Inaugural Professorial Lecture: Questionnaire, Powerpoint, Lecture Notes (preview and download below)

Feel free to use my material so long as you reference me. If you have any feedback/comments I'm always interested - email me: j.buchanan@glyndwr.ac.uk

Since the late 1970s illicit drug use has established itself as a major social problem. The response has largely been dominated by tougher measures to coerce people to accept treatment and become drug free or ultimately face prison. But after decades of tough drug policies our prisons have become crowded silos for drug users and people with multiple personal difficulties. Relatively little progress seems to have been made in reducing the overall size of the drugs problem or the proportion of people taking illicit drugs.

This lecture will reflect upon the way in which a ‘war on drugs’ is played out as a ‘war on drug users’. While most strategies have concentrated upon the physical and psychological aspects of dependence, this paper will highlight the important but often overlooked structural and social context of problem drug use. It will be argued that the stigmatisation of illicit drug use has made it more difficult for problem drug users to recover. Alternative conceptual models that promote a more inclusive approach will be explored.

Tackling Problem Drug Use: A New Conceptual Framework

Journal of Social Work in Mental Health (The Haworth Social Work Practice Press, an imprint of The Haworth Press, Inc.) Vol. 2, No. 2/3, 2004, pp. 117-138;

Successful ‘recovery’ from long-term problem drug use has depended largely upon understanding and tackling the physiological and psychological nature of drug dependence; however, drawing upon research and practice in Liverpool, England, the author questions whether this discourse is sufficient given the changing nature, context and attitudes towards drug consumption in the twenty-first century. This article emphasises the importance of incorporating structural and social factors. Drawing upon qualitative data from three separate studies, the author illustrates how stigmatisation, marginalisation, and social exclusion are significant debilitating components that have tended to be overlooked. This paper contributes new insights into the damaging impact of political rhetoric and structural discrimination that has placed many long-term drug users vulnerable to relapse. In response to these findings the author offers a new conceptual framework for practice that incorporates and pro-motes an understanding of the social nature and context of long-term drug dependence.

Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Issue on Problem Drug Use, Vol 51 No.4 pp.387-397

In the late 1980s illicit drug use became a major social problem in the UK. Since then policy and practice has largely been shaped by psychological and medical perspectives that emphasise the physiological and psychological nature of dependence. Concerned by the limited impact in reducing the number of problem drug users, in 2000 the Government shifted the emphasis away from voluntary treatment by the Health and Voluntary sector, towards coercive treatment, initially in the form of a Drug Treatment and Testing Order (DTTOs). The Drugs Interventions Programme (DIP), a £447m programme to ‘direct drug misusing offenders out of crime and into treatment’ (Home Office, 2004 p. 29) further illustrates and reinforces this shift. This article argues that this shift in approach is also likely to founder, as it continues to be dominated by a narrow focus on the individual and their drug dependence, and fails to adequately address the social context, nature and underlying causes of problem drug use.

ENABLING DEPENDENT DRUG USERS: A COGNITIVE BEHAVIOURAL ASSESSMENT

Buchanan J (1991) ‘Enabling Dependent Drug Users - A Cognitive Behavioural Assessment.’ Practice Vol 5 No.1, 1991 BASW, London P34-46

Based upon six years social work practice with dependent drug users in Merseyside, the author introduces the broad principles of a cognitive behavioural approach, and then integrates this theoretical understanding to a highly specific area of practice, - assessing dependent drug users. Assessment is discussed in detail and using examples the article provides a much needed model of good practice. The approach is based upon a risk reduction philosophy and is underpinned by cognitive behavioural principles. The article offers a comprehensive outline from which a practitioner could follow and conduct an assessment. Importantly, the process seeks to empower clients, redressing the balance by returning to them responsibility for their future, thus enabling them to set their own targets and plans without coercion from the worker.

This paper briefly outlines the emergence of cognitive behavioural therapy from within behaviourist theory and then, using examples, relates it to dependent behaviour. Based upon six years social work practice with dependent drug users, the paper provides a detailed framework of an established cognitive behavioural assessment which has been developed and refined through practice.

Vocational rehab and social reintegration: The Needs of Problem Drug Users

National Drug Treatment Conference 2006 (Audio & PowerPoint Presentation)

Intervention strategies for tackling problem drug use tend to be dominated by a focus upon the physical (e.g. detox, drug testing, substitute prescribing) and psychological (motivational interviewing, the cycle of change) aspects of dependence. In contrast this paper will promote the social dimension of drug dependence. It will critically explore the structural, cultural and personal difficulties recovering problem drug user’s face when trying to engage with mainstream society. In particular it will outline the challenges posed by social exclusion and discrimination.

Evidence suggests that for many problem drug user’s social exclusion was a difficulty prior to the onset of a drug problem. A drug centred lifestyle has added further layers of exclusion and exacerbated the situation. These layers of exclusion make vocational rehabilitation, social integration and participation within the wider community extremely difficult. This paper will illustrate how attitudes, policies and practices serve to reinforce isolation and create a ‘wall of exclusion’ that effectively prevents problem drug users from engaging with mainstream society.

