someone or something' or the 'management and care of a patient' or in medical terms 'the combating of disease or disorder'.

The definitions for the word 'limbo' are 'oblivion: the state of being disregarded or forgotten' or 'an imaginary place for lost or neglected things' or 'a place or condition of confinement, neglect'.

It is clear the NTA use the word treatment in relation to 'the management of' and not in the medical sense of 'combating of disease or disorder' which they never clarify but let people assume. However, the experience of the 207,000 people in 'treatment' is of been 'left in limbo, neglected and forgotten about' which is a more accurate description of NTA activities due to their policy of 'harm reduction' and 'drug maintenance programs' rather than seeking to end dependency, therefore 'limbo' is a more accurate description rather than 'treatment'.

The NTA should provide clarity for the tax payer and state either 'we are managing 207,000 people with addiction problems but with no focus on ending their dependency' or 'we have 207,000 people in limbo'. This would then explain their poor results but it would also question the need for such an organisation that costs £20million per annum to run and spends £1.2billion per annum on meaningless and ineffective 'drug maintenance' programs.

National Treatment Agency for Substance Misuse (NTA)

The NTA is a special health quango, established by the Government in 2001 to improve the availability, capacity and effectiveness of drug treatment in England. [NTA: from 27 employees in 2001 to 184 employees in 2009 with a direct operational cost of £20million per annum]

  • improves the commissioning of drug treatment services
  • promotes evidence-based and co-ordinated practice
  • improves the performance of drug treatment commissioners and practitioners

The NTA is responsible for implementing the treatment target of the Government's national drug strategy:

  • to increase the participation of problem drug users in drug treatment programmes by 55% by 2004 and 100% by 2008 (against a baseline set in 1998)
  • to increase the proportion of users successfully sustaining or completing treatment programmes year on year

The NTA also impacts on the other elements of the drug strategy, such as protecting communities from drug-related crime.

The NTA is responsible to the Secretary of State for Health. The NTA has a central office in London and nine regional offices across England.

Criteria for success
The NTA is monitored against the following criteria for success:

  • access to treatment - double the number accessing structured treatment between 1998 and 2008
  • capacity - recruit an additional 3,000 practitioners to the drug treatment workforce
  • efficiency - increase efficiency of treatment services - indicated by reduced waiting times
  • effectiveness - increase the proportion of people completing or appropriately continuing treatment
  • (no mention of actually getting people off drugs)

Drug misuse impacts on many areas of people's lives. It causes or risks damage to individuals' health and welfare, the emotional and psychological well-being of their families and the safety of the wider community, and leads to the continuation of social exclusion and poverty. Evidence shows that appropriate treatment is the most effective way to tackle these harms.

While drug misuse has become widespread, for the majority it will not escalate into problematic drug misuse. A small minority of approximately 330,000 people will develop serious problematic misuse, typically of heroin and/or cocaine. This is the group that the NTA targets.

But in reality the NTA has been a massive failure with no real success rate and fudged statistics.

THE STORY OF DRUG ‘TREATMENT'

The UK has the worst drug problem in Europe. Below is the story of the events leading up to this.

  • The election of the Labour government in 1997 marked a new direction for drug policy. It developed a ‘harm reduction' strategy which aimed to reduce the cost of problem drug use.
  • The focus was switched from combating all illicit drug use to a smaller sector: problem drug users, depersonalised as “PDUs”.
  • Cannabis was reclassified downwards.
  • Spending on methadone prescriptions tripled between 2003 and 2008.
  • The aim of ‘treatment' for drug offenders was no longer abstinence but ‘management' of their addiction with the aim of reducing their reoffending. In practice, this meant prescribing methadone.
  • Government targets were imposed on new quangos such as the National Treatment Agency for Substance Misuse in an attempt to increase the number of PDUs in treatment – which for most people meant getting a methadone prescription.
  • Of the 200,000 or so problem drug users currently claimed to be in ‘treatment', only 6,700 have undergone “inpatient treatment” (ie, brief detoxification, a physical first step before treatment). Only 4,300 have had residential treatment.
  • A Drug Intervention Programme was introduced to direct those guilty of drugs-related offences into ‘treatment' – again, in practice this meant prescribing methadone. There is little evidence that this has been effective.
  • This disproportionate harm-reduction focus has failed. It has trapped 207,000 people in state-sponsored, taxpayer-funded drug use.
  • At the same time, the numbers of recorded offences for importing, supply and possession of illicit drugs have all fallen in the past decade.

source: Addiction Today

Drug Figures 2009 - 1 in 23 Success Rate
The NTA 2009 report now claims in '2008/09 8,980 individuals exiting 'free of dependency' which represents just a 0.7% increase on the previous year to 4.3%, 1 in 23 or £89,086.00 per addict.

DAT Whistleblower
But one of their own increasingly disillusioned Drug/Alcohol Action Team commissioners wrote to Addiction Today and said 'the terms ‘treatment complete' or ‘treatment complete, drug free' are not clinical terms/definitions – the terms essentially record entry into and exit from the NDTMS reporting framework and have no clinical value at all.

