Senedd Cymru / Welsh Parliament
Cross-Party Group on Substance Use and Addiction
ANNUAL REPORT 2023
MEMBERSHIP
Chair: Peredur Owen Griffiths MS
Jayne Bryant MS
Jane Dodds MS
John Griffiths MS
Altaf Hussain MS
Secretariat:
Crispin Watkins (Executive PA to the CEO and Board of Kaleidoscope, Campaigns & Communications Officer) on behalf of the Kaleidoscope Project
External Members:
The CPG circulation list currently numbers 243 invitees from across Wales’ Drug and Alcohol Services from the 3rd Sector, NHS Drug and Alcohol Services, Service Area Planning Board Commissioners and Representatives, Local Councils, His Majesty’s Prison and Parole Services (HMPPS), Police and Crime Commissioners, Police Services, Homelessness, Housing, Childrens and Woman’s Charities, Mental Health and Recovery Services, and Peer Workers.
MEETINGS
The Group met three times during 2023:
17th January 2023 AGM and meeting – Peredur Owen Griffiths MS was elected Chair. Kaleidoscope were elected to provide Secretariat services.
The fourth meeting of the Senedd CPG sought to explore the challenges faced by people with substance use issues presented by the existing Welsh Criminal Justice arrangements, and opportunities for further Harm Reduction activities within those bounds.
Speakers and topics:
Dr Rob Jones of Cardiff Law School presented an academic analysis asking ‘Are people with substance use issues caught on the jagged edge of the Welsh Criminal Justice system?’ He noted that Wales is unique that ‘Wales is the only common law country in the world to have its own parliament and government but not its own justice system’ (National Assembly for Wales’ Constitutional and Legislative Affairs Committee 2012). This leads to complexity, challenges over joined-up policy, and a lack of clarity over accountability. In the field of substance use and addiction it creates a tension between the devolved government which treats substance use as a health issue, and Westminster policy on criminal justice in England and Wales, which treats it as a criminal justice issue. He highlighted the report of the Commission on Justice in Wales in 2019 ‘unanimously concluded that the people of Wales are being let down by the system in its current state’ (Thomas Commission 2019: 8). In response they proposed the devolution of justice responsibilities to:
• enable the proper alignment of justice policy and spending with social, health, education and economic development policies in Wales, to underpin practical long-term solutions;
• place justice at the heart of government; [and]
• enable clearer and improved accountability.
Each table of attendees then had a discussion on criminal justice and substance use in Wales, Chaired by Senedd Members. Discussions included:
• An aspiration that the Senedd should encourage the granting of Letters of Comfort by Police and Crime Commissioners and Chief Constables, to enable enhanced harm reduction approaches such as Drug Consumption Rooms.
• Those PCCs and Chief Constables with the vision to do so should be celebrated
• The Senedd should acknowledge the difference between Harm Reduction and Abstinence and should support a person-centred approach
• Joined up services are vital, and long term structural multi-agency funding is key
• Continuing to focus on substance use as a health issue, rather than a criminal justice issue, including increased emphasis on police using diversion techniques is key
• Provision of naloxone in the prison and probation services could save lives
• Actively positively campaigning to address issues around stigma associated with substance use and addiction
• Campaigning for change to Magistrates Sentencing Guidelines
• The Senedd should also seek to better address the underlying traumas and causes that lead people to find themselves with substance use issues
14th June 2023
The fifth meeting focussed on exploring the unique challenges faced by people who use Image and Performance Enhancing Drugs, and also the subset of the LGBT+ community who participate in Chemsex.
Speakers and topics:
Richard Amos from the Gwent Drug and Alcohol Service (GDAS) spoke about the routes into Image and Performance Enhancing Drug (IPED) use, including both body dysmorphia and the pressure of competitive sports. He used his lived experience of being a high performing sports person who suffered injury to illustrate the temptation and societal pressures to use IPEDs to hasten recovery from a range of injuries including (in his case) cruciate ligament damage and the need for bone marrow and stem-cell transplants.
