Scottish Families Affected by Alcohol and Drugs

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1 Scottish Families Affected by Alcohol and Drugs Scottish Families Affected by Alcohol and Drugs is Scotland s authoritative voice on supporting families affected by the problem substance use of a loved one. Through our helpline, family support groups and online presence we engage with family members across Scotland providing a variety of support options or signposting them to the most appropriate support locally. Scottish Families welcomes the opportunity to contribute to the review into the impact on employment outcomes of drug or alcohol addiction (we are not covering obesity as this is outside our area of expertise). Extensive consultation of the organisation s stakeholders, family members and our membership Scotland-wide informs Scottish Families response. The respondents are as follows: 62 family members, 57 of whom are supporting a loved one with problem substance use whilst the other 5 have problem drug and/or alcohol use themselves; 24 professionals with a range of expertise including social work, criminal justice, addiction treatment services, mental health services, Police Scotland, Kinship Care and prison chaplains. Stigma is still rife in our society and the DWP review brings this into sharp focus. Addiction is not a lifestyle choice. People with problematic drug and/or alcohol use often have very chaotic and irregular lifestyles. Their thinking may not always be clear and they may find it very difficult to navigate the benefits system and be poorly placed to comply with any demands the system may place on them. Often, compared to the rest of the population people with addiction to drugs and/ or alcohol are more likely to be from low income groups often with poor mental health and a poor or non-existent work history. These additional barriers to employment will likely have preceded addiction therefore it is insufficient to address in isolation. A generalised one size fits all approach cannot necessarily suit the diversity of needs of individuals with problem substance use. In order for recovery to be sustained individuals with problem drug and/or alcohol use will require a home, a job and a stake in society. Employment alone is insufficient for this. Progress needs to be made towards housing and improving employment opportunities and towards increasing an individual s recovery capital through appropriate support of the family/ concerned significant others (CSOs). A recent publication from NHS Health Scotland entitled Good work for all (2015) highlighted that jobs which don t protect against poverty, offer limited autonomy and increase the risks to mental or physical health are as bad for health as unemployment. The publication cited the Marmot Review (2010) which argued, getting people off benefits and into low paid, insecure and healthdamaging work is not a desirable option. Around 30% of those moving into employment remain in poverty. Although mainstream public and political opinion appears to support the increased use of conditionality within the social welfare benefit system the 1 P a g e

2 key issue of its effectiveness in changing and sustaining behaviour remains largely unanswered. (ESRC evidence briefing July 2015) Overview of responses A recurring comment from both professionals and families was the availability of alcohol and how cheaply it can be purchased. One mother commented, Every shop sells alcohol, even the Post Office! Another stated, Alcohol is everywhere; either for sale, on the TV or advertised in the street. It is really difficult to discourage kids from trying it when it is being either glamourised or normalised at every opportunity by the drinks business. Another theme was the lack of aftercare particularly for individuals who have had long term problem drug or alcohol use. For many their lifestyles have been chaotic and irregular and long term support is often needed for those in recovery to help them adopt and maintain a routine which does not involve problem substance use. Some of the comments around this include: The lack of facilities for treating individuals with mental health problems is a cause for some concern. If an individual is successfully treated for substance use the underlying causes of this need to be addressed if long term abstinence/ controlled use is to be maintained. I needed help to cope with housing, bills, medication, letters, getting to health appointments, my child attending school, me attending parents evenings with support and anything else I get stressed with. Circle* helped me with all of that. (*A Scottish charity working with disadvantaged communities) It s like starting a completely new life and you need lots of help to do that, especially when your old life has been so far removed from what society would consider normal. Intensive support should still be provided at home after you leave a treatment centre. Many of the family members commented on the lack of support for those affected by a loved one s problematic drug and/or alcohol use. They felt the review has highlighted just how little is known about the issues facing not only the addict but their families. Whilst many of them favoured linking benefits to treatment the following comments reveal some of their concerns around this: There are definitely not enough support services and treatment services think it s enough to prescribe methadone and leave you and your family to get on with it. Funding more places like the Hub* where people can interact, make friends and learn new skills. Close family and children can get involved and this helps everyone s recovery. (*The Recovery Hub run By VOCAL Family Support Addictions in Edinburgh) The review has to be about more than just getting people off drugs and into work to save money in the immediate future. Long term investment is needed if people are to stay off drugs and hold down a job, house etc. Family members often have difficult lives which lack routine due to the demands of their loved one s addiction. If my partner was to come off the drink and get a job I would have no idea what to do with my time as I spend it looking after him. Will there be a service that will help me back into work? My sister has a drink problem but no one in the family would know where she could get help. Will staff at the benefits office sort all that out for her or will we all be left to try and figure it out ourselves? 2 P a g e

