In this blog Emma Wincup, one of the Relations Study co-investigators, reflects on the contrasts between a recent report from Adfam, sharing the perspectives of families affected by alcohol, drug use and gambling, and the latest UK drug strategy. She raises questions about how far families affected by drug use are involved in or represented by UK drug policy.
Adfam Report: Overlooked?
In November 2021, Adfam – a national charity tackling the effects of alcohol, drug use and gambling on family members and friends.– published the findings of a major research study exploring the impact of someone else’s drinking, drug taking or gambling. Its headline finding was that 5.5 million people in Great Britain – one in ten of us – are coping with the fallout of those close to them using drugs or alcohol, or gambling. Typically, those affected felt their experiences were overlooked with little recognition for the harms experienced and limited access to services and support.
About the study
The Adfam study is based on a survey of just over 2,000 adults (aged 18 and over) from across England, Scotland and Wales. It was conducted in mid-June 2021, just over one year into the Covid-19 pandemic providing an opportunity to capture its impact. Whilst in most instances, the pandemic had exacerbated the problems families and friends were already facing, sometimes it had allowed people to reduce their involvement in, or desist from, drugs, alcohol or gambling.
Whilst aiming to be representative of adults living in Great Britain, the online survey format inevitably fails to capture those who are digitally excluded. This can be for a variety of reasons but cost is a major barrier. We know from those who completed the survey that financial disadvantage was identified as the most significant impact of someone else’s drinking, drug use and gambling.
That limitation aside, the report is a rich source of evidence on the nature and extent of the harms experienced by families and friends when the drinking, drug use or gambling of someone close to them becomes problematic. It highlights the far-reaching negative impacts; for example, on household finances, health, and educational and employment opportunities; often experienced over many years. It also sheds light on what needs to be done to better recognise and support families and friends. Here we focus on the report’s recommendations to ensure families and friends are no longer overlooked.
What do people affected by someone else’s drinking, drug use and gambling want?
The report contains four key recommendations.
1. Increase services to support children and adults affected by a loved one’s substance misuse or gambling
2. Ensure that where services are available, families and friends of people with a drug, alcohol or gambling problems are prioritised for identification and referral
3. Ensure that families and friends who have vital caring responsibilities are recognised and supported financially, emotionally and practically
4. Ensure that family members of people with drug, alcohol and gambling issues are included in all relevant Parliamentary Inquiries and policy making
A strong case is provided for each of the recommendations. The overwhelming majority felt that there was insufficient support available, and that the pandemic had accelerated the decline in service provision that was already underway. Limited availability is one barrier to ensuring family members and friends get the support they need but there are others too. A more proactive approach is needed to ensure this group get the support they need, as they may be unaware of what support is available, or be prioritising accessing support for their loved one. Places used frequently such as food banks or GP surgeries can play an important role in signposting people to much needed sources of help.
The pandemic has begun to shine a light on the vital yet often ignored contribution by unpaid carers (Alarilla et al., 2021). Yet when we think of unpaid carers it is likely we focus on those caring for people with a disability or long-term health condition rather than those supporting people affected by drinking, drug use or gambling. All forms of unpaid care can have extensive physical, emotional and financial impacts (Carers UK, 2021).
Adfam’s report explores what family members and friends believe would make a difference to enhance support available for those affected, reduce the stigma around the issue and prevent more people experiencing harms caused by someone else’s drinking, drug use and gambling. The final recommendation aims to amplify their voices, creating spaces for the lived experience of family members and friends to contribute to evidence gathering and influence policy-making.
What does the latest drug strategy promise those affected by someone else’s drug use?
In December 2021, the latest UK drugs strategy was published. Entitled ‘From Harm to Hope: A 10-year drugs plan to cut crime and save lives‘, it claims to be ‘the most ambitious for a generation’ (p.6). The strategy is based on the familiar three-pronged approach: enforcement, treatment and prevention. There are references to families in each of the respective chapters, and particular emphasis in the latter two. There are no references to friends.
The impact of drug use on families is acknowledged in the strategy. However, the vision it outlines falls short of making sizeable steps that might progress the recommendations contained in the Adfam report. Arguably the main priority in relation to families is identifying those that place young people at greater risk of engaging in drug use, thus requiring early intervention. This includes families where drug use is already present. Consequently, the discussion of enhanced service provision is limited to families with children. Despite noting in the Foreword that drug use can ‘shatter’ families (p.6), there appears to be little recognition of the far-ranging issues family members may be facing and the breadth of services needed. The role of unpaid carers is not acknowledged explicitly. The latest UK drug strategy describes itself as a living document, implying there is the possibility for it be to influenced. It does note the need for people with lived experience to work alongside government departments, local authorities and service providers to ‘deliver a world-class treatment and recovery system’ (p.14). We need to find ways to amplify the voices of those supporting people who use drugs (as well as those who use drugs) so that drug policies look beyond the usual focus on ‘risky families’. Doing so will allow us to recognise the myriad ways families can support recovery, but they need to be supported to do so.