The recent cabinet reshuffle has seen responsibility for the issue of substance misuse return to a senior Ministerial brief, as Minister Varadkar takes direct responsibility under the health portfolio. This news has been welcomed by Non-Government Organisations (NGOs) who operate drug and alcohol services, as it’s an important step in keeping substance misuse close to the top of the political agenda.
However, it is also important to remember that drugs and alcohol are part of the Minister’s portfolio in the context of a health budget which is significantly overspent, and in circumstances where saving money across state supported services very much remains the order of the day. In this article, I look at some key issues to consider in ensuring that addiction services provide both high quality care for service users and value for money for the taxpayer.
We need to follow the evidence
How best to deal with drug and alcohol use is, at this point, fairly well understood. Drug and alcohol use is both an unavoidable reality of the human condition and an expensive burden to states on a number of fronts, not least in healthcare and costs in relation to lost working time. As a result, it has been the focus of reasonably extensive studies in a number of disciplines, from economics to psychiatry, and there are reputable sources for good practice readily available. The European Monitoring Centre for Drugs and Drug Addiction has a best practice portal, for instance. Both the National Institute of Clinical Effectiveness in the UK and National Institute for Drug Abuse in the US publish good practice guidelines on a variety of issues related to the treatment of addiction.
Simply put, there is reasonable consensus in relation to ‘what works’, and this is where the focus needs to be. Modern addiction services need to be able to point to the evidence base for what they do; they need to ground what they’re doing in the academic literature. Being there for people, being empathic, being supportive, being advocates for those that use addiction services – these are all taken as given. They are necessary conditions to running a good service; but they are not sufficient.
More needs to be done, and it is up to everyone within the addiction sector to do more. Addiction services need to be strategic in how they spend their time. There is a need for flexibility in work practices so that we can ensure that the service users of addiction services are receiving high quality care in line with the best available evidence. In this regard, it is worthwhile remembering that one of the best ways for services to obtain and retain funding is to show objective evidence for the efficacy of the interventions that they provide.
Source: Tony Duffin, thejournal.ie, 25/07/14
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