34%*
Median ADHD prevalence across addiction treatment cohorts.Royal College of Psychiatrists
When ADHD is left waiting,
addiction steps in.
And it doesn't come quietly.
A targeted ADHD + addiction continuity intervention: 12 weeks, 50 people, adults already visible to services — where unresolved ADHD may be the underlying cause of their addiction.
61%*
Improved addictive-disorder outcomes after ADHD diagnosis and treatment.START study
30%*
Trial-end abstinence in ADHD + cocaine dependence.JAMA Psychiatry
86%*
Alcohol users also have mental health problems.Sun Network public figure
850*
Estimated local Cambridge & Peterborough overlap cohort.Local planning estimate
*Rounded / median planning figures. Sources and caveats: Evidence & Sources →
From Dean — directly to you
I told you I'd come back. I built it.
I told you I'd come back. I built it.
Here it is.
This is a private briefing for the people who helped me through the system — and who I promised I would return to with something that could help the next person get there faster, and with less damage along the way.
Some of you know me quite new, some met me back in the thick of it. You've allwitnessed every stage. Individual pages explain more around your service/role and hopefully, involvement.
Hope it makes sense, I'm simply asking for an open conversation about what's possible and a short note of support I can take into my next meeting with the local Public Health Drugs & Alcohol team.
Read the full briefing → or click below
You have a page written specifically for you
Choose your route.
Choose your route.
Open your draft note.
Each page explains your specific role, what we're asking, what you don't need to do — and has a 2–3 sentence support note ready to edit and send.
You were my last detox. OTOS means the next person doesn't have to blag their way in. The handoff is logged before they leave the ward.
You signed me up in an emergency. You know how often people cycle back without the thread ever holding. Here is how OTOS changes that.
I'm still on your waiting list. OTOS doesn't solve that — it stops people falling out of contact while they wait for you.
You held me while I waited. OTOS gives that holding support a receipted thread — so when someone moves on, the continuity moves with them.
Right to Choose was the route that finally worked. OTOS makes it visible and receipted from first contact — without adding clinical burden.
GP-referred social prescribing — WorkWell referred me to Mind, who funded Jo Fenton therapy while I waited for my GP to take on a Shared Care Arrangement. OTOS makes that thread visible and receipted.
Cambridgeshire County Council / public health lead? Open the Local Authority briefing →
Why this exists
I was your patient.
I was your patient.
I built the fix.
35 years of self-medication. Six A&E presentations. Three detoxes at Addenbrooke's. £90,000 of residential rehab with my ADHD medication removed on arrival.
Then a private diagnosis. Three days on Elvanse. Everything made sense. The chaos wasn't a character defect. The addiction wasn't a failure of treatment. It was what happens when the underlying neurological condition stays unresolved while the system treats the visible damage.
OTOS is the thread that should have held between the services I moved through.
Read the full story →
"Next time we meet, I won't be your patient. I'll be your partner."
The evidence in three facts
Full evidence register →
61.3%
Improvement in addictive disorders after ADHD diagnosis and treatment. START study, France 2025. This is the comparator the pre-pilot is designed to test locally.
23–45%
Of people in addiction treatment have undiagnosed ADHD. Royal College of Psychiatrists. In the CPFT footprint: an estimated 800–900 adults in this overlap.
£90k = £91k
Three-month residential rehab for one person costs roughly what a 12-week OTOS pre-pilot costs for 50. This is the cost-redirection question the pilot is designed to answer.
What OTOS will never do
- ✕Diagnose, prescribe or make any clinical decision
- ✕Replace, access or write back to any EPR system
- ✕Create a new clinical record or share identifiable data
- ✕Automate any decision that should have a human in it
- ✕Commit you to a full rollout by joining a scoping call
The bounded pre-pilot
50 people. 12 weeks. Cambridge & Peterborough. One continuity thread. Zero clinical record merge. One named contact per partner. One 30-minute scoping call to start.
"OTOS surfaces signals. The partner teams make the decisions."
How it works
Four steps. One connected pathway.
OTOS holds the continuity thread across services so each partner can see the relevant continuity status — not another service's clinical notes.
01 — Identify
People already visible
Adults already touching addiction, recovery, crisis, hospital, GP, ADHD or community support — where co-occurring ADHD may be clinically relevant.
02 — Connect
The next step is named
The next appropriate route is named: ADHD assessment, Right to Choose, CPFT, GP, recovery or community support. The referral is logged and visible.
03 — Co-ordinate
Thread stays visible
The continuity thread shows whether the next step landed, stalled or needs human review. No extra clinical record is shared between services.
04 — Sustain
Drift becomes visible
Silence and missed follow-through become visible early enough for partner-led review, safe re-engagement and measurable learning.
What it looks like in practice
The overview a commissioner sees at Week 7.
Real pilot data structure. Anonymous threads. No identifying details. 89% continuity held. 94% handoff receipt rate.
"ADHD, when unsupported, is a potent route into educational failure, long-term unemployment, crime, substance misuse, suicide, mental and physical illness. Economic costs of at least £17 billion are avoidable."
Independent NHS ADHD Taskforce — April 2025
The next step is not a purchase decision. It is a partner conversation.