Scottish Drugs Forum
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11 July 2003
Specialist adult drug services should be given specific funding for family support workers to help minimise harm caused to children whose parents are problematic drug users, according to Scottish Drugs Forum.
The call follows the ground-breaking Government report into the impact of problem parental drug use on their youngsters which estimates that the percentage of children in Scotland with a problem drug-using parent is double that in England and Wales.
The UK Advisory Council on the Misuse of Drugs (ACMD) Prevention Working Group’s report “Hidden Harm: responding to the needs of children of problem drug users” estimates between 4% and 6% of children under 16 in Scotland have a problematic drug using parent compared to 2% to 3% of children under 16 south of the border.
The actual numbers of youngsters affected in Scotland are thought to be between 41,000 and 59,000, while the estimate is that between 200,000 and 300,000 children in England and Wales are similarly affected.
The ACDM report - which assesses for the first time the number of affected children in Britain – makes a total of 48 recommendations for improving the health and social wellbeing of the children problem drug using parents throughout the UK. It follows publication in February this year of the Scottish Executive’s “Getting Our Priorities Right” national guidance to agencies to assess the needs of children and provide services to safeguard their welfare.
The report states that parental problem drug use can and does cause serious harm to children at every age from conception to adulthood; calls for the voices of the children of problem drug users should be heard and listen to, and urges that reducing harm to children as a result of parental drug use should be the main objective of the UK’s drug strategies.
Key recommendations range from issues of contraception and child health, education and social welfare issues from the womb on to proposals for improving data collection, access to maternity services and partnership working between statutory and specialist services including:
The report also examines child protection/social services aspects of the problem and says that the child’s own perception of the situation should be sought and recorded whenever possible.
Support for parents and the extended family could include not only treatment of the problem drug use but advice and support on parenting skills and help with improving accommodation and benefits, while children could be supported through expressing their own ideas and feeling, having fun, providing special educational support, as well as access to health care and other services and treatment for emotional and behavioural problems.
The report was unable to establish the number of children in care as a result of parental problem drug or alcohol use. However, residential care for the children of problem drug users should be considered as the option of last resort, the report concludes. Other recommendations in this section include:
David Liddell, Director of Scottish Drugs Forum, said: “This report highlights one of the most tragic aspects of the wider harm caused by problematic drug use and its conclusions are both interesting and thought-provoking.
“SDF believes that there is a need for specialist drug services and childcare agencies to work more closely together so that there is a shared understanding of when a child is at risk.
“Problem drug users can be suspicious of children and family teams because of their powers to remove children from family care. Users tend to trust specialist adult drug services more, which is why we believe that specific funding streams to allow these services to family support workers would be the most effective way of addressing the huge and important issues highlighted in the report.”
A spokeswoman for the Scottish Executive said the issue had already been identified as a significant problem in Scotland.
“The report will provide the opportunity for us to reflect further on our existing and planned actions to address the needs of children of drug misusing parents, “ she said.
"This range of current and planned initiatives in Scotland aim to ensure the better integration of services which recognise that children requiring support will often have a range of complex problems, including those caused by parental substance and will do much to improve the lives of children affected by substance misuse."
ACDM’s report and the executive summary are available on the national drugs strategy website www.drugs.gov.uk (Opens in new browser window).
11 July 2003
Drug workers, doctors and pharmacists in Scotland, England and Wales, will be able to supply certain types of drugs paraphernalia, including filters, to drug users under changes to the law from 1 August 2003.
The Home Office has announced that from 1 August, drug and health care workers will be able to supply specified equipment to drug users to help them avoid health risks arising from practices such as dissolving drugs in dirty water or injecting traces of dirt.
From 1 August, it will no longer be an offence for doctors, dentists, pharmacists and “persons employed or engaged in the lawful provision of drug treatment services”, - including nurses and employees of needle exchange schemes - to supply swabs, filters, citric acid, certain mixing utensils (e.g. spoons, bowls, cups and dishes) and sterile water ampoules to drug users who have obtained controlled drugs, such as heroin and cocaine, without a prescription.
However, because “water for injection” is currently controlled under the medicines’ legislation as a prescription only medicine, the legislation will limit its supply to occasions when it is prescribed to an individual in a prescription, or when it is approved for supply to an individual under a Patient Group Direction.
