Harms still hidden?

Blink and you may have missed it. Last week the Advisory Council on the Misuse of Drugs (ACMD) published a review of progress on 'Hidden Harm', its ground breaking report on parental drug misuse. In 2003 the ACMD estimated that there were up to 300,000 children of problem drug users in England and Wales and as many as 59,000 in Scotland.

After barely a flicker across the news wires the ACMD's press release for the review issued on 9th February went largely unreported. Contrast that with saturation media coverage a couple of days later of David Cameron's alleged use of cannabis when aged 15. The ACMD's review deserves attention but it is necessary to read the full report to get an accurate picture of progress, or otherwise, as the accompanying press release was short on specifics and seems to have pulled its punches. Journalists appear not to have received advance copies of the report and few if any will have worked against deadlines through its 123 pages to extract something 'newsworthy'.

Undoubtedly there has been progress in addressing the needs of children whose parents or carers misuse drugs, with improvements in services and greater awareness among professionals. Much credit for this must go to the ACMD. But progress is far from uniform across the UK, with gaps in the implementation of the ACMD's original recommendations. Most strikingly the report highlights time and again insufficient progress in England compared with other countries in the UK and particularly compared with Scotland. For example, on the need for a cross-government structure to lead in co-ordinating policy delivery: "It therefore continues to disappoint the ACMD that this approach has been rejected by the UK Government in relation to England", and so on.

The fact it took the Department of Education and Skills nearly two years to published the UK Government's response to 'Hidden Harm' was not particularly auspicious, and concerns then about the level of commitment and leadership find echo in the ACMD's review. The Scottish response to 'Hidden Harm' (e.g., centrally funded training, local protocols) has been impressive by comparison, which makes it all the more tragic that the issue of parental substance misuse has become such a prominent and politically heated topic in Scotland, driven in part by the media's highlighting of cases of children coming to harm. In one, a toddler was left to cope on his own for several weeks after his mother died following an overdose. The fact that he was the child of a problem drug user may explain how he managed to feed and look after himself for so long, but it was a scandal that no one missed him or his mother and thought to raise the alarm.

This and other cases have put politicians in Scotland on the defensive, it seems unfairly. But such is the climate of debate in Scotland, that proposals such as requiring women to agree to take contraceptives during treatment are worryingly being aired.

'Hidden Harm' was a necessary wake-up call on an important, difficult and neglected subject. It seems, at least in England, that the alarm was not loud enough, despite what can be learnt from Scotland.

Hidden Harm Three Years On: ACMD Press Release:
http://www.drugs.gov.uk/Hidden_Harm_Press_Release__1.pdf
Hidden Harm Three Years On: Full Report:
http://www.drugs.gov.uk/Hidden_Harm_3_Years_On_Fina1.pdf