Abstract
There is an unprecedented level of deaths from alcohol and other drugs in Scotland, and rural areas are not immune to the devastation that addiction can bring on individuals, their families, and their communities. But addiction looks different in rural Scotland in comparison to its urban counterparts, where the vast majority of recovery services are based. This chapter will look at why this is: It will look at how crime, poverty, stigma and urbanisation contribute to a stereotype of what a person with a substance use disorder ‘looks like’ and its impact in how research and services around recovery are funded. The chapter will also explore the seldom seen barrier of affluence as a contributor to addiction being hidden in rural areas. It will argue that addiction in rural Scotland is hidden in plain sight.
Additionally, the chapter will look at how someone with a substance use disorder may face additional barriers in accessing support in rural Scotland, as well as how the informality of rural local agencies and support can benefit a person who may be struggling with a substance use disorder.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Abernethy, C., McCall, K. E., Cooper, G., Favretto, D., Vaiano, F., Bertol, E., & Mactier, H. (2018). Determining the Pattern and Prevalence of Alcohol Consumption in Pregnancy by Measuring Biomarkers in Meconium. Archives of Disease in Childhood. Fetal and Neonatal Edition, 103(3), 216–220.
Bailey, N., Spratt, J., Pickering, J., Goodlad, R., & Shucksmith, M. (2004). Deprivation and Social Exclusion in Argyll and Bute - Report to the Community Planning Partnership. Accessed April 2022, from https://www.researchgate.net/publication/237760118_Deprivation_and_social_exclusion_in_Argyll_and_Bute_Report_to_the_Community_Planning_Partnership
Bellis, M. A., Hughes, K., Leckenby, N., Perkins, C., & Lowey, H. (2014). National Household Survey of Adverse Childhood Experiences and Their Relationship with Resilience to Health-Harming Behaviours in England. BMC Medicine, 12, 72.
Bernard, C. (2017). An Exploration of How Social Workers Engage Neglectful Parents from Affluent Backgrounds in the Child Protection System. Child Family & Social Work, 24(2), 340–347.
Brown, P., & Head, B. (2019). Navigating Tensions in Co-production: A Missing Link in Leadership for Public Value. Public Administration, 97(2), 250–263.
Butler, A., Schafran, A., & Carpenter, G. (2018). What Does It Mean When People Call a Place a Shithole? Understanding a Discourse of Denigration in the United Kingdom and the Republic of Ireland. Transactions of the Institute of British Geographers, 43(3), 496–510.
Carrell, S. (2008). Heroin Death Exposes Shetland Drugs Blight. The Guardian Online. Accessed April 2022, from https://www.theguardian.com/uk/2008/apr/23/scotland.drugstrade
Chan, G. C. K., Leung, J., Quinn, C., Kelly, A. B., Connor, J. P., Weier, M., & Hall, W. D. (2016). Rural and Urban Differences in Adolescent Alcohol Use, Alcohol Supply, and Parental Drinking. The Journal of Rural Health, 32, 280–286.
Chandler, A. & Nugent, B. (2016). Alcohol Stories: A Lifecourse Perspective on Self-Harm, Suicide and Alcohol Use Among Men. Accessed December 2022, from http://www.meldap.co.uk/data/uploads/finalreport-alcohol-stories.pdf
Church, S., Bhatia, U., Velleman, R., Velleman, G., Orford, J., Rane, A., & Nadkarni, A. (2018). Coping Strategies and Support Structures of Addiction Affected Families: A Qualitative Study from Goa, India. Families, Systems & Health, 36(2), 216–224.
Cragg, A. (2003). Drugs in Rural Areas: Qualitative Research to Assess the Adequacy of Communications and Services. Home Office.
Cree, V., Jain, S., & Hillen, P. (2016). The Challenge of Measuring Effectiveness in Social Work: A Case Study of an Evaluation of a Drug and Alcohol Referral Service in Scotland. The British Journal of Social Work, 46(1), 277–293.
