National Mission on Drugs: annual monitoring report 2022-2023

10. Outcome 6: Children, families and communities affected by substance use are supported

10.1 Summary

Outcome 6: Children, families and communities affected by substance use are supported

72% of ADP areas have an agreed set of activities and priorities to implement the Whole Family Approach Framework in 2022/23

• This is the first year for which data are available

30% of people would be comfortable living near someone getting help to stop using heroin in 2021/22; 59% of people would be comfortable working with someone getting help to stop using heroin in 2021/22

• This is the first year for which these data are available

Positive progress is being made towards supporting children, families and communities. However, further work is needed to consider how experiential data can be gathered directly from people, families and communities affected by substance use to better inform this understanding.

10.2 Background

Families and communities play a vital role in supporting people who use drugs. Families require dedicated support to empower them and allow them to support the recovery of their loved ones. They also need access to services to enable their own recovery. The Whole Family Approach Framework aims to ensure holistic family support that addresses the needs of children and adults within a family is consistently available for all families across Scotland at the time of need rather than at crisis point.^[66] The traumatic impact that parental drug use can have on children and the risk that drug use becomes intergenerational is now well understood. The role and attitudes of the wider community in supporting a person with problem substance use are also understood to be important to enable and promote recovery.

10.3 Headline metrics

10.3.1 Headline metric: Percentage of ADP areas with agreed activities and priorities to implement the holistic Whole Family Approach Framework

In 2022/23, 72% of ADP areas reported they have an agreed set of activities and priorities with local partners to implement the holistic Whole Family Approach Framework in their ADP area.^[67] This is the first year for which these data are available, following the publication of the ‘Holistic whole family support: route map and national principles’ in July 2022.^[68]

10.3.2 Headline metric: Percentage of people who would be comfortable (a) living near, (b) working alongside, someone receiving support for problem drug use

In 2021/22:

• Three in ten people (30%) reported they would be comfortable living near someone getting help to stop using heroin.
• Almost six in ten people (59%) reported they would be comfortable working with someone who was getting help to stop using heroin.^[69]

The question on attitudes about living near someone getting help to stop using heroin had previously been asked in the Scottish Social Attitudes Survey^[70] in 2009. That year, 26% of respondents reported feeling comfortable with the idea of living near someone getting help to stop using heroin.^[71]

Attitudes towards both working with and living near someone receiving help to stop using heroin varied by sub-group. People with higher levels of educational attainment and people living in urban areas tended to report higher levels of comfort working with and living nearby to people receiving help to stop using heroin, compared to people with lower levels of educational attainment and people living in rural areas.

10.4 Supporting metrics

10.4.1 Supporting metric: Percentage of ADP areas with support services for adults affected by another person’s substance use

Every ADP area reported offering support services for adults affected by another person’s substance use in 2022/23. Naloxone training and support groups were the most offered services (in place in 93% of ADP areas), and there was also evidence of high levels of advocacy services (86%) and one to one support (83%).^[72] It is not currently possible to compare trends in support service provision over time as 2022/23 was the first year that data was collected in this format.

10.4.2 Supporting metric: Percentage of ADP areas with support services for children/young people affected by a parent’s or carer’s substance use

Every ADP area reported that treatment or support services for children and young people (under the age of 25 years) affected by a parent’s or carer’s substance use were available in their area in 2022/23.^[73] Almost all ADP areas reported having family support services (93%), information services (93%), carer support services (90%) and mental health services (90%) in place for one or more age groups under 25 years old.^[74] The proportion of ADP areas with support services in place for children and young people affected by a parent’s or carer’s substance use increased between 2021/22 and 2022/23.^[75]

10.4.3 Supporting metric: Percentage of adults saying drug use or dealing is common in their neighbourhood

In 2021, 13% of people reported that ‘drug misuse or dealing’ was either very or fairly common in their neighbourhood.^[76] This is a slight decrease from both 2020 and 2019 (15% and 14% respectively). Survey results from 2020 and 2021 are not directly comparable to results from previous years due to changes in survey methodology due to COVID-19 and these data must therefore be interpreted with caution when trying to draw conclusions about trends.

People living in the most deprived areas and people living in social rented housing tended to report that drug misuse^[77] or dealing was common in their neighbourhoods at higher levels than those in the least deprived areas or either owner occupied or private rented housing. The percentage of people who reported that drug misuse or dealing was common in their neighbourhood was similar for people living in large urban areas, other urban areas, accessible small towns, and remote small towns; with lower rates in accessible rural and remote rural communities. Finally, people aged between 25 and 34 years reported the highest rates of drug misuse or dealing being common in their neighbourhoods (16%) followed by people aged between 35 and 44 years (15%) and people aged between 45 and 59 years (14%).

10.4.4 Supporting metric: Number of new Child Protection Register registrations with an identified parental substance use concern

There were 2,358 new registrations onto the Child Protection Register during 2022 where parental drug misuse or parental substance misuse was identified as a concern at the Case Conference.^[78],[79] This is a decrease of 266 (10%) compared to 2021, when there were 2,624 such new registrations. This follows a downward trend that has been observed since 2019.

10.5 Discussion

Positive progress is being made towards supporting children, families and communities. However, further work is needed to consider how experiential data can be gathered directly from people, families and communities affected by substance use to better inform this understanding.

Implementation of the holistic Whole Family Approach is at a relatively early stage but positive progress is being made, with almost three quarters of ADP areas reporting they have activities and priorities in place to implement the Whole Family Approach. Data on social attitudes to people living with problem drug use provide an indication of the level of support communities have for people who use drugs and serve as a foundation for measuring progress in future years.

The supporting metrics provide additional context and indicate some positive progress. Support for people affected by another person’s drug use (including children affected by a parent’s or carer’s drug use) is available across the ADP areas. The types of support services on offer vary by ADP area and for children and young people in particular the range of services has increased compared to 2021/22. New registrations onto the Child Protection Register where there is an identified parental substance use concern have continued to fall, although this trend started before the start of the National Mission and may be due to a range of wider factors not associated with the National Mission. There has also been a slight improvement in whether people consider that drug use or dealing is common in their neighbourhood.

Metrics identified to measure progress towards outcome 6 focus primarily on social attitudes and perceptions, and the existence or provision of services and activities for people affected by drugs. Work is needed to consider how experiential data can be gathered directly from people, families and communities affected by substance use to better understand the extent to which progress is being made and people feel supported.