These slides outline the case made by Collective Voice to the public consultation on the government's Comprehensive Spending Review. We make the case for continued investment in drug and alcohol treatment on the basis that it has a continuing role to play in reducing the burden on the state of crime and ill-health.

1. Spending Review Submission
The Case for Investing in Drug and Alcohol Treatment

2. “We have a policy which
actually is working in
Britain. Drug use is coming
down, the emphasis on
treatment is absolutely
right and we need to
continue with that to make
sure we can really make a
difference.”

3. About Collective Voice
 Collective Voice is a collaboration of eight of
the largest providers of alcohol and drug
treatment and recovery services in the
country, we have come together to promote
and defend the interests of those who need
our services.
 Collective Voice is sponsored and overseen by
a group of third sector providers including
Addaction, Blenheim, Cranstoun, CRI, Lifeline
Project, Phoenix Futures, Swanswell and
Turning Point.
Together we:
 Work with 400,000 people each year.
 Employ 10,000 staff, including 120 doctors
and 370 nurses.
 Draw on the time of 3,000 volunteers.
 Deliver services in 70 prisons.
 Have an annual turnover of £380 million.

4. Summary
 Drug and alcohol treatment in the UK provides excellent value for money; robust cost benefit
research has shown that for every pound spent on providing interventions leads to savings of
between £2.50 and £8 depending on the age of the recipient, the complexity of their needs and the
substances.
 Successive government’s investment in drug treatment is responsible for between a quarter and a
third in the fall in crime, saves at least 880 lives a year, and has allowed hundreds of thousands of
individuals to recover from their addictions.
 As well as traditional challenges there are clear new ones that the sector is keen to develop
responses to. For example, how to improve the longer term recovery outcomes for people with
substance misuse conditions – their wider health, their employment prospects, and their social
capital. How to better meet the needs of those with multiple and complex needs – working on ways
to better integrate with services for homelessness, mental health and offender rehabilitation.

5. Context
£50
£550 £542
£200
£200 £200
2001 2008 2011
SPENDING ON DRUG
TREATMENT (MILLIONS)
Central government Health and local authorities
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
2008/09
2009/10
2010/11
2011/12
2012/13
2013/14
2014/15
DRUG USE IN THE LAST YEAR

6. Current challenges
 294,000 heroin and crack users in England
 40% of prisoners have used heroin
 Over 1 million families affected
 21,000 deaths from alcohol per year
 2,000+ deaths from illegal drugs
 1 in 7 deaths for young adults drug related
Source: Crime Statistics, Focus on Violent Crime and Sexual Offences, 2013/14 (ONS 2015)
Perception that perpetrators of violent
crime are under the influence of alcohol or
drugs
53%47%
Alcohol
Yes No
23%
77%
Drugs
Yes No

7. Current challenges (Crime)
48%
22%
16%
12%
25%
64%
41%
57%
43%
28%
24%
47%
54%
30%
TAKEN DRUGS WHEN COMMITTED OFFENCE(S)COMMITTED OFFENCE(S) TO GET MONEY TO BUY DRUGSCOMMITTED OFFENCE(S) TO OBTAIN DRUGS DIRECTLYCOMMITTED OFFENCE(S) TO SUPPORT DRUG USE OF SOMEONE ELSEOFFENDING A LOT OR ALWAYS CONNECTED WITH DRUG USEDRUNK ALCOHOL WHEN COMMITTED OFFENCE(S)OFFENDING A LOT OR ALWAYS CONNECTED WITH ALCOHOL USE
OFFENDING IN LAST 12 MONTHS AND CONNECTION WITH
DRUG OR ALCOHOL USE
18 to 20 21+
Source: Needs and characteristics of young adults in custody

