BMJ Editorial by Dr Emily Finch: Drug treatment services are broken, says review

NHS APA Vice-Chair Dr Emily Finch’s recent editorial discusses the key takeaways from the phase 2 report of Dame Carol Black’s landmark drug review.

Dr Finch, Clinical Director of Addictions at the South London and Maudsley NHS Foundation, and Vice-Chair of NHS APA, agrees that Black is right in her findings; opiate use is on the rise, cases of treatment completion are depleting, drug-related deaths are increasing and all of this points to the conclusion that ‘drug treatment services are broken’.


In the report, Dame Carol Black makes 32 recommendations including the formation of a new Central Drugs Unit, and a substantial increase in funding for drug treatment. The new unit would sit within the Home Office but have a clear brief to hold all government departments to account in delivering a new national outcomes framework focused on reducing demand for illegal drugs. The report also recommends more funding for treatment for drug users, rising each year to an extra £552m (€640m;$760m) in the fifth year.


In her assessment of the recommendations, Dr Finch worries that additional funding may not be enough.

‘The number of higher training posts in addiction psychiatry across England has fallen by 58%, from 64 in 2011 to just 27 in 2019, leaving some regions without a single trainee.’


Finch suggests that ‘urgent action is now required to increase the number of training posts in addiction psychiatry.’

She concludes that whilst Black’s report is intelligent and comprehensive, it is also ambitious. It will require a coordinated effort from local and national government, the NHS and many other treatment providers if it is to bring the standard of healthcare treatment given to drug users to the same level given to patients with other chronic health conditions.

Original editorial published by The BMJ July 2021: https://www.bmj.com/content/374/bmj.n1828

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