The Scottish Government

« Previous | Contents | Next »

Listen

SCOTTISH EXECUTIVE'S ANNUAL REPORT ON DRUG MISUSE

TREATMENT

PROGRESS

The number of new clients reported to the Scottish Drug Misuse Database increased from 10,514 in 1999-00 to 10,798 in 2001-02, an increase of 3%. The Information and Statistics Division is currently investigating the accuracy of the data provided by agencies and whether they are under-reporting new activity, in light of the increased service provision provided through the additional treatment money.

PROGRESS

The proportion of injectors who reported sharing needles and syringes 'in the previous month' has increased from 34% in 1999-00 to 36% in 2001-02.

The proportion of injecting drug users who had a named HIV test and who were positive for Hepatitis C has fallen from 62% in 1997-98 to 48% in 1999-00 (based on tests from the four main testing centres in Glasgow, Edinburgh, Tayside and Grampian).

PROGRESS

In 2001, there were 332 drug-related deaths, compared to 291 in 1999 and 292 in 2000.

PROGRESS

All DATs report that shared care schemes are either operating within their area, or are in the process of being developed.

PROGRESS

Of the 22 DATs in Scotland, 10 report targeted services for drug misusers under 16. New services for children feature prominently in all DAT plans for 2002-03.

PROGRESS

We have:

• provided 5.3 million in additional resources to support treatment services across Scotland, and 6.8 million for drug rehabilitation, bringing a total of 12.1 million for financial year 2002-03
• increased by 18% the number of GP practices signed up to local shared care schemes, thus improving access to treatment services (441 to 552)
• expanded the number and range of specialist drug treatment and care services - DAT plans indicate that 52 new services came on stream in 2001-02, including substitute prescribing, detox, harm reduction, community rehabilitation, training and employment and criminal justice interventions (in addition, the plans indicate enhanced provision within existing services, increased staff training opportunities, improved information collection, increased evaluation of services and on-going needs assessment)
• increased by 37% the number of dispensings of methadone
• expanded facilities for needle and syringe exchange - in 2001-02, for the first time, all DATs reported having facilities for needle and syringe exchange, mainly through a 40% increase in community pharmacy provision (from 72 to 111)
• secured three-year funding for the majority of voluntary sector providers
• considered the emerging trend in psychostimulant use in Scotland (mainly cocaine and crack cocaine) and issued practical guidance to service providers to address the needs of psychostimulant users in Scotland
• set up a joint SACDM/Scottish Advisory Committee on Alcohol Misuse (SACAM) Working Group to consider the needs of those drug and alcohol users with underlying mental health problems
• published, through the EIU:
  • a research review of the risks, and the effectiveness of primary prevention strategies for, Hepatitis C in injecting drug users;
  • a research-based guide on psychostimulants, based on the evidence drawn together by the Scottish Executive Psychostimulants Working Group;
  • Integrated Care for Drug Users, which was launched at the Scottish Executive/DAT conference in October; and
  • a systematic review of the research literature on the effectiveness of treatment for opiate dependent drug misusers and a survey of NHS services for opiate dependents in Scotland, both to support the work on integrated care
• organised a major conference on Hepatitis C in July 2002
• reviewed the guidance relating to the operation of needle exchange schemes, and increased the limits on the number of needles than can be exchanged, in order to discourage needle-sharing by injecting drug users and reduce the potential for the transmission of blood-borne viruses
• worked with the UK Government in considering the case for legislative change relating to drugs paraphernalia
• through the SDF:
  • continued to support the Scottish Needle Exchange Workers Forum, a network of specialist needle exchange workers across Scotland;
  • continued to develop user involvement groups across Scotland, and undertook peer research including a survey of service users' experiences in accident and emergency departments in Glasgow
  • established user involvement posts in Greater Glasgow, Tayside and Fife; and
  • undertaken a range of capacity building work with the voluntary sector across Scotland

Staff from Signpost Forth Valley, a groundbreaking community project for drug misusers and their families

• published the document The Right Medicine, A Strategy for Pharmaceutical Care in Scotland, which identifies a commitment to support improvements in community pharmacy premises (2002) and explore ways to maximise the contribution of pharmacists in the provision of services to substance misusers (2004)
• continued to invest in the development of community pharmacies - this has helped pharmacists to:
  • disperse medication other than methadone, such as dihydrocodeine, buprenorphine, benzodiazepines, and certain psychotropic treatments;
  • step up the supervision of consumption - not just confined to methadone - to reduce the leakage of medication into the community (50% of practices now have private counselling areas in place); and
  • enter into an agreement with their local Primary Care Trust to provide free injecting equipment to drug misusers to help reduce the spread of blood-borne viruses
• improved the delivery of methadone and other prescribing and linkages between medical and therapeutic treatment by providing additional nursing provision on addictions within prisons
• through the Partnership Drugs Initiative with the Lloyds TSB Foundation for Scotland:
  • funded 12 projects across Scotland that provide intensive therapeutic services to young people affected by their own drug misuse (approaches emphasise one-to-one and group work and are informed by counselling techniques, family therapy, mentoring or art therapy e.g. Perth's Connect Project, Dumfries & Galloway's Crannog service and the Highland Mentoring Project).

THE FUTURE

We will:

• drive down waiting lists through the implementation of integrated care for drug misusers within the framework of the Joint Futures agenda
• fund a pilot service for psychostimulant users in Aberdeen and implement the other recommendations of the SACDM Working Group, which reported on the issue
• consider the needs of those drug and alcohol users with underlying multi-mental health problems, following the work of a SACDM/SACAM Working Group
• ensure DATs and constituent agencies improve drug treatment through the application of integrated care and Joint Future principles and practice
• improve the effectiveness of drug treatment for opiate dependent drug users, following the EIU's review of evidence published in August 2002
• provide annual localised data to DATs to aid the planning and delivery of drug services
• complete a review of the funding allocation formula for the prevention of blood-borne viruses, ensuring that from 2003-04 the distribution of funds across Scotland will be more closely linked to need.
• support the 7th International Hepatitis C Conference, which is to be held in Edinburgh in June 2003
• publish the results of a study to examine the injecting practices of a sample of drug users at a level not previously achieved in the UK, a related pharmokinetic study that will examine the risks of injecting practices, and a pilot project examining the feasibility and acceptability of citric acid provision
• through the SDF:
  • hold a harm reduction conference with the Scottish Needle Exchange Workers Forum; and
  • deliver a range of user involvement work, including peer research and inputs to DATs and drug fora
• in prisons, develop an expanded range of treatment programmes to assist prisoners develop safer and drug-free lifestyles
• through the Partnership Drugs Initiative with the Lloyds TSB Foundation for Scotland, continue to fund projects delivering treatment services to young people (funding decisions will be influenced by the emerging evidence and guides from the Effective Interventions Unit and will aim to support DATs to meet the national standard for providing services to
  under 16s)
• continue, through the work of the Information and Statistics Division, to provide timely, robust, accessible drug misuse information to aid service planning and delivery, and to optimise the benefits of new technologies in gathering and delivering the information.

« Previous | Contents | Next »