Daly, C. (2014). Mental Health Services and Social Inclusion in Remote and Rural Areas of Scotland and Canada: A Qualitative Comparison. [Dissertation]. Accessed March 28, 2022, from https://pure.uhi.ac.uk/portal/files/3084034/Clare_Daly_thesis.pdf
Damon, W., Callon, C., Wiebe, L., Small, W., Kerr, T., & McNeil, R. (2017). Community-Based Participatory Research in a Heavily Researched Inner City Neighbourhood: Perspectives of People Who Use Drugs on Their Experiences as Peer Researchers. Social Science & Medicine, 176, 85–92.
Dirks, H., Francke, L., Würz, V., Kretschmann, C., Dehghan-Sanij, S., & Scherbaum, N. (2019). Substance Use, Comorbid Psychiatric Disorders and Suicide Attempts in Adult FASD Patients. Advances in Dual Diagnosis, 12(1/2), 6–13.
Duffy, C., & Smith, C. (2016). Community Attitude Research on Alcohol and Other Drugs, Qualitative Research Report. Australian Government Department of Health. Accessed March 25, 2022, from https://www.health.gov.au/resources/publications/community-attitude-research-on-alcohol-and-other-drugs-qualitative-report
Ellis, L. & Grant, J. (2019) NHS GGC Guidelines on Neonatal Abstinence Syndrome. Accessed December 18, 2021, from https://www.clinicalguidelines.scot.nhs.uk/nhsggc-guidelines/nhsggc-guidelines/neonatology/neonatal-abstinence-syndrome-nas/
Fecht, D., Jones, A., Hill, T., Lindfield, T., Thomson, R., Hansell, A. L., & Shukla, R. (2017). Inequalities in Rural Communities: Adapting National Deprivation Indices for Rural Settings. Journal of Public Health, 2, 1–425.
Filipe, A., Renedo, A., & Marston, C. (2017). The Co-production of What? Knowledge, Values, and Social Relations in Health Care. PLoS Biology, 15(5), e2001403.
Forsyth, A., & Barnard, M. (1999). Contrasting Levels of Adolescent Drug Use Between Adjacent Urban and Rural Communities in Scotland. Addiction, 94(11), 1707–1718.
Galloway, J., Forsyth, A. & Shewan, D. (2007) Young People’s Street Drinking Behaviour: Investigating the Influence of Marketing & Subculture. Glasgow Centre for the Study of Violence. Accessed March 2022, from https://alcoholchange.org.uk/publication/young-peoples-streetdrinking-behaviour-investigating-the-influence-of-marketing-subculture
Gralton, E. (2014). Foetal Alcohol Spectrum Disorder (FASD) – Its Relevance to Forensic Adolescent Services. Journal of Intellectual Disabilities and Offending Behaviour, 5(3), 124–137.
Greer, A. M., Pauly, B., Scott, A., Martin, R., Burmeister, C., & Buxton, J. (2019). Paying People Who Use Illicit Substances or ‘Peers’ Participating in Community-Based Work: A Narrative Review of the Literature. Drugs: Education, Prevention and Policy, 26(6), 447–459.
Healthcare Improvement Scotland. (2019). Foetal Alcohol Spectrum Disorder: A Booklet for Parents, Carers and Families of Children and Young People Exposed to Alcohol During Pregnancy. ISBN 978-1-909103-72-6. Accessed December 2021, from https://www.sign.ac.uk/assets/pat156_fasd.pdf?msclkid=aa90bf16a2fd11ec8a1aafdebe41fa98
Holleran, J (2020) Constantly Just Holding It Up and Together. Exploring Family Support in Relation to Problem Substance Use in Scotland. Scottish Families Affected by Alcohol and Drugs. Accessed January 20, 2022, from rhttps://www.sfad.org.uk/content/uploads/2020/12/Constantly-Just-Holding-It-Up-and-Together-Report.pdf
Institute of Alcohol Studies. (2020). Alcohol and Health Inequalities. Accessed January 2022, from https://www.ias.org.uk/wp-content/uploads/2020/12/Alcohol-and-health-inequalities.pdf
Krentzman, A., & Glass, L. (2021). Gossip and Addiction Recovery in Rural Communities. Qualitative Health Research, 31(14), 2571–2584.
MacDonald, S. (2020). Whisky, Women and the Scottish Drink Problem. A View from the Highlands. In M. McDonald (Ed.), Gender, Drink and Drugs. Routledge.
