September 3, 2025

Children and young people in the UK are being exposed to gambling content at ‘unprecedented levels’, according to a new report from GambleAware. In a survey of more than 630 13-17-year-olds, 87 per cent said they had been exposed to gambling content online, often via celebrities or social media influencers.

87 per cent said they had been exposed to gambling content online

More than half said they felt they had ‘no control’ over the amount of online gambling content they saw, while a quarter said they had been tempted to spend money on gambling after seeing a celebrity either gambling or advertising gambling. Sixteen per cent stated that they’d seen content creators advertising gambling products, while almost 80 per cent agreed with the statement that no one under 18 should be exposed to gambling advertising or content. While GambleAware acknowledges that the sample is not nationally representative, the results do have ‘important implications for policy-makers and educators, and provide useful avenues for further research’, it says.

Platforms like TikTok, Instagram, YouTube and Twitch play a ‘central role’, the report states, with 16 per cent of survey respondents saying they had seen content creators sharing links and sign-up codes for gambling operators, and 14 per cent saying they’d seen them sharing gambling tips. The charity is calling on regulators to address the impact of digital platforms and influencer marketing in promoting gambling to young audiences, and for the Advertising Standards Authority to revise its guidelines on celebrities – particularly those who appeal to children – appearing in gambling adverts.

‘A comprehensive review and mapping of the regulatory landscape is urgently needed for influencer marketing, gambling, gaming, and online safety to understand the extent to which influencer marketing is able to fall through regulatory gaps and what could be done to address this,’ the report states. The 2023 gambling white paper, High stakes: gambling reform for the digital age, was widely criticised for its lack of measures to strengthen the regulations around gambling advertising, despite widespread public support for tighter restrictions.

‘Digital technology has transformed how children and young people consume content, with mobile phone ownership widespread and many spending hours daily on social media,’ said GambleAware CEO Zoë Osmond. ‘Social media platforms and influencers now play a pivotal role in shaping attitudes and behaviours and this research shows that some are playing a part in encouraging young people to gamble. It is unacceptable that children’s environments continue to be flooded with age-restricted content. Consistent exposure to influencer-driven gambling content contributes to the normalisation of gambling amongst school aged children and we know that early exposure to gambling at a younger age can lead young people to have a higher risk of experiencing gambling harm later in life. Urgent action must be taken by the government to catch-up with the digital age.’

Understanding trends between online gambling content, and gambling attitudes and behaviours among children and young people available here

Mutual benefit

DDNWeb

September 2, 2025

‘We believe the greatest respect we can pay our clients is to listen,’ Lisa Ogilvie, a psychologist with Acorn Recovery Projects, told the conference. ‘Without the notion of applied expertise, but rather with the intent of learning to be better’. This had been her organisation’s response to the growing demand it was seeing for residential rehab places for ketamine use disorder (DDN, June, page 10). ‘Speaking to our ketamine clients to better learn how we could support them.’

Clear themes had started to emerge, including ‘the acute embarrassment they felt with their bladder issues, which were severely impacting their dignity and self-confidence.’ Acorn had implemented measures such as flexible comfort breaks and more comfortable seating arrangements, but there was one theme that continued to stand out – the lack of relatable peer connection, she said.

UNMET NEEDS
‘Our young ketamine clients didn’t have an outlet where they could go and talk about their sensitive health and social issues with people they could relate to. This saw the inception of our Ketamine Care Hub in Stockport – the first of its kind in Greater Manchester and, to the best of our knowledge, the North West of England and potentially further afield as well.’

The clients had been instrumental in establishing and shaping what was now a very successful care hub, she said. ‘Already in the short amount of time it’s been running we’ve been seeing some great successes, including one of our clients, Ethan, returning home and opening an equivalent service in North Wales.’

‘This time last year I was eight stone, isolated, suicidal, riddled with depression and anxiety,’ said Finn, a founding member of the Stockport hub. ‘I had kidney pains, liver pains, there was blood every time I went to the toilet, broken relationships and friendships – everything that comes with ketamine addiction. I thought it would take my life, or I’d take my own life.’

After a ‘messy’ recovery journey, Acorn had changed his life, he said. ‘We saw the need for peer-led support groups specifically for ketamine, which is something I hadn’t found in my years of trying to get clean and sober. So we set it up.’ The level of need meant that there was now a widespread network of users, ex-users, family and friends. ‘It’s an amazing community where people can ask questions and share experiences, and we also work one-to-one with young people for local services.’

MULTI-FACETED APPROACH
The complexity of what ketamine did to the body needed to be understood, said clinical lead at Delphi Medical, Dr Abida Mohamed. ‘It affects so many different organs. The need for services is vast, and we need to look at multi-faceted approaches to tackle this problem. Otherwise it’s really going to end in a lot of devastation.’

In 2023 Blackpool’s Adolescent Drug, Alcohol and Sexual Health service (ADASH) had approached her at the local Horizon service, as more and more of the young people they were dealing with were presenting with pain and bladder issues as a result of their ketamine use. ‘They didn’t know where to turn.’

The young people felt dismissed by their GPs, she said. ‘The GPs would Google what ketamine was in front of them’, and offer either unsuitable pain management medication or treatment for UTIs they’d tested negative for. ‘So we thought, let’s go to the base of the problem – education and GPs. We looked at four things: information – ‘assume they know nothing’ – harm reduction advice, clinical presentations, and communication. Young people want to trust that you’re listening to them.’

EFFECTIVE PATHWAYS
When the young people were referred to hospital there was often a waiting list of up to two years, she said. ‘We know that with long-term use you cause irreversible damage, so what use is that referral? So we needed to look at effective pathways. With persistence and many emails we approached pain management and urology and got two consultants onboard.’

It became apparent that the young people also had a wide range of other problems, she said – mental health, schooling issues, losing contact with their families. ‘So we decided to do something different – let’s have an out of this world, wish list expert MDT [multi-disciplinary team] panel. And we did it.’

ADASH was the nucleus, but the level of need and the fact that local services of all kinds were struggling to manage young people with ketamine issues meant that others were eager to get on board, she said. ‘Now we’re adding housing, harm reduction, public health.’ Multi-agency working was proving effective, with many decisions being made on the day, she said.

‘Moving forward we’re looking at developing guidelines, streamlined pathways, access to funding and dedicated clinics,’ she told the conference. ‘The key message for me is that we need to work together and listen to young people. If we don’t listen we’re not going to get them on board for the treatment they need. Trauma-informed practice is essential, and when the motivation for change is there from this young person it’s our responsibility to make sure that everything is streamlined so we seize that opportunity for change. The ketamine tsunami is here, so either we prevent a catastrophe or we deal with the consequences later.’

SOCIAL DAMAGE
On the subject of consequences, drug and alcohol policy was an issue where attitudes were ‘often sadly shaped by political prejudice and ideology,’ MP for Easington and chair of the Drugs, Alcohol and Justice APPG, Grahame Morris, told delegates. ‘The desire to seem tough on crime, rather than support people going through a health crisis.’

The reality was that there were more votes in the ‘arrest, prosecution and throwing away the key approach’, he said. ‘This is not only short-sighted, it’s morally bankrupt – and economically and socially damaging to communities like those I represent.’ International evidence showed that ‘treatment, not punishment’ was the way to address addiction and reduce harm – both to individuals and the community, he said. ‘Our objective in the APPG is to be your voice in parliament, bringing politicians closer to providers, practitioners and the frontline, and hearing from your lived experience.’

Grahame Morris, MP for Easington and chair of the Drugs, Alcohol and Justice APPG

INVALUABLE INPUT
The APPG supported the Anti-Stigma Network and had campaigned for an alcohol strategy from the new government, as well as to expand access to naloxone and increase diversion schemes. ‘Your input into these debates is invaluable,’ he told delegates. ‘It’s gives us politicians the ammunition, the evidence and the priorities we need to feed directly back to Parliament and to ministers. We need to have people like yourselves holding politicians to account.’

The UK’s approach to drug policy had remained static, he said. ‘It seems to me we’ve been repeating the same policy mistakes for more than 50 years.’ The new ten-year health strategy was a welcome step forward, ‘but it’s not all that we hoped for. So it’s up to us to demand a radical shake-up in drugs and alcohol policy, and we need your help to shape that policy by sharing information and best practice – people who provide and use services shaping decisions in Westminster. You’re the experts, we’re your representatives.’

Policy decisions needed to be genuinely shaped by lived experience, he said. ‘We need to harness our collective power. We often seem to spend too much time in dispute over our small differences in opinion when in fact we have far more in common. We all want to see improved public health services, with people at the heart of them. Let’s unite and use our collective voice to bring about change.’

Watch video footage of session two here.

Thirteen per cent fall in Scottish drug deaths

News

DDNWeb

September 2, 2025

There were 1,107 drug misuse deaths in Scotland last year, according to the latest official statistics from National Records of Scotland (NRS) – a 13 per cent decrease from 2023’s figure of 1,172. However, Scotland’s drug death rate remains the highest in Europe, with the country’s most deprived communities again bearing the brunt.

More than 90 per cent of the deaths were classified as accidental poisonings, with 6 per cent recorded as intentional self-poisonings. Opiates and opioids were present in 80 per cent of the deaths, benzodiazepines in 56 per cent and cocaine in almost 50 per cent – the highest level on record.

Men were more than twice as likely to die a drug-related death than women, with the average age of drug misuse deaths overall increasing from 32 in 2000 to 45. People in the most deprived areas of Scotland were 12 times as likely to have a drug misuse death compared to people in the least deprived, with the highest rates recorded in Glasgow City, Dundee City and Inverclyde.

Scotland’s drug death toll stands at 3.6 times the rate in 2000, at more than 19 per 100,000 people. Although deaths increased over two decades to their peak in 2020, they have been slowly decreasing since – with the exception of a 12 per cent rise in 2023. However, provisional figures for March to May this year showed a 15 per cent increase on the previous quarter, along with a 45 per cent increase in Scottish Ambulance Service naloxone administration incidents. Last month Public Health Scotland warned that highly potent nitazenes were now being ‘widely detected’ in all parts of the country in both community and custodial settings, posing a ‘substantial risk of overdose, hospitalisation and death’.

‘These statistics show a decrease in drug misuse deaths over the last year and represent the lowest number of deaths in the last seven years,’ said head of vital events statistics at NRS, Phillipa Haxton. ‘The longer-term trend shows that drug misuse deaths are still much more common than they were two decades ago.’

People in the most deprived areas of Scotland were 12 times as likely to have a drug misuse death compared to people in the least deprived

‘It is welcome that we have seen progress with the number of deaths at the lowest level since 2017, but I know there is still work to be done and we will continue to do everything we can to save and improve lives,’ said the Scottish Government’s drugs and alcohol policy minister Maree Todd. ‘This is particularly true as we face new threats from highly dangerous synthetic opioids like nitazenes, which further raise the risk of overdose and death. That is why we are providing record levels of funding for drugs and alcohol programmes and widening access to treatment, residential rehabilitation and life-saving naloxone. We have also supported and funded the opening of the UK’s first safer drug consumption facility and are working at pace to deliver drug-checking facilities.’

The figures showed that Scotland ‘continues to face a devastating drug death epidemic,’ said Abbeycare chief executive Paul Bowley. ‘While some progress is being made thanks to the Scottish Government’s national mission, with more people being given the opportunity to access treatment, this has not yet led to a significant reduction in the death toll. It is clear that more must be done.’

‘Scotland’s drug death rate remains around three times higher than England, and is still the highest in Europe,’ said Annemarie Ward of FAVOR UK. ‘That isn’t progress – it’s national shame.’

Drug-related deaths in Scotland, 2024 available here

More than 85 per cent of treatment provider workforce now in the voluntary sector

News

DDNWeb

September 1, 2025

Eighty-six per cent of the drug and alcohol treatment provider workforce last year were working in the voluntary sector, according to the latest workforce census, compared to 80 per cent in 2023 and 78 per cent in 2022. The proportion of unpaid or volunteer members of staff, meanwhile, was 11 per cent – 4 per cent up on 2023 but in line with 2022.

The figures are from the latest National drug and alcohol treatment and recovery services workforce census published by NHS England in partnership with the NHS Benchmarking Network and the Office for Health Improvement and Disparities (OHID). The report is the third in an ongoing series, with the first published in 2023.

There were 14,121 whole time equivalent staff, 96 per cent of whom were in delivery services – treatment providers or LEROs. Half of treatment provider staff were drug and alcohol workers, while the turnover rate in the delivery workforce stood at 19 per cent – down from 2023’s figure of 25 per cent but in line with 2022. Almost 40 per cent of staff had been in post for less than a year. The vacancy rate remained largely unchanged, at 8 per cent, while the vacancy rate for the commissioning workforce stood at 9 per cent – down from 12 per cent in 2023 and 14 per cent in 2022.

More than 70 per cent of treatment provider staff were aged between 30 and 59, while Asian and Asian British people continue to be underrepresented compared to the working age population as a whole, the report says – at 5 per cent compared to 10 per cent.

The census is ‘designed to provide insights into the workforce size, skill mix and diversity in terms of age, gender, and ethnicity’, says NHS England, covering local authority-commissioned adult and young people’s services in the voluntary, NHS, local authority and private sectors, along with the commissioning workforce and LEROs. The findings will help providers and local areas compare their services with national figures and trends, and help to identify development priorities, it says. The participation rate for the census was more than 70 per cent, providing a ‘comprehensive summary’ of the service delivery and commissioning workforce, the document states.

The profile of the treatment provider workforce remained ‘largely consistent’ with previous reports, it concludes, with the three largest role groups – drug and alcohol workers, nurses and service management and administrative staff – maintaining similar proportions. However, there had been ‘a notable increase in volunteering or people in an unpaid role, particularly within the voluntary sector for treatment providers – this was broadly returning to the levels reported in 2022,’ it says. ‘Furthermore, increasing workforce diversity continues to be challenging with Asian or Asian British people underrepresented in the workforce, compared to the English working age population.’

National drug and alcohol treatment and recovery services workforce census report 2024 available here

Speaking from experience

DDNWeb

September 1, 2025

Jamie Poole, Surrey County Council’s Changing Futures programme

I’ve been a lived experience practitioner for 18 years, and it’s been a tough call,’ Jamie Poole, lived experience project lead for Surrey County Council’s Changing Futures programme, told the conference’s first session. Pervading stigma had meant sometimes overhearing things like ‘you’d better hide the petty cash’, he said. ‘That’s some of the stuff we encounter, so we’re about changing cultures and educating people.’

Changing Futures was a joint £91.8m initiative between the Ministry of Housing, Communities and Local Government (MHCLG) and the National Lottery’s community fund. Operating in 15 areas, it was designed to improve the lives of people experiencing multiple disadvantage, he said. The objectives were to test and innovate new approaches, with wraparound support available for up to two years. ‘We really work around a trauma-informed relational model where the support isn’t rationed.

‘Everybody comes with complex problems,’ he told delegates, which is why it was important to widen the net to include things like adverse childhood experiences (ACEs). ‘We’re looking to go upstream. We’re an adult service but we need to look at interventions much earlier.’ What ‘multiple disadvantage’ ultimately meant was ‘multiple disadvantage to the service’, he said. ‘Services like to turn it around and say it’s about the individual – that they don’t meet the criteria because of their many challenges’.

SYSTEM CHANGE
The initiative’s objectives were not only to meet the needs of people who had fallen through the gaps in the system, but lasting system change. ‘Don’t open the gate and then shut it again,’ he stated. ‘Open it and then smash the fence down – disrupt it, challenge it. We need lived experience to be at the forefront of developing and commissioning, not just tokenism.’

The team had worked to get the local five-year Joint Strategic Needs Assessment (JSNA) document co-produced, he said. ‘Lots of people are signing up to this, and our Changing Futures lived experience group started to do some peer research training to get involved with a co-produced document that could really be a game changer in our area. But we had to be really robust with our methodology, because we knew this ship needed to be watertight.’

However, the ‘efficacy and authenticity of the document shone through’, he told the conference. The ’golden strand’ was lived experience – and the fact that the governance had been led by lived experience meant that ‘they couldn’t challenge it within the system, because the evidence was saying it. There was a genuine moral justice.’ Comprehensive independent reviews were vital, he said, rather than services simply ‘marking their own homework – of course they’re going to say it’s good. Let’s have some proper research around what’s working and what’s not. Let’s be brave and make it more inclusive. We’re very early in our journey, but we’re really moving forward, and there’s a momentum there to really make this happen and make the system more accountable.’

SENSE OF PURPOSE
‘Where I found myself was never the place I wanted to be,’ said Zack Haider, community development director for Intuitive Thinking Skills (DDN, July-August, centre pages). ‘I always wanted respect and a sense of purpose. Once I’d left services that’s what I set out to do – to regain my identity.’

He’d had a heroin and crack habit and spent 20 years homeless from the age of 15, he told delegates. ‘So I saw quite a lot of things in that time, and learned a lot of skills. To me language is an incredibly important thing because I hate labels. I’ve lived with labels all my life – mixed race, homeless – and I just wanted to return to my identity as a human being. We don’t have to hold people to ransom for their past forever.’

The point was to use lived experience for power and change, he said. Twenty years on, Intuitive Thinking Skills – the organisation he’d helped to launch – had almost 160 staff across the country. It delivered behaviour change programmes, ‘but it’s not forced – it’s about them and what they want in their lives. We passionately believe that anyone can change and become a role model for others, for their family, for themselves.’

The key thing that he always stressed to people was the importance of getting purpose back into their lives, he said, something that could be achieved through Individual Placement and Support (IPS). This was intensive, and tailored around people’s needs. ‘As we know, one of the big challenges is “What if I do get a job and they find out about my past – will it be held against me?” Stigma does exist.’

SOCIAL INTEGRATION
Gaining an identity in the workplace was incredibly important, he said, as well as the ‘clear direction of travel’ provided by work. ‘Everyone in this room has talent – it just needs to be explored. That’s the whole principle of IPS. My self-esteem had been shot to pieces – I didn’t believe in me, so I didn’t expect anyone else to.’ Work provided structure, routine, responsibility and social integration, he said. ‘It becomes an antidote.’

While there had been numerous government employment schemes over the years, what was different about IPS was that it was voluntary – ‘so no one’s forcing anyone’. Intuitive Thinking Skills’ IPS service was called i-SET – ‘as in, I set the goals, I set the place, I set the pace. This is not done to them,’ he told the conference.

IPS was also genuinely competitive, however. ‘You have to do the interview and get the job – it hasn’t just been put aside for people with addictions. So people’s ambitions really do come true – if you take it seriously. I helped set up Intuitive 20 years ago and we’re now part of an organisation that works in seven countries. If I can do it, anyone can do it – it’s about re-setting that button. No matter who you are and what you’ve been through, you have a right to your identity, your dignity and your independence. Let’s focus on what’s strong, not what’s wrong.’

COLLECTIVE RECOVERY CAPITAL
‘Inspiration and the desire to help are hard-wired human attributes, and a force that needs to be ever-present in our day-to-day work,’ said Jon Roberts from the Leicester-based peer-led social enterprise Dear Albert. ‘Part of our job as LEROs is to ensure that this is a collective, coherent, cohesive force – the harnessing of collective recovery capital from across the whole system, and directed as an energy for positive change.’ It was energy that needed to go beyond ‘the ferocious, energetic nature of hardcore addiction’, he said.

In his own journey out of addiction he’d been given ‘time and hope’, he said. ‘Let’s not forget to always be offering those.’ Bringing what residential rehabs delivered to much wider audiences in the community – and at a lower cost – was ‘precisely what LEROs can do, and we need to be doing. With innovation, quick decision-making, and while staying true to our values. Having the confidence that what we do can actually help’.

Addiction was a ‘warzone’, he said. ‘So how can we help in making the journey from war to peace? It’s clearly a complicated question, and an answer will be found in us all working together.’ At his first DDN conference around a decade ago – ‘fresh out of residential rehab’ – there had been ‘academics, teachers, specialist doctors, MPs, prescribers, pharmaceutical companies, technological innovators, national providers’, he said. ‘And I thought “this is big. There are huge resources available”.’

MAGIC INGREDIENT
Lived experience was the magic ingredient that brought all the building blocks together, he told delegates. ‘Let’s use it well. LEROs need to be building teams, supportive environments and effective programmes. In other words, people, places and things, one day at a time. And one day I believe all treatment services will be built that way.’ Partnerships were central to this, he stressed – ‘the ability to harness that collective recovery capital’. Solution-focused partnerships could foster respect for each other’s abilities, strengths and differences – ‘community and professionalism coming together.’

With Dear Albert this had meant things like employing peer mentors, establishing a breakfast club, daily outreach, naloxone distribution, and ‘bringing the message of recovery to wider audiences with the help of established providers. We’re grateful to Turning Point, commissioners and everybody else for a willingness to be open to shared learning. Ultimately LEROs will need to become more professional than the professionals, and that’s a tall order. It’s not for the faint-hearted, but it can be done.’

Turning Point had been delivering treatment services in Leicester since 2016, said operations manager Andrea Knowles, ‘and our partners at Dear Albert have been working with us right from the very beginning.’ Initially this had been focused around mutual aid, access and making sure that recovery was visible in the community. ‘Then the team started working with our aftercare offer and have made some amazing impact in that area. Now we’re really working across the board together – coming in right at the beginning of someone’s treatment journey.’

One of Turning Point’s core values was the belief that everyone had the potential to change and grow. ‘So everything we do as a partnership is around that person-centred focus, coming to them where they are at any one time. I’m really proud of the partnership we have in Leicester. By working together we really see the needs of our community and we’re able to build services and systems that really work for the people that we’re here to support.’

FIGHTING TO SURVIVE
Originally from Zimbabwe, Andrew Mtizwa-Mubayiwa had been teaching in the UK when addiction issues led to the collapse of his marriage. Interviewed by Hannah Mordey of the Social Interest Group, he told the conference that this was followed by him becoming street homeless for 15 years. He’d been on a spouse visa, which had been revoked following his marriage breakdown. ‘So I became illegal. I couldn’t go home and at the same time I couldn’t stay. I probably found the wrong solution for my problems – I went deeper into addiction. It was the only way for me to find solace.’

Fear of revealing his immigration status meant he was unable to access services, and it also changed the way he interacted with people, he said. He moved around – from Cardiff to Bristol, Bath and then London. ‘It was very frightening. Every day I had to survive. I met some wonderful people, but I always kept my addiction secret. I was begging, and people would ask what I needed the money for – “tell me, I can help you”. It hurt me so much that I couldn’t tell them my situation because I was illegal and wanted by immigration. I kept it secret for years and years.’

Finally, he confided in a worker at St Mungo’s. ‘I was tired. Things were so bad that I needed help.’ He was put in touch with an immigration solicitor who told him that after 20 years in the UK he’d be able to apply for leave to remain, regardless of his legal status. ‘So this meant another eight years. It wasn’t easy, but I just managed to retain that sensibility of “at least I’ve got a life”. I always tried to keep myself in a reasonable state.’

