Rewards for drug addicts.
An NHS watchdog, the National Institute for Health and Clinical Excellence (NICE), which extols advice of NHS treatments and practices, last week made the proposal that addicts should be given vouchers if urine tests show they have not taken drugs while undergoing remedial treatment(s), the rewards increasing in value the longer addicts stay free of illicit substances.
The draft guidance as published for consultation (with the final guidance due in July), suggests that vouchers which can contribute toward fulfilling basic needs may act as an incentive for facilitating good behaviour and dedication from drug users.
The guidance envisages that they might be given an initial voucher for a negative sample worth as little as £1.50, but the next might be £3 and the third £5. If a sample proves positive for drugs, the value of the reward would drop back to the previous level. Other possible incentives are free parking spaces or meals within the clinic.
International trials of a similar nature have already taken place so this is not completely unknown territory for policymakers. Voucher schemes have been used in the US, for example, where they were found to be cost-effective as well as effectively encouraging treatment attendance.
Phoenix Futures, a drug treatment charity, has already shared a similar concern to mine when I first heard the news. Many people are likely to find great difficulty in seeing any justification for the state rewarding drug users to stay clean in the proposed manner, but the benefits could well outweigh any costs.
Many drug users have a comparatively low quality of life in juxtaposition non-users. Often the ever increasing addiction leads to financial shortfalls and resultant entry into crime and prostitution. Vouchers for items such as food and clothing will allow these people to begin taking control of their lives at the very most basic level. Not only will they have the benefit of kicking their dependence, they shall also begin to feel better about themselves and their prospects.
Clearly this approach will have the largest positive impact on the poorest addicts. More chaotic users, such as those with mental health problems and those who come from financially stable backgrounds, stand to be less likely to respond positively to this reward scheme.
There are concerns that this will be used as a blanket scheme irrespective of the above issue. However, NICE has clearly stated that its proposal is best served if employed in unison with a comprehensive plan of care that aims to broach all underlying and mutually constitutive needs, such as housing, training and employment.
The current draft makes a number of interesting recommendations on the use of suitable privileges or rewards to encourage compliance with treatment regimes. The guidance contains important suggestions that should certainly be further discussed. I, for one, am supportive of its adoption.
Typically, however, the Daily Mail has taken the more inflammatory stance in stating that “drug addicts who kick their habit are to be rewarded with iPods and televisions while cancer and Alzheimer’s patients are denied life-prolonging treatments”.
Clearly their biased reporting fails to consider the financial drain that addicts are currently causing. Not just in terms of the time and money required from health authorities, but also in terms of crime rates and their not contributing to the economy through employment and taxation.
Small rewards of but a few pounds per person could stand to keep people out of these problems more effectively as well as increasing take-up rates at treatment clinics. In the long term the financial impacts upon society and the state stand to be lessened.
Indeed the guidance suggests ‘clinic lotteries’ as a means of offering prizes in the form of electrical goods, but this is just one of a number of proposals contained within the initial draft which stand no chance of making their way through Parliament; such rewards, whilst incentives, do not ameliorate the underlying problems experienced by many users like poverty and social isolation.
The draft guidance for consultation can be found here.
Comments
Leave a Reply