MacLeod, A., Glancy, M., Went, A., Smith, S., Weir, A., McAuley, A., Hutchinson, S., & Goldberg, D. (2019). Surveillance Report: Surveillance of Hepatitis C Testing, Diagnosis and Treatment in Scotland, 2019 Update. Accessed April 2022, from https://hpspubsrepo.blob.core.windows.net/hps-website/nss/2834/documents/1_hcv-testing-diagnosis-treatment-scotland-2018.pdf
Marryat, L., & Frank, J. (2019). Factors Associated with Adverse Childhood Experiences in Scottish Children: A Prospective Cohort Study. BMJ Paediatrics Open, 3, e000340.
Martin, G., Inchley, J., Marshall, A., Shortt, N., & Currie, C. (2019). The Neighbourhood Social Environment and Alcohol Use Among Urban and Rural Scottish Adolescents. International Journal of Public Health, 64(1), 95–105.
Matthews, B., Collier, B., McVie, S., & Dibben, C. (2021). Understanding Digital Drug Markets Through the Geography of Postal Drug Deliveries in Scotland. European Journal of Criminology. https://doi.org/10.1177/1477370821997323
Munro, C. (2020). Orkney Drugs Dog Helps Police in Glasgow Sniff Out. £10,000 Substances. The Press and Journal. Accessed April 2022, from https://www.pressandjournal.co.uk/fp/news/highlands-islands/2590348/orkney-drug-dog-efforts-lead-to-woman-charged-in-glasgow/
National Records of Scotland. (2021a). Alcohol Specific Deaths in Scotland Increase. Accessed April 2022, from https://www.nrscotland.gov.uk/news/2021/alcohol-specific-deaths-in-scotland-increase
National Records of Scotland. (2021b). Drug-Related Deaths Rise. Accessed April 2022, from https://www.nrscotland.gov.uk/news/2021/drug-related-deaths-rise
National Statistics Scotland. (2018). Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALUS). Scottish Government. Accessed October 2021, from https://www.gov.scot/publications/scottish-schools-adolescent-lifestylesubstance-use-survey-salsus-alcohol-report-2018/
NHS Ayrshire & Arran Specialist FASD Centre. (n.d.). Accessed April 2022, from https://www.nhsaaa.net/media/7953/fasd-a-lifelong-condition-blog.pdf
NHS National Services Scotland. (2019). Prevalence of Problem Drug Use in Scotland. Accessed April 2022, from https://www.isdscotland.org/Health-Topics/Drugs-and-Alcohol-Misuse/Publications/2019-03-05/2019-03-05-Drug-Prevalence-2015-16-Report.pdf
NICE. (2016). Chapter 6 Reviewing the Evidence. In Social Care Guidance Manual. Accessed March 2022, from https://www.nice.org.uk/process/pmg10/chapter/reviewing-the-evidence
Orford, J. (2017). How does the common core to the harm experienced by affected family members vary by relationship, social and cultural factors? Drugs: Education, Prevention and Policy, 24(1), 9–16. https://doi.org/10.1080/09687637.2016.1189876
Orford, J., Velleman, R., Copello, A., Templeton, L., & Ibanga, A. (2010). The Experiences of Affected Family Members: A Summary of Two Decades of Qualitative Research. Drugs: Education, Prevention and Policy, 17(s1), 44–62.
Pape, H., Rossow, I., Andreas, J. B., & Norström, T. (2018). Social Class and Alcohol Use by Youth: Different Drinking Behaviors, Different Associations? Journal of Studies on Alcohol and Drugs, 79, 132–136.
Parr, H., Philo, C., & Burns, N. (2004). Social Geographies of Rural Mental Health: Experiencing Inclusions and Exclusions. Transactions of the Institute of British Geographers, 29, 401–419.
Public Health Scotland. (2020). Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS). Accessed November 2021, from https://publichealthscotland.scot/media/3089/mesas-monitoring-report-2020-english-updated-march-2021.pdf
Public Health Scotland. (2021). Births in Scottish Hospitals. Accessed March 2022, from https://publichealthscotland.scot/publications/births-in-scottish-hospitals/births-in-scottish-hospitals-year-ending-31-march-2021/
Pugh, R. (2007). Dual Relationships: Personal and Professional Boundaries in Rural Social Work. The British Journal of Social Work, 37(8), 1405–1423.
