FAIL (the browser should render some flash content, not this).
 
 

The Failure of the NTA

The NTA has the worst success rate just 4.3%, in treating addiction and dependency problems. They will continue to deliver these disastrous results until they introduce better treatments options to help with addiction and dependency problems.

"During a decade of Labour drugs strategy, policy itself has become an intrinsic part of the problem. It has been a costly investment in failure. The combination of centralised targets and a ‘medical management' approach to treatment has further entrenched addiction, adding to intergenerational cycles of substance dependency'.

The Tory's have said they will abandon Labours failed addiction policy and David Cameron said 'we urgently need reform to make our whole health service more efficient'.

Some have called for the 'NTA to be dismantled if the Tory's return to power as they continually block change and better treatment options'. In February 2010 Iain Duncan Smith MP gave a speech in which he called for the National Treatment Agency for Substance Misuse to be replaced.

Graham Lettington DAT Co-ordinator also said "During the 8 years working in the delivery of local drug and alcohol strategies I increasingly despair at the direction the NTA has led addictions treatment. In my view their abolition is essential to remove an unneccesary layer of bureaucracy including the burdensome data collection systems they have imposed on treatment providers, which serves no useful prupose and is only utilised to justify the continued need for the NTA".

The National Treatment Agency is a health quango started in 2001 to improve the availability, capacity and effectiveness of drug and alcohol treatment in England however critics say 'it is an overwhelming failure arguing that these bodies 'are used by ministers to avoid taking responsibility for failures in public service delivery'.

Results of NTA Treatment

  1. UK is the worst in Europe
  2. Alcohol deaths up 40%
  3. Drug deaths at 8 year high
  4. Cocaine five-fold increase
  5. £10bn spent on treatment
  6. Only 2% referred to rehab
  7. 4.3% remission rate
  8. Misleading Lancet study
  9. Blocks change & innovation
  10. Failed treatment options
  11. Harm Reduction a disaster
  12. £39billion cost to society
  13. No New Treatments

Critics say 'year on year the NTA fails to deliver success as the numbers of addicts emerging from Government treatment programmes are at the same level as if there had been no treatment at all'.

Unfulfilled Pledge
As Health Secretary Patricia Hewitt in 2006, pledged to help families affected by drug abuse. She said: 'We will continue to reduce the effects damage caused by the most dangerous drugs by ensuring effective treatment is available.'

But 4 years on, no new treatments have been commissioned to help with addiction and dependency problems.

After 8 years of failure even the NTA are beginning to recognise the need for success and so published a study in the Lancet medical journal.

The Lancet Study
In 2007/08 the NTA recorded success rate was just 3.6% however in 2009 they published an article in the Lancet medical journal in (October 09) claiming 'around two-thirds (66%) of people stopped using these drugs within six months of treatment initiation'.

0% Success
The truth is, they treated 14,656 addicts over 6 months and not a single person left the program drug free, they were simply put on methadone (heroin substitute). In effect the Lancet study is 'evidence based' that NTA treatments do not work.

Professor David Clark Director, Wired In said 'this whole agenda was about protecting the so-called integrity of the NTA (and the government-supported treatment system), rather than caring whether we are actually helping people whose lives have been so badly affected.

This is a disgraceful matter and should be looked into further. The implications for the future of drug treatment are potentially very serious'.

Critics suggest the Lancet should retract the 'meaningless and irresponsible' study.

The NTA Dodgy Dossier
Addiction Today have called the Lancet study a dodgy dossier. 'We must all be very careful about data taken from agencies which are potentially under threat if they are not seen to be getting good outcomes. At the end of the day, these findings will be used to continue with the same ineffective system of non-treatment and denying patients, their families and society the promise of improved lives'.

No Hope
Experts agree 'addicts have 'no hope' of getting off drugs with current NTA treatment options' as rehab doesn't work and the Lancet confirmed other treatments do not work either, this explains why so few addicts stop their drug use and the ones that do, are those who would have quit anyway, just 4.3%.

NTA U-Turn
In January 2010 The NTA launched a dramatic U-turn less than 3 months since The Lancet study claimed '66% of drug user stop using drugs due to their treatment methods'.

New Buzzword - Recovery
The objective is to now 'communicate the NTA shift in policy towards recovery and explain the recovery concept to tier 3 prescribing drug workers to facilitate a shift in thinking and a change of culture across the NTA/DATs, and demonstrate how to make recovery relevant and accessible to serious drug users'.

Critics have said this is just 'lipservice and a desperate bid for survival' before the next government, who have questioned the need for the NTA. 'New rhetoric, same old treatments' said one critic.

The Way Forward
We can help solve these problems but the NTA have ignored our efforts to help those people who are in need of real treatment.

