A 1% shift to change lives and change communities

Recovery from addiction
Addiction is one of the most costly social issues we face in Scotland, wrecking lives, families and communities. Yet people can and do recover and sustain abstinence, transforming their lives and contributing to society.
Investment in treatment for addiction is important, but it is even more important that people who want to change their lives and maintain their recovery after treatment are given the right support which will help them recover their health and their place in a community.
Research
The Scottish Government’s own research (Research for Recovery, a review of the drugs evidence base, Sept 2010) confirms there are several ingredients that help people to achieve long term recovery, including personal development, social networks that support abstinence, and peer support. The report acknowledges that recovery community development helps ensure that people find local, accessible support:
“Recovery community building encompasses activities that nurture the development of cultural institutions in which persons recovering from severe [alcohol and drug] problems can find relationships that are recovery-supportive, natural (reciprocal), accessible at times of greatest need (e.g. nights and weekends) and potentially enduring. Recovery community building activities include cultivating local recovery community (advocacy) organisations and peer-based recovery support groups, promoting the development of local peer-based recovery support services/institutions focusing on such areas as recovery-focused housing, education, employment and leisure (White, 2009b)”.

Current expenditure

The total economic and social cost of illicit drug use in Scotland was estimated to be just under £3.5billion in 2006. The total cost of alcohol abuse is £2.25billion. Audit Scotland estimates that £173 million is spent on drug and alcohol services annually, of which 6% is prevention activity and 68% (£117m) is spent on treatment and care. There is no identified spend on helping people maintain recovery – this would include people who have been in treatment, and people who ‘self manage’ into recovery.

The risk to Scotland’s investment
We know that addiction to drugs and/or alcohol is a chronic, long term condition with frequent relapses. Relapse rates soon after treatment are particularly high. In Scotland we have not yet dared to measure this properly, to see what the pay-off is in the long term outcome from investment in treatment. It makes sense to protect our investment in treatment by doing all we can to help people avoid relapse. This is why investment in developing a recovery community is so important.
Making a 1% shift in expenditure from treatment to helping people maintain recovery is all it would take to enable recovery community development to take place in every health board area in Scotland.

What a 1% shift would mean

Value for money
We want to make it clear – we absolutely support treatment and for many of us treatment has given us an initial foothold on the recovery path (it is certainly not the whole journey). However many of us have needed several attempts at treatment and many detoxes before recovery became a reality. In calling for a shift in expenditure we are not calling for disinvestment in treatment.  In the current climate we have to look at value for money. We believe a 1% shift from treatment to maintaining recovery would make expenditure on treatment more efficient (less recycling of people after relapse) and improve long term outcomes (more people achieving long term recovery).

This is what a 1% shift in spend from treatment to recovery community development would buy in each of the health board areas in Scotland – a shift of £1.17m giving each area £78k:

• Premises for recovery community hubs where people can meet, organise peer support and recovery-oriented activities, as well as building social networks through drink and drug free cafe and nightclub events
• A community development facilitator to help people in recovery become skilled in developing their own community and helping each other
• A small starter budget for new groups and activities, and volunteer expenses for volunteers in recovery