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Claire says measuring the impact of drug and alcohol services is complex and not an exact science. She says that in a tightening financial climate there is a need for targeting the resource and establishing a strategic approach to spend.
Claire outlines Audit Scotland’s role in public scrutiny in Scotland and how the organisation disseminates its findings and recommendations.
Nick describes the background of a conference he convened with Rudy Vuchinich on behavioural economics and its relevance to addiction, and the book that arose from this conference. He also talks about Alcoholics Anonymous and how its benefits could be applied to secular mutual-aid groups. He then references the work of Keith Humphreys on self-help groups.
Nick explains that he is ‘a legaliser’ and believes that eventually this is the only way to resolve the problems caused by illicit drugs. He also says we have a legal drug, alcohol, which is the most harmful we know.
Nick talks about the work of Mansell Pattison in the 1970s of ‘attenuated drinking’ and makes other points about the goals of controlled drinking and moderation. “It’s when you extend that principle (of harm reduction) to everybody, I think, that you get the problems.”
Nick says we demonise illicit drugs use to irrational levels but equally we underestimate the harmful effects of alcohol. He goes on the discuss ways of reducing alcohol-related harm by pricing. Controlling the alcohol industry and reducing health inequalities.
Claire talks about Audit Scotland's response to complexity when tracking the way public money is spent across drug and alcohol services. She talks about Audit Scotland's experience of National reviews, and how groups and individuals helped in producing the study.
Claire describes the 'broad reach' necessary for producing the study and describes the range of stakeholders and providers involved in the area of drug and alcohol misuse
Claire says the report recommends work to simplify arrangements and funding design. Claire talks about the uncertainty and constraints the services are facing.
Claire says that the sense of variety came through, but that there is not equity in terms of access to services across Scotland.
Claire describes the decision making process behind the shaping of the Audit work
Claire comments on Accident and Emergency as an example of where we need to get to grips with the harms in the light of costs