The next item of business is a debate on motion S5M-11695, in the name of Aileen Campbell, on safe injection facilities.
14:30
In 2016, 867 individuals lost their lives through problem substance use, and countless others were devastated by the loss caused by its impact. Alongside such loss of life, problem substance use can inflict pain, trauma and suffering on individuals, families and communities right across the country. At a time when we are updating our national drugs strategy to take into account changes that have happened in the past 10 years, we have a chance to review and improve the services that we offer to people and the methods by which we engage with and support them.
Since I came into this post, the rising number of drug-related deaths has weighed heavily on me. Given the nature of the population that we are talking about, and the allied challenges of austerity, I am very aware that that pain will remain in Scottish society for some time. Each number represents an individual loss of life, potential unfulfilled and a family devastated by grief. We cannot tolerate that, and therefore we need to examine what we are currently doing to help and support some of the most vulnerable people in our society and consider what we can do differently, even if it is unpopular or uncomfortable.
Sadly, we are not alone in facing that challenge, with other countries also needing to find ways to cope with problem substance use. However, the treatment and harm-reduction approaches that are taken vary, as do the results, so it makes sense to explore further those for which the evidence suggests that they can make a positive difference.
I have recently returned from Australia, where I was supporting our fantastic sportsmen and sportswomen at the Gold Coast Commonwealth games. Like Scotland, Australia has seen recent increases in the number of drug-related deaths. Between 2012 and 2016, the number of heroin-related deaths in Melbourne, Victoria doubled. In an effort to seek a solution, the Victorian state Government looked to the successes seen in Sydney, which had introduced a safer drug consumption facility—SDCF—in 2001. In the 16 years in which the Sydney SDCF has been open, it has had more than a million visits from individuals who seek to use its facility. During that time, it has treated more than 7,000 overdoses without there being a single death. It has also recorded an 80 per cent reduction in the number of ambulance call-outs to the area, the number of used needles and syringes discarded in public has halved and nearly 80 per cent of local residents say that they support the facility.
I have spoken with officials from the Victorian state Government about their recent decision to approve an SDCF in the North Richmond neighbourhood of Melbourne. Like us, Victoria has chosen to treat the problems associated with substance use as a health issue rather than a justice one, which means taking a health-led response to the situation. For the Victorians, that meant looking at the evidence for what works and what would reduce the number of deaths. They did not have to look far to see the impact that an SDCF could have.
Closer to home, just before I left for Australia, I addressed the Dundee community forum as it launched a drugs commission to explore the problems that it faces on problem substance use, amid a growing number of drug-related deaths, and to look for potential solutions. At that forum, I explained that such solutions might initially seem controversial or unpopular, but we owe it to families who have lost loved ones and to those who have lost their lives to try something different, as the status quo for those furthest away from services is not working.
I am well aware that, for some, the idea of an SDCF is unpalatable and that the idea of offering a safe space for individuals to consume drugs seems wrong. However, I am clear—as is the Government—that our vision for this country is one in which all our treatment and rehabilitation services are based on the principle of recovery. Indeed, that commitment lay at the heart of our 2008 publication “The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem”. For some people, the possibility of recovery or abstinence is a long way off. In the meantime, it is important that we focus on keeping them alive and in touch with services that may provide them with the support that they require eventually to take further steps towards their own recovery.
I agree with all that the minister says on the health aspect, but so far she has not touched on the supply aspect. It seems to me that the proposed model is built on people buying and selling drugs illegally, which is linked to organised crime. My main reservation about the policy is that we are building crime into the system.
I do not agree with that assessment. It is about taking a public health approach to a public health issue. We currently do not have the powers to enable that to happen legally. That is why I am seeking Parliament’s agreement to enable us to ask the United Kingdom Government to give us the opportunity to take a public health response to the public health need in the city that John Mason represents.
An SDCF can offer a place where individuals can go and a safe space where they can be treated with respect, but it is also a place where they can build a relationship with treatment workers so that, if and when an individual decides that they want to make a change to turn their life around, they will have support on hand to do so. An SDCF would be a real shift in service provision. It would be a service that has no barriers to engagement and one that provides a highly marginalised population with a place to engage with staff, build trust and get support to address some of the wider issues that they face.
Following a recent debate on the topic at Westminster, the UK Government minister came under attack for misrepresenting some of the evidence on such facilities, and I am keen not to make the same mistake. Instead, I will defer to a 2017 report from the European Monitoring Centre for Drugs and Drug Addiction, which summarises some of the evidence on these facilities. The report found that the evidence that SDCFs can
“reach and stay in contact with”
highly marginalised individuals is
“well documented”.
The report says that
“This contact has resulted in immediate improvements in hygiene and safer use for clients ... as well as wider health and public order benefits.”
Such facilities are associated with increased uptake of diverse types of dependence care such as referral to an addiction treatment centre, initiation of detoxification programmes and initiation of methadone therapy. The report also states that evaluation studies have shown that there has been a “positive impact” on the communities in which the facilities are placed, including a
“decrease in public injecting ... and a reduction in the number of syringes discarded in the vicinity”.
That is an important point in response to John Mason’s question. Surely those outcomes deserve exploration to ensure that our communities feel supported.
I hear much of what the minister has to say. If there is evidence, we should indeed look at it, but what she is saying is focused on intravenous drug use. What about the wider services and the engagement that goes beyond that cohort of intravenous drug users in tackling the wider drug problem?
I am talking about that specific group and a problem with drug-related deaths. There are examples from across the world where countries have taken up the opportunity to proceed with such facilities, which has resulted in a reduction in the number of drug-related deaths. I do not pretend that the measure would be a panacea for all the issues of drug and substance misuse in Scotland, but I am seeking agreement for us to try to initiate dialogue with the UK Government through which we can try to take forward a public health response to the growing and very real public health need that is felt keenly in Glasgow.
The evidence from the Sydney facility shows that it has had support from the local residential and business communities, because they have witnessed a positive change in the area as a result of the success of the SDCF. In Melbourne, locals actively campaigned for a safe injecting facility.
From the interventions that I have had, I am aware that, for some, the argument will be that there is no safe way to take a class A drug such as heroin. My answer to that is that SDCFs do not claim to make drug use safe; rather, they are based on the premise that it is safer to use drugs under supervision than to do so in a disused building or on the street or in any other place where an individual might take them and not be found should anything go wrong.
We rehearsed the arguments previously when setting up needle and syringe exchange programmes. We did not claim that doing so would make injecting safe; instead, we claimed that the programmes would make injecting safer by reducing the chances of the transmission of blood-borne viruses and bacterial infections.
An SDCF would also provide the opportunity for individuals to access the health and social care services that are usually out of their reach. On that point, evidence from the Sydney facility shows that about 70 per cent of the people who registered had never accessed any local health service before and that, since the introduction of the SDCF, almost 12,000 referrals have been made, connecting people to health and social welfare services in a way that never happened in the past.
The minister is absolutely right to say that there is a link between safe injecting rooms and use of other healthcare facilities. A key service in that regard is the alcohol and drug partnership. Will she take this opportunity to confirm that budgets for ADPs will be protected in future? They have not been protected in the past under this Government.
We have invested record levels in ADPs, and in the previous budget we committed to invest a further £20 million, to ensure that we can deliver on our new and refreshed approach to drugs.
Closer to home, the UK Government’s Advisory Council on the Misuse of Drugs published a report in December 2016 in response to the growing number of drug-related deaths in the UK. In that report, the council recommended that consideration be given to the establishment of SDCFs in areas with a high concentration of injecting drug users. The council reported that in addition to the evidence that SDCFs reduce the number of drug-related deaths, there is evidence that they reduce the transfer of blood-borne viruses while improving access to primary care and more intensive forms of drug treatment. The council was clear that the evidence showed that the facilities did not result in an increase in injecting behaviour, drug use or—I address this to John Mason—local crime rates.
All that leaves me wondering just how much more evidence in support of SDCFs the Westminster Government requires before it will act. How many more people need to die before the UK Government agrees that such facilities save lives?
The issues that I am talking about affect individuals and communities throughout our country, but it is Glasgow that leads the charge for Scotland in its attempt to open an SDCF. For that reason, I want to take a moment to focus on the current situation in the city. The most recent statistics that I have seen indicate that the HIV epidemic in the city continues unabated. The outbreak among injectors in greater Glasgow involves about 120 people. Such a level of HIV infection is unacceptable in our society, and I am adamant that we must offer some solution to the situation. If one in five of the people who inject drugs in and around Glasgow city centre is involved in the outbreak, it seems essential that we should have a service that gives those people regular contact with services so that they can get effective HIV treatment.
In addition, Glasgow has had the largest number of drug-related deaths in the country in recent years, with 170 such deaths recorded in 2016. Again, the figure is unacceptable and the situation demands action.
I was encouraged by Glasgow City Council’s recent discussion on the issue. The discussion was initiated by Scottish National Party councillor Mhairi Hunter, but agreement was sought from members of all political parties on the need for a safer drug consumption facility to be introduced in Glasgow, and the discussion ended with a unanimous vote to pursue the provision of an SDCF in the city.
In addition, a Conservative councillor invited Amber Rudd, the Home Secretary, to come to Glasgow to see the situation for herself. The invitation was backed by the rest of the council, and I add my voice to those who are calling for the Home Secretary or her minister with responsibility for drugs, Victoria Atkins, whom I am due to meet next month, to discuss the pressing and urgent issues to do with substance use on which we are unable to act due to powers being reserved.
My officials have been involved in discussions with Glasgow health and social care partnership, which has been developing the proposal from the start. They will continue to engage with the partnership as things progress. I will also soon meet Susanne Miller, the chair of Glasgow’s ADP and chief officer of the health and social care partnership, to get a further update on the situation in the city.
We are currently working to renew our national drugs strategy. The current strategy has achieved a great deal and I pay tribute to the hard work of the people who were involved in delivering it: the ADPs, drug services, professionals, clinicians, people with lived experience and people from the third sector who introduced the world’s first national naloxone programme, presided over a decline in drug use among our young people, supported more than 120 independent recovery communities and greatly reduced drug and alcohol waiting times.
I support much of what the minister has said about injecting rooms. She is right to focus on that today, but will she bring to the Parliament a debate in Government time to allow members to discuss the whole issue of drugs and the holistic approach that we need to take to drugs policy?
