Community perceptions of drugs and drug services: perspectives from 3 ethnic minority communities in Edinburgh. Tasneem Irshad

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1 Community perceptions of drugs and drug services: perspectives from 3 ethnic minority communities in Edinburgh Tasneem Irshad

2 Background: Initiative from Scottish Government Drugs policy unit to increase understanding of the needs of Scotland s Black & Minority Ethnic (BME) communities in relation to problem drug use. NHS Lothian and the University of Edinburgh jointly applied for funding from the Equalities Fund in May 2009

3 Aims of the research project Increase knowledge within NHS Lothian, the communities it works with and its partner organisations about how Black & Minority Ethnic (BME) communities are affected by drugs, the nature of the problems they experience and the help they would like to receive. Increase awareness of drug issues in BME communities and improved capacity to engage with health services to address these.

4 The communities selected Black African & Caribbean South Asian Middle-Eastern

5

6 Why we chose the three communities (1) Black African/Caribbean communities newer migrant population in Scotland. South Asian communities comprise a mix of both older and recently settled populations Arab communities younger transient population

7 Why we chose the three communities (2) Anecdotal evidence from drug and mental health services of increasing use by people from these communities Support other work to engage with these communities on health issues, e.g. sexual health, HIV Provided an opportunity to engage with a relatively new community (Arabic-speaking community)

8 Methodology Three interviewers appointed from the three communities to carry out the interviews. Majority of interviews conducted in English or in a mixed language setting where English and the person s first language were used. Participants recruited from both community groups and snowball

9 Recruitment: Community Females Males Total Format African Single Interviews South Asian Focus Groups 8 Interviews Arabic Single interviews

10 Data Analysis Interviewers followed a semi structured qualitative interview schedule, interviewing both individuals and focus groups within the communities in both public and private settings. Data coded according to emergent themes

11 Planning and oversight Steering group: Edinburgh University City of Edinburgh Council (Edinburgh Alcohol & Drugs Partnership) NHS Lothian s Minority Ethnic Health Inclusion Service (MEHIS) NHS Lothian s Equality & Diversity team NHS Lothian s Public Health & Health Policy Department Scottish Government Drugs Policy Unit representatives also in attendance Met 4 times over duration of project

12 Findings: African community Main drugs identified included cannabis, alcohol, tobacco, steroids and crack cocaine Various reasons for drug use: Boredom, loneliness, peer pressure and lax social morals benefit system it makes people lazy and left them time to think about drugs. The Government is the cause, benefits, they make people lazy. African male

13 Religion a strong factor, with many respondents taking a negative moral view of drug users taking drugs is wrong because it is against religious beliefs, as drugs make people behave strangely ( out of a natural order ) and behave badly. African male

14 Although drugs are shameful, I would prefer my daughter was hooked on drugs than have a teenage pregnancy. South Asian female Findings: South Asian community Main concerns about alcohol, steroids, cannabis and prescription drugs e.g. painkillers, with some young males referring to heroin Shame associated with drugs less in comparison with other social issues:

15 Findings: Arabic community Some knowledge of cannabis and heroin. Strongest levels of denial of drug use among the selected communities; I don t know what you mean, you are telling me people take drugs in our community? I have two sons and if I knew one of them is using drugs he would not be my son anymore. Finished. Older Arab male

16 Younger people interviewed were more aware of recreational drug use: in my experience all kinds of people take drugs Yes, a number of people in the community have been using or been affected by drugs use. Young Arab male Strong influence of religion and notions of shame and stigma

17 Cross cutting issues: Awareness of drug use Common across all communities Uniformly negative religious views towards drug use and drug users South Asian respondents more pragmatic

18 Cross cutting issues: religion Uniformly negative religious views towards drug use and drug users Religious leaders distrusted but sometimes called to aid families e.g. perform exorcisms

19 Cross cutting issues: Impact of drug use General agreement about detrimental impact of drug use on users and families: Exclusion from own community for whites it is no problem as parents can still accept them but for Africans it is a big problem African male Inability to socially and economically contribute to family and life

20 Cross cutting issues: Managing drug use Differences between communities: Asians more likely to favour cold turkey or early marriage. This strategy was treated with derision by female participants who felt that such families were. deceiving innocent girls who would only realise the truth of their situation once they were in this country away from their kin

21 Cross cutting issues: gender Arabic-speaking and South Asian women had more awareness of alcohol, cannabis and prescriptive medicine abuse within friendship and familial groups. Gender expectations and depression cited as one reason for drug abuse Males cited migration, unemployment and peer pressure as reasons for drug

22 Cross cutting issues: access to drugs Drugs were obtained from many sources: Some buy from dealers, some from their home countries, some grow cannabis. African male Drugs funded by theft, benefit money and from the family business

23 Cross cutting issues: traditional drugs Traditional substances such as Khat Nuswar (snuff) and paan were not viewed as drugs: Many of us smoke and chew khat. We don t treat these as drugs. Young Arab male Traditional drugs seen as way of retaining cultural link with back home where they are used in social gatherings.

24 Cross cutting issues: access to support Little knowledge of how to access information or educational materials. GP considered first point of contact. Fear of stigma in addition to issues of trust and confidentiality. Communication/language barriers.

25 Strategies for prevention and recovery Targeting children earlier in education programmes Counselling; both patient and family centred. Better awareness of impact of drug use. More use of local community groups e.g Fast Forward and Amina.

26 Conclusions: Reasons for drug use Changing nature of substances used What constitutes a drug? Ways of coping with drug use can differ Access to services

27 Recommendations 1. Better diversity monitoring of users of drug services 2. More culturally-sensitive health promotional and awareness-raising activities 3. Ethnicity and cultural specifications to be included in all drug service commissioning 4. Develop the knowledge and skills within communities to address misconceptions about drugs and improve awareness about services 5. Stronger communication of the confidentiality of drug services particularly to BME communities.

28 Future challenges and opportunities Building recommendations into Alcohol & Drug (& Tobacco) Partnership plans Further research required into drug use within hidden groups such as LGBT communities, travelling communities and asylum seekers. Prevalence of drug use and types of drugs. Sharing learning from other DPUfunded research projects with

29 Questions James Glover Head of Equality & Diversity NHS Lothian

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