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Integrated Care for drug users: Principles and practice

Appendix 4 Scottish Drugs Forum - study of service provision needs of psychostimulant users - Summary

Introduction

The Scottish Drugs Forum (SDF) were commissioned by the Psychostimulants Working Group of the Scottish Advisory Committee on Drugs (SACDM) to undertake a short project on the service provision needs of psychostimulant users in spring 2002. This work has also helped inform the present document on integrated care for drug users.

Aim

The primary aim of the study was to obtain a snapshot of the views and experiences of stimulant users on their needs and available service provision.

Methods

The two qualitative methods were used: one-to-one interviews and focus groups. The study focused on three psycho-stimulants: cocaine, crack cocaine and amphetamine. The study sought to identify the views and service needs of different groups of stimulant users, including both primary and secondary psychostimulant users. The total sample of respondents was thirty-three. Questions related to seven key themes:

• Their reasons for psychostimulant use
• The problems they experienced relating to stimulant use
• The services they had accessed
• The support they had received at services
• Their views on service satisfaction
• Their views on future service provision

Results

• The study showed that stimulant users are not a homogenous group. They include opiate users who also use psychostimulants, primary (and heavy) psychostimulant users, and recreational users.
• Users felt there was an information and training deficit among health professionals and specialist drug agency workers regarding psychostimulants.
• Users felt that drug services are primarily, and predominantly, geared to dealing with problems of opiate use.
• Stimulant users are not keen to discuss their drug use with GPs, due to GPs' lack of knowledge about stimulants. There was also concern about losing their methadone script if the GP knew about their stimulant use.
• Many respondents stated a preference to be seen by drug agency workers who had personal experience of drug use.
• Alternative therapies were regarded positively by respondents as a treatment option for those experiencing problems.
• Respondents expressed a need for employment skills and help in finding work.
• Respondents expressed a desire for counselling to explore the reasons behind their drug use.

Conclusions

Overall users felt:

• There should be different approaches to care which recognises the diversity of users.
• Drug agency workers and health care professionals generally need more information and training about psychostimulants.
• There is a need for improved co-ordination between agencies.
• There is a need for early access to confidential, trustworthy advice and information without recourse to a GP.
• Short-term prescribing of dexamphetamine may be helpful to keep users off the streets.
• The present variety of treatment approaches should be encouraged.
• Employment support and associated aftercare services are needed.
• Ex psychostimulant users should be involved in delivering services.

Acknowledgement

The Psychostimulants Working Group and the EIU would like to thank all service users and recruitment sources for their assistance and help. SDF would particularly like to thank all those who participated in the focus groups.

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