The policy context: Reversing a state of neglect

Abstract

This article briefly outlines the neglect of families within previous UK policy documents relating to drugs and alcohol, and discusses the significant progress that has been made in focusing on the family over the past decade. Although substance misuse causes major problems for many family members, this was not even recognized across the Western world: substance misuse was seen primarily as a problem for the individual misuser. When at last the impact on family members did start to be recognized, this led to interventions which tended to blame or pathologize affected family members (they were seen as co-dependent or in need of family therapy). Simultaneously, major policy and strategy documents within both the alcohol and the illicit drug worlds gave minimal attention to family members.This is at last starting to change. A range of Government and other national documents from England and the devolved administrations across the UK, along with some wider international strategy documents, are examined. Many have started to reflect on both the needs of, and the advantages of including, family members and other close network members. The vast majority of these documents refer primarily to substance-misusing parents and the effects that they have on their children. There is however still a major need to increase the visibility both of the needs of all family members, including spouses and parents of substance misusers, to be able to access appropriate help in their own right (such as the 5-Step Method, the focus of this supplement) and of their important role as part of the treatment that their substance-misusing relatives might receive.

Notes

1. This Updated Drug Strategy (2002) introduced the term ‘carers’ alongside parents and families, and this was a key development: the possibility that family members of those with substance misuse problems might also be seen as carers. This is discussed further below.

2. There are a very large number of strategies and guidance documents, and this article will examine only the main ones. For example, the 2008 Drugs strategy states that there are close links with it to a wider range of other such strategic documents, and it then lists 42 such strategies, plans and programmes, divided into four different categories (the number of document out of the 42 in each category is shown in parentheses): Crime and offending (10), Young people and families (20), Substance specific (4) and Wider context (8).

3. Confusingly, some policy documents and guidelines relate to the (UK), others relate to countries within that (e.g. Scotland or Wales) and others relate to combinations (e.g. England and Wales). The UK consists of the entire British Isles, including the whole island comprising England, Scotland, and Wales, and Northern Ireland. The various islands which make up the Channel Islands and the Isle of Man are Crown Dependencies which means they are constitutionally tied to the British Monarch but are not part of the UK (although they are treated as part of it for many purposes including nationality). This also means that parts of various policy documents (e.g. 2008 Drugs Strategy) relate to all of the UK, whereas other parts relate to one or more countries within the UK.

4. This section will look at international policy produced by collective bodies such as the EU, the UN and WHO, and will not examine specific countries, although it is the case that there are some documents from both Australia and the USA which also have some family focus.