I am always happy to engage—indeed, I have sought to engage—with parties across the parliamentary chamber, to ensure that members feel a degree of ownership of our drugs strategy. We took forward our road to recovery strategy in that way. I will happily engage with the member, who takes a keen interest in the issue, and I hope that he takes that commitment in the spirit in which it is meant, so that we can get something that delivers for people who are marginalised and vulnerable in the here and now, and make progress on safer injecting facilities.
Our refreshed strategy will seek to build on the achievements of the road to recovery strategy. It is also important that it seeks to rectify the gaps and shortfalls that have become all too evident. The new strategy must be innovative in its approach. It must be guided by the evidence of what works and it must be unafraid to suggest approaches that might make some people uncomfortable, at first. That will include ideas such as SDCFs or heroin-assisted treatment. Against the backdrop of rising numbers of drug-related deaths, those bold ideas could be what makes the difference.
It is important, however, that we do not view such approaches as a panacea for all the challenges that we face with problem substance use in Scotland. Again, I would welcome all members who want to contribute to the refreshed strategy. The strategy will be backed by an additional £20 million each year during the current parliamentary session, and I have been clear that that money is not just to produce more of the same. Instead, I want it to encourage new thinking and approaches, and to encourage ambitious and innovative front-line responses.
Unfortunately, at this time, we are, to an extent, curtailed in what we can do as a nation in response to the problems that we face from substance abuse. The options that are available to us under current legislation are limited, but the situation in Glasgow is serious enough to warrant considering alternative approaches, including a supervised consumption room. I am pushing for a change in the legislation to let that happen. There are SDCFs in more than 70 cities around the world, but not one in the UK. Such a position is no longer tenable and I seek the agreement of Parliament to help change that.
I move,
That the Parliament believes that substance abuse must be approached as a public health issue; notes that Glasgow City Council and the Glasgow City Integration Joint Board have developed proposals to implement a safe drug consumption facility in the city in an effort to reduce harm and save lives; agrees that international evidence indicates that safer drug consumption facilities can potentially save lives and that implementation should be permitted in Glasgow; notes that, as the Lord Advocate has indicated, the lawful operation of safer injecting facilities could only be secured through changes to the existing legislative regime; asks the UK Government to make the necessary changes to allow the introduction of a facility in Glasgow, and believes that, irrespective of the creation of such a facility, every effort should be made to help prevent people from starting to misuse illegal substances and to help them get the support that they need to be protected from the harm caused by their use of drugs.
14:45
As an MSP for Glasgow, and the Conservative Party spokesperson for public health, I have a particular interest in the proposal to set up a safe injection facility in Glasgow. The fact that the proposed safe injection facility has had so much local and national media attention shows how much public interest there is in the topic.
I fundamentally do not support the creation of such a facility because I believe that it will mask the reasons why we have reached this crisis point in the first place. That is why I am calling for “a full sector-led” drug strategy review, as mentioned in my amendment, and an open and honest discussion about the drawbacks of such a facility.
The current strategy is evidently not working. In Scotland, drug-related deaths rose by 23 per cent in 2015-16. In Glasgow, which is a city that has a long and complex history with drugs, an HIV outbreak among drug users is now being described as a “health epidemic”.
Having grown up and still living in one of the most deprived areas of Glasgow, I know only too well what drug addiction can do to an individual and to their family, friends and community. When I was leaving my flat one day only last year, I saw emergency services in my street, only to find out that a former friend of mine had died because of drugs. I grew up with the guy; we played together and we were in and out of each other’s houses. His partner later told me that she had tried to resuscitate him after he had taken a cocktail of heroin and methadone.
Many years ago, I also lost a close friend to a drug overdose. She was a young woman with a child, and I had grown up with her and known her my whole life. She was such a lovely girl and, although we had grown apart, her death and seeing the impact that it had on her family have stayed with me until this very day.
That is why I am so passionate that we need to work first and foremost to get people off drugs altogether. Deaths are happening because people are falling through the net of a system that is not working. We have to ask ourselves how we got to this position in the first place. As I stated earlier, drug-related deaths are on the rise, having increased by 23 per cent in 2015-16. As the minister said, that means that 867 people died in 2016 alone. Worryingly, it is a long-term trend, with more than twice as many people dying from drug use in Scotland than was the case a decade ago.
The Scottish Government’s flagship road to recovery programme has been branded a total failure. Professor Neil McKeganey of the University of Glasgow’s centre for drug misuse research has spoken of the financial “black hole” that has been created by a drug programme that parks people on methadone with no attempt being made to get them off drugs altogether.
Last year, we saw huge cuts to alcohol and drug treatment funding, with health boards being told to top up budgets themselves. Described as “a false economy” by the British Medical Association, alcohol and drug partnership budgets were cut by 22 per cent. Can the minister honestly say that the Government has really committed to getting people off drugs altogether, and to addressing the number of reasons why people might be on them in the first place?
I thank Annie Wells for taking my intervention and I am sorry to hear about the losses that she has experienced. Does she accept that we are not talking about an either/or situation? It is not about preventing or stopping harmful drug use in the first place; it is about providing protection for the 400 to 500 people who are injecting publicly in the area that Annie Wells represents, and who are vulnerable to real harm.
I am trying to say that there is so much that we could have done before we got to this crisis point—which is why I would like to see a full sector-led debate. Are we seriously making a concerted effort to take people off methadone altogether, which in itself is a huge problem, or are we merely parking them on the drug in the hope that the issue will just go away?
Significantly, among the 867 people who unfortunately died in 2016, the heroin substitute methadone was implicated in 42 per cent of those fatalities. We need greater transparency about the issue. Information on the numbers of people on methadone prescriptions and on whether those on long-term methadone programmes are being seen by their general practitioner every three months, as recommended, is difficult to obtain.
For effective intervention, we need to understand what is happening on the ground, but we do not. Seven years ago, the Scottish Government made a commitment to create a new system of collating information on drugs and alcohol—the drug and alcohol information system, otherwise known as DAISy. However, from what I understand, that has been pushed back again to October this year. It should be a priority, as should a focus on promoting smaller abstinence-based local treatment programmes that help drug users to kick the habit.
I have visited some of those places. During a visit to Turning Point in Glasgow, I was struck by what the lasting effects of drug addiction can be. I had frank and open discussions with service users—some had completed the abstinence programme and some were still on that journey—and their personal stories were deeply moving. Most of them had realised that their addiction to drugs was due to adverse childhood experiences such as abuse and family breakdown. Within the programme, they were receiving the help and support that they needed to deal with what was at the root of their problem.
One of the service users whom I spoke to—a female in her 30s—explained that she had been abused as a young girl, which had started her on the path to taking heroin. She never got the help and support that she needed during the initial years of drug abuse. She then had a baby in her late teens and was unable to have a proper relationship with her child, who she did not see for 16 years. Through the abstinence programme that is run by Turning Point, the peer support that she received, and access to mental health treatment, she was starting to build a relationship with the child she had never known.
I also spoke to a man in his early 40s who had been in and out of prison and had lost any kind of relationship with his family because of his addiction to drugs. That addiction started at an early age. Again, the crux of his problem was never realised. He was still in the methadone programme while he was in prison, but he was also able to obtain illicit drugs.
Those are just two examples, but there are many people out there with similar stories to tell. That is why locally based abstinence programmes are so vital. The situation in Glasgow is extremely worrying.
Annie Wells needs to realise that some people are far away from abstinence and need help with their recovery. Does she concede that it is not an either/or choice and that, actually, the proposal would enable people who are not currently connected with services to connect with services, which would be the best approach to protecting people from drug-related death? Will she concede that that is what the evidence tells us?
I absolutely want people to be connected to services: of course I do. I would rather not have seen an ambulance in my street last year because a friend of mine had died. He had been on drugs for 25 to 30 years and had been on methadone all that time. I know that there are people who will not connect with services, but surely we need to look at the whole solution and not just at one thing. What we are talking about here—[Interruption.] Excuse me, minister—you intervened, and I am answering your question. What we are talking about here is setting up a place where we can put people who are so far removed from abstinence and saying, “There you go. There’s a place to go and take heroin.” Is that like saying, “We’ve forgotten about you”?
No.
I am sorry, but the minister asked about services.
In 2016, 30 per cent of drug-related deaths in Scotland occurred in the NHS Greater Glasgow and Clyde health board area, and about 20 per cent of all drug-related deaths in Scotland occurred in Glasgow city. As most of us are aware, there has been a recent surge in HIV cases in Glasgow, which has been described as a “health epidemic”. Therefore, although I fundamentally do not support the creation of a drug facility, I do believe that it is time to have a sector-led review of Scotland’s drug strategy.
If the facility ever gets the go-ahead, it would have to be part of a wider recovery-focused strategy that aims to reduce the number of addicts. Addicts who use the facility would have to be provided with additional support towards recovery. The facility would have to be monitored extremely closely and be evidence led, and if it was shown to be not working, it should be abandoned.
To finish today, I reiterate my call for a full review of Scotland’s drug strategy. I am concerned that the introduction of a safe injection facility is a crisis measure in response to the long-term failings of Scotland’s drug policy. We should never have got to this point. As I have said, I am concerned that such a facility would send out the message to people that we have given up altogether.
I want Scotland to be ambitious with its strategy, and I want the Scottish Government to focus on the powers that it has to make real progress when it comes to addiction. The stakes are too high. Hope surely comes in getting people off drugs altogether so that they can live their best lives.
I move amendment S5M-11695.2, to leave out from “agrees that international evidence” to end and insert:
“recognises concerns regarding this approach; asks the Scottish Government to conduct a full sector-led review of its existing drug strategy, and believes that, irrespective of the creation of such a facility, every effort should be made to help prevent people from starting to misuse illegal substances and to help them get the support that they need to recover from addiction.”
14:56
The increase in drug-related deaths is a tragedy—it is a tragedy for the individuals concerned, for their friends and families, and for society. Scotland tops the league table in the European Union for drug-related deaths, and the position is getting worse, not better. In the past decade, the drug-death rate has doubled. Drug deaths in Scotland are 160 per million of population, while the EU average is 21.
It is not just an issue of ageing drug users. Drug use among young people is, I believe, as prevalent now as it has ever been. The substances might not all be the same, but we are kidding ourselves on if we believe that young people are not using drugs. MDMA, legal highs, cannabis, cocaine and others are rife in communities across our country.