Until the NTA commission new treatments to help with addiction and dependency problems this situation will continue and tax-payers will continue to fund a system which wastes £800 million per annum.





National Treatment Agency for Substance Misuse (NTA)

The NTA is a special health authority, established by the Government in 2001 to improve the availability, capacity and effectiveness of drug treatment in England.

  • improves the commissioning of drug treatment services
  • promotes evidence-based and co-ordinated practice
  • improves the performance of drug treatment commissioners and practitioners

The NTA is responsible for implementing the treatment target of the Government's national drug strategy:

  • to increase the participation of problem drug users in drug treatment programmes by 55% by 2004 and 100% by 2008 (against a baseline set in 1998)
  • to increase the proportion of users successfully sustaining or completing treatment programmes year on year

The NTA also impacts on the other elements of the drug strategy, such as protecting communities from drug-related crime.

The NTA is responsible to the Secretary of State for Health. The NTA has a central office in London and nine regional offices across England.

Criteria for success
The NTA is monitored against the following criteria for success:

  • access to treatment - double the number accessing structured treatment between 1998 and 2008
  • capacity - recruit an additional 3,000 practitioners to the drug treatment workforce
  • efficiency - increase efficiency of treatment services - indicated by reduced waiting times
  • effectiveness - increase the proportion of people completing or appropriately continuing treatment
  • (no mention of actually getting people off drugs)

Drug misuse impacts on many areas of people's lives. It causes or risks damage to individuals' health and welfare, the emotional and psychological well-being of their families and the safety of the wider community, and leads to the continuation of social exclusion and poverty. Evidence shows that appropriate treatment is the most effective way to tackle these harms.

While drug misuse has become widespread, for the majority it will not escalate into problematic drug misuse. A small minority of approximately 330,000 people will develop serious problematic misuse, typically of heroin and/or cocaine. This is the group that the NTA targets.

THE STORY OF DRUG ‘TREATMENT'

The UK has the worst drug problem in Europe. Below is the story of the events leading up to this.

  • The election of the Labour government in 1997 marked a new direction for drug policy. It developed a ‘harm reduction' strategy which aimed to reduce the cost of problem drug use.
  • The focus was switched from combating all illicit drug use to a smaller sector: problem drug users, depersonalised as “PDUs”.
  • Cannabis was reclassified downwards.
  • Spending on methadone prescriptions tripled between 2003 and 2008.
  • The aim of ‘treatment' for drug offenders was no longer abstinence but ‘management' of their addiction with the aim of reducing their reoffending. In practice, this meant prescribing methadone.
  • Government targets were imposed on new quangos such as the National Treatment Agency for Substance Misuse in an attempt to increase the number of PDUs in treatment – which for most people meant getting a methadone prescription.
  • Of the 200,000 or so problem drug users currently claimed to be in ‘treatment', only 6,700 have undergone “inpatient treatment” (ie, brief detoxification, a physical first step before treatment). Only 4,300 have had residential treatment.
  • A Drug Intervention Programme was introduced to direct those guilty of drugs-related offences into ‘treatment' – again, in practice this meant prescribing methadone. There is little evidence that this has been effective.
  • This disproportionate harm-reduction focus has failed. It has trapped 147,000 people in state-sponsored, taxpayer-funded drug use.
  • At the same time, the numbers of recorded offences for importing, supply and possession of illicit drugs have all fallen in the past decade.

source: Addiction Today

Drug Figures 2009
The NTA 2009 report now claims in '2008/09 8,980 individuals exiting 'free of dependency' which represents just a 0.7% increase on the previous year to 4.3% in 2009 or £89,086.00 per addict.

DAT Whistleblower
But one of their own increasingly disillusioned Drug/Alcohol Action Team commissioners wrote to Addiction Today and said 'the terms ‘treatment complete' or ‘treatment complete, drug free' are not clinical terms/definitions – the terms essentially record entry into and exit from the NDTMS reporting framework and have no clinical value at all.

Even accepting this figure crtics say 'The NTA's key error is to attach clinical significance to these numbers when they actually just show those 'in and out' the reporting framework'.

So no-one really knows if any of the 8,980 people who were claimed to be drug free, were actually drug free.

James Brokenshire MP
Shadow Home Affair Minister asked [3.11.09] the Secretary of State for Health what criteria the National Drug Treatment Agency uses to make its assessment of whether a person leaving treatment is drug-free; and whether such assessments take account of the use of alcohol', we look forward to their reply.

Natural Rate of Remission
In any event, critics point out 'any of those who are said to be 'free of dependency' (4.3%) are just the ones who would have quit anyway, known as the natural rate of remission'. In any given year at least 4 to 5 per cent of people will quit their drug use simply because they have had enough and want to be drug free.

