Social work and substance use policy

Dr Sarah GalvaniUniversity of Bedfordshire

Chair, BASW SIG in Alcohol and other Drugs

Purpose of policy

• Outline Government’s plan of action

• Identify its primary concerns

• Outline priorities and focus

• [Indicates where funding allocated!]

Illicit drugs - strategy

• Crime– Reducing supply– Tightening controls and deterrents– Improving effectiveness of enforcement

• Health– Increasing participation in ‘treatment’

Illicit drugs – strategy (cont.)

• Social?– Emphasis on young people’s use (located

within health and criminal justice agendas)– 2008 - recognition of families – need to work

with whole family [how implemented?]– Protecting communities? [criminal justice

issues, eg. enforcement]

Alcohol - strategy

• Ambivalent policy relationship• First strategy came much later than illicit

drugs (2004 vs 1985)• Focus on

– crime and health– better education and communication about

risks of drinking alcohol– working with alcohol industry – voluntary code

of good practice/social responsibility

Alcohol strategy (cont.)

Social?– Acknowledged impact on families– Need to support people with particular

vulnerabilities, eg. homeless, yp, mh– Relationship with domestic violence

• Sensible drinking notions• Review of alcohol pricing/taxation• Guidance to parents and yp• Local alcohol strategies – local needs

Drug strategy 2010

• First ever combined alcohol and drug strategy by English Government

• Three priorities:– Reducing demand for drugs– Restricting supply of drugs– Building recovery from drug use

Drug strategy 2010 (cont.)

• Move away from harm reduction• Language of ‘dependence’ not ‘reducing harm’• Move away from substitute prescribing and

stabilisation• Move towards ‘full recovery’ = drug free

• Importance of families and communities supporting people to recover fully

• Whole family focussed interventions• Recognition of their needs in their own right

Drug Strategy 2010 (cont.)

• “Active promotion” of self-help networks• Community involvement

– Housing – tackling visibility of homeless people– Supporting people initiative

• Employment– Skilling people to get jobs – training,

volunteering and work trials– Benefits – sanctions for non compliance;

additional requirements; reduction if in residential rehabilitation

Drug Strategy: Benefit sanctions

• “We will offer claimants who are dependent on drugs or alcohol a choice between rigorous enforcement of the normal conditions and sanctions where they are not engaged in structured recovery activity, or appropriately tailored conditionality for those that are.”

• “In practice, this means that those not in treatment will neither be specifically targeted with, nor excused from sanctions by virtue of their dependence, but will be expected to comply with the full requirements of the benefits regime or face the consequences.”

(p.23)

Building Recovery

• “Building recovery in communities - this Government will work with people who want to take the necessary steps to tackle their dependency on drugs and alcohol, and will offer a route out of dependence by putting the goal of recovery at the heart of all that we do. We will build on the huge investment that has been made in treatment to ensure more people are tackling their dependency and recovering fully. ...

What is recovery

• “voluntarily sustained control over substance use which maximises health and wellbeing and participation in the rights, roles and responsibilities of society”

(UK Drug Policy Commission, 2008)

• “a process through which an individual is enabled to move from their problem drug use, towards a drug-free lifestyle as an active and contributing member of society.”

(Scottish Government 2008) • AA/NA fellowships use concept of ‘recovery’

What you need for recovery?

Recovery capital (Drug Strategy 2010)• Social capital

– support received and commitment to others “resulting from relationships”

• Physical capital– money and safe place to live

• Human capital– “skills, mental and physical health, and a job;”

• Cultural capital– “values, beliefs and attitudes held by the individual”

Who is supporting “full recovery”?

• Recap

Potentially huge change to treatment system Focus on abstinence not harm reduction Move away from individually focussed,

relatively short term intervention (?) Longer term support required Holistic focus of support

Who is supporting “full recovery” (cont.)

Recap (cont.)

Attention to family and children’s needs Help people to build ‘recovery capital’ Language of responsibilities and

participation of substance users Involvement of communities Involvement of mentors, peers, self-help

groups

Implications for social work: risks

• SW picking up pieces of changes to treatment system?

• More work?! ie. supporting people over longer term

• Withdrawal/reduction of benefits:– higher levels of individual poverty?– higher levels of family poverty?– increases in homelessness?– Increase in acquisitive crime?

Who is supporting recovery? (cont.)

... “building on huge investment”..• ? New services to respond to change in focus, eg.

“whole family approaches”• ? Changing practice of existing services• Who and how going to monitor recovery• Don’t know what that means yet!• Do know self-help is key part of plan

“Active promotion and support of local mutual aid networks such as Alcoholics and Narcotics Anonymous will be essential.”

Implications for SW: opportunities

• Sub use and social work move closer together?• Supporting sub use colleagues

– to consider impact on families and need for support

– advice on working with children and families• Possible SW role in developing ‘recovery capital’• SW – used to providing ongoing, longer term

support (e.g. care management)• SW used to adopting holistic approach –

coordination of support services

Implications for SW: opportunities

• Implementation of strategy is locally led – opportunity to influence service agenda?

• Take initiative to discuss implications of recovery agenda with local sub use partners

• Develop rolling programme of training and knowledge exchange with substance use partner agencies

• Ensure local universities receive feedback on need for substance use in sw education

• Take individual responsibility for ensuring you are confident and competent to engage with substance use issues

Thank you

• Sarah.galvani@beds.ac.uk

• Tel: 07884 007222

• www.basw.org.uk/networks/alcdrugs

• www.beds.ac.uk/goldbergcentre