We cannot allow ourselves to be viewed as distant “suits” who are out of touch with reality. Sadly, much of what we see on our television screens and at the cinema continues the glorification of some forms of drug use.
That is why we must, with honesty and in good faith, consider whether the current approach is working. This is not a political attack on the Scottish Government’s current drug strategy; it is a candid reflection that we are failing as a nation. I say that in full recognition that drug deaths have been steadily increasing since 1995—for long periods since then, my party has been in power. I want to make it clear that I do not believe that we can continue as we are. That is why, today, we will support the Scottish Government’s motion. I hope that the Government will recognise the good faith of our amendment and support it, too.
This is far too serious an issue, with far too many lives being lost and families affected, for it to be used as a political football or as a proxy for constitutional conflict between the Scottish and UK Governments. We should not allow it to become that.
Whatever position we agree today, we have to be honest enough to say that safe injection facilities are not the answer in themselves. Whatever benefits they may bring, they are not the magic bullet for solving Scotland’s drug problem. Nobody in the chamber is seriously suggesting that one injection room in one part of one city is an adequate response to Scotland’s very serious drugs problem, but it may well have a part to play,
We believe that, if necessary, powers should be devolved if all other avenues have been exhausted. In supporting the Government’s motion, however, we are not willing to give the Government a free ride. There are serious questions to answer—not the least of which is how the minister believes that cutting the funding to drug and alcohol partnerships will make things better. A budget that was more than £69 million in 2014-15 is a budget of less than £54 million now. It cannot simply be written off as a coincidence that, over that period, the number of drug-related deaths has increased sharply, and it cannot simply be a coincidence that the health impacts of dirty needles are increasing when needle exchanges are closing down. I would therefore welcome the minister’s explanation of how the cutting of budgets has made a positive difference, if it has.
I come back to the motion. Labour supports the Glasgow safe injection space proposals, but it is clear that we need a wholesale change in the approach to our drug strategy. Why? It is because the evidence that is before us is stark: whatever else our drug strategy might be, it is not a success. Our drug strategy is failing: it is failing individuals, families, whole communities and our nation.
I appreciate a lot of what Anas Sarwar has said and how he has articulated it. However, I worded the motion as I did in order to ensure that we focus on one element of drug policy so that the issue does not become a constitutional one and we could achieve consensus.
However, on the reference to a “failing” strategy, will Anas Sarwar concede that there have been successes, and that many people do not want to rip up the current strategy but to build on it? We have had the first-ever national Naloxone roll-out programme, we have seen a reduction in numbers of young people who are taking drugs, and we have a flourishing recovery community. All those can trace their roots back to the road to recovery strategy. We know that the strategy has shortfalls, but we want to plug any gaps. However, that does not suggest that the entire strategy and approach has been a failure. In fact, saying that it has been a failure does a disservice to the many people who are working incredibly hard to deliver it.
I emphasise that what I am saying is not an attack on the Scottish Government, the existing strategy, the minister or the people who are doing lots of very important work across the country. What I am saying is a reflection on the stats and facts—the numbers and the evidence on the ground.
I note what the minister says about young people’s use of drugs, but I am sorry to say that that is not what I understand from my experience of talking to young people the length and breadth of our country. Young people are now seeing drugs in a much more normalised way.
There seems to be increased drug use among crisis individuals and people in crisis families, but what worries me is that there are lots of people right across the country who would not be regarded as crisis individuals or as being in crisis families who are normalising use of drugs. That might not be about intravenous drugs like heroin, but about legal highs, MDMA, cannabis and cocaine. That is why I think that we need a fresh approach.
There is a large degree of consensus across the chamber on the issue, and some of that has been articulated. I also think that there is a large degree of consensus among people who work with drug issues every day across our country. That is why we are committed to taking a fresh and wide-ranging approach to dealing with our country’s drug problems.
Will the member take an intervention?
I am willing to, but I think that I am running out of time.
The member is coming into his last minute, but I will give him a little extra time as he took a long intervention previously.
Thank you.
Your intervention must be brief, Ms Johnstone.
I am not entirely clear about whether Anas Sarwar sees substance misuse as a public health issue or as a criminal justice matter, so I would be grateful if he could clarify that.
I am just coming on to that. I see substance misuse as a public health issue. The complex nature of substance abuse means that it must be addressed across portfolios. We should look not only at our justice system, but at policing, housing, local government and—more important—the impact of poverty, inequality and austerity on the prevalence of drug use. That is why Labour will hold a wide-ranging cross-sector and cross-portfolio drug summit to consider innovative ways to improve the policy and political response to Scotland’s addiction problems. I think that Alison Johnstone and I are probably very much on the same wavelength in terms of making the issue less about a criminal justice reaction and more about public health.
We should seek to learn lessons not only from around Scotland and the UK but from all around the world, so that we can see how other countries have changed their approach and, as a result, changed levels of drug use. There are bold and innovative examples: Portugal is one, but I will not go into detail, given the time that I have left. However, we need to be brave enough to consider innovative proposals in a cross-party way.
Simply doing the same things over and over again, with the same forlorn hope that things might be different in the future is not the definition of an effective evidence-led policy. I urge the Scottish Government to do as the minister has said and not use our support for the motion as a proxy for a different disagreement, but to use it, and the willingness of members across the chamber, to take a fresh look and to consider new ways so that, years from now, people can look back and say that today, in the Scottish Parliament, we began the process of turning around Scotland’s position as the drugs-death capital of Europe.
I move amendment S5M-11695.3, to insert at end:
“; believes that this is too important an issue for it to become a constitutional conflict between the Scottish and UK governments; notes with grave concern the spike in drug-related deaths in Scotland; recognises that substance abuse is not limited to any one demographic or age group, and believes that the addiction strategy is failing and a new, more holistic and rounded approach, recognising the complex nature of substance abuse, is needed, which considers wider inequality and appropriate support, whether that be in primary care, schools, prisons or other settings.”
15:04
I thank the Scottish Government for securing time for today’s debate. It is a crucial issue, and the recent coverage on “Channel 4 News” and our own understanding of the issue make the debate absolutely prescient. I welcome the minister’s efforts to foster consensus around the motion. It was important to me that she reached out to each of us to talk about the wording of the motion, and I am grateful for that. I also recognise the journey that her party has been on in taking the progressive attitude to addiction that the phrasing of the motion hints at, and I thank her for that, too.
However, before I give the fulsome support of the Liberal Democrats to the motion, I fear that I must briefly depart from that spirit of consensus. In this country, more than twice as many people are dying from drug use as were dying from drug use when her Government came to power, and this country’s rate of drug-related deaths is two and a half times that of the UK as a whole. Despite the minister’s response to my intervention, ADP funding is not at record levels. In fact, her Government’s response was to cut that funding by 23 per cent in 2015, which represents £1.3 million each year in our capital city alone.
I and colleagues such as Neil Findlay, Anas Sarwar and Miles Briggs raised that issue repeatedly over the past two years, but the Government did not rectify the situation fast enough and people are dead as a result. In 2016, a total of 867 people in Scotland died after using illegal or prescription drugs—23 per cent more than in the previous year and 106 per cent more than in 2006. Figures also show that heroin and opioids were implicated in 88 per cent of those deaths, which is why we will support the Government’s motion.
I would pinpoint the fact that, as Anas Sarwar said, evidence shows that the number of drug deaths has actually been increasing since the mid-1990s. We are in the situation that we are in because there has been an increasing trend. It is not correct merely to correlate funding scenarios with drug-related deaths. That does a disservice to the point that we are addressing today in trying to find an effective solution to some of the issues that we are grappling with in Scotland.
I am grateful to the minister for that intervention. However, if her Government’s response to an upward shift in the number of drug-related deaths is to cut ADP funding, there is something fundamentally wrong with its approach to drugs policy.
Although I have to remind the Government of its failure in that regard, I welcome the motion and hope for more like it to come, because there are many benefits to safe injecting spaces. There are 100 such facilities globally and, with more than 30 years of experience, they have amassed a weight of empirical evidence as to their efficacy in reducing the risky behaviour of needle sharing. I declare an interest as a co-convener of the cross-party group on sexual health and blood-borne viruses. Such behaviour is, in part, why we have seen a rise in HIV infection in the city of Glasgow. There is a direct correlation with the number of drug deaths in that city.
I share the Government’s consternation that the Lord Advocate will not give immunity from prosecution to people who use the centre. I have some sympathy with the idea of devolving drugs policy, consistent with other models of federalism that my party aspires to, but my focus right now, and that of my party, is on changing the landscape of our policy response to drug use across the whole of these islands, and my amendment delineates the rest of the iceberg of which safe injection services are just the tip.
The Government’s motion rightly describes this as a public health issue. If I may, I will use the example of cannabis, because I think that there are public health benefits to cannabis that we are not yet exploring. I have raised before with the cabinet secretary the example of Murray Gray, a five-year-old constituent of mine in west Edinburgh. Murray suffers from a very severe form of epilepsy that causes him to suffer many violent episodes, attacks and fits every day. The only thing that can offer him any kind of relief is a cannabis derivative called cannabidiol. Murray’s mother Karen is about to take him to the Hague—against the advice of his doctors, because he is too unwell to travel—so that he can have that medication prescribed there. I accept that it is not down to the cabinet secretary and that cannabis therapy prescription is a UK problem, but it is a problem nonetheless.
Cannabis can provide many untold health benefits for a range of conditions, but right now it is causing only incalculable harm. It causes harm through the farms that are tended by children who have been trafficked to this country and who are held in slave conditions. It causes harm through the weapons-grade skunk that is available on the black market, which is linked to severe psychological difficulties—we could be generating revenue streams that could be funnelled back into treatment. It also causes harm through the waste of police time and capacity issues in our prisons. We should remember that 60 per cent of drug arrests last year were for the possession of cannabis. The war on drugs was lost a long time ago, yet members in the chamber are still fighting it.
Will the member take an intervention?
The member is just about to enter his last minute, so the intervention must be brief, please.
Does the member advocate the decriminalisation of cannabis for all uses or for health use only?
As well as wanting cannabis decriminalised for health use, my party has called for a UK-wide regulated market for cannabis for recreational use. We need to take the profit that is derived from the recreational cannabis market out of the hands of dealers and human traffickers and put it into the Treasury.
