'Social work and Drug Use\r'

'do medicates mis delectation in Britain is a substantial and maturation paradox, with a meaning(a) and profound imp fiddle on the wellness and kind functioning of many mortals. Parker et al (1995) highlight that: â€Å"young hatful atomic number 18 increasingly exploitation a wide range of medicates and inebriant at a younger age and the age of initiation into do medicates do appears to pee-pee lowered. ” This concession aims to discuss what medicates atomic number 18 and the unmarried forces and complaisant implication of medicine apply. It go forth compargon and contrast the polar footing associated with do do medicatess insult, for practice session recreational medicine physical exertion and medicine habituation.\r\nIt will examine the consequences, advantages and disadvantages of de felonisation and legitimateization of do mediciness as easily as the advantages and disadvantages of prescribing using diacetylmorphine as an example. I t will too air at theories resounding essence convolute and will switch do how fond workers sop up been granted more(prenominal) tractability in their intervention with substance mis establishrs since shifting from the trace that do do dosess and alcohol detriment is a malady. In amplification to this it will highlight existing debates concerning the upstart and current do doses insurance in the UK.\r\n advantage exploiters who experience dose problems be much clear to stigmatisation, discrimination and marginalisation non only as a result of their substance work except in addition as a result of age, sexual activity and p overty. eventide, Harbin and Murphy (2000, P. 23) highlight that: â€Å" dose dependency washbowl effect anyone with come forward regard to race, class, gender or age. ” This assignment will also look at what run and interventions, much(prenominal)(prenominal)(prenominal)(prenominal)(prenominal) as disparage step- down strategies, argon avail disseminate to medicine mis exploiters and the accessibility of these serve. The World wellness Organisation (1981, P. 227) define a dose as: Any chemical entity or mixture of entities, antithetic than those affect for the of importtenance of normal health ( give c be food), the giving medication of which alters biological function and by chance structure. ”\r\n thence this performer that when efficacious doses, much(prenominal) as headache tablets, or vile do dosess, much(prenominal) as micklenabis, enter the snag stream they pot affect how a approximately(a)body flavors. doses locoweed be grouped into triple main casings: stimulants such(prenominal) as cocaine, depressants for example heroin, and h all tolducinogens such as dissimulation mush retinue. (http://www. admitthescore. info, 2005). In addition to the divergent groupings the constabulary divides drugs into three classes: A, B and C.\r\n varianceificati on is base on the rail at that specific drugs whitethorn bring on to single(a)s, families and communities. (NHS Health Scotland, 2004, P. 10). Class A drugs don on heroin, ecstasy and crack. In stage for drugs to work, they must setoff enter the body. The main ship rotteral that a drug basin be administered embarrass: orally, smoking, snorting and stack awaying. How a mortal will controvert after taking drugs will depend on a number of factors such as the type of drug, how it is interpreted, what it is mixed with, the cordial context and whether the person is on naked as a jaybird(prenominal) drugs at that time.\r\nFactors which whitethorn influence drug taking abide be split into cardinal broad categories: individual influences for example personalizedity or genetics and environmental influences such as society, match pressure or family. (Swadi, 1992, P. 156). All drugs affect the brains limbic shoesment irrespective of in that location efficaciousity. Di fferent drugs act on different argonas of the brain and alter the chemical balance and these deviates argon responsible for the feelings and sensations nearwhattimes associated with drug use. (NHS Health Scotland, 2004, P. 7).\r\nScientists call this the â€Å"reward” transcription. Usually, the limbic system responds to pleasurable experiences by releasing the neurotransmitter dopamine, which creates feelings of pleasure. This could explain wherefore lot go on to misuse drugs. However, somewhat muckle can occasionally use drugs without growing a tolerance or pulling out symptoms whereas otherwisewise the great unwashed abuse drugs by repeatedly using them to produce pleasure, alleviate stress, or negate reality. This can lead to other drug related problems such as drug colony.\r\nThere be devil types of settlement, psychological and somatogenetic. â€Å"Physical dependency comes when the body is divest of drugs……. this deprivation leads to p hysical symptoms that vary with the drug. ” Whereas â€Å"psychological dependency …… is based more on the individuals traits (habits, lifestyle) than on the substance itself. It is the memory of the pleasure associated with the object of the dependency that the individual thinks roughly often and capaciousingly. ” (http://thebrain. mcgill. ca/flash. par. tml, 2002)\r\nThis highlights that different drugs fork up different set up and will require different interventions depending on the substance being employ. do drugs dependency is characterised by craving a drug so much that it has control over the persons life. For example if individual is dependent on heroin and goes without it for any aloofness of time, they will suffer extremely unpleasant pulling out symptoms for several days. Taking heroin will make the drug user feel ‘normal again (Drugs have it away your Stuff, 2005).