Personal budgets help reduce substance misuse, suggests study

Substance misusers who are given personal health budgets do better at controlling their addiction than those without budgets, according to an evaluation for the Department of Health.

The Personal Health Budget Evaluation study examined two pilot sites where problem drug and alcohol users were given budgets against a control group who received support through conventional processes.

It found those with budgets reduced their excessive drinking and drug taking more than those without budgets, and that residential detox services were the single biggest expense selected by those given budgets.

The study also found that personal budgets encouraged better relationships with health professionals and that patients also spent money on ‘innovative’ services such as driving lessons, leisure activities and alternative therapies, such as homeopathy and massage.

However it also found that budget holders wanted more information on potential uses for their budgets at the care planning stage and questioned why after-care counselling could not be funded through their budget.

The study warned that its results were based on a small sample and that this was “a major limitation” as it prevented analysis of the cost effectiveness and outcomes of personal budgets.

Also, both sites offered personal health budgets as notional sums held by commissioners rather than direct payments; researchers noted that there were significant challenges in making direct payments work for this group, notably the perceived risks of giving problem drug or alcohol users cash payments.