New drugs strategy must tackle underlying inequalities

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4 February 2008

A SHARE of Scotland’s billion-pound regeneration budget should be invested into directly tackling the underlying health, income and social inequalities at the root of the country’s drugs problem.

At least 750 support worker posts should be created to help people with the housing, employability, family and drug treatment issues which frequently conspire to undermine their resolve - and ability - to overcome problematic substance use.

The calls are made by Scottish Drugs Forum membership in their submission to the Scottish Government on the direction and shape of the forthcoming new Scottish drug strategy, which is expected in the spring.

The SDF paper – which has been submitted to Community Safety Minister Fergus Ewing - says the Scottish Government should provide robust and sustained support at various levels and on an immediate and longer term basis to:

Provide additional investment over the next three years to ensure drug services are high quality and not doomed to inadequacy because of lack of resourcing
Develop innovative regeneration schemes to undermine destructive local drug economies and create meaningful job opportunities
Integrate existing drug services with mainstream services to ensure housing, employability, family services and outreach programmes can offer services better equipped to respond to the individual needs of clients.

“The vast majority of Scotland’s high levels of damaging drug use has its roots in, and is perpetuated by, poverty and inequalities such as income, housing, amenities, jobs and health which can span several generations of a single family.

“Tackling the deep-rooted social ills associated with these inter-related issues will, therefore, require very substantial and widespread will among Scotland’s civil society. This must be underpinned by wide-ranging, well-resourced and widelytargeted support across a large spectrum.”

At least 200 of the 750 support posts are needed to help people cope with housing issues. Two hundred jobs should be set up to open up the potential for routes out of drug use through education, training and employment - nearly seven out of 10 drug users seeking help in Scotland are unemployed, many long-term.

And at least 250 family support posts should be in place to offer a range of family planning, pregnancy, children and family projects and parenting support services which can overcome or avert the risk of drug problems developing because of existing or potential family difficulties.

The document makes clear that only this type of high-intensity, individually tailored action plan – and not conventional mass media and drug education campaigns – stands a chance of influencing young people in deprived communities, who are the most likely group to be at risk of developing serious drug problems.

More sophisticated approaches are required regarding the welfare of children living with parents with drug and alcohol problems - and this must include sustained support for substance-using parents which focus on improving parenting capacity as well as managing their drug problem.

Research is also required to improve clarity and understanding of what constitutes serious risks to children, and consensus on how best to respond.

A further 100 posts should also be created to intervene earlier with the most hard-to-reach drug users. This will slowly encourage them to seek help and prevent or minimise long-term damage to their health through contracting bloodborne viruses as a result of sharing injecting equipment.

Other measures called for include:

Creation of centrally-funded cocaine and other stimulant services in hot spots such as Edinburgh, Glasgow and Aberdeen
an increase in drug services for the under 18s
local Alcohol and Drug Action Teams (ADATs) should have control of budgets pooled from partner agencies
action to prevent the potential effectiveness of methadone programmes should not be undermined by short-term prescribing, unplanned discharges, inadequate dosage and punitive treatment responses
wider and more genuine support for User Involvement in the design and delivery of service – and encouragement for advocacy agencies to develop specific services for people with drug problems
rigorous evaluation for “bold and innovative” measures to prevent drugs deaths including safer consumption rooms and distributing the opiate reversal drug Naloxone to users, friends and carers
increasing the number of shortstay drug crisis centres from two to at least five to cover the country.

The document also describes the need to tackle low morale and job dissatisfaction among staff who are over-burdened with complex cases and competing demands from clients and their managers.

Too many voluntary services – who deliver frontline service son behalf of council and NHS commissioners – are struggling on short-term contracts and must be given contracts of at least three years to ensure stability and strengthen their role in addressing Scotland’s drug problem.