Social work and Drug Use

medicate mis riding habit in Britain is a substantial and growing conundrum, with a signifi outho uptaket and profound impact on the surfaceness and mixer functioning of many exclusives. Parker et al (1995) highlight that one- yr-old pile atomic number 18 increasingly using a wide tar bring of doses and alcoholic beverage at a younger age and the age of insertion into medicine go for appears to father lowered. This assignment scrams to discuss what medicines atomic number 18 and the item-by-item effects and loving implication of medicine riding habit. It eachow compargon and telephone line the distinct terms associated with medicate mis use up, for vitrine recreational dose use and medicate colony.It will examine the consequences, advantages and disadvantages of decriminalization and statutoryisation of medicines as swell up as the advantages and disadvantages of prescribing using diacetylmorphine as an example. It will withal encounter at theo ries surrounding pump revilement and will consider how well-disposed disciplineers have been granted more than flexibility in their intervention with substance mis substance abusers since shifting from the view that do doses and alcohol misuse is a disorder. In assenting to this it will highlight existing debates concerning the new-made and current medicate policy in the UK.Service users who experience do doses problems ar often playing field to stigmatisation, discrimination and marginalisation non only as a result of their substance use but as well as as a result of age, grammatical gender and poverty. provided, Harbin and Murphy (2000, P. 23) highlight that medicine dependency raft effect anyone without regard to race, class, gender or age. This assignment will besides look at what serves and interventions, much(prenominal)(prenominal) as molest diminution strategies, ar avail fit to drug misusers and the narkibility of these function. The Worl d Health face (1981, P. 227) define a drug as Any chemical entity or mixture of entities, other than those postulate for the maintenance of normal health (like aliment), the brass of which alters biological function and possibly structure. wherefore this means that when efficacious drugs, such(prenominal)(prenominal) as headache tablets, or smuggled drugs, such as cannabis, complot the bloodstream they can affect how a psyche knows. Drugs can be grouped into 3 main types stimulants such as cocaine, depressants for example heroin, and hallucinogens such as magic mush suite. (http//www. knowthescore. info, 2005). In sum to the lineageing groupings the intelligentity divides drugs into three classes A, B and C.Classification is based on the misuse that specific drugs whitethorn cause to individuals, families and communities. (NHS Health Scotland, 2004, P. 10). Class A drugs include heroin, ecstasy and crack. In order for drugs to stimulate, they must first ent er the body. The main ways that a drug can be administered include orally, ingest, snorting and injecting. How a slightlybody will react after winning drugs will depend on a number of factors such as the type of drug, how it is taken, what it is mixed with, the tender context and whether the person is on other drugs at that time.Factors which whitethorn invite drug taking can be split into deuce kind categories individual entices for example personality or ge interlockics and environmental influences such as society, peer pressure or family. (Swadi, 1992, P. 156). All drugs affect the judgements limbic system irrespective of in that respect legality. Different drugs act on distinguishable aras of the thinker and alter the chemical balance and these changes be liable for the feelings and sensations almosttimes associated with drug use. (NHS Health Scotland, 2004, P. 7).Scientists discover this the reward system. Usually, the limbic system responds to congenial expe riences by releasing the neurotransmitter dopamine, which creates feelings of delectation. This could explain why commonwealth go on to misuse drugs. However, some sight can occasionally use drugs without development a tolerance or withdrawal symptoms whereas other concourse deprave drugs by repeatedly using them to produce pleasure, alleviate stress, or distract reality. This can lead to other drug tie in problems such as drug habituation.There argon two types of dependency, psychological and physiologic. Physical dependency occurs when the body is deprived of drugs. this deprivation leads to physical symptoms that vary with the drug. Whereas 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 about often and farsightedingly. (http//thebrain. mcgill. ca/flash. par. tml, 2002)This highlights that distin guishable drugs have different effects and will require different interventions depending on the substance being misused. Drug dependency is characterised by craving a drug so much that it has control over the persons life. For example if mortal is mutualist on heroin and goes without it for any length of time, they will digest extremely unpleasant withdrawal symptoms for several days. Taking heroin will make the drug user feel normal again (Drugs Know your Stuff, 2005).In this respect the drugs are having a medicinal effect on the individual because the drug relieves the person from their withdrawal symptoms. Drug use in todays society is a problem non only for the individual but for their families and communities. Drugs protecting families and communities (2008) jumps this by saying The intimately damaging effects for communities are those caused by drug dealing, drug cogitate execration and anti- mixer behaviour, which can undermine stable families and sticky communities . In the UK drug the genial effects of dependency are most commonly associated with criminality.Drugs know your stuff (2005, P. 21) identifies that Every year about 40,000 mess in the UK are arrested for drug disrespects. An example of a drug related offence could be shoplifting. This capability enable the drug user to raise money to finance their drug use. It whitethorn also be associated with the stereotyped image of young commonwealth wearing hooded tops sniffing glue or shooting up in shabby flats who are labelled junkies. However, drug use does non continuously fit into this image as it is not age, gender or class specific.For example, white middle class populate who use cocaine as a recreational drug do not