Decriminalisation would also free up criminal justice capacity. We must ensure that those who can derive medical support and help from cannabis-derived therapies are supported to do so.
Our drugs policies have failed. I end my speech similarly to how Anas Sarwar ended his, by noting that the definition of insanity is to do things again and again and expect different results.
I move amendment S5M-11695.1, to insert at end:
“; urges, therefore, the Scottish and UK governments to adopt evidence-led drug policies to protect public health and prevent unnecessary drug-related harm and deaths, and believes that the scale of the challenge necessitates a step change in the approach to drugs, with solutions, in addition to safe injection services, that include heroin assisted treatment, protecting drug and alcohol service budgets, ending the destructive use of imprisonment for people misusing drugs and instead diverting them to treatment and education as part of the decriminalisation of the possession of drugs for personal use, local authorities making licensing decisions based on venues' efforts to keep their customers safe, and introducing a regulated market for cannabis.”
I call Alison Johnstone to open for the Scottish Greens. She looks a bit surprised. Did you not know that you were going to speak?
15:11
I knew that I was going to speak, Presiding Officer; I am just pleasantly surprised.
The outbreak of HIV infections in Glasgow is a completely needless public health crisis, which might affect more than one in five of the 500 vulnerable people who are thought to inject drugs in Glasgow city centre, as we have heard. It is the worst outbreak that there has been in the UK for three decades. There can be no room for complacency. In Glasgow City Council, and on the area’s integration joint boards, there has at least been cross-party consensus on the need to treat it as the crisis that it is. We must commend all those who are involved in the plans to institute a safe drug consumption facility.
The Scottish Greens have long believed that substance abuse is a public health issue. We fully agree that it is incumbent on the UK Government to make necessary changes to the existing legislative regime to allow vital health services to be introduced. Given the public health basis for the facility, I believe that the most appropriate change would be to devolve the relevant powers over the control of drugs to the Scottish Parliament. Efforts to save lives, reduce harm and support people who struggle with addiction are hampered by a counterproductive insistence on treating substance abuse as a criminal matter.
I also stress that I have real concerns about the loss of a needle-exchange service in Glasgow city centre. There are no legislative barriers to providing hygienic injecting equipment, and the lack of provision in that area must be addressed immediately. The facility was the busiest of its kind in Scotland, and every day without good access to hygienic injection equipment puts people at greater risk.
Although there is clearly work to be done to reach agreement on the powers that are needed to establish safe drug consumption facilities, there is no excuse for failing to provide appropriate needle-exchange facilities where they are in greatest demand.
A number of members have raised concerns about the action that NHS Greater Glasgow and Clyde has taken. Does the member think that the Scottish Government should have taken action earlier to prevent the closure?
Action is needed urgently, and I would be very grateful if we could reach a consensus on that point today.
Similarly, there is no need to delay the provision of heroin-assisted treatment. I am glad that NHS Greater Glasgow and Clyde is pressing ahead with the development of such treatment. A heroin-assisted treatment facility could also operate a needle-exchange facility without contravening existing prosecution policy.
However, in the long term we need to be able to introduce safer drug consumption facilities. Plans to do that in Glasgow were developed on the basis that it would be instrumental in tackling the recent HIV outbreak. It would also build a greater level of engagement with drug users who have complex health needs and who are not receiving the help that they need from other services, which is key.
It is well documented that safe drug consumption facilities can reduce the risk of disease transmission and overdose and can prevent other harm by improving access to addiction services and other health and social care support. NHS Greater Glasgow and Clyde’s report “Taking away the chaos” illustrates that the majority of people who inject drugs in public places in the city centre are vulnerable in many ways. They have experienced homelessness, imprisonment and chronic poverty. The Scottish Drugs Forum is clear in its view that drug consumption rooms will help health professionals to reach the most marginalised drug users.
The European Monitoring Centre for Drugs and Drug Addiction’s review of evidence shows that, in many European cities, drug consumption rooms provide a range of other health services, including referral to treatment and access to a nurse or a GP for primary care. The BMA supports the introduction of such facilities and highlights strong evidence that, when drug users can access such safe spaces, there is less public injection and syringe sharing. Consequently, the risk of transmitted infection is reduced.
In Scotland, we have made a commitment to eliminate hepatitis C by 2030. Prevention through treatment is an important part of that, but so is ensuring that drug users do not share syringes. Therefore, I was alarmed to read in “Taking away the chaos” that people who injected drugs considered hepatitis C “ubiquitous and therefore inevitable” and that sharing
“communal batches of drugs or ... using needles stored at public injecting locations ... was commonplace.”
We cannot hope to eliminate hepatitis C without providing sufficient clean injecting equipment and safe places to use it, and the Hepatitis C Trust supports the introduction of safe drug consumption facilities.
We cannot tolerate such a serious public safety issue. Nobody should have to worry about dangerous needles being left in their closes or back courts, on the streets or in our parks. It is a really important point that drug consumption facilities will make our cities safer for everyone.
The BMA makes it clear that there is no basis on which to believe that introducing supervised consumption rooms increases drug use. In fact, in Switzerland and Spain some facilities have closed because heroin use has decreased. Therefore, it was beyond frustrating to find out that the plans for such facilities had been blocked as a result of reserved legislation. The Lord Advocate has recognised the clear public health basis for those plans and has recommended that the UK Government be approached to get the relevant powers devolved. It is simply unacceptable for the UK Government to have stated that it has no intention of supporting the proposal or of devolving the necessary powers. It is extremely important that the Scottish Parliament sends out a clear message on the need for the proposed facilities to be introduced and for legislation to be amended or powers devolved, as necessary.
We come to the open debate. Speeches should be of a tight six minutes.
15:17
I am pleased to speak in the debate. Given what has been said, it is clear that we must look at different approaches to help people who have problems with heroin use. I am even more convinced that the provision of safe consumption facilities is the path that we need to go down and that the Parliament must support that.
In preparation for today’s debate, as a member of the Health and Sport Committee, I refreshed my memory on the committee’s strategic plan, which states:
“In all our actions our overriding aim is to improve the health of the people of Scotland”.
Therefore, it is my firm belief that any drug policy change should focus on providing help and support to those who need it rather than on punishing people.
I absolutely support the proposals that the minister has put forward in the motion so that we can do something different to help people and provide harm reduction and, in so doing, avoid unnecessary deaths. I welcome Alison Thewliss MP to the gallery, and I will follow the progress of her private member’s bill as it proceeds through the UK Parliament. I firmly believe that we need to take a different approach. We must recognise that the most vulnerable people need our help.
In the evidence that it took, the committee was told that we need to address the stigma that is attached to drug use and misuse, and that our fellow human beings—our brothers, sisters, parents, aunties, uncles and friends—need our help. We need to treat people with compassion, dignity and care. As I mentioned, we must not impose criminality.
As a registered nurse with more than 30 years of experience who has cared for people with addiction problems, I had my eyes opened when I was studying for my degree at the University of the West of Scotland. One module focused on drugs and alcohol. The tutor, Dr Iain McPhee, inspired me, and I learned a lot about what Annie Wells was discussing in relation to the causes of people taking opioids and other drugs in the first place.
Bruce Alexander, a Canadian addiction specialist and researcher with over 40 years’ experience conducted the rat park experiments, which aimed to show the effect that environment has on drug consumption, and demonstrated that the drug itself is not the sole cause of addiction. He built a rat colony that was 200 times the size of a normal laboratory cage, and housed within it rats of both sexes. He wanted to show that the reason why, in previous experiments that others had carried out, rats showed signs of addiction after drug exposure related to their poor, cramped cage conditions, which caused stress and anxiety. His experiment showed that, when the rats had improved conditions with toys, comforts and mates, the rats chose normal water over sweet morphine water.
The same experiment was happening at the same time in relation to humans, in the Vietnam war. Many of the American troops used opioids while in Vietnam but, when they returned home, 98 per cent of the users did not use heroin again.
Environment is important, and addressing that issue is one of the things that we can do as we explore the options before us. The safe injection sites are part of the multimodal approach that we can take to support the most vulnerable and marginalised people in our cities and places.
Safe injection sites are in use already in Vancouver, Toronto, Boston, Barcelona and Sydney, where they provide a stable, supervised and safe place to inject, which significantly reduces unnecessary deaths that can occur through overdose. The staff can supervise the use of the drugs and administer naloxone if a person’s respiratory rate becomes so slow that they fail to breathe or they breathe at a rate of less than 6 to 8 breaths per minute, which is a complication of overdose. I have given naloxone to patients who have come out of the operating room with too much opioid on board. The supervised aspect of the safe injection sites prevents people from dying. We need to focus on the support that we can give people. The centres do not even need to be run by the national health service.
The motion states:
“international evidence indicates that safer drug consumption facilities can ... save lives”.
In light of that, I want to make a point about Spain, one of our European neighbours. In Barcelona, a centre for safe drug consumption gives people access to sterile equipment for taking drugs. The issue has been spoken about already. Counselling is also provided at the site, as well as emergency first aid, if it is needed. As we tackle hepatitis C, which Alison Harris mentioned, we also need to consider the issue of HIV deaths, which Annie Wells mentioned. In order to reduce the incidence of HIV and hepatitis C infections, we need to support the sterile equipment aspects of the safe injection facilities.
The arguments in favour of consumption rooms in Scotland are evidence based and progressive and clearly show that the centres can save lives. The outdated Misuse of Drugs Act 1971, which aims to criminalise people, means that, if the Scottish Government was to introduce safe injection facilities, the medical staff and the people working at the facility could be prosecuted. I am, therefore, in support of the motion’s call for the UK Government to act on drug laws.
15:23
I welcome the opportunity to speak in this debate, not least because of the fact that it challenges the position that I would have taken prior to becoming an MSP. I freely admit that, not that long ago, my instinct would have been to rail against any policy that allows or enables illegal drug taking in any form. I have always struggled to understand how a person could get to a point at which they would voluntarily and knowingly enter into an activity that causes such self-harm. However, one of the things that this job allows an MSP to do, should they choose to do so, is to engage with members of the public from all backgrounds in order to inform and educate themselves.
To that end, I thank the many organisations across communities that have offered me the opportunity to speak to them and, more importantly, to their service users. That honest, warts-and-all engagement has certainly helped to inform and, in many cases, challenge and change my approach. I thank Addaction in Kilmarnock, Catalyst, HM Prison Kilmarnock and Centrestage Communities, to name but a few, for their continuing access and input on the specific issue that we are discussing.
