UK State-Funded Drug and Alcohol Rehab Centres NHS

Residents of England are entitled to public health care once they are registered with the NHS. The National Health Service (NHS) is primarily funded through general taxation, supplemented by NICs (National Insurance contributions). [1]

This funding has been increased since 2003, with an aim to boost funding for the NHS. This is added to by a small contribution from private patient treatment, as well as payment for medication and some dentistry work.

How much funding is given to the NHS each year is dictated by the government through the Spending Review Process.

The funding for the NHS often follows the economic pattern of the UK, which has been in recovery since the recession. Since the NHS was set up in 1946, there has been a duty to provide free health services without discrimination.

The S2 Funding Route

S2 funding provides NHS-funded treatment in an EU country and Switzerland. To be eligible, you must fulfil the following criteria laid out by NHS England [3]:

You must be a resident in England and therefore entitled to NHS treatment and healthcare, which would normally be provided to you given your circumstances. You must provide valid evidence that you have received a full assessment by a clinician in an EEA country, Switzerland, or the UK.

This clinical assessment must state why the treatment you require is needed, including the time of the treatment. The treatment in question must be available under the country’s healthcare system or scheme. This treatment cannot be experimental or part of a trial, nor can it be emergency treatment.

What are ‘State-Funded’ Rehab Centres?

Entitled health care includes treatment for addiction, as not everyone is able to afford private addiction treatment. The price of private rehab can reach the high thousands, so people opt for NHS-funded rehab if they are eligible.

‘State-funded’ rehab centres, also called ‘government-funded’ rehab centres operate by using money from the government. This means that treatment comes free of charge for clients and patients that desperately need medical treatment [2].

The main difference between private addiction treatment and funded treatment offered by the NHS is whether it is residential. Most NHS rehab facilities are outpatient treatment centres, meaning you will reside at home and attend therapy sessions or other forms of treatment.

Private rehab is residential, also called inpatient treatment. This requires you to move into the clinic for the period of your treatment. Whilst treatment at private clinics can be expensive, it does offer 24/7 medical care.

This does not mean the type of treatment and services are more effective than NHS rehab centres – it entirely depends on the nature of your addiction. It is common for state-funded rehab to be people’s only option, but luckily there is a wide range of recovery services available.

Getting Help: Detoxification

Detoxification is often the first step of rehabilitation. Home detox is possible if the addiction in question is mild or relatively new, but for severe addictions, a monitored detox is the safer option. Withdrawal symptoms that accompany detox are often uncomfortable, and sometimes life-threatening.

Funded rehab centres offer medical detox programmes, where you will be offered medication to ease the uncomfortable side effects and to prevent you from using drugs or drinking.

Medication in the UK is paid for by most adults, as the only medication included in treatment is medicine provided for inpatients in hospitals. The price of medication as it stands is £9.35 per prescription.

If you are struggling with your detox, there are 24-hour medically supported units that offer support and medical assistance. Your withdrawal symptoms are likely to be their worst on the third day, but mild symptoms may last for weeks.

Therapies on Offer

Therapy and counselling are offered as secondary care in order to tackle the mental effects of addiction.

During rehabilitation, patients will visit the centre for an initial assessment and will be allocated specific treatments based on their availability, severity of addiction, symptoms, and available professionals. [4]

These rehab programmes offer treatment of different levels and in different settings, such as:

• Substance abuse treatment centres
• Community health clinics
• Mental health clinics
• Hospital-affiliated clinics
• Offices
• Residential facility outpatient centres

CBT, ‘cognitive behavioural therapy’ is offered as a talking therapy during outpatient treatment. CBT aims to tackle behaviour by altering the way we think and rationalise ourselves.

This breaks large problems down into smaller issues, changing negative patterns of thought to avoid being overwhelmed. CBT is mainly used for mental health issues such as anxiety and depression but has been found to be incredibly useful for substance abuse and addiction.

By looking at the way we automatically think about situations, we can then address underlying problems causing this negative outlook. In reference to addiction, this can help identify direct causes or any elements that may exacerbate addiction.

Dialectical behavioural therapy (DBT) is a form of CBT. DBT was originally used as a talking therapy but is specifically designed for those who are very emotional and feel emotions deeply. This is mainly used by people suffering from BPD, borderline personality disorder.