3 Families and carers want to be involved in treatment and can help someone stay off drugs and drink but there is not enough information for services or families to make sure this happens. Response from the Kinship Care Service at Citizens Advice Scotland Many of the service users of the Kinship Care Service at Citizens Advice Scotland find themselves caring for their grandchildren, nieces and nephews, siblings, etc. because of parental substance addiction, and while this may seem slightly removed from the core intent of the review, it s worth noting the impact that this has on many kinship carers. Our service regularly offers advice and information to kinship carers who have been disadvantaged in seeking, or keeping employment, and consequently significantly financially disadvantaged, as outlined in the following scenarios:- In the case of Looked After children, kinship carers may be required to give up employment as a condition imposed by local authority social workers before taking on the care of the children. Some kinship carers find that they feel compelled to give up employment because of the emotional or health needs of the child or children, which necessitates intensive support from the kinship carer. Many kinship carers who care for children with emotional, behavioural or health needs find that employers are unwilling to allow them time to attend the numerous appointments with medical, social work or education professionals necessitated by their caring role. Formal kinship carers of Looked After children are eligible to apply for Income Support for as long as the child remains in their care and remains Looked After, while informal kinship carers, who care for children who are Not Looked After find themselves providing the same or greater levels of care but are not entitled to apply for Income Support and are therefore required to apply for Job Seekers Allowance, actively seek employment and are at risk of facing benefit sanctions when appointments relating to the child s wellbeing coincide with attendance at the Job Centre. All of these situations have a significant impact on the financial circumstances of the kinship carer, and of course, on their ability to provide for the child or children in their care, and while some are entitled to an allowance from the local authority, many are not. Summary of professionals views All agree that more needs to be done to get individuals with problem substance use into employment, but focussing on employment alone is insufficient. Evidence shows that decent quality, secure housing plays a very positive role in helping people maintain recovery (and reduce offending if this has been part of an individual s history). All agree that if outcomes are to be improved work opportunities will need to be improved. People need to be offered meaningful employment, education opportunities and be paid a wage which will allow them to have a decent standard of living. All agree that coercive treatment is not the best way forward and sanctions are probably not helpful in what is essentially a vulnerable group in society. More than half agree that more needs to be done in prevention, education and early intervention. All agree that more needs to be done to tackle inequalities in society as a whole not just for a specific group of people. 3 P a g e

4 The professionals working in addiction treatment services felt that more work needs to be done to integrate services, reduce unnecessary bureaucracy and confusion for both professionals and service users and reduce duplication. One professional commented, As a specialist agency for the treatment of alcohol issues we are committed to supporting individuals with varying degrees of alcohol misuse to identify their specific issues, assist them to moderate their alcohol use, or more efficaciously to give up alcohol and move into recovery from addiction. The major problem for us, as ever, is the lack of sustainable funding to provide these services. It would seem to me that the watchwords should be speculate to accumulate, as by identifying and treating the problems at an early stage, we can save a great deal of money for the government by giving individuals the chance to recover before the illness becomes so long term that recovery is no longer an option. Family members responses on linking benefit entitlements to treatment 27 respondents felt that it may be positive to link benefit entitlements to take up of appropriate treatment. However many of them had concerns including: Several family members felt that this would ease some of the responsibility they had for trying to encourage a loved one into treatment however were unsure of how effective the long term outcome would be if the individual was only motivated by the need to secure benefits. The lack of appropriate services and employment opportunities. The pressure this would put on existing services with the potential for a tick-box exercise to get as many as possible into treatment regardless of the quality of treatment offered. The potential to jeopardise treatment places for individuals not on benefits and the consequences this may have on them. 33 respondents felt that not only would this be detrimental to the individual with problematic substance use but that it would also negatively impact family members: This will put added pressure on family members to provide if an individual has benefit sanctions. Alongside increased financial pressure will be increased stress and anxiety for families who fear their loved one may resort to criminal activity. Several family members expressed concern that this would negatively impact on prevention and early intervention if money is used to increase service provision for individuals with problematic substance use who are receiving benefits. If someone had entitlements reduced or withheld this results in parents having less money to pay bills and feed and clothe children appropriately. Several family members felt that this would lead to further stigma for both the individual and the families. 1 lone parent with problem substance use felt that she would have to consider placing her child with someone else if sanctions prevented her from caring for her child and another expressed concern that the authorities may remove her child if sanctions prevented her from caring adequately for her children. 4 P a g e

5 Family members responses to how children and families will be affected 55 of the 62 respondents and believe children and families will be adversely affected. Comments include: Families of a loved one using drugs already face financial hardship and stigma and if sanctions are introduced this will only get worse. Children and families of users should not be held to account. Families will feel financially responsible to support their loved one. Children will be at higher risk of living in poverty. If there is no money coming in there is a risk that children might be taken into care if they cannot be looked after properly at home. Or that a parent will turn to crime to support their habit and their family. Of the remaining respondents 3 were unsure if or how families would be affected and the other 6 did not think the review would affect them as neither they or their loved one were receiving benefits. Comments include: My partner uses drugs and he spends his benefits on drugs not family. I already support him and feed him so the review will not change that. He would probably steal stuff to buy his drugs rather than go into treatment. My son s family will be alright because his wife works but I can see how it might affect a family dependent on benefits. It could lead to arguments about treatment and money and maybe cause the family to break up. Or could lead to crime and someone going to prison and breaking up the family. All too often it is the family who step into support; providing food, money, telephone or dealing directly with the service involved. The families supported by our organisation tell us this as do the callers to our national Helpline. The stigma associated with drug and alcohol use extends to the families of the individual with problematic substance use. This is a huge barrier to families seeking support or advice. The average time a family members lives with a loved one s problematic substance use is eight years before seeking help for themselves. The isolation caused by stigma leads to many families suffering hardships unnecessarily and this can have a huge impact particularly if there are children involved. The comments from professionals and families reveal some of the complexities of problem substance use. Adult family members and children are impacted negatively, and often severely, by a loved one s addiction. Whilst Scottish Families welcomes the move towards improving outcomes for individuals with addiction we also agree with the comments from professionals and families with lived experience. Services need to address underlying causes and work holistically with the whole family if recovery is to be achieved and sustained for the individuals with problem substance use and their close significant others. 5 P a g e

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