Scottish Drugs Forum
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THE MOUNTAIN of reports and statistics published over the summer spells out clearly the scale of the
challenges facing the new administration as it gears up to taking on Scotland’s massive drug problem.
Alcohol and Drug Action Teams need to be more strategically focused, the methadone programme needs to
be standardised and everyone agrees that provision of far better “wraparound” services is necessary to support it.
Meanwhile, problems in identifying the true extent of children living in families affected by parental drug dependency have been highlighted, recorded crime - significantly fuelled, no doubt, by drug dependency - has rocketed and, most tragically of all, 421 deaths in 2006 were drug-related, the highest on record.
enormity
The new Scottish Government has made early pledges to tackle the three “Ds” – Drink, Drugs and Deprivation - and and there is no doubting the enormity of the task which lies ahead especially among impoverished communities and families where problematic substance use has become an accepted way of life in the absence of anything else to motive or inspire.
The new opportunities for cross-cutting work within the Scottish Government’s cabinet portfolios offer a tantalising vision of what could be possible if responses are to be truly integrated, and the appointment of the first Minister of Public Health has to be commended.
In a discussion document, Better Health, Better Care, Health Secretary Nicola Sturgeon states that every portfolio is being challenged to contribute to health and wellbeing “wherever, whenever and however”. The expansion of the health and wellbeing portfolio to including issues such as poverty, housing, social and financial inclusions, and homelessness lay the groundwork for a “more radical and inclusive” approach to achieving shared objectives.
Better Health, Better Care - which will receive submissions until 12th November – sets out the need to improve patients’ experience of care, encourage people to take responsibility for their own health and wellbeing but also to focus on health inequalities on “everything we do.” Working in partnership to provide anticipatory care and improve services for long-term conditions, early intervention and prevention to give children the best possible start in life are included in the stated aims.
guarantees
The introduction of waiting times guarantees appropriate to needs – already a definite policy pledge – is one way of making life so much better for the hundres waiting to be assessed, never mind offered treatment.
Although obviously not written specifically for the drugs field, several issues dear to the heart of many are directly addressed in the document. It talks of “setting out and giving force” to standards which every patient has a right to expect from the healthcare system such as individual healthcare plans, provision of information, handling of complaints and access to information. There will be a focus on supporting the needs of families and carers of people with disabilities and long-term illnesses, though there is no explicit mention of people with drug problems here.
It refers to embedding “independent scrutiny” within the process of major service-change so that local people and NHS staff are assured that proposals are robust, evidence-based, patient-centred and consistent with clinical best practice and national policy.
It also highlights the need to identify variation in practice and take action to raise performance standards across the country to best performing organisations of practices. The call for developing greater capacity for cognitive therapies and other psychological therapies should lead the way for expanding the low level of psychostimulant services in Scotland.
underlying
Perhaps the most significant point articulated, however, is the need to take effective action on underlying problems such as quality of life, deprivation, homelessness, barriers to employment, substance dependency and the family environment in children’s early years.
Services – and indeed communications campaigns – must be designed to reflect the specific needs of deprived communities and those with the most complex and challenging needs such as those with mental illness, ex-offenders, homeless people, looked-after children and children whose parents have drug problems.
Supporting effective parenting in the earliest stages of a child’s life and supporting the problem-solving skills of parents are two crucial measures most likely to assist the desire to support from birth the children of parents with drugs problems.
investment
Creating resilient, confident citizens is the key here and that will require significant investment over a sustained period.
There is, however, a cautionary note in the document about the need to economise in an era of smaller
increases of Government spending although this could bring beneficial spin-offs to users and services.
The new administration has a clear desire to challenge traditional boundaries between public sector organisations and pursue an investment strategy that builds public sector services - supported by
the use of the voluntary sector and the social economy
Such ambitious goals, however, will never be achieved on the cheap. But the massive dividends to be
gained from stemming a significant proportion of the social problems of tomorrow - including new generations of problem drug users – make it a price worth paying.