How will the Government’s new Drugs Strategy help LGBT people?

Our CEO Monty Moncrieff takes a look at the Government’s new Drugs Strategy and what it means for LGBT people.

The Government has unveiled its new Drug Strategy, a ten-year ambition to tackle drug-related harms. The previous strategy failed to mention LGBT people at all, despite significantly higher levels of substance use within our communities than seen in the population generally. What does this ambitious new strategy offer LGBT people?

Despite pressure to view drug use as a public health issue the Government has doubled down on its criminal justice focus. There’s a focus on tackling harmful supply chains, including actions to prevent vulnerable children and young adults falling under so-called County Lines and gangs.

There’s also a commitment to tackle ‘recreational’ use with renewed vigour – and increased penalties. This offers the Government an eye-catching headline for Middle (Class) England, though I’m less convinced stronger criminal sanctions will do anything to genuinely deter a ‘recreational’ user; they certainly haven’t so far.

Alongside this, we do get a welcome commitment to improve drug treatment and support for people who experience difficulties with substance use, and at our Antidote service, the UK’s largest LGBT specific drug and alcohol treatment project, this is where our interests lie.

The Strategy comes on the back of a comprehensive review of drug treatment by Dame Carol Black, who didn’t hold back in her assessment of the impact of a decade of austerity and savage funding cuts. Dame Black found treatment services to be on their knees, and working with partners in treatment services (which are commissioned by local authorities for local residents – a true postcode lottery) I’ve seen first-hand the burden of staggeringly huge caseloads and staff burnout.

It’s no coincidence that the Government’s own wording is a promise to ‘rebuild’ treatment services and the workforce delivering them. It’s perhaps the closest to an acknowledgment we’ll get that those years of cuts have done immeasurable damage to the drug treatment system.

Coping with the daily demand has left services with little time or resource to develop different approaches with diverse communities, although we know from 20 years’ experience that not doing so will perpetuate barriers and inequalities for LGBT people, as well as for other minority groups. Parliament itself has recognised this in a wide-ranging 2019 report on LGBT health and social care by the Women and Equalities Committee. The recognition in this new strategy that minority groups have not received effective services has been a long time coming.

LGBT people get a mention where the strategy talks about treatment services becoming more agile in responding to the needs of different groups. We welcome this inclusion: it’s a long-standing recommendation we repeated in our submission to Dame Black’s review, and in 2014 published guidance to assist treatment services, their frontline staff and those who commission them to consider how to improve their practice in relation to LGBT people using them. LGBT people tell us they need services that enable them to feel safe and understood, so they can talk openly and honestly about their needs.

Welcome too are commitments to improve integration with mental health and sexual health services. A promise to review how chemsex services are provided is long-overdue and we look forward to engaging with the Government on this.

LGBT people are also impacted through criminal justice initiatives and there are opportunities here to vastly improve practice. Working with the Police and Probation services we know there is an increase in offending related to chemsex, and we welcome Project Sagamore, a joint response addressing chemsex, health and justice, an initiative which pre-dates today’s policy announcement.

It’s vital that investment in treatment services reaches organisations experienced in supporting chemsex users including those with offending histories. Much of this expertise exists outside of traditional treatment providers in small and specialist charities like our own and our LGBT sector partners. We understand the factors that lead to problematic use of chems and are trusted by the communities we work within. As demand for this specialist support grows treatment provision can’t be left to chance, backed by a commissioner or two here and there, or – more likely – left to grant giving trusts to pick up the slack. It must form a core strategic element of a joined-up approach.

The Government is pinning many of its hope to its ‘flagship’ project ADDER, a whole systems approach to link rehabilitation, housing, health, and training for those in the criminal justice system through enhanced partnership work. We’re already part of a project testing this approach in Hackney, and we welcome the commitment to a targeted LGBT pathway from the local commissioner and our partnership lead Turning Point. It’s rare for LGBT people to be integrated into such schemes; we’re often an afterthought, if even that.

Perhaps of greatest opportunity is an impressive commitment to co-produce an outcomes framework for treatment and recovery support with a promise to measure longer-term goals and improvements in mental health and wellbeing. Here we need the Government to really show its ambition and measure how these outcomes compare for LGBT people within their revamped treatment services, and not just lump everyone receiving treatment together.

To do this requires adoption of further of our recommendations: services need to monitor the sexual orientation and trans status of their service users to be able to plot their successes and failures delivering to these populations – and their commissioners need to require them to do so, otherwise we’ll continue to have no data on how well the system meets our needs. Our partners at the LGBT Foundation have guidance to help them do this; spoiler – its not actually hard to do.

The Strategy comes with the title From Harm To Hope and repeats the motto of this Government to Level Up. After omission from the last Drugs Strategy and all the years of cuts our treatment system has endured, we must seize this opportunity to make vast improvements. Our ambition goes further than just ‘hoping’ things will improve for LGBT people in need of treatment and support; I want to do more than hope that the Government’s truly does too.

Monty Moncrieff MBE

Chief Executive, London Friend