By Karen Reid, Chief Executive of the Care Inspectorate

DRUG and alcohol problems blight lives. It’s not unique to Scotland, but it has taken a generational change to face up to our relationship with the bottle and drugs – even when the consequences are felt far beyond those addicted.

How many of us can honestly say we have never seen a friend, colleague, or neighbour struggle with powerful addictions? The costs are felt in hospitals, police stations, courts, communities – and also in the misery and pain caused to families and the squandering of a person’s potential.

Because problem alcohol and drug use stops people from leading healthy and fulfilling lives it is a top priority for councils and government. For the last 18 months, the Care Inspectorate has been reviewing how well new approaches to tackling problem drug and alcohol use are working across Scotland. Inspectors have found encouraging signs and some examples of outstanding practice.

Many of those most affected have already experienced adversity, loss and trauma in their lives. If they are to recover, they need skilled, consistent and responsive support which tackles the complex issues underpinning addiction. Services need to be available at the right time, in the right way and for as long as needed.

At the Care Inspectorate, our vision is that every person in Scotland should receive high quality, safe and compassionate care that reflects their rights, choices and individual needs. That is why I have so warmly welcomed the opportunity to work alongside the 29 local alcohol and drug partnerships to provide support and constructive challenge.

These partnerships, bringing together all the key local agencies to support people with serious addition problems, are asked to use a set of quality principles agreed by the Scottish Government to ensure resources are spent in ways which deliver real impact and improvement for people. They help communities become safe places for people to achieve recovery in a way that is person-led and stigma-free.

Our specialist inspectors have looked in depth at the way addiction services across Scotland are using these principles to support people. A key concept behind the principles is recovery – the idea that people need help overcome their addictions and be healthy, rather than services just managing a problem. We wanted to understand the extent to which these principles are having a positive impact for people

Inspectors found that in most Alcohol and Drug Partnerships, services are being planned in a positive way. Inspectors noted a big shift towards a recovery philosophy, with many committed staff who are skilled in what they do.

There is still scope for improvement. The best way of supporting someone always involves understanding what works for them, so we want to see stronger evidence about how the views of people affected by drugs and alcohol are heard and taken into account.

It is also important that different agencies work well together. There can be no silo-working in pursuit of supporting vulnerable people, so it is critical for integrated health and social care services to be streamlined and joined. We need a holistic approach: it’s not just addiction specialists who have a role to play, but everyone working across health and social care.

In some areas, but not all, we found a need for more education of frontline staff to increase their awareness and understanding of the complexities of problematic substance misuse and recovery, including the impact of traumatic events on each individual’s unique circumstances. Staff who work in frontline services play a key role in reducing the stigma attached to addiction, but we need to see a shared approach across other professions in health, social care, and housing.

One group of people need specific attention: children and young people affected by substance misuse. If we want them to achieve at school and have the best start in life, they need a stable and supportive environment free from the traumas of drug and alcohol misuse. We need to think of the child within the family, and the family within the community. Inspectors found excellent examples of addiction staff working with schools, childcare, social work and health, and we need to see more of it. Only by working together can we make recovery a reality for everyone – young and old.

The ambition in the national outcomes is for Scotland to be a great place to grow, live and prosper should be a reality for everyone. Addiction services which really focus on recovery play a major role in making that happen.