A few weeks ago, having dropped into Addaction for a catch-up, I raised the question of safe injection houses, and the answer that I received was not quite what I expected. There was caution and a suggestion that people would be interested to see what results would come from establishing a trial in Glasgow. It was thought that a safe injection house would have a very limited place in Kilmarnock, for example, and that, in itself, it would not be a solution to an increasing drug problem in East Ayrshire, especially given the rurality and therefore the limited access to any such facility for many users in the area. We need to note that East Ayrshire has had the highest rise in drug-related deaths in Scotland—some 104 per cent in a year—and that a similar trajectory is expected this year. That is against a backdrop of Scotland having the unwanted tag of the drug death capital of Europe, which has already been mentioned. I asked about the reasons for that alarming rise. A lack of resource and a lack of joined-up thinking between the third sector and the public services were front and centre in the response.
The Health and Sport Committee recently investigated drug issues in the community. As part of that process, I took evidence from service users. I heard the story of a woman who had been put on methadone and had remained on it for over 20 years. It is incredible that she had been unaware that she could get off that drug. It was not until she bumped into a peer who told her how she had managed to take the steps to continue her rehabilitation and eventually get clean from all drugs and treatments that she realised that her journey was not complete. She is now completely clean and has a job and a positive relationship with her daughter. I related that story and other stories of service users who were parked on methadone to the Health and Sport Committee and discovered that other committee members had heard similar stories.
The guidance says that a person’s medication profile should be revisited annually. Obviously, that guidance is not being universally applied. My concern is that treatments such as methadone are not in themselves the solution; rather, they are only part of a potential solution. We should go back to Addaction’s assertion that a reduction in resources is filtering through to the front line. I am concerned that all that the current strategy is doing is shifting the issue and not adequately supporting those who require help to get a lifestyle without illicit drugs and their treatments. It has become obvious to me that, in the Scottish Government’s drug strategy, which is mirrored by other strategies, such as the much-criticised mental health strategy, its approach seems to be based very much on clinical solutions rather than there being the much broader approach that is required, including a cohesive preventative element. The rising issue of addiction to antidepressants, the Scottish Government’s initial approach to our obesity epidemic and its obvious lack of a basic understanding of the preventative health agenda are related to that.
Brian Whittle misunderstands much of what has been achieved through “The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem”, including the 120-plus recovery communities. It is not about a medical solution to recovery, but about finding peer support among people who have gone through the journey themselves. Surely Brian Whittle welcomes that and would not suggest that the Scottish Government’s attempts are being made only through an NHS response to drug addiction. The attempts are much broader and more holistic than that and are very much in the way that Labour’s amendment suggests we should take forward our approach.
The reality is that drug deaths in Scotland are rising at an exponential rate. I am telling members about evidence that is coming from the front line. People are telling us that resources are not getting to them and that their resources are being reduced—that is the fact of the matter. The minister has to get a grasp of reality.
Will the member take an intervention?
No.
That speaks to the crux of this debate and why the Scottish Conservative amendment calls for a sector-led review of the existing drug strategy. That is because the current strategy is quite simply failing. The Scottish Government should be able to accept that, take a step back and allow service users, the third sector and healthcare professionals the opportunity to develop a more cohesive, evidence-based strategy that will tackle the issue of drug addiction and the rising drug deaths rate in Scotland.
Although my thoughts on the creation of a safe injection facility in Glasgow are no longer black and white, it cannot, as has already been said, be seen as a panacea in tackling the drug issue.
There are elements of the Government’s motion that we would support. Of course we should make
“every effort ... to ... prevent people from starting to misuse illegal substances and ... help them get the support that they need to be protected from the harm caused by their use of drugs.”
The trouble is that such a vision is without meaning if there is no plan on how it is to be achieved, and those words are reminiscent of many of the statements that I have heard from the Scottish National Party in this chamber. As we know, the definition of madness is to keep doing the same thing and expect a different result. It is time for change.
15:30
I take this opportunity to remind those in the chamber that I am the parliamentary liaison officer to the health secretary.
I fully support the Government motion. I consider that the UK Government should devolve power to allow the Scottish Government to take the action that is needed to implement its ambitious plans, which are designed to tackle unsafe drug consumption, and allow us to implement safe injection services in our cities.
Our drugs problems are not as simple as saying that we are at war with drugs, or arguing that we should pursue a drugs-free society. That latter aspect is an ideal and does not deal with the reality of how people are. People need to face the reality that addressing our relationship with drugs is much more complicated than eradicating their supply or use.
The Government’s proposal seeks to help the most vulnerable. We need to be bold and radical to help a generation of people, many of whom had to face horrendous policies in their youth and teenage years. Methadone, Suboxone and counselling just do not work for that group. It is not an either/or situation. Annie Wells talked about needing a net to catch people. The proposal, which is aimed at protecting those 400 to 500 people injecting publicly who were mentioned, is part of the net.
Brian Whittle talked about the front line. Prior to being elected, I worked intensely with the drug services in my role as a criminal justice social worker. My experience is that drug injection facilities are needed—indeed, there is evidence that safe injection services are successful, and supervised consumption has become an integrated component of the services that are offered in the drug treatment systems in a number of European countries.
I was heartened to read that some drug consumption rooms in Switzerland and Spain have been so successful that they are no longer needed and there has been a reduction in the number of those injecting heroin. We cannot ignore such inspiring evidence.
We have seen the success of needle exchange facilities. Again, we cannot ignore the outbreak of HIV in Glasgow. In 2017, 24 new cases were identified as a result of drug use, whereas in the other regions—except my own, Lanarkshire—there were none. In Lanarkshire, there were five new cases, which is also deeply worrying.
It is estimated that one in five of the 500 users who inject drugs in Glasgow is involved in the HIV outbreak, which now seems to be affecting about 120 people. There are challenges faced in engaging that population and ensuring that they are seeking treatment. A drug consumption facility would offer the opportunity to engage with them and ensure that treatment is in place.
I back the refreshed substance misuse strategy as it will ensure that the wider health and social needs of those who struggle with drug and alcohol addiction are taken into account as part of people’s on-going treatment and support. By joining up with the range of on-going work across Government to tackle poor mental health, homelessness, social isolation, stigma and employability, we are ensuring that engagement among the vulnerable is high and that they will be encouraged to use the services available to them and that the associated harms of drugs are reduced.
Although we must encourage needle exchange, there is obviously a problem in Glasgow. As the Royal Pharmaceutical Society points out, Scotland’s busiest needle exchange at Glasgow Central station has closed, which will no doubt have a long-term negative impact on public health. That issue was mentioned by Alison Johnstone. If there is no safe place to exchange needles, we will undoubtedly see a rise in needles on the street, with the potential to cause harm to others.
I understand that the proposed drug consumption facility is designed to service the needs of an estimated 400 or 500 individuals who inject publicly in the city centre. There will also be the opportunity to ensure that individuals inject away from the family environment, where children and younger siblings might witness drug abuse. That aspect must be considered within the context of Gail Ross’s members’ business debate on ACEs and the need to protect children and young people from that harm.
The research and the evidence show that supervised drug consumption facilities result in a reduction of high-risk injecting behaviour, such as needle sharing, leading to a lower risk of HIV transmission and death from overdose. Ecological studies have provided evidence that, where coverage is adequate, drug consumption rooms may contribute to reducing drug-related deaths at city level; ultimately, there are no recorded cases of a fatal overdose in a drug consumption room.
In 2016, there were 867 deaths in Scotland from a fatal overdose of drugs, which is the highest number of such deaths in Europe, as many others have highlighted. There is no denying that Scotland has a high rate of drug overdose deaths—indeed, it averages an overdose death every 10 hours—but the wide introduction of drug consumption facilities would ensure that such facilities become an alternative to public injecting, and the Government should be commended for tackling the issue head on. That would perhaps not tackle those who inject at home or in other environments, but it would certainly have an impact on those who overdose in city centres.
The level of drug taking in the general adult population is indeed falling and the level of drug taking among young people remains low, but the issues in Scotland are deep rooted and long-standing and we need a robust strategy to tackle them.
The proposal for a safer consumption facility in Glasgow is an example of how ambitious and innovative responses are being generated at the front line. I believe that working in partnership will ensure that we take measures at the correct level to address drug consumption and its associated risks.
Of course we should ensure that drug problems do not develop in the first place. However, we are not there yet and those who use drugs should have the opportunity to do so safely and with support available. If we introduce a safer consumption facility, vulnerable and exposed users would have a support system in place offering an opportunity for care, harm reduction and treatment options. Many users of heroin are homeless and suffer poor mental health, and they require support as they are members of one of the most marginalised populations.
Such facilities will work only if there is acceptance of them and correct promotion and if we ensure that they are safe environments without risks to users and support workers.
The evidence is there. The Scottish Drugs Forum supports the proposals based on the evidence collected from existing facilities around the world, of which there are now more than 100.
As the minister said, the proposal is not a cure-all, but I believe that it is an appropriate and robust step to take in tackling Scotland’s relationship with drugs. We have a unique opportunity to deliver an innovative drugs policy that would transform Scotland into a beacon of compassionate, effective approaches to drug use. Let us be bold and support the motion at decision time.
15:36
I make it clear from the outset that I am speaking for myself on this issue; I am not speaking as a spokesperson for my party and I am not attempting to undermine anyone. I am not attempting to attack the Government or any other political party, because this issue is just too important to be a party-political dogfight.
Other members have mentioned the statistics. In 2016, almost 900 Scots died drug-related deaths. Every one of those is a son, daughter, brother, sister, mum or dad to someone. There has been a 106 per cent increase in deaths over 10 years. It is the duty of every one of us to speak out about this. If those were the rates for flu or another illness we would be rushing to do something. The figure is twice the rate of that for deaths from liver cancer and the same rate as that for deaths from prostate cancer.
Fulton MacGregor said that there is a death every 10 hours—let that sink in. That is eight times higher than the EU average. We must do something about that.
I fully support the proposal for drugs consumption rooms, but focusing on that today undermines the absolute gravity of what we are facing. If we go about our villages, town and cities, if we go into bars and pubs, and if we look out the window and speak to people where I live, we get the real picture: drugs are readily and cheaply available. The price of cocaine is such that it is now available in every community. Ecstasy is selling for £5, heroin is selling for £10 and Valium is selling for less than £1. Much of the street Valium is counterfeit and laced with the likes of Rohypnol.
