Treatment services
Drug treatment services are organised in England according to Drug Action Teams (DATs). Drug Action Team boundaries are co-terminous with local authority boundaries, as such there are 149 DATs in England.
Drug Action Teams have the responsibility of delivering the National Drugs Strategy at a local level. As such they should plan, commission and purchase services according to local needs, in order to meet the aims of the strategy. To do this they work with other local bodies to co-ordinate the response to drug use locally. DATs receive guidance and help to do this from government departments and especially the Drugs Strategy Directorate, the National Treatment Agency for Substance Misuse, and the Drugs Prevention Advisory Service. These organisations also monitor the work of the DATs.
Each year the DAT has to produce an annual plan and a Young People’s Substance Misuse Plan, outlining the local response to drug use, including the provision of drug treatment.
Drug treatment can be described in modalities and it is expected that each local area should be providing treatment in all of the modalities, or at least access to all modalities. The modalities of inpatient detoxification, structured day programmes and residential rehabilitation may not be situated in all local authorities but there should be provision for access to them when required.
Accessing drug treatment
Some drug treatment can be accessed directly by the drug user. That is, there is not usually a need to obtain a specialist referral, drug users can phone up directly and make an appointment. However, drug services should also accept referrals from other professionals such as social services or health care workers as this is often a first point of contact for a drug user.
Advice and information services, harm reduction services, community prescribing – specialist, structured counselling and aftercare should all be accessible in this way.
For other drug treatment services that are more intense or more structured a referral from a professional is required. The referring agency is most often one of the drug treatment services listed above. Drug treatment services that require a professional referral include; structured day programmes, residential rehabilitation, inpatient detoxification and community prescribing – GPs.
Payment and funding
The majority of drug treatment services are free at the point of contact for service users. However, some drug treatment such as structured day programmes, residential rehabilitation, and inpatient detoxification, may require funding applications to be made to social services, primary care trusts or probation services. These funding applications should be arranged for drug users by drug treatment practitioners operating in services that are free at point of contact, these include; advice and information services, harm reduction services and community drug teams.
Some private facilities also provide in-patient detoxification or residential rehabilitation, for these services funding may be accepted or the drug user will have to provide the money themselves.
When a drug user considers entering into a treatment modality that requires funding or payment they should first contact another local free drug treatment service. The practitioners in the local services can advise drug users on the method of obtaining funding, the likelihood of being accepted for funding and the suitability of the drug treatment modality meeting the drug users needs.
Waiting times
Some drug treatment services offer drop-in sessions or very quick access within a couple of days. Unfortunately many drug treatment services have long waiting lists, especially for prescription based services or intensive programmes such as in-patient or residential services.
The National Treatment Agency for Substance Misuse has recently issued targets for drug treatment services to reduce their waiting times. However, while every attempt is being made to increase quick access to drug treatment, drug users may still encounter services that have no spare capacity. Referral agencies and drug users are advised to enquire about the length of the waiting list when making a referral, so a clear picture of the anticipated wait is known from the outset.
Making a complaint
All drug treatment services should be operating to QuADS Organisational Standards for Alcohol and Drug Treatment (DrugScope/Alcohol Concern, 1999). In addition, drug treatment ran by social services or a primary care trust should be operating in-line with the citizen’s and patient’s charter, respectfully. These standards and charters all state that an organisation should have a clear complaints procedure that is know to its service users, organisations should help service users make complaints where this is required.
