The government has underlined its determination to bring drug misusers in from the cold with a 217m boost for the treatment and prevention elements of its three-year anti-drugs strategy for England.

Health and local authorities will get 70.5m of that money. But with the funds comes a warning from the government's drugs tsar, Keith Hellawell, that ministers expect to see the money spent in a 'business-like' manner, and on 'treatments that work'.

Cost-effectiveness will be monitored locally by the 106 drug action teams (which get an extra 10.5m) and nationally by Mr Hellawell.

Health authorities and trusts will have to find room on their crowded list of priorities for drug misusers. They will also be asked to help improve co-operation between the agencies involved.

Roger Howard, chief executive of the Standing Conference on Drug Abuse, says the funding boost is overdue, but for many struggling services it has come too late.

'We welcome this very much, but we are seeing drug treatment programmes fold already. Everything is being whittled to the bone.'

Despite evidence that every 1 spent on treating offenders saves the taxpayer 3, drugs services are still soft targets for cuts.

'Compared with cancer and other acute services, drugs are really small- scale. It's been difficult to persuade purchasers and commissioners that it's their responsibility to act.'

By the government's reckoning, only one in five drug misusers have access to services. According to Mr Howard, addicts face a wait of a year in some parts of the country to get treatment.

He is disappointed that the shift towards treatment and prevention was not more dramatic; 61 per cent of the new money will still go to enforcement agencies, including 60m on the treatment of prisoners and ex-prisoners.

According to Alan Jones, consultant in public health and commissioner of drug services for Manchester HA, his authority has been a 'victim of its own success', with demand for the highly popular services creating a log-jam.

Ironically, changes to the national funding formula have forced it to cut its drugs budget by 100,000. Dr Jones is not yet sure where the new money will go, but there is an obvious need to reach teenage 'dabblers' before they need treatment, he says.

Mike Read, co-ordinator of the Croydon drug action team, hopes the 70.5m for HAs and local authorities will not be spent on 'glamour' youth projects designed to appeal to the majority.

'We should be trying to identify the 3 to 6 per cent who will go on to have a problem.'

Hard choices will have to be made about how the money is spent, but there is no shortage of ideas waiting for resources to implement them, according to Cathy Hamlyn, associate director of health policy for the NHS Confederation.

She hopes that DATs, many of which are headed by HA chief executives, will increase their influence and lead the process of implementing the drugs strategy and distributing the new money.

'At one stage the government suggested HAs should be spending something like 1 per cent of their allocation on drugs services.

'This isn't getting up to that level - but it is designated funding that won't be squeezed by other priorities. It all helps.'

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