The inclusion of filters follows a recommendation by the Advisory Council on the Misuse of Drugs in May this year to include filters in the new legislation after the original Home Office consultation at the end of last year had left them out.
Scottish Drugs Forum – which forwarded a three-page submission to the Home Office on the topic - had urged the Home Office and ACDM to include filters, on the grounds that this was a serious and illogical omission which could lead to an increase in injection-related infections.
Home Office Minister, Caroline Flint, said: “ Our top priority is to get drug users off the drugs that cause so much harm to themselves and our communities. But we need to be realistic that, for some drug users, that will not happen overnight, and we need to help them reduce the amount of harm they do to themselves and others.
“Providing these items is currently illegal. We know that treatment workers and doctors have been making sensible decisions to provide equipment anyway, but faced the risk of prosecution. We have decided to change the law to help reduce the health risks to drug users.
“The Government is working harder than ever to fight the scourge of drugs and to treat the 250,000 chaotic drug users. This year alone we are investing more than £1.2 billion in the fight against drugs, almost half a billion of which will be used to expand and improve treatment services."
These changes to section 9A of the Misuse of Drugs Act 1971 were laid in Parliament on 8 July under the Misuse of Drugs (Amendment) (No.2) Regulations 2003.
The Circular announcing the changes can be downloaded from the Home Office website, www.homeoffice.gov.uk (Opens in new browser window).
2 July 2003
Employability prospects for some methadone users appear to have been given a boost after a ruling by a Government medical advisory panel to the Driver and Vehicle Licensing Agency.
Stable methadone users on small reduction dosages and using no other illegal drugs could be considered for a temporary one year return of their driving licences – overturning a previous DVLA ban on all users on methadone reduction programmes.
The clarification follows pressure by Scottish Drugs Forum on the Transport Secretary’s Honorary Medical Advisory Panel on Alcohol, Drugs and Substance Misuse to ease licence eligibility restrictions on methadone users and to accept user stability reports from specialist drug workers and not just GPs or consultants.
Until now, DVLA medical advisors have opposed the return of licences to methadone users on reduction or withdrawal programmes because of fears that these drivers would be unsafe on the roads due to variations in drug levels causing instability or liability to relapse. However, stabilised users have been eligible for the temporary one-year return of their licences because their dosage has been regarded as not presenting the same potential problems as those on reduction dosages.
At its April meeting, the Panel said its experience was that approximately 90% of patients on methadone would use other drugs, mainly cannabis, cocaine and amphetamines, and that many clinics did not undertake routine cannabis screening of patients on methadone programmes.
However, the Panel did agree that in cases where there was a small dosage reduction in a patient who had been on a long-standing methadone treatment programme and has demonstrated stability with no use of other illicit drugs, then licensing could be considered.
Nevertheless, the Panel rejected SDF’s plea to consider reductions in periods of stability for Group 1 and Group 2 licensing. SDF had asked for the minimum period of stability to be cut from one year to between 4-6 months for Group 1 licences, and from three years to one year for a Group 2 licence.
The Panel ruled that there was insufficient evidence to support a general reduction in the period of stability required before licensing could be considered but said it would welcome a more in-depth literature review on methadone and treatment programmes.
Regarding the use of supplementary reports from specialist workers, the Panel was advised it was restricted under legislation to commission reports from non-medical specialists and had no legal authority to request reports directly from specialist workers. However, any such information could be submitted by the licence holder and could be taken into account on an individual basis, the Panel has told SDF.
Phil Hogben, Head of SDF’s Employability Team, said:
“I am delighted at this apparently small but extremely significant concession by the Panel because it unlocks a gateway to driving – and therefore employability - opportunities for methadone users wanting to get back into mainstream community life.
“We pointed out to the Panel that there are two separate dangers by restricting the return of licences – albeit on a temporary one year basis – to stable dosage users only.
“One is that drug users keen to get their licence back will want to detox from methadone too quickly, thus making them vulnerable to a relapse into chaotic drug use. The contrasting danger is that users could be tempted into staying on unnecessarily prolonged methadone maintenance.
“Neither of these is a desirable state of affairs and we are very pleased at the Panel’s clarification of matters. The long-term aim of employability is to promote the move from drug rehabilitation to sustained employment. Accessing opportunities to earning a living, new horizons and circles of friends through regaining a driving licence is, therefore, a crucial part of the rehabilitation process.”