Drug Deaths Taskforce response: cross government approach

3. Early intervention

Taskforce Recommendation: The Scottish Government should prioritise intervention at an earlier stage, tackling the root causes of drug dependency. Links between work on poverty, structural inequality, education, children and young people and work on drug policy should be clearer.

The need to focus on prevention was highlighted by the Christie Commission (2011)^[21] who reported that "a cycle of deprivation and low aspiration has been allowed to persist because preventative measures have not been prioritised. It is estimated that as much as 40 per cent of all spending on public services is accounted for by interventions that could have been avoided by prioritising a preventative approach."

This is further supported by the Advisory Council on the Misuse of Drugs (ACMD) review on prevention of drug misuse in vulnerable groups^[22] which concluded that prevention should be "targeted at the risk factors, contexts, and behaviours that make individuals vulnerable, including targeting the structural and social determinants of health, well-being and drug use."

The Scottish Government approach to prevention and addressing inequalities is holistic and includes many strands. In addition, we are developing a number of specific programmes focused on prevention and early intervention in relation to problem drug use.

Tackling Child Poverty: We know that poverty, alongside other adverse childhood experiences, has a strong correlation with problem substance use in later life and that many children are growing up in households where problem substance use is present alongside poverty. Therefore, our efforts to tackle child poverty are key to addressing one of the fundamental challenges families face^[23].

The Scottish Government's second Tackling Child Poverty Delivery Plan 'Best Start, Bright Futures'^[24] sets out bold action to drive progress to tackle child poverty, including our focus on long-term parental employment support, increased social security, and measures to reduce household costs.

The Plan, which is backed by a £50 million Tackling Child Poverty Fund over the next four years, aims to improve parental access to fair work, reduce costs of living for families, provide greater help via social security, and improve children and families' quality of life. In tackling the three key drivers of child poverty – increase income from employment, reduce household costs and maximise income from Social Security and benefits in kind, we aim to move families out of poverty.

The Promise: The Independent Care Review^[25] highlighted that care experienced children are almost twice as likely to moderately use drugs at 16and care experienced adults are 1.5 times more likely to experience multiple disadvantage (homelessness, substance use, mental health or offending) than those who are not care experienced.

In April 2022, the Scottish Government published our Keeping the Promise Implementation Plan which sets out the actions and commitments we will take to improve the lives of our care experienced community. Being in care should not be a negative experience and the Scottish Government wants to lead the way in ensuring the right supports are in place to reduce the requirement for children and young people to go into care and where it is necessary, to ensure the experience of care is no longer a disadvantage but is one that has love and compassion at its heart.

3.1 Education: Building on the evidence-based approach consensus on prevention and education

While the majority of young people do not use drugs, in 2018, 6% of 13 year olds and 21% of 15 year olds reported having used drugs. Furthermore, 4% of 13 year olds and 12% of 15 year olds reported using drugs in the last month^[26]. This indicates that there is a significant vulnerable minority who are at particular risk of experiencing harm from substance use.

Our approach to education and prevention with young people is placed within the overall approach to meeting the needs of children and their families. This includes specific targeted prevention for vulnerable young people and young people with emerging problem substance use, alongside ensuring that universal education and prevention programmes, delivered through schools and other local providers, are evidence based and effective.

"What works in Drug Education and Prevention?"^[27] published by Scottish Government in 2016 provides a comprehensive literature review and concludes that prevention programmes for young people are more likely to be effective if they combine social and personal development, resistance skills and normative education techniques.

Planet Youth, sometimes referred to as the Icelandic model, is a model of substance use prevention. It uses an evidence-based approach to bring together communities including young people, their parents, their teachers and other adults in the vicinity of the young people. Using local data, communities are empowered to make decisions on building healthy environments for young people. This helps them identify the risks and protective factors for substance use among their own group of young people and implement plans and actions to protect them. Some areas in Scotland are already implementing this model, although only one, Highland, has funding through their Alcohol and Drug Partnership (ADP) to build capacity in schools.

Key actions

• Public Health Scotland (PHS) is developing a consensus statement and programme of prevention activity including undertaking broad engagement in the form of panel sessions with key stakeholders which will report in March 2023.
• An expert multi-agency working group is supporting our comprehensive approach to early intervention for young people with emerging problem substance use. This group will inform policy development and scope out action which will support young people with emerging drug use.
• We are undertaking a co-design process with young people to develop a set of expectations for delivery of drug and alcohol support for young people. This is being informed by our expert working group and will conclude in Spring 2023 and will be followed by a comprehensive action plan for delivery and implementation.
• We are building on the ambitions of Rights, Respect Recovery and the refreshed GIRFEC policy and practice guidance^[28] to ensure early help and support for children, young people and families is in place.
• We will build on the "What works in Drug Education and Prevention?" report and the Personal and Social Education Review recommendations to ensure that we are providing our children and young people with the best education to make them, their families and their communities, happier and healthier. We will work to strengthen delivery of current learning so that it is updated to reflect the latest evidence of what works in drugs education and explore ways to support teachers through development of updated teaching resources and professional development opportunities.
• We will build on collaborative approaches to the statutory planning and delivery of services and support to improve outcomes for children, young people and families through Getting It Right For Every Child and each area's Children's Services Plan.
• We will help to share the learning and encourage areas to take up programmes based on Planet Youth and support the programme to scale up this model through developing partnerships with local ADPs. We will provide an additional sum of up to £1.5 million to support Planet Youth scale up their activity in up to eight regions across Scotland.