He was finally housed thanks to the ‘Everyone In’ programme for rough sleepers during COVID, which also coincided with him being granted leave to remain. ‘So Corona in a way was a blessing in disguise,’ he said. ‘It was the first time in 15 years I’d managed to sleep in a bed and have a decent bath. I used to sleep on the bus when it was cold, and one time I’d gone for six months without bathing. I got on the bus and everyone just got off. I cried.’

He’s since returned to college – where he was named student of the year – and has recently had a book of his poetry published. ‘Everybody here today will know that when you try to remake your life and you want to start again, there are barriers – and that’s when people should come together. I was going to college but I wasn’t healed. You need time to heal and do normal things, eating good food, sleeping. If you try to rush, it’s disastrous.’

Watch video footage of session one here.

DDN September 2025

DDNWeb

September 1, 2025

It takes courage to relive the worst days

Imagine being homeless, dispossessed, and afraid to ask for help. Imagine coming out of prison without the first idea of how to find an income, let alone a career. Imagine having no clue that there would be help to get back on track from all-consuming addiction. We hope that the energy from our DDN Conference will come through the pages of this month’s issue. Taking the platform takes a lot of courage if you’re talking about yourself – but especially if you’re reliving the worst days of your life. To take that experience and share it with others who might be struggling is truly inspirational. We are indebted to everyone who contributed – thank you for inspiring us.

We often receive letters from people who are far from this stage, especially those on long-term prison sentences who dread the ‘what next’ after release (p22). I hope they draw comfort – and information – from the support networks made up of people who’ve been in a similar situation that will be ready to help, guide and offer new hope for the future. Our conference delegates included staff members from drug and alcohol services, but most had lived, living – and thriving – experience, and they prove constantly that they are key to informing the therapeutic partnership.

Read the September issue as an online magazine (you can also download it as a PDF from the online magazine)

Claire Brown, editor

‘I nearly died. I wish I’d known that there is a way out’

Your story

DDNWeb

September 1, 2025

A 26-year-old man from Scunthorpe whose struggle with ketamine left him hospitalised with liver and kidney failure has shared his life-saving story for Recovery Month.

Tom Kirk was told in March 2024 that his bladder, kidneys and liver were functioning at 20% after six years of taking ketamine. Doctors warned him that he would die if he kept taking the drug.

‘My grandma was worrying about having to go to my funeral,’ Tom said. ‘I was sitting there thinking that no 25-year-old should be in hospital, unable to walk like that because of drugs.’

Having first taken the drug at Creamfields festival in 2018, Tom began to struggle during the Covid lockdowns. When he returned to work, he was spending £50 daily on ketamine – taking it before work, during breaks, at lunch, and after work. When he was made redundant, his use of ketamine increased.

‘I’d try to go to sleep but I’d get up to go to the toilet every 20 minutes,’ he said. ‘I was in excruciating pain for hours and hours, sat in the shower – before going back into my room to take more ketamine.

‘Ketamine was this escapism, it was escapism from reality. And I feel like that’s a big thing for people, especially people with poor mental health, it takes them away from the world they’re in.’

The physical toll was devastating. The tubes from his kidneys to his bladder were blocked up with an infection and inflammation – nothing could pass through. He was bed-bound for two months, with nephrostomy bags in his back to help him urinate, because ketamine had damaged and shrunk his bladder.

But Tom’s story doesn’t end there. Through charity WithYou’s support, he secured three months in rehab, and then began attending group sessions at partner organisation, Double Impact.

Today, he works for Double Impact, runs a weekly ketamine group, contributes to North Lincolnshire council’s ketamine research team, and next year will be going national with his ketamine research.

Tom’s story highlights a growing problem – ketamine cases among WithYou’s young clients rose from under 10% in 2019/20, to 23% in 2024/25. His recovery work is now about helping others like him.

‘People are struggling and they’re young people – I’m talking 16-18 year olds,’ said Tom, who wants to take his work nationwide. ‘I try and tell my story to share where I’ve been and where I’m at now. A lot of people ask me how to get help. This place is a godsend. Without this I would have been lost.

‘It took me being in hospital for a month to get help. I was screaming for help but I didn’t really want to change. I wanted help but just didn’t want to do anything for it. I wanted it to be given to me.

‘Recovery is far from easy. That’s why these groups are so good – these people have the same goals but come from completely different backgrounds.’

For Recovery Month, Tom’s message is clear: ‘I nearly died. I wish I’d known that there is a way out. If my story helps one person get help sooner, it’s worth telling.’

Taking Action on Addiction launches the Road to Recovery campaign

Partner Updates

DDNWeb

September 1, 2025

This September, to mark Recovery Month 2025, Taking Action on Addiction (TAOA), led by The Forward Trust, is launching an inspiring new campaign: the Road to Recovery.

Taking Action on Addiction launches the Road to Recovery campaign — Each brick represents the number of recovery days and carries a message of encouragement to someone still finding their way

The campaign invites people to celebrate their recovery by adding a ‘brick’ to a virtual pathway. Each brick represents the number of recovery days and carries a message of encouragement to someone still finding their way. Together, these bricks will form a symbolic road that demonstrates the power of recovery and the strength of the community behind it.

Building the path together

TAOA’s Road to Recovery is about inclusion. Recovery takes many forms, and this campaign recognises them all – whether from alcohol, drugs, gambling, mental health challenges, or other struggles. The campaign also features a recovery totaliser, showing the collective recovery time added by participants, proving that every milestone matters.

Through the TAOA campaign, we’re proud to support this campaign and encourage everyone, whether in recovery themselves, supporting a loved one, or simply standing in solidarity, to get involved.

How to take part

Visit the campaign page.
Choose your brick.
Share your recovery milestone.
(Optional) Leave a message of support and make a donation to help fund vital recovery services.

All donations raised can support people at the start of their recovery journey through the care, services, and community they need.

Join the movement

By adding your brick, you’ll be part of a growing message of hope: that recovery is possible, and no one has to walk the road alone.

This Recovery Month, help us and TAOA build a Road to Recovery – one brick, one step, one day at a time.

This blog was originally published by Forward. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Forward

Via Harrow marks over a year of sustained hep C micro-elimination

Partner Updates

DDNWeb

September 1, 2025

We’re thrilled to announce that Via Harrow has successfully sustained its hepatitis C micro-elimination status for over one year. This marks an incredible milestone, as Harrow is the first Via service to achieve and sustain this status.

A massive shoutout to everyone involved, especially to our clinical team and BBV champion, for their critical roles in this achievement. Also a special thank you to our incredible recovery practitioners, who tirelessly carry out dry blood spot tests for those beginning their treatment journey with us, working to ensure no one is left behind.

Oasis Azeez-Harris, senior public health commissioner for sexual health and substance misuse from Harrow Council, said, ‘Congratulations to the Via Harrow team for their achievement of maintaining one full year of hep C micro-elimination. I am thrilled to celebrate their remarkable achievement of hepatitis C micro-elimination for the second consecutive year. Their dedication and hard work in combatting this virus is truly commendable. This milestone is a testament to their unwavering commitment to improving public health and making a significant difference in the community. Via Harrow’s efforts do not only bring hope to many but have also set a shining example for others to follow. Keep up the fantastic work and know that your contributions are deeply appreciated. Warmest congratulations once again.’

Dr Vivienne Gosnell, clinical lead at Via Harrow, said, ‘Congratulations to all at Via Harrow for sustaining hep-C micro-elimination for over one year. It’s been a joint effort, and we are very grateful for the support centrally from our hep C co-ordinator making sure we had reliable, up-to-date data. We met regularly and shared this with our team to ensure testing opportunities wouldn’t be missed. We also worked closely with our hospital infectious diseases unit and the Hepatitis C Trust mentors to reach those not attending the service. Successful hepatitis C treatment not only prevents long-term health complications such as cirrhosis and liver cancer for those affected, but also stops transmission to others. We want to thank everyone involved for their hard work and dedication in achieving this goal.’

This blog was originally published by Via. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Via

International Overdose Awareness Day: WithYou’s street outreach takes life-saving help directly to North East Lincolnshire’s most vulnerable

Partner Updates

DDNWeb

August 31, 2025

On International Overdose Awareness Day (31 August), local charity WithYou is highlighting its innovative approach to reaching people in Grimsby struggling with drugs and alcohol: bringing support directly to food banks, homeless shelters, and the streets – anywhere vulnerable residents feel most comfortable.

International Overdose Awareness Day: WithYou’s street outreach takes life-saving help directly to North East Lincolnshire’s most vulnerable — Brian and Clare, WithYou outreach workers in Grimsby

The outreach team works alongside partners including Rock Foundation, We Are ONE Foundation, and Women’s Aid, to identify people who have gone ‘off the radar’ and connect them with help where they are.

Crucially for overdose prevention, the team offers needle syringe provision, and lifesaving naloxone training.

Staff carry naloxone – the overdose-reversal drug – and have trained food bank workers and community volunteers how to administer it, creating a network of overdose prevention across the area.

Brian, WithYou outreach worker in Grimsby, said, ‘There’s never a day we don’t go somewhere and identify someone who needs some support or advice. I’m passionate about it. It’s not just a job. Even members of the public ask us what we’re doing when they see us helping clients and by the end of the conversation, I’ve trained them to administer nasal naloxone.

‘It’s helping to remove stigma and educate the wider community on the vulnerability of some local people and the support that’s available to help.’

The outreach team often works from community hub Harbour Place, where clients can access multiple services including WithYou’s prescribers, dental care, The Hepatitis C Trust workers, stop smoking services, and a hairdresser – all under one roof.

Clare, WithYou outreach worker in Grimsby, said, ‘We can meet potential clients wherever they feel most comfortable – at their doctor’s appointment, at the food bank, or in community spaces like Harbour Place. It makes the most vulnerable in society realise that someone does actually care. That little “hello” or a cup of tea from our flask sometimes makes someone’s day.’

Sam Palmer, food bank manager at the Rock Foundation, said, ‘Having the service doing weekly drop ins in our community hub is extremely useful for our clients to engage in a relaxed setting for substance misuse support. I feel this is extremely beneficial to us and the community.

‘Our collaboration involves working closely with clients to understand their needs, expectations, and feedback. It is a mutual relationship that encourages open communication and trust, ultimately leading to better outcomes and client satisfaction. Clare and Brian are so accommodating and a pleasure to work with!’

Many clients lack phones or stable housing, making traditional appointment-based support difficult to access. The outreach model allows workers to pass messages for clients between services, and co-ordinate care for people who need multiple types of support.

At WithYou, we understand not everyone wants to or feels ready to access traditional services. We provide a person-centred approach to support people to meet their goals with compassion and respect, meeting people wherever they are in their recovery journey.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by WithYou

Sites identified for potential Edinburgh consumption room

News

DDNWeb

August 27, 2025

The two potential locations identified in the document are on Spittal Street and Cowgate, both in Edinburgh’s Old Town

A new report from the Edinburgh Integration Joint Board (EIJB) has identified two sites for a proposed drug consumption room in the city. The facility would be the first to launch in the UK since The Thistle in Glasgow opened at the beginning of this year.

The report from the EIJB – which is a partnership between the local authority, NHS Lothian and third sector and service user representatives – makes a commitment to developing a business case for consideration by the Scottish Government. The two potential locations identified in the document are on Spittal Street and Cowgate, both in Edinburgh’s Old Town. Around 10 per cent of the city’s drug-related deaths this year have resulted from public injection in the Old Town area, the report states.

The Scottish Government has said it would consider a business case as long as it was ‘informed by a public consultation’, the document says. The consultation – which is planned for early next year – would ‘attract substantial attention and raise both hopes and fears within different communities’, the report acknowledges.

Sites identified for potential Edinburgh consumption room — The proposed facility would have seven injection booths (Pictured: Glasgow’s Thistle facility)

The proposed facility would have seven injection booths, along with a post-use area for additional support. Seven-day opening is ‘considered essential’, the report states, with the opening hours to be determined ‘on the basis of lived and living experience recommendations and the available data on times of overdose in the area’. The service would be integrated with existing outreach teams, and offer additional services like wound care and sexual health.

Although the costings remain unconfirmed pending the final choice of location they are likely to be ‘substantial’, the report says, with Glasgow’s Thistle facility currently backed by £2m annual government funding. The long-delayed Thistle was finally green-lit in late 2023 after Scotland’s lord advocate clarified that it would ‘not be in the public interest’ to prosecute people for possession offences onsite.

Scotland’s drug death figures have long been the worst in Europe, with the most recent figures – for 2023 – recording 1,172 deaths. The official figures for 2024 are expected to be released soon.

WithYou in North East Lincolnshire celebrates hepatitis C micro-elimination milestone

Partner Updates

DDNWeb

August 26, 2025

WithYou’s North East Lincolnshire team recently held an event to celebrate achieving micro-elimination of hepatitis C.

Chaired by clinical lead Yvonne Ward, the event brought together key partners and stakeholders who have been instrumental in achieving this significant public health victory. Public health programme manager for North East Lincolnshire Council – which commissions WithYou to deliver the service – Sarah Lumley delivered a keynote speech thanking staff for their incredible work. She presented operations manager Fiona Wilkinson with a special recognition award, acknowledging her leadership and the team’s dedication in reaching what she described as ‘not just a public health milestone’ but also ‘a deeply human achievement’.

The event featured presentations from leading experts and partners across the hepatitis C elimination landscape:

Andy Madison from the Office for Health Improvement and Disparities
Emma Lamond, director of integrated treatment at WithYou
Frances Barrowclough from Gilead Sciences
Jason George from The Hepatitis C Trust
Layla Spauls, hepatitis C specialist nurse at Northern Lincolnshire and Goole NHS Foundation Trust
Kasey from the NHS’ Operational Delivery Network
Dr Easom, consultant in Infectious Diseases and ODN Clinical Lead, who sent a congratulatory message and celebratory refreshments to mark the occasion

Hepatitis C micro-elimination represents a rigorous standard requiring services to demonstrate:

100% of clients in structured treatment are offered a hepatitis C test
100% of those with a history of injecting have been tested
90% of current and previous injectors have had a hepatitis C test within the last 12 months
90% of clients who tested positive have completed or commenced treatment

Hepatitis C is a bloodborne virus that can cause serious liver damage, cirrhosis and cancer if left untreated. However, with early detection, more than 95% of people who receive treatment can be completely cured.

The North East Lincolnshire service’s success contributes to the World Health Organisation’s ambitious goal to eliminate hepatitis C as a major health threat by 2030.

This blog was originally published by WithYou. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by WithYou

Rob Burns – I am a…

DDNWeb

August 22, 2025

WHAT MADE YOU WANT TO WORK IN THIS FIELD?
I’ve always been passionate about supporting people, especially those going through difficult times. I’ve seen first-hand how alcohol misuse can impact individuals and families, and I wanted to be someone who could offer understanding, practical advice, and encouragement. There’s real meaning in helping someone make positive changes in their life, no matter how big or small.

WHAT DOES A TYPICAL DAY LOOK LIKE?
Every day is different, but generally I spend my time meeting with clients online, assessing their needs, and offering one-to-one support. I help them explore their relationship with alcohol, set realistic goals, and provide guidance tailored to their situation. I also signpost them to other services that might be helpful, such as the local mutual aid groups, local counselling services or support for their health and wellbeing.

WHAT DO YOU FIND MOST REWARDING?
The most rewarding part is seeing someone achieve a goal they’ve set for themselves. Whether it’s cutting down their drinking, attending a session, or even just opening up for the first time, it’s a privilege to be part of that journey. Knowing I’ve contributed in some way makes the work deeply fulfilling.

WHAT WOULD YOU LIKE TO CHANGE?
I’d love to see more awareness and funding for services like DrinkCoach, which is an incredibly valuable and under-used resource. It has the potential to be integrated much more widely, not just in substance misuse services, but also in mental health teams, GP surgeries, liver clinics, housing services, schools – and even in sport and education settings.

There’s such a high demand for support, and DrinkCoach can play a key role as a first point of contact. It’s ideal for clients who might be at a lower level of risk, or who are waiting for a full assessment – it means they can start receiving support straight away. That early intervention can make a real difference and gives clients reassurance that they’re not being left to manage alone.

At the same time, it helps take pressure off over-stretched substance misuse services, knowing that people are still getting quality support in the meantime. We also need to do more to educate the public about the realities of alcohol misuse and how services like DrinkCoach can offer confidential, professional help quickly and easily.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
Go for it. It’s not always easy, but it’s one of the most rewarding roles you can have. You need to be patient, empathetic and non-judgmental, and you really have to be able to listen. If you genuinely want to help people and be part of their progress, it’s a brilliant career path. Start by getting some experience – volunteering is a great way to get a feel for the work and see if it’s right for you.

Rob Burns is a DrinkCoach and alcohol treatment specialist, drinkcoach.org.uk
To find out if you’re eligible for a free online coaching session, and to book a private session with Rob, visit: drinkcoach.bookinglive.com

See opportunities like Rob’s on DDN Jobs

Ketamine use in the UK: insights from Phoenix Futures’ residential services

DDNWeb

August 20, 2025

As ketamine use continues to rise across the UK we have surveyed our residential staff and residents to shed light on the growing prevalence, motivations, and harms associated with ketamine use, particularly among young people. We hope this will aid the development of much-needed support for people affected by ketamine use.

The survey paints a stark picture of ketamine’s growing impact on young people in the UK. Insights from residential staff and residents themselves underscore the urgent need for targeted education, specialist treatment pathways, and non-judgmental, compassionate care to address both the physical and social harms of ketamine use.

A rising trend among young people
Our network of residential treatment services reports a steady increase in ketamine-related admissions to their residential services since 2021. In 2021, just four people cited ketamine as a problem drug; by 2025, that number had risen to 27. Notably, 63% of these individuals were under 30, with the 25-29 age group most affected.

Staff observed that ketamine use often begins in adolescence, sometimes as early as GCSE age, and is frequently linked to clubbing culture, peer pressure, and emotional coping. Many residents reported using ketamine to escape trauma, stress, or difficult emotions – often unaware of the drug’s full risks.

Polydrug use and access
While ketamine was often the primary substance of concern, many users also reported combining it with cannabis, alcohol, cocaine, and MDMA. These combinations were typically aimed at balancing effects or easing comedowns.

Residents had accessed ketamine through friends, dealers, social settings like college parties, and increasingly via online platforms such as Snapchat. Methods of use included snorting, swallowing, and smoking, with consumption occurring in homes, public spaces, and even classrooms.

Health harms
The health consequences of ketamine use reported by the survey are severe and often long-lasting. Our nurses highlighted Ketamine Bladder Syndrome (KBS), incontinence, and chronic pain as common issues. Some residents required invasive treatments such as nephrostomies and blood transfusions. Long-term damage included irreversible bladder dysfunction, kidney and liver failure, and extreme weight loss.

Residents described their symptoms such as:

Urinating blood
Constant pain
Memory loss
Fatigue and weakness
Reduced mobility and self-confidence

One resident reported the death of a friend due to ketamine-related harms.

Social harms and stigma
Beyond physical health, ketamine use has led to significant social consequences. These include:

Family breakdowns
Housing instability due to incontinence
Stigma in healthcare settings
Relationship and employment loss
Disrupted education
Experiences of violence and exploitation

Staff noted that stigma from healthcare professionals – such as dismissive or judgmental comments – can deter people from seeking help. These comments tended towards a view of the physical effects of ketamine as being self-inflicted and suggesting people, especially younger people are less worthy of treatment.

The survey paints a stark picture of ketamine’s growing impact on young people in the UK

Barriers to support and treatment
The survey identified several barriers to early intervention including:

Embarrassment and stigma around incontinence
Lack of specialist ketamine services
Poor mental health and trauma
Limited community support post-rehab

Crucially, both staff and residents perceived that residential treatment was only funded after people experienced severe physical decline.

Recommendations for change
To address these challenges the survey highlighted a number of recommendations from staff and residents including:

Early, factual education in schools
Peer-led awareness campaigns
Development of ketamine-specific harm reduction materials
Creation of dedicated ketamine support groups
Improved access to urology and pain management services

And most importantly for residential services the development of specialist treatment pathways into detox and rehab that are non-judgmental and considerate of the specific needs of young people.

Action is needed
The survey paints a stark picture of ketamine’s growing impact on young people in the UK. Insights from residential staff and residents themselves underscore the urgent need for targeted education, specialist treatment pathways, and non-judgmental compassionate care to address both the physical and social harms of ketamine use.

This blog was originally published by Phoenix Futures. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Phoenix Futures

Throwaway terms

Features

DDNWeb

August 19, 2025

What do we really mean by ‘community’ and ‘peer’? The terms might sound simple, but they can just as easily exclude as include. That’s the central message of a new paper by April Wareham, which explores how these labels shape people’s sense of identity – and the role services play in that process.

Wareham begins with the dictionary: community, she notes, can mean a group viewed collectively, or people who share something in common. But definitions like that don’t always hold up in real life – belonging is rarely that neat. People know instinctively who feels like ‘one of us’ – and who doesn’t. When services try to group people by a single characteristic, they often miss the complexity of individual lives and relationships.

She demonstrates the point with the example of Bangladeshi women experiencing domestic abuse in east London: they may be hidden not just from services, but from the wider Bangladeshi community itself. These are the kinds of distinctions that get lost when identity is applied from the outside.

‘Peer’ is no easier to pin down, she explains. The term is contextual – someone might be your peer in a hospital waiting room but not in the school playground. It’s another way of sorting people, and while it can be useful, it often oversimplifies.

Services frequently try to encourage involvement by booking a room, laying on some sandwiches, and hoping a user group will form, says Wareham. But as the late Australian advocate Jude Byrne put it, this can feel like ‘contrived spontaneity’. Sometimes no one turns up; sometimes people leave disappointed – or angry – when there aren’t enough vouchers to go around.

That’s not to say peer groups can’t work, she says. The ones that do work tend to have a clear focus from the start – a defined purpose and a clear idea of who the group is for. Southall Black Sisters is one example: a support service rooted in the experiences of Black and minoritised women affected by domestic abuse. The Hepatitis C Trust began with just four people seeking support and information. It’s now a national charity working to eliminate the virus by 2030 – but its work remains grounded in lived experience and clearly defined goals.

Wareham’s message is clear: lasting involvement isn’t about building one big structure that suits everyone. It’s about supporting smaller, purposeful projects that speak directly to the people they’re for – and giving them the space to grow.

Read the full paper and join the conversation at workingwitheveryone.org.uk

SIG Penrose Roots recognised for its environmental and social impact

Partner Updates

DDNWeb

August 18, 2025

We’re thrilled to share that the Roots to Recovery Garden at SIG Penrose Roots has been awarded a Highly Commended honour in the Grassroots and Green Shoots category at the CPRE Bedfordshire Living Countryside Awards 2025.

Since 2008, the Living Countryside Awards have celebrated exceptional contributions to Bedfordshire’s communities and natural spaces. This year’s Grassroots and Green Shoots category highlights initiatives that support both people and the planet – and our garden truly shone.

