Drugs in Scotland: Report of ministerial taskforce

DRUGS IN SCOTLAND: MEETING THE CHALLENGE

Drug misuse is a serious and escalating problem in Scotland. For the individual, drugs can provide a quick boost, but at the risk of prosecution, damage to health, a drift into destitution and, in a significant and worrying number of cases, even death. For the families of misusers - their parents, spouses and children - drugs can mean anguish, social conflict and break-up, and poverty. For the wider community, drug misuse imposes heavy demands on services, is a major contributor to crime levels, gives rise to public health hazards and, in relation to drug trafficking, is closely associated with organized crime, intimidation and violence.

The most commonly abused drug in Scotland is cannabis. Other so called "recreational" drugs, such as Ecstasy, are widely used by young people and are a focus of growing public concern. . A particular feature of the Scottish drugs scene is the high incidence of injecting drug misuse. This is especially harmful to health because unsafe injecting practices can lead to the transmission of HIV and hepatitis and can give rise to other problems such as abscesses and septicemia.

Injecting drug misuse is a particular problem in some of the peripheral housing schemes of the Scottish cities, but there are also significant drug misuse problems in the smaller Scottish towns and in rural areas. "Recreational" drug misuse is very widespread, geographically and socially, throughout Scotland. A general shift in social attitudes towards drugs, especially among young people, is required.

Drug misuse is therefore a major social problem which society as a whole needs to tackle. It is not a problem which can be left to the NHS, the social work services and the police, though they have important roles to play. The response needs to be multi-agency and multi-disciplinary. Vigorous, imaginative, co-ordinated action is required at local and Scottish level.

The Drugs Task Force, consisting of experts from the statutory and voluntary sectors led by the Minister of State, Lord Fraser, has conducted a comprehensive review of the efforts to tackle drug misuse in Scotland, and

the following are its key conclusions.

(i) Much more emphasis should be given to efforts to reduce the demand for drugs. Pilot community drug action schemes should be set up with a particular focus on the development of alternative activities which seek to engage young people at a time in their lives when they are attracted by excitement and risk. Social work departments and the voluntary sector child care organisations should incorporate drugs prevention activity in their work with children and young people. The Health Education Board for Scotland should lead in developing innovative prevention work at the national level.

(ii) In the schools, new drug prevention packages should be developed for the under 10s and over 14s. Schools should be given guidance on the development of a comprehensive drug policy. The Inspectorate of Schools should seek to stimulate increased activity where necessary, disseminating good practice, and ensuring that a consistent approach is taken throughout the country.

(iii) There should be a review of the effectiveness of various types of drugs services, leading to advice at national level on which type of service, or which combination of services, is likely to suit which type of misuser.

(iv) Substitute prescribing has an. important part to play in tackling drug misuse, within a structured framework of services. More specific guidelines on the prescribing of substitute drugs should be drawn up.

(v) The community drug problem services in Scotland should be further developed with a view to achieving more referrals from and to generic social work services; providing additional support to, and obtaining the assistance of, the families of drug misusers; and reaching drug misusers at an earlier point in their drug careers.

(vi) In dealing with drug-misusing offenders, a range of options should be available to the prosecuting authorities and the courts for deployment according to the circumstances of the case. Noncustodial disposals linked to programmes which seek to tackle drug misuse may be suitable in some cases, particularly in dealing with young offenders or those who are seriously trying to overcome their drug misuse problems. Work in developing such programmes should be taken forward as a priority.

(vii) Recent initiatives taken by the Scottish Prison Service to tackle drug misuse in prisons are to be commanded. This work now needs to be consolidated and taken forward through the development of reduction to abstinence and education programmes for long-term prisoners and the regular training of prison medical staff. Consideration should be given to the piloting of throughcare arrangements which seek to ensure that a prisoner who has become drug free while in prison remains so on his release into the community.

(viii) Drug Action Teams should be set up to lead and co-ordinate local efforts to tackle drug misuse. These teams, which should be based on health board areas, should consist of very senior people from the local agencies concerned. They should draw up, by autumn 1995, strategic plans for tackling drug misuse. Thereafter they will be responsible for driving the plan and securing its delivery. Each team should be supported by a drugs development officer and be able to refer to a wider group - the drugs forum - which will bring together a wide range of community-level experience.

(ix) A Scottish committee on the misuse of drugs, reporting to the Secretary of State, should be set up to advise on policy, priorities and strategic planning.

On the following pages is a full list of the Task Force's recommendations.