\r\nIn this respect the drugs be having a ‘medicinal effect on the individual be fuck off the drug relieves the person from their withdrawal symptoms. Drug use in todays society is a problem non only for the individual except for their families and communities. Drugs: protecting families and communities (2008) supports this by saying: â€Å"The most prejudicious fix for communities are those birthd by drug come up toing, drug related roughshod offence and anti- well-disposed behaviour, which can undermine fixed families and cohesive communities. ” In the UK drug the friendly effects of habituation are most publicly associated with criminality.\r\nDrugs know your stuff (2005, P. 21) identifies that: â€Å"E truly year or so 40,000 spate in the UK are arrested for drug offences. ” An example of a drug related offence could be shoplifting. This efficiency enable the drug user to raise coin to finance their drug use. It whitethorn also be associated with the stereotypical image of young flock draining hooded top s sniffing glue or `shooting up in shabby flats who are designate `junkies. However, drug use does not evermore fit into this image as it is not age, gender or class specific.\r\nFor example, gaberdine middle class great deal who use cocaine as a recreational drug do not need to wash up baffling in criminal offense to support their drug use. thitherfore drug use is not always spliceed to criminal offense. This is in contrast to the ingest of the authoritiess 1998 drug outline which had the main objective the plan to tackle drug abuse, first and foremost, as an burn up of reducing hatred. It focused generally on criminality and supported drug users who had grant curses. In addition to this, tonic measures were introduced under the Drugs bet (2005) where the focus is also primarily on criminality.\r\nThe new solve has implemented new police powers to examination for class A drugs such as heroin. These measures let in â€Å"testing on arrest” which means the great unwashed who are arrested for trigger offences are tested for drugs on arrest rather than when charged. The aim of this is to steer more offenders into interposition and away from crime. This will ensure that those who misuse drugs are not charged however religious goed to mesh in treatment. However, major power (2007) does not agree and believes that these measures should be discarded as they are ineffective and inefficient.\r\nAs an alternative baron recommends that greater use should be make of specialised drug courts. According to the juvenile regime drug outline (1998) on that point was a particular focus on problematic drug users and links to crime because statistics showed they were responsible for 99% of the be to society (estimated between i??10 and i??16 billion) 88% of which is drug related crime. (The Drugs Act, 2005) Therefore, often as an alternative to imprisonment a drug misusing offender within the criminal cleanice system will automaticall y be granted antecedence to access treatment.\r\nDrug Treatment and Testing Orders do under Section 1A (6) of the 1991 Criminal Justice Act compulsory offenders to attend drug treatment as a condition of a probation order. ” (Hough et al, 2003, P. 6). This may cause problems because when faced with a prison sentence or a treatment programme the majority of batch would most probable choose the latter on that pointofly removed when they do not want cooperate for their drug problems. Ironically, soul who is serious about getting suffice for their drug problems and has not broken the law will usually be placed on a long waiting list for treatment.\r\nAlthough, Tackling Drugs Changing Lives (2005) postulate that the average national waiting times for treatment have fallen almost three quarter since 2001; (from 9. 1 weeks in December 2001, to 2. 3 weeks in June 2007). However, this belt up could possibly result in non offenders slipping through the net especially s ince the most common referral route into treatment is self referral (NTA, 2006, P. 7). Thus possibly resulting in them not getting the treatment or support they require at that time.\r\nTherefore whilst they carry on on the waiting list for treatment tender workers have a responsibility to give advice on minimising harm associated with drug misuse. Government policy has prioritised criminal costs of drug use King (2007) states that the wider issues that surround drug misuse such as the effects on communities, families and health are not taken into distinguish. Therefore advocates a harm step-down policy by saying:\r\nâ€Å"Given that drugs may, and often do, cause significant harm to individuals, their family, their friends and their communities, the main aim of the law should be to castrate the nub of harm that they cause. In response to the 1998 drug strategy The Royal hunting lodge for the encouragement of Arts, Manufactures and Commerce (RSA), (2007) comment, through its cathexis, that drugs are a matter of health and not just crime. The Commission argues that addiction to drugs and other substances should be treated as a chronic health condition and a fond problem, not just a crime or cause of crime. In addition to this they also recommended that the primary aim of the new drugs policy should be to veer harm.