A clear strategy to reduce drug use could save UK government billions. Here's how

Amid the fallout of the government’s decision to scrap the HS2 Birmingham to Manchester leg, one of the biggest public health interventions in a generation flew largely under the radar.

The prime minister’s pledge to raise the legal age that people in England can buy cigarettes by one year, every year, until it is eventually illegal for the whole population, is intended to reduce the strain on the NHS and, by extension, the public purse.

The government’s rationale, that prevention is better than cure, rings true in other areas, such as the harm caused by illegal drugs. The National Audit Office recently looked into this, reporting that it is estimated to cost the taxpayer around £20bn each year.

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Our report – Reducing the Harm From Illegal Drugs – assessed progress against the government’s 10-year strategy, launched following a surge in drug-related crime and deaths between 2011 and 2021. This surge overlapped with a 40% real-terms decrease in spending on drug and alcohol treatment services between 2014-15 and 2021-22, with many local authorities experiencing funding cuts of 50% or more.

The new strategy sees the government commit more than £900m for the first three years, including £768m to build back treatment and recovery services. It has also established 106 new partnerships in local areas across England which will bring together the key people from the criminal justice and health sectors.

While this is a positive step forward, the government still faces significant barriers to reducing drug use, deaths, and related crime. To date, departments have used nearly all the new funding to continue or expand existing projects or, in the treatment sector, reverse some of the declines in funding seen over the last decade.

By contrast, not enough is being done to address prevention, with the government committing less than £30m of the strategy’s £900m funding towards reducing long-term demand.

Putting prevention front and centre is vital to cutting demand and freeing up space in treatment services, which will ultimately reduce the multi-billion pound cost to society. To do this, government needs to better understand the complex reasons why people use illegal drugs and invest in wider interventions across government, including tackling homelessness and addressing mental health needs. So far, the strategy hasn’t led to the fundamental shift in approach that will be needed to make a difference.

Departments have made progress in some areas. For example, the Home Office has increased activity to disrupt the supply of drugs, and local government has recruited more than 1,200 new drug and alcohol workers, exceeding its target of 950 new staff by 2024-25.

As readers of Big Issue will be all too aware, drug dependence can be both a cause and consequence of homelessness and rough sleeping. It is encouraging, therefore, that the Department for Health and Social Care and the Department for Levelling Up, Housing and Communities are using drugs strategy funding to improve housing support for people in drug and alcohol treatment.

However, difficulties remain in co-ordinating a cross-sector response. For example, people with complex needs have contact with a range of services, which cut across departmental responsibilities, including those connected with homelessness, employment, accommodation, and mental health. These services need to provide integrated support to minimise the risks of gaps and overlaps, helping vulnerable people and their families.

Currently, services aren’t sufficiently targeted towards vulnerable groups. Encouragingly though, the new local partnerships could help to ensure drug strategy funding is being used to re-establish and expand treatment services based on local needs and priorities.

With only three years of the 10-year strategy having been funded to date, it’s vital that Whitehall departments, in partnership with the cross-government Joint Combating Drugs Unit, do the work to understand the impact the strategy is having. This will help them prepare for the next government Spending Review and focus on the measures that will lead to the best outcomes.

As with the proposed approach to smoking, emphasising prevention and focussing on reducing the demand for drugs will address the causes of harm as well as the consequences. This will not only save money but help millions of people escape the vicious cycle of addiction and the damage this causes them and their families.

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Oliver Lodge is director of home affairs at the National Audit Office