8. Current challenges (Prison Health)
 60,000 - the approximate number of
individuals received into a secure
environment each year with a diagnosable
drug or alcohol dependence
 70% of prisoners in substance misuse
treatment have at least one mental ill-health
problem and on average 3.4
 36% of male prisoners (26% of women) say
that it is easy or very easy to get illegal drugs
in prison
Sources: Service specification No. 29: public health services for people in prison NOMs, NHS England, PHE (2013), Substance misuse and mental health in prison RAPt (2015), Annual Report 2014–15 HM Chief Inspector of Prisons for
England and Wales (2015), Annual report on the Home Office forensic early warning system (FEWS) Home Office (2015)
26
123
224
24
738
Class A
Class B
Class C
Controlled NPS
Non-controlled NPS
0 200 400 600 800
Analysis of drugs in 20 prisons in
England

9. Current challenges (Drug and Alcohol Related
Deaths)
0.0
5.0
10.0
15.0
20.0
1994 1996 1998 2000 2002 2004 2006 2008 2010 2012
Alcohol deaths, rates per 100,000 of
population
0
500
1,000
1,500
2,000
2,500
1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013
Drug misuse related deaths

10. Current challenges (multiple needs)
 About 58,000 people with concurrent needs
across substance misuse, homelessness, and
offending – 92% with mental ill-health
 The ‘average’ local authority might expect to
have about 1,470 active SMD cases over the
course of a year
 The current cumulative cost of severe and
multiple disadvantage could be as high as
£58bn
Source: Hard Edges; Mapping severe and multiple disadvantage

11. Opportunities (Treatment and Employment)
 “We will review how best to support
those suffering from long-term yet
treatable conditions, such as drug or
alcohol addiction, or obesity, back
into work. People who might benefit
from treatment should get the
medical help they need so they can
return to work.”
Conservative Party Manifesto (2015)
 About 60% of problematic drug users are in
contact with structured treatment
 About 6% of dependent drinkers are in
contact with structured treatment
 About 20% in substance misuse treatment get
concurrent support for mental health
problems – compared with needs in range of
60-80%
 Only 27% of people leaving drug treatment
are in work or education

12. Opportunities (meeting multiple needs)
 “In its final budget statement in 2015, the
Coalition government committed to carrying
out an assessment of how to reduce the
estimated £4.3 billion spent on ‘troubled
individuals’ struggling with homelessness,
addiction and mental health problems, ahead
of the next spending review (HM Treasury
2015a). The new Conservative government is
now actively considering the case for
extending the Troubled Families programme
to these individuals as part of their
preparations for that spending review.”
£-
£1,000
£2,000
£3,000
Crime Drug and
alcohol
Health Mental
health
Housing
Investing in coordinated services for
people with multiple needs reduces
the overall cost
Baseline Year 1 Year 2
Source: Evaluation of the MEAM pilots - Year TwoSource: Breaking boundaries: Towards a ‘Troubled Lives’ programme for people facing multiple and complex
needs IPPR (2015)

13. Opportunities (devolution)
 “We believe that the government’s agenda of
devolving power to highly visible and
democratically accountable regional city mayors
has the potential to allow for further integration
of health, wellbeing and crime reduction
interests of localities. This could and should be
to the benefit of cross-cutting issues such as
substance misuse – where the savings often
accrue outside of the budgets of those paying
for the interventions.”
Collective Voice
 RELEVANT POWERS BROUGHT TOGETHER
UNDER GREATER MANCHESTER AGREEMENT
 Control of a new £300 million Housing Investment
Fund.
 Take on the role currently covered by the Police
and Crime Commissioner.
 Opportunity to be a joint commissioner with
Department for Work and Pensions (DWP) for the
next phase of the Work Programme
 Develop plans for the integration of health and
social care across Greater Manchester
Source: Greater Manchester Agreement: devolution to the GMCA & transition to a
directly elected mayor

14. Stay in touch with
Collective Voice
Paul Hayes
• paul@collectivevoice.org.uk
• @collect_voice
• http://www.collectivevoice.org.uk/