It is therefore more likely any NTA success is attributed to the natural rate of remission rather than successful treatment as the Lancet study proves NTA treatments do not work, out of 14,656 addicts not a single person left the study drug free.

2% Residential Rehab
Around 19 rehabs in the UK have closed and others made counsellors redundant. Most depend on the state for clients – but it refers only 2% of drug abusers to drug-free treatment as NTA board member Peter McDermott stated in The Observer last November that "Residential rehab doesn't actually work very well" and NTA head-office staff told BBC home editor Mark Easton, when researching a programme, that “there is no evidence that rehab works”.

Relapsing - Waste of Money?
One of the mains reasons why the NTA is reluctant to use rehab which costs between £500 to £1,500 per week, is because of the high relapse rates for this type of care.

Addiction is a 'chronic relapsing condition' according to the NTA yet they have no figures on how many of the 4.3% who leave 'free of dependency' relapsed straight back into drug use, which is 'unrealistic'.

If/when addicts starts using again, the money spent on residential rehab has been wasted and some addicts have been through rehab several times.

12 Week Claim
Critics also say that if '92% of addicts were effectively engaged in treatment for 12 weeks or more', that means out of 163,127 addicts not a single person became drug free after 12 weeks of treatment, which is 'unacceptable'.

Others suggest the figure of 92% is mainly achieved by providing the first appointment in week 1 and the second appointment in week 12 therefore allowing the claim of 'retaining clients for 12 weeks or more'.

One addict said 'I was first seen on the 4th March then didn't get another appointment till 20th May, 11 weeks later. Over the last year I've been to see a counselor 4 times, that's 4 hours, it's a waste of time'.

Overall
Nothing has changed, the results are still poor, Dr. Dalrymple argues 'in short, the bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction' and 'his profession has totally misunderstood addiction & continues to perpetuate the myth to protect its own existence'.

As a result, 'a self-serving, self-perpetuating and completely useless medical bureaucracy has built up to deal with the problem'.

Critics claim 'the NTA are still struggling to make headway in drug treatment as current treatment methods [methadone] do not work and new treatments are urgently required'.

End of the Road for the NTA?

The next tory government think so. To put the scale of addiction into context, consider the following facts.

There are 327,000 problem drug users of heroin and crack cocaine alone. This is more than 10 per 1,000 of the adult population – compared to 4.5 for all drugs in Sweden and 3.2 in the Netherlands. Addiction devastates our local communities, particularly our poorest areas. The Cabinet Office estimates that the harms arising from drug abuse, including health and social costs, amount to £24billion a year.

The National Treatment Agency for Substance Misuse was established in 2001 to tackle drug addiction. Regular readers of Addiction Today will be familiar with its failings – despite the fact that its bureaucracy has grown dramatically: from 30 to 184 employees, with annual operating/administration costs standing now at £20million a year.

Since 2001, the NTA's ‘Pooled Treatment Budget' has reached at least £2.7billion. Spending on prescribed methadone alone has reached £300million a year. Up to 1.65million children are living in homes where a parent has a serious drug or alcohol problem.

CURRENT TARGETS ARE FOR PROCESS, NOT LIFE CHANGE

There has been an obsession with getting addicts into ‘treatment' alone, rather than recovery. Success is measured as completion of 12 weeks ‘in treatment' – usually a methadone script; I have heard anecdotes that sometimes even less is offered. It seems there has been no strategy or incentive to reduce the numbers on maintenance treatment, or move people from dependence to independence.

In 2008-9, only 8,980 of 207,000 addicts claimed by the NTA to be in structured treatment completed it free of illegal drugs: only 4%. Of those, only 4,600 had access to residential rehabilitation. In the space of two years – until Addiction Today began campaigning last year – 20 residential rehabilitation centres closed down, despite an increase in the number of addicts seeking treatment.

In the same period, the number of heroin users prescribed methadone reached 147,500. The NTA hails this as a success, because a record number of addicts are described as “in treatment”.
This obsession with numbers in treatment alone, alongside a fatalistic and undignified strategy of maintenance not recovery, fuels such ongoing failure.

Forecast to Failure
The next government intends to focus entirely on residential rehab as the way forward, however this is also a mistake as rehab suffers from:

  • abuse
  • cross contamination
  • high costs
  • high drop out rates
  • high relapse rates
  • low success rates
  • multiple attempts required
  • no ongoing support

Residential rehab is not cost effective and success rates are no better than current treatment methods at 4.3%.

We predict the next government will realise their mistake 2½ years into their residential rehab program when the cost of treatment outweighs the results obtained. Eventually someone will realise our treatment method is the way forward. Unfortunately the NHS takes around 8 to 10 years to recognise a different treatment process, which critics say is 'excessive and unnecessary'.
[Feb 2010].

 
Copyright 2009 © All rights reserved.
Tel: 0845 466 1400