Drug and alcohol services - improving holistic family support

Ministerial Foreword

For every person who has a difficulty with drugs or alcohol, the findings of Ask the Family demonstrate that on average 11 other people are affected by harms associated with a loved one's substance use.

We welcome this framework to improve holistic support for families. It will support local partners, their workforce and family members to work together in developing local family support services, making them more approachable and accessible for anyone who has not yet sought support.

This framework will ensure that family members receive support in their own right, and collectively as a family, to recover from the harms caused by alcohol and drug use. We would like to express our thanks to the multi-agency working group who have led the work on this framework and welcome their agreement to provide implementation support and oversee evaluation.

Scotland faces a public health emergency in relation to drug deaths; and the most recent figures for alcohol deaths show a steep increase of 17% (2020). Our national mission to reduce drug deaths recognises the important role that family members play. More poignantly it recognises the devastating impact that each death has on a family.

Through this framework we expect local areas to put in place accessible, consistent, sustained and inclusive support for families, which meets their specific needs and directly benefits the support and outcomes for children and young people, who have told us that their desire is to keep their families together. This mirrors the findings from the Independent Care Review and has led to the development of the Promise. Getting It Right For Every Child (GIRFEC) provides a clear existing framework for local areas to provide the support that children and young people need.

Family members are often at the forefront, providing support for loved ones with alcohol and drug problems, trying to keep family life going, whilst being affected by harms themselves. As Ministers, we have heard personal testimonies from family members about their experiences and it is clear that the important role that they play can be demanding, we recognise that families need more support from us.

Some families don't have strong positive relationships and our workforce needs to be sufficiently skilled to recognise domestic abuse in the home and harms experienced by children. Families need to be considered in terms of their individual circumstances, ensuring thorough assessment and comprehensive support – whether working with individual family members or the family as a collective.

Our national strategy to address alcohol and drugs harms, Rights Respect and Recovery, sets out the importance of ensuring that all family members – adults, young people and children – have access to support to meet their needs and highlights the critical role of services for adults in Getting It Right For Every Child.

We know that alcohol and drug problems on the part of a parent or principal care giver are recognised adverse childhood experiences (ACEs). We also know that individuals can develop alcohol and drug problems as a result of their own childhood adversities and trauma, through no fault of their own. Services will want to understand the impact this has on families and ensure that all those affected have the support they need.

This may be through specialist services or through well-connected approaches to peer support. Rights, Respect and Recovery recognises that family members have rights and that each family is unique – although their experience and journeys are all different, they all require support, compassion and understanding. We expect a diverse range of families and family members to be fully involved in service design, implementation, evaluation and workforce development, as well as family inclusive systems change and improvement.

We want to focus on supporting all families to be resilient and strong – the Independent Care Review and our commitment to keeping the Promise is fundamentally rooted in providing better holistic support to families. We will enable the building of universal, holistic support services across communities in Scotland through our commitment to investing £500 million in a Whole Family Wellbeing Fund over the course of this Parliament, giving families access to the help they need, where and when they need it. Our long-term ambition is that from 2030, we will be investing at least 5% of all community-based health and social care spend in preventative whole family support measures.

The Medication-Assisted Treatment Standards set out the help that people who use drugs should be able to expect, regardless of where in Scotland they live. The implementation of these standards must continue to take into account the important role that all family members can play. However, we must also go further than this and remove the barriers that people experience in accessing support, including the stigma associated with substance use. We must ensure that people working in our services as well as more broadly across the general public, think about the biases or stereotypes they may have about those who use drugs and alcohol, their families and their lives. This can have devastating consequences and can stop people seeking the help and support they need. We are committed to supporting the roll-out of the stigma charter developed by the lived experience members of the Drug Deaths Taskforce and later this year, we will be launching a national campaign to tackle stigma that will challenge us all to think about the part we can all play in creating a stigma-free Scotland. Addressing stigma is something we can all do to improve the lives of families affected by alcohol and drugs.

That is why the Scottish Government is fully committed to developing a trauma-informed workforce and services across Scotland, supported by the National Trauma Training Programme. Safe and supportive relationships are known to be key in fostering resilience and in enabling recovery. For this reason, it is important that we all recognise the potential for every interaction that we have with someone affected by trauma is an opportunity to afford safety, enhance resilience and promote recovery.

Much of what needs to be done to implement this framework, will be driven forward at the local level by a range of local partners working together to ensure delivery, in particular Alcohol and Drug Partnerships and Children's Service Planning Partnerships. At Scottish Government level we will continue work closely with local partners towards implementation of this framework and have already committed to an annual £3.5 million investment through Alcohol and Drug Partnerships for this very purpose.

We believe that implementation of this framework will save lives, reduce harms and transform the quality of life for families and we urge local areas to review their current provision and plans against the recommendations within this framework
and initiate action.

Angela Constance MSP
Minister for Drugs Policy

Maree Todd MSP
Minister for Public Health, Women’s Health and Sport

Clare Haughey MSP
Minister for Children and Young People

Kevin Stewart MSP
Minister for Mental Wellbeing and Social Care

"In September 2021 COSLA Leaders endorsed the output of the Working Group Chaired by the Principal Reporter of SCRA, and commends this Framework document to all partners in Scotland's Alcohol and Drugs Partnerships.

There are clear links with the Framework and the Promise, and COSLA and Local Government have made public commitments to 'Keep the Promise' by 2030. Significant reprioritisation and service redesign is underway to meet and deliver the recommendations set out within the Promise, Plan 21 – 24 and Change Programme ONE.

Adopting whole family approaches and family inclusive practices will help to support all family members effected by alcohol and drug use, this Framework provides a welcome articulation of how to make this a reality."

Councillor Stuart Currie,
COSLA Health and
Social Care Spokesperson