The proposal for the injecting room was a response to the spike in HIV infection in Glasgow. In my view, it has great merit, but it is just one tiny part of a big, complex jigsaw that we have to construct if we are serious about addressing this public health crisis. That is why I appeal to the minister to come back in Government time with a much wider debate on this issue.
Like other members, I have met several groups and individuals over the past year who are seeking help for their drug use. They told me that the system is failing them and society. They said that when a drug user seeks initial help, they feel supported and can be stabilised, but when that period of support ends and their case is passed over to their general practitioner, it becomes a medical issue and the support services very often disappear, leaving the person exposed again. They said that the situation had been exacerbated by the cuts to adult support services and council services that often play a supporting role.
A number said that they felt that they had been “parked on methadone”—those were their words—for long periods. I spoke to one man who had been on it for 25 years and to another who had been on it for 15 years. Both of them wanted to be drug and methadone free. Methadone has its place. I am not here to bash opiate replacement—far from it—but being crime free and illicit drug free was not the success that they sought.
Does Neil Findlay agree that although methadone has its place, heroin-assisted therapies in other countries have been backed up by scientific evidence as being particularly efficacious?
Yes, we should look at all of that.
All the people who I spoke to brought up the need for mental health support and the lack of community psychiatric treatment. When people do get support, it is helpful, but provision is patchy and is often not sustained. Several people spoke to me of the depression, loneliness and social isolation of addiction, which are all factors that added to their predicament.
Funding for projects was raised as a significant problem that services face. Alex Cole-Hamilton mentioned the cuts to the drug and alcohol partnerships, which were made at a time when we need more support than ever. That is an error.
The system is broken and we need a brave and radically different approach. Prohibition and telling people that drugs are evil and that people who take them are bad and feckless will mean that we see death rates rise even further. We need a new approach. We will never arrest our way to a drug-free society—indeed our jails are often the place where people are introduced to new drugs, such as spice.
We must recognise the scale of this public health crisis, particularly in working class communities, because if this was a middle class crisis, we would have had action to address the issues a long time ago. Many of the issues can be addressed here and now.
We should go much further and examine the Portuguese model that looks at the relationship that people have with drugs and focuses on them as individuals. In 2001, Portugal became the first country to decriminalise the possession and consumption of all illicit substances. Rather than being arrested, those who are caught with a personal supply might be given a warning, a fine or told to appear before a local commission to discuss treatment, harm reduction and support. Dealers and organised criminals are still dealt with robustly through the criminal law.
After that policy was introduced, the following years saw dramatic drops in problematic drug use, infection rates, overdose deaths, drug-related crime and incarceration rates. HIV infection plummeted from an all-time high of 104.2 new cases per million to 4.2 cases per million in 2015, and drugs use declined overall.
I understand that the Misuse of Drugs Act 1971 is a UK act and that the issue is reserved. I want see change across the UK, but not just in relation to consumption rooms. We need a holistic approach. Such a change will take bravery, commitment and honesty, but the status quo means more deaths, more infection and greater profits for organised criminals.
I fully understand why people have the reaction that they do to drug users. In our society, we have been taught that the best way to deal with drug users is through imprisonment and the criminal justice system. That approach has failed communities, the police and the 867 families who had someone die of an overdose in the past year.
15:42
I refer members to my entry in the register of interests, in that I am a registered mental health nurse and currently hold an honorary contract with NHS Greater Glasgow and Clyde.
I am grateful for today’s opportunity to discuss safe injecting rooms. This will be the third occasion on which I have spoken in favour of this type of healthcare facility, which is proven, across the world, to save lives. It is a huge source of frustration to me that the Scottish Parliament is unable to pass legislation that would allow safe injection facilities to be established in Scotland—a place where they are greatly needed.
The heart of Glasgow city centre is just a 10-minute drive from my constituency office in Rutherglen. It is a city centre where street injecting of heroin continues, where associated health issues are on the rise and where people who use drugs are risking their lives daily. Many of those people are long-standing heroin users, and despite repeated rounds of treatments, such as methadone and residential rehabilitation, their addiction and the risk to the public health and public order remains.
Research undertaken by the Glasgow city health and social care partnership suggests that there are approximately 400 to 500 people injecting drugs in public places in the city centre on a regular basis. However, many do not have the option of taking drugs in a clean and secure environment—they often take the drugs while hidden under bridges, in alleys, on waste ground and in dark public car parks. Each and every day those people risk losing their lives if they overdose out of sight with no immediate help available to them.
The scale of Glasgow’s problem can be evidenced by looking at the proportion of Scotland’s drug-related deaths that occurs in the city. Of the 867 such deaths in 2016, 30 per cent—or 257—took place in the Greater Glasgow and Clyde NHS health board area. Those 257 deaths are not merely a statistic: each represents an individual person, with their own story and background. They were mothers, fathers, sons and daughters who were let down by UK drugs policy and a UK Government that refuses to look at the evidence of successive years of safe injection facilities overseas.
As members will be aware, Glasgow is not only counting the cost of drug-related deaths; it is in the midst of an HIV outbreak that currently involves around 120 people. As reported by ITV’s Peter Smith last month, almost every person diagnosed with HIV in Glasgow uses heroin, and its prevalence is spreading faster there than it is anywhere else in the UK. In a step that will only exacerbate the growing problem, as Alison Johnstone alluded to, in September 2017 Network Rail closed its needle exchange service in Central station. That service was Scotland’s busiest, handing out over a thousand clean injection sets to people each month and having benefited 2,000 people since it opened in 2016. As it stands, it is extremely difficult to control the spread of the virus, therefore new ways of thinking are required. Drastic public health issues need drastic solutions.
In 2015, Glasgow city health and social care partnership published a report entitled “Taking away the chaos”, which looked specifically at the health needs of people who inject drugs in public places in Glasgow city centre. The report concluded, quite explicitly, that the way to deal with public drug use is to provide safe, managed spaces for people to inject in. As we have heard, not one person has ever died in a drug consumption room. Such spaces also improve access to, and increase integration between, existing services. In the report, particular reference was made to giving people the opportunity of accessing housing services, social work, welfare advice, primary care and drugs counsellors, all under one roof.
Indeed, a 2014 study into 62 drug consumption facilities across Europe found that they provided a wide range of auxiliary services. They treat people holistically, looking at all their health and social care needs. They also treat the whole person, because that is exactly what those who are addicted to drugs are: they are people—not addicts or users—and they deserve the best evidence-based care that we can provide. The benefits of safe injection rooms are not unique to those who use drugs, but apply to wider society, too. They reduce the risk of public injecting, reduce drug-related litter and cut down on the number of people who share injecting equipment, which, in turn, reduces behaviours that increase the risk of HIV and hepatitis C transmission.
The only things that stand in the way of introducing such a facility in Glasgow are the UK Government and its drugs laws. It is clear from today’s debate that we have cross-party support here at Holyrood, but that is the case at Westminster and at local government level, too. Earlier this month, Glasgow City Council passed a motion that unanimously supported establishing a drug consumption facility in the city, which it did with support from the Conservative group. In contrast to that for other UK cities that have previously considered such measures, the evidence shows that the scale of public injecting in Glasgow and its associated implications for the user and wider society justify the introduction of a pilot facility in the city.
This is not a political issue but a public health one. While politicians debate drugs policy, lives are being lost and families and friends are being bereaved. I therefore call on the UK Government to look at the evidence, listen to the calls of politicians, the Scottish Drugs Forum and health professionals, and do the right thing. No one is naive enough to think that the introduction of a safe injection facility will be a silver bullet. However, with sensible policies from Westminster, at Holyrood and at local level, we can make great progress in tackling the crisis. Scotland’s unhealthy relationship with drugs is not changing, so it is time to change our laws.
15:49
I welcome the opportunity of speaking in today’s very important debate. For decades, Scotland has faced a serious drug addiction problem. With the rise of opiates, and synthetic and psychoactive drugs, the problem has continued to grow and evolve, becoming more difficult to tackle. Throughout Scotland, and especially in our most vulnerable communities, we continue to see drug addiction take the lives of friends and families. We are also seeing a growing number of cases of diseases such as HIV and hepatitis C as a result of increased needle sharing. As Annie Wells said, in 2016, 867 people died from a drug overdose, and, from 2006 to 2016, there was an increase of 106 per cent in the total rate, which clearly puts community safety at risk.
In an ideal world, we would have a drug-free Scotland. Given the current crisis levels of drug addiction in Scotland, it is necessary to take small steps to achieve that. I want us to think globally. We need to get the United Nations involved, through the World Health Organization, to get to grips with the growing distribution of high-grade heroin from the poppy fields of Afghanistan. We need to restrict the growing and distribution of heroin in the Helmand province, which I saw when I worked there. Addressing that issue would go a long way towards dealing with the addiction issue. We could direct supplies into analgesics through the World Health Organization for health purposes. In fact, some years ago, the UK Government considered that approach.
How would cutting off the supply help the 400 to 500 people in Glasgow whose lives are at risk today because they are injecting in the street? What do we do about them right now?
You may or may not know that the heroin that is produced in Afghanistan by the 100 farmers who grow it is high-grade heroin from the poppy fields. It goes on its way to Pakistan and is watered down or diluted and impregnated with wrong products. It then comes to the UK market, which is where the damage is done. We could get the World Health Organization to take up that production. I see no reason why we could not restrict the distribution.
I am curious to know whether you can give a timescale for when your strategy will result in help reaching the 400 to 500 individuals in the city that I represent who are exposed and vulnerable right now.
I will not put any timescale on it; I am just saying that this is a bigger problem than just the one that we have here. It is a global problem, and we need to go back to the sources of the product. My concern is that the product is being adulterated when it gets into the marketplace, and that is part of the problem in Glasgow or any other city in our country.
[Interruption.] Sorry for sitting down. Right—
I like the way that you corrected yourself there. Off you go.
Thank you, Presiding Officer. I am always one for procedure.
