15 Oct 2025

The UK government has invested £532 million in the last three years* to recruit more drug and alcohol treatment staff.

Considering that deaths related to drug poisoning have risen every year since 2012, the drive to expand the workforce increases in urgency with every passing day. In England and Wales, 5,448 deaths related to drug poisoning were registered in 2023, the highest number since records began in 1993 (ONS Deaths related to drug poisoning, released in Oct 2024).

With new data showing that almost one in five (19%) staff leave the sector every year, why are we neglecting the “Forgotten Workforce”?

Pouring money into a leaky bucket

“The fact that so many addiction staff leave the job annually isn’t a surprise to anyone on the front line”, says Lester Morse, Rehabs UK Founder and Director, “It's a direct result of a failing government strategy that pours money into a leaky bucket.”

A 2025 survey of the drug and alcohol treatment and recovery workforce found that over a quarter of staff (28%) would strongly consider leaving the sector in the next two years. The report also revealed that:

  • Pay is the most common challenge faced by workers, with 48% saying it is a challenge for them.
  • The drug and alcohol treatment and recovery workforce is more likely to report stressful levels of demand than other healthcare workers.
  • More than two in five (43%) of those who work directly with people who use drugs and alcohol say they have too many people on their caseload.
  • While the vast majority (91%) of respondents said the drive to make a difference to others was the most important reason to join the sector, 8% of respondents do not believe they are able to make a difference to the people that they work with.

Those who report having ‘too many’ people on their caseload are three times more likely to say they are unable to make a difference to the people they support.

Jakana Rita, BACP Therapist at Rehabs UK, knows this feeling of frustration well. She started her career in a local drug and alcohol service on a voluntary basis, before training to become a therapist. On her reasons for leaving her previous role, she states: “The frustrations I had were the lack of understanding of the mental components that accompany addicted clients. Basic knowledge of addiction accepts the loss of control over the amounts of substance used after the first one. Yet, the recommendation was to use a diary to help cut down. This idea may work for some, but not for those who suffer from addiction.”

Rita also struggled with not being able to disclose her own recovery status: “It’s like having a secret solution to their problem and not being allowed to share it. From experience, sharing my own recovery with the people I'm supporting can build trust, rapport and willingness to engage. For those living with addiction, it is important that you not only understand but also truly know what you are talking about.”

Investing in the "Forgotten Workforce"

Jakana Rita, Therapist for Rehabs UK

Jakana Rita started her career in addiction treatment after her own experience with addiction

Morse explains that the real solution lies in the "Forgotten Workforce": people who have achieved long-term recovery. He argues that investing in long-term recovery helps build a powerful support system: “The answer to the addiction crisis isn't just hiring more professionals to fill the gaps, it's to invest in the people who've already beaten it.”

“There's a core principle in recovery: you only keep what you have by giving it away. Someone who has been through the fire of addiction and found recovery has a unique power to help others do the same. They become the backbone of the recovery community.”

According to the national drug and alcohol treatment services staff survey, people with lived experience of addiction are nearly six times more likely to enter the sector through volunteering than those without (39% vs. 7%). This proves that thriving recovery communities are the most effective engine for building a sustainable and experienced support system.

However, Morse warns that this proven workforce is being systematically dismantled by a lack of funding at the most critical stage: "The system is a revolving door, but for many, the tragedy is that they can't even get through the entrance. Detox is the critical first step, but it's so severely underfunded that most people are left stranded before they've even begun.”

“Those who do manage to get a detox often lack support because the long-term community programmes are also starved of cash. It's a cycle of failure that not only condemns the individual but also robs us of the 'forgotten workforce' of the future. Every person who fails to get the right help is a potential peer mentor we've lost."

Harm minimisation and recovery-based services – finding a holistic approach

Another frustration Rita experienced was the system's focus on harm minimisation instead of long-term, abstinence-based recovery: “Not promoting or working towards abstinence means that clients never overcome their addiction, and end up in never-ending circles of trying to ‘minimise harm’ and ultimately and inevitably end up repeating the harm.”

