I move Amendment 2, which regrets that the 2017 annual report for the Welsh Government’s 10-year substance misuse strategy, 'Working Together to Reduce Harm', shows that there has been an increase in both alcohol-related and drug-related deaths in Wales.
Whilst this report also claims good progress on providing quicker treatment, our amendment 2 also quotes Welsh government statistics showing that the number of people completing treatment substance free has fallen; and fewer people are starting treatment within 20 days since their referral than two years ago.
Cases closed as a result of death in April-June was the highest on record.
Alcohol-specific deaths in Wales rose 7% in 2016, the highest number since 2012.
Alcohol-related deaths rose 9%, the highest number since 2008.
It is therefore concerning that the total number assessed by specialist substance misuse providers fell by 5% and that the total number starting treatment was down 4.6%.
Hospital admissions relating to the use of illicit drugs rose by 3.8% since 2015-16 and drug misuse deaths in Wales rose 14.3% on 2015 to the highest recorded levels since comparable records began in 1993.
Our Amendment 3 Calls on the Welsh Government to increase capacity in Tier 4 in-patient detoxification and residential rehabilitation services, recognising that this is not an alternative to recovery-focused services within the community.
I have been championing model here, since the days when Welsh Government still prioritised medical management and maintenance treatments for addicts.
In a recent exchange of correspondence with the Public Health Minister regarding Tier 4 in-patient detoxification and residential rehabilitation, she stated that more recovery focused services have reduced the need for residential rehabilitation services.
In reality, they must each be part of a seamless network of support.
In an equivalent debate almost a decade ago I referred to the loss of Welsh beds at the Hafan Wen detoxification unit in Wrexham and to the independent review of detoxification and residential treatment in north Wales commissioned by the then Minister, anticipating that this would endorse a switch to detoxification in the community.
Having been buried, this report was leaked to me and made public. It found that the whole service, including in-patient beds, was underfunded. When I put this to the Minister, she told me she did not accept it.
A further independent review looking at Substance Misuse Tier 4 treatment services in Wales was also buried, leaked to me and made public.
It identified numerous reports of people reoffending so as to be able to be detoxed in prison, and of hospital admissions because of the unavailability of in-patient detoxification and residential rehabilitation.
It called for a substantial increase in capacity and for the development of three drug and alcohol detoxification and rehabilitation units across Wales working with Third sector providers.
A further report in 2010 reinforced this message and the then Welsh Government stated that it was taking forward work on development of the three units.
Instead, it is understood that the Welsh Government residential detoxification cuts a decade ago remain in place - and that the number of rehab places in Wales has significantly reduced over the past 6 years.
In October, the Minister said she had been advised that a decline in the demand for residential rehabilitation places was primarily due to the eligibility criteria being strengthened in line with NICE guidelines.
However, as NICE Guideline 115 states “the more severe and less socially stable fare better in inpatient”.
The sector tells me that numbers are down because there are fewer residential rehabilitation places in Wales and people are being moved into the community without evidence of need.
Regarding the Welsh Government’s Substance Misuse Residential Rehabilitation Framework, Wales has only seven places at Ty’n Rodyn Bangor, and approximately 20 at Brynawel, near Cardiff, the latter including Alcohol Related Brain Damage.
Since the Framework commenced, 16 of 24 referrals to Ty’n Rodyn from within Wales did not arrive through the Framework.
Regarding joined up health and social care, Brynawel is continually seeing the negative consequences of funding disputes between Local Authorities and Health Boards.
Meanwhile residential rehabilitation placements outside Wales last year went to three organisations on the Framework and six outside it.
Yes, the potential of community‐based treatments for dependent drug users and drinkers with relatively less complex needs must be maximised-
BUT we also need investment in Tier 4 interventions, their integration with the other tiers of alcohol and drug treatment, and enhanced links between them and community‐based services, aftercare and wrap‐around services.
To do otherwise will cost more lives and more money.