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In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP).

The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny.

This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD.

The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources.

This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD.

Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities.

The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance.

Alcohol and other drug (AOD) use is common worldwide. There is a wide spectrum of AOD issues that pose a major threat to public health, safety and the wellbeing of communities, families and individuals. There is no doubt that nurses have primary roles in identifying, preventing and addressing AOD use issues in emergency departments and general hospital units, clinics, specialist mental health and drug and alcohol services, sexual health services, youth services and community settings where people seek health care and other assistance. Nurses have credibility and are trusted by communities for their ability to address many health issues, including AOD health problems. Despite the enormous economic burden associated with AOD use across the world, the nursing profession has yet to fully acknowledge and embrace this serious issue for nurses.

Anecdotal feedback obtained from alcohol and drug and mental health staff across the eastern metropolitan region of Melbourne, Australia suggests that attitudes towards working with people experiencing a dual diagnosis are becoming more positive. The purpose of this paper is to understand if dual diagnosis-specific training delivered to staff within mental health and alcohol and other drug services was a factor positively influencing attitudes.

No formal evaluation assessing the impact of dual diagnosis-specific training on staff attitudes had previously occurred within this region of Australia. Access to staff on two occasions from three distinct sectors provided an opportunity to examine if and, to what degree, attitudes can be influenced by dual diagnosis-specific training. Using a co-designed attitudes survey, information was gathered from mental health and alcohol and drug staff on their attitudes to working with people with co-occurring mental health and substance use problems.

Two surveys were conducted involving 186 staff in 2012 and 110 staff in 2016. The dual diagnosis attitudes survey showed that positive attitudes to working with people experiencing a dual diagnosis were associated with recency of training. While attitudes may be improved by dual diagnosis training, these findings cannot exclude the impact of other dual diagnosis capacity building activities.

This study highlights the benefits of a regional partnership between mental health and alcohol and drug services and people with lived experience of dual diagnosis and the benefit of recent co-designed dual diagnosis training on longitudinally assessed worker attitudes.

The purpose of this paper is to examine the implications for drug and alcohol treatment of radical policy changes being implemented by the government, particularly the proposed transition of responsibility for treatment from the National Treatment Agency to a new public health service from 2013.

It is argued that this is a critical moment in the development of substance misuse services in England, particularly given the impact of health service reform. Concerns are raised about the lack of reference to drug and alcohol treatment in key policy documents, such as the Department of Health's White Paper Healthy Lives, Healthy People. The removal of the “ring fence” from the pooled treatment budget may result in national disinvestment at a time when public spending cuts are likely to reduce local authority spending on drug and alcohol treatment. It will be challenging to deliver on the vision of recovery in the “Drug strategy 2010”.

The new public health structures and the commitment to recovery create new opportunities to improve services too – for example, the potential for joint working through Health and Wellbeing Boards. It is also positive that Healthy Lives, Healthy People stated that the NHS Constitution will apply to the public health service.

While these changes could provide a platform for improving outcomes, there is a genuine risk that substantial disinvestment in drug and alcohol services will be witnessed.

This paper seeks to explore the views and experiences of female offenders with problem drug/alcohol use living in rural areas and to provide their perspectives on shortcomings in support services.

The research used in‐depth interviews with (ex) female offenders with problem drug/alcohol use living in rural areas in the East of England.

The research indicates that the barriers to adequate provision of services for women in rural areas have distinct, but overlapping, gender and geographical elements. Gender issues centre on the failure to see the female offenders in the context of their roles as mothers and partners. The geographical element includes a significant and under‐reported lack of public transport and childcare support.

Given the localised and opportunistic nature of the study, no attempt is made to claim that one can necessarily generalise from these results to all rural areas.

Increased recognition of women attending drug/alcohol support services as mothers with children, faced with problems of organising childcare, or accessing public transport. This is exacerbated by inadequate, public transport provision.

The importance of service providers recognizing the insight which clients could provide through their own lived experiences as users of services. In a rural situation with thinly spread provision, the importance of women‐only provision should not take precedence over quality of service provision.

The Glasgow acute addiction liaison nurse service provides a unique service to patients with alcohol and drug issues who are admitted to general hospitals in the Glasgow City area. It offers guidance on withdrawal management, educates patients and staff and provides a facility to refer to appropriate community services. Since its foundation in 2005, patient referrals have increased by more than 3,000. Additionally, it has taken on a greater educational role and is more involved in research and evaluation.

The purpose of this paper is to improve current evaluation designs for Indigenous Australian residential alcohol and drug treatment centres, by understanding the context of treatment in this modified TC context. The aim of the research is to present an analysis of the key features of treatment associated with four Indigenous Australian alcohol and drug treatment centres, as expressed by staff working in these centres.

Ethnographic observations were made at each site between 2008 and 2009 with the first author attending treatment groups, education sessions, staff meetings and other events. The first author conducted informal conversational discussions with all programme staff and board members. In addition, 23 staff and 15 board members participated in a semi-structured interview with an emphasis on gaining views on the essential elements of residential alcohol and drug treatment, potential barriers to effective treatment delivery and “what works” in residential treatment.