Judges visited our vibrant one-acre site in Luton and were moved by the scale of the project, the passion of our team, and the transformative impact it has on members and the wider community. From therapeutic horticulture to peer-led recovery, Roots to Recovery continues to grow as a space of healing, connection, and hope.

Learn more about this project: socialinterestgroup.org.uk/roots

This blog was originally published by Social Interest Group. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Social Interest Group

Cranstoun launches first charity run at Worcester Racecourse

Partner Updates

DDNWeb

August 18, 2025

A new charity event will see Worcester runners lace up their trainers for a run with purpose, raising funds for a social justice charity.

Cranathon Cranstoun charity run — Adult runners can choose to take on a 5K or 10K distance, while younger athletes can take part in a 2.5K kids’ race

Cranstoun will hold its first-ever Cranathon running event on Sunday 26th October 2025 at Worcester Racecourse. Open to all ages and abilities, the Cranathon will raise vital funds for Cranstoun, a charity which supports people with lived experience of social justice issues.

In Worcestershire, Cranstoun provides support to people with experience of domestic abuse, homelessness and the criminal justice system, individuals who use alcohol and drugs, and young people impacted by substance use and other social challenges.

Jessica Brown, head of fundraising at Cranstoun, said, ‘The Cranathon is more than just a race: it’s a chance to support someone experiencing life’s challenges, giving them the opportunity to recover and rebuild. By taking part and putting one foot forward, you’ll help us give a leg up to people experiencing some of the hardest challenges life can bring.’

Adult runners can choose to take on a 5K or 10K distance, while younger athletes can take part in a 2.5K kids’ race.

There will be music to motivate participants to reach the finish line, where they’ll receive an exclusive Cranathon finishers’ medal and will be able to track their performance with chip timing. Participants who commit to fundraising for Cranstoun will receive a £5 discount on their entry fee, and the event promises a feel-good day for families, friends and fitness enthusiasts alike.

Matt Barnes, youth support, engagement and recovery worker in Worcestershire, said, ‘The Cranathon came about after we raised £2,000 during an endurance challenge. We wanted to ramp it up to help even more people supported by Cranstoun and spread awareness of our services across Worcestershire.

‘Whether you know it or not, someone close to you is likely to be affected by one of the areas we work in. Supporting people during tough times can be challenging, so it’s great to channel our energy into a fun, active and positive event with the whole community. Come and get involved!’

Alex Fotheringham, volunteer coordinator and service user involvement lead in Worcestershire, added, ‘After the endurance walk in January, I discovered a passion for fundraising to go with my admiration for our community across Worcestershire. Through the Cranathon, we’re increasing awareness of Cranstoun’s vital work and raising money for people who are determined to improve their lives.

‘I’d love to see the Cranathon become an annual event that brings everyone together, no matter their circumstances, to get active, have fun and support people in their community.’

To sign up for the Cranathon, visit: cranstoun.org/cranathon

This blog was originally published by Cranstoun. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Cranstoun

Time for a chat

Features

DDNWeb

August 18, 2025

The drug market in the UK is evolving rapidly, and not in a good way. Substances are more widely available, more unpredictable and more dangerous than ever before – everything from synthetic opioids and cannabinoids to contaminated ketamine and stimulants. This has meant that people who use drugs are forced to navigate a landscape full of unknowns, and in many cases they’re doing so without reliable information.

In drug and alcohol services, we regularly see the barriers that prevent people from accessing support. For many, it’s not as simple as walking into a service and asking for help. Stigma and shame are powerful deterrents, and so is the fear of being judged and criminalised.

That’s where the idea for Drugbot came from. Drugbot is a free, confidential AI chatbot that can help to answer questions about drugs and respond to simple or more complex queries with accurate harm reduction advice. It’s the result of a partnership between Cranstoun and Substancy, which comes from our shared values and belief that people should have access to information to help them make safer choices in an increasingly dangerous world.

We know that not everybody is ready, able or willing to stop using drugs – while that may be the safest option, it isn’t the reality for many people. Drugbot can help to reduce some of those harms and risky behaviours with harm reduction advice in the meantime.

The bot can offer guidance on dosage, aftercare, mixing risks and signs of overdose, and it can also provide advice on how to look out for other people who might be using drugs. It draws on a rich database of accurate information and sources – including from peer-led organisations and other experts – curated by the Substancy team.

Every record has been rigorously reviewed and approved by a team of experts in drug treatment, harm reduction and health services. In its development stages, Drugbot answered more than 20,000 real questions, helping people to stay safer and make better decisions. But we know that this tool could be a real lifeline for people who are unlikely to access traditional drug treatment services.

We’ve embedded crucial safety features into Drugbot – these include measures that ensure that the bot won’t provide any information which could lead to or encourage illegal activity. Where questions around riskier drug taking are identified, the bot helps to suggest reflection on that risk without judgment or lecturing while promoting safe, harm reduction practices. This balance is crucial to the success of Drugbot.

Reducing and breaking down that barrier of the fear of being judged or seen has also been important. People can ask questions privately, whenever they need to, with no one watching and no assumptions made. It’s a way of giving people space and agency, which can often help when it comes to accessing further support.

Cranstoun Drugbot — The bot can offer guidance on dosage, aftercare, mixing risks and signs of overdose

To be clear, Drugbot is not about replacing human-led care and support. It is designed to be a complement to – not a substitute for – face-to-face drug and alcohol services. In fact, the chat bot is designed to encourage people to seek further help from drug treatment services where appropriate. Our goal is to ease that first step and ensure that drug services aren’t left behind by a world that increasingly communicates through screens.

We also know that Drugbot must keep improving. Feedback from people who use the tool will shape its development, and as new substances and threats emerge, Drugbot will be able to provide advice to meet those needs.

This is the future of harm reduction – smart, responsive tools that work alongside human compassion to reduce risk and save lives. If even one person reconsiders a decision, avoids a dangerous mixture of substances and activity, or reaches out for help because of Drugbot, then it’s doing its job. We believe it will do more than that – we’re optimistic that it will change the way that people access support and reduce the harms caused by drugs at scale.

Everyone deserves access to accurate, non-judgemental information free of stigma, Drugbot is helping to deliver that.

Meg Jones is director of new business and services at Cranstoun
Mark Tudor is strategic partnerships and delivery excellence at Substancy

Drugbot is now available in the UK for anyone aged 18 and over: drugbot.cranstoun.org

Funding uncertainty sees NHS tobacco services cut

News

DDN

August 15, 2025

Hospitals are starting to decommission their stop smoking services as a result of budget uncertainty, according to new data published by ASH. Services have already been decommissioned in six acute and two mental health trusts across three integrated care boards (ICBs) – the organisations responsible for planning local health services – the charity states.

Hazel Cheeseman: ‘We risk turning a public health success story into a missed opportunity.’

The NHS has been rolling out dedicated stop smoking support for hospital patients and pregnant women since 2019, supporting more than 160,000 people in the last year alone and delivering ‘significant’ results, says ASH. However, the survey – conducted in partnership with Cancer Research UK – shows cuts ‘abandoning’ vulnerable patients, the charity warns. More than 80 per cent of these ‘vital, lifesaving’ programmes are now facing uncertain futures as a result of budget uncertainty, it adds.

Representatives from a range of medical organisations including the royal colleges of physicians, psychiatrists and nursing as well as the BMA have written in the BMJ that dismantling the services will reverse ‘hard-won’ progress and derail the government’s ambition to shift the NHS to a prevention model. The recent ten-year NHS plan (https://www.drinkanddrugsnews.com/campaigners-criticise-nhs-plans-lack-of-focus-on-alcohol/) included a commitment to embed opt-out stop smoking interventions into all hospital care in England.

Losing stop smoking services will result in ‘tens of thousands of vulnerable patients being abandoned to a deadly addiction’, says the BMJ

‘If these services are lost, it will set the NHS prevention agenda back five years and result in tens of thousands of vulnerable patients being abandoned to a deadly addiction,’ the BMJ article states. ASH is calling on the government to ensure protected, long-term funding for NHS tobacco dependence services, as well as ‘clear accountability’ to make sure ICBs deliver them.

The most recent ONS figures showed that the proportion of current smokers had fallen to its lowest level, at around 12 per cent of the adult population (https://www.drinkanddrugsnews.com/proportion-of-current-smokers-falls-to-lowest-ever-level/) – down from more than 80 per cent of men and 40 per cent of women when the NHS was launched in 1948. However, smoking is still estimated to cost the NHS around £1.8bn a year, with the health harms increasingly concentrated in the most disadvantaged populations. The government’s tobacco and vapes bill aims to create a ‘smokefree generation’ by phasing out the legal sale of tobacco products to anyone currently aged 15 or younger (https://www.drinkanddrugsnews.com/tobacco-and-vapes-bill-introduced-to-parliament/).

‘Tobacco treatment in the NHS is one of the rare interventions that saves lives, cuts costs, and reduces inequalities – yet it’s under threat just at the point when the NHS wants to “shift to prevention”,’ said ASH chief executive Hazel Cheeseman. ‘We’ve made real progress, but without sustained funding and leadership we risk turning a public health success story into a missed opportunity. Strategic sanity demands we protect what works.’

Survey at https://ash.org.uk/resources/view/at-risk-tobacco-dependence-treatment-in-the-nhs-findings-from-a-survey-of-integrated-care-boards-in-england

BMJ article at https://www.bmj.com/content/390/bmj.r1730

PHS issues new nitazenes alert

News

DDN

August 13, 2025

A new nitazenes alert has been issued by Public Health Scotland’s Rapid Action Drug Alerts and Response (RADAR) early warning system. Aimed at people working and volunteering in drug services, emergency services, healthcare settings and ‘high-risk’ environments like hostels and prisons, the alert urges people to follow the correct harm reduction advice for opioids and polydrug use, and to ‘promote and provide’ naloxone.

Nitazenes are increasingly found in post-mortem toxicology samples

Nitazenes are now being widely detected in all parts of Scotland in both community and custodial settings, the alert stresses, posing a ‘substantial risk of overdose, hospitalisation and death’. They were present in 6 per cent of all post-mortem toxicology samples testing positive for a controlled drug in the first quarter of this year, it states, as well as 4 per cent of emergency department samples taken as part of the PHS ASSIST project between February and May.

The WEDINOS drug testing service has also detected nitazenes in more than 50 samples from ten Scottish NHS boards since 2022, it adds. While almost 60 per cent were in samples purchased as heroin, more than 20 per cent were purchased as oxycodone and 17 per cent were bought as benzodiazepines, usually diazepam. While the signs and response actions for nitazenes are the same as any other opioid overdose, their increased strength means the overdose ‘may be more sudden and severe’, the alert points out, adding that Scotland’s drug supply is ‘increasingly toxic and unpredictable’. PHS warned earlier this year of an increase in ‘sudden and rapid collapse overdoses’ requiring multiple doses of naloxone to reverse, with a ‘nitazene-type opioid’ linked to many (https://www.drinkanddrugsnews.com/public-health-scotland-issues-warning-after-increase-in-sudden-overdoses/).

NHS Ayrshire & Arran became the latest Scottish health board to issue its own nitazene warning earlier this month (https://www.drinkanddrugsnews.com/nhs-ayrshire-arran-issues-nitazene-warning/), while the most recent RADAR quarterly report warned that suspected Scottish drug deaths in the period March to May were up 15 per cent on the previous quarter and naloxone administration incidents had increased by 45 per cent (https://www.drinkanddrugsnews.com/drug-related-harms-on-the-increase-across-scotland-warns-phs/). The most recent Scottish drug death figures showed a total of 1,172 fatalities in 2023, four times the total in 2000 and by far the highest death rate in Europe.

Rapid Action Drug Alerts and Response (RADAR) alert: nitazenes at https://publichealthscotland.scot/publications/rapid-action-drug-alerts-and-response-radar-alert-nitazenes/rapid-action-drug-alerts-and-response-radar-alert-nitazenes-version-20/public-health-alert-for-action-nitazene-type-drugs-in-scotland/

Adfam and Collective Voice launch new families group

News

DDN

August 8, 2025

The launch of a new group to improve support for families and affected others has been announced by Adfam and Collective Voice. The Collective Voice Affected Others Group will bring together family support organisations and people with lived experience to ‘work together to improve support for affected others’, the organisations state.

The new group aims to ‘connect, share, and influence change’.

Despite the critical role that family support groups play in improving people’s wellbeing, equipping them with the tools to make sense of their situation and connecting them with others going through similar experiences, provision of family support services remains inconsistent across the country, the organisations stress. Collective action is therefore ‘vital to raise awareness, influence policy and ensure families receive the support they need and deserve’.

It’s estimated that around 5m people in the UK are negatively affected by someone else’s drinking or drug use. An FOI request submitted by Adfam in 2024 revealed that while spending on residential rehab, needle exchange provision and substitute prescribing were all routinely accounted for, less than half of local authorities were able to provide any data on funding for family and carer support. Among those that did report allocating funding, the figures were ‘alarming’, said Adfam, with some allocating just 0.1 per or 0.2 per cent of their substance misuse budgets and the national average sitting just above 1.5 per cent (https://www.drinkanddrugsnews.com/counted-out/).

The new group is an extension of the Alliance of Family Support Organisations, which Adfam set up three years ago. It will function as a ‘space for professionals, volunteers, and experts by experience to connect, share, and influence change’, and is open to anyone – professional or voluntary – who has a role supporting families, friends or children affected by someone’s substance use, as well as family members who want to help improve services and policies.

The aim is for the group to meet quarterly by Zoom to help influence national and local decision making, grow the family support sector by building knowledge and identifying gaps, and support wider advocacy and campaigning. It will also help to make sure best practice is shared as extensively as possible, and create a direct channel for Collective Voice, Adfam – which celebrated its 40th anniversary last year (https://www.drinkanddrugsnews.com/adfam-celebrating-40-years/) – and other member organisations to hear directly from frontline workers and families themselves. ‘If this speaks to you, we’d love you to join us,’ the organisations state.

Anyone interested can get touch at admin@collectivevoice.org.uk

Pic credit: Oleksiy Makhalov

‘Urgent’ strategy needed to address alcohol harm, campaigners warn

News

DDN

August 7, 2025

An open letter to health secretary Wes Streeting is calling for an ‘urgent and ambitious’ strategy to address rising levels of alcohol harm. The call follows what was widely seen as the watering down of alcohol policies in the new ten-year NHS plan for England (https://www.drinkanddrugsnews.com/campaigners-criticise-nhs-plans-lack-of-focus-on-alcohol/).

The letter calls for Wes Streeting to address the growing alcohol crisis with an ‘urgent and ambitious’ strategy

Signatories to the letter, which stresses the need for a ‘preventative and evidence-led approach’, include the royal colleges of physicians, general practitioners, surgeons and emergency medicine, alongside the BMA, Alcohol Change UK, the Alcohol Health Alliance, Change Grow Live, Waythrough and With You. Alcohol-related deaths and hospital admissions are continuing to rise, the letter states, while key alcohol policies – such as plans to tighten advertising regulations – were reportedly ‘removed’ from the final version of the ten-year plan.

Thirty per cent of UK adults are drinking at risky levels, says the letter, with almost one in 25 new cancers estimated to be alcohol-linked. The impact falls disproportionately on the most deprived communities, it adds, with death rates in the North East of England now overtaking those of Scotland in a ‘stark sign of the growing crisis’. The most recent ONS figure for alcohol-specific deaths in the UK was almost 10,500, the highest number on record and almost 40 per cent up on the total for 2019 (https://www.drinkanddrugsnews.com/alcohol-specific-deaths-hit-highest-ever-level/).

While the letter welcomes some of the policies included in the ten-year plan, they are not sufficient to address the ‘scale and complexity’ of alcohol harm, it warns. Among the measures the signatories want to see implemented are stronger marketing restrictions, the introduction of MUP and the reinstatement of the alcohol duty escalator for ‘fairer taxation’. These should go alongside improved NHS support, it says – including ‘resourcing alcohol care teams and integrated services’.

The ten-year plan offered a ‘once-in-a-generation opportunity to shift gear and deliver genuine preventative action that would reverse the rising rates of alcohol-related hospitalisations and deaths we have seen in recent years’, the letter states. ‘While the introduction of mandatory alcohol labelling and increased support for community led schemes is welcome, these measures alone are not sufficient to address the scale and complexity of harm. The public want and deserve action, and we stand ready to work with government to deliver real progress. By taking meaningful and coordinated action now, the burden of alcohol harm can fall significantly within the term of this government, with visible results for families, the NHS, crime, and the economy.’

Open letter at https://ahauk.org/news/health-experts-warn-alcohol-measures-are-not-sufficient-to-stop-harm/

Lord Timpson visits ISC Pilot in Bristol

Partner Updates

DDN

August 6, 2025

Prisons minister Lord Timpson met with a client supported by Turning Point services in Bristol as part of his review into the pilot of a new criminal justice intervention programme called Intensive Supervision Courts (ISCs).

Lord Timpson spoke to 28-year-old Kane Lawrenson, who is currently on a recovery programme at Turning Point’s Horizons: Bristol’s Drug & Alcohol Partnership.

Working with Turning Point to tackle his drug use was one of the conditions of his sentence to a two-year ISC. He is required to regularly meet with the judge alongside his probation officer and substance use recovery worker.

In an interview with the BBC, Lawrenson said that he was ‘feeling the most positive I have for years’. The judge noted that Lawrenson’s progress has been ‘incredibly impressive’.

‘I’m really excited for the future, to be honest,’ said Lawrence.

‘Now I’m waking up thinking, right, let’s have me a protein shake. Let’s have me a bowl of oats. ‘What gym am I going to?’

‘Every day I can go to sleep and think, ‘you’ve actually made something productive out of the day’.’

Lord Timpson told the BBC that these intensive programmes were ‘often tougher than going to prison’.

He added: ‘They’re having to work every day to prove that they’re not taking drugs, they’re not drinking, and they are going through all the courses that we’re putting them through.’

ISCs are designed to reduce reoffending by supporting individuals with a range of different needs depending on their circumstances.

The individuals in the scheme are typically those who are at high risk of reoffending, have not complied with standard probation or have needs around things like substance use and mental health.

Those under an ISC order are given tailored rehabilitation plans that provide support from multi-agency teams including drug and alcohol workers, housing providers, mental health support workers among others.

Together with a judge and the person under order, a plan is made a periodically reviewed to check in on the persons progress and to unlock any barriers.

This approach provides a high level of support with a focus on long term rehabilitation for offenders with the aim of keeping people out of prison and reducing the effects of crime on society.

Since starting in April, the Ministry of Justice says there is ‘clear evidence that the model is working’.

Justin Hoggans, Senior Operations Manager at Horizons – Bristol’s Drug & Alcohol Partnership said: ‘This ISC pilot offers a holistic and collaborative approach to supporting people engaged with probation. We’ve seen this approach make a real difference for the people we support through the scheme and our workers in the criminal justice team at Horizons have found it to be an overwhelmingly constructive intervention that offers people a bit of hope.’

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Turning Point

Community Drug and Alcohol Recovery Services

DDN

August 5, 2025

CDARS aims to improve the mental health, well-being and recovery capital of individuals experiencing mental health issues, substance and alcohol misuse and neurodiversity.

Recognising a crucial support gap in Neurodiversity, our mission is to empower each service user to discover their unique needs, and leverage them strengths, and foster resilience, enabling them to thrive and flourish.

CDARS is offering a new training package:

‘Working Effectively with Neurodiverse Individuals with Substance and Alcohol Misuse Needs’

This practical workshop explores Autism and ADHD in the context of substance use, offering tools to adapt assessments, improve communication, and create neuro-inclusive environments.

Designed for professionals across addiction, mental health, education, and criminal justice, the session includes real-world case studies and interactive learning, available as a half-day or full-day, online or in-person.

For pricing, availability, and group bookings, contact:

Email: Info@cdars.org.uk Telephone: 07947526781

www.cdars.org.uk

Prison system came ‘close to collapse’ on three occasions

News

DDN

August 5, 2025

Overcrowding saw the prison system come close to collapse on three separate occasions, according to a new review by former chief inspector of prisons Dame Ann Owers.

At one point there were fewer than 100 spaces available in adult male prisons, says the Independent review of prison capacity.

‘From 2023 onwards, prisons were running very close to the edge of capacity,’ the document states. ‘On three occasions, this was only pulled back at the last minute’ – by the use of early release schemes and powers to allow release on compassionate grounds. Senior officials were so concerned about a ‘potential breakdown in the criminal justice system’ that an audit was kept of all decision-making and documents in case there was a public or parliamentary inquiry, the review adds. The system then ‘limped through the summer of 2024, helped by the knowledge that relief was coming’ in the shape of the new government’s pledge to reduce the custodial element of most standard determinate sentences to 40 per cent.

The system was once again ‘in sight of another capacity crisis’ when the new government commissioned its independent review of sentencing by former justice secretary David Gauke, it continues. Gauke’s review then recommended a shift away from sentences of less than 12 months, saying they should only be used in ‘exceptional circumstances’ (https://www.drinkanddrugsnews.com/gauke-review-signals-shift-away-from-short-prison-sentences/).

Dame Anne Owers: Capacity crisis is ‘seriously hampering’ prisons’ ability ‘to operate safe, positive and purposeful environments’.

Although particularly acute in the last few years, the country’s prison capacity crisis is a symptom of a ‘systemic and long-running problem’, the document says – ‘the apparently irresistible pressure for more and longer prison sentences coming up against the immovable object of the difficulty, expense and overall effectiveness of building and running more prisons.’ From time to time that pressure ‘erupts into a crisis that requires executive action – sometimes unnoticed and sometimes public’, it adds.

The 2022-24 capacity crisis, however, was ‘probably the deepest and longest’ and was ‘described by many of those who lived through it as an 18-month “permacrisis”’ – affecting the prison service at every level as well as much of the wider the criminal justice system. It is also ‘far from over’, the review adds. Among the document’s recommendations are a ten-year strategy for developing capacity within probation and community services, as well as the establishment of an independent advisory body to provide ‘advice and external validation’.

The crisis is also seriously hampering prisons’ ability to ‘operate safe, positive and purposeful environments’ that help to reduce the likelihood of reoffending, the review warns. In surveys carried out last year two thirds of prisoners said they had little to occupy them and were spending most of their time in their cells, with the link between inactivity and the availability and use of drugs frequently raised by HM Inspectorate of Prisons, prison governors, independent monitoring boards and others. ‘While too many prisoners may be inactive, the organised crime groups that look for (literally) captive markets for their illicit drugs are, conversely, extremely active,’ the review states. ‘In one local prison visited, the prevalence of spice and opioids meant frequent emergency calls (code blues) to healthcare staff,’ who had had to administer naloxone to 50 men in a single week. Widespread availability of drugs also inevitably leads to accumulation of debts and consequent violence, the report warns.

Pia Sinha: This report ‘lays bare the systemic failures’ and highlights the urgent need for long-term strategic planning.