pauperisation to absorb involved in aversion to patronize their drug use. whence drug use is not always amoured to crime. This is in contrast to the view of the regimens 1998 drug strategy which had the main objective the final cause to tackle drug abuse, first and foremost, as an onward motion of reducing crime. It focused in the first place on criminality and maintenanceed drug users who had act crimes. In addition to this, spick-and-span measures were introduced under the Drugs mo (2005) where the focus is also primarily on criminality.The new Act has implemented new practice of law powers to runnel for class A drugs such as heroin. These measures include testing on arrest which means hatful who are arrested for trigger offences are tried for drugs on arrest rather than when aerated. The aim of this is to steer more wrongdoers into handling and by from crime. This will ensure that those who misuse drugs are not charged but befriended to engage in treatment. However, efficiencyiness (2007) does not agree and believes that these measures should be discarded as they are ineffective and inefficient.As an alternative King recommends that greater use should be make of specialised drug courts. handicaponize to the recen t Government drug strategy (1998) in that location was a particular focus on knotty drug users and relate to crime because statistics showed they were responsible for 99% of the constitutes to society (estimated between i10 and i16 billion) 88% of which is drug related crime. (The Drugs Act, 2005) and then, often as an alternative to imprisonment a drug misusing offender within the criminal referee system will automatically be stipulation priority to access treatment.Drug Treatment and Testing Orders made under Section 1A (6) of the 1991 Criminal Justice Act required offenders to string up drug treatment as a condition of a probation order. (Hough et al, 2003, P. 6). This whitethorn cause problems because when faced with a prison sentence or a treatment programme the majority of people would most likely take up the latter even when they do not want uphold for their drug problems. Ironically, individual who is good about getting help for their drug problems and has not broken the law will usually be placed on a long wait contestation for treatment.Although, Tackling Drugs Changing Lives (2005) state that the intermediate national waiting times for treatment have fallen most three quarters since 2001 (from 9. 1 weeks in December 2001, to 2. 3 weeks in June 2007). However, this still could possibly result in non offenders slipping through the net especially since the most common referral route into treatment is self referral (NTA, 2006, P. 7). thence possibly resulting in them not getting the treatment or support they require at that time. then whilst they remain on the waiting list for treatment social workers have a responsibility to give advice on minimising wound associated with drug misuse. Government policy has prioritised criminal speak tos 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 account. Therefore advocates a harm step- down policy by saying wedded 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 knock down the amount of harm that they cause. In response to the 1998 drug strategy The Royal Society for the hike upment of Arts, Manufactures and Commerce (RSA), (2007) comment, through its Commission, 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 social 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 reduce harm.The review of the National Drug Strategy in 2008 argued that the previous drugs policy did little to help the arguable drug users and to mitigate the impact on drugs in society. Professor Anthony Kings the hot seat of the RSA Commission explains that in their v iew drugs in society are not just about crime. They criticised the previous strategy by saying thither was too much emphasis on crime and that on that point requisite to be a shift from crime reduction and the criminal justice system onto an understanding of the more varied and complex social problems.For example the social consequences of drug use can include social exclusion. pile 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 living standards and may result in home slightness for example if their drug use is given priority over their house take charge outgoings such as rent. Therefore King (2007) suggests that at that place should be wraparound serve which include individual social needs such as physical exertion and housing as these problems often come hand in hand with chaotic drug use.The 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 Minister Gordon Brown that the new strategy would shoot a more holistic approach when works with drug users and there would be more support for people undergoing treatment. However, when the Governments new 2008 10-year drug strategy was revealed there were proposals to shake-up the welfare system, effectively punishing drug abusers who fail to get clean. The Press Association (2008) highlighted that benefit payments to drug users may be reduced if they drop out of treatment.This could possibly result in people not accessing treatment for the fear of dropping out and having their income reduced. Therefore the new strategy gives no consideration to relapse. Drug relapse is a exercise that bug outs when an individual slips back into old behaviour patterns and as identified by Regan (2003) as being the most damaging characteristic of drug taking. throwback may occur because drug users are often stereotyped an d may find it hard to reintegrate back into society. Therefore this proposal may not be very effective.In addition to this if a drug misusing parents benefits are cut and they are faced with purchasing food, for their children, or drugs that they are dependent on they may not necessarily be resourceful of making a rational finding. Cleaver et al (1999, P. 245) lends support to this by stating Family income may be used to satisfy parental needs. Purchasing food and clothing or paying essential house postponement 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 exam Association (1997, P. 8) highlights that Drug use itself by parents need not cook a risk but neglect or abuse may be associated with problem drug use and should be addressed appropriately. However, long term drug misuse could impact on the families living standards and possibly result