An alternative conceptual framework that incorporates the social context of problem drug use will be detailed and discussed. This model ‘Steps to Integration’ will be further explored as a template to consider the policy and practice implications of helping recovering problem drug users achieve social integration.

Buchanan J & Corby B (2005) Drug Misuse and Safeguarding Children: A Multi agency Approach pp 163-179 in R Carnwell & J Buchanan ‘Effective Practice in Health & Social Care: A Partnership Approach’ Open University Press, Maidenhead

This chapter will: explore the social context in which ‘problem drug users’ and ‘inadequate parents’ are constructed; outline key issues and difficulties involved in working with problem drug users whose children are considered to be at risk of abuse or neglect; draw on research carried out with social workers, health visitors, drugs clinic workers and parents to examine the barriers of working together to assess children’s needs where parents misuse drugs; and  explore strategies for better partnership approaches.

Parrott L, Buchanan J and Williams D (2006) Volunteers, Families and Children in Need: An Evaluation of Family Friends’ Child & Family Social Work, 2006, 11, pp147-155 Blackwell Publishing

This paper explores the findings from a small-scale research project that analysed the impact of Family Friends – a voluntary agency that provides support to families under stress who have children aged between 5 and 11 years. The study, funded by Family Friends, evaluated service users' perceptions of the support they received, specifically in relation to the significance and impact of the volunteer befrienders. The research identified that there are a proportion of families in need who fail to attract services from mainstream statutory agencies. It also identified that the Family Friends voluntary agency makes a particular contribution to service provision by offering a friendly, non-stigmatizing, caring and responsive service.

Stigma, Drug Use & Society

Keynote address at the Scottish Drug Forum a one-day conference 30 September 2008 Glasgow

This paper explores the changing attitudes towards legal and illegal drugs over the years and the way in which some drugs have at times received widespread approval whereas as other have been subject to stigma. The implications and consequences of stigmatising illicit drug users are discussed in detail.

The challenge is not becoming drug free but to develop a meaningful lifestyle

article in the Western Mail 16th July 2009

The professorial lecture series at Glyndwr University is open to the public and has proved very popular. The lecture I gave, It’s Their Own Fault For Doing Drugs, was based upon 25 years working in the drugs field – initially as a probation officer and drugs worker before studying the issue as an academic.

Drug use in society is a major concern. It is also fraught with contradictions and misunderstandings. Illicit drug-taking per se is seen as a deviant activity. Anyone taking an illicit drug (unlike legal drugs) is labelled and stigmatised. At great financial and personal cost, the full force of the criminal justice system is used to eradicate illicit drugs from society. However, this has often caused more harm than good. Our prisons are bursting at the seams and we now have one of the highest rates of incarceration across Western Europe. There are experimental and recreational drug users – in fact more than 11 million people in the UK have used an illegal drug at some point in their life – but most concern is rightly placed upon problem drug users.

The “war on drugs” has become a “war on drug users” which serves to isolate people who have a drug problem and leaves them labelled and stranded across “enemy lines”. This not only has the unintended outcome of keeping them entrenched in addiction, but also has the pervasive impact of creating institutional, cultural and personal discrimination. This firmly excludes people with drug problems from mainstream society and makes it more difficult for them to access the help they need. Often the only people they know are other drug users. They are forced to live in drug “ghettos”.

Drug policy focuses upon the need to get these people drug free and to improve their motivation. These physiological and psychological approaches take little account of the social context and social circumstances surrounding problematic drug use. Instead, problem drug use is seen as an individual flaw, a physical problem or personality defect. This locates the drug problem with the person, rather than locating it within the wider family, community and/or society.

Research consistently indicates many problem drug users had serious negative early life experiences. Such as: Disrupted unsettled childhoods (marred by domestic violence, physical and/or sexual abuse, parental unemployment, poor housing, poor neighbourhoods); around one in three problem drug users had been taken into care and looked after by the local authority as a child; an inability to settle or achieve in education (perhaps due to dyslexia, learning difficulty, poor family support) often resulting in school exclusion or a failure to complete – perhaps not surprisingly around 50% of problem drug users don’t possess qualifications; limited or no experience of employment; and/or early experience of the criminal justice system.

It is easy to see illicit drugs as the root of their problems – but for many this is clearly not the case. Drug dependence will have made their situation worse, but many were struggling with major personal difficulties and disadvantages before drugs became a problem. The real challenge is not how to become drug free. The real challenge is how to find a legitimate, constructive and meaningful lifestyle to replace a drug-centred lifestyle. It is hard to see how these problem drug users (without considerable support) will find the personal resources, support systems and opportunities needed to radically turn their lives around.

The war on drugs is a civil war that ensures this section of society will continue to face stigma, hostility and exclusion. This inevitably makes recovering problem drug users more vulnerable to ongoing episodes of chronic drug relapse. We followed the US, who led the “war on drugs”. The Obama administration now appears ready to abandon this ill-conceived war. Let’s hope that we are ready to follow.

Julian Buchanan
j.buchanan@glyndwr.ac.uk