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Enhancing Crack Services in Lambeth: A Comprehensive Approach to Drug Treatment

This document outlines the current state of drug treatment services in Lambeth, South-West London, with a focus on the significant prevalence of crack cocaine use among the population. It highlights the partnership approach involving key providers, including NHS Trust (SLAM), to diversify services and develop crack-specific expertise. A needs assessment reveals that nearly 93% of problem drug users in the area report crack use. The document discusses service specifications, operational management, and strategies for improving treatment outcomes, emphasizing holistic care and user involvement.

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Enhancing Crack Services in Lambeth: A Comprehensive Approach to Drug Treatment

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  1. Commissioning A Crack Service Megan Jones Lambeth DAT Manager

  2. Lambeth • South-west inner London Borough • Brixton, Clapham, Streatham • Population ~270,000 • 62% white • 26% Black • 5% Asian • 5% mixed • 3,000 – 5,000 problem drug users • ~2000 drug users in treatment per year

  3. Key providers in DAT/Borough • NHS Trust (SLAM) • Prescribing service – specialist and GP shared care • Psychology services • CDP • Arrest referral • Assessment for access to structured drug treatment • Day care • Mainliners • Open access • Harm reduction

  4. Commissioning Lambeth Harbour • Needs assessment 2002 • Current services – specialist and general • Users • Criminal justice agencies • Lambeth DIP positive testers 2005/6: • Cocaine 51% • Cocaine & opiates 42% • Opiates 7% • 2005/6 Treatment data (primary and secondary drug use) • 58% report heroin use • 50% report crack/cocaine use } 93%

  5. Crack-specific Service? • Funding available • Lambeth: • 93% problem drug users use crack • ~70% budget funds “opiate" services • Diversify existing services? • Develop crack expertise?

  6. Lambeth Harbour Tier 2/3 stimulant service • Partnership approach • Staff seconded from all key providers • Development of specialist expertise • Opportunities for learning to be absorbed back into host agencies

  7. Partnership Approach CDP as Lead Provider • Premises • Operational management • Staffing of direct access services • Key working within tiers 2 and 3 provision • Group work SLAM as key provider • Psychological treatments • Dual diagnosis • Clinical practice Mainliners • Recruit, train and support volunteers • Support all project activities

  8. Service Specification • Strong management • The “hook” • Crisis intervention • Complementary therapies • Shower/laundry provision • Food • Assessment , referral and care planning • Psychological interventions • Motivational interviewing • CBT • Relapse prevention • Life skills • Housing

  9. Considerations • Staffing capacity • Location • Opening hours • Physical space – day service • User involvement • Methamphetamine

  10. Where are we now • Up to 93% PDUs use crack • Two year review • Staff capacity issues • Re-think volunteering • More in-reach into other services • User involvement • Crack Needs Assessment

  11. Wish List • Loads more money! • Safe house • Dual diagnosis Email: mjones2@lambeth.gov.uk

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