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%