A damning report from HM Inspectorate of Prisons last month stated that drugs were now undermining every aspect of prison life – with assaults on staff rising by 13 per cent in the space of a year – and called on the government to ‘take far more seriously the widespread ingress of illegal drugs into prisons’ (https://www.drinkanddrugsnews.com/drugs-undermining-every-aspect-of-prison-life-say-inspectors/). A separate report earlier this year from the Prison Reform Trust revealed that less than half of people leaving prison in 2023-24 had settled accommodation on their release, with 13 per cent finding themselves either homeless or sleeping rough (https://www.drinkanddrugsnews.com/less-than-half-of-prison-leavers-have-settled-accommodation/).

‘This welcome report from Dame Anne Owers doesn’t pull any punches,’ said Prison Reform Trust chief executive Pia Sinha. ‘It lays bare the systemic failures behind repeated prison capacity crises, with devastating consequences for victims, prisoners, staff, and the wider justice system. It highlights the urgent need to shift from reactive crisis management to long-term, strategic planning that prioritises rehabilitation and effective community-based alternatives. Yet even if these measures succeed, prisons will remain under severe pressure in the short term as the population continues to rise. Repairing the damage of recent decades will require sustained focus, investment, and political will to rebuild prison and probation services so they can operate safely and effectively.’

Independent prison capacity review: final report at https://www.gov.uk/government/publications/independent-prison-capacity-review-final-report

Ruby reflections

Features

DDNWeb

August 5, 2025

Over the last 40 years, The Nelson Trust has supported thousands to achieve long-term recovery. Each year, it provides holistic, trauma-informed and gender-specific support to more than 5,000 individuals through its recovery services and women’s community centres.

Its residential rehabilitation services were founded in 1985 near Stroud, Gloucestershire, and now comprise four gender-responsive treatment centres for abstinence-based recovery. Over the years the trust has pioneered new approaches including its work with women, families and working with multiple unmet needs.

In 2004, Dr Stephanie Covington, a leading pioneer in addiction, trauma and recovery, opened The Nelson Trust’s women-only house, one of the first women-only treatment centres in the UK.

Ruby reflections — Preparing food for Wellbeing Day at Bristol Women’s Centre

A NEW MODEL OF CARE
In 2021 the trust – in collaboration with Dr David Best and in co-production with clients – introduced a new model of care, merging a recovery capital and trauma-informed approach. A new four-stage programme was co-created, with expertise from current clients and alumni.

‘The COVID-19 pandemic offered us an unexpected opportunity to continue to innovate,’ said director of recovery, Kirsty Day. ‘Driven by our clients’ voices, we joined together to evolve our service delivery model to ensure that our offer is truly holistic. Under The Nelson Trust umbrella, from day one of abstinence through to long-term recovery – including employment opportunities – we provide support to ensure that recovery is achievable, and sustainable.’

The trust also has three move-on recovery houses and alongside this five community projects as part of its hub enterprises, including the Hub Academy, The Sober Parrot and The Clean Plate cafes, offering accredited training, peer-led initiatives and pathways to employment, alongside regular recovery social events.

‘We’ve learned that having a job and learning new skills can make a real difference in someone’s recovery journey,’ said Hub Academy lead Beanie Cooke. ‘Our Hub Enterprises create opportunities for people to gain hands-on experience and build confidence and skills, whether that’s through catering or other practical work. Volunteering is also a crucial part of this pathway, especially for those who are not yet employment ready. The aim is to create real opportunities for moving forward and helping that person take their next step.’

GENDER-RESPONSIVE RECOVERY
After years of paving the way for gender-responsive recovery support throughout the UK, with recognition from the Ministry of Justice, The Howard League for Penal Reform, and King’s College London, the trust developed services for women in the community, opening its first women’s centre in Gloucester in 2010. The focus was on providing holistic care to women leaving prison or in the community on probation orders as an alternative to custody.

As The Nelson Trust celebrates its 40th anniversary, Eleanor Telfer looks back at how the organisation has been providing specialist support to some of society’s most vulnerable people Fast forward to 2025 and the trust now runs nine women’s centres across South West England and Wales. The centres work with women facing multiple unmet needs – substance use, trauma, violence and abuse, mental ill-health, housing instability, poverty, parental challenges and criminal justice involvement. Support is trauma-informed, gender-responsive and rooted in what works – a trusted therapeutic relationship, one-to-one sessions, group work, treatment interventions, counselling, therapies, peer support, and strong multi-agency working including co-location to provide a true ‘one-stop-shop’.

Their range of services include SWOP (Sex Work Outreach Project) police custody diversion (SHE – support, help, engage) Family Focus (family support and therapies) and specialist women’s treatment pathways.

‘What makes our women’s community service truly special is that it’s built around what women really need,’ said CEO Christina Line. ‘Our “one-stop-shop” centres provide a safe space where a woman can access the support she needs, with whatever she needs. With an onsite crèche and co-location of partner agencies, we reduce the frequency of women having to access multiple sites. We have teamed up with partners such as Turning Point and Via to combine our expertise to deliver specialist women’s community treatment.’

As part of its women’s centres and recovery services, The Nelson Trust works closely with multiple agencies to ensure clients can access a wide range of specialist support available in their communities.

A client from the Family Support Model programme, delivered in partnership with Via, said: ‘I feel more confident – having the support has really helped me. I love my daughter and I’m seeing my other children a lot more, and my recovery is going really well. I’ve been clean for over a year now – all I think about is the future and I can’t wait to watch my children grow up.’

EXPONENTIAL GROWTH
At the heart of The Nelson Trust’s work are the men and women it’s worked with over the last 40 years, whose experiences have driven the exponential growth and reach of their services.

After completing treatment at one of the residential houses and now volunteering at her local women’s centre, one woman shared that her experience of The Nelson Trust is ‘that it’s magic. The staff that work here, they’re just beautiful… and they show you there’s a new way of life out there for you. And today it makes me really emotional because I have so much hope and faith about the future. I’m able to do some volunteer work, so I’m giving back.’

Another woman spoke about the difference art psychotherapy made after years of isolation linked to trauma: ‘Art psychotherapy group became such a safe place where you knew it didn’t matter if you’re having a good day, a bad day, or just full of emotion. The group was safe so you could release it, and you knew it was left in that room – it was locked there, and you walked away, and no one judged you for it. And it just gives you confidence again that you’re a person.’

Eleanor Telfer is marketing and communications lead at the Nelson Trust

The Nelson Trust was established in 1985 in Brimscombe, near Stroud. The charity offers an abstinence-based, residential rehabilitation programme including therapeutic support and practical help with housing, education, training and employment.

The Nelson Trust opened a women-only residential service in 2004 to help women with multiple needs and established its award-winning Women’s Centre in Gloucester city centre in 2010. It now operates eight more women’s centres in Swindon, Bridgwater, Bristol, HMP Eastwood Park, Cardiff, Swansea, Newport and the Dyfed Powys area.

The centres are for women who experience multiple vulnerabilities and may be at risk of offending and provide immediate access to support and guidance on a variety of issues including family and relationships, housing, substance misuse, domestic violence, health, debt, employment and training. To find out more about The Nelson Trust visit nelsontrust.com

This article uses quotes from 40 Stories for 40 Years, a new series launched as The Nelson Trust marks its 40th anniversary – sharing voices from past and present clients and staff.

As well as hosting fundraising events throughout the year, the trust is organising a 40-year reunion for graduates of The Nelson Trust: nelsontrust.com/events/graduate-reunion

NHS Ayrshire & Arran issues nitazene warning

News

DDN

August 4, 2025

NHS Ayrshire & Arran is the latest Scottish health board to issue a warning about potent synthetic opioids in the drug supply. The board’s public health department was working closely with partner organisations to ‘address growing concerns about the rise in drug deaths and near-fatal overdoses among people using street drugs’, it said.

Sally Amor urged people to be ‘extremely cautious’ as there was ‘no reliable way to know’ which drugs may be contaminated.

Nitazenes had not only been found in the heroin supply but also in ‘the wider drug market’, including benzodiazepines and counterfeit painkillers, the board stated, adding that it was working closely with alcohol and drug partnerships, peer recovery communities, the police, ambulance services and hospital emergency departments to monitor the situation and reduce harm.

‘Many of the harms we’re seeing involve the use of multiple drugs at once, which increases the risks significantly,’ said consultant in public health Sally Amor. ‘We urge everyone who uses drugs to be extremely cautious. There’s no reliable way to know what substances might be contaminated or how different drugs might interact. Having someone nearby who can help in an emergency is a vital harm reduction step, but it’s important to remember that there is no completely safe way to use these substances.’

Last month the most recent Rapid Action Drug Alerts and Response (RADAR) report from Public Health Scotland warned that suspected drug deaths across the country were up 15 per cent on the previous quarter, while Scottish Ambulance Service naloxone administration incidents had increased by 45 per cent – to an average of 84 per week (https://www.drinkanddrugsnews.com/drug-related-harms-on-the-increase-across-scotland-warns-phs/). Naloxone administration incidents in NHS Ayrshire and Arran had risen by 48 per cent, the report stated, although other board areas had recorded increases of up to 124 per cent. The majority of drug-related harm continued to involve more than one substance, it said, with the average number of controlled drugs detected per sample standing at six in hospital settings and four in post-mortem toxicology.

Public Health Isle of Man has also issued a warning about a suspected batch of ‘contaminated or high potency’ cocaine on the island, after a recent spike in hospital admissions. Anyone seeking medical treatment should ‘be honest’ with hospital staff about what had been taken, it urged.

Why self-employment support matters for people with complex barriers

Partner Updates

DDNWeb

August 1, 2025

Self-employment can be a powerful path to independence, dignity, and economic empowerment, writes Tevfick Souleiman. But for individuals facing multiple and complex barriers, the journey into self-employment is far from straightforward. Without targeted support, their entrepreneurial potential may remain untapped.

For many people, the traditional route into employment is paved with relatively few obstacles. But for others, those facing multiple, complex barriers, this path can feel more like a maze with no exit.

In this reflective blog, I explore why self-employment support tailored to those with complex barriers is not just important, it’s essential for inclusive economic growth, where the benefits of economic expansion are shared by all segments of society, and that opportunities are available to everyone, particularly those who are most disadvantaged. These reflections are formed from both my own lived experience of entrepreneurship and the criminal justice system.

I have also reflected from my role as head of enterprise at Forward over the last five years and, in particular, our recent Dragons’ Den style events funded through our City Bridge Foundation project and our Brent Residents project, funded through the Brent Community Grants Team. These events provided an opportunity for 10 service users to present their business idea and to receive valuable feedback from professionals and potential investors. The winners received some funding and a package of intensive, targeted support from our service.

Breaking down the barriers
For many, the dream of starting a business can feel out of reach. Some of the most common barriers include:

Limited access to capital: Traditional financial institutions often view individuals with poor credit histories or unstable income as high-risk borrowers.
Lack of formal qualifications: Many aspiring entrepreneurs may not have the formal education or credentials often seen as prerequisites for business success.
Mental health and wellbeing issues: These can severely impact confidence, motivation, and the ability to engage with mainstream business support.
Social stigma and marginalisation: Individuals with criminal records, long-term unemployment, or homelessness often face judgment or exclusion from conventional business networks.
Digital exclusion: In a digital-first economy, lack of access to technology or digital literacy can shut people out from online business opportunities.

Self-employment can be a powerful path to independence, dignity, and economic empowerment — Even the process of starting a business, registering with HMRC, opening a bank account, writing a business plan, can feel insurmountable without help

Even the process of starting a business, registering with HMRC, opening a bank account, writing a business plan, can feel insurmountable without help and it’s important to note that these barriers don’t exist in isolation – they overlap, making entry into self-employment particularly challenging.

Why self-employment support matters
As of June 2025, in the UK, there are just over 4.2 million self-employed people, which represents approximately 13% of the total workforce. This is quite a large section of the UK working population. Self-employment support isn’t just about providing advice on business plans and tax forms. For people with complex barriers, it must be holistic, trauma-informed, and flexible. Here’s why it’s vital:

Empowerment through ownership: Self-employment allows individuals to take control of their time, income, and career path. For someone who has been disempowered by authorities or circumstance, this can be transformative.
Flexibility for individual needs: Many people with physical or mental health conditions need flexibility that traditional employment cannot offer. Self-employment can provide that flexibility, allowing people to work around their health or caring responsibilities.
Building confidence and resilience: Tailored support, especially when delivered by trusted, community-based organisations, can help individuals build confidence, reduce social isolation, and foster resilience.
Creating inclusive economic growth: Supporting underrepresented entrepreneurs contributes to a more diverse and resilient economy. It ensures that innovation and productivity are not limited to those with privilege or access.
Reducing long-term dependence on services: Effective self-employment support can help people move away from long-term reliance on welfare, housing, and health services, reducing strain on public resources.

What effective support looks like
At Forward, we have been providing enterprise support since 2019 and have supported over 700 people from disadvantaged backgrounds with their entrepreneurial journey. From a very early stage, we swiftly identified that supporting people with complex needs into self-employment isn’t a one-size-fits-all process. Further, we also recognised the importance of developing our service users’ behaviours; 94% of Forward Enterprise clients presented with improved behaviours.

We have supported over 700 people from disadvantaged backgrounds with their entrepreneurial journey

Through our experience and expert knowledge, we subsequently created the Forward Enterprise Bootcamp programme designed to take these challenges into account and to offer effective, flexible support, including:

Holistic wraparound support: Including financial mentoring and digital skills training.
Peer networks and mentoring: Connecting aspiring entrepreneurs with others who’ve walked similar paths.
Long-term engagement: Acknowledging that success takes time and providing support beyond business launch. (80% of our service users on our City Bridge project moved into Trading or demonstrated growth in their business.)
Non-judgmental, inclusive environments: Spaces where individuals are treated with dignity and not defined by their past.
Access and/or support to seed funding: Forward £1k micro-grant, mainstream and charitable foundation grants, and alternative financing models to support startup costs. We have awarded over £16,000 by way of Forward micro-grants over the last four years.

Moving forwards
Self-employment is not a silver bullet, but for many facing multiple complex barriers, it offers a meaningful and realistic pathway out of poverty, economic inactivity, exclusion, and dependence. With the right support, people who have been overlooked or underestimated can become innovators, business owners, and community leaders.

The question isn’t whether we can afford to provide this support; it’s whether we can afford not to.

Are you an organisation working with marginalised communities? Consider building or partnering on programmes that provide tailored self-employment support.

Are you a funder or commissioner? Fund programmes such as Forward’s Enterprise Bootcamp, which focuses on inclusive entrepreneurship, not just for the ‘high-growth’ startups, but for everyday people with extraordinary potential.

Are you an individual who’s walked this path? Share your story. You might inspire the next entrepreneur to take the first step.

This blog was originally published by Forward. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Forward

Free workshops for kinship carers

Partner Updates

DDNWeb

August 1, 2025

Adfam is delighted to be working with the charity Kinship to provide a number of free in-person and online workshops for kinship carers, on understanding the effects of drug and alcohol misuse on kinship families.

Kinship carers are family or friends who step up, often during an unexpected crisis, to care for a child when their parents aren’t able to. Many children are in kinship care as a result of parental substance use.

In this workshop, attendees will learn how to:

Understand how drug and alcohol misuse directly and indirectly impacts family life and child wellbeing
Identify potential safeguarding risks of drug and alcohol users to children, and how to keep them (and other family members) safe
Consider practical strategies to employ when encountering drug and alcohol misuse and related issues like neglect and contact issues
Understand child experiences, including the impact of parental substance misuse
Find and explore further information and support

These workshops are open to all kinship carers living in England whose families have been affected by drug and/or alcohol misuse, or who want to learn where to get support around this topic. They are also an opportunity to meet other kinship carers, connect and learn together.

The workshops are being organised at venues across the country, as well as online via Zoom. Please find further details and registration links to all workshops below.

In-person workshops
Further details of in-person workshops are to be released soon.

Online workshops
11th September 2025, 7-9pm
14th October 2025, 10am – 12 noon
14th November 2025, 10am – 12 noon

These workshops are part of a wider series of training and events being organised by Kinship, covering a range of different issues and topics relating to the experience of kinship families. For a full list of events that are taking place visit the Kinship website.

This blog was originally published by Adfam. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Adfam

Not just homeless: the overlooked health needs of women in crisis

Partner Updates

DDNWeb

August 1, 2025

At Brighton Women’s Service (BWS), we see firsthand how health is shaped not just by biology, but by inequality, trauma, and exclusion, writes Janie Pamment, BWS manager. For the women we support – many of whom have experienced homelessness, abuse, and systemic neglect – accessing healthcare is not just difficult, it can feel impossible. This blog explores the deep-rooted barriers they face and the work we do to help them reclaim their right to health and dignity.

At BWS, we support women facing some of the most acute health inequalities in our community. Many of the women we work with have experienced significant trauma, including domestic abuse, exploitation, trafficking, and early childhood adversity. These experiences often manifest in complex physical and mental health needs, which are frequently compounded by systemic barriers to accessing care. The vast majority of our residents live with multiple diagnoses, such as PTSD, depression, anxiety, and unmanaged physical conditions, yet many arrive with little to no current engagement with healthcare services.

Nationally, data from Homeless Link shows that 85% of homeless women report mental health conditions, and 78% experience physical health issues, figures that closely reflect what we see within BWS. Screening rates are also significantly lower for women experiencing homelessness, just 37% have had breast screening and 54% have had cervical screening, compared to 62% and 70% in the general population. These disparities are mirrored locally and are often exacerbated by fear, shame, past trauma in medical settings, and services that are not designed with women’s needs in mind.

Domestic abuse also creates significant barriers. Many women carry internalised beliefs shaped by years of coercion and violence that they are not worthy of care or protection. This can lead to a reluctance to seek medical support or advocate for their health needs, even when in crisis. In many cases, women are actively prevented from accessing healthcare by partners using coercive control. This enforced isolation and restriction of movement is often misinterpreted by services as non-engagement, rather than recognised as a safeguarding concern.

Neurodiversity presents an additional barrier. Many women at BWS are neurodivergent, and clinical environments like A&E can be overwhelming and over-stimulating; bright lights, noise, long waits, and unclear processes can lead to shutdowns or heightened distress. These environments often lack understanding of how trauma and neurodiversity interact, resulting in women being misunderstood, dismissed, or even removed before they’ve received support.

Brighton Women’s Service — We work closely with outreach nursing teams, substance misuse services, and GPs to bridge these gaps, offering screenings and other medical interventions within the project

We work closely with outreach nursing teams, substance misuse services, and GPs to bridge these gaps, offering screenings and other medical interventions within the project. On-site trauma stabilisation, creative therapies, and trauma-informed keywork all play a part in helping women feel safe enough to re-engage with healthcare. For women who have spent years in survival mode, even attending a health appointment can feel overwhelming. Our work is about creating consistent, compassionate relationships that rebuild trust not just in services, but in themselves.

This deeply relational approach is critical because the consequences of these inequalities are stark. Life expectancy for women experiencing long-term homelessness can be as low as 43 years. At BWS, we are advocating for women to access the care they deserve and supporting them to take up space.

Every woman deserves access to compassionate, trauma-informed healthcare, no matter her past or present circumstances. At BWS, we walk alongside women as they rebuild trust in themselves and in the systems meant to support them. But we can’t do it alone.

This blog was originally published by Social Interest Group. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Social Interest Group

Iain Lee speaks about his devastating addictions to drugs and alcohol

Rehab News

DDNWeb

July 31, 2025

Iain Lee speaks about his devastating addictions to drugs and alcohol — Lee said he smoked ‘tonnes of weed’ and took ‘loads of cocaine’, partly to hide his own extreme insecurity

Broadcaster Iain Lee has opened up about his addictions to drugs and alcohol, describing how at the height of his fame in the 1990s he was ‘fuelled by fear and cocaine’.

He said he first started drinking at the age of 15, and was soon sneaking bottles of alcohol into school and experiencing blackouts. He later experimented with other drugs, trying cocaine shortly before landing his breakthrough TV role as host of The 11 O’Clock Show on Channel 4. Suddenly famous and well paid, he said he smoked ‘tonnes of weed’ and took ‘loads of cocaine’ during his time on the show, partly to hide his own extreme insecurity.

Lee was speaking on the fifth episode of Listen UP, an addiction recovery-themed podcast from Abbeycare, one of the UK’s leading residential rehabilitation centres.

The broadcaster, who also appeared on I’m a Celebrity… Get Me Out of Here! in 2017, spent time at Abbeycare’s clinic in Gloucestershire in December 2020 after having suicidal thoughts, but has since maintained his recovery and now works as a counsellor.

During his appearance on the podcast, released today, Lee said he had experienced sexual abuse during his childhood, growing up on an estate in Slough. He was bullied at school and told by one teacher he was ‘one of the worst children they’d ever seen’, turning to alcohol at the age of 15 partly as a form of escape.

Speaking about the first time he drank, he told the podcast’s host Eddie Clarke, ‘I felt how I imagined a normal person would feel: confident, sexy, funny – and that was the start of the illness.

‘I loved it. I felt so good drinking. I didn’t get a hangover that first time, and I remember thinking, I want to do this for the rest of my life.’

He soon began smoking marijuana, and later at university tried speed, acid, ecstasy, and then cocaine, spending the money he earned from comedy gigs or acting jobs on drugs.

He recalled, ‘Shortly after trying cocaine, I got my first job on the television. I got The 11 O’Clock Show, and it’s the late 90s, and suddenly I’m earning a lot of money. I’ve gone from signing on, living at my mum’s, to earning a lot of money. I went nuts. It was inevitable I would go nuts. Suddenly I was earning thousands of pounds a week, you know, and people would deliver cocaine to me.

‘I was allergic to fame, because I still thought I was this ugly, talentless kid that didn’t deserve any form of success. So to hide that insecurity and that fear, I took more cocaine… it very quickly became literally insane. It became psychosis. I was full of fear and low self-esteem.

‘There’s no two ways about it – I became a thoroughly unpleasant person to work with, fuelled by fear and cocaine, a really, really bad combination. I became everything I didn’t want to be.’

Eddie Clarke, outreach manager at Abbeycare and the host of Listen UP — Listen UP host Eddie Clarke

Listen UP features a new guest each month who is invited to talk about their first-hand experience of addiction and recovery. It aims to reduce the stigma around drug and alcohol addiction through honest conversations, as well as demonstrating that recovery is possible.

Lee described how his addictions led him to walk out on the fifth season of the The 11 O’Clock Show days before it was due to air, despite being offered a fee of £3,000 an episode. He later started attending Narcotics Anonymous meetings, initially hating the experience but eventually coming to rely heavily on them to maintain his abstinence.

‘The guy next to me was a rock star, the guy next to me was a homeless bloke. And that for me summed up recovery – no-one is safe from this disease,’ he said. ‘You can be a multi-millionaire, you can be literally sleeping on the street, as this guy had been. But the disease doesn’t care.’

His message to others going through similar experiences is simple: ‘Talk to people, talk to people, talk to people. The addiction is a disease of isolation, it wants us on our own in a corner of a room. Don’t listen to that. Speak to someone.’