Even accepting this figure crtics say 'The NTA's key error is to attach clinical significance to these numbers when they actually just show those 'in and out' the reporting framework'.

So no-one really knows if any of the 8,980 people who were claimed to be drug free, were actually drug free.

James Brokenshire MP
Shadow Home Affair Minister asked [3.11.09] the Secretary of State for Health what criteria the National Drug Treatment Agency uses to make its assessment of whether a person leaving treatment is drug-free; and whether such assessments take account of the use of alcohol', we look forward to their reply.

Natural Rate of Remission
In any event, critics point out 'any of those who are said to be 'free of dependency' (4.3%) are just the ones who would have quit anyway, known as the natural rate of remission'. In any given year at least 4 to 5 per cent of people will quit their drug use simply because they have had enough and want to be drug free.

It is therefore more likely any NTA success is attributed to the natural rate of remission rather than successful treatment as the Lancet study proves NTA treatments do not work, out of 14,656 addicts not a single person left the study drug free.

2% Residential Rehab
Around 19 rehabs in the UK have closed and others made counsellors redundant. Most depend on the state for clients – but it refers only 2% of drug abusers to drug-free treatment as NTA board member Peter McDermott stated in The Observer last November that "Residential rehab doesn't actually work very well" and NTA head-office staff told BBC home editor Mark Easton, when researching a programme, that “there is no evidence that rehab works”.

Relapsing - Waste of Money?
One of the mains reasons why the NTA is reluctant to use rehab which costs between £500 to £1,500 per week, is because of the high relapse rates for this type of care.

Addiction is a 'chronic relapsing condition' according to the NTA yet they have no figures on how many of the 4.3% who leave 'free of dependency' relapsed straight back into drug use, which is 'unrealistic'.

If/when addicts starts using again, the money spent on residential rehab has been wasted and some addicts have been through rehab several times.

12 Week Claim
Critics also say that if '92% of addicts were effectively engaged in treatment for 12 weeks or more', that means out of 163,127 addicts not a single person became drug free after 12 weeks of treatment, which is 'unacceptable'. Also as NHS detox treatments cost the tax payer £1,700.00 per week, it costs £20,400.00 to provide this 12 weeks of treatment, for 96% of clients to fail.

Others suggest the figure of 92% is mainly achieved by providing the first appointment in week 1 and the second appointment in week 12 therefore allowing the claim of 'retaining clients for 12 weeks or more'.

One addict said 'I was first seen on the 4th March then didn't get another appointment till 20th May, 11 weeks later. Over the last year I've been to see a counselor 4 times, that's 4 hours, it's a waste of time'.

Tackling Problem Drug Use Report 2010
A Report by the National Audit office confirms 'The Government is spending £1.2 billion in 2009-10 with the objective of bringing down the costs to society of problem drug use of £15 billion a year. But there is no framework in place for evaluating the achievements of the 2008 Strategy which limits Departments’ understanding of the overall value for money achieved and where future resources should be prioritised. Without an evaluative framework for the Strategy as a whole we are not able to conclude positively on value for money'.

Critics say 'this is ridiculous, they [Labour] are spending £1.2bn a year on their drug treatment strategy but have no idea of whether or not it is successful. The lack of a 'evaluative framework' is either, intentional so the NTA can hide their dismal success rate, which was a questionable 4.3% in 2009 or gross incompetence'.

End of the Road for the NTA?

The next tory government think so. To put the scale of addiction into context, consider the following facts.

There are 327,000 problem drug users of heroin and crack cocaine alone. This is more than 10 per 1,000 of the adult population – compared to 4.5 for all drugs in Sweden and 3.2 in the Netherlands. Addiction devastates our local communities, particularly our poorest areas. The Cabinet Office estimates that the harms arising from drug abuse, including health and social costs, amount to £24billion a year.

The National Treatment Agency for Substance Misuse was established in 2001 to tackle drug addiction. Regular readers of Addiction Today will be familiar with its failings – despite the fact that its bureaucracy has grown dramatically: from 30 to 184 employees, with annual operating/administration costs standing now at £20million a year.

Since 2001, the NTA's ‘Pooled Treatment Budget' has reached at least £2.7billion. Spending on prescribed methadone alone has reached £300million a year. Up to 1.65million children are living in homes where a parent has a serious drug or alcohol problem.

CURRENT TARGETS ARE FOR PROCESS, NOT LIFE CHANGE

There has been an obsession with getting addicts into ‘treatment' alone, rather than recovery. Success is measured as completion of 12 weeks ‘in treatment' – usually a methadone script; I have heard anecdotes that sometimes even less is offered. It seems there has been no strategy or incentive to reduce the numbers on maintenance treatment, or move people from dependence to independence.

In 2008-9, only 8,980 of 207,000 addicts claimed by the NTA to be in structured treatment completed it free of illegal drugs: only 4%. Of those, only 4,600 had access to residential rehabilitation. In the space of two years – until Addiction Today began campaigning last year – 20 residential rehabilitation centres closed down, despite an increase in the number of addicts seeking treatment.

