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Health Committee, 23 Jan 2007

23 Jan 2007 · S2 · Health Committee

Item of business

Treatment of Drug Users

Byrne, Ms Rosemary Sol South of Scotland Watch on SPTV

How effective is the current approach? Drug treatment and rehabilitation in Scotland is patchy and unequal, and for those attempting to access services it is often a postcode lottery. In Ayrshire and Arran, as in other areas, there is a cap on methadone, which means that if someone does not have mental health problems, does not have a child on the at-risk register or is not pregnant, they will not get access to a maintenance programme. In Dumfries and Galloway, a Social Work Inspection Agency report found that nearly one third—30 per cent—of people with substance use problems who were interviewed did not feel that they had been fully involved in decisions about the help or services they should receive. Thirty-three per cent of substance users said that they had not been given a clear plan. While more than two thirds of people surveyed had seen written assessments of their needs, 67 per cent of those with substance use problems who responded had not seen written assessments. There were significant gaps in services for drug users seeking help from mental health teams, and in services to support children of drug users. That is replicated across the country, in many different health board areas. Waiting lists is another issue about which research has recently been printed. I will not go through that because I think we are all aware of the mismatch with waiting times in different areas. Approximately 60,000 children are living with parental drug misuse. However, across the country, child and family teams struggle to make adequate provision due to lack of resources and poor integration of services. In spite of the fact that support work with women and drug users and their families could be up to one tenth of the cost of placing children in foster or state care, little heed is paid to the extended family, involving the family in drug treatment and in looking after the children and ensuring that they are safe. Kinship carers do not get paid allowances in some local authority areas. Again, there is a patchiness of care for the very young and vulnerable. On crime figures, a recent report to the House of Lords found that the cost of heroin addiction to the United Kingdom economy was approximately £30 billion; the cost to the Scottish economy was approximately £3 billion. There is a revolving door: people are going in and out of prison and are not being given treatment. I agree with Tom Wood that it is essential that the best treatment and support is given to people in prison; in fact, it would be cheaper and would achieve a better outcome to send people into residential rehab rather than prison. There are too many areas in which there is reluctance to send people to residential rehab, yet we hear all the time from the Minister for Justice and from the First Minister that we need more rehab. The rehab is there; it is just not being used. How can the current approach be improved? The Treatment of Drug Users (Scotland) Bill seeks to address the major issues of inequality and child protection, and crime and its impact on communities, by shifting the focus from criminal justice to health. I firmly believe that drug addiction is a health issue and that it sits in the wrong place with criminal justice in the Parliament. Such a shift would signal a different way of looking at drug addiction, and not the punitive approach that many people take at the moment. Offering a statutory right to assessment and a comprehensive range of assistance would move us forward considerably. That is one of the major proposals in the bill. It is important that people are assessed properly before an holistic care plan is put together. Plans should include all health needs, family support, employability, welfare and housing. It is important that the work and the money we spend are monitored. Another huge gap where monitoring has been absent is the integration of services through a care worker, who can ensure that that happens. Key to that is ownership of the care plan by the drug user, so that they feel that they are part of the programme. A range of treatments based on assessment could include substitute prescribing and a pilot in Scotland on the use of heroin under clinical conditions. It is important to stress that methadone prescribing stabilises and that the problems highlighted recently have more to do with inadequate rehab services. I would like a definition of what the minister means when she talks about rehab. A range of treatment must be offered. We need to have residential and good community rehab, rather than a script and counselling once a fortnight for 20 minutes, which is what some people think rehab is.

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Health Committee, 23 Jan 2007

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