Eddie Clarke, outreach manager at Abbeycare and the host of Listen UP, said, ‘I remember watching Iain on TV when I was growing up. Talking to him now and hearing what he was really going through at the height of his fame was an extraordinary experience. His story shows that even those who appear to be enjoying great success in their careers can still be struggling with unaddressed and potentially devastating addictions.

‘Given the levels of alcohol and drug-related harm across the UK, it’s more important than ever that we talk honestly about addiction, and that is what our podcast does.

‘We hope that Iain’s brutally honest reflections on his life and career will be heard by others who are going through the same thing, helping them realise that they are far from alone.’

The Listen UP podcast can be found here

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Abbeycare

Crafting a new approach

Features

DDNWeb

July 30, 2025

George Charlton I was once told by a social work manager (well shouted at, actually) whilst delivering CRAFT practitioner training that I was ‘the most unprofessional professional’ he’d ever met.

I can recall smiling and saying, ‘well thank you my brother, I’ll wear that like a badge of honour’. And I do.

The reason I think he got so upset was because I was talking about the fact that I love the clients and families I support, and I tell them I do every single day. But I do love them, and I will always go above and beyond, because the lives of families really matter.

My name is George Charlton, and I’m the UK’s only independent CRAFT trainer and supervisor to be licensed and endorsed by CRAFT founder Dr Robert J Meyers from the University of New Mexico to train and supervise families and practitioners in the solution focused and evidence-based Community Reinforcement and Family Training approach.

EMPOWERING FAMILIES
What I want to share with you isn’t only about my work but how I believe, deep down, that family members are ambassadors for change and 100 per cent have the power to save lives if we show them the way.

CRAFT isn’t just another training programme – it’s a revolutionary way of thinking about people who use drugs and addiction support, and it’s a dynamite model for implementing whole-family recovery and harm reduction interventions that are empowering, person centred, and family led. In my view, families matter and their love has power. They deserve to be at the front and centre and heart of the solution, not pushed to the side and ignored – which they typically are.

According to ADFAM there are around 5m family members across the UK who are directly impacted by a loved one’s substance use, and they are lacking the support they desperately need to help themselves and their loved ones. The Dame Carol Black report laid it bare – ‘our treatment system is at capacity, caseloads are too high, and families are paying the price’. I’m inclined to agree with Dame Carol.

It’s estimated that around 300,000 people in England alone are using opiates or crack cocaine, but what we often forget is that behind every one of those numbers is a family – a mother, father, partner or child who are desperate for, and to, help but all too often told they’re powerless and there’s nothing they can do until the user is ready to change. These messages are total nonsense, and we need to stop with this pointless and harmful rhetoric.

For too long, families have been bombarded with negative messages from certain support groups and professionals – ‘You can’t do anything until your loved one hits rock bottom’, ‘you have to show them tough love’, or ‘just cut them off and don’t go down with a sinking ship’. Imagine that as your starting point for the therapeutic relationship – there’s nothing you can do, you have no power and you’re better off just cutting your loved one out of your life. It’s total madness.

FLIPPING THE SCRIPT
Family members come to me saying all of the above and that they don’t know what to do for the best, and that’s where CRAFT comes in. CRAFT is a behavioural change system which flips the script. It starts by telling families that they aren’t powerless and that they are actually crucial collaborators and key players in the therapeutic journey towards harm reduction and recovery.

And there’s a global evidence base to back it up too. Research consistently shows that CRAFT achieves above 70 per cent success rate in getting people who use drugs to engage in treatment and support services which is higher than other traditional family interventions.

The National Institute on Drug Abuse (NIDA) research found that 74 per cent of family members using the CRAFT approach managed to successfully engage and support their loved ones to access treatment, support and wider prosocial activities, including people who were previously resistant to treatment.

I’ve been delivering CRAFT practitioner training for well over a decade now and it’s an absolute honour to be able to train and coach people in this beautiful evidence-based approach. Every time I see those lightbulb moments where people realise they have the power to change things using love as a therapeutic tool it reminds me why this approach matters so much. When I deliver my training I’m not just talking about the theory – I’m actually bringing the whole programme to life. Practitioners and families love going through this training, but don’t just take my word for it:

Alana from New Way Scotland: ‘The energy was amazing and this is by far the best training course I have ever been on.’

Debs from WithYou: ‘George is so passionate about CRAFT and his training makes me want to be a better worker for my clients and a better person at a core level. It’s the best training I’ve ever been on, hands down.’

In the training sessions we explore motivational interviewing techniques, communication skills, functional analysis, positive reinforcement and harm reduction strategies – all wrapped up and delivered with kindness, humanity and love. I make sure the training is empowering and practical – we don’t just talk about CRAFT skills, we practice them – a lot! Participants leave the training not just with a certificate but with the confidence and clarity to use what they’ve learned right away.

We also know that working with families can be hard at times and that’s why we’ve built in an ongoing CRAFT community of practice for everyone who completes the training. I deliver this in partnership with my besties Scottish Families Affected by Alcohol and Drugs (SFAD) and every 12 weeks we come together online to support each other, share what’s working, and keep that spark of hope alive.

ARCHITECTS OF CHANGE
No one knows the person struggling with substances better than their family members, and that’s why it makes complete sense to equip families with the behavioural change skills needed to support their loved ones to access treatment, reduce harm and build a future where everyone can thrive. CRAFT isn’t about waiting for that ‘rock bottom’ to happen, it’s about meeting people where they are – with love, compassion, and proven evidence-based strategies to influence change. Don’t forget, small steps carry you long distances

I’ve seen it first-hand time and again – when families recognise that their love has power they become passionate architects of change, which is a beautiful thing to be part of.

So whether you’re a commissioner looking to improve outcomes, a service provider wanting to support your staff, or a family member desperate for answers, I want you to know there’s always hope and I’m here to help you find it. You can reach me at info@georgecharlton.com. Let’s work together to save lives, empower families, and build a future where love truly does have the power to heal.

George Charlton is a trainer and consultant, georgecharlton.com

CRAFT MOTIVATION

CRAFT teaches families how to motivate their loved ones in a way that’s loving, compassionate and grounded in kindness. It’s not about blame or shame, it’s about practical strategies empowerment that brings people back to family connection, health, and hope. In the CRAFT approach families learn to:

• Use motivational conversations that truly make a difference

• Use positive reinforcement to encourage healthy behaviour change

• Spot the signs of an overdose and use naloxone to save a life

• Set helpful boundaries with love, not conflict

• Prioritise their own wellbeing – because family members deserve a good life too.

Families going through CRAFT report feeling less anxious, more confident in supporting their loved ones and more connected as a result of the whole CRAFT training process. CRAFT is all about creating a safe, loving environment where change for the person using substances can truly begin. I’ve seen it happen time and time again – CRAFT really works!

WHY CRAFT MATTERS

If you’re a commissioner or service provider, you already know the challenges – high caseloads, staff burnout and families in crisis. What we offer with CRAFT is a chance to do things differently – to create a whole-family recovery model that’s evidence-based, cost-effective, and most importantly, life-changing. And not just for families, but for the practitioners delivering the intervention and the service delivery model as a whole. CRAFT really is a transformational programme.

By investing in community reinforcement and family training at a local, regional and national level you really can:

• Increase treatment engagement rates

• Reduce drug-related deaths, relapse and family breakdown

• Widen the supply of naloxone

• Build sustainable recovery and harm reduction models that strengthen communities

• Motivate and energise the staff and the services you commission to reconnect with the reasons they decided to do this work in the first place.

As one participant said after a recent CRAFT training session, is like hitting ‘Control, ALT, and Delete’. It’s a total reboot for services and staff and a chance for everyone to feel inspired and reconnect with the mission of saving lives.

Drug-related harms on the increase across Scotland, warns PHS

News

DDNWeb

July 30, 2025

Drug-related harms are increasing across Scotland, says the latest Rapid Action Drug Alerts and Response (RADAR) report from Public Health Scotland (PHS) – underlining the need for ‘continued action’.

Suspected drug deaths in the period March to May this year were up by 15 per cent on the previous quarter and 7 per cent on the same period last year, the document states. Naloxone administration incidents, meanwhile, showed an increase of 45 per cent compared to the previous quarter, with emergency department attendances also up by nearly 20 per cent. Almost 1,100 Scottish Ambulance Service naloxone incidents were recorded between February and May, an average of 84 per week, with the Dumfries and Galloway NHS board area recording an increase of 124 per cent on the previous quarter.

The majority of drug-related harm continues to involve more than one substance, with the average number of controlled drugs detected per sample standing at six in hospital settings and four in post-mortem toxicology. ‘There is an urgent need for coordination to improve Scotland’s ability and agility in responding to polysubstance use and a continually evolving drug market,’ the document states. ‘A focus is needed on development, implementation and evaluation of measures to prevent and reduce the harms of polysubstance use.’

RADAR naloxone — Naloxone administration incidents showed an increase of 45 per cent compared to the previous quarter

The findings highlight the country’s ‘persistently’ high levels of drug-related harm and the ‘serious impact’ of an unpredictable drug supply, the report says. Nitazenes, which were first detected in Scotland in 2022, accounted for 6 per cent of deaths in the first quarter of this year, with adulteration of heroin, benzodiazepines and oxycodone with nitazene-type opioids continuing to be reported in the testing data. The agency issued a warning earlier this year after an increase in ‘sudden and rapid collapse’ overdoses – some fatal – linked to nitazene-type opioids.

‘Instances of very high levels of drug-related harm were identified in Scotland following the pandemic, which then decreased,’ PHS states. ‘The current report indicates this decreasing trend appears to be over and levels of harm have approached those seen in previous peaks.’ Scotland’s drug death rate has quadrupled since 2000 and remains the highest in Europe.

‘The recent trends in increasing drug-related harms are deeply concerning, and it’s vital that the response continues to be prioritised in order to protect lives,’ said PHS consultant in public health medicine Dr Tara Shivaji. ‘There are complex reasons for the increase in harms we’re seeing. Scotland has an evolving drug supply, which is often contaminated with toxic substances. Most of the harm also involves the use of more than one substance. We urge caution to all people who use drugs – there’s no way of telling which substances may be contaminated or what the combined effects will be. Having someone who can help in an emergency is an important harm reduction measure, but there‘s no safe way to take these substances.’

Rapid Action Drug Alerts and Response (RADAR) quarterly report available here

DDN Conference 2025: in pics

DDNWeb

July 29, 2025

DDN CONF 25 in pics

Did you attend the DDN Conference 2025? Did our roving camera snap you? Take a look at a selection of photos from the big day and see if you can spot yourself!

ddn conf 2025 pics

Stay tuned for more conference coverage coming very soon!

If you have any feedback, photos or video clips of the day, we’d love to hear from you. Please share on social media using the hashtag #ddnconf or send to us directly via DM or by emailing carly@cjwellings.com

DDN Conference 2025: video highlights

DDNWeb

July 29, 2025

The DDN Conference 2025 offered a packed programme of inspirational presentations, interactive sessions, networking, socialising and much more!

Take a look at our highlight reels below for a quick recap of the day…

In this video, DDN editor Claire opens the conference and we hear from: Kim Moore, Blossome; Jamie Poole, Bridge the Gap; Jim Duffy, Smoke Works; and Fin, Ketamine Care Hub. Watch the highlights here:

This video features delegate feedback as well as presentations by: Dr Abida Mohamed, Delphi Medical; Mark Gilman, Harm Reduction Research, Policy and Practice; Andrew Mitzwa-Mubayiwa in conversation with Hannah Mordey, Social Interest Group; and Grahame Morris MP, Chair of the APPG on Drugs, Alcohol and Justice. Watch the highlights here:

Hear reactions from exhibitors in this video, along with talks from: Jon Roberts, Dear Albert; and Zack Haider, Intuitive Thinking Skills. Watch the highlights here:

Stay tuned for more conference coverage coming very soon!

White House targets harm reduction funding

News

DDNWeb

July 28, 2025

White House targets harm reduction funding — The provision is part of a wider push to remove rough sleepers from US streets

The US health secretary will take ‘appropriate action’ to ensure that the discretionary grants issued by the country’s Substance Abuse and Mental Health Services Administration (SAMHSA) do not fund programmes ‘that fail to achieve adequate outcomes’, according to a new executive order from president Donald Trump. These include ‘so-called “harm reduction” or “safe consumption” efforts that only facilitate illegal drug use and its attendant harm’, it states.

The provision is part of a wider push to remove rough sleepers from US streets, including reversing federal and local legislation that restricts authorities from forcing people into mental health treatment. The number of people living on the streets in the US on a single night reached almost 275,000 during the previous administration, says the White House, the highest ever recorded.

‘Endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks have made our cities unsafe,’ the executive order states. ‘The overwhelming majority of these individuals are addicted to drugs, have a mental health condition, or both. Nearly two-thirds of homeless individuals report having regularly used hard drugs like methamphetamines, cocaine, or opioids in their lifetimes. An equally large share of homeless individuals reported suffering from mental health conditions.’

Federal and local government had spent ‘tens of billions of dollars’ on programmes that failed to address the root causes of homelessness, the order continues, ‘leaving other citizens vulnerable to public safety threats’. Shifting people into ‘long-term institutional settings for humane treatment through the appropriate use of civil commitment’ would help to restore public order, it says. The order also calls for agencies to prioritise funding for the US states and cities that enforce their laws on open-air drug use, loitering and urban camping ‘to the maximum extent’.

‘Surrendering our cities and citizens to disorder and fear is neither compassionate to the homeless nor other citizens,’ the order says. ‘My administration will take a new approach focused on protecting public safety.’

There are currently three consumption rooms operating in the US – two in New York and one in Rhode Island. Although provisional figures released by the US Centers for Disease Control and Prevention (CDC) earlier this year showed a ‘remarkable nearly 27 per cent decrease’ in 2024’s predicted drug overdose deaths compared to the previous year, the figure still stood at more than 80,000, with overdose remaining the leading cause of death for Americans aged 18-44. More than a million people in the US died a drug-related death in the first two decades of this century, with the country’s opioid crisis officially declared a public health emergency in 2017.

The executive order was a ‘dangerous step backwards that will only deepen harm’, said the Legal Action Center (LAC) charity. ‘Instead of investing in affordable housing, voluntary care in community-based mental health and substance use disorder treatment programs, effective overdose prevention strategies, and the public health infrastructure our communities need, the order doubles down on non-evidence-based policies of displacement and forced treatment,’ it stated. ‘If this administration truly seeks to reduce overdose deaths and improve community safety, it must embrace and sustainably fund what public health experts and advocates say works,’ said the LAC’s senior health policy attorney Deborah Reid: ‘Harm reduction programs, overdose prevention centers, and widespread access to voluntary, non-coercive treatment and care. These programs save lives.’

‘The safest communities are those with the most housing and resources, not those that make it a crime to be poor or sick,’ added the National Homelessness Law Center. ‘Forced treatment is unethical, ineffective, and illegal.’

Stanford University addiction psychiatrist and former White House drug czar during the Obama administration Keith Humphreys (DDN, June 2012, page 16) told the Washington Post that the federal government’s power to force people into involuntary treatment was limited. However, ‘lots of Americans across the political spectrum are fed up with homelessness disorder and public drug use,’ he said. ‘And they are right to be. There has been a lot of public policy failure in this area.’

Executive order available here

Art attack

DDNWeb

July 28, 2025

ANEW creativity — Main image: Samadhi by Fallen Angels. Above: Eve Steele in The Political History of Smack and Crack

‘People in recovery have creative minds,’ says John Platt, operations lead at the ANEW recovery community in Hyde, Greater Manchester. ‘Through this whole experience I’ve seen nothing but happy, smiley faces.’

Over five months, designer Joe Hartley has been making twice weekly visits to ANEW as its very own artist in residence. Through exploratory sessions featuring everything from carpentry to ceramics and even chicken husbandry, Joe and the ANEW community have been having a ball while pushing the boundaries of what creativity means to the limits.

‘This is exactly why we picked him,’ says John, who sat on the artist selection panel alongside project commissioners Portraits of Recovery (PORe) and Castlefield Gallery. ‘Working with Joe complemented so well what we already offer at ANEW, which includes intensive group therapy, education and work placements, equine therapy and supported employment. When Mark Prest of PORe approached us about hosting an artist’s residency, I thought “we already work quite creatively” so it didn’t feel like a huge stretch.’

With a professional background in the arts, PORe founder Mark is himself a man in recovery. He launched the organisation in 2011 with the mission of making art and recovery familiar bedfellows (DDN, October 2023, page 10). PORe also works with galleries and museums, advocating for the inclusion of recovery themes in their public programmes and better access for this mostly uncatered for audience.

Participants co-produced teapots by passing them round and each making a different element

‘I’ve been in rehabs where the only creative activity was colouring by numbers,’ he says. ‘For me, that’s not art – and it’s certainly not going to help people redefine or progress their recovery journeys. Contemporary art, thoughtfully conceived, has a powerful role to play in recovery. And that’s what this project is about. We wanted to work with a rehab and push their boundaries about what art is and can be, demonstrating the huge potential benefits for clients and also empowering and developing staff and volunteers to lead their own creative health sessions.’

REDEFINING NARRATIVES
The project is part of PORe’s pioneering three-year CHAORDIC programme, delivered in partnership with Castlefield Gallery, the Whitworth and Manchester Art Gallery. It explores the social impact that co-designed and made contemporary visual arts can have in redefining substance use narratives and recovery identities. With exhibition dates agreed at Castlefield Gallery, it was up to Joe and the 60 participants – including clients at every stage of recovery, staff and volunteers – to co-design the show alongside curators from the gallery and PORe.

For Joe, who co-owns a ceramics studio and runs community gardening sessions, it was an exciting, if somewhat challenging, prospect. ‘I was the only person in the room not in recovery and worried that people might think, “who does he think he is?” But I was made to feel very welcome,’ he says.

Another concern of Joe’s proved to be unfounded. ‘I thought people might struggle with the idea that everything would be created collectively,’ he says – ‘so no one could look at a finished piece and say “I did that”. To get around this, we made teapots in our first session. I asked everyone to pass them around, so one person crafted the main body, another made the handle and a third, the spout. It turned out that working collaboratively was not at all new to the groups, as it’s at the heart of their recovery process. It was really nice to see.’

Photography was one of the artforms explored by the ANEW community

The workshops – which ran from February to this month – have the potential to revolutionise how creativity is embedded into ANEW’s recovery programmes, and were also transformative for Joe. ‘I’ve never felt so fully absorbed and present,’ he says. ‘Because I knew what everyone at ANEW was going through, it would have felt rude not to be 100 per cent present at all times.’

IMMEDIATE IMPACT
Katherine Light has worked as a caretaker at ANEW for more than two years, after completing their 22-week programme herself. She joined many of Joe’s wide-ranging sessions, including ceramics and photography, and says their impact was immediate. ‘Joe earned everyone’s respect simply by being himself,’ she says. ‘He’s made a massive impact on clients, staff and the wider ANEW community. He might have come in to “do art” but what he’s really shown us is freedom to be yourself, express emotions and accept things as they are. I hope to use some of this when I run my own sessions.’

John, who’s worked at ANEW since it was founded in 2015, particularly likes the exhibition title, ANEW Way to Peel an Orange. ‘A client said they could peel an orange inside their pocket,’ he says, ‘and it felt like a great metaphor for recovery. At rehab we would say “there’s a better way than peeling it in your pocket” – get it out, don’t keep secrets, there’s no need to be embarrassed, peel it in front of the group. So the title is about trying out doing things more openly.’

Another metaphor that resonated for John, whose own recovery journey began at age 50, is that of the ‘recoverist chicken’. Recoverist is a portmanteau word blending recovery and activism, and when Joe brought groups to his allotment to help care for his chickens, one laid eggs – the chicks then grew under the group’s watchful eyes. ‘They’re coming to live with us at ANEW,’ says John. ‘We’ve named them the recoverist chickens, because they represent new life.’

EXHIBITING THE PROCESS
As Joe puts it, ‘the outcome is exhibiting the process’, which means the exhibition will tell the story of the creative journey everyone has been on. Adorning the walls at Castlefield Gallery will be black and white photographs taken by the groups, and a floor-to-ceiling spray-painted mural, influenced by Victorian botanical illustrations. Handmade tables in the centre of the gallery space will display some of the teapots, while a chicken coop will share the feathery fun and freedom of the recoverist chickens via livestream. Outside will be a new garden, created with the ANEW clients, while workshops will run upstairs.

‘I hope visitors find humour,’ says Joe. ‘Our sessions were full of laughter. It’s not about laying bare people’s pain. Recovery is not for the faint hearted, but I hope this is an accessible way in. You don’t have to know anything about art to get something from this exhibition.’

For Joe, who lost his younger brother to substance use four years ago, the project holds huge personal significance. ‘My brother never reached recovery, so I haven’t seen this side before – the human potential for enormous personal growth and transformation. It’s been a highly emotional, but positive experience, to see that struggles with substance use don’t always end the same way.’

Sara Teiger is a freelance PR and writer

ANEW Way to Peel an Orange is part of PORe’s September 2025 Recoverist Month programme, placing lived experience of recovery at the heart of arts programming. It is a Portraits of Recovery and Castlefield Gallery commission, developed with ANEW, funded by Brian Mercer Trust and The Howarth Trust and supported by Arts Council England, GMCA and Manchester City Council.

The exhibition runs from 3 August to 19 October 2025 at Castlefield Gallery, 2 Hewitt St, Manchester M15 4GB. Entry is free.

Chloe Cooke – I am a…

DDNWeb

July 28, 2025

Chloe Cooke is a young people’s recovery worker at WithYou. We asked her about her career path and role.

WHAT MADE YOU WANT TO WORK IN THIS FIELD?
I’ve always worked with teenagers, and it’s always been something I’ve enjoyed doing. I left uni with a degree in criminology. I worked for a different organisation before, and when I saw this job come up, it just seemed perfect. Substance use was never a field I had thought about working in. I hadn’t even heard of WithYou before I saw the job advert. But getting to support vulnerable young people and make a difference, that was the big thing. I feel like I can make more of an impact on young people, and I just find them easy to get along with. I also really appreciate the flexibility and, of course, just getting paid to talk to people, it’s like a dream.

WHAT DOES A TYPICAL DAY LOOK LIKE?
There is no typical day – when they say no two days are the same, that’s definitely the truth. Every day is very different, and there’s a lot of flexibility in my role. I’m often based in schools and family hubs. We’re now in the youth centre building and often out in the community, seeing young people. So really I’m here, there and everywhere, which I absolutely love, it makes the day fly by. I don’t do well with being sat in an office for long periods of time, so that’s why I feel like this job is just absolutely perfect. It’s just going from young person to young person.

There are a lot of meetings to attend as well – for example child in need meetings, and other social and partner agency meetings.

‘Don’t touch my diary,’ is what I always say to my team lead. I plan everything for myself so I know where I’m going and the routes I’m taking.

WHAT DO YOU FIND MOST REWARDING?
When young people reach out to me in crisis – when they’re using substances. It shows that they trust me to talk them through it. With teenagers, it’s very rare that they do reach out for help. So when they do, it’s massive.