\r\nThe review of the National Drug dodging in 2008 argued that the previous drugs policy did little to economic aid the problematic drug users and to mitigate the restore on drugs in society. professor Anthony Kings the Chairman of the RSA Commission explains that in their view drugs in society are not just about crime. They criticised the previous strategy by saying thither was too much tenseness on crime and that there needed to be a shift from crime reduction and the criminal justice system onto an understanding of the more alter and complex social problems.\r\nFor example the social consequences of drug use can include social exc lusion. good deal may lose their friends and family because of the stigma that surrounds drug misuse resulting in isolation. In addition to this drug use can have an impact on aliment standards and may result in homelessness for example if their drug use is given over priority over their dwelling house outgoings such as rent. Therefore King (2007) points that there should be wraparound run which include individual social needs such as employment and alert accommodations as these problems often come hand in hand with chaotic drug use.\r\nThe work of Professor A King has informed the new Government drug strategy and prior to the 2008 drug strategy being unveiled it was suggested by Prime look Gordon Brown that the new strategy would adopt a more holistic prelude when works with drug users and there would be more support for volume undergoing treatment. However, when the Governments new 2008 10-year drug strategy was revealed there were proposals to amaze the welfare system , effectively punishing drug abusers who unwrap to get â€Å"clean”. The Press Association (2008) highlighted that turn a profit payments to drug users may be dressd if they spill out of treatment.\r\nThis could possibly result in passel not accessing treatment for the fear of dropping out and having their income cut downd. Therefore the new strategy gives no circumstance to relapse. Drug relapse is a process that begins when an individual slips back into old behaviour patterns and as set by Regan (2003) as being the most electronegative characteristic of drug taking. Relapse may occur because drug users are often stereotyped and may find it disfranchised to reintegrate back into society. Therefore this proposal may not be very effective.\r\nIn addition to this if a drug misusing parents benefits are cut and they are faced with buying food, for their children, or drugs that they are dependent on they may not necessarily be capable of do a rational termination. Cle aver et al (1999, P. 245) lends support to this by stating: â€Å"Family income may be used to satisfy maternal(p) needs. Purchasing food and clothing or paid essential household bills may be sacrificed. ” However it is recognised that parental drug use may not always affect the parents capacity to look after their children well. The British Medical Association (1997, P. 8) highlights that: â€Å"Drug use itself by parents need not install a risk of exposure but neglect or abuse may be associated with problem drug use and should be addressed appropriately. ”\r\nHowever, long edge drug misuse could impact on the families living standards and possibly result in a destiny for Social Services to intervene under member 17 of The Children Act 1989. In addition to this good deal may resort to crime so they can afford the drugs they are dependent on. Critics of the new drug strategy say there should be more focus on treatment and less on punishment (http://drugshealtha lliance. et, 2008). Therefore better strategies need to be introduced to encourage drug users into treatment. An improvement to enable this could be not giving everyday Practitioners the alternative to avoid providing drug treatment. This would allow pot to be seen square(p) away by their General Practitioner and not placed on long waiting lists with other agencies. All drugs, hard or soft, wrong or intelligent can cause social problems to some degree. Although, it is suggested that many drugs are thought to cause problems plainly because they are il legitimate.\r\nHowever, The British Medical Association (1997, P. 385) highlights that: â€Å" some(prenominal) the Green and White Papers, Tackling Drugs Together, rejected any arguments for legalisation or decriminalisation on the grounds that wider use and addiction are very serious risks which no responsible Government should take on behalf of its citizens. ” In contrast to this view Mullis (2003, P. 3) argues that all drug laws should be abolished. The legalisation of drugs would mean that multitude could buy drugs but only through legal sources, thus removing a major criminal resource and reducing crime levels.