Richard illustrated the challenges facing IPED users in sourcing ‘legitimate’ IPEDs clinically controlled and intended for human use by giving out 6 sets of empty packaging and asked people to assess if they are legitimate or fake. There was one clinically approved set of packaging, but all had a variety of legitimising markings, holograms, braille, medical advice leaflets, QR codes to health websites etc, which showed the extent to which criminal gangs will go. These complexities place IPED users at risk of extreme harm.
He concluded by flagging the under-represented issue of low testosterone levels experienced by men as they get older, and the links with poor mental health, self-harm and suicide, and called on the health service to offer more testosterone testing and medical support for men in mid- and later- life.
Jack Wilkinson from the Bristol Drugs Project PRISM Service (BDP) spoke about working with the LGBT+ community in general, and the people who practice Chemsex in particular.
The BDP PRISM Service was set up in 2016 to address the specific barriers that LGBT+ population face. LGBT+ adults are more likely to use drugs than heterosexual adults (3 – 4 times more likely). Clear evidence shows that there are systemic barriers to members of the LGBT+ community accessing the health service, including stigma, discrimination and criminalisation.
There is an intersection between the LGBT+ community, substance use, mental and sexual health so there are some common themes, but also complexity. Jack explored the unique challenges that exist in accessing this community and providing support and also the unique risks that they face taking cocktails of drugs including crystal meth, GBH and GBL over prolonged intense periods of consumption.
25th October 2023
The sixth meeting of the Cross Party Group focussed solely on a legal drug for the first time. Alcohol-related deaths are more than twice as high in Wales than all the illegal drug-related deaths combined, and many include alcohol as a factor.
Speakers and topics:
Wulf Livingston is Professor of Alcohol Studies at the Faculty of Social and Life Sciences, Glyndwr University, and Chairs the Welsh Centre for Alcohol and other Drugs.
Wulf asked ‘Why do we struggle to deliver effect alcohol policy?’ In Wales some of our policy area is impacted by Westminster, which currently has one of the least proactive approaches to reducing alcohol related harms. Some alcohol companies have larger turnovers than the GDP of some small European countries. There are no votes in the evidence that relates to the legal status of drugs; but there are ‘votes in a pint’ and alcohol may be politicised during the forthcoming Westminster elections. Wulf noted that the most subsidised place to buy alcohol in the UK is the Houses of Parliament. And there are massive social pressures to ‘consume’ in general. As a legal drug, central to sections of the economy, tourism and the social fabric, policy makers are challenged in that alcohol is economically important, but ‘we don’t want people to drink too much’.
Wulf presented the case for a comprehensive approach focussing on sustainable local small industries over conglomerates, on responsible local retailing and on community devolution of management of the night time economy. Alongside this encouraging personal responsibility and a comprehensive public health bill including increased spending on recovery services.
Liam Cherry is a counsellor and psychotherapist working in Western Bay (Swansea and PT) working closely with people who find it very difficult to manage their addictions.
Liam started with a focus on the term ‘Co-occurring’, sometimes termed ‘dual diagnosis’. Sometimes substance use and mental health are treated as 2 separate issues with 2 separate solutions. The question is asked does one need addressing before the other can be addressed? This stems from misunderstanding of what addiction is and where it comes from.
85% of people struggling with substance use including alcohol have experienced trauma; most have experienced 4 or more TYPES (not EXPERIENCES but TYPES). Liam asked ‘why is alcohol a ‘solution’?’ and highlighted how it is used to self-medicate to overcome these traumatic experiences. Acknowledging with a service user how good alcohol is at dealing with such traumas is a valuable first step in getting a service user to reflect, and start to explore the trauma underlying the substance use. Liam reflected on the importance of providing social framework and support network that the service users can access and fall back on, and how this social framework is so often lacking during the period in service users’ lives where the trauma was first experienced, and where substance use started to become a problem.
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FINANCIAL STATEMENT
There was no income, funds held, or expenditure by the Cross Party Group over the period covered in this annual report.
Tea and coffee was purchased for attendees of the CPG 2023 January AGM by Peredur Owen Griffiths MS, at the cost of £85.20 (receipts held by the Secretariat).
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Crispin Watkins
Secretary, Cross Party Group on Substance Use and Addiction,
April 2024