Opinion split over government's attutide to drugs and alcohol

Social workers and medical experts warn against MSP's calls for policy overhaul

An ideological debate on how Scotland addresses the issues of drug and alcohol abuse is being waged between elected representatives at Holyrood and the nation's leading social workers.

Lothians MSP Ian McKee has called for a reappraisal of the government’s present stance on tackling the abuse of drugs and alcohol in Scotland, forcing a defence of current measures by Scotland’s anti-drugs and alcohol taskforce.

Dr McKee, an SNP backbencher and former GP, has expressed his view that the Scottish Association of Alcohol and Drug Addiction Teams has created a major problem by focusing the bulk of its attention on drug-related incidents at the expense of those involving alcohol.

Dr McKee highlighted the fact that, whilst the government aims to reduce the abuse of drugs and alcohol, the two are rarely combined, with only ten per cent of cases involving both narcotic and alcoholic substances, according to health experts.

He said: “Our strategy for dealing with alcohol and drugs is to combine the two - that's why we have Alcohol and Drug Action Teams throughout Scotland.

“But they have concentrated mainly on drugs. And while that's very important, alcohol is probably one of the biggest causes of premature death in Scotland. It deserves a good crack of the whip and I'm worried it doesn't get it.

“Apart from both being addictive habits, they are two very different problems and they deserve individual specialist strategies.”

He continued: “We already know the vast majority of people with alcohol problems do not have a drug problem. We now know in Lothian only ten per cent of people with a drug problem also have an alcohol problem. That's a very tenuous link and it blows away the idea the two should be linked in Alcohol and Drug Action Teams.”

However, in an exclusive interview with The Journal, Tom Wood, Chairman of the Scottish Association of Alcohol and Drug Teams, claimed that there is an inextricable link between drug and alcohol abuse, maintaining that the two should be treated and addressed together.

“If you keep drugs and alcohol separate, you are destined to fail,” he said. “The truth is that they are almost always linked. Not identifying the relationship between the two has been a mistake in past years; we tend to separate drugs and alcohol as we see one as illegal and the other as social. We treat them separately in the same way as we deal with homelessness, isolation, and crime as separate issues – this is a big mistake.

“We must be sure to read across and recognise the relationship between the two; drugs are much, much more of a problem than alcohol, and this is where I agree with what Ian McKee has to say. What I am saying is this: fifteen years ago, drugs were our major concern with the rise of AIDS and HIV and the deaths they were causing. Nowadays, it is true that far more deaths are being caused by alcohol, but let us not let the pendulum now swing the other way so that we ignore the impact of drugs by focusing all of our attention on alcohol; they are both related and must be treated as such.

“The papers in Scotland are always talking about drug-related deaths; the truth is that there is virtually no such thing. What we see is people who may have ultimately died of an overdose, but who, in almost every case, have a history of both substance and alcohol abuse. The two exist almost always together and this is a good example of why it is unwise to isolate them.”

Mr Wood told The Journal that there are three key elements to ensuring that drug use, particularly amongst the youth population, remains under control in Scotland.

He said: "The first step is to make sure that young people are given the information required in order to make important choices. If they decide to experiment with drugs, we want to make sure they are doing so with their eyes open, so that they are aware of the risks and implications involved.

“Secondly, we want to get a hold of people who are already involved in drug-taking so that we can reach out to them, providing them with help and support.

“And finally, we want to provide a recovery service which will show people the way through.”

Although Mr Wood’s sentiments towards treating drug and alcohol related cases as virtually one and the same may appear somewhat controversial, they were echoed by Fiona Watson, clinical lead for substance misuse within NHS Lothians. Dr Watson acknowledged that the number of cases involving patients with both drug and alcohol problems is comparatively low, but stated that it is important not to separate the two.

She said: "Having reviewed the drug service caseload we have found approximately ten per cent have a drug and alcohol problem. Services must address the needs of all patients in a holistic way as we are increasingly seeing patients with a range of drug and alcohol issues. The direction of travel is to integrate drug and alcohol services.”

Health Secretary Nicola Sturgeon remained neutral on the issue of whether drug and alcohol misuse should be bracketed together by the police and health services, but reiterated the government’s intention to devote maximum attention to instances of misuse.

She said: “We recognise that most individuals with addiction problems require different types of treatment at various times during recovery and we are determined that people will have access to all appropriate support, when it is right for them to do so.”

The Journal