Drug Trends in Wales

Article excerpt

This paper describes the evolution of responses to drug related problems in Wales, from the.t National Health Service in-patient admissions in the late 1960's until the publication of Forward Together, the Welsh Office strategy for drug and alcohol problems, in May 1996. Service developments are placed in the context of the available data about the nature and extent of drug use across Wales, the particular challenges faced, and the strategies adopted in Britain, in Wales, and at the local level.

Introduction

To understand drug misuse within a society, and the response in the form of services, we must consider such issues as public perception, central government policy and funding, availability of drugs, prevailing drug use patterns, changing opinions about different types of drug services, and local cultural factors (Klingemann 1996). This paper discusses how these factors influence drug trends in Wales. Geography

Wales is one of Europe's Celtic countries. Surrounded on three sides by the Irish Sea and Saint George's Channel, Wales' eastern border is with England, following the Dee Estuary to the North and the Severn Estuary to the South. The population (2,835,000 at the 1991 census) is unevenly distributed across Wales' 2,076 hectares. The mountainous nature of much of the country has pushed centers of population to the coasts, whereas the wealth of iron and coal deposits in the southeastern valleys led to large scale immigration in the 19th and early 20th centuries, turning rural valleys into industrial (and in the last 30 years, too frequently, post industrial) landscapes. Wales is economically poor compared to the rest of Britain, with lower proportions of the population in the non-manual and professional classes and a higher proportion of youth unemployment The topography of Wales, the differing principal sources of employment, the historically poor transportation networks within the country, and the dominant influence of the English on British central government, have exaggerated cultural dices across the Welsh nation to a marked degree for a total population smaller than many of Britain's larger cities. For example, Europe's oldest spoken language, Welsh, is used by approximately 20% of the population, but is generally used in public life only in rural northern and western Wales.

Wales' problems with and responses to drugs are different from those of the rest of Britain for a number of reasons: the different governance of Wales and the consequences of this for strategic planning and service development, the geographical distribution of the population that has had effects on service delivery, and the nature of the drugs used by those attending services. Government

The government of Wales is under the direction of the Secretary of State for Wales, based at the Welsh Office, in Cardiff. It is the Welsh Office that controls drugs policy in Wales. The Welsh Office reorganized almost every aspect of Welsh civic life during 1996. National Health Service purchasing bodies were reduced in number from 9 to 5, and in local government 8 county councils and 37 district councils were dissolved and replaced by 22 Unitary Authorities,which are new single tier councils. No other country or area of Britain has been so revolutionized in all its essential local services and it will take time for the impact of the changes to work through.

Strategic Responses

Drug services in Wales increased with the start of a Central Funding Initiative (CFI by the Welsh Office in 1985. The first round of the CFI allowed each Health Authority to bid for ring-fenced monies to employ a health promotion officer for drugs and to found or further develop treatment services. The CFI began 2 years after a similar initiative in England but differed in the way that funds were allocated. In England services were established using new central money for "pump priming" in the expectation that local funding would be found later. …