“It’s not something that you just openly discuss” - Supporting British South Asian carers affected by drug and alcohol use

Posted by Jayne Black, Public Health Officer, Harm Reduction and Social Inclusion, Public Health Directorate, Newcastle City Council

Access to services, such as those related to drugs and alcohol and other health services, can be challenging. This challenge may be harder for some minority communities due to a variety of additional factors which impact people from accessing support when required. It is important that we identify these issues and barriers that prevent people in need from accessing help.

PROPS Community Connector, Fatema Rahman (C) with colleagues Annette
  Walby (L) and Helen Thompson (R), celebrating Eid at Fenham Library

In Newcastle, an ethnic minority needs assessment has been carried out and is available on our Joint Strategic Needs Assessment webpage.

We have also partnered with Northumbria University to explore barriers and perceptions to accessing drug and alcohol support.

An important area of focus is how family members are affected by a loved one’s substance use. In Newcastle, a recent research project backed by Fuse seedcorn funding investigated the perspective of British South Asian carers, who care for people who use drugs and/or alcohol, regarding their experiences and access to specialist drug and alcohol carer services in Newcastle.

The collaboration which included, co-production with people with lived experience, was between Newcastle City Council, PROPS (Specialist Family Drugs and Alcohol Service), Northumbria and Newcastle Universities.

What do we know are some of the barriers?

Attitudinal (personal)

The limited research suggests that attitudinal barriers within minority groups exist in relation to accessing care services. These are suggested to be in relation to not wanting to involve services. This is due to low awareness of services and availability, and concerns around cultural or religious appropriateness.

Stigma

Stigma is harmful and has been defined as the devaluing of an individual based on their characteristics or behaviour.

We know that stigma in general can have an impact on whether an individual seeks support for alcohol or drug issues, or other health issues.

Within the British South Asian and Muslim community, it has been identified that societal stigma, within the community, can impact upon people’s willingness to access help. This stigma may be centred around concerns of what other members of the community perceive about a particular individual or family and their use of alcohol or drugs.

Carers

The research evidence within this area rarely extends to those who are in a caring role for family or friends who are struggling with issues around alcohol or drugs. This could be an important area of focus, as support from a family member or friend is incredibly important. Whether day-to-day or during recovery, supporting carers is vital. However, it is worth noting that some people may not identify or recognise themselves as a carer and therefore, are unaware of support.

The Census of England and Wales in 2021 identified that North East England has the highest number of people providing unpaid care. It also suggests that unpaid carers in the North East provide the most hours of care.

Providing care may impact the health and wellbeing of a carer, this could include financial as well as if someone is a kinship carer. Therefore, it is important to identify if there are barriers to accessing carer support services for people who care for family members or friends using drugs and or alcohol.

What did we discover?

Our research results identified a variety of key areas. These areas related to the topic of drugs and alcohol in terms of it being ‘taboo’, with associated stigma, the barriers that are experienced for accessing family support, along with the general awareness of family support services.

Drug and alcohol use as a taboo topic

Carers highlighted the difficulty of discussing their loved one’s use of drugs and alcohol with other people who are close to them. The topic itself can be seen as something which creates unease. This creates a possible negative effect as talking with others may help create a supportive network and help carers feel supported and provided with guidance.

“the drug use; it’s not something that you just openly discuss. It’s like [frowned] upon. You know, people, I think, blame the parents, “well why aren’t you doing something?” […] Unless somebody can help you, you know, guide you, there’s no point having these discussions with people […] I mean, I’ve spoke to their grandma about it and stuff. Like, people who genuinely care.” 

                                                                             Participant

In contrast, others mentioned conversations about drugs and alcohol being more prevalent in the community, requiring more awareness for community members.

Barriers to accessing family support

The issue of stigma is evident from the discussion, with drug and or alcohol use being seen as an individual issue of choice, which not only impacts the individual, but affects the reputation of the family. It is seen as different to mental health issues, as something that people are unable to physically observe or have an understanding of.