The resistance to a recovery model within drug and alcohol treatment services in the UK is not new. In a 2010 analysis in the Journal of Groups in Addiction & Recovery, researchers explain that the way UK drug treatment services have evolved and been funded has had "unintended but unfortunate consequences for recovery." The analysis found mainstream services can be "resistant" to engaging with community-driven recovery approaches.

Since this review, harm minimisation approaches have seen a lot of progress, but the “unfortunate consequences for recovery” persist. Rehabs UK argues that an effective addiction strategy can include harm reduction tactics that have been proven to work, but it should be part of a larger framework that aims to help people work towards sustainable long-term recovery.

Morse also argues that staff are not leaving because the work is hard, but because the system prevents them from providing the solutions that they know are effective. "Imagine knowing the cure for an illness but being told you can only hand out plasters. That's what it's like for a lot of addiction workers.”

“Staff are leaving in droves because they're being asked to manage a crisis with tools that don't work, while the real solution, of long-term, abstinence-based recovery in strong communities, is completely underfunded."

What does a recovery approach look like?

Image: Pexels

Breaking the cycle of failure will require more than just money; we will need to shift the way we think about addiction and treatment, moving away from a medical mindset to a holistic approach. Instead of mainly focusing on how to minimise the harm from addiction, we need to work towards a system that helps people build a fulfilling life away from addiction.

Recent UK government guidance gives an overview of the growing body of evidence** that the recovery approach works, including:

  • Interventions supporting people in recovery had the greatest potential to reduce opioid deaths, according to an American study (Stringfellow and others, 2022).
  • AA and 12-step programmes are more effective than some other treatments for increasing abstinence and produce healthcare cost savings (Kelly and others, 2020).

European studies found similar results, in that peer support can complement formal addiction treatment and being part of a mutual aid group, such as the AA, typically results in a stronger commitment to sobriety.

Addiction expert Professor David Best*** uses the concept of Recovery Capital: the total of all the resources a person can draw on to support their recovery. This includes their network of friends, family, and community groups, as well as factors like stable housing and employment. The higher someone’s Recovery Capital, the more likely they are to achieve a sustainable recovery.

The key here is human connectedness. Simply put, an active recovery community increases everyone’s chances of achieving recovery. Professor Best explains: “So what recovery generally does is to increase the visibility and attractiveness of recovery by ensuring that there is a community presence and a sense that recovery is possible.”

The allegory of the lake

The power of a strong recovery community becomes obvious when using Professor Best’s “allegory of the lake”. In this metaphor, most people spend their life on the surface of the lake, with occasional dips. However, people who go on to become addicted are often already below the surface before their substance abuse, and are dragged even deeper as their addiction progresses.

In the treatment approach, each individual starts from the bottom of the lake, and the focus is on how to get them back to the surface. Many treatment services only bring people to the surface temporarily. When complex life issues come back, they go back under.

Conversely, the recovery model focuses on supporting people to achieve “somewhere to live, someone to love and something to do.” In this model, the focus is on building a community where the lake becomes less deep, and more early interventions mean people are less likely to sink.

Calling for a new direction

It's time to stop pouring money into a failing system and instead invest in the proven, sustainable solution that fosters the "Forgotten Workforce." Building strong recovery communities is not just a compassionate strategy; it's the only one that creates a future where everyone has a real chance to get well.

If you or a loved one are struggling with addiction and don't know where to turn, the expert team at Rehabs UK can help you navigate your options and find the right path to recovery.

Sources

* In response to Dame Carol Black’s independent review of drugs, the UK government committed to developing a comprehensive workforce strategy and invested an additional £532 million between 2022 and 2025 to improve the capacity and quality of drug and alcohol treatment (see NHS Drug strategy. Page 7) This additional funding was meant to expand the workforce by the end of 2024/25 with:

  • 800 more medical, mental health and other regulated professionals
  • 950 additional drug and alcohol and criminal justice workers
  • Additional commissioning and co-ordinator capacity in every local authority

**Sources cited on the UK government guidance page:

*** Professor David Best is a professor of addiction recovery at Leeds Trinity University, the first professor in this subject globally.