1. The mainstream challenges of developing healthier alcohol and drug policies and practice Mike McCarron, The Scottish Association of Alcohol and Drug Action Teams Scotland’s Futures Forum – 3 rd April 2008

2. Global View The Global Village proportionately reduced to 100 people includes: 6 possessing 59% of wealth and living in USA 80 living in poverty 70 illiterate 50 suffering hunger and malnutrition 52 women and 48 men

3. Global Substance Use by Adults 50% Alcohol 30% Tobacco 5% Prohibited drugs (inc 4% cannabis) 0.6% Problem drug use is mainly in poorest communities (as in Scotland)

4. Inter-Country Comparisons

5. Sweden Tax rates Sweden: Individual: Under 26000 - 31% over 26000 51% over 40000 56% Employers Social Security contribution 32% of gross income VAT 25% Most services

6. Community Contrasts

8. Individual Situations “If there is less [food] I eat less.I have to feed the family first. Most days I don’t eat.The only place my diet will get me is death and is that really such a bad option?” -Service User (SDF Gallery)

10. Structural Relative Inequality

12. Scotland’s Challenge Sizing the problem: alcohol- related deaths Male liver cirrhosis mortality rates: Scottish rate = 2.5 times E&W rate

13. Sizing the problem: deprivation and alcohol

14. Scotland: Some Promising Policies

15. New Futures Fund 10,000 Clients over 5 years in 70 projects, costing £34m (1,630 clients with drug problems in last two years) –75% reported increased self confidence and motivation –50% thought their chances of getting a job had increased –21% went into a job –12% moved into education or training –14% joined a government employment or skills programme –10% went into volunteering

16. Promising Policies Housing right for all by 2012 Unemployment analysis – Community Benefit (Raploch) – apprenticeships (Glasgow) Improving individual sense of wellbeing Promoting “recovery”& essential services Lower income proportionate increase Early years prioritisation – kinship care allowance

17. The Next Step 1998 “We want now and in the future to see deprivation given its full and proper place in all considerations of drug prevention policy, at both the local and strategic levels, and not let slip from sight” (ACMD, Drug Misuse and the Environment) 2008 From now on alcohol an drug policy and practice should be fully integrated within strategies and practice seeking to reduce poverty, multiple deprivation and social exclusion – and vice-versa

18. Because A big reduction of inequality in Scotland would make a major contribution to reducing the damage caused to its population by alcohol and drugs by half by 2025