Reducing the harm from illegal drugs

Public Accounts Committee Closed Inquiry
Opened: 12 Sep 2023 Closed: 3 Apr 2024 Parliament page
Illegal drug use causes significant harm to both individuals and to wider society, and costs an estimated £20 billion a year. In December 2021, the Government published ‘From Harm to Hope,’ its 10-year plan providing £900 million of new funding to reduce the harm caused by illegal drugs. The Committee’s … Read more
6 Recommendations
19 Conclusions
1 Report
2 Oral sessions
3 Letters
2 Events
Oral evidence sessions 2 sessions
Reducing the harm from illegal drugs
Rachael Millar · Home Office Sir Chris Wormald · Department of Health and Social Care Sir Matthew Rycroft KCMG CBE · Home Office
Pre-panel: Reducing the harm from illegal drugs
Alice Wiseman · Association of Directors of Public Health Mark Lay · National Police Chiefs’ Council Mike Trace · The Forward Trust Professor Dame Carol Black · Combating Drugs
Recommendations & Conclusions
25 results
2 Conclusion
Eleventh Report - Reducing the har…
Assess the next drug strategy phase to embed system-level focus, address barriers and threats.
Achieving the long-term aim of reducing drug-related harms will only be possible if departments work collaboratively and adapt their approach to the evolving threats. The government has created new national and local structures to enable a co-ordinated response to implementing … Read more
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3 Recommendation
Eleventh Report - Reducing the har…
Confirm drug-related funding and public health grants early, providing long-term certainty to local authorities.
Uncertainty over funding allocations has made it difficult for local authorities to commission and deliver the high-quality treatment and recovery services that are needed. In 2022–23 and 2023–24, DHSC encountered delays in allocating substance misuse treatment funding to local authorities. … Read more
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4 Conclusion
Eleventh Report - Reducing the har…
Build understanding of local variations, disseminate good practice, support authorities and review performance metrics.
There are variations in local outcomes which the JCDU and DHSC have not yet addressed. The capacity and capability of local authorities to deliver drug treatment and recovery services have been significantly eroded in recent years. Between 2014–15 and 2021–22, … Read more
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5 Conclusion
Eleventh Report - Reducing the har…
Ensure JCDU and departments understand barriers for diverse drug user cohorts, enabling targeted local authority action.
The JCDU and departments have not put sufficient emphasis on the importance of addressing the specific needs of different cohorts of people who use drugs. It is unacceptable that drug-related deaths in England increased by 80% between 2011 and 2021, … Read more
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6 Conclusion
Eleventh Report - Reducing the har…
Coordinate urgent JCDU work to develop an evidence-based plan for reducing illegal drug demand.
Despite previous attempts to reduce the demand for illegal drugs, the JCDU and departments still do not understand how to change behaviours and prevent people from taking drugs. Reducing the demand for illegal drugs is crucial to mitigating the harms … Read more
HM Treasury
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1 Conclusion
Eleventh Report - Reducing the har…
Evidence gathered from Home Office, DHSC, and key drug strategy stakeholders.
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Home Office and the Department for Health and Social Care.2 We also took evidence from Dame Carol Black, author of the government’s independent … Read more
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7 Recommendation
Eleventh Report - Reducing the har…
JCDU lacks adequate evaluation capacity to demonstrate strategy impact for future funding.
We raised concerns that government would not be able to make a compelling case for continued funding at the next Spending Review. The JCDU and departments need to demonstrate to HM Treasury the impact of the £900 million of funding … Read more
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8 Conclusion
Eleventh Report - Reducing the har…
JCDU and departments face challenges developing sufficient evidence base within the timeframe.
We were also concerned that the JCDU and departments would not be able to develop a sufficient evidence base in the time available. They have begun to collect evidence on ‘what works’ but told us that timing was an issue … Read more
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9 Recommendation
Eleventh Report - Reducing the har…
New drug strategy structures improve coordination and accountability, but JCDU remains under-resourced.
The introduction of the From harm to hope strategy has led to positive change. The appointment of a Combating Drugs minister and the nomination of the Home Office permanent secretary as senior responsible owner, alongside the creation of the Joint … Read more
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10 Conclusion
Eleventh Report - Reducing the har…
Progress observed in drug worker recruitment, county lines disruption, and police diversion tactics.
There have been signs of progress in some areas.24 For example, local areas have recruited an extra 1,220 drug workers, exceeding the 3-year target already.25 In terms of disrupting the supply of drugs, over 2,000 county lines have been closed … Read more
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11 Recommendation
Eleventh Report - Reducing the har…
Lack of fundamental shift towards system-wide change, alongside recruitment and retention challenges.
Dame Carol told us that she had challenged government to work together in a more collaborative and integrated way to deliver system-wide change. The whole system needs to join up to support longer-term recovery and enhanced rehabilitation, including mental health … Read more
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12 Conclusion
Eleventh Report - Reducing the har…
Drug strategy requires rapid adaptation to emerging synthetic opioid threats, with ongoing government preparedness.
Mr Trace told us that changes in drug markets can happen rapidly, and that if synthetic opioids became more prevalent in the UK, the strategy would need to adapt rapidly.35 Mr Lay told us that there had been a synthetic … Read more
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13 Conclusion
Eleventh Report - Reducing the har…
Delays in public health and substance misuse grant allocations impede local authority planning and commissioning.
