Substance Misuse Report

Healthwatch Derbyshire engaged with 59 people living with substance misuse, 15 carers and 15 staff members during 2016 to understand experiences of accessing health and social care services. Many participants said their substance misuse was linked to mental health problems, bereavement, trauma, abuse or chronic pain. A recurring theme was the difficulty of accessing mental health support, with many reporting that they were told their substance misuse needed to be addressed before mental health services would accept them. Participants often described this as a barrier to recovery, particularly where substance use was being used to cope with underlying psychological difficulties. 

Experiences of healthcare services were mixed. Some participants praised their GPs, nurses, ambulance staff, pharmacies and specialist support workers for being caring, professional and non-judgemental. However, others reported feeling stigmatised because of their substance misuse, particularly in some hospital and primary care settings. Concerns were raised about delays accessing mental health support, pain management services, and specialist treatment, as well as difficulties obtaining appropriate support after discharge from hospital. Positive feedback was consistently given about organisations such as SPODA, Derbyshire Alcohol Advice Service and a number of community recovery projects that provided peer support, activities and opportunities to rebuild confidence and wellbeing.

Many participants and carers raised concerns about drug treatment services, including long waits to see key workers, inflexible appointment systems, poor communication and concerns about waiting room environments. Some felt treatment focused too heavily on substance use rather than the wider reasons behind addiction. Carers frequently reported feeling excluded, unsupported and unsure where to access help for themselves. Social care experiences were also mixed, with some parents describing social workers as helpful and supportive, while others reported feeling judged, experiencing poor communication and wanting greater access to advocacy support during meetings. 

Healthwatch concluded that better integration between substance misuse services, mental health services and social care was needed. Recommendations included improving access to mental health support, recognising and supporting carers, strengthening communication between services, improving complaints processes and waiting room environments, addressing issues around prescription management, increasing access to advocacy, and expanding recovery-focused opportunities such as peer support, community projects, employment support and activities that help people sustain long-term recovery.