\r\nThe British Medical Association (1997, P386) also suggests that crime would be significantly overthrowd if drugs could be purchased de jure and money spent on law enforcement could be spent on treatment and education. On the other hand there is evidence that drug users commit crimes for other reasons and not just to finance their habit. more drug users are involved in crime even when they have access to drugs on prescription medicine such as methadone. (Graham and Bowling, 1995, P. 49). Therefore the social understate of the drug user may also top to why they commit crimes.\r\nHowever, even if crime was not construeably reduced, quite a little buying drugs through legal sources would know the strength and quality of what they were using thus possibly reducing the risk of over dose. If drugs were legalised there is no evidence to indicate that crime levels would reduce. People would still need money to purchase drugs from legal sources and as highlighted by Robertson (1998, P. 209) it is uncertain that legislation would significantly reduce the cost of drugs. In addition to this alcohol and nicotine are highly addictive drugs that hold legal side.\r\nKing (2007) suggests that the pervert of Drugs Act (1971) should be repealed and replaced with a subvert of Substances Act which includes alcohol and tobacco. As well as being addictive they can also cause major health problems. For example smoking can cause chronic lung disease, coronary heart disease, strokes, and miscellaneous cancers. â€Å"Some doctors have even reported that nicotine is just as addictive as heroin or cocaine, which indicates quite clearly as to how people develop dependent so rapidly and stay hooked for so long. ” http://www. servicingwithsmoking. com/effects-of-nicotine. php) Heavy drinking is linked to suicide, murder, smuggled accidents, and many fatal diseases. It can increase chances of ontogenesis cirrhosis of the liver, and it has been associated with many different types of cancers. However, the NHS Direct (2008) accentuate that drinking a moderate amount of alcohol will not do any physical or psychological harm. In a recent survey Lifeline publications (2007) highlighted that slightly 114,000 people pass along every year from smoking tobacco.\r\nAbout 40,000 people die from using alcohol and the least amount of deaths occur as a result of all illegal drugs put together and is about 2,000 people. This clarifies that: â€Å"Although drug misuse poses risks to the user and others, from a health scene it still remains a small problem in relation to the medical harm caused by alcohol and nicotine. ” (The British Medical Association, 1997). Therefore it is unequivocal that the reason why some drugs are illegal is nothing to do with d angerousness.\r\nIf drug classification is based on the harm that specific drugs may cause to individuals, families and communities. NHS Health Scotland, 2004, P. 10) then unquestionably nicotine and alcohol would twain be classified. However, consideration needs to be given when looking at the above figures because more people may use alcohol and/ or tobacco because they are socially acceptable and hold legal status. If all drugs were legal, or the same amount of people who smoked used illicit drugs, then drug related deaths may significantly increase. However King (2007) suggests that the majority of people who use drugs are able to use them without harming themselves or others.\r\nWhich means, according to King, the use of illegal drugs is not always harmful anymore than alcohol use is always harmful. Although it is paramount that people are still aware of the risks involved when using legal or illegal drugs. For example high impact adverts explaining the effects on all drugs as well as warning messages on alcohol quasi(prenominal) to the messages on cigarette packets. Although King suggests that illegal drug use is not always harmful, heroin has been bedded the most dangerous drug by researchers The gig (2007).\r\nThese finding were based on three factors which were: physical harm; latent for dependence and the impact on society such as costs to health care. Heroin dependency is an increasing problem in the UK which causes high social and criminal costs. (Stimson, 2003, P. 1) Therefore, some view prescribing the drug as a way to reduce drug-related crime and others emphasise the advantages of heroin prescribing as a way of reducing health problems, for example blood borne viruses. However prescribing heroin may have risks as well as benefits.\r\nPrescribing might attract more people into treatment. More heroin users might get dish up as they would be identified thus resulting in fewer untreated heroin users in the community. In addition to this presc ribing would stop or reduce illicit heroin use. This would undercut the b miss grocery store in illicit heroin possibly back up to phase out drug dealers. BBC News (2002) also highlights that the idea has gained favour amongst some senior police officers, who believe it could reduce the amount of drug-related crime.\r\nHowever General Practitioners worry that prescribing heroin would maintain the level of dependency reducing any motivation for a person to stop using the drug creating an â€Å"addict for life. Therefore this may not necessarily be the silk hat response to drug misuse. Since we live in a drug taking society it is paramount that there are interventions on hand(predicate) to substance misusers to jockstrap downplay any potential harm. Under the National occupational Standards social workers have a duty to divvy up risk to individuals, families, carers, groups, communities, self and colleagues.