A number of key themes emerged, including the importance of the flexibility of programmes to include a wide variety of treatment approaches, the importance of culture (although defined differently) in the delivery of appropriate service, provision of safe spaces that allow for clients and staff interaction, the potential for improvement in the provision of effective client case management, the need to reduce job-related stress through staff professional development and organisational culture change and the need to address the difficulties experienced in the provision of effective aftercare.

Currently, there is very little evidence related to Indigenous Australian approaches to the treatment of alcohol and drug misuse. The paper contributes to the understanding of the key features of treatment delivery, as identified by staff employed in drug and alcohol residential treatment. This understanding is vital so that government agencies can provide appropriate funding to areas of need for treatment services.

The study examines alcohol and drug related accidental dwelling fire injuries during 2006–2016 in Merseyside in England.

The study carries out an examination of alcohol and drug related fire injuries from 2006 to 2016 in Merseyside, including analysis of injuries by age group, gender, level of deprivation and housing type.

Deprivation was a significant factor in alcohol and drug related fire injuries over the period studied, with 70% of such injuries occurring in areas with the highest level of deprivation. Males appeared roughly twice as likely to be injured in an alcohol and drug related fire incident than females. The majority of those injured were in the age range 35–59.

There were limitations on the generalizability of the research findings to other fire and rescue services, as Merseyside has some of the highest levels of alcohol consumption and deprivation in UK.

An understanding of those vulnerable to alcohol and drug related fire risks can support more targeted fire prevention strategies and aid referrals to partner health agencies to help to reduce underlying alcohol and drug misuse issues.

The study provides a detailed analysis of the circumstances associated with alcohol and drug related fire injuries over a ten-year period covered by a UK fire and rescue service, in particular, in terms alcohol and drug related fire injury risk differences between different groups.

Against Violence & Abuse (AVA) and DrugScope undertook research into good practice interventions for supporting women involved in street-based prostitution and substance use. The purpose of this paper is to report on the findings of a survey of service providers and interviews with both service users and providers about women's involvement in prostitution and substance use, their associated support needs and how these can be met by services.

As part of a mixed methods study, this paper focuses on the findings of interviews with 19 women involved in prostitution and of a survey of and interviews with 64 services that support women involved in prostitution.

Generic substance misuse services are more likely to associate women's involvement in prostitution with funding their own or their partner's substance use. By comparison, specialist sex work projects are more likely to report women using substances to manage the emotional and physical pain of selling sex. These beliefs impact on the interventions delivered, with specialist services offering a more diverse package of care than generic services.

This study covered predominantly two English regions. A more systematic study of service provision across the UK would be welcomed and could be used to inform guidance for national and local policymakers.

This paper adds to the existing evidence base of “what works” in supporting women involved in prostitution. It is novel in its focus on women involved in prostitution who also use substances and in offering a detailed picture of the types of support currently available in England.

This study aims to provide data on substance use amongst young people in Scotland to inform policy and practice for an age group who generally do not access specialist alcohol and drug services. The main objectives of the study were to assess the problem severity scores of items from a modified version of the DAST-10 brief screening instrument among respondents; examine correlations between a range of variables in relation to DAST-10 problem severity scores; and explore respondent knowledge of how and where to seek help.

A fixed quantitative design methodology recruited a non-probability sample of 4,501 respondents from an online survey made available by “We are With you” Scotland.

The survey was ethically approved by the School of Education and Social Sciences, University of the West of Scotland. It consisted of 32 questions exploring substances used within the past 12 months, and 12 weeks, and included the DAST-10. We further explored help seeking, and knowledge of support available to respondents.

Substance use patterns were markedly different from people currently known to specialist alcohol and drug services. Over half of respondents were under 25, and 62% report being employed. The most commonly used substances were cannabis and cocaine. One third of respondents recorded substantial or severe problem severity scores and reside in Scottish Local Authorities with high concentrations of socio-economic inequality.

Secure accommodation, stable relationships and being employed are protective factors in relation to reported negative health consequences associated with problem substance use.

Just under one third (27%) of respondents report knowing where to seek help for substance use problems; however, they are unwilling to attend existing specialist alcohol and drug services.

A non-probability sample of the Scottish population has a potential for response bias due to how and what way the survey was made available to respondents. It is acknowledged that while useful as a method of generating drug use data, there are limitations in how recently the substance use occurred, and in relation to the types of substances reported (cannabis, cocaine and ecstasy).

The study provides data to inform wider public health measures in relation to accessing support and addressing societal discrimination associated with the use of substances. The study provides data on service design for young people who do not access specialist alcohol and drug services.

The study informs substance use policy in the Scottish context in relation to a population of young people who use licit and illicit substances. Data contributes to evidence supporting correlations between problematic substance use and socio-economic inequality. Data indicates that existing specialist services require redesign.

The study is the first to be conducted within a Scottish context.