The cost of problem substance use
• Cost of illicit drug use £3.5bn
• Cost of alcohol misuse total £2.25bn
Treatment for substance use
£173 million on drug and alcohol services in Scotland
£84 million specifically on drugs services £30 million specifically on alcohol services. £59 million spent on joint drug and alcohol services.
68% spent on treatment and care 6% spent on prevention
0% spent on protecting the investment in treatment
Treatment for substance use
• £22,827,123 cost of drug treatment for problem drug users
Problem drug users not in treatment £35,069 Problem drug users in treatment <1yr £15,025 Problem drug users in treatment >1yr £3,072
A Life Course Approach
13 problem drug use GP
Prescribing Prison
Methadone programme
Residential Treatment
Programme
Prison
Residential Treatment
Programme
Methadone programme
Non-residential Treatment
Programme
34
3 years abstinent
2nd year at Uni
3000+ hours volunteering
£13 k
£2 k
£20 k£161 k
£20 k
£8 k£5.7 k
£3 k
HospitalisationsCrime££££
Recovery from addiction• No reliable national information on outcomes
of treatment (Audit Scotland)• 3 % achieve abstinence in prescribing
programmes (DTORS)• 65 % achieve abstinence in services with
abstinence as a goal (LEAP)But, relapse rates in all forms of treatment are
high• 60% relapse after one year (NIDA, USA)• Cost of relapse?
Cost of problem substance use
Cost of treatment
Continuing improvement of
outcomesContribution to
society
Relapse
Cost of treatment to achieve abstinence is offset by savings 3:1
Preventive Spend
“Prevention”
Treatment and care
Relapse prevention
The Power of Recovery
Time
Pot
enti
al
Lessons from the USA
Recovery Capital• Recovery capital is the strength of internal
and external resources that can be drawn upon to initiate and sustain recovery from severe alcohol or drug problems– Hope in recovery– Supportive relationships– Secure and stable housing– Learning and personal growth– Connections to a community– Making a contribution to the community
Impact on outcomes of Recovery Capital
• Determines the success or failure of recovery• Increases in recovery capital create turning
points• It may take several years to accumulate
recovery capital• Sustained recovery is harder for
disadvantaged groups who lack recovery capital
Learning from the Serenity Cafe• Year 3• By people for people in recovery• 30 volunteers• 200 ‘customers’• Cafe-club nights• Social networking• Sport, leisure and recovery-oriented activities• Peer mentors• Recovery coaches• Links with treatment services and education/training
providers
What will it take?
1%