West Dunbartonshire and Scotland as a whole have a long legacy of substance use, damaging lives, impacting on families and contributing to violence and crime. Many of those affected will have experienced difficult life circumstances, and are among the most vulnerable in society, subject to stigma because of their addiction. In the last ten years our understanding of the underlying causes of addiction and substance use has developed, recognising that deprivation, poverty, trauma and adverse childhood experiences can cause people to turn to alcohol and drugs.
Understanding the extent of substance related harm throughout West Dunbartonshire has its own challenges as data is not always available at local authority level. In cases where data is available for West Dunbartonshire it is presented and where it is not available, the best proxy indicator has been selected.
The demographics of West Dunbartonshire show that the area has a population of 89,130[i] with a life expectancy lower than the Scottish average of 79.2 years for females and 75 years for males[ii] (NRS, 2019). Over 33% of the population are over 60+ years of age and the gender split is 52% female, 48% male. The majority of the population identify themselves as ‘White’, with the ‘Asian, Asian Scottish and Asian British’ and ‘Other’ population at 4%[iii] (NRS, 2014).
The social indicators of the area highlight that 78% of the working age population are in employment. However, West Dunbartonshire has a significantly lower proportion (38.4%) of its population engaged in management, professional or technical occupations than the Scottish average (44.2%)[iv] (Office of National Statistics, 2019). The Scottish Index of Multiple Deprivation (SIMD) which provides an analysis of deprivation across Scotland, states that West Dunbartonshire has 48 data zones in the 20% most deprived, which equates to a local share of 40% of all data zones within West Dunbartonshire falling within the most deprived category (Scottish Government, 2020)[v].
Burden of Disease
The Burden of Disease National Programme (West Dunbartonshire HSCP, 2018)[vi], indicates that greatest burden of disease in West Dunbartonshire is cancer. The second highest is mental and substance use disorders.
Many cases of cancer can be prevented or risk reduced by changes in an individual’s lifestyle behaviours (Scottish Government, 2016)[vii]. There is strong evidence (World Health Organisation, 2017)[viii] that consumption of alcohol is a cause of cancer of mouth, pharynx, oesophagus, liver, bowel and breast. The evidence suggests even small amounts of alcohol can increase the risk of cancers.
There is also an association between the use of alcohol and domestic abuse. Although domestic violence should never be excused when alcohol and other substances are involved, there is a need to confront the problems of alcohol over-use as part of our strategy to prevent domestic violence. In a systematic review there was consistent evidence that alcohol use by one or both partners contributes to the risk and severity of Intimate Partner Violence (Wilson et al, 2014)[ix].
The reported rate of domestic abuse to the Police in West Dunbartonshire has remained consistently among the highest in Scotland with the latest figures in 2018/19 placing West Dunbartonshire as the second highest local authority (Scottish Government, 2020b)[x].
The NHSGGC Director of Public Health (DPH), Dr Linda de Caestecker provided a West Dunbartonshire specific DPH report in 2017-19[xi] to highlight gender based violence as a major public health problem for the area, with the most prevalent effects being on mental health, including post-traumatic stress disorder, depression, anxiety, suicidal ideation, and substance use (Feder et al, 2011)[xii].
Alcohol Consumption and Related Harm
Drug Use Prevalence and Related Harm