were maybe 20 services , mostly two people and a dog ,’ says outgoing Scottish Drugs Forum CEO Dave Liddell of Scotland ’ s drugs sector in the mid ‘ 80s . ‘ There were no local planning structures or anything , so you had almost a blank sheet to develop policies and ideas .’

He ’ s retiring this month , having worked at SDF since it was set up in 1986 – the longest job he ’ d had before ‘ was about 18 months ,’ he says , so his tenure has safely beaten that record . He ’ d previously trained as a biochemist , then become a social worker before going to work for SCODA , the forerunner of DrugScope .

Parts of Scotland were already in the grip of a serious heroin problem when SDF was set up , and he was one of the people calling for the establishment of needle exchanges . ‘ There was a complete lack of knowledge in terms of the development of anything

like that , but obviously HIV drove those changes so even the Tory government at the time had to agree to needle exchanges being developed .’

‘ DUNGEONS OF DEATH ’ The arguments were not dissimilar to later debates around naloxone and the current back and forth over consumption rooms . ‘ It ’ s like all these things – there ’ s a period where they ’ re completely controversial , then they become mainstream and no one remembers the time when you were pilloried for suggesting them ,’ he says . ‘ I remember we had a conference in 1996 on drug consumption rooms with a speaker over from the Netherlands – the headline in one newspaper was “ Dungeons of death ”.’

The whole debate around drugs has moved on significantly , with a growing recognition that many people with a drug problem will have underlying trauma or other mental health issues . ‘ We ’ ve obviously still got a huge way to

go , but we have made progress . Incremental change is mostly the way things happen , particularly in controversial areas .’

Looking back at the biggest changes he ’ s seen over almost four decades in the sector , the current level of service provision is a ‘ huge one ’, he says . ‘ I think we forget that we have pretty well-developed provision of help and support . We ’ ve just been through so many epochs – from the abstinence approach in the mid ‘ 80s to HIV and public health and the move towards harm reduction .’ Then came the ‘ whole focus on recovery , particularly abstinent recovery . I think we suffered significantly from that in terms of a narrow focus . We ’ ve obviously come through that now , but at some considerable cost .’

GOOD PROGRESS In the Scottish context while there ’ s more money in the system there ’ s now another issue which is ‘ one of bureaucracies and the numbers of policy folk involved ’, he says . ‘ I

guess the difference from ’ 86 is that we could produce a paper or run a conference on anything , and there was no one to tell us we couldn ’ t . Now it ’ s so cluttered , and that ’ s the bit I won ’ t miss – it becomes quite a lot harder to achieve anything because of the slowness . We ’ ve made quite good progress with medication-assisted treatment and same-day prescribing – all that stuff is brilliant and I think we can say we were significant drivers of that , particularly in the early stages , but it ’ s become very hard to see the wood for the trees just because of the number of people involved .’

It mirrors a wider problem in the system with the move to much larger providers and the potential that the therapeutic relationship might suffer as a result , he believes . ‘ It can sometimes be hard to provide a really individualised service . In the peer research we do , people name a particular person who ’ s helped them to get better .’ When someone who presents to a service gets seen by a different person each time ,

sdf . org . uk

16 • DRINK AND DRUGS NEWS • MAY 2023

WWW . DRINKANDDRUGSNEWS . COM