WHAT WOULD YOU LIKE TO CHANGE?
The stigma schools have around substances. We often find that schools won’t deliver any form of harm reduction or awareness of any substances because they’re afraid that they’re teaching the young people to use substances rather than how to keep safe. But I speak to so many young people who didn’t even know what harm reduction was, or how to keep themselves safe. So I feel if it was more widely spoken about within schools and in the sector, then it would help in the long run. If you can educate from a younger age, there would be a big change.

We find a lot of our clients are using cannabis when they’re in school, and they will say things like ‘Well, my mates have done it for so long and they’re fine’, so they’re learning from each other. There’s a lot of naivety there, and a lot of young people think it’s fine, and obviously they don’t realise the risks.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
I’d say it’s not for the faint of heart. It can get extremely heavy, but the rewards definitely outweigh that. I don’t think there are many jobs you’d find that are more rewarding than working with vulnerable young people, but it does take a lot of patience, a lot of resilience, and quick thinking.

I think young people are so unpredictable sometimes, you often need to think on your feet and change a strategy of delivering harm reduction to them, especially when working with young people with different complexities, such as neurodivergence. Our care is person-centred – it’s adapting so you can still teach them harm reduction and not just expect them to learn the way that you want to teach.

See opportunities like Chloe’s on DDN Jobs

Milestone hit on World Hepatitis Day as local drug and alcohol charity confirms micro-elimination of hepatitis C

Partner Updates

DDNWeb

July 28, 2025

Shropshire Recovery Partnership – run by national drug and alcohol charity WithYou – has reconfirmed micro-elimination of hepatitis C; a huge step towards the Government’s target to eliminate the virus by 2030.

Hepatitis C is a bloodborne virus which can cause liver cirrhosis and cancer. Early testing is vital, as quick detection and treatment reduces the likelihood of serious liver damage. More than 95% of people who are treated can be cured. World Hepatitis Day, marked on 28 July every year, aims to raise global awareness of hepatitis and encourage prevention, diagnosis and treatment.

The charity has been actively raising awareness of the importance of testing and treatment, which includes taking testing right to people’s doorsteps.

Jan Burrows, head of service delivery at the Shropshire Recovery Partnership, said, ‘We are incredibly proud that Shropshire has once again been recognised for eliminating hepatitis C within our drug and alcohol services. This achievement reflects the dedication of our team, our strong partnerships with local and national health providers, and the commitment of those we support in engaging with testing and treatment.

‘Hepatitis C is preventable and curable, and this revalidation shows what is possible when services are person-centred, proactive, and inclusive. We remain committed to keeping Hep C elimination a reality for everyone in our community.’

Micro-elimination is defined as:

100% of clients in structured treatment are offered a hepatitis C test
100% of those with a history of injecting have been tested
90% of current and previous injectors (at risk) have a hepatitis C test date within the last 12 months
90% of clients who’ve tested positive for hepatitis have completed or commenced treatment

Most hepatitis C infections occur through exposure to blood from unsafe injection practices, unsafe health care, unscreened blood transfusions and some sexual practices, but the virus can also be shared through tattoos, sharing razors and even toothbrushes.

Across the world, around 58 million people live with chronic hepatitis C, and there are around 1.5 million new infections each year. The NHS have committed to eliminating hepatitis C before 2025, and through achieving micro-elimination, the service has played a key part in helping the NHS to achieve this target.

This blog was originally published by WithYou.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by WithYou

Homeless people disproportionately at risk of hep C, charity warns

News

DDNWeb

July 25, 2025

Homeless people disproportionately at risk of hep C, charity warns — ‘The longer their health needs are unaddressed, the more intense they become’

People experiencing homelessness are one of the most at-risk groups for hepatitis C infection, the St Mungo’s charity has warned in advance of next week’s World Hepatitis Day.

‘Hep C is a real risk for the people we support,’ said the organisation’s hepatitis C coordinator, Sara Hide. ‘The intense psychological trauma of being homeless can lead to substance use and sharing of needles, and we see people who are homeless facing many other conditions alongside a hep C infection, including poor mental and physical health.’

The quicker hep C infections were treated the less likely people were to eventually develop liver cancer, she stressed. ‘The longer their health needs are unaddressed, the more intense they become.’ The ongoing collaboration between St Mungo’s, the Hepatitis C Trust and NHS UCLH Find and Treat as part of the hep C elimination programme was playing a key part in finding people with the infection who otherwise would not present at mainstream health services, she added.

‘We meet people affected by homelessness where they are; this can be through outreach, home visits, and clinics with screenings and treatment – the latter now less invasive and with shorter courses of medication,’ she said. ‘We look forward to strengthening this partnership over the coming years, and we hope the much-awaited homelessness strategy will crystallize the fact that homelessness and health, including treatment of hep C, can never be seen in isolation.’

Of Welsh adults who drink, almost 20 per cent drink at hazardous levels and 4 per cent at harmful levels

Meanwhile, a new modelling report on alcohol pricing mechanisms has been issued by the Welsh Government. Of Welsh adults who drink, almost 20 per cent drink at hazardous levels and 4 per cent at harmful levels, says the document – with the latter group accounting for 27 per cent of all alcohol consumed in Wales. Increasing the MUP rate from its current level of 50p would ‘lead to further reductions in alcohol consumption and harm, with the biggest impacts in the most deprived groups’, it states. The Welsh Government is considering raising the MUP level to 65p, as the Scottish Government did last year.

New modelling of alcohol pricing policies, alcohol consumption and harm in Wales available here

When meta-analysis misleads: the need for methodological integrity in e-cigarette research

Lung Health

DDNWeb

July 25, 2025

Tobacco harm reduction (THR), especially in the context of electronic cigarette (EC) research, remains highly contested within public health, often due to studies compromised by methodological flaws. These shortcomings in study design, analysis, terminology, or interpretation can distort scientific record, erode public trust, and generate misleading or uncritical media coverage and policy reports. These challenges become especially consequential when flawed evidence is aggregated and amplified through meta-analyses, which play a central role in shaping policy and clinical guidance.

In this issue of Internal and Emergency Medicine, Rodu and colleagues critically assess a widely cited 2024 meta-analysis by Glantz et al., published in NEJM Evidence. Glantz and coauthors concluded that e-cigarette use is associated with disease odds similar to those of cigarette smoking for cardiovascular conditions, and still substantial, though lower, for asthma, COPD, and oral diseases. Rodu et al. identify major methodological flaws that call these conclusions into question. This underlines the urgent need for rigorous and transparent evidence synthesis in tobacco harm reduction science.

When meta-analysis misleads: the need for methodological integrity in e-cigarette research

‘E-cigarette smoking’ is a misleading term: a critical review of its use in academic literature

Lung Health

DDNWeb

July 25, 2025

The terminology used to describe e-cigarette-related behaviours in academic literature is critical for accurate communication and interpretation. Despite fundamental differences between e-cigarette use (vaping) and tobacco smoking, terms such as ‘e-cigarette smoking’ have been used to refer to vaping, potentially conflating the two behaviours. This study aims to assess the use of the term ‘e-cigarette smoking’ and its variants in peer-reviewed literature and discuss the implications of their usage.

A review of academic literature published between 2015 and 2024 was conducted using Embase, Scopus, Web of Science, ScienceDirect, and ProQuest databases. Searches included terms such as ‘e-cigarette smoking’ and related variants, with database-specific filters applied to exclude irrelevant document types. A supplementary search in Google Scholar was performed to capture broader usage, including grey literature. The search identified 613 articles in Embase, 462 in Web of Science, 407 in ScienceDirect, 282 in Scopus and 121 in ProQuest, highlighting the widespread use of ‘e-cigarette smoking’ and related terms. The Google Scholar search returned approximately 4,680 results, reflecting the widespread and informal use of ‘e-cigarette smoking’ across diverse publication types, including grey literature. The term has also appeared in highly cited and recent studies in ways that conflate e-cigarette use with smoking, obscuring the fundamental differences between these distinct behaviours.

The use of ‘e-cigarette smoking’ and its variants in academic literature has notable implications for research integrity, addiction science, public health, and policy. Misleading terminology can contribute to distorted understandings of nicotine dependence, complicate harm reduction strategies, and risk shaping restrictive policies that fail to differentiate e-cigarette use from smoking. Standardising terminology in academic literature is essential to ensure accurate communication, support evidence-based policymaking, and enhance public health initiatives.

‘E-cigarette smoking’ is a misleading term: a critical review of its use in academic literature

Irish government delays introduction of mandatory alcohol health labelling

News

DDN

July 24, 2025

The Irish government has delayed the introduction of mandatory health labelling for alcohol, which was originally scheduled for next year, until 2028. Alcohol Action Ireland (AAI) called the move ‘a failure of leadership and democracy’.

Mandatory labelling carrying health warnings about the risk of liver disease, alcohol-related cancers and drinking while pregnant formed a key part of the country’s Public Health (Alcohol) Act 2018 (PHAA), and was praised by the WHO and other health bodies. The section of the act covering pre-watershed bans on alcohol advertising came into force earlier this year (https://www.drinkanddrugsnews.com/irelands-ban-on-pre-watershed-alcohol-advertising-comes-into-force/), with the labelling regulations signed into law in 2023 and due to be introduced next May after a three-year lead-in period.

Sheila Gilheany: Criticised the drinks industry for ‘disparaging the need for labelling’

However, AAI CEO Sheila Gilheany told DDN earlier this year that there had been an ‘ongoing campaign disparaging the need for labelling’ from the drinks industry (https://www.drinkanddrugsnews.com/caught-in-the-act/campaign), and in April AAI was one of 75 health organisations to sign an open letter urging the government to ensure the introduction of the regulations was not ‘derailed or delayed’ by industry lobbying (https://www.drinkanddrugsnews.com/campaigners-urge-irish-government-to-make-sure-mandatory-alcohol-health-labelling-goes-ahead/).

Alcohol industry trade body Drinks Ireland had been urging the government to reconsider the labelling regulations in light of threatened US trade tariffs. ‘Our members are currently contending with major trade uncertainty, new tariffs on products entering our most important export market, the US, and threats of further tariff escalation,’ it said. ‘In these uncertain times, companies must be as competitive as possible to survive in international markets.’

AAI, which has accused the industry of using ‘every dirty trick in the playbook to muddy the waters’ around labelling, states that ‘alcohol labels tell people the facts – that alcohol causes liver disease and cancer’. Ireland also has third highest level of Foetal Alcohol Spectrum Disorder (FASD) in the world, it states, affecting up to 7.4 per cent of the population.

‘To say that this delay is a blow for public health in Ireland is an understatement,’ Gilheany said. ‘It is a failure of leadership and of democracy. It’s not just that Irish people are being denied their right to information regarding some of the facts about alcohol so that they can make informed decisions. It’s not just that the government is allowing its own groundbreaking legislation to be undermined by the very industry it is designed to regulate. This delay will have real-life consequences that will be felt by ordinary Irish people every day.’

The implementation of the PHAA so far had been slow and lacking in strategic planning, she continued, which had ‘played right into the alcohol industry’s hands’ and allowed ‘misinformation to flourish’. Other sections of the PHAA yet to be implemented, such as those restricting the content of alcohol ads, were also being ‘ferociously resisted’ by the drinks industry, she added. ‘Ireland’s well deserved international public health reputation has undoubtedly been tarnished by these actions, where clearly the profits of an already immensely wealthy industry were deemed more important than the lives of babies, women and men right across Ireland.’

Time for a new HAT

Features

DDNWeb

July 21, 2025

Heroin-assisted treatment’s moment has come, says Mark R Gilman — Charles Romley Alder Wright, an English lecturer/researcher in chemistry and physics, focused on new opiate compounds. In 1874 he developed synthesised diamorphine. Photo: Wiki Commons

One hundred years ago, the UK became the first country in the world to prescribe heroin (diamorphine) to heroin users as a treatment for opioid dependency. The ‘British system’ was formally established in 1926 and took a medical approach to opioid dependency – heroin users could be prescribed diamorphine as their drug of choice to stem illicit use and improve health. At that time, most of the users were middle or upper class, and the system was in operation until the 1960s.

The ‘British system’ came under international pressure from the United States which viewed heroin use as a moral – rather than medical – issue. There was also concern amongst the British establishment that we were seeing a shift from middle-class ‘iatrogenic’ use (ie the result of medical activity) to dependence that arose because of hedonistic use by young people.

Remember, this was the ‘Swinging Sixties’ – mods and rockers were fighting on the streets and on the beaches. Hippies began to emerge, and working-class teenagers were becoming rebellious and using drugs. Some were using heroin that they got via the prescription pads of a small group of London GPs.

For almost 40 years, middle class heroin users in the UK could receive diamorphine to treat their opioid dependency from their own general practitioners. From 1968 onwards, however, only doctors with a Home Office licence could prescribe heroin via a specialist clinic, usually referred to as a regional drug dependency unit (DDU). From 1968 to 1978, the percentage of people in treatment for opioid dependency prescribed diamorphine dropped to less than 10 per cent.

‘Heroin screws you up’ – 1986 government posters. Contraband Collection / Alamy

THE RISE OF METHADONE
‘Brown’ powder heroin began to arrive in the UK in the early 1980s. Unemployed, working-class young people began to smoke and inject this brown heroin, and those who developed a habit, and went looking for treatment, were offered methadone or methadone. As ever in British drug policy, social class determined who got what. Posh people could get prescriptions from private doctors and pay for expensive residential rehabilitation treatments. The rest of us got what we were given.

Daniel Ahmed (right) and the Cleveland police and crime commissioner Barry Coppinger launched the Middlesbrough heroin assisted treatment (MHAT) programme in 2019. It ran for three years until closing on the grounds of cost. Photo: PA Images/Alamy

Fast forward to 1999, and new Department of Health clinical guidelines are produced which further restrict access to diamorphine. By the year 2000, there were approximately 500 diamorphine patients and by 2019, this number had fallen to less than 300. The vast majority of the approximately 150,000 patients in medication assisted treatment (MAT) in the UK receive methadone or buprenorphine.

Despite the decline in diamorphine prescribing for the treatment of opioid use disorder in the UK, the case for its efficacy and legitimacy remains. In recent years, there have been clinical trials of heroin-assisted treatment (HAT). These trials require patients to come into a medically supervised clinic space, usually twice a day, to inject diamorphine under conditions that dictate the route, dose and frequency of administration. These clinical trials have consistently shown that HAT works for people who are not responding to methadone or buprenorphine. HAT is effective in health gains, crime reduction and prosocial behaviour. The evidence jury has decided that HAT works. So, why is HAT not on offer?

BARRIERS TO HAT
The most often cited barrier to further expansions of HAT is cost. That is, the cost of the medication itself, the cost of nursing staff to supervise injections and the opportunity cost – money spent on HAT could be spent elsewhere in the treatment system. After all, you can’t have enough recovery navigators, recovery coaches and recovery whatevers… or can you?

The price of another signposting team could provide a safe supply of diamorphine to keep marginalised users alive. A difficult choice for commissioners and providers – offer HAT or further expand the workforce. The expanded workforce can then reach out to the most marginalised and disenfranchised users and be reminded that they have nothing to offer… bye bye.

Funding for HAT expansion has been precarious. For example, the Middlesbrough heroin assisted treatment (MHAT) programme ran for three years until closing on the grounds of cost in 2022. There are currently HAT programmes in Scotland and the West Midlands, and there are also some ‘legacy’ patients scattered around who have managed to hold on to their diamorphine prescriptions.

It’s tempting for advocates of HAT to argue the case primarily on the grounds of crime reduction. However, the UK is currently facing an epidemic of drug-related deaths. HAT can reduce these deaths, lengthen lives and improve the quality of those lives. We can now access regular supplies of diamorphine in different formats that expand the offer and may reduce cost. As well as injectable diamorphine, there are 200mg tablets and a nasal spray.

In March 2022 Scottish drugs policy minister Angela Constance visited the heroin assisted treatment programme in Glasgow and reiterated her intention to expand HAT services to other areas. Photo: @scotgovhealth

HIGH RISK GROUPS
One of the features of those at highest risk of premature death is recycling in and out of opioid substitution treatment (OST). For this group, methadone does not hold enough attraction to ensure retention and buprenorphine does not provide enough of an anxiolytic effect to treat a lifetime of trauma. Heroin is very effective at suppressing trauma-related feelings of being exposed, anxious and vulnerable.

This means that the most marginalised people who use drugs are not being offered suitable opioid agonist maintenance treatment (OAMT) options that would support them to move off street opioids. Harm reduction is undergoing a renaissance in the UK as we see the limits and dangers of forcing people out of treatment and into unwanted states of abstinence.

If we’re serious about addressing drug related deaths, it’s time for a new HAT.

Mark R Gilman is a consultant on substance use at Harm Reduction Research, Policy & Practice

Two weeks left to apply for tobacco harm reduction scholarship

DDNWeb

July 17, 2025

There are two weeks left to apply for the Tobacco Harm Reduction Scholarship Programme (THRSP), which aims to create the ‘tobacco harm reduction leaders of tomorrow’. THRSP is looking for its eighth cohort of scholars, who will receive a 12-month bespoke mentoring programme to undertake a tobacco harm reduction project of their own design.

THRSP 2025 — In its first seven years the programme has had ‘an unprecedented impact around the world’, says K•A•C

The scholarship, which is operated by Knowledge•Action•Change (K•A•C) with the support of a grant from Global Action to End Smoking, is open to applicants from all professional backgrounds. Successful candidates will also receive up to $12,000 in financial support, says K•A•C.

In its first seven years the programme has had ‘an unprecedented impact around the world’, says K•A•C – developing the careers of almost 120 scholars from more than 40 countries. Applicants will need to complete a short online course, which has been designed in partnership with a range of public health and tobacco harm reduction experts, including medical professionals and researchers.

The programme was launched to boost research and practice capacity in places where tobacco harm reduction resources were limited, with a particular focus on low- and middle-income countries. ‘It aims to introduce new thinkers, new ideas and new methods to tobacco harm reduction, as well as increasing the use of social media and new technologies to disseminate accurate information about the potential for safer nicotine products to reduce the global number of smoking-related deaths – which currently total 8m every year,’ K•A•C states.

Applications are open until 31 July. More information at thrsp.net

Spread the word

Features

DDNWeb

July 16, 2025

In a podcasting world awash with celebrity soundbites and performative wellness, the Believe in People podcast has quietly become one of the UK’s most trusted and transformative recovery platforms. Recorded inside ReNew – Hull’s drug and alcohol support service, provided by Change Grow Live – the show operates on a ‘recovery on the go’ model: stripped back, authentic, and rooted in lived experience.

Now entering its fourth year, the series delivers longform one-on-one episodes with individuals whose lives have been shaped by addiction, trauma, homelessness, mental health crises, or the criminal justice system. Its guests are diverse, but united by a single principle – every voice matters. There are no scripts, no overproduction, no polished narratives, just unflinching honesty.

With more than 5m engagements to date and thousands of listening hours downloaded weekly, the podcast has become a powerful tool for connection. The team regularly receives messages from listeners who say the show helped them access support for the first time, encouraged a loved one to seek treatment, or in some cases saved a life.

The project gained national attention when BRIT and Emmy Award winning Michelle Heaton chose Believe in People as the first non-mainstream media platform to share her recovery story. She was so moved by the experience that she stayed in contact with producer Robbie Lawson and arranged for her Celebrity Mastermind fee to be donated to help build a permanent studio in the heart of Hull’s recovery service. She then returned 18 months later to record a second episode, driven by her passion for breaking stigma and supporting other people facing addiction.

Other high-profile guests have followed suit. Nineties icon Amy Jo Johnson spoke publicly about sobriety for the first time, while Razorlight lead singer Johnny Borrell shared a candid account of his teenage heroin addiction and recovery and Love Island’s Adam Maxted used the platform to talk openly about steroid use and body image.

High-profile guests don’t receive special treatment, however. ‘The point is that no one voice is more important than another,’ says host Matthew Butler. ‘Celebrities don’t come to perform or promote – they have meaningful conversations with me and they let their guards down in our safe and trusted environment.’

The podcast has now released more than 70 episodes and received national recognition. It won Best Interview at last year’s British Podcast Awards and earned nominations at the ARIAS (Radio Academy awards) in both 2024 (Best New Podcast) and 2025 (Best Speech & Entertainment), sharing the shortlist with industry giants like Louis Theroux, Annie Mac, the BBC and Apple Music.

‘This is about breaking stigma on a national scale and ensuring that recovery stories are no longer confined to the margins,’ says producer Robbie Lawson. ‘We’ve had a profound effect on how recovery is understood and accessed – not just by individuals, but by families, services, and communities. At a time when podcasting is the fastest-growing media format in the world, we’re making sure that the modern recovery journey is part of that conversation.’

Robbie Lawson is producer and Matthew Butler is host of the Believe in People podcast

You can listen to Believe in People: Addiction, Recovery & Stigma on Spotify and Apple Music. For show notes, transcripts and additional content, visit believeinpeoplepodcast.com

Turning Point launches national campaign for naloxone Click & Deliver service

Partner Updates

DDNWeb

July 15, 2025

Turning Point has launched a national video campaign to highlight the importance of carrying the life-saving medication naloxone.

Naloxone is a first aid medication that can reverse the effects of an opioid overdose and is available from drug treatment providers and some pharmacies.

Turning Point has created a video, that was shown at the DDN Conference in Birmingham on 10 July, to raise awareness of its naloxone Click & Deliver programme that is available at its substance use recovery services across the country.

In England, anyone can carry a naloxone kit. However, Turning Point recognised that there are people with mobility issues, or who live in rural areas where there is not a service nearby, and for some, particularly family members of people at risk of overdose, there is a fear of being stigmatised.

The Click & Deliver programme see naloxone kits delivered to people at a location of their choice. It is being implemented at Turning Point services across the country and is currently available in Somerset, Herefordshire, Leicester City, Leicestershire & Rutland, Lincolnshire, Rochdale & Oldham, Slough, Bristol, Hammersmith & Fulham, Kensington & Chelsea, and Suffolk.

After filling out an online form and completing an optional short training session, individuals receive a free naloxone kit sent through the post in discreet packaging.

Zita, a peer mentor at Turning Point, has had first-hand experience with naloxone. ‘Naloxone is really important to me because not only has it been used to save my life, I have used it on others on four different occasions. I also know a number of people who have had their lives saved by the use of naloxone,’ she said.

‘When naloxone is used on you, you’re sometimes not aware of what has happened or the impact it has had on you or others around you. But being the person administering it, you see the positive action and quick effect of a life-saving medication.’

‘With the increasing risk from potent synthetic opioids, it’s never been more important to make it as easy as possible for people to access naloxone’

On one occasion on her way home, Zita came across someone who had overdosed. She quickly took out the naloxone kit from her bag, assembled it as she had been shown and injected the person’s thigh. It took the five doses to bring her back round. When the paramedics arrived, they said the naloxone had saved the person’s life. A minute later and the lack of oxygen could have caused permanent damage, if not death.