\r\nSocial workers can help to reduce risks by implementing harm reduc tion strategies. â€Å" ravish reduction policies, programmes, operate and actions work to reduce the health, social and economic harms to individuals, communities and society that are associated with the use of drugs. ” (UKHRA, 2005) injure reduction has a very high visibility in drug treatment programmes it aims to focus on issues such as phonograph prick exchange schemes and the risk of infection. The strategy is led primarily through the NHS and influences the Drug Action Teams (DAT).\r\nHowever, the strategy mainly focuses on minimising harm associated with intravenous heroin use. The NTA (2006, P. 7) highlights that: â€Å"Heroin was identified as the main problem drug for over 2 thirds (67 per cent) of clients receiving drug treatment. ” Nevertheless, the strategy accepts that people are drug dependent and therefore consideration is given on how best to reduce harm this includes access to information and clean injecting equipment. However, information need s to be astray available, written in relevant languages, and produced in an tender format.\r\nWithout any focus on harm reduction there are issues with blood borne viruses such as Human Immunodeficiency Virus (HIV) and Hepatitis C that could be overlooked. Hepatitis C is a viral disease that destroys liver cells and can lead to cirrhosis and liver cancer. Balkin (2004) identifies that: â€Å"Most new cases of Hepatitis C occur in people who use contaminated needles or injecting equipment for drug use. ” Therefore although there are harm reduction programmes available for take away users they may not be easily accessible. For example, an intravenous heroin user who needed clean needles is not likely to travel a few miles by bus to collect them.\r\nThis could result in the person using, or sharing, dirty needles which increases the risk of blood borne viruses. With this is oral sex it may be useful to establish if there are mobile needle exchange assists available to espec ially in rural areas where people are often more isolated and may be less likely to travel long distances for clean needles. The advantages of this attend to could be that because the assist comes to the people who need it, clean injecting paraphernalia is more likely to be used therefore helping to reduce the risks of blood borne viruses.\r\nHowever, there may be some users who might be worried about using, or not want to use, a mobile needle exchange dish out. This could be because of the stigma attached to drug use and they may be worried about neighbours finding out that they have a drug problem. Another overhaul that may possibly help drug misusers to minimise harm is drug wasting disease suite. However this go is currently not available in the linked Kingdom. â€Å"Drug economic consumption rooms are places where dependent drug users are allowed to inject drugs in administer, hygienic conditions.\r\nThere are approximately 65 drug consumption rooms in operation in e ight countries around the humanity but there are none in the UK. ” (http://www. jrf. org. uk/pressroom/releases, 2006) Drug consumption rooms may help to minimise blood borne viruses and fatal overdoses. They would also help to take drug use off the streets and reduce numbers of discarded needles in public places. â€Å"Drug users who congregate in public areas or open drug scenes are often homeless and marginalised, and lack access to social and health care services.\r\nStudies suggest that severe health risks are linked to street-based injecting. ” (Klee, 1995; scoop up et al. , 2000). Additional services within the drug consumption rooms can include needle exchange, safer injecting advice, Hepatitis B vaccines, safer sex information as well as counseling, showering and washing facilities. However, as highlighted by Drugscope (2004), there are some areas of controversy concerning drug consumption rooms. For example could the Government justify providing a service th at enables people to engage legitimately in activities that are twain harmful and illegal?\r\nSince drug users will take drugs regardless of there harmfulness and legality the Government should take into consideration that drug consumption rooms have potential benefits. However, if these rooms were available in the UK they might encourage people to use hard drugs or increase drug related problems in the areas where they were located. In addition to this support from communities and local services such as police would be required if the consumption rooms were to be work in communities.\r\nNew or amended legislation may also be necessary since under the Misuse of Drugs Act (1971) drug possession for personal use is an offense. However if drug consumption rooms were legal then would drug possession be legal? If this was not the case then there would be a contradiction between the two. Other services available within the United Kingdom for drug misusers include wilful agencies such as drug support agencies, counselling, rehabilitation and aftercare services. Services available need to be both accessible and available to people who require them.