TACKLING SOCIETY'S DRUG AND ALCOHOL CRISIS AT ITS ROOTS

IF YOU have been in a city centre late on a Friday or Saturday, you
won't have failed to notice the number of legless party-goers. If you
have seen or taken part in the debauch, the fact that consumption of
alcohol and illegal drugs is on the increase will come as no surprise.
There is a creeping acceptance that bingeing on drink and drugs is
just part of being Scottish, young and/or male. How can we change this
deep-seated belief?

The Futures Unit of the Scottish Parliament has a remit to think
further ahead than the electoral cycle and to get beyond party
political boundaries. It is committed to understanding and severing
the national obsession with drink and drugs and has set a challenge:
how can Scotland reduce the damage to its population through alcohol
and drugs by half by 2025?

The question recognises that we cannot and probably would not want to
rid society entirely of either drink or drugs. Prohibition sends
producers and distributors into an unregulated black market and, for
many of us, the occasional glass of wine or a dram is one of life's
great pleasures.

But the question masks the severity of the challenge. In the past 25
years, largely as a result of rising disposable income, alcohol has
become 62 per cent more affordable.

Drink is a major Scottish industry, employing 150,000 people in
manufacturing, distribution, retail and hospitality. It accounts for
UKP3.3 billion of Scottish exports. An industry of this size and clout
is not going to wither away.

Alcopops for teenagers and super-strength lager in cans (and large
plastic bottles for street drinkers) show the industry is very
inventive in creating and serving the market. Statistics on illicit
drug sales are harder to come by, but they are the largest sector of
the informal economy, and their suppliers have excellent marketing
skills.

Professor Neil McKeganey, head of Glasgow University's Centre for Drug
Misuse, calculates that one per cent of today's population abuses
drugs, and given the rate of growth among different segments of the
population, especially the young, the total number of drug users could
triple within 20 years.

Such growth threatens to undermine our community. The Scottish
Government calculates in its Hidden Harm report that 50,000 children
are affected by substance-misusing parents and 90,000 by parental
alcohol abuse. Every primary school class is thus likely to have at
least one or two such potentially disruptive children. Double these
numbers, in 20 years, would result in 280,000 harmed children. If we
assume all these children are at primary school, and the average
primary school has 400 children, we will have the equivalent of 700
primary schools full of the children of alcohol- and drug-abusing
parents by 2025.

If the Scottish Futures Unit is to reduce this abuse, it has to arrest
a profoundly alarming growth rate. This is a huge challenge.

So what causes alcohol and drug abuse? Evidence suggests that factors
include a lack of parental discipline, family cohesion and parental
monitoring, peer drug use, drug availability, genetic profile,
self-esteem issues, hedonistic attitudes, and social deprivation. Put
simply, it's about genetics and nurture, followed by factors such as
fashion, free will, and the pursuit of pleasure.

Restricting sales and slapping punitive tax on alcohol has had an
affect in other countries, notably Scandinavia. It may be possible to
change fashion and culture so that alcohol is not so ubiquitous at
social events or so significant to young people or the dinner party
habit of the middle classes. It requires all of us to change our habits.

However strong the evidence that genetic profile increases the
likelihood of substance abuse, we cannot manage our genes. But we can
radically improve individual and collective nurture, not by giving
each newborn a set of booties, but by the wholesale creation of
resilience in children. For if our children are resilient, they are
more likely to make wise decisions about alcohol and drugs and have
the wherewithal to move on and away.

Alcohol and drugs are, at a personal level, what nuclear weapons are
to international relations. However much we want to get rid of them,
we can't turn back the clock. So with drugs and alcohol; they are part
of life and we have to learn to live with them.

Alan Sinclair CBE is a visiting fellow at the Work Foundation. This
is the first in a three-part Medical Matters series about drink and
drugs.