in a require ment for Social Services to inject under section 17 of The Children Act 1989. In addition to this people 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 penalization (http//drugshealthalliance. et, 2008). Therefore better strategies need to be introduced to encourage drug users into treatment. An betterment to enable this could be not giving General Practitioners the prime(a) to avoid providing drug treatment. This would allow people to be seen straight away by their General Practitioner and not placed on long waiting lists with other agencies. All drugs, hard or soft, illegal or legal can cause social problems to some degree. Although, it is suggested that many drugs are thought process to cause problems merely because they are illegal.However, The British aesculapian Association (1997, P. 385) highlights that two the Green and White Papers, Tackling Drugs Togeth er, 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 people could buy drugs but only through legal sources, and so removing a major criminal resource and reducing crime levels.The British Medical Association (1997, P386) also suggests that crime would be significantly reduced if drugs could be purchased legally and money fagged on law enforcement could be spent on treatment and education. On the other hand there is demo that drug users commit crimes for other reasons and not just to finance their habit. many an(prenominal) drug users are involved in crime even when they have access to drugs on prescription such as methadone. (Graham and Bowling, 1995, P. 49). Therefore the social background of the drug user may also contribute to why they commit crimes.However, even if crime was not considerably reduced, people buying drugs through legal sources would know the strength and quality of what they were using thus possibly reducing the risk of overdose. If drugs were legalised there is no evidence to signify 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 canon would significantly reduce the cost of drugs. In addition to this alcohol and nicotine are highly habit-forming drugs that hold legal status.King (2007) suggests that the debauch of Drugs Act (1971) should be repealed and replaced with a Misuse 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 illness, coronary heart disease, strokes, and various cancers. slightly doctors have even repor ted that nicotine is just as addictive as heroin or cocaine, which indicates quite clearly as to how people cash in ones chips hooked so rapidly and stay hooked for so long. http//www. helpwithsmoking. com/effects-of-nicotine. php) expectant drunkenness is linked to suicide, murder, fatal accidents, and many fatal diseases. It can accession chances of developing cirrhosis of the awaitr, and it has been associated with many different types of cancers. However, the NHS Direct (2008) underline that potable a moderate amount of alcohol will not do any physical or psychological harm. In a recent survey Lifeline generalations (2007) highlighted that approximately 114,000 people die every year from smoking tobacco.About 40,000 people die from using alcohol and the least(prenominal) amount of deaths occur as a result of all illegal drugs put together and is about 2,000 people. This clarifies that Although drug misuse poses risks to the user and others, from a health perspective 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 evident that the reason why some drugs are illegal is nothing to do with dangerousness.If drug classification is based on the harm that specific drugs may cause to individuals, families and communities. NHS Health Scotland, 2004, P. 10) then by all odds nicotine and alcohol would both(prenominal) 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.Which means, agree 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 resembling to the messages on cigarette packets. Although King suggests that illegal drug use is not always harmful, heroin has been ranked the most dangerous drug by researchers The Lancet (2007).These finding were based on three factors which were physical harm strength 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 benefit s.Prescribing efficacy attract more people into treatment. More heroin users might get help as they would be identified thus resulting in fewer untreated heroin users in the community. In addition to this prescribing would stop or reduce illicit heroin use. This would undercut the black market in illicit heroin possibly helping 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.However 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 addict for life. Therefore this may not necessarily be the best response to drug misuse. Since we live in a drug taking society it is paramount that there are interventions gettable to substance misusers to help minimise any potential harm. Under the National Occupational Standards social workers have a indebtedness to manage risk to individuals, families, carers, groups, communities, self and colleagues.Social workers can help to reduce risks by implementing harm reduction strategies. price reduction policies, programmes, improvements 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) Harm reduction has a very high profile in drug treatment programmes it aims to focus on issues such as needle diversify schemes and the risk of infection. The strategy is led primarily through the NHS and influences the Drug exercise Teams (DAT).However, the strategy mainly focuses on minimising harm associated with endovenous heroin use. The NTA (2006, P. 7) highlights that Heroin was identified as the main problem drug for over two thirds (67 per cent) of clients receiving drug treatment. Nevertheless, the strategy accepts that people are drug dependent and wherefore consideration is given on how best to reduce harm this includes access to information and clean injecting equipment. However, information needs to be widely available, pen in relevant languages, and produced in an tender format.Without 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 nearly new cases of Hepatitis C occur in people who use grime needles or injecting equipment for drug use. Therefore although there are harm reduction programmes available for dug users they may not be easily accessible. For example, an intravenous heroin user who needed clean needles is not likely to stumble a few miles by bus to collect them.This could result in the person using, or sharing, dirty needles which increases the risk of blood borne viruses. With this is mind it ma y be useful to establish if there are mobile needle exchange function available to especially 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 benefit could be that because the service 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.However, there may be some users who might be hard-pressed about using, or not want to use, a mobile needle exchange service. 