\r\nThere are many different manakins that can be used when running(a) with people with addictions. However: â€Å"When working with substance misusers it is helpful to consider two different representatives, the ‘disease warning and the ‘wheel of change. ” (Goodman, 2007, P. 103). In the 19th century the first disease opinion was established. This mould considered that alcohol and drugs were evil and people who misused them were labelled victims. Therefore, alcohol and drugs addiction was starting to be seen as a disease that required treatment.\r\nIn the 20th century the second disease pattern evolved and alcohol consumption was once again socially acceptable. Only a small minority of individuals highly-developed a problem with excessive drinking. However, alcohol and drug addiction was still co nsidered as an illness that required treatment and support. Goodman (2007) highlights that the disease precedent works for some and is supported in self help groups such as Alcoholics Anonymous. He goes on to explain that people accessing the programme are told that they have a disease which prevents them from controlling their drink or drug problem.\r\n accordingly they need to avoid former drinking associates or drinking situation. However this copy has implications as the disposition of the disease has never been identified. It also suggests that a person with drug or alcohol problems has no choice or control over their decision making thus taking away their personal responsibility. slam (2006) lends support to this by saying: â€Å"Drug misuse is not a disease; it is a decision, like the decision to step out in bearing of a moving car.\r\nYou would call that not a disease but an error of judgement. In addition to this by following the disease imitate there is no considera tion given to other factors such as psychological, cultural and family factors which may influence why someone may misuse substances. Therefore it does not adopt a holistic approach when living the service user. However according to National wreak on Drug Abuse (2008) drug addiction is a brain disease and highlights that: â€Å"Although initial drug use might be voluntary, drugs of abuse have been shown to alter gene expression and brain circuitry, which in turn affect human behaviour.\r\nOnce addiction develops, these brain changes interfere with an individuals ability to make voluntary decisions, leading to compulsive drug craving, seeking and use. ” However, although this model will work for some people it may restrict social workers with their intervention because the model requires off abstinence. Therefore there would be no harm reduction strategies needed such as needle exchange. The model also contradicts the General Social worry Council Codes of Practice (2002) a s it does not work in an anti-oppressive manner.\r\nFor example, by following the disease model approach the service user is not treated as an individual with individual needs and choices but as a person with no choice, control or autonomy over their situation because they are labelled as having a disease. In addition to this because the model does not adopt a holistic approach factors such as housing, employment and education are not taken into consideration. Although this model works for some consideration still needs to be given to the wider problems that surround drug misuse. The second model, the ‘wheel of change was intentional by Prochaska and Diclemente (1994).\r\nIt was produced from work they had done with people wish to change their smoking behaviour, it soon became evident that their possibleness was helpful for all addictive behaviours. It is a holistic approach and looks at areas such as housing and financial issues when supporting someone throughout the diff erent stages of their alcohol or drug problems. Since the model is holistic it also allows social workers to work in union with other agencies such as housing. As far as social work practice is touch on this model is the value base of the codes of practice as it works within a positive exemplar promoting anti oppressive practice.\r\nIn this model there is a cyclical process. It starts with a distributor point of pre-contemplation when the service user does not know or feel that they have a problem. For those who are thinking about change they are at the contemplation stage. This is when the service user acknowledges the risks and problems caused by their behaviour and recognise the benefits of ever- changing their behaviour. This may be when services are accessed, such as drug treatment agencies, for support. Following the period of contemplation service users who feel that change is coveted and possible begin preparing for the change.\r\nThis stage of the cycle involves view goals and making plans. Social workers can help service users by using motivational interviewing. This emphasises the say-so of the service user and seeks to involve them in the work of changing their behaviour. It is non-judgmental, non-confrontational and non-adversarial. The approach attempts to increase the service users awareness of the potential problems caused, consequences experienced, and risks faced as a result of the drug taking behavior. However a great deal of commitment is required from the service user for this model to work.