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| Shopping voucher plan for addicts | Shopping voucher plan for addicts |
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| Drug addicts receiving treatment should be given shopping vouchers to encourage them to kick their habit, an NHS body is suggesting, the BBC has learned. | Drug addicts receiving treatment should be given shopping vouchers to encourage them to kick their habit, an NHS body is suggesting, the BBC has learned. |
| The National Institute for Health and Clinical Excellence accepts the idea for England and Wales is controversial. | |
| But evidence from international trials shows modest financial incentives can cut drug abuse by hardened addicts. | But evidence from international trials shows modest financial incentives can cut drug abuse by hardened addicts. |
| Users could get vouchers worth up to £10 at NHS treatment programmes - if tests show they are free of drugs. | Users could get vouchers worth up to £10 at NHS treatment programmes - if tests show they are free of drugs. |
| I don't think it's bribery - I think it's an effective treatment that brings real benefit Mr Stephen PillingConsultant clinical psychologist | I don't think it's bribery - I think it's an effective treatment that brings real benefit Mr Stephen PillingConsultant clinical psychologist |
| NICE says the idea would be cost-effective, and there would be a public health benefit because addicts could also be screened for infectious diseases - such as HIV and tuberculosis. | NICE says the idea would be cost-effective, and there would be a public health benefit because addicts could also be screened for infectious diseases - such as HIV and tuberculosis. |
| The proposal for an incentive scheme is contained in draft guidance on how the NHS in England and Wales should handle drug misuse. | The proposal for an incentive scheme is contained in draft guidance on how the NHS in England and Wales should handle drug misuse. |
| Debates about how NHS money should be spent have intensified in recent years. | Debates about how NHS money should be spent have intensified in recent years. |
| NICE will soon face its first legal challenge when groups angry about restrictions on drugs for Alzheimer's Disease challenge its processes. | NICE will soon face its first legal challenge when groups angry about restrictions on drugs for Alzheimer's Disease challenge its processes. |
| Could help many | Could help many |
| Mr Stephen Pilling, a consultant clinical psychologist from University College London, who advised the NICE group, estimates 50,000 addicts in England and Wales could take part in the scheme. | Mr Stephen Pilling, a consultant clinical psychologist from University College London, who advised the NICE group, estimates 50,000 addicts in England and Wales could take part in the scheme. |
| He believes it could help up to half of them stay off drugs. | He believes it could help up to half of them stay off drugs. |
| The cost of a few sandwiches is a small price to pay if it keeps more drug users on the path of recovery and off illegal drugs Richard Phillips, Phoenix Futures | The cost of a few sandwiches is a small price to pay if it keeps more drug users on the path of recovery and off illegal drugs Richard Phillips, Phoenix Futures |
| He said: "I think the group, having thought it through carefully, have firmly come to the view that it provides a much better and positive way to relate to drug users than sometimes we have done in the past. | He said: "I think the group, having thought it through carefully, have firmly come to the view that it provides a much better and positive way to relate to drug users than sometimes we have done in the past. |
| "I don't think it's bribery - I think it's an effective treatment that brings real benefit. We are convinced it is a proper way to deal with people." | "I don't think it's bribery - I think it's an effective treatment that brings real benefit. We are convinced it is a proper way to deal with people." |
| Mr Pilling said the key was that the system provided an incentive for people to present a clean drug test. | Mr Pilling said the key was that the system provided an incentive for people to present a clean drug test. |
| "There will be some big challenges in spelling out the benefits to NHS staff and monitoring the implementation of this. | "There will be some big challenges in spelling out the benefits to NHS staff and monitoring the implementation of this. |
| "But the evidence shows small incentives can have a marked impact." | "But the evidence shows small incentives can have a marked impact." |
| Cost effective | Cost effective |
| The NICE group looked at evidence from more than 20 trials, mainly done in the US. | The NICE group looked at evidence from more than 20 trials, mainly done in the US. |
| The results convinced the group that incentive schemes worked and were cost-effective. | The results convinced the group that incentive schemes worked and were cost-effective. |
| Studies have shown many people with drug problems respond much better to positive incentives than to programmes which focus on punishment and make them feel guilty. | Studies have shown many people with drug problems respond much better to positive incentives than to programmes which focus on punishment and make them feel guilty. |
| Some of the American trials involved giving drug addicts vouchers for burger chains, but Mr Pilling said that wouldn't be the case in the NHS. | Some of the American trials involved giving drug addicts vouchers for burger chains, but Mr Pilling said that wouldn't be the case in the NHS. |
| I'd rather money was spent on drug treatment centres Linda, whose son Neil was an addict for 15 years | I'd rather money was spent on drug treatment centres Linda, whose son Neil was an addict for 15 years |
| He said: "A clear purpose of the use of vouchers would be to promote a healthy lifestyle - we would want to encourage them to buy appropriate food or improve their leisure activities." | He said: "A clear purpose of the use of vouchers would be to promote a healthy lifestyle - we would want to encourage them to buy appropriate food or improve their leisure activities." |
| Richard Phillips, director of services at Phoenix Futures - drug and alcohol treatment specialists - said providing incentives to people receiving treatments could be controversial. | Richard Phillips, director of services at Phoenix Futures - drug and alcohol treatment specialists - said providing incentives to people receiving treatments could be controversial. |
| But he said: "If it works to keep people in treatment there would be considerable benefits to the public. | But he said: "If it works to keep people in treatment there would be considerable benefits to the public. |
| "The cost of a few sandwiches is a small price to pay if it keeps more drug users on the path of recovery and off illegal drugs." | "The cost of a few sandwiches is a small price to pay if it keeps more drug users on the path of recovery and off illegal drugs." |
| 'Deep-seated problems' | 'Deep-seated problems' |
| Linda and her son Neil live in a pleasant London suburb - but that hasn't protected them from the misery of 15 years in which Neil, now 37, was using heroin and crack cocaine. | Linda and her son Neil live in a pleasant London suburb - but that hasn't protected them from the misery of 15 years in which Neil, now 37, was using heroin and crack cocaine. |
| Linda thinks faster access to treatment is more important than vouchers. | Linda thinks faster access to treatment is more important than vouchers. |
| "I'd rather money was spent on drug treatment centres, where people could be helped immediately. | "I'd rather money was spent on drug treatment centres, where people could be helped immediately. |
| "These young people have deep-seated problems - that's what needs to be addressed. | "These young people have deep-seated problems - that's what needs to be addressed. |
| "That's where the money should go - not giving them vouchers for food, clothes or shopping." | "That's where the money should go - not giving them vouchers for food, clothes or shopping." |
| Professor Peter Littlejohns, NICE's clinical and public health director, said the aim of the new guidance would be to over a package of interventions to provide support for people trying to beat their addiction. | Professor Peter Littlejohns, NICE's clinical and public health director, said the aim of the new guidance would be to over a package of interventions to provide support for people trying to beat their addiction. |
| The draft guidelines also consider how to give addicts information about self-help groups, such as Narcotics Anonymous, and how to best support families and carers. | The draft guidelines also consider how to give addicts information about self-help groups, such as Narcotics Anonymous, and how to best support families and carers. |
| A consultation on the proposals is open until early March, with full guidance due to be issued to the NHS in the summer. | A consultation on the proposals is open until early March, with full guidance due to be issued to the NHS in the summer. |