Radley, A., de Bruin, M., Inglis, S. K., Donnan, P. T., Hapca, A., Barclay, S. T., Fraser, A., & Dillon, J. F. (2020). Clinical Effectiveness of Pharmacist-Led Versus Conventionally Delivered Antiviral Treatment for Hepatitis C virus in Patients Receiving Opioid Substitution Therapy: A Pragmatic, Cluster-Randomised Trial. The Lancet Gastroenterology & Hepatology, 5(9), 809–818.
Roderick, E., Penney, J., Murrells, T., Darganl, I., & Norman, J. (2018). Epidemiology of Adolescent Substance Use in Norfolk Schools. QJM: An International Journal of Medicine, 111(10), 699.
Schölin, L., & Fitzgerald, N. (2019). The Conversation Matters: A Qualitative Study Exploring the Implementation of Alcohol Screening and Brief Interventions in Antenatal Care in Scotland. BMC Pregnancy and Childbirth, 19316, 1–11.
Scottish Drugs Death Taskforce. (2020). A Strategy to Address the Stigmatisation of People and Communities Affected by Drug Use - We All Have a Part to Play. Accessed January 2022, from https://drugdeathstaskforce.scot/media/1111/stigma-strategy-for-ddtf-final-290720.pdf
Scottish Executive Interventions Unit. (2004). Rural and Remote Areas: Effective Approaches to Delivering Integrated Care for Drug Users. ISBN-10:0755925912. Accessed March 2022, from https://core.ac.uk/download/34711094.pdf
Scottish Families Affected by Alcohol & Drugs. (2020). Helpline Report 18th March to 30th July 2020. Report Available upon request from https://www.sfad.org.uk/
Scottish Families Affected by Alcohol and Drugs. (2019). Behind the Numbers Findings Report. Accessed January 2022, from https://www.sfad.org.uk/content/uploads/2020/05/Behind-the-Numbers-Findings-Report.pdf
Scottish Government. (2015). Community Empowerment (Scotland) Act. Accessed November 2021, from https://www.legislation.gov.uk/asp/2015/6
Scottish Government. (2017). Scottish Maternal and Infant Nutrition Survey. Accessed April 2021, from https://www.gov.scot/binaries/content/documents/govscot/publications/statistics/2018/02/scottish-maternal-infant-nutrition-survey-2017/documents/00531610-pdf/00531610-pdf/govscot%3Adocument/00531610.pdf
Scottish Government. (2018). Rights, Respect and Recovery: Scotland’s Strategy to Improve Health by Preventing and Reducing Alcohol and Drug Use, Harm and Related Deaths. Accessed December 2021, from https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2018/11/rights-respect-recovery/documents/00543437-pdf/00543437-pdf/govscot%3Adocument/00543437.pdf?forceDownload=true
Scottish Government. (2019a). Scottish Health Survey. Accessed January 2022, from https://www.gov.scot/publications/scottish-health-survey-2019-volume-1-main-report/
Scottish Government. (2019b). Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS): national overview 2018. Accessed November 2021, from https://www.gov.scot/publications/scottish-schools-adolescent-lifestyle-substance-use-survey-salsus-national-overview-2018/documents/
Scottish Government. (2019c). National Islands Plan. Accessed March 2022, from https://www.gov.scot/publications/national-plan-scotlands-islands/documents/
Scottish Government. (2020a). How Is Social Capital Distributed in Scotland? – Social Capital in Scotland Report. Accessed October 2021, from https://www.gov.scot/publications/social-capital-scotland-measuring-understanding-scotlands-social-connections/pages/6/
Scottish Government. (2020b). The Scottish Crime and Justice Survey 2019/2020. Accessed March 2022, from https://www.gov.scot/publications/scottish-crime-justice-survey-2019-20-main-findings/pages/2/#:~:text=The%202019%2F20%20Scottish%20Crime%20and%20Justice%20Survey%20%28SCJS%29,of%20being%20a%20victim%20of%20crime%20since%202008%2F09
Scottish Government. (2022). Long-Term Monitoring of Health Inequalities. Accessed April 2022, from https://www.gov.scot/publications/long-term-monitoring-health-inequalities-march-2022-report/
SHAAP (Scottish Health Action on Alcohol Problems). (2020). Rural Matters: Understanding Alcohol Use in Rural Scotland. A Qualitative Study. Accessed November 2021, from https://shaap.org.uk/our-work/alcohol-rural-communities.html
SHAAP (Scottish Health Actions on Alcohol Problems). (2018). Dying for a Drink: SHAAP Report on Alcohol Related Mortality in Scotland. Royal College of Physicians. Accessed November 2021, from https://www.shaap.org.uk/images/dying-for-a-drink-text_for_web.pdf
Sher, J. (2017). Accessed March 2022, from https://www.holyrood.com/comment/view,prevention-means-never-having-to-say-youre-sorry_7227.htm
Sher, J., Frank, J. W., Doi, L., & Caestecker, L. (2019). Failures in Reproductive Health Policy: Overcoming the Consequences and Causes of Inaction. Journal of Public Health, 41(2), 209–215.
