People With Substance Abuse Problems

Published Date: 23 Mar 2015 Last Modified: 17 May 2017

Why People Develop Problems with Substances 

Psychological and sociological theories as to why people develop problems with substances and their application vary; some theories relate to genetics others to the environment. Most Theories focus on particular features of the rate of drug use: Illicit drugs, Alcoholism, Addiction, The drug experience-how and why people use them, Individuals, Society, Career.

Social learning is just one of the theories that try to explain the use of substance misuse. A degree of difference is found in society's attitudes and behaviours. Learning depends on priority, intensity, time and involves practice, motivation, attitude, and meaning. (Edwin Sutherland 1939).

Thinking about different theories on behaviour can help us to understand why and how some people have substance problems, for example,

Behavioral theories: behavioural psychology or behaviourism is based on all behaviours being learned through conditioning. Cognitive theories:focus on internal thoughts such as motivation, attention, decision making and problem solving. Developmental theories: think about learning, development and growth. Humanistic theories: look at human beings being basicaly good. Personality theories: looks at the behaviours, thoughts and feelings that make each person an individual. Social psycology theories: focus on explaining social behaviours. (Psychologist World)

Applying these theories can assist in understanding why some people depend on substances while others do not.

Looking at society as a whole does not give a clear picture as to why some people develop substance dependency. If you look at different areas of society you start to see deprived areas, poverty, unemployment, peer pressure, boredom or pressures from work, family history or a pre-disposition to substance problems as well as the environment that a person is brought up in could influence someone's substance dependency.

If a child is born to a mother that is dependant on drugs or alcohol then the child may be born with a predisposition to that specific dependency, if a child is raised in an area where drugs and alcohol are freely available then they could be pressured by peers to consume the available substances. This is seen commonly among teenagers when they start to experiment with new things and where peer pressure to be the same as everyone else can entice a young person to start taking a substance to please or maintain relationships with peers. This can lead to long term dependency that can continue into adult hood especially if the child has a predisposition to substances or has an addictive tendency, causing the cycle to continue. Society's attitude towards alcohol problems has been largely accepted as the "Scottish way of life" according to the 2004 Scottish social attitudes survey carried out by the Scottish government.

Cultural Attitudes

"Every person in Scotland has a part to play in reviewing their attitudes and behaviours, and contributing to the debate about how we collectively address these problems." (Carolyn Churchill, 2010)

Alcohol problems are estimated to cost Scotland around £3.56 billion per year in NHS, social work, police, emergency services, and the wider economic and human costs. Alcohol misuse not only affects the health and wellbeing of individual drinkers, but also have a major impact on family relationships, the wider communities as well as society as a whole. (Alcohol Focus Scotland)

Through using these services society is trying to reduce the amount of substance abuse within Scotland. This is however an uphill struggle and until attitudes change it will be left to the medical profession, police and emergency services and the social work department to fire fight the problems within the Scottish communities. Social justice is concerned with equality of justice, not just in the courts, but in society as a whole. This idea stresses that people have to have equal rights and opportunities from the poorest to the wealthiest in society deserve equal chances and opportunities. New legislation may assist the problem however it is the attitude of the individual that will ultimately start to change the attitude of society as a whole.

Criminal Justice law changed in 2010 this gave courts more flexibility in the way they were able to sentence people that passed through the courts. This now allows courts to look at ways of reparation without using short term imprisonments.

Statutory Orders are those non-custodial sentencing options available to all Sheriff Courts in Scotland. This allows greater choice of sentance for the sherriff. Using Social Enquiry Reports, Community Service Orders, Probation Orders (including those with a requirement of unpaid work), Probation Orders with a Requirement of Unpaid Work, Supervised Attendance Orders, Drug Treatment and Testing Orders, Restriction of Liberty Orders, Statutory Throughcare, Voluntary Assistance and the Throughcare Addiction Service, Home Circumstances Reports, Diversion from Prosecution and Bail Information, the sheriff can now look at the crime and the persons background and apply a decision/sentence that is proportionate to the crime. (Criminal Justice Act 2010)

Safer and stronger communities are at the heart of Scottish Government policy. Communities that people are proud to belong to, where they feel safe and have confidence that justice and fairness will prevail, where people take responsibility for each other and for their own actions. (People and the Law)

Youth justice is closely connected to Getting it Right for Every Child which underpins the principals of agencies involved with young people. Getting It Right For Every Child is the Government's policy for addressing the needs of all children - and it provides the framework within which public agencies can work better together with a focus on improving outcomes for children. Building the capacity of families and communities to engage in activities that support children is central to this approach. The Early Years and Early Intervention Framework being developed jointly by the Scottish Government and CoSLA will ensure a strong focus on what needs to be done to ensure that all children, including the most vulnerable, get the best start in life. (The Road to Recovery)

Youth justice is about intervening at an appropriate time with a plan and a good framework for the intervention. Multi agency co-operation is needed for this to work effectively using a range of procedures and practices dealing with young people who are putting themselves and/or others at risk or offending.

Scotland's children's hearing system was initiated by a change to the Social Work (Scotland) Act 1968 and is now part of the Children (Scotland) Act 1995 and is at the heart of youth justice. Since its introduction children under the age of 16 are only considered for prosecution in an adult court if the crime they have committed is deemed to be very serious such as murder. The hearing system deals with children and young people who are in need of care and protection as well as those who have displayed offending behaviours.

Youth justice traditionally worked with children from the age of 8 to 16 but has recognised the need to start preventative work with younger children to support them in the transition from children to adults in a more positive way. In recognising this youth justice introduced several preventative measures including restorative justice in schools, safer school partnership, and positive activities for young people, targeted youth support and targeted mental health in schools. The government also introduced the Youth Justice Re-investment Pathfinder Initiative this allows local authorities to act as "Pathfinders" to develop ways locally of reducing offending and re-offending without a custodial sentence.

