Some of this research was supported by the MRC and the Scottish Government Chief Scientist Office at The University of Glasgow.

The views expressed are those of the authors. (17/17)

References: drdsystemstructures.my.canva.site

⭐ Where can systems mapping be applied in your sector? ⭐
Share this post and your thoughts on using systems science methods for complex problem-solving in public health and policy (16/17)

Using more than one source of data can show us a bigger picture of how systems are experienced, it is important to think about how we can further leverage available healthcare information with data linkage 🔗
You can learn more about data linkage on post 17. #healthequity #datalinkage

The key value of a systems map is that it offers a way to step back, assess different perspectives, and ensure all relevant factors and stakeholders are considered and given a voice when making decisions. We can then integrate evidence-informed decisions in the UK drug policy landscape. (14/17)

If we consider co-prescription as one aspect of service quality, in what ways could the system map help us consider this more broadly? Moving beyond the roles of GPs and pharmacists, improving treatment planning requires incorporating lived experience at an organisation and policy level. (13/17)

Understanding the broader structure allows for policy decision-making that can better visualise tensions and trade-offs. Let’s unpack how public health policy makers can work with challenges at a treatment provision and co-prescription when trying to achieve health orientated goals. (12/17)

Stigma can influence experiences of treatment choice, dosing, what ‘recovery’ should look like, and ideas around the care people are entitled to. You can read more about the way stigma impacts treatment provision and experiences from links on post 16. (11/17) @scottishdrugsforum.bsky.social

Access to quality and consistent drug treatment has the strongest evidence-base in reducing DRD risk. Stigma compounds in effect across services, individuals within them, and risk of experiencing a DRD. This can be mitigated with appropriate and empowering treatment on a case-by-case basis. (10/17)

The prevalence of stigmatising norms around drugs is characterised by feedback loops mentioned a few posts back. Factors reinforce one another and entrench these norms at the cultural level, making it harder to break the cycle and influence change. (9/17)

Let’s explore the subsystem of Public and workforce stigmatising attitudes.
Addressing stigma can’t happen through single intervention points. Targeting upstream and downstream factors—at same, and cross-level subsystems will allow for whole system change—it will change how our sky looks. (8/17)

There’s a view that current UK strategy positions on stigma are “fundamentally incoherent”. Systems thinking can identify how stigma is experienced and reproduced in the real world. This method is currently used at a government level with DEFRA in mapping systems for environmental policy.(7/17)

When the relationships between causes and effect are unpredictable, we can identify how factors interact via relevant system characteristics. In the context of DRDs in Scotland, these can include:
🔁Feedback loops
💡Emergence
🤝Interdependencies
💪 Influence
(6/17)

What are some examples of subsystems identified as direct causes of experiencing a drug related death in Scotland?
⛔ Public and workforce stigmatising attitudes
🌱Life experiences
🗨️ Social Influences on drug harms
👩‍⚕️Experience of services
🔎Public perspectives on substance use
(5/17)

DRDs occur as part of a broader system, where policies, social environments, and individual behaviours are interconnected. Systems mapping helps us understand the social ecological system, showing cause-effect relationships and the need for multi-stakeholder solutions. (4/17) #systemsmapping

When thinking of a whole system, we can think of it as comprised of subsystems, or clusters of closely related factors. This may look confusing, but we can identify subsystems composed of upstream and downstream factors and their causal interconnections in this constellation. (3/17) #stopthedeaths

In 1998, calls advocating for harsher drug laws and a “drug-free world” were supported by the UN. It is now said that we are seeing progress in viewing DRDs as a public health over criminal issue. In addressing Scottish DRDs, Dr Priyadarshi calls for a “whole package of treatment and care”. (2/17)

journals.plos.org/plosone/arti...