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Managing the damage from drugs and alcohol

The Futures Forum think tank, established in 2005 by the Scottish Parliament, has produced a major review of managing drugs and alcohol in Scotland. The report considers policy and practice to 2025 and is the culmination of a 12 month investigation which included evidence from 25 renowned experts in the drug and alcohol field. This evidence from experts forms a companion report, 12 Dimensions of a Manageable Problem: A Collection of Expert Views. This supplementary report can be downloaded from the website: http://www.scotlandfutureforum.org/assets/ files/12_Dimensions.pdf. Approaches to Alcohol and Drugs in Scotland: A Question of Architecture is a brave report that shows the authors are willing to think outside of the narrow politically constrained perspectives that dominate drug policy. For example, the report questions the wisdom of ongoing prohibition law enforcement-led strategies and instead suggests a more holistic approach to managing drug and alcohol consumption by placing a greater emphasis upon health, lifestyle and social issues. Instead of repeating the over-simplistic mantra of ‘eradicating drug use’ the report pragmatically sets out to explore how Scotland can significantly reduce the damage caused by ongoing alcohol and drug use. The report uses a systems mapping technique and advocates a ‘new approach’ to the drug and alcohol problem, which includes what might appear to be radical ideas such as a legally regulating and taxing cannabis sales, creating drug consumption rooms (safe, clean, managed areas where prescribed drugs can be taken), and the availability of heroin on prescription. Although these ideas raise complex legal, ethical and perhaps more importantly political issues, they are well worn, considered and practised approaches that have had success in other countries. In this respect it appears that Scotland is willing to explore alternative approaches whereas others in the UK may not be ready or willing to do so. Perhaps Scotland has been motivated to think differently because of the failure of traditional UK approaches that led to Scotland having the highest rate of drug-related deaths in Europe. This wide-reaching report has seven key chapters covering: substance culture; governance; enforcement; interventions and recovery; public health; community; and evidence and research. It encourages an ‘all options open’ approach to reduce the damage caused by drug and alcohol. It suggests that all psychoactive substances should be placed within a single legal framework and calls for policy