Assessing, Planning and Intervention

Getting It Right for Every Child (GIRFEC) is a good place to start when assessing the needs of children and their families. GIRFEC takes a holistic view of the child GIRFEC has an integrated, common approach to gathering information about a child's well-being. It uses three tools, the Well-being Indicators: identify record and share concerns, and take action as appropriate My World Triangle: Triangle helps practitioners gather relevant information to look at the strengths and pressures affecting a child and their family. The triangle is deliberately offered from the child's view to reinforce the Getting it right for every child principle that children should always be kept at the centre. The Resilience Matrix: help organise and analyse information.

All children can be: Confident Individuals, Effective Contributors, Responsible Citizens and Successful Learners. To achieve this all children need to be Safe, Healthy, Active, Nurtured, Achieving, Respected and Responsible and Included. These are known as the 'wellbeing indicators' and are remembered by the acronym S.H.A.N.A.R.I. (GIRFEC)

Doing a GIRFEC assessment takes a multi agency view where social work, health and education professionals have a part to play in the assessment process. An assessment should be appropriate, proportionate and timely, once an assessment is done a more holistic picture about the needs of the children and the family has been obtained allowing the practitioner to plan a course of action for the children and family. Through careful planning strategies and interventions can be put into place to allow the children and family to move forward. All interventions and strategies need to be consensual so the whole family need to be involved in the planning and decisions made to ensure their commitment to the action plan. Intervention strategies will vary depending on the family and the problems they are facing. Using evidence based practice the best relevant information based on the best practices in the field of social work, health and education will achieve the most desirable outcome for the family, this also allows for the assessment and intervention to be transparent and informed.

The Key Capabilities document has four headings which together form the Key Capabilities in Child Care and Protection:

Effective Communication, The Scottish Social Services Council (SSSC) codes of practice describe communicating as being done in an appropriate, open, accurate and straightforward way. Knowledge and Understanding, this includes keeping up to date with relevant legislation, being accountable, using professional judgment and knowledge based social work practice, working effectively as a professional. Professional Confidence and Competence include, carrying out duties accountably, using professional judgment and knowledge based social work practice. Values and Ethical Practice, Work at all times within the professional codes of practice, ethical principles and service standards that underpin high quality social work practice, by applying these to any assessments or interventions it is possible for the practitioner to take an non-judgemental and anti discriminatory approach to the clients and there issues.

Assessment of the Key Issues Affecting this Family

Dean has already been involved in a previous incident involving alcohol where he had assaulted Sandra and her brother in front of the children while he was under the influence of alcohol. Dean has been working with the social worker in an attempt to rectify his relationship with Sandra. Through getting drunk and losing control he has committed a serious offence Dean needs help with his problematic drinking, aggression and anger management as his actions will have a lasting effect on the children and Sandra.

Resilience varies from child to child some children do not develop any problems either as children or adults. Families being together in harmony and good social networks are just two of the ways a child builds their resilience however the issues faced by Nathan and Jordan are numerous, they may have to take on responsibilities far beyond their years which effects their education and peer relationships, they may suffer physical and psychological health issues, domestic violence and child abuse, there are concerns regarding anti social behaviour increasing the risk of aggression towards others, hyperactivity or conduct disorders, emotional and attachment disorders and neglect. Building resilience in this situation will need a good level of self esteem, confidence and self efficiency as well as the ability to adjust to change and problem solving skills. There are implications for the children's safety and welfare which may become a child protection issue.

Dean and Sandra are in crisis which would imply that a short piece of intervention work could be used to rectify this situation. Working with Dean and Sandra on new skills to avoid this type of situation and setting achievable goals and supporting them they should be able to continue to work on their relationship as they were before this incident happened.

As a longer term intervention such as Cognitive Behavioural Therapy could be a useful tool in this situation, by getting Dean to think about his own thoughts, emotions, physical feelings and actions may assist Dean at looking at his behaviours thoughts and feelings differently and try to take a more positive look at how he can deal with similar situations in the future. This is about getting Dean to view situations in a more positive way therefore being able to handle the situation in a more positive way. This work is not a quick fix for Dean's behaviours and he needs to want to take part for it to work. Sandra should be included in part of this therapy as she seems to be one of the objects of Dean's anger as does Sandra's brother. (PSYCH)

Dean would also benefit from working with people who have experience in substance related problems such as his GP or a voluntary group. Dean would have to be in agreement with these strategies for them to work. Giving Dean options allows him to take charge of the situation and enables him to move forward at a pace he is comfortable with.

If Dean is working voluntarily towards resolving his alcohol, anger and aggression issues it may help his assault case when it goes to court.

The impact on the family will be minimized if dean and Sandra are working together to tackle this situation and work through the problems they are now facing as a family unit supporting each other and the children to a mutually beneficial outcome for the family and wider society.

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Case Study

The role of the social worker in criminal justice

From 1 February 2011 a Social Enquiry Report will be called a Criminal Justice Social Work Report.

When a sheriff or judge wants to know more about an accused persons background, they will ask for a Criminal Justice Social Work Report. If a person is likely to be going to jail for the first time, the court must have a report. The report provides the court with the information needed to decide the most appropriate way to deal with offender. A Criminal Justice Social Work Report is written by a social worker, who contacts you by letter and asks you to attend an interview. The social worker will ask for information about your, current circumstances, personal and social history, previous offences, and current or previous supervision.

At the end of the interview the social worker will explain to you what sentencing options are available to the court.