Rights, Respect and Recovery: Scotland’s strategy to improve health by preventing and reducing alcohol and drug use, harm and related deaths.

Scottish Government
Scottish Government, 2018
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Taking a public health and human rights-based approach, the 2018 strategy from Scotland strives to improve citizens’ lives by preventing and reducing the harms of drinking and drug use.

Summary The featured strategy promotes the Scottish government’s vision for a Scotland where its citizens have the right to live free from the harms of alcohol and drugs, are treated with dignity and respect, and are fully supported to find their own type of recovery.

This is underpinned by a public health and human rights-based approach to drugs and alcohol. In practice this means:
• Recognising the impact of problem drinking and drug use on population health and wellbeing.
• Encouraging work across multiple policy areas to reduce the harms of drugs and alcohol, including housing, education and criminal justice.
• Grounding approaches in the legal rights that citizens have under both domestic and international laws.
• Involving people in decisions that affect their rights.
• Preventing and eliminating all forms of discrimination, prioritising people who face the biggest barriers to realising their rights.

Four outcomes are defined in the strategy, along with corresponding commitments to ensure each outcome is achieved. These are summarised below.

Outcome 1: Fewer people develop problem drug use

• Identify and implement actions to reduce inequalities and improve Scotland’s health.
• Work with key experts, including those with lived experiences of drug and alcohol problems, to address stigma in order to prevent and reduce related harm.
• Alongside services already working with at-risk groups, develop a comprehensive approach to early intervention amongst those who are at risk of developing problem drug use.
• Revise and improve the programme of alcohol and drug use education in schools to ensure it is good quality, impactful, and in line with best practice.
• Develop education-based and person-centred approaches that are delivered in line with evidence-based practice which aim to reach all children and young people. This should include those not present in traditional settings, such as looked after and accommodated children, excluded children, those in touch with services, and children attending youth groups or community learning and development projects.
• Develop existing online resources to ensure they provide accurate, evidence-based, relevant, and up-to-date information and advice around alcohol and drug use, and how to access help.

Outcome 2: People access and benefit from effective, integrated, person-centred support to achieve their recovery

• Invest in advocacy services through the National Development Fund to support a human rights-based approach.
• Ensure people in need have good access to treatment and recovery services, particularly those most at risk.
• Ensure people who experience problem drinking and drug use receive effective services and interventions which support them to reduce harm and achieve their recovery.
• Ensure the voices of people with lived experiences of drug and alcohol problems inform the development, design and delivery of treatment and recovery services, interventions and approaches.
• Improve access to key interventions which will reduce harm, specifically focusing on those who inject drugs.
• Develop person-centred approaches across treatment and recovery services, and health and social care services which work with people with alcohol and drug problems.
• Support the growth and expansion of Scotland’s recovery communities into wider community settings.
• Develop trauma-informed (unfold supplementary text) approaches in alcohol and drug treatment and recovery services.
• Build on current public health surveillance to ensure that service design is informed by data, intelligence and academic evidence.
• Commission an up-to-date resource providing information and guidance on equalities issues for alcohol and drug prevention and treatment services.
• Co-produce an action plan with key partners to deliver these commitments and supporting actions.

Outcome 3: Children and families affected by alcohol and drug use will be safe, healthy, included and supported

• Ensure family members have access to support in their own right and where appropriate are included in their loved one’s treatment and support.
• Ensure all families have access to services (both statutory and third sector) in line with the values, principles and core components of the Getting it Right for Every Child (GIRFEC) approach (unfold supplementary text).
• Involve children, parents and other family members in the planning, development and delivery of services at a local, regional and national level.

Outcome 4: Vulnerable people are diverted from the justice system wherever possible and those already within criminal justice settings are fully supported

• Ensure that people who come into contact with the criminal justice system are provided with the right support from appropriate services.
• Pro-actively review local services in prisons to ensure they meet the new inspecting and monitoring standards for health and wellbeing.
• Support the work of Police Scotland to ensure that groups involved in drug dealing or distribution are being effectively targeted for prosecution.
• The Scottish Government will set up a group to advise health ministers on the contribution and limitations of the Misuse of Drugs Act 1971 in support of health outcomes in Scotland.

commentary Alongside the featured strategy, the Scottish government published a new alcohol framework, outlining 20 key actions that seek to “reduce consumption and minimise alcohol-related harm arising in the first place”.

Approaches to alcohol policy differ widely across the UK. An appraisal in 2015 found Scottish policy to be most closely aligned with evidence-based recommendations, framing alcohol as a whole population issue in contrast with UK government policy which is influenced to a greater extent by prevailing beliefs about personal responsibility.

Scotland has led the way on minimum unit pricing, implementing plans in 2018 to set a £0.50 minimum price after a five-year battle with the drinks industry. On drug consumption rooms too, Scotland has been nudging the UK position, referring in the featured strategy to the Scottish government’s efforts to “press the UK Government to make the necessary changes in the law, or if they are not willing to do so, to devolve the powers in this area so that the Scottish Parliament has an opportunity to implement this life-saving strategy in full”. Not letting this be a footnote in the strategy, the Minister for Public Health, Sport and Wellbeing Joe FitzPatrick used drug consumption rooms in his opening remarks (see page 3) as an example of “supporting responses which may initially seem controversial or unpopular”:

“Adopting a public health approach also requires us all to think about how best to prevent harm, which takes us beyond just health services. This, requires links into other policy areas including housing, education and justice. It also means supporting responses which may initially seem controversial or unpopular, such as the introduction of supervised drug consumption facilities, but which are driven by a clear evidence base.”

The Effectiveness Bank has previously documented the UK Government’s 2017 drug strategy and now lapsed 2012 alcohol strategy, as well as the 2016 Modern Crime Prevention Strategy which identified alcohol and drugs as two key drivers of crime and disorder.

In early May 2018 the UK government committed to developing a new national strategy on alcohol for England. What this might mean for the UK is discussed by Alcohol Policy UK, an organisation which provides news and analysis for the alcohol harm reduction field.

Last revised 12 December 2018. First uploaded 03 December 2018

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