As part of a wide review of all drugs services, we must look into whether the implementation of a safe injection facility in Glasgow city centre could help to reduce the number of overdose deaths and the number of cases of diseases being contracted from the use of unsterile needles. I have every sympathy with what members have said about the dire situation in Glasgow, and I understand it, having worked in Maryhill and Possilpark in Glasgow and having seen the problems on the streets there and in Bosnia and Afghanistan. The situation presents an environment that could allow us to examine whether such programmes could be beneficial in Scotland.
Around the world, such facilities have been introduced in many communities that face addiction problems. As has been referred to, as of 2015, nearly 100 facilities operated in 66 European and North American cities. The European Monitoring Centre for Drugs and Drug Addiction has reviewed many of those programmes and found that the results have been positive in many locations. In the Canadian city of Vancouver, the Insite facility has undergone extensive analysis to ensure that it is serving its purpose. Research has found that clients are less likely to engage in behaviour that has an HIV risk and that there has been a considerable decrease in public injections and injection-related litter in the area of the facility. Within one year of the facility opening, there was a 30 per cent increase in the use of detoxification programmes by clients and, most strikingly, Vancouver saw a 35 per cent decrease in overdose deaths after the facility had been opened for two years.
If we were to open a facility in Scotland, it would need to undergo similar vigorous analysis to ensure that it was impacting the community positively, and it would also need to be part of a wider strategy. That would require independent studies and on-site monitoring to ensure that the facility was functioning as intended. Detailed rules would need to be established for the facility and for the individuals utilising its services, bearing in mind that many addicts lead chaotic lifestyles.
A facility could also provide important insight into how drug addiction is changing and allow the various sectors that work to combat drug abuse to understand the current state of the problem. The information could help us to better understand the problem and therefore help us to find better solutions.
The important facet of safe injection facilities is that they offer support and resources in relation to not only safe administration of drugs but pathways to recovery. A facility in Scotland should have such resources and recovery should be its main focus. The facility would need to be used on a transitional basis. Attendance at a safe injection facility should be seen not as a long-term solution but as a way for people to learn about resources and treatment options while they are struggling with addiction.
In many European countries that have introduced such facilities, particularly the Netherlands, there has been a significant decrease in injecting drugs, but there has been an increase in smoking.
I am sorry, Mr Corry, but you must conclude there.
In conclusion—
I am intervening now, Mr Corry. That means that you stop.
Oh, right. Okay.
Thank you. I remind members that you are slipping into using the word “you” again. You should speak through the chair; I am the only “you” in the chamber. I am not just speaking to Mr Corry; that applies to other members, as well.
15:55
I want to be brutally honest: we are talking about long-term drug users who lead chaotic lives. I think that the whole Parliament agrees that such people need help in some form or another.
I am the constituency MSP for Glasgow city centre and I live in the city centre. I know exactly what goes on there; I see the discarded needles, as do my constituents. The issue is raised with community councils and with the police. However, I want to put that into perspective. There are certain areas in Glasgow city centre where, unfortunately, those poor people who have chaotic lifestyles go to discard their needles. The rest of Glasgow city centre is perfectly safe and welcoming for anyone who wants to go there. That absolutely has to be said.
The people who are suffering—the 400 to 500 injecting drug users—are the ones that we need to think about. We need to think about what is happening to them, and we need to save their lives, because they have reached a stage at which they cannot help what they are doing.
As members said, people do not want to inject in public; unfortunately they do inject in public and kids and members of the public see that happening. I thank everyone who has given evidence to me and other people and who has allowed me to speak to them about what is happening out there, not just in Glasgow city centre but in other areas—Jenny Marra might talk about Dundee, and other members might talk about Edinburgh.
In the long term, we have to regard drug misuse as a health issue, not a justice issue—although I will come back to the justice issue if I have time—and I thank Glasgow City Council for unanimously agreeing to a motion on consideration of an injection centre.
My colleague Alison Thewliss MP, who has been mentioned, is in the public gallery. We share responsibility for Glasgow city centre, which is in our constituencies, and I thank Alison for her Supervised Drug Consumption Facilities Bill. I want to read out something that she said in the debate on her proposal. She said:
“On Monday, one of my constituents mentioned to me that Glasgow already has drug consumption facilities: they are behind the bushes near his flat and in his close when it rains.”—[Official Report, House of Commons, 14 March 2018; Vol 637, c 903.]
I think that anyone who has been in the position of Alison Thewliss’s constituent will know that the person was absolutely right. There are drug consumption facilities in bin shelters, in bus shelters, in empty and disused buildings and in fields. We need to do something about that, to help people.
We want to help people, but questions have to be asked about legality. As far as I am concerned, this is not a party political debate. It is not about the constitution and what is devolved to the Scottish Parliament. It is not about Westminster refusing to give us something. It is about asking for powers to ensure that people can go somewhere safe to inject. Somewhere safe—that is what it is all about.
I have been asked a couple of questions by constituents that I am duty bound to put to the minister—and I want to know for myself exactly what the situation is. Are we talking about a safe injection facility or a heroin-assisted treatment facility? That has not been made clear to me or to my constituents.
One of the biggest issues for me as well as for my constituents—I live in the city centre and I represent it—is where it will be sited and what is the police’s involvement in that? I see this as a health issue but, unfortunately, there are issues around justice and policing. We cannot hide from those issues; we need to look at them. I therefore ask the minister if she could answer those questions in her summing up. Are we looking at a safe injection facility to which people will come with their heroin or other drugs to be injected? Are we looking at a heroin-assisted treatment centre at which they will be provided with the drug? That has to be made clear.
Will the member take an intervention?
It might be early yet to talk about where the centre is to be sited but it would be good to find out whereabouts in Glasgow’s city centre. What about police involvement? What do the police have to say about this? How will they be involved?
I am not sure whether you are going to take the intervention or you are both just going to stand up.
I am happy to take the intervention.
I have been clear that I am looking for Parliament to unite behind an approach to the UK Government to permit the pursuance of a safe injection facility. We do not have the power to do that. I understand that the Glasgow health and social care partnership is currently looking at heroin-assisted treatment, but today’s debate is about a safe injection facility or safe consumption rooms. We do not have the power to take those forward in the here and now.
Ms White, you will need to finish in the next 30 seconds.
That is fine. The minister has clarified things for me because those questions were not clear as far as I could see.
I want to mention the removal of the clean needle exchange. That was a disgrace—we need more such initiatives.
I would like to know more about the police involvement and what will happen to people who are travelling to and arriving at the centre with drugs and that sort of thing. I am supportive of doing something to alleviate the suffering that these people are going through.
16:01
No one can doubt the harm that is being caused to our towns and cities by drug addiction, nor can we doubt that the current addiction strategy is not working for all our citizens. In that context, the Scottish Government’s willingness to consider radical proposals should be welcomed.
However, like my colleagues, I caution the minister that, for her to begin the process of reforming addiction services with a proposal that the Government cannot enact under its own powers opens her up to the charge that she is playing politics. I am happy to take an intervention from her, but I urge her not to allow the topic to be dragged into yet another of our interminable constitutional fights.
I do not want to do disservice to the private and confidential conversations that I had to try to get to a point at which we could unite behind a motion, but I did try to ensure that Opposition parties understood that this is not an attempt to find a way to have a constitutional argument. I am trying to respond to the problems that we face in Scotland and to find a Scottish solution to them, and we recognise that we need the powers and the ability to act on this. We do not have those powers and I want us to unite behind allowing me to go to the UK Government and tell it that Parliament is speaking with one voice on this issue.
I thank the minister for her clarity. I have been a member of the Parliament for seven years and we have not been inundated with Government debates on Scotland’s huge problem with drug abuse and alcohol misuse and how those two problems are connected. That is why I make the point to the minister today. She does not look very pleased about it, but we have said that we will support her motion. However, this is one of her staging debates and there are myriad issues that need to be considered. If she could commit more Government time and more of her own chamber time to discussing such issues, she would give comfort to those of us who want to see more time spent on them.
As Anas Sarwar said, we support the idea of safe injection sites, but we do so on the understanding that no one facility in one city, and indeed no one idea, can be enough to address the problems that our country faces from drug misuse. Scotland’s drug death rate is a national tragedy and we owe it to our communities to keep an open mind on how to deal with that.
In 2016, 867 people in Scotland died drug-related deaths. In Dundee that same year, there were 38 drug-related deaths, under the narrow definition of drug-related deaths. Other people who were using drugs died of alcohol-related causes, which takes the overall figure much higher; we forget that at our peril.
Those figures mean that Dundee has the worst drugs death rate in Scotland and the worst in Europe. In 2016, that meant 38 or more families dealing with the death of children and grandchildren and, heartbreakingly, young children suffering the pain of the loss of a parent. It is a scar and a curse on our community in Dundee and it needs urgent attention, as I have just outlined.
On a strategic level, the Scottish Government’s plan to develop a new substance misuse treatment strategy is welcome. In Dundee, we have just launched a new drugs commission to look again at how we address addiction in the city. Welcome though those developments are, I am a little worried that we are not seeking the fresh ideas and perspectives that we need.
Dundee City Council has appointed a member of the board of NHS Tayside to chair the commission and although I do not impugn that person, I feel that we need to bring fresh eyes and fresh ideas to Dundee and I wonder whether it is right to ask someone who is responsible for delivering and scrutinising statutory drug services to take that fresh look at the problem, which may include how services are delivered and reforms to those services. I ask the minister to kindly take up that point and address it if she agrees with me that we need a fresh chair and fresh eyes to look at this.
We absolutely have to have fresh ideas because we have a major and specific problem in Dundee and if we are doing things differently there that contribute to having the highest drugs death rate in the country, the commission must be able to identify what we are doing differently and begin the process of reform. I look forward to the parameters and objectives of that commission being published very soon.
Any debate on drugs has to take account of the reality of what is going on. Drugs are coming in to Dundee and to homes all across Scotland through legal deliveries—through delivery companies and through the post. They are bought on the internet and they are arriving in shoe boxes. Drugs are being openly sold on Facebook. Facts such as those make the landscape more difficult and more complex and in a longer series of debates, minister, we could explore and take account of these myriad issues.
As Anas Sarwar said on behalf of Labour this afternoon, we are happy to support the Government motion but we would like to see more focus on giving all the aspects of drug and alcohol misuse equal attention as soon as the minister can secure time.
16:08
I will start my contribution with a question. If your son, daughter, niece or nephew had a drug addiction problem, would you rather they injected those drugs in a dark alleyway or in safe, clean premises, supervised by medical staff?
