The National Treatment Agency (NTA) is a special health authority, created by the Government in 2001 to ensure that there is more treatment, better treatment and fairer treatment available to all those who need it.

Their overall purpose is to:

• double the number of people in effective, well-managed treatment from 100,000 in 1998 to 200,000 in 2008.
• increase the proportion of people who successfully complete or, if appropriate, continue treatment.

This is the first time an organisation has been established to oversee the development of drug treatment services at a national level. Parallel structures have been established with the Scottish Executive and the Welsh and Northern Ireland Assemblies.

The NTA exists to serve the needs of drug treatment service users, their unpaid carers and the communities in which they live. They work in partnership with service providers, commissioners of treatment services and communities to improve the quality and effectiveness of treatment.

Around four million people in England and Wales use at least one illicit drug each year, and around one million people use at least one of the most dangerous drugs (such as heroin and crack). For most people this will be a passing phase and they will not continue to take drugs or require any special treatment in order to deal with it. A minority of approximately 250–300,000 will, however, develop serious drug problems, typically involving heroin and/or cocaine.

While the numbers of people with serious drug problems may be small, drug misuse affects everyone. Providing drug misusers with well-managed, effective treatment is the most successful way of tackling all of these harms. But giving up and staying off drugs is difficult. Most drug misusers relapse and need to return to treatment a number of times before getting their habit under control. However, around 50 per cent of those who do complete a comprehensive treatment programme are still drug-free after five years. Drug misuse causes economic and social decline in some of our most deprived communities. Drug treatment helps to reduce the demand for drugs. It can also enable drug misusers to reintegrate into society and become economically and socially active citizens. Treatment for drug misuse can help to reduce the offending rates of drug misusers who commit crimes to fund their habit. For every £1 that is spent on drug treatment, society gets £3 worth of benefit from reductions in offending.

Drug treatment gives clients the opportunity to improve their health, rebuild relationships and return to education or employment. Drug misuse causes around 1,350 premature deaths each year in England and getting into treatment reduces the chances of someone overdosing. Injecting drugs can contribute directly to the spread HIV and hepatitis. Getting good advice and information from a service can help to reduce risky behaviour as well as provide vaccinations against hepatitis B and treatment for HIV and Hepatitis.

UK drugs strategy

A new government 10-year plan was announced by the Drugs Co-ordinator in April 1998 and a new prison service drug strategy was announced in May 1998.The Government’s drugs strategy, updated in 2002, aims to give direction and coherence to separate government initiatives related to drug misuse. This strategy sets the context in which the NTA works to tackle the harms associated with problematic drug misuse. The NTA is responsible for the treatment aim, and is actively involved in all other areas of the strategy.

The national strategy has four aims:

• To help young people resist drug use in order to achieve their full potential in society.
• To stifle the availability of illegal drugs on our streets.
• To protect our communities from drug-related anti-social and criminal behaviour.
• To enable people with drug problems to overcome them and live healthy, crime-free lives.

Improving the commissioning of drug treatment services

Approximately £450 million was spent on drug treatment in England in 2003/04. The aim of the NTA is to ensure that money is spent to best effect, on treatment that really works and that meets the needs of local people. Drug action teams (DAT’s) are responsible for using central government and local funding to pay for (or commission) treatment from NHS and voluntary sector organisations.

The NTA’s nine regional teams provide guidance and support to DAT’s on how to spend this money. This includes ensuring that DAT’s are able to provide drug misusers with a full range of services. For example, all DAT’s should be able to provide drug misusers’ with access to advice and information, needle exchanges, counselling, community based prescribing, inpatient detoxification and residential rehabilitation.

DAT’s are local consortiums that bring together representatives of all the local agencies involved in tackling the misuse of drugs, including primary care trusts, local authority, police, probation. There are 149 DAT’s in England covering all local authorities.

Promoting best practice in drug treatment

NTA believes that treatment should be based on evidence rather than unfounded theory. They provide a summary of existing research, carried out by studies and test new approaches to treatment in order to identify what works, and then publish the findings and recommendations. Service users and their unpaid carers have a vital role to play in improving services, and the NTA actively promote their involvement at local, regional and national level. In order to ensure equally high standards of treatment across the country, they have developed a set of basic standards that all services should meet. This is the first time that a national standard will have been set for drug treatment.

Improving the performance of drug treatment services and staff

As well as providing information and guidance to drug treatment workers to help them improve their performance, the NTA also work with the key organisations and colleges to improve training for new and existing staff. For example, the Royal College of General Practitioners and the Royal College of Psychiatrists to increase the level of tuition on drug misuse in standard doctor’s training.

They also work in partnership with other parts of the health service, including public health and social services, as well as criminal justice agencies including the probation and prison services. These partnerships are vital because drug misusers come into regular contact with these services. By working with these services drug misusers can be provided with appropriate support and treatment.

Prevention work with those who do not use drugs

Education and prevention work seeks to prevent anyone (especially young people) from beginning to use drugs. The belief is that we must work with young people now to try to reduce the level of drug use in the future.

The present Government have placed a great deal of emphasis on this approach, funding a number of Home Office Drugs Prevention Teams to promote drugs education and prevention work in areas of high drug prevalence. Originally it was felt that those engaging in education and prevention work should focus exclusively on prevention.

More recently it has been recognised that education and prevention work should acknowledge and work with the fact that many young people may be experimenting with drug use.

The quality of education and prevention work varies considerably. It ranges from simplistic and probably ineffective 'just say no' messages and scare tactics to more sophisticated attempts to allow young people to reflect on the potential risks and problems associated with both illicit and legal drug use.

Education and prevention work may be undertaken by specialist drugs education and prevention teams, health promotion departments, youth clubs or youth workers, or schools. It may also be part of the work of a agency which offers direct services to drug users. The Home Office or your local health promotion department should be able to advise you on your local services.

Local drug services can be found on the governments’ website http://www.talktofrank.com/ or through drugscope http://www.drugscope.co.uk/