“I would like to … try to provide – difficult though it will be given the shortage of money we have been left – more residential treatment programmes. In the end, the way you get drug addicts clean is by getting them off drugs altogether, challenging their addiction rather than just replacing one opiate with another.”

These comments, made by former Prime Minister David Cameron in August 2010, were reiterated in February 2015 when he said he remained “committed to funding residential, abstinence-based rehabilitation, difficult though it may be in the current climate. Rather than maintaining people on substitutes like methadone, we have to help more people get off drugs and into work.” His words both reflected and promised to embed in policy the current emphasis on treatment which explicitly aims for recovery, reintegration and abstinence, trends which in turn have focused attention on what has been seen as the treatment best suited to all three – residential rehabilitation. However, add the claim that residential treatment has been side-lined in pursuit of ‘manage the problem’ objectives, and the fact that they are among the most expensive options at a time of financial cutbacks, and you have a combustible mixture.

What does residential rehabilitation have to offer?

‘Residential rehabilitation’ is the umbrella term for programmes which require residents to stay overnight at a facility to receive treatment, and typically expect residents to be drug and alcohol free before they start (though in some cases detoxification is offered by the centres themselves as the first of the treatment). Beyond these common factors, programmes may differ according to their philosophy, intensity, inclusion criteria, programme content, and duration.

One simple way to look at what residential rehabilitation has to offer is to break it down into those with rehabilitative versus supportive goals: rehabilitative programmes provide a structured, care-planned programme of therapeutic and other activities; whereas supportive programmes provide specialist drug/alcohol and related support, often following treatment in a rehabilitative programme, but no structured therapy ( illustration)..............