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. other service that may possibly help drug misusers to minimise harm is drug manipulation rooms. However this service is currently not available in the united soil. Drug purpose rooms are places where dependent drug users are allowed to inject drugs in supervised, hygienic conditions.There are approximately 65 drug custom rooms in outgrowth in eight countries around the world 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. 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.Studies suggest that severe health risks are linked to street-based injecting. (Klee, 1995 lift out 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 that enables people to engage legitimately in activities that are both harmful and illegal?Since 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.New 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 voluntary 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.There are many different warnings that can be used when working with people with addictions. However When working with substance misusers it is useful to consider two different mannikins, the disease manikin and the cycle per second of change. (Goodman, 2007, P. 103). In the 19th century the first disease concept was established. This determine 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.In the 20th century the second disease concept evolved and alcohol consumption was once again socially acceptable. Only a small nonage of individuals developed a problem with excessive drinking. However, alcohol and drug addiction was still considered as an illness th at required treatment and support. Goodman (2007) highlights that the disease model 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.Consequently they need to avoid former drinking associates or drinking situation. However this model has implications as the nature 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. Dick (2006) lends support to this by saying Drug misuse is not a disease it is a decision, like the decision to step out in front of a moving car.You would call that not a disease but an error of judgement. In addition to this by following the disease model there is no consideration 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 supporting the service user. However according to National Institute on Drug Abuse (2008) drug addiction is a brain disease and highlights that 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.Once 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 complete abstinence. Therefore there would be no harm reduction strategies needed such as needle exchange. The model also contradicts the General Social Care Council Codes of approach pattern (2002) as it does not work in an anti-oppressive manner.For example, b y 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 ramble of change was designed by Prochaska and Diclemente (1994).It was produced from work they had done with people wishing to change their smoking behaviour, it soon became evident that their theory 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 different stages of their alcohol or drug problems. Since the model is holistic it also a llows social workers to work in coalition with other agencies such as housing. As far as social work practice is concerned this model is the value base of the codes of practice as it works within a positive framework promoting anti oppressive practice.In this model there is a cyclical process. It starts with a accomplishment of pre-contemplation when the service user does not know or feel that they have a problem. For those who are sentiment 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 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 desirable and possible begin preparing for the change.This stage of the cycle involves setting goals and making plans. Social workers can help service users by using motivational interview ing. This emphasises the empowerment 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.Once 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 lasting because service users may feel they can reach 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 required, such as positive encouragement, to enable the service user to touch into a period of ma intaining the change.However 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 come upon their drug use as a problem. Therefore this model would not work because they have not even pre contemplated change. The cycle of change model links with the social model and allows social worker more flexibility when working with service users who misuse substances because it is predominately about empowerment and it involves the service user.This approach helps people recognise the risks involved with their behaviour and allows them to do something about it. closedown 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 increased 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.Problems 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 erect 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.In 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.Therefore crime levels may reduce and people would know exactly 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.However provided they were supervised and people used them the advantages outweigh the disadvantages. The disease model allows social workers limited flexibility 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 account harm reduction as the aim of the disease model is complete abstinence.Whereas 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 addictions of any kind and therefore social workers work in partnership with other agencies or professionals to help support the individua l with additional problems that link to their substance misuse.The 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.