Outpatient treatment also offers a treatment called Eye Movement Desensitisation and Reprocessing (EMDR). This is a form of individual addiction therapy, focusing on memories that have formed PTSD.

EMDR then aims to change how these memories are stored in the brain through eye movements.

Group therapy is also used during state-funded rehab sessions. These can be daily, weekly, or monthly, but all involve sharing experiences with different people.

Usually, a qualified professional gathers people together who are all dealing with a common challenge such as alcohol addiction. This is talked about in a safe and secure environment, to gain an in-depth understanding of addiction, its consequences, and techniques to help recovery.

Alcoholics Anonymous (AA) is a famous type of group therapy. Recovered and current alcoholics gather together to discuss their problems with alcohol, including causes, triggers, and personal recovery stories.

This is also called a 12-step facilitation therapy, founded on 12 principles at the heart of AA recovery: [5]

1. We admitted we were powerless over alcohol – that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

Pros and Cons of Funded Rehab Centres

For those without private health insurance and for those who cannot afford the accommodation costs of private treatment, NHS treatment and health centres aim to reduce health inequalities. For a reduced cost (or for free), the NHS gives medical access to patients that need it the most.

The NHS provides addiction rehab services for alcohol treatment and drug treatment.

This works well if you don’t want the intensive therapy that residential rehab provides, but you must have a strong support network as much of the recovery is worked on at home. This is not round-the-clock treatment, but outpatient treatment allows you to continue with your work and family life whilst working on addiction at the same time.

You may choose a clinic close to you or do virtual sessions online. The only problem with not attending face-to-face therapy is that you will be tempted to skip sessions, perhaps you will be distracted, and you might be tempted to slip back into old habits.

That being said, outpatient treatment is very flexible. Sessions can fit your schedule and they won’t interrupt your daily life.

If loved ones and friends aren’t aware of your addiction or recovery (and you want to keep it that way) outpatient treatment might be your best option.

Outpatient rehabilitation provided by the NHS allows you to implement techniques and methods learnt directly into real life. Inpatient treatment is intense, and you won’t suffer from cravings or triggers, unlike when you are going through normal life.

Further, outpatient treatment often includes family counselling that can help mend the bonds broken by addiction.

However, the high risk of drug and alcohol exposure can slow down the recovery process, as you will still have access to drugs and alcohol. The amount of access you will have to counsellors and therapists will be unknown for now, as there is less funding and resources than in private facilities.

Further, this is not 24/7 care, but this does not mean it is any less effective.

Recent Advances in Funding

On the 6^th of December in 2021, the government published a ten-year Drug Strategy. This will be the largest increase in government funding for drug treatment, with the goal to treat drug addiction and prevent crime. [6]

This strategy involves investing £780 million into the rehab system; every local authority in England is set to receive extra funding over the course of three years.

This aims to tackle drug and alcohol misuse, where the areas with the worst addiction statistics will receive the funding first.

The funding will go towards:

• Improving access to treatment
• Increasing the capacity of services
• Reversing the upward trend of drug use

The range of services available on the NHS is directly linked to funding. Alcohol and drug treatment services should be available for those who cannot afford them at a reduced cost.

Access to treatment for patients without private health insurance should be available, and the NHS offers this through outpatient treatment for addiction.

References

[1] https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/how-nhs-funded#:~:text=The%20NHS%20is%20funded%20mainly,National%20Insurance%20contributions%20(NICs).

[2] Substance Abuse and Mental Health Services Administration. (2020). National survey of substance abuse treatment services (N-SSATS): 2019. Rockville, MD: Substance Abuse and Mental Health Services Administration.

[3] https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/what-is-the-s2-route/

[4] Center for Substance Abuse Treatment. (2014). What is substance abuse treatment? A booklet for families. HHS Publication No. (SMA) 14-4126. Rockville, MD: Substance Abuse and Mental Health Services Administration.

[5] https://www.alcoholics-anonymous.org.uk/about-aa/the-12-steps-of-aa

[6]  https://www.gov.uk/government/news/largest-ever-increase-in-funding-for-drug-treatment

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