DHSC is responsible for allocating the annual Public Health Grant and Supplementary Substance Misuse Treatment and Recovery Grant to local authorities each year. The NAO’s report highlighted that there had been significant delays in confirming allocations of these grants for … Read more
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14 Conclusion
Eleventh Report - Reducing the har…
Lack of long-term funding certainty for drug strategy poses risks for local bodies.
While the strategy has a 10-year timescale to achieve its intended outcomes, its funding allocations are restricted to government Spending Review periods, typically for two to four years.42 When asked about how they could provide greater assurance to local bodies … Read more
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15 Conclusion
Eleventh Report - Reducing the har…
Specialist drug treatments prove effective but require national funding due to high cost.
Successful recovery from addiction to illegal drugs, such as opiates, is difficult, with high levels of recidivism.45 In its recent report, the Home Affairs Committee highlighted the efficacy of specialist programmes—such as diamorphine assisted treatment—in helping those with a long … Read more
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16 Conclusion
Eleventh Report - Reducing the har…
Significant real-terms funding cuts have severely damaged drug treatment services across England.
Drug treatment services declined over the last decade, with a real-terms funding cut of 40% across England between 2014–15 and 2021–22. The position varies widely across local areas, with 42 of 150 unitary authorities seeing falls of 50% or more.48 … Read more
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17 Conclusion
Eleventh Report - Reducing the har…
Variations in local drug treatment funding and services hinder access for many in need.
DHSC has allocated strategy funding for drug treatment and recovery to local authorities on a phased basis over three years, with the areas suffering greatest harm receiving priority.52 Mr Trace told us there is no national system, with variations in … Read more
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18 Conclusion
Eleventh Report - Reducing the har…
Patchy progress across local authorities indicates variability in drug strategy implementation effectiveness.
DHSC highlighted that local areas will base treatment and recovery services on local needs and demographics. We heard that the strategy was leading to innovation and good practice but the JCDU and departments could not point to specific examples.56 Dame … Read more
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19 Conclusion
Eleventh Report - Reducing the har…
Drug strategy's outcomes framework risks perverse incentives, prioritising process over recovery and impact.
We have previously highlighted the importance of effective performance metrics as a means of assessing progress in implementation.60 The JCDU has developed the National Outcomes Framework as a basis for assessing progress towards outcomes of reduced 48 C&AG’s Report, para … Read more
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20 Recommendation
Eleventh Report - Reducing the har…
Establish specific drug use reduction targets for young people and other vulnerable cohorts.
In the year ending June 2022, 9.2% of 16–59-year-olds in England and Wales reported having taken drugs at least once within the past year, with 2.7% having taken Class A drugs. These proportions are higher for younger adults, with 19% … Read more
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21 Conclusion
Eleventh Report - Reducing the har…
Limited consideration of women in drug strategy overlooks specific barriers to treatment access.
We were concerned that the government’s drug strategy made little reference to women.70 Written evidence submitted by the Office of the West Midlands Police and Crime Commissioner underlined the limited consideration of women and girls in the strategy, and the … Read more
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22 Conclusion
Eleventh Report - Reducing the har…
Illegal drug use remains high, underscoring the critical need for effective prevention strategies.
Around 3 million people in England and Wales take illegal drugs each year, around one in 11 adults. Despite attempts in the 2010 and 2017 drugs strategies to reduce long- term demand, this figure has remained largely unchanged since 2010–11.74 … Read more
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23 Recommendation
Eleventh Report - Reducing the har…
Government lacks evidence base on effective prevention strategies to stop individuals taking drugs.
The JCDU and Home Office did not have an evidence base about what works in preventing individuals from taking up drug use.77 The drug strategy has a strong focus on the link between criminal activity and drug use, with initiatives … Read more
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24 Conclusion
Eleventh Report - Reducing the har…
Investment in research for drivers of substance misuse behaviours remains inadequate
Dame Carol and Ms Wiseman told us that there was little investment in research into the behaviours and factors that lead to substance misuse.80 The JCDU pointed to the £5 million investment in the ‘innovation fund’ which is looking at … Read more
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25 Conclusion
Eleventh Report - Reducing the har…
Substance misuse prevention requires integrated 'whole of society' approach addressing root causes
Ms Wiseman told us that preventing vulnerable people falling victim to substance misuse must include consideration of issues such as deprivation, trauma, poor mental ill health, and adverse childhood experiences. The support networks and services that were once available to … Read more
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Correspondence 3 letters
6 Feb 2024 Correspondence from Sir Matthew Rycroft KCMG CBE, Permanent Secretary, Home Office, re Government’s work to reduce the harm from illegal drugs, dated 29 January 2024
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15 Jan 2024 Correspondence from Sir Chris Wormald, Permanent Secretary of the Department of Health and Social Care, re follow up Public Accounts Committee hearing on 4 December 2023 - Reducing the harm from illegal drugs, dated 4 January 2024
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10 Jan 2024 Correspondence from Sir Matthew Rycroft KCMG CBE, Permanent Secretary, Home Office, re follow up Reducing the harm from illegal drugs session, dated 15 December 2023
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