Drugs in Scotland: Report of ministerial taskforce

DRUGS IN SCOTLAND: MEETING THE CHALLENGE

SERVICES

20. Proposals for crisis-intervention centres in Aberdeen and Dundee should be developed as quickly as possible (para 4.3).

21. Future service development must be based on a systematic and comprehensive assessment of the nature, extent and distribution of need. This assessment should be carried out by both health boards and social work departments reporting to the area Drug Action Team (para 4.4).

22. The proposed Scottish advisory committee should establish a subgroup of experts to advise on the effectiveness of various types of provision, including advice on what type of service, or combination of services, suits which type of misuser (para 4.6).

23. The proposed Drug Action Teams should take the lead in ensuring that arrangements are in place locally to monitor the extent to which services are meeting the needs of drug misusers. Drug Action Teams should stimulate the development of services; and they should ensure that the local range of services is subject to systematic review (para 4.8).

24. The proposed Scottish advisory committee should take stock of initiatives undertaken in developing community-based services with a view to developing, funding and evaluating further pilot projects and disseminating information on the most effective and worthwhile approaches (para 4.11).

25. The Community Drug Problem Service model for providing services to drug misusers 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 (para 4.21).

26. More specific guidelines on the prescribing of substitute drugs should be drawn up. In addition, independent and objective monitoring of those Scottish drug services which incorporate substitute prescribing should be conducted with a view to further identifying good practice in the delivery of services, including an assessment of effectiveness in controlling and changing drug use behaviour (para 4.23).

27. GPs have a key role to play in the treatment of drug misusers and the Scottish advisory committee should keep under close review action and support for GPs at both local and national level (para 4.26).

28. The Scottish Office should pursue with the Deans of the Medical Schools how enhanced training in dealing with drug misuse might be provided during the undergraduate training of medical students (para 4.28).

29. The agencies employing outreach workers should establish clear objectives and standards of practice for outreach workers and ensure that they are well supported at management level (para 4.30).

30. The Scottish Office should issue guidance for local authorities and licensing boards to bring to the attention of the organisers of "rave" events. This should deal with appropriate levels of stewarding, paramedic staff, "chill out" areas and free accessible water supplies, and information on sensible behaviour and harm minimisation issues surrounding drug use (para 4.33). The Scottish Office, in consultation with the police, local authorities and other relevant interests, should examine the extent to which it might be practicable and useful for model licensing conditions reflecting these areas of concern to be prepared for use by local authorities and licensing boards according to circumstances pertaining in their areas (para 4.34).

31. Needle and syringe exchange schemes have clearly demonstrated their worth and following careful consideration of the Drugs Task Force’s views the Lord Advocate has agreed to an increase from 10 to 15 in the number of sets of equipment which an injector may obtain during the second and subsequent visit to an exchange (providing the quantity issued on the previous occasion is returned safely for disposal). In building on the concept of outreach work in rural areas some carefully selected schemes involving exchange staff making home visits to selected injectors in rural areas should be piloted on a trial basis with a view to considering whether the practice might be adopted more widely (para 4.40).

32. There is considerable potential for pharmacists to play an even greater role in "frontline" services to drug misusers. Health boards should consider how best this can be developed (para 4.41).

33. All female drug misusers, particularly pregnant women and women with children, should have access to regular, sensitive counselling, support and information (para 4.43).

34. Drug Action Teams should examine the need for women-only residential provision (which would enable women to remain with their children if they so wish) in their areas (para 4.44).

35. The agencies concerned should review their services for women drug misusers (including child care needs) and, in particular, consult their women clients for their views on the services offered and encourage them to be involved in the long term monitoring and evaluation of service provision with the aim of developing a more attractive service to women drug misusers (para 4.45).

36. Service providers should ensure that their services are "user-friendly" to members of the ethnic minorities and that they are capable of recognising and addressing possible barriers to the effective provision of services to those who need them (para 4.46).

37. The development of a range of social care and health care responses for drug misusers in Glasgow, supported by inter-agency cooperation and planning should have an impact over time in reducing the high number of drug-related deaths in the city. The setting up of the multi-disciplinary Glasgow Drug Problem Service is particularly welcome (para 5.4).

38. The Scottish Drugs Forum has been commissioned, through The Scottish Office, to develop information/publicity materials focusing on and directed at polydrug using injectors, highlighting these dangerous practices and providing commonsense advice on reducing the risks (para 5.5). All the agencies involved should take steps to ensure that in their contacts with persistent drug misusers they continually emphasise the dangers of reckless injecting behaviour and polydrug misuse (para 5.6).