“I don’t even talk about his mental health condition, ‘cos it’s a stigma. People like, laugh at it and things and say, ‘look, he’s barking; he’s crazy’. It’s this whole attitude that he’s crazy. You know, there’s no sympathy. […] it’s better and easier to get cancer than it is to [have anything] like that, because no one’s going to be understanding. […] People don’t understand, they think they’re putting it on half the time. They’re not understanding the side effects that it has.” 

                                                                            Participant 

There is recognition that seeing or being aware of someone in a community accessing help for drugs and alcohol, or in recovery, can help shift perceptions and show that support is accessible to other members of the community.

Misconceptions around confidentiality and issues of trust can be seen within those working with services or accessing a service. Carers need to be reassured that services are bound by confidentiality. In terms of confidentiality within the community, raising awareness about available support can play a major role in reducing stigma associated with engagement and seeking support.

There is hope in the organisations that provide family support services, and allowing a carer to progress on their support journey at their own pace is important.

“I got involved with them and *the family support service* were really good, because at that time, I didn’t want anyone to know, ‘cos I didn’t know what was happening and they offered me so many different solutions and like, I don’t have to see them straight away […] Cos some people don’t want to talk about… You know what I mean? So at that time, I didn’t want to see who I am in this. I just wanted to understand what’s happening.” 

                                                                             Participant

Awareness of family support services

It was identified that there is limited knowledge of services that provide support for drug and alcohol recovery. This may create difficulty, as the role of the carer can be a ‘navigator’. Therefore, limited knowledge may add an additional pressure to the carer, which was an issue raised during the interviews.

Services reaching into communities, rather than people who require support finding their own their way, is highlighted as being a positive - which can be used to make recommendations for a future response.

Using an approach which makes the most of existing support already within communities and working at a pace that suits the carer. Also, harnessing the power and visible importance of communities can create a support network, ensuring assistance is sustainable and effective.

“Over the phone, it was fine. Then eventually, they came to my house. Eventually met in cafes, then started a course with them.”

“[They] are very good with giving me a variety of choices that suited me when I needed, so whatever suits you, with patients and carers, however it suits them. However it suits every individual is different, so they met my needs.”     

                                                                             Participant

Recommendations

We must connect with those who have relationships with members of a community to enhance trust and help support people who need it. Recommendations from the research included outreach into the community for connections with leaders. This must include vital considerations around caring and family support.

Encouraging visibility of services and people in recovery or who have lived experience within the community is also important to help not only the carers, but those who are struggling with the use of alcohol and drugs.

Developing work in Newcastle

Work in Newcastle is being developed within this area. Public Health have been engaging with British South Asian community leaders to enhance treatment and recovery efforts including carers. Two key meetings were held with stakeholders such as the Bangladeshi Association, local Imams, and university researchers. These meetings facilitated open dialogue on barriers to treatment, cultural sensitivities, and support systems, building trust and shared goals.

Engagement with the Health and Race Equality Forum (HAREF) emphasised the initiative's importance, with leaders showing enthusiasm for ongoing collaboration. A rough plan is being developed from these discussions, with next steps involving continued dialogue and refining the action plan to meet community needs. This approach highlights the value of community-led, culturally informed initiatives in promoting health equity.

Newcastle is also working with PROPS to fund a part time South Asian Muslim worker who will serve as a community connector to bridge the gap between community and support services. This is building on their existing effective practice in this space. The community connector worker will provide tailored support to facilitate access to support, ensuring carers, and families get the help they need in a culturally sensitive manner.

Personal reflection

The research highlights the importance of the voice from carers and communities, and those with lived experience. The importance of understanding the issues from those with lived experience who are supporting someone and working through any daily challenges. We must ensure that valuable information that we discover from research, such as this, is used to act and ensure that everyone has an opportunity to be supported and live well.

