Intended for healthcare professionals


Drug treatment services are broken, says review

BMJ 2021; 374 doi: (Published 21 July 2021) Cite this as: BMJ 2021;374:n1828
  1. Emily Finch, consultant addiction psychiatrist
  1. South London and Maudsley Foundation NHS Trust, London, UK
  1. Emily.Finch{at}

More money, more trainees, and greater accountability are urgent priorities

In announcing the second part of her drugs review, focusing on prevention, treatment, and recovery, Carol Black said that the current system in England was “broken and wanting.”1 She is right. The number of people using opiates is rising, treatment completions are dropping, and drug related deaths are rising.23

Funding for treatment and prevention has fallen,4 perhaps most worryingly for children aged 11 to 15, among whom drug use has increased by over 40% since 2014.5 Other indicators of a broken system are the increasing numbers of drug users repeatedly in and out of prison and the growing number who are homeless and rough sleeping.6 Drug use is an important driver of social inequalities.

Drug use affects many areas of people’s lives so responsibility is fractured across numerous government departments. Even within the health sector, responsibility for managing drug related harms cuts across primary care, mental health, and …

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