‘It definitely made me realise the importance of always making sure that the yellow box is in my bag. I’ve needed to use it a number of times since. If someone was thinking about carrying naloxone, I would definitely encourage them to do so. Not only can it save a life, there’s also no damage done while using naloxone if the cause wasn’t opioid – so there are only positives to carrying it, no negatives. Please carry naloxone, you can save a life.’

Natalie Travis, Turning Point national head of service, said, ‘With the increasing risk from potent synthetic opioids, it’s never been more important to make it as easy as possible for people to access naloxone. By removing the barriers experienced by some, Click & Deliver helps us raise awareness and make sure we’re getting naloxone into the hands of the people who need it.’

Adam Sutcliffe, senior operations manager at Lincolnshire Recovery Partnership, added, ‘The Click & Deliver service offers a discreet, convenient, and efficient way to distribute naloxone, ensuring that residents and professionals alike have the tools needed to protect vulnerable people in our community. In addition to our Click & Deliver service, we are also providing face to face training through our services.’

To view the naloxone Click & Deliver video, please click here.

To request a naloxone kit, please click here.

This blog was originally published by Turning Point. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Turning Point

Bottling it: Have we missed an opportunity to address alcohol harm?

Partner Updates

DDNWeb

July 15, 2025

Recently, the Government published its 10 Year Health Plan. It’s smart, considered, and in many ways, sensible, says Change Grow Live chief executive Mark Moody. It takes a welcome, broad approach, understanding that our health isn’t just built in hospitals, but within communities. That placing multiple services together under one roof, closer to home, can improve access and reduce the stark inequalities that currently exist in accessing NHS care. The plan acknowledges that prevention matters. That we need to put measures in place to support people’s health and stop them from getting sick, not just treat them when they do.

The plan goes into impressive detail on many areas. From HPV vaccination to GLP-1 medications for weight loss, to genomic sequencing for adults.

It shows what’s possible when ambition meets clarity, which makes the total absence of action on drug use, and the brief commitments to alcohol harm, all the more stark.

It’s no surprise that drug use is unmentioned – it’s too often seen as separate from health, hidden in the stigmatising shadow of crime, needle litter or anti-social behaviour. That’s not the focus of this article, though. Because perhaps more surprising, given it’s a topic we’re all more familiar with, one fully embedded in our culture and everyday life, is the subdued section of text devoted to addressing alcohol harms.

A huge opportunity may have been missed.

Alcohol is one of the biggest preventable causes of ill health and early death in the UK. Over 10,000 people die as a result of heavy drinking each year.

Recently, the Government published its 10 Year Health Plan. It’s smart, considered, and in many ways, sensible, says Change Grow Live chief executive Mark Moody — Earlier drafts of the plan reportedly included minimum pricing, ad restrictions, and clearer public messaging, none of which have made it into the final iteration

Alcohol is linked to cancer, liver failure, domestic violence, homelessness, A&E visits, widening health inequalities and unrelenting pressure on our health system.

Earlier drafts of the 10-year plan reportedly included minimum pricing, ad restrictions, and clearer public messaging, none of which have made it into the final iteration. There’s room to debate their impact, but in the end, it’s their absence that speaks loudest.

According to The Guardian and The Times, those ideas were pulled after internal pushback and industry pressure. This happens, and is expected as the alcohol sector faces its ‘tobacco moment’. I’ve read the objections. I don’t agree with them, but I do understand. Times are hard. Costs are rising, we’re all trying to protect jobs, and money is tighter than ever. But this isn’t about budgets or balance sheets, and it shouldn’t be about what’s in the interests of any one sector.

This is about the hundreds of thousands of people with an alcohol dependence in the UK. This is about people like Jo, who began drinking to numb her grief after losing her son’s father, until alcohol nearly took her life. Her story says more than I, or any statistic, ever could.

In 2023-24, more than 100,000 people in England and Wales accessed treatment services for alcohol, 26% higher than four years before.

Bottling it - CGL — The reason alcohol is so hard to tackle is right in front of our eyes. It is everywhere. It’s cultural. It’s commercial. It’s normal

Change Grow Live services are and will always be there for those who need support, and we are seeing more and more people come to us for help. Against this backdrop of dramatically growing need, preventative measures are crucial.

The reason alcohol is so hard to tackle is right in front of our eyes. It is everywhere. At celebrations, commiserations, stitched into our weekends, our advertising, our social lives, our conversations. It’s cultural. It’s commercial. It’s normal. And that visibility, that acceptance, is exactly what makes it so difficult to confront.

This isn’t a matter of minor adjustments like expanding voluntary guidelines for alcohol labelling. It requires bold, almost definitely unpopular choices. It means disrupting what has come to be a normality for many and being honest about what the cost of alcohol is to us – as an economy, as a society, as individuals.

It’s been 13 years since the last national alcohol strategy. In that time, the impact of alcohol harm has deepened. Deaths have risen for five years in a row. They’re now 40% higher than before the pandemic. And behind each statistic is a life lost too soon.

The 10-Year Health Plan sets out some genuinely ambitious goals and gets a lot right, especially in recognising the importance of prevention and community-based care.

But two of the biggest factors behind poor health, drugs and alcohol, deserved more. And people deserved more. For a plan that puts prevention at its heart, that’s a missed opportunity.

Without significant preventative measures as part of this otherwise ambitious new vision for health, we must continue to do what we can, and advocate for others to do what they can, to face alcohol harm with the urgency it demands.

A time will come when alcohol harms are addressed with the severity they deserve. The only question is, how much more are we willing to lose before then?

This blog was originally published by Change Grow Live. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Change Grow Live

Parents and families invited to complete national online survey into alcohol harms

Partner Updates

DDNWeb

July 15, 2025

During Alcohol Awareness week (7-13 July), Forward’s Family Support and Specialist Programmes team launched a new national survey which aims to improve understanding of how alcohol use impacts families.

Following a successful pilot survey in Medway, this new survey aims to reach a national audience with an interest in sharing their experiences of alcohol use, addiction and dependency in a family setting.

Complete the survey – closes 25 July

Who can complete the survey?

Professionals within the fields of family support, health agencies, social workers, and children and young people (CYP)
Service users and former clients of addiction-led family support services
Family members impacted or affected by someone else’s drinking and alcohol use

We would especially like to hear from:

New parents, or parents with children under five-years-old
Parents in blended or non-traditional family units
Professionals working with families – this includes social workers, therapists or practitioners
Family members (including grandparents, step-fathers/mothers and foster carers) – if you are a close family member with lived experience of supporting someone with an existing or history of alcohol use
Volunteer and charity workers working with children and young people

Why should I complete the survey?

Supporting children can help break the cycle – sadly children may also learn the same addictive and harmful behaviours of a parent with alcohol dependency
Improve our research – allowing us to reach more people to improve the validity (accuracy) of our study
Share your lived experience to help shape and improve Forward’s family support provision

If you have a view about the availability of information, guidance and education around alcohol harms please complete the survey – we want to hear from you.

Complete the survey – closes 25 July

This blog was originally published by Forward. You can read the original post here.

DDN magazine is a free publication self-funded through advertising.

We are proud to work in partnership with many of the leading charities and treatment providers in the sector.

This content was created by Forward

Harm reduction first

Features

DDNWeb

July 15, 2025

After a six-year gap, the National Needle Exchange Forum (NNEF) returned with a renewed focus on the need for standalone, specialist harm reduction services. Opening the Birmingham event, chair Philippe Bonnet led a minute’s silence for those lost to drug-related deaths and reflected on the changes since the last gathering. ‘Back then we didn’t have crack pipe schemes or drug consumption rooms,’ he said. ‘Some things have changed – but there is a lot more that needs to be done.’

Speaking on behalf of a group of harm reduction advocates, Chris Rintoul argued that specialist harm reduction had been squeezed by integration into treatment services. Tracing its roots back to 1980s Liverpool, he said harm reduction had since been absorbed by recovery-focused systems that weren’t always equipped to deliver it well. ‘One-stop shops can work,’ he said, ‘but when harm reduction is bolted to treatment you miss everyone who’s not in treatment.’ He warned that many newer staff had had little exposure to harm reduction expertise, as experienced workers and dedicated roles had steadily disappeared.

NITAZENE WAVE
Retired GP Dr Judith Yates presented death data gathered from coroners in the West Midlands, identifying more than 1,000 drug-related fatalities between 2009 and 2023. The last three years were particularly concerning, she said, with nitazenes driving a new wave of deaths. A single Birmingham batch was believed to have killed 30 people, while barriers to toxicology testing meant they were often misidentified as fentanyls. Two key at-risk groups who were not engaged with services were teenagers buying pills online and people in temporary accommodation using contaminated heroin, she warned.

Eleanor Clarke from the UK Health Security Agency (UKHSA) presented an overview of a proof-of-concept pilot to monitor NSP provision across a subset of services within England. During the pilot, data has been collected on both equipment distributed by NSP services as well as anonymised demographics of the service users. The data from the pilot are being used to evaluate the acceptability and feasibility of data collection to inform future work to monitor NSP provision nationally. She described the pilot as a first step in ‘a big piece of work’ to improve national understanding of NSP activity.

LIVED EXPERIENCE
Reflecting on the power of lived experience in harm reduction, The Hepatitis C Trust’s Stuart Smith said his organisation employed more than 100 peers and had five harm reduction hubs designed and run by people with lived experience. A 2023 pharmacy mapping project had reached 1,400 pharmacists, with further outreach and FOI work underway to assess the shrinking footprint of pharmacy-based NSPs. Danny Morris described how peer-led NSP outreach was engaging with people outside of services, with large numbers testing positive for hep C. ‘Some people are scared to pick up injecting equipment in case they lose their OST script,’ he said. New agreements with services allowed peers to distribute supplies and return anonymised data, helping to close the gap.

NNEF — Speakers (from left) Sue McCutcheon, Jamie Poole, and the team from Bristol-based Dandelion, who discussed NSPs for gender-affirming care

DYNAMIC MODELS
Sue McCutcheon, a harm reduction nurse in Sandwell, outlined the DEMO (Dynamic Evolving Model of Outreach) model, funded by Cranstoun, and challenged the idea that people ‘don’t want’ to engage.

‘They want help – but they want it how and when they need it,’ she said. DEMO provided nursing care, street prescribing, harm reduction and other essentials, with a focus on those with complex needs. ‘It’s shocking how much reused equipment we see,’ she stated. ‘It’s causing infections, wounds, and suffering.’ Peter Furlong of Change Grow Live echoed the message: ‘It’s our responsibility as services to go out and find people.’

Jamie Poole from Bridge the Gap Surrey challenged services to reflect on whether they were truly designed around the people who use them. Linking services – including housing, physical health, and mental wellbeing – was essential to creating systems that people could actually engage with, he said.

A BROADER VISION
Speakers throughout the day emphasised the importance of trauma-informed design, lived experience leadership, and truly integrated care across housing, mental health and physical wellbeing. The discussion around drug consumption rooms (DCRs) was a focal point of this broader vision for inclusive harm reduction. Ryan Connolly shared insight from Ireland’s first medically supervised injecting facility in Dublin, which had recorded more than 800,000 visits and responded to 98 overdoses without a single death. Naloxone and oxygen were on hand and the model was built on low barriers – there were no restrictions to access and people could come and go as needed, he pointed out.

From Scotland, Lynn MacDonald presented Glasgow’s Thistle DCR, which opened without a change in law when the country’s Lord Advocate confirmed that possession inside the facility would not be a police priority. Operating every day from 9am to 9pm, the service placed strong emphasis on lived and living experience, which had shaped its development. ‘We don’t have “interview rooms” – that sounds like the police,’ she explained. ‘We have chat rooms.’ The centre also included practical facilities, from a washing machine to vein-finding support.

With 362 individuals registered – a large percentage of whom injected cocaine – the Thistle had overturned 30 overdoses and required seven ambulance call-outs. Staffed by nurses and health workers, the service continued outreach efforts to understand why some eligible individuals were not yet using it, and was working to build public trust through community engagement.

Progress had been slower in England, said Release’s Shayla Schlossenberg. The Home Office still maintained that DCRs were illegal under the 1971 Misuse of Drugs Act but wouldn’t clarify reasoning, she said, citing ‘privileged information’. Campaigners were exploring two possible routes forward – either legislative reform or local agreements backed by ‘letters of comfort’ from police forces to enable pilot projects to proceed. She stressed the need for community buy-in and political courage. ‘Policymakers are worried about negative headlines,’ she said, ‘but the evidence and the need are clear.’

The message throughout the day was that harm reduction needed to be rebuilt – not just as a set of services, but as a specialist, evidence-led discipline capable of responding to a fast-changing drug market. And it must be built with – not just for – the people using it.

‘Soaring risk misperceptions’ around vaping, warns ASH

DDNWeb

July 14, 2025

Public confusion about the risks of vaping is on the increase, according to new data from anti-smoking charity ASH. Fifty-six per cent of adults and 63 per cent of young people now wrongly believe that vaping is as harmful or more harmful than smoking, up from 50 per cent and 58 per cent last year.

The estimated overall proportion of people who vape in the UK has ‘stalled’ at 10 per cent of adults, while 7 per cent of 11-17-year-olds now vape. This illustrated not just a ‘worrying lack of progress’ in reducing use among children but the potential underuse of vapes as a smoking cessation tool ‘amid soaring risk perceptions’, ASH states. Delegates at the recent Global Forum on Nicotine in Warsaw heard how ‘fear-driven’ media narratives were undermining vaping’s potential as a tobacco harm reduction tool.

While 7 per cent of 11-17-year-olds currently vape, 20 per cent have tried it. However, despite ‘compelling evidence’ that vaping can be an effective smoking cessation tool more than a quarter of adult smokers have never tried vaping. Misperceptions about the relative harms of vapes compared to cigarettes were highest among smokers who had never tried it, the charity adds.

ASH research published last year found that of all the people who had successfully quit smoking in the last five years, around 2.7m of them had used vapes to do so.

vaping risks — ‘We must urgently pass regulations to reclaim vaping as a quit aid’

A strong government communication strategy to reinforce the greater harms of cigarettes over vaping is urgently needed, says ASH, along with more support for initiatives like ‘swap to stop’ to maximise the potential of vapes to help people quit smoking. It is also calling for immediate scheduling for the committee stage for the tobacco and vapes bill to ‘unlock regulatory powers to reduce youth vaping’, such as banning brightly coloured packing and flavour descriptors.

‘We are stuck in a dangerous limbo,’ said ASH chief executive Hazel Cheeseman. ‘Misconceptions about the relative harms of vaping are acting as a barrier to switching among people who smoke, meanwhile children remain exposed to products designed to appeal to them. It’s the worst of both worlds. Inaction by the last government, and now delays by this one, mean we’ve waited too long to act; we must urgently pass regulations to reclaim vaping as a quit aid, reduce youth access, and get the UK back on track to end smoking.’

Use of vapes (e-cigarettes) among adults in Great Britain available here

#ddnconf 2025: that’s a wrap!

DDNWeb

July 11, 2025

The DDN Conference is over for another year – huge thanks to all of this year’s visitors, exhibitors and speakers. Look out for our conference coverage coming soon!

In the meantime, we’ve taken to social media to share some of your fantastic feedback. Read on for some conference highlights…

An excellent day spent at the DDN Conference in Birmingham today! Thank you again to the event organisers and everyone that chatted to us.

The team enjoyed meeting and chatting to attendees and sharing what we do at Abbeycare and the support available to help begin recovery from… pic.twitter.com/C94u1Tr9lW
— Abbeycare (@Abbeycare) July 10, 2025

We are today at the DDN Conference 2025.

Proud to be here alongside colleagues from Adferiad, Clouds House, Castle Craig, Yeldall Manor, and Broadway Lodge, all working together to support effective, trauma-informed, abstinence-based recovery.https://t.co/7CS72nqlnu #DDN pic.twitter.com/a4U08AceEA
— Choices Rehabs UK (@ChoicesRehabs) July 10, 2025

‘Alcohol is a silent killer. It can just take your life like that’: Rotherham woman shares her story for Alcohol Awareness Week

Your story

DDNWeb

July 11, 2025

This Alcohol Awareness Week, Zoe, a previous client of Rotherham Alcohol and Drug Service (ROADS), provided by the charity WithYou, is speaking out about her journey to recovery.

Her story comes after earlier this year, the latest statistics showed that in 2023, the UK saw 10,473 alcohol-specific deaths, a record high – 234 of those were in South Yorkshire.

Zoe’s story
Zoe suffered from three decades of alcohol dependency, which led to multiple detox and rehab attempts. After finding herself in a number of unhealthy relationships and coping by using alcohol and drugs, Zoe realised she was masking her true self. ‘I was not dealing with emotions and turning to substance. I was very unhappy – and in my late 30s I found out I couldn’t have a baby and that really hit me. But I pretended it didn’t. I never dealt with anything – grief, relationship breakdowns.’

Despite completing an 18-month rehab programme, Zoe’s drinking worsened when she got home. ‘I was so chaotic. I tried to take my own life. It was a vicious cycle all the time.’

Zoe’s turning point came when she met a new partner – now fiancé – and gained a step-daughter. She reached out to ROADS in 2021, and by January 2023 knew she needed intensive help.

Through the ROADS to Rehab programme, she prepared for treatment and attended groups, and secured a place in a residential centre. After six months of treatment, she graduated in January 2024, and hasn’t had a drink in two years.

Zoe WithYou — ‘I stopped drinking for everyone else, then soon relapsed. I realised I had to want to stop for me’

A new life
Today, Zoe has been transformed by her hard work and determination. She’s pursuing education – taking courses in mentoring, counselling skills, criminology and mental health at her local college. She swims nearly every day for her mental health, and she plans to marry her partner in September.

‘I’m a different person now,’ Zoe said. ‘I still have a fear factor but life’s so much different – it’s better and normal. I’m spending lots of time with my step-daughter, doing things I would have never done before.’

A message of hope
Zoe’s message to others struggling with alcohol is clear: recovery is possible, through professional support and personal resolve. ‘When you’re in addiction, you need people to believe in you as you have no self belief at all,’ she explained. ‘If it wasn’t for the people in ROADS believing in me, I wouldn’t have kept persevering.’ But it wasn’t just ROADS, she said, ‘ROADS was part of my recovery, however I believe it’s down to the person too and their commitment – their want and need to get the help. I stopped drinking for everyone else, then soon relapsed. I realised I had to want to stop for me, as I deserve a better life, not just those around me. When you want to do it for you, you will succeed.’

In the future, Zoe wants to help others, particularly vulnerable women. For the moment, she’s happy with her life as it is. ‘My main hope is that I want to remain like this. I don’t have any big aspirations. If I can just get up every morning and feel healthy and know I can get through the day.’

‘I’m happy to share my story to help anybody else,’ she added. ‘If it helps another person then it’s done some good. If it helps them realise there is some help if they want it. As a lot of people just give up.’

Richard Hopper – I am a…

DDNWeb

July 11, 2025

Richard Hopper is a recovery worker at WithYou North Lincolnshire. We asked him about his career path and role.

WHAT MADE YOU WANT TO WORK IN THIS FIELD?
I’ve been a service user myself and the staff were really supportive and a big part of my recovery. I have a really good work ethic, I think of how much people have given to me, and I want to pay that forward and do anything I’m able to.

Towards the end of my treatment journey, I got myself involved in setting up and running a recovery cafe for service users, a safe space. For that work, I received a High Sheriff’s Award at Lincoln, which meant going to Lincoln Castle to receive the award and meeting the High Sheriff at the time – it was amazing.

In 2010 I became a volunteer for Rotherham, Doncaster and South Humber NHS Foundation Trust, and, towards the end of coming off my prescription, I did a peer mentoring programme – so I was actively involved with work going on within drug services in the area. After coming out of treatment and doing all of this work I thought, that’s what I’d like to get into. In 2012, at the end of the peer mentoring training, a role came up in Scunthorpe for a recovery champion, which was paid employment, and I got that role. As part of that I was attached to an aftercare worker, so I was working a lot with aftercare clients, but also those hard-to-reach clients who were taken into one to ones with the staff as part of the drug intervention programme. I actually ended up running the aftercare service myself.

Then in 2016 two staff members went on maternity leave and a chance came up for me to express my interest in the recovery co-ordinator role, which I got. So I’ve been doing that ever since. I still remember the very first meeting in the morning, and all these acronyms were being thrown all over, and I felt like a fish out of water. But the staff have been amazing, management as well. I’ve been quite lucky. It’s a fantastic place to work, and I absolutely love it every day.

WHAT DOES A TYPICAL DAY LOOK LIKE?
In the morning I come in early and prepare myself for the day. At 9:15 we have the flash meeting where we discuss who’s attending appointments, any safeguarding issues that have arisen, or any clients who are in hospital or having any issues. Then usually 9:30 is my first appointment of the day with a client.

Recently I was supporting a client who had been needing to visit the GP for a while to address his health concerns. I picked him up and took him to his GP appointment, and soon I’ll be taking him to another for a blood test. He just needed support to actually go and be seen.

On a Monday and Tuesday, I work with colleagues at a satellite service near the Humber Bridge. The location makes it a lot easier for clients to access treatment. I have one to ones with clients and a prescriber and a nurse come out once every two weeks.

I also work with other organisations. Recently our community engagement worker and I visited The Forge Project, which supports homeless people, to deliver training and distribute naloxone to staff and volunteers at the project. On a recent Saturday, I went to a festival raising money for mental health where we hosted a stall. A colleague and I also gave a talk about alcohol to the fire brigade, and we’re working with the police and probation on naloxone training.

Richard Hopper — ‘You may be the only contact your client has, and it could make their day coming into that appointment, having someone to offload to, someone to listen to them. Everyone deserves that’

WHAT DO YOU FIND MOST REWARDING?
The engagement with the clients. A lot of the ones I work with, I’ve had past, lived experience with those clients as well. So it’s nice to be able to see them move forward with their journey, with their own recovery, whatever that looks like. We’ve got a lived experience worker who works here, who happens to be one of my clients as well. Actually seeing them come through treatment, then working here and being so successful within their new role – that’s just fantastic as well.

WHAT WOULD YOU LIKE TO CHANGE?
People’s perception of our clients. Not just the general public, but also the other services they access. Sometimes our clients struggle with hospitals, pharmacies and the GPs. In some places you get treated like a second class citizen. I know they have met some clients who might be a bit more vocal, but there isn’t always an understanding of what that client might have been through that morning or that day, and the frustration they’re experiencing, especially when they can see they aren’t being treated the same as others. Substance users are human beings. They’ve got mothers, brothers, sisters and uncles. It would be great if we could change people’s perceptions.

WHAT’S YOUR ADVICE FOR ANYONE CONSIDERING A SIMILAR CAREER?
For anyone, I think it’s a very rewarding job. It can be hard and frustrating, but even seeing just those small little wins, that’s enough to inspire you to keep going. You may be the only contact your client has, and it could make their day coming into that appointment, having someone to offload to, someone to listen to them. Everyone deserves that.

