Drug treatment service provision in the UK: policy comprehensiveness versus practice effectiveness.

The contemporary history of drug abuse treatment service provision in the United Kingdom (UK) can be traced to the late 1960s when the first drug clinics were opened following the introduction of the Dangerous Drugs Act. Treatment services were established then to tackle the emerging problem of opiate dependence and associated morbidity and mortality. Since then, service provision has come a long way to reflect population needs as different problems emerged. Service provision was expanded to include community drug teams whose remit was wider than offering only opiate substitution therapy. The emergence of HIV/AIDS in the 1980's also resulted in another treatment response that was geared towards reducing the risk of HIV transmission. The last few years, however, have seen the introduction of major policies that should have far reaching effects on the provision of drug treatment services in the UK. Some of these policies and related documents are generic while others are specific to drug abuse treatment. The NHS Plan (Department of Health, 2000) articulates the objectives and operational requirements of earlier policy documents such as the New NHS: modern and dependable (Department of Health, 1997); the NHS Performance Framework (Department of Health, 1998a); Saving Lives: Our Healthier Nation (1999); Modernising Mental Health Services: Safe, Sound and Supportive (Department of Health, 1998b); among many others. The core principles of the NHS Plan (Department of Health, 2000) are as follows: • Provision of a universal service for all, based on clinical need, rather than on ability to pay