PREVENTION OF DRUG ABUSE AMONG VULNERABLE GROUPS Dr Marcus Roberts Director of Policy and Membership DRUGSCOPE

A bit of background to UK situation Comparatively high levels of drug use (3 million adults say they have used drugs in the previous year) Only a small minority use the most harmful drugs (2.2 million cannabis/0.2 per cent opiates) The trend is downward – last year use is at its lowest level since we have been recording figures Problem drug users are from the most vulnerable groups in society and have multiple needs

More Background : Specific issues Concerns about potency of cannabis (mental health) Use of power cocaine (last year use at 800,000) Alcohol! Poly-drug use – the ACCE profile New synthetic drugs (EMCDDA – 41 new drugs in last year, 16 first identified in UK) Injecting drug use falling (137,000 in to 117,000 in 06-07)

Drug treatment and PDUs  320,000 PDUs (dependent on heroin/crack)  206,889 adults in contact with treatment  192,367 in contact for 12 weeks or more  23,680 complete treatment/leave drug free  24,053 young people (under 18) in treatment …That costs about £800 million a year Figures for

A couple of questions PREVENTION OF WHAT? (e.g. drug use or drug-related harm) UK focus on drug-related harm and problem drug use VULNERABILITY TO WHAT? (e.g. the vulnerability factors for poly-drug use not the same as for problem drug use) Focus on PDU with links to homelessness, family breakdown, unemployment, mental health problems and crime.

Approaches 1: Where preventing harm means saving lives Addressing Harm to dependent/injecting PDUs (prevalence among homeless, prison release) Targeted information campaigns on risks Needle Exchange Use of NALOXONE (prison release) Drug Consumption Rooms? Low rate of HIV/AIDs. Falling IDU numbers.

Approaches 2: protecting other vulnerable groups and people Crime reduction – for example, investment in treatment in prisons and testing in police stations. Making the case for drug treatment and cost effectiveness (£1 saves £2.50) Impact on vulnerable families – work with our partners at ADFAM, family support Protecting and safeguarding children – Family Drug and Alcohol Court in London.

Approaches 3: Prevention and young people’s services Young people in treatment are not PDUs Drug or alcohol use is a problem because of age (development) and/or because it is mixed up with other things in their lives – vulnerability factors The approach in the UK has been to work with young people in a way that relates to their reasons for wanting to address drug problems Drug and alcohol services work jointly with other children’s services (youth justice, care system)

‘We need … to start from where young people are. For example, someone says ‘I want to be fitter for football’ and we start with that. He hasn’t come in to our service because he wants to stop smoking weed but because he wants to play football and that enables us to work with him on the drug issues too. Let’s us talk to him about the outcomes that matter to him’. Drug worker at DrugScope event

Approaches 4: Prevention, relapse and recovery Need to prevent people’s lives falling apart again - dependency as a ‘chronic relapsing’ condition Methadone and recovery debate (getting them in and getting them out) Professional services and recovery networks (mutual aid, peer support, service user groups) Building a life/social integration (e.g. employment and housing) Stigma and social attitudes

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