26/07/10

By Andrew Holt

The latest UK Drug Policy Commission (UKDPC) report, published today, finds drug services of ‘little relevance’ to many in Britain’s diverse communities, including LGBT groups, disabled people and BME communities.

The review The Impact of Drugs on Different Minority Groups: A review of the UK Literature, led by UKDPC Commissioner Professor Baroness Haleh Afshar, argues that a better understanding of drug use within diverse minority communities is needed to reduce drug problems and could also provide warning of ‘new’ or emergent patterns of drug use.

Appropriate data-gathering and intelligence sharing mechanisms could be used to flag up health risks associated with new drugs before their use becomes widespread.

The UKDPC report, drawing on national statistics from the British Crime Survey and information from the National Treatment Agency, warns that the needs of drugs users within certain risk groups are not being adequately met by mainstream service providers.

Key findings:

Illicit drug use amongst LGBT groups is higher than among their heterosexual counterparts (BCS: 33% of gay or bisexual people took drugs last year, compared to 10% of heterosexuals)

Overall drug use is lower among minority ethnic groups than among the White population (BCS data set: 2006/07, 2007/08 & 2008/09)

Reported drug use prevalence is highest among those from mixed ethnic background (mainly as a result of high levels of cannabis use)

Rates of Class A drug use are higher among people from White or mixed ethnic backgrounds than among other ethnic groups

Poly drug use is most common among White groups, compared to other ethnic groups

Disabled people are at increased risk of drug problems because information and services are less accessible to them

People with long standing illness or disability are less likely to report illicit drug use

People with hearing impairments suggest some use substances to a ‘problematic extent’

Large numbers of people with learning disabilities within prisons are especially vulnerable

Other report findings include:

On LGBT groups, the report stated:

Illicit drug use among LGBT groups is higher than among their heterosexual counterparts, especially among gay men.

‘Recreational’ drug use is comparatively high among LGBT groups, so they may use new drugs and experience associated problems before they are widespread in the general population.

LGBT people may also be at risk of misusing other drugs, such as steroids and Viagra.

Use of some types of drugs may be associated with risky behaviour, including exposure to HIV infection.

The focus on heroin and crack cocaine in the drug strategy means that the drug problems of LGBT groups may not be adequately addressed by current services.

Local partnerships and commissioners need to identify the specific needs of LGBT groups in their future plans including arrangements to strengthen joint working between mental health and sexual health services.

Services for LGBT people need to be developed in a range of mainstream drug services settings to reach those with drug problems. The introduction of a ‘kite-mark’ system for services demonstrating good practice could promote confidence in drug services amongst LGBT groups.

Different approaches to prevention, perhaps focusing on community venues, networks and resources, such as internet sites, using of innovative social media approaches may be more effective at changing drug using behaviour among LGBT groups.


On BME communities, the report highlighted:

In general, overall drug use is lower among minority ethnic groups than among the White population.

Among some BME groups, particularly South Asians and the Chinese the stigma attached to drug use (directed at drug users and also families) can lead to drug users hiding their drug use, so drug use in these communities could be underestimated.

There are no reliable statistics on how many refugees and asylum seekers use drugs and not all institutions involved with drugs and drug treatment record refugee status.

Peer pressure and influence are perceived as primary reasons why young people use drugs.

The growing influence of western culture and trends may lead young people to distance themselves from ‘traditional’ cultural values.

BME communities may be at greater risk of drug use because they often live in disadvantaged and deprived areas, where drug markets thrive.

Although within drug treatment services there seems to be little difference in outcomes for different ethnic groups’ community engagement studies low knowledge of and uptake of services in many groups.

Specialist drug services for ethnic groups will not be sustainable in many areas. It is crucial that local partnerships and commissioners look to assess local needs and stimulate innovative solutions to meet the needs of a growing ethnic population

Lack of information about drug services in a barrier to treatment for BME groups. GPs, faith-based bodies and religious leaders could be utilized more to communicate and engage with young people and families from some ethnic groups.

Peer educators and positive role models can be important. Social and cultural media and networks can be used to reinforce or cultivate positive pro-social behaviours rather than just to inform about harms and risks.

There is well rehearsed evidence BME groups experience disproportionate levels of ‘stop & search’ and a higher percentage of these are for drug offences compared to White groups, despite their lower levels of drug use.

The introduction of police and crime commissioners could afford the opportunity to put the use of stop and search tactics in certain areas under the local microscope in order to judge their efficacy and value.

It would appear that BME involvement in drug markets is rarely undertaken to finance a personal drug habit, but to fund education, repay loans or debts, or afford lifestyle accessories.

Where there is concern about local drug markets with a BME dimension, innovative approaches to get low-level and non-violent dealers into ‘dealer exit programmes’ should be tested and evaluated, as has been done in the United States.

On disabled people, the report states:

Young disabled people, like all young people may be exposed to drugs and some may develop drug problems. However, their access to information and help may be restricted.

A number of factors may also place them at risk of using drugs: communication problems, social pressure to ‘fit in’, isolation and exclusion.

Mental health, poverty and medical use of cannabis to alleviate chronic pain or long term illness may also be risk factors.

Disabled ex service people facing multiple problems, including drug use, may be an emerging challenge to local commissioners, drug services and other social support bodies.

A coalition forged between the major disability and substance misuse services, professional bodies and the Department of Health could help foster a supportive climate to promote better access to services.

Current drug services are often ill-equipped to deal with people with learning disabilities.

Organisational and workforce development programmes should specifically address issues of diversity including meeting the needs of disabled people.

Young people with hearing impairments may suffer from the reliance of oral communication in the delivery of mainstream substance misuse education in the curriculum. We suggest supportive material and information is made available and (teacher) training is provided in the use of materials.

The use of cannabis for pain relief is one of the few areas identified as leading some people with disabilities into conflict with the law.

The advice of the Sentencing Advisory Panel as to the appropriate response to cases of domestic cultivation where chronic pain relief is a mitigating factor should be adopted.

Consideration and further information about the needs of the apparently large number of people with learning disabilities within prisons is needed.

The wide ranging reports suggest drug strategies and services including treatment and prevention need to change otherwise the needs of drug users from diverse communities risk being overlooked by mainstream service providers. The reports present challenges for commissioners of and practitioners within drug services, as well as for the criminal justice system and wider drug policy makers and communities.

Lead Commissioner (UKDPC) Professor Baroness Haleh Afshar said: “When the new coalition government is bringing forward public service reform plans and a new drug strategy, against the backdrop of new Equalities legislation, there is a fresh opportunity to rethink the way we respond to drug use amongst a range of diverse communities, whose needs have become overshadowed by other issues. So many groups are not being adequately protected, making the debate on drugs and diversity more urgent than ever before.”

The aim of the UKDPC review is to encourage consideration of the needs and challenges of drug problems among diverse minority communities within the UK.

By bringing together a variety of evidence in one place the Commission hopes to encourage a broader view of the evidence and its implications in relation to drug strategy plans being brought forward by the new coalition government.

Chief Executive of UKDPC Roger Howard added: “The new government's ambition is to see fewer people using drugs and we hope our review aimed at improving our understanding about which groups are misusing drugs, why and what the effectiveness of responses have been, will make a useful and timely contribution at the national and local level.

"It is striking that as other national challenges have taken centre stage, progress in addressing drug use and problems amongst various diverse communities has become neglected.”

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