Where is the strategy?

Real harm is being done by the absence of a national alcohol strategy and there is a serious shortage of people working in the alcohol and drug sector. These conclusions, drawn in a report by Healthwork UK, come at a time when those concerned solely with alcohol are complaining that the major part of funds available is going towards work with illicit drugs. The increasing size of the problems, the money available, and the demands of new ways of working in partnerships and multi-disciplinary teams, contribute to the unsatisfactory situation.

In commissioning the report, A Competent Workforce to Tackle Substance Abuse, Healthwork UK, the health care national training organisation, aimed at producing data to support its case for national standards of training in the alcohol and drug sector. Because this sector is "diverse, complex, and fast-changing" it can be confusing to anyone working in it for the first time. One of the aims of the report was to provide an accessible introduction to the field whilst at the same time identifying those standards and qualifications, out of the many available, which need to be applied throughout the country.

The report points out that alcohol and drug work cuts across a number of vertical sectors of the economy. It was partly for this reason that the so-called Drug Tsar, the UK Anti-Drug Co-ordinator, was appointed in 1997 to bring together drug-related work in the health, social services, education, criminal justice, employment, housing, and other fields. The areas of concentration of people in these various areas are diverse, as indeed is their individual motivation. Some may be trained health, educational, or criminal justice professionals who have specialised in substance misuse, whilst other may be volunteers with, as the report says, "a personal mission to help others, or people who have chosen to work in the sector as a result of personal experience of substance misuse and its effects".

It is therefore difficult to define where the boundaries of the sector lie, who is involved, and what is their level of intervention. The sector is also rapidly expanding, especially in the drug area, often, some professionals argue, at the expense of those bodies dealing specifically with alcohol problems. As more money becomes available, at least to certain areas, then there is an increased need to develop accountability and to measure results. The reports says that, whilst this diversity "is the sector's strength, it also provides challenges for those wishing to develop a framework of common standards to which people should be working".

In one area, however, there is a major difference between the alcohol and illicit drug sectors. The report states: "There is a national drug strategy which spans government departments, statutory bodies, voluntary agencies and private organisations within the sector. This strategy, and the funding associated with it, is leading to a homogeneity of policy and action across the sector. It is also drawing in resources at an unprecedented rate. There is currently no such policy for alcohol, with the result that this part of the sector is more heterogenous but much less well-funded. There is evidence of valuable human resources haemorrhaging from alcohol (and other substance) misuse services to drugs."

These comments will confirm the suspicions of professionals that alcohol services are being neglected at the expense of those for illicit drugs, despite the scale of the problems being in reverse proportion. They will also add to the calls for a national alcohol policy which for several years the government has been ignoring. However useful the data collected by Healthwork UK and however sensible its suggestions for national standards in training and performance, these will have marginal effect in the alcohol sector until it receives the same attention as that given to other drugs.