This isn’t just about food. It’s about fairness, dignity, and giving communities the tools they need to support themselves

Why Community Food Organisations deserve a place in the Child of the North APPG report

Posted by Andrea Burrows, Dr Claire O’Malley, Dr Helen Moore and Professor Amelia Lake, Fuse researchers from Teesside University

Andrea Burrows, Helen Moore with other contributors at the launch of the report in parliament

Across the North of England, families are facing a dual crisis: rising food insecurity and growing food waste. In response, Community Food Organisations (CFOs) - like social supermarkets and pantries - are stepping up in powerful, community led ways. These aren’t just places to get food. They’re places of dignity, connection, and hope.

But despite their growing role, CFOs are still flying under the radar. They’re under-researched, inconsistently defined, and often left out of the bigger policy picture. That’s why they were included in the Child of the North APPG report.

What is the Child of the North APPG?

The Child of the North All-Party Parliamentary Group (APPG) is a cross-party group of MPs, peers, researchers, and practitioners working together to tackle the deep-rooted inequalities affecting children in the North of England. From poverty and poor health to educational disadvantage, the APPG is committed to finding evidence-based solutions that give every child a fair start in life.

Backed by research from the Northern Health Science Alliance (NHSA), Health Equity North and the N8 Research Partnership, the APPG has already produced influential reports on the cost of living, education, and health. Now, it’s time to shine a light on food, and the role CFOs can play in transforming communities and the lives of children.

A different kind of food support

Unlike traditional food banks, CFOs operate more like supermarkets, offering surplus food at low prices. Often delivered in a familiar, retail-style setting, this model not only reduces food waste but also gives people choice and dignity in how they access food. It’s a far cry from the stigma that can come with emergency food aid.

Research shows that this approach better meets the needs of people experiencing food insecurity. It empowers them, rather than making them feel like recipients of charity.

One model, many faces

CFOs are incredibly diverse. Some are membership-based and serve specific groups; others are open to all. Some offer wraparound support like job training or help with household income; others focus purely on food. This flexibility is a strength, it not only allows CFOs to adapt to local needs, but it also makes it hard to evaluate their impact or share what works best.

"Community Food Organisations... aren’t just places to get food. They're places of dignity, connection, and hope."

A recent review led by by colleague Claire O'Malley (currently under review) found that there’s no single definition of a social supermarket. And many operate informally, relying on local relationships and community goodwill to source food. This makes them agile, but also vulnerable.

Why now?

Since the pandemic, food insecurity has increased, especially in the North. But so too has the rise of CFOs. In the North East and North Cumbria, there are now 67 social supermarkets. In the North East town of Middlesbrough alone, the number of Eco Shops, the dominant social supermarket model, has jumped from nine in 2021 to 28 in 2025.

This growth shows just how much communities value these spaces. But it also raises urgent questions:

• How can we make these models sustainable?
• What support do they need to thrive?
• How do they fit into the bigger picture of public health and food policy?

Why the Child of the North report matters

Including CFOs in the report will:

• Raise national awareness of their role and potential.
• Create shared definitions and standards to help evaluate impact.
• Highlight best practices and support scaling of successful models.
• Ensure CFOs are recognised as part of the wider food and health system - not just a stopgap.

This isn’t just about food. It’s about fairness, dignity, and giving communities the tools they need to support themselves. CFOs are already making a difference. With the right recognition and support, they could transform community support with accessible, socially accessible methods of community aid.

About the authors:

Andrea Burrows is a Research Associate at Teesside University and a Fuse Associate member

Dr Claire O'Malley is a Research Associate at Teesside University and a Fuse Associate member

Helen Moore is an Associate Professor at Teesside University and a Fuse Associate member

Amelia Lake is Professor of Public Health Nutrition at Teesside University, Deputy Director of Fuse, the Centre for Translational Research in Public Health, a dietitian and public health nutritionist.