Skerratt, S., Meader, E., & Sprencer, M. (2017) National Rural Mental Health Survey Scotland: Report of Key Findings. Scottish Rural University College. Accessed April 2022, from https://www.sruc.ac.uk/downloads/download/1239/national_rural_mental_health_survey_scotland_report_of_key_findings
Skerratt, S. (2018). Recharging Rural. Creating Sustainable Communities to 2030 and Beyond. The Prince’s Trust Countryside Fund. Accessed April 2022, from https://www.princescountrysidefund.org.uk/our-impact/our-research/recharging-rural/
Stallwitz, A., & Shewan, D. (2004). A Qualitative Exploration of the Impact of Cultural and Social Factors on Heroin Use in Shetland (Scotland). Journal of Psychoactive Drugs, 36(3), 367–378.
Still, H. (2020). Paradise Explored – Investigating the Experiences of Alcohol and Drugs on Arran – Health and Social Communication and Barriers to Care. Arran Council of Voluntary Service.
Streissguth, A. P., Bookstein, F. L., Barr, H. M., Sampson, P. D., O’Malley, K., & Young, J. K. (2004). Risk Factors for Adverse Life Outcomes in Fetal Alcohol Syndrome and Fetal Alcohol Effects. Journal of Developmental Behaviour in Pediatrics, 25(4), 228–238.
Turbett, C. (2014). Doing Radical Social Work. Palgrave.
Turbett, C., (2019). Rural Social Work in Scotland. Iriss. Accessed April 2022, from https://www.iriss.org.uk/resources/insights/rural-social-work-scotland
Turbett, C. (2020). Rediscovering and Mainstreaming Community Social Work. Iriss. Accessed April 2022, from https://www.iriss.org.uk/resources/insights/rediscovering-and-mainstreaming-community-social-work-scotland
UK Health and Security Agency. (2021). Shooting Up: Infections and Other Injection Related Harms Among People Who Inject Drugs in the UK 2020. Accessed March 2022, from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1053202/Shooting_Up_2021_report_final.pdf
Vivancos, R., Maskrey, V., Rumball, D., Harvey, I., & Holland, R. (2006). Crack/Cocaine Use in a Rural County of England. Journal of Public Health, 28(2), 96–103.
Whiteford, M., Haydock, W., & Cleave, N. (2016). Two Buses and a Short Walk: The Place of Geography in Recovery. Drugs and Alcohol Today, 16(1), 72–83.
World Health Organisation. (2018). Global Status on Alcohol and Health. Accessed November 2021, from https://www.who.int/publications/i/item/9789241565639
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Still, H. (2024). Alcohol and Other Drug Harm in Rural Scotland: Addiction Looks Different Here. In: Turbett, C., Pye, J. (eds) Rural Social Work in the UK . Rethinking Rural. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-52440-0_3
Download citation
DOI: https://doi.org/10.1007/978-3-031-52440-0_3
Published:
Publisher Name: Palgrave Macmillan, Cham
Print ISBN: 978-3-031-52439-4
Online ISBN: 978-3-031-52440-0
eBook Packages: Social Sciences