Response to the new UK Drugs Strategy The UK government’s new drug and alcohol strategy – ‘From Harm to hope: a 10-year drugs plan to cut crime and save lives’ – was released last week. Foundation for Changes (FfC) welcomes the increased emphasis on treatment and ring-fenced funding, but we believe the strategy falls short in several key areas. One of the most significant missed opportunities is a much-needed reframing in how substance use is understood: rather than continuing to see substance use as a disease that blights society, at Foundation for Change we see it as something that arises out of a society that is itself broken and needs healing. It is encouraging to see an acknowledgement of the multi-faceted nature of substance use in the new strategy (as something that co-occurs ‘with a range of health inequalities such as mental health, homelessness, contact with the criminal justice and rough sleeping’), the connection of substance use to trauma, the prevalence of addiction in low-income areas, and the greater emphasis on trauma-informed care. However, without ackonwledging the relationship between substance use and social inequality, we believe there continues to be an disproportionate focus on treating the symptoms of substance use and not enough on addressing the reasons the trauma – and the subsequent use of substances as a coping mechanism – exists in the first place. Dame Carol Black, in her independent review of addiction policy, research and treatment in the UK, released in July 2021, made reference to a treatment system that was ultimately broken. Funding has fallen year on year since 2014 - whilst there is no doubt that an increase in treatment-specific funding will have a positive impact on current outcomes, it is difficult not to wonder where the system would be had it continued to receive the funding it needed. We believe it is important to be cautious about correlating increased levels of funding with more successful treatment outcomes. FfC Chief Executive, Bob Bharij, has worked in the sector since 2004 and repeatedly witnessed a system that repeatedly failed the individuals it aimed to help. He states that: “we need a far greater emphasis on reviewing the failures of the current treatment system to ensure the mistakes of the past are not repeated, and a much higher level of accountability to explore the role the treatment system plays in the high relapse rates post-treatment”. Furthermore, he seeks a greater focus on implementing innovative approaches to service delivery that have the potential to positively - and sustainably - impact the lives of individuals accessing support and deliver cost savings. At Foundation for Change, we have developed an innovative approach we want to ensure is part of the changing landscape of treatment for substance use. We believe it is vital for the individuals we work with to develop more accurate and compassionate understandings of their life experiences by seeing them through a systemic lens. Our work contextualises individual experiences and supports people to understand how wider forces in society – particularly social inequality, capitalism, gender and race inequality – shape their lives and play a significant role in their substance use. Through developing this bigger picture perspective, individuals begin to see that they are not individually responsible for their situations which significantly destigmatises and reduces the feelings of shame that can perpetuate social exclusion. The system doesn't simply need more funding. It definitely doesn’t need more meaningless targets to chase or payments-by-results. It needs a more sophisticated understanding of the intersecting challenges that people in disadvantaged communities face and the reasons that drive people to use substances. It needs fresh approaches to recovery that focus on developing self-understanding, agency and meaning and the societal structures that support these instead of symptom-management approaches where individuals live in fear of a relapse. The system needs change.