In the same period, the number of heroin users prescribed methadone reached 147,500. The NTA hails this as a success, because a record number of addicts are described as “in treatment”.
This obsession with numbers in treatment alone, alongside a fatalistic and undignified strategy of maintenance not recovery, fuels such ongoing failure.

Definition of Madness
Critics say the situation is madness, 'how can the addiction services expect treatment outcomes to improve if they continue with the same failed treatment methods? It's a classic definition of 'madness' expecting better results while using the same failed treatment methods which have proven 'ineffective' for the last 40 years, in effect, continue doing the same thing but expecting better results'.

Forecast to Failure?
The next government said they may focus on 'talking therapies' and residential rehab as the way forward and increase present capacity from 2,500 beds to 10,000 beds however this is also a mistake as talking therapies don't work and rehab suffers from:

  • abuse
  • cross contamination
  • high costs
  • high drop out rates
  • high relapse rates
  • low success rates
  • multiple attempts required
  • no ongoing support

The typical success rate of most drug rehabs is 2% to 20% but they are not cost effective with an approximate 46% drop out rate and an 80% relapse rate. Many addicts require two or three attempts at rehab as their methods suffer from chronic relapsing, which at a cost of £9,000 to £15,000 per visit, means they are not a feasible option considering the budget deficit. They also have many 'operational difficulties'.

'I have been on heroin and methadone (150mls) on and off for 21 years, done lots of other programs which have always been very difficult mentally and with a lot of withdrawal symptoms and which always take along time to complete, if I could actually make it to the end of them. With the New Way program I was clean in 12 days without any major withdrawals at all. I'm just so please to be off so quickly and easy, feeling good and can now get on with my life again. I really would recommend this program to anyone on drugs'.

Talking therapies and residential rehab use to be the preferred option for drug addiction treatment 10 years ago before the failed 'harm reduction' policy however talking therapies were dropped because they didn't work and rehab was dropped due to its high cost and low success rates, so it makes absolutely no sense to restart a previously failed policy.

Eventually the addiction services will realise our treatment method is the way forward. Unfortunately the NHS takes around 8 to 10 years to recognise a different treatment process, which critics say is 'excessive and unnecessary' however patient choice may change that time scale.

Tory Health Reform
Tory health reform plans include:

  • Scrapping all politically-motivated targets
  • Putting more detailed NHS performance data online
  • Improving cancer and stroke survival rates
  • Enabling patients to rate hospitals and doctors
  • Giving anyone the power to choose any healthcare provider that meets NHS standards
  • Putting patients in charge of their own health records
  • Opening up the NHS to new independent and voluntary sector providers
  • Linking GPs' pay to the quality of results they deliver

'Together our reforms will result in a dramatic improvement in the quality of treatment and access to treatment for recovery. They will simplify budgets and ensure the availability of holistic, committed and integrated care. They will also lead to significant long-term savings to the Exchequer'. Center for Social Justice

A similar plan from the Tories in the 1990s – GP fundholding – improved speed, reduced waiting times and widened the range of available services. But it failed to reduce costs as much as expected and there was lower patient satisfaction with services due to being restricted to just NHS services.

Mr Lansley will promise to "empower patients as well as health professionals" and "disempower the hierarchy and the bureaucracy". "I want the service to listen to patients, to take responsibility, to realise how much patients know about their need, especially for those living with long-term conditions."

Mr Lansley will say that targets focused on processes, data returns and more Department of Health circulars will not achieve these aims. Neither will "pointless structural upheavals or increasing the number of administrators in primary care trusts, nor even just by supplying more money".

"What I am saying today is in part about focusing on patient safety and on better care for patients. "This safer, better care is also more cost effective and if I can cut, as I will do, the cost of bureaucracy, the cost of administration, cut out waste in the NHS, then we can get those resources to support increasing quality for patients."

Health Secretary Andrew Lansley has reiterated his vision for a National Health Service that is patient-centred, focused on outcomes, innovation friendly and free from “half-baked” reforms.

We offer a unique 3 stage treatment process:

Stage One - Lower Tolerance
Our treatment is the only method capable of lowering the body's tolerance levels so less drugs are 'automatically' required after each treatment session. Clients do not stop using their drugs on day one but they are able to reduce their usage in a controlled manner which stops any serious withdrawal symptoms from developing.

Stage Two - No Serious Withdrawal
As tolerance levels have been reduced it allows the individual to use less substance each day without suffering the usual withdrawal symptoms such as shaking, drug craving, nausea, vomiting, abdominal cramping, diarrhoea, confusion, agitation, depression, anxiety and other behavioral changes when they try to 'reduce' without any treatment.

Stage Three - Normal or Step Off
When the individual has reduced to a normal dosage or to a minimum amount [1 or ½ a tablet/mls] they are ready to 'step off' and 'might' experience some 'temporary symptoms' such as restless legs, runny nose, aching arm etc as their body finally adjusts from drug dependency to non-dependency.

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