\r\nOnce the goals have been established the changes need to be implemented. If plans are clear and goals are realistic they are more likely to be long stable because service users may feel they can give way their aim. Strategies to deal with problematic situations that may arise, such as relapse, are also very important, as are rewards for success and ongoing support. Adapting to this new behaviour is a difficult period where huge support is r equired, such as positive encouragement, to enable the service user to move into a period of maintaining the change.\r\nHowever service users need to believe in the possibility of change otherwise this model will not work. For example, someone who had committed a crime for a drug related offence and chosen treatment over prison may not identify their drug use as a problem. Therefore this model would not work because they have not even pre contemplated change. The wheel of change model links with the social model and allows social worker more flexibleness when working with service users who misuse substances because it is predominately about empowerment and it involves the service user.\r\nThis approach helps people recognise the risks involved with their behaviour and allows them to do something about it. Conclusion Drug misuse in Britain is a substantial and growing problem. It is not only a problem for the individual but for the Government and society. Problems for the Government could include change magnitude crime resulting in financial costs and overcrowded prisons. Problems for the individual include social exclusion, physical and mental health problems, finance and legal issues and relationship problems.\r\nProblems for society include increased crime and increased cost on resources for example treatment and rehabilitation, police and social service involvement. Therefore treating the individual would benefit society and the Government. Policies to help treat individuals should include wraparound services which include issues such as housing, legal and financial issues and should also allow good aftercare treatment. However the new 2008 10-year drug strategy focuses more on punishment than on treatment and does not take relapse into consideration. Therefore new strategies need to be introduced to encourage people into treatment.\r\nIn addition to access to treatment should be made easier for non offenders because at present problematic drug users who commit offences get preferential treatment over those who also have problematic drug problems but have not committed any offences. Society place different values on drugs and although alcohol and nicotine are highly addictive drugs they hold legal status and are socially acceptable. However, although legalising all drugs may be unrealistic and could possibly encourage drug use it would allow drugs to be bought from legal sources.\r\nTherefore crime levels may reduce and people would know barely what they were buying thus possibly preventing overdose. There is a large emphasis on harm reduction strategies, which mainly focus on heroin misuse, and although interventions such as needle exchange services are available for drug misusers they are not always easily accessible. Introducing drug consumption rooms to the United Kingdom has advantages as well as disadvantages. It is a controversial subject and has many contradictions regarding the law.\r\nHowever provided they were supervised and people used them the advantages outweigh the disadvantages. The disease model allows social workers limited tractableness when working with service users who misuse substances as it does not adopt a holistic approach. It also links with the medical model as the individual is regarded as a victim. It suggests that a person with drug or alcohol problems has no choice or control over their decision making thus taking away their personal responsibility. In addition to this it does not take into poster harm reduction as the aim of the disease model is complete abstinence.\r\nWhereas the wheel of change model takes into consideration the possibility of relapse when working with drug misusers and respects the autonomy of the service user to make their own decisions. It allows social worker more flexibility because it is predominately about empowerment and it seeks to involve the service user changing their behaviour. It adopts a holistic approach when working with people with addict ions of any kind and therefore social workers work in partnership with other agencies or professionals to help support the individual with additional problems that link to their substance misuse.\r\nThe wheel of change model takes into account both physical and psychological factors again allowing social workers more flexibility with their intervention. Although the disease model can work for some individuals it requires limited intervention from social workers whereas the wheel of change model adopts a holistic approach which gives social workers more flexibility when working with service users who misuse substances.\r\n'