See opportunities like Richard’s on DDN Jobs

Drugs undermining every aspect of prison life, say inspectors

News

DDNWeb

July 8, 2025

The supply and use of illicit drugs are ‘undermining every aspect of prison life’ says a damning report from HM Inspectorate of Prisons.

The threat from organised criminals is not only destabilising jails but also stopping them from delivering the kind of rehabilitative work that cuts reoffending rates, says the document, which calls on the government to ‘take far more seriously the widespread ingress of illegal drugs into prisons’.

The influx of drugs is creating ‘huge pressure’ for people living and working in the prison estate, says chief inspector of prisons Charlie Taylor, who added that it was ‘unsurprising, though deeply worrying’ that assaults on staff had risen by 13 per cent in a year while those on other prisoners were up by 10 per cent.

‘Far too little’ is being done to keep drugs out of prisons, says the report, with drones making regular deliveries to prisons like Manchester and Long Lartin, both of which hold ‘some of the most dangerous men in the country’. Positive random drug test results frequently reach more than 30 per cent, it continues, with a ‘staggering’ 59 per cent of randomly selected prisoners testing positive in one category C prison. However, mandatory drug testing has still not returned to pre-pandemic levels, the document points out, ‘making it difficult to estimate national drug use or compare outcomes between prisons’.

Overcrowding and boredom caused by lack of activity were driving the demand for drugs, the report states, with 28 of 38 prisons inspected delivering ‘poor or not sufficiently good’ outcomes in purposeful activity. Six of the prisons rated poor were category C, establishments that ‘should have been providing prisoners with the skills they needed to resettle successfully in the community’. The poorest scores for safety, meanwhile, tended to be in local and category B training prisons, with many inmates ‘trapped in a cycle of boredom, frustration and poor behaviour, which fuelled the demand for drugs and increased violence, debt and self-harm’.

In prisons like Manchester (formerly Strangeways) inexperienced staff were being routinely ‘manipulated or simply ignored’ by prisoners, while many other jails saw little interaction with staff, exacerbating levels of frustration and poor behaviour. ‘Prisoners often struggled to get busy or inexperienced officers to help them with simple requests, and women were particularly affected, with a lack of day-to-day support causing such distress that some resorted to self-harm,’ the document states. A separate report from the inspectorate earlier this year found that the rate of self-harm in UK women’s prisons had ‘skyrocketed’ and was now eight times higher than in men’s, with ‘astonishing gaps in basic decency’ including women being given ill-fitting prison-issue men’s clothes to wear.

Capacity pressures on the prison system had brought it ‘dangerously close to collapse’ last year, according to former justice secretary David Gauke’s sentencing review, which recommended a shift away from sentences of less than 12 months. While the government has accepted the majority of the review’s recommendations, the impact will take time to be felt, says the chief inspector’s report, while the government’s controversial early release schemes ‘have only temporarily alleviated’ the capacity crisis. Many prisoners were spending most of their days in ‘cramped, shared cells, where broken furniture and windows, and infestations of vermin, were common’, it adds.

A report almost a decade ago from the previous chief inspector of prisons, Peter Clarke, warned that drugs were behind a ‘huge increase’ in prison violence, with ‘shockingly high’ numbers of people developing drug problems while detained.

Drugs undermining every aspect of prison life, say inspectors — Positive random drug test results frequently reach more than 30 per cent

‘This has been another very difficult year for all those living and working in prisons in England and Wales,’ said Taylor. ‘I cannot overstate my concern about the rapid and widespread ingress of illicit drugs, which is severely impacting the essential work of staff in reducing the risk of prisoners’ reoffending. Only when the prison service is able to keep drugs out of jails so that staff can focus on getting prisoners involved in genuinely purposeful activity, can we expect to see them play a meaningful role in rehabilitating, rather than simply warehousing, the men and women they hold.’

The report painted a ‘bleak but sadly familiar picture of a prison system in deep crisis,’ said Prison Reform Trust chief executive Pia Sinha. ‘When over 30 per cent of drug tests are coming back positive, when prisoners are locked in squalid, overcrowded cells with little to do, and when mental health needs are going unmet, it’s not just a prison problem – it’s a public safety issue. Prisons should be places of rehabilitation, not warehouses of despair.’

‘Drugs, and the violence associated with them, in part fill the void that is created by overstretched and under-resourced prisons failing to offer positive regimes that get people out of their cells and involved in activities,’ added chief executive of the Howard League for Penal Reform, Andrea Coomber.

With the number of drug seizures by prison officers now standing at more than 21,000 annually, the figures were ‘truly shocking’, said an editorial in the Independent – ‘or they would be, were it not for the pervasive sense of resignation about everything that pertains to our prisons. The ubiquity of drugs then risks being seen as just one aspect of a disastrously failing system.’

HM inspector of prisons for England and Wales, annual report 2023-24 available here

DDN Conference 2025: speakers

DDNWeb

July 8, 2025

10 - 11.20 am Session one

Jamie Poole

Jamie Poole, Bridge the Gap Surrey: Trauma-Informed Outreach

Levelling the field: How lived experience is proving a lifeline to those affected by multiple disadvantage.
Jamie Poole is a lived experience project manager for the Changing Futures programme with Surrey County Council. Jamie’s own lived experience has helped to shape the person he is today.

Zack Haider

Zack Haider, Intuitive Thinking Skills

New prospects: Changing the course of your future through the individual placement and support (IPS) employment programme.
Zack Haider has been with Intuitive Thinking Skills from the beginning and brings a wealth of personal and professional experience to his role as Community Development Director. He says, ‘My real passion is in helping people solve their own problems rather than create another dependency.’

Jon Roberts, Dear Albert and Andrea Knowles, Turning Point

LEROs at large! How do you work in partnership with providers while maintaining your independence?
Jon Roberts is the founder of Dear Albert, a Midlands-based peer-led social enterprise promoting positive change by communicating recovery as a viable and attractive option. Dear Albert delivers targeted support, combining innovative approaches with evidence-based initiatives.

Andrea Knowles is the Senior Operations Manager for Turning Point, Leicester City. Andrea has worked in substance use treatment services since 2002 in a range of roles, before working with Turning Point Andrea worked in the NHS. Andrea has a specific passion around women’s health, safeguarding and the power of education and prevention.

Andrew Mitzwa-Mubayiwa Hannah Mordey

Andrew and Hannah, Social Interest Group

From the outside in: A personal journey from homelessness, showing how the right support is crucial.
Hannah Mordey, Activities Coordinator within a Complex Needs Support service in the Social Interest Group, talks to Andrew Mitzwa-Mubayiwa about his experiences when homeless, his recovery, and his projects and ideas for creating meaningful change for individuals facing homelessness.

11.50 am - 1.00 pm Session two

Grahame Morris

Grahame Morris, MP Chair of the All Party Parliamentary Group on Drugs, Alcohol and Justice

Power in our hands: Politics starts with you – how we can all be agents for change.
Labour MP Grahame Morris has represented Easington since 2010. He chairs the All-Party Parliamentary Group on Drugs, Alcohol and Justice – a policy forum for providers and interested parliamentarians, with a focus on evidence-based harm reduction, treatment, and recovery.

Dr Abida Mohamed

Lisa Ogilvie

Syncora/Acorn Recovery/Delphi

The ketamine challenge: How can we tackle the rise in ketamine use and provide appropriate support – with young people’s insights.
Dr Abida Mohamed, Clinical Lead, Delphi Medical
Dr Abida Mohamed is a GP with a background in psychiatry and a clinical focus in addiction medicine. She is the Clinical Lead at Delphi Medical, where she develops and oversees treatment pathways for ketamine addiction and other substance use disorders, with a focus on early intervention and integrated care models.
Fin, Founding Member, Ketamine Care Hub
Fin, 25, was in recovery treatment with Acorn when he realised there were no specific support groups for ketamine use. He founded the Ketamine Care Hub to offer a confidential and safe space for people to talk about addiction and sensitive health issues in a peer-led environment.
Dr Lisa Ogilvie, Chartered Psychologist, Acorn Recovery Projects
Dr Lisa Ogilvie is a Chartered Psychologist working with Acorn Recovery Projects and a Visiting Academic at the University of Greater Manchester. She specialises in applying positive psychology to support individuals undergoing treatment for substance use disorders.

Kim Moore

Kim Moore, Blossome Support

The ripple effect: Looking at how you can use self-compassion and self-care for yourself and your family – a story told from a very personal perspective.
Kim founded Blossome Support following the loss of her husband to alcohol. The organisation provides support and connection for anyone who has endured a loved one’s suffering from alcohol or addiction. Blossome offers group support, activities, and self-compassion training in a trauma-informed, compassionate community.

2.00 - 3.45pm Session three

Jim Duffy

Jim Duffy, Smoke Works, Boston

Feel the need, be the change: An exciting and innovative peer-led harm reduction initiative from across the pond!
Lived experience led Jim to direct service work in the Boston harm reduction community in 2018. A former stimulant user, he was impressed with the resources available for people who inject drugs but disheartened by the lack of engagement with stimulant users. Smoke Works aims to dismantle barriers to help harm reduction programmes reach more people with safer smoking supplies.

Mark Gilman

Mark Gilman, Harm Reduction Research, Policy and Practice

Bringing it back to you: Organising, mobilising, influencing… how do we get the right treatment and support for every one of us?
Mark Gilman has spent over 30 years working in addictions research, policy, and practice. He has worked for Public Health England and the National Treatment Agency. Mark has championed the importance of lived experience in shaping policy and treatment, and he passionately advocates for integrating harm reduction into treatment services.

Break the cycle

Features

DDNWeb

July 7, 2025

In a system where many feel left behind, Foundation2Change (F2C) stands out as a beacon of possibility. Built by people with lived experience of addiction, offending and long-term recovery, this innovative organisation is transforming how rehabilitation works – starting with trust, continuity, and meaningful opportunity.

The founding directors of F2C spent years working in frontline health and social care, managing services that supported individuals repeatedly cycling through prison, addiction, and homelessness. Despite their commitment, they witnessed the same people return time and again trapped in a relentless revolving door. Drawing on their own lived experience of addiction and offending, and having achieved long-term recovery and stable employment, they understood that good intentions weren’t enough. The system needed to be reimagined from the inside out.

Rather than assuming what people needed, the team began by asking prisoners directly: What would it take to create lasting change in your life? The answers were consistent – trust, lived experience support, through-the-gate guidance, and safe, stable housing.

Foundation 2 Change was built on those insights. Grounded in lived experience and person-centred practice, we mapped the prison system from the inside – speaking with more than 100 prisoners to understand the barriers they faced. From these conversations we developed a programme co-produced with individuals who had lived through the very challenges we aim to address. This approach helped us secure a seven-year contract with the NHS, and we are now proudly in our third year of delivery.

The F2C model is a comprehensive rehabilitation journey that begins in custody and extends into community life. The organisation works with individuals during the last three months of their sentence, delivering structured rehabilitation group work focused on trauma-informed care, emotional literacy, and behaviour change. The aim is to help people identify the internal and external triggers that keep them stuck in destructive cycles.

This work has seen tangible success – 86 per cent of participants who engage in custody-based programming and transition to community support do not return to the system. That impact is driven by consistent, relational engagement and a model based on Maslow’s hierarchy of needs, supporting individuals to first stabilise, then grow.

Many people affected by addiction have lost confidence, self-worth, and basic life skills. Foundation 2 Change understands that recovery takes time and the right support.

That’s why life skills training is a key part of the programme – from cooking and budgeting to financial resilience workshops delivered with HSBC, participants learn how to manage everyday life. They also get help preparing for work, including writing CVs, interview practice, and job searching.

Sustainable recovery is about more than sobriety – it’s about connection. F2C supports participants in building lasting relationships through integration into 12-step fellowships and other community-based recovery interventions. By embedding individuals into a wider network of support, F2C ensures that no one must face the challenges of change alone.

86 per cent of participants who engage in custody-based programming and transition to community support do not return to the system

Beyond the prison gates, Foundation 2 Change has worked in close partnership with an established housing provider, which offers one-bedroom flats to individuals who have shown a clear commitment to their recovery – maintaining abstinence, engaging in education or volunteering, and preparing for employment.

This is more than just housing – it’s a platform for long-term independence. Each resident benefits from wraparound support, including recovery coaching, housing guidance, and mentoring from staff with lived experience. The aim is not only to help individuals stay sober, but to empower them to thrive.

F2C isn’t just supporting individuals – it’s changing attitudes towards addiction and offending. By partnering with the NHS, police, probation services, education, and housing providers, F2C is showing that lived experience is a powerful asset, not a liability. The organisation’s success comes from its staff and leadership, who have walked the same path as those they support. They offer hope through both words and actions.

In its third year of the NHS contract, Foundation 2 Change is expanding its reach and deepening its impact. Its work proves that recovery is not always a straight path, but with the right support, change is possible. By combining rehabilitation, safe housing, practical skills, and community support, F2C is breaking cycles and building futures to help people once again become productive members of society.

Jay Arnold and Andrew Shelton are co-founders and directors of Foundation 2 Change

Save the children

Features

DDNWeb

July 7, 2025

A report from the National Police Chiefs’ Council’s (NPCC) National County Lines Coordination Centre (NCLCC) late last year found that the traditional county lines business model was changing, with activity now starting to become much more localised.

A 12 per cent drop in ‘external lines’ – activity that crossed a policy force boundary – was accompanied by a significant increase in lines that began and ended within a single force’s boundary.

The NCLCC estimates that there are almost 1,500 organised crime groups linked to county lines activity, which continues to be dominated by street or ‘burner’ phone sales of crack or heroin. Despite a perceived drop in the number of children involved, the basic county lines model still involves widespread child criminal exploitation as well as child sexual exploitation. The Home Office estimates that around 14,500 children were identified as at risk of, or involved in, child criminal exploitation last year. ‘We know this is likely to be a significant underestimate,’ it acknowledges.

EXTREME VIOLENCE
Transporting drugs, or selling drugs directly to customers, puts children ‘in the most dangerous role within the supply chain’, says the NCLCC – ‘possessing valuable cash and commodity that other criminals may seek to steal, and with potential for violent conflict linked to the drugs operations, particularly over territory.’ The stark reality of the situation was highlighted in a harrowing 2021 report from the University of Nottingham, which described how county lines activity was becoming characterised by more and more extreme violence and sexual exploitation (DDN, July/August 2021, page 5), with young people often controlled through the harbouring of sexually explicit images, along with widespread sexual abuse of both females and males

The Youth Justice Board’s (YJB) Serious incidents report from earlier this year also highlighted the fact that children involved in serious incidents are often the victims of the ‘challenging circumstances in which they live’. While this didn’t ‘diminish the significant impact that these children can have on others’, said the board’s CEO Stephanie Roberts-Bibby, it did underscore the need to ‘address their vulnerabilities and exploitation, and to ensure effective early intervention to safeguard them from harm’.

There were almost 440 serious incidents notified to the board in 2023-24, involving nearly 550 children, and more than 40 per cent of the children notified were said to be ‘gang affiliated, criminally exploited, or involved with the national referral mechanism (NRM) process’ (designed to identify victims of modern slavery). More than half of the notifications were for GBH, with 13 per cent for murder or manslaughter, 9 per cent for attempted murder and 16 per cent for rape. Eighteen per cent of the murder/manslaughter incidents, 23 per cent of attempted murder incidents and 10 per cent of ‘death of a child’ incidents were ‘potentially gang or county lines related’, the document adds.

DEBT BONDAGE
One of the key reasons that the scale of child criminal exploitation linked to county lines is highly likely to be under-reported is that victims frequently ‘do not see themselves as such’, says the NCLCC report. Those most at risk of exploitation by county lines gangs remain boys aged between 15 and 17, usually ‘groomed with the promise of money and gifts and then exploited, forced or trapped into day-to-day drug dealing by debt bondage or threat of violence’. The boys describe ‘being trafficked to trap houses across the country, deprived of food, heat and any comforts, and being required to forego sleep to respond to orders 24/7’, it continues. Children are frequently robbed, including by associates of the same people they work for, then forced to work more to pay off the ‘debt’.

Added to this, of course, is the significant problem of ‘cuckooing’, where often-vulnerable adults have their homes taken over by the gangs to sell or store drugs (DDN, May, page 6). In cuckooed premises there is a rise in video diaries being shared on social media platforms, the NCLCC report states. These will ‘often be of vulnerable adults (male or female) who visibly present suffering from the effects of long-term drug addiction and/or poor mental health’ with the videos showing them being ‘abused, laughed at, violently assaulted, made to clean up or perform in a demeaning way.’

Recording of cuckooing varies from force to force, with limited datasets meaning that the true scale is hard to assess. However, ‘some indication’ can be taken from the fact that almost 730 drug lines are currently recorded as using cuckooing as part of their modus operandi, says NCLCC, while almost 1,300 properties where cuckooing had been either reported or suspected were visited during this year’s ‘county lines intensification week’ in March – a figure largely unchanged from last year.

NEW OFFENCES
While new specific offences for both cuckooing and child criminal exploitation form part of the government’s crime and policing bill (DDN, March, page 4), the NCLCC report stresses that policing needs to ensure it ‘consistently recognises and responds appropriately to vulnerability and exploitation’, particularly in light of the shift towards a more localised model.

So how much of an impact are the new specific offences likely to have in terms of getting to grip with the problem? ‘We believe the new offences of child criminal exploitation and cuckooing in the crime and policing bill will have an impact on tackling county lines,’ an NPCC spokesperson tells DDN. ‘It will be much clearer that these are crimes and therefore assist in identifying and responding to that offending.’

However the changing county lines model – with fewer young people crossing force boundaries – may mean that it’s ‘harder to identify children who are being exploited locally’, the NPCC adds. ‘This could be because the warning signs are not so obvious – for example missing episodes are shorter, and/or they are reported missing less.’

It also remains unclear whether this shift represents a permanent trend. ‘We are actively working on a new threat assessment at the moment, which we hope to publish towards the end of the summer,’ the NPCC tells DDN. ‘However, early indications are that the threat has remained relatively stable for the last 12 months, and therefore the localisation of the model has not advanced much further since that last report.’

‘We need to continue to educate children and young people so that they understand what grooming looks and feels like' — ‘We need to continue to educate children and young people so that they understand what grooming looks and feels like’

IMPROVED TRAINING
The need for better training for police and other professionals was one of the key themes of a 2022 report from criminal justice consultancy Crest Advisory (DDN, October 2022, page 4), as agencies were frequently missing the ‘red flags’ indicating children were at risk of exploitation, it said. The document included 13 detailed case studies, with common features including domestic abuse, drug misuse, and periods of going missing. The Children’s Society has also previously warned about inconsistencies in the approach of professionals working with children, with some recognising county lines activity as exploitation and others viewing the young people simply as criminals.

So is that perception becoming less common now – is there more awareness among frontline officers, and are they less likely to miss the red flags that might indicate the young people are potentially being exploited? ‘There is a much greater perception of child victims of criminal exploitation amongst police officers and this is reflected in the large reduction in arrests and prosecution of children, particularly for drug supply offences,’ says the NPCC spokesperson. ‘It is also shown in the large number of safeguarding referrals, where policing is identifying those at risk of child criminal exploitation and then making referrals to statutory and non-statutory specialist provision to get them support and safeguarded.

‘We need to continue to educate children and young people so that they understand what grooming looks and feels like, understand how they may be exploited and help to build resilience against the threat of county lines gangs who wish to exploit children.’

Youth Justice Board Serious incidents annual report 2023-24 available here

County lines strategic threat risk assessment available here

DDN July/August 2025

DDNWeb

July 7, 2025

With no time to lose, our sector has a vital role

Violence and exploitation have dominated the grim world of county lines, and authorities and children’s charities are working out how to respond more effectively (cover story). What’s clear is that the ‘red flags’ that could indicate a trail of abuse are highly likely to cross our paths so there’s no time to lose in understanding the latest strategies. The future of thousands of vulnerable young people is at stake and our sector has a vital role to play.

Strategy for our services has a central thread of lived experience these days – and is all the richer for it. Innovation is king among the entrepreneurial communities that share their stories in this issue, and the work to transform life in the criminal justice system to a horizon of opportunity is particularly inspiring (page 8 and our centre-page pullout). They are running on the inside lane of campaigns to smash stigma and their results speak for themselves.

And while we look back on some crucial milestones – for the sector’s history (p18) and for many individuals (p26) – we look forward to more of the creativity that brings joy to this month’s pages (p10 and p20). Never be in doubt that ‘people in recovery have creative minds’!

Read the July/August issue as an online magazine (you can also download it as a PDF from the online magazine)

Claire Brown, editor

Nearly two thirds of people drinking more for work-related reasons

News

DDNWeb

July 7, 2025

Nearly two thirds of people drinking more for work-related reasons — ‘Job stress, pressure and anxiety’ had all caused people to increase their consumption in the past 12 months

Almost two thirds of UK workers report drinking for work-related reasons, according to a survey of more than 2,000 people by Alcohol Change UK. ‘Job stress, pressure and anxiety’ had all caused people to increase their consumption in the past 12 months, said research released as part of Alcohol Awareness Week.

The theme of this year’s Alcohol Awareness Week – which runs from 7 to 13 July – is alcohol and work. More than a third of workers said they felt more comfortable talking about mental health in the workplace than alcohol, with 40 per cent reporting drinking more because of work-related anxiety, 38 per cent drinking more to cope with stress at work, and 36 per cent drinking to cope with the pressure of deadlines. Almost 30 per cent also reported drinking more because of fears over job insecurity, but just 21 per cent thought their alcohol consumption during the evening and at weekends was having a negative effect on their work performance.

However the findings also pointed to a ‘strong appetite’ among employees for preventative action and education, says the charity, with more than 80 per cent of workers believing that employers have some responsibility to address alcohol in the workplace.

Alcohol health campaigners recently criticised the government’s new Ten-year health plan for England for its failure to include ‘key policies’ to tackle alcohol-related harm, such as tighter advertising restrictions or the introduction of minimum unit pricing.

Almost two thirds of UK workers report drinking for work-related reasons, according to a survey of more than 2,000 people by Alcohol Change UK — More than 80 per cent of workers believe that employers have some responsibility to address alcohol in the workplace

‘Although the work we do is hugely varied, this research suggests that in the last year many of us have been drinking more alcohol in an attempt to manage work-related stress, anxiety, pressure and job insecurity,’ said Alcohol Change UK’s head of consultancy and training, Jane Gardiner. ‘Yet, from poor sleep and hangovers to high blood pressure, depression and other health conditions, alcohol can take a big toll on our health and wellbeing. While it may offer short-term relief for some, over time it’s more likely to worsen feelings of stress, anxiety and pressure and lead to a cycle of self-medicating that can be hard to break free from, even if we want to.

‘Mirroring the progress seen in mental health in the workplace in recent years to drive conversations, boost compassion and support and reduce stigma, it’s so encouraging to see such strong appetite for alcohol awareness and education from workers,’ she continued.

More on Alcohol Awareness Week here