I would say that the answer is a bit of a no-brainer. Studies have shown that safe consumption facilities can succeed in reaching long-term drug users who have had no previous contact with treatment services, and can be effective in getting some users of the facilities into treatment programmes.
A hundred safe injection rooms across 66 cities in 10 other countries—including in Switzerland, Germany, the Netherlands, Spain, Norway, Australia and Canada—have proved successful at reducing drug deaths and HIV infection rates.
Senior medical professionals have described the soaring HIV infection cases in Glasgow as a public health emergency. As we have heard, in 2016 Scotland had 867 deaths from fatal drug overdoses—the highest number of deaths from drug overdoses in Europe. Across the UK 1,573 people died in 2015 as a result of heroin overdoses.
There is an on-going outbreak of HIV in Glasgow, to which public injecting and needle sharing has contributed. By the end of 2016, 78 cases had been linked to the HIV outbreak in Glasgow, with further cases expected in the next few years, and 83 per cent of those affected by the outbreak reported that they had injected drugs in public places.
The costs of dealing with drug overdoses and the health problems associated with addiction in Glasgow have been rising sharply, along with the increase in drug-related deaths. The cost of drug addiction is mounting for the NHS. With increasing HIV infection rates and with the lifetime cost of treating HIV estimated at £360,000 per person, the treatment cost is expected to reach £28 million for NHS Greater Glasgow and Clyde. Taking into account use of front-line health services and the costs of dealing with long-term blood-borne infections, the status quo costs the NHS in Glasgow over £29 million. It is, however, the human cost that I believe should be the most important factor in the argument for providing safe facilities.
Evidence from safe drug consumption facilities operating in other countries has shown reductions in the discarding of needles, reductions in high-risk public injecting and reductions in deaths from overdoses. They reduce the spread of blood-borne diseases through needle sharing and discarding.
We simply cannot do nothing. We must make changes and make them fast. The problem, as we have heard, is that despite the Scottish Government agreeing that there is evidence that safer injection facilities are successful, we cannot legally introduce safe injection rooms.
Victoria Atkins MP, parliamentary under-secretary at the Home Office, said in January this year:
“We have no intention of introducing drug consumption rooms, nor do we have any intention of devolving the United Kingdom policy on drug classification and the way in which we deal with prohibited drugs to Scotland.”
I hope that she changes her mind. Like others, I believe firmly that this is a health issue, not a justice issue. We are where we are. The Supervised Drug Consumption Facilities Bill, sponsored by my colleague at Westminster Alison Thewliss MP and mentioned by Sandra White, seeks to amend the Misuse of Drugs Act 1971 to enable the supervised drug consumption facility proposed by Glasgow city health and social care partnership to operate legally.
Primary legislation from the UK Parliament, or the devolution of drugs law to the Scottish Parliament, is required to make the necessary changes to the law to protect service users and staff from prosecution. Alison Thewliss’s bill seeks to make the necessary amendments to the Misuse of Drugs Act 1971 to enable the supervised drug consumption facility to operate legally.
Safe injection facilities are a civilised, grown-up response to a problem that will not go away and is getting worse year on year. Safe injection rooms will reduce problems for the wider community, such as discarded needles that can easily be picked up by children, but they also reduce risks for users, who face increased risk of infection, blood-borne viruses or overdose.
The status quo is not an option. Let us learn from good practice in other countries. This is a public health issue and we must do everything that we can to deal with it now. Of course it will not solve the wider drug problem in Scotland, but it will save lives now.
I urge members to support the Government’s motion.
16:13
“What do you want me to do?” That was the question I faced.
Scotland tops the drugs-death rate in Europe and is breaking records for heroin and methadone hospital admissions. That is a very sad source of national embarrassment, to say the least. The overrepresentation of older drug users aged 35 and over is indicative of the failure under successive Scottish Governments to get people off drugs entirely. Many of those users have prolonged histories of drug abuse. Some may even be old enough to be part of the “Trainspotting” generation, the 1980s addicts immortalised in the best-selling Irvine Welsh novel, which was based in an area not far from the Parliament. They have led a life of addiction for decades and, as the Scottish Drugs Forum has warned, current services are unprepared to meet their care and support needs.
Although positive signs can be found among younger age groups, there are still worrying statistics that may indicate a reversal in trends, such as those showing that the number of 15-year-olds saying that they had tried ecstasy more than doubled between 2013 and 2015, and that cocaine use doubled between those years.
Those figures mean that we, as a society, are failing some of the most vulnerable people, who often come from more deprived backgrounds. Factors such as weak family and social bonds and few employment opportunities and community resources can all interplay and foster an environment in which drug taking occurs.
Unfortunately, in my work in the criminal courts, I have had much direct experience of what can happen as a result of drug abuse. The sheer devastation that drug use can cause, for individual lives, families and society generally, can be profound. The question “What do you want me to do?” was from a judge to me. It was asked in a sad case of a female drug user who had become involved in crime—indeed, she had lost fingers as a result of her habit and addiction. The only answer that I could give to the judge’s question was “Please give her another chance.” That was not a legal argument, but it was all that I could say on her behalf. However, he gave her another chance, rather than send her to prison.
That drug user was typical of many drug users who have ended up in lives of crime due to their addictive habit. The solution is not to give up on those users as if they are beyond help, and it is not to assist them to continue a harmful habit through so-called safe injection facilities, because those same people remain reliant on drugs that prevent them from helping themselves and engaging with opportunities in the world of work and mainstream society that could take them away from the life that they find themselves in.
Opioid replacement therapies such as prescribed methadone can have a role in taking people off dangerous street drugs, but only if they are used to progress a user’s recovery and eventually take them off drugs altogether. That requires regular engagement with the user to assist them on that road; otherwise, the therapies can simply become another part of a devastating and dangerous cocktail of drug abuse. Sadly, many who have been given the methadone alternative have subsequently been forgotten about and put to one side without any tangible progress being made towards recovery, sometimes for decades.
Those are now the failures of the SNP Government. There has been a failure to ensure that checks and balances are in place in the health system to ensure that users are recovering. Supervised consumption treatments focus on the circumstances in which drugs are taken rather than on the consumption of the drugs, which should be the main focus. To give users the best possible chance of turning their lives around, the Scottish Government should focus on taking them away from drugs altogether.
A legal basis is already there if the Scottish Government truly wanted to act, because there is the possibility of heroin-assisted treatment, which allows for legally prescribed heroin—rather than users bringing in street drugs, the content of which is unknown. Such treatment can be given under supervision and as a road to recovery. It can already be delivered legally within the framework of existing medicines legislation, as confirmed by the Lord Advocate, and it does not require a change in law by the UK Government
Scotland’s drugs strategy is failing. We need an approach that puts resources into drug use prevention and recovery rather than into substitution, which continues the cycle of drug abuse.
16:18
I believe that problematic drug use is a public health issue and should be treated as such. Many people using drugs on the streets are struggling with multiple, complex issues. Safe injection facilities are about ensuring the dignity and safety of some of the most vulnerable people in our communities, and about saving lives—and these lives are worth saving. A news report last month on the topic of safe injection facilities shared the story of Jane, a 29-year-old from Glasgow who uses in the city centre. She woke from a fix to find a rat chewing through her arm. She spoke about wanting to die. I was genuinely shocked to hear about the reality of Jane’s life in 21st century Scotland.
It would seem logical that providing safe injection facilities would guard against such tragic situations and provide people with some safety and an opportunity for additional support and help. In such facilities, health professionals are always on hand to treat overdoses as well as offer health checks for any physical or mental health problems. Safe injection facilities could also help to reverse the alarming drug-related HIV outbreak that we are currently seeing in Glasgow. Almost every new case involves a person who is addicted to heroin. Through providing a safe space to inject drugs, with clean needles that would be disposed of carefully, safe injection facilities would be an essential tool in the fight against HIV—a fight to which every one of us in the chamber should be committed.
Treating people with dignity and respect is a good first step towards tackling the most profound issue of stigmatisation that surrounds addiction. Instead of leaving people to inject with dirty needles in alleyways, safe injection facilities treat people like human beings with a health problem, rather than as criminals. In building relationships and trust with often hard-to-reach or easy-to-ignore people, safe injection facilities also increase the likelihood of people engaging with services that can help treat their addiction and aid their recovery.
I commend work that is being done in my constituency through the peer mentoring approach that is being delivered by the North Ayrshire ADP in conjunction with NHS Health Scotland’s public health directorate. Through that initiative, peer support workers, who have lived experience of addiction, support individuals who are undertaking treatment for a blood-borne virus and identify those who are at risk. That approach has enhanced the number of people being tested for blood-borne viruses and sexual health issues and increased the number of people commencing treatment. It has reached a number of marginalised individuals, particularly in homeless and prison settings. One of the people who benefited from the service said:
“The Peer workers have given me confidence to deal with everyday life. I feel safe with the peers knowing they have lived experience; this gives me hope that I can also recover if I do what they did. The power of example is very powerful.”
I am pleased to tell the chamber that that peer approach won a health and social care innovation award for its good work. It is a strong example of how finding different ways to engage people can have a properly transformational impact in helping them on the path to recovery.
Safe injection facilities have an important role to play in getting Scotland to a stage where it is no longer the drug-death capital of Europe. Although it is important to note that youth drug use is falling—with smoking, alcohol consumption and drug use among young people at record low levels—we cannot ignore Scotland’s rate of drug deaths.
I hear quite a lot about the number of young people taking drugs having fallen, but I have to say—and I am quite willing to put this on the record—that I have grave reservations about whether those statistics are correct, to judge from my experience of listening to young people in the communities that I represent. Does Ruth Maguire share those concerns?
I do share those concerns. The ready availability of drugs and the cost of drugs reflect the fact that the war on drugs has not worked, and there is a lot to be done.
As I said, we cannot ignore Scotland’s rate of drug deaths. The year 2016 saw the highest number of drug-related deaths recorded across the Ayrshire and Arran health board area since 2004, following a longer-term, more gradual upward trend. Sadly, that increase mirrors the picture across Scotland. A substantial number of those who die are not in contact with specialist services at the time of their death. In Ayrshire and Arran, the number is slightly higher than the national average of 36 per cent. We must find new ways to reach those who are not in contact with services.
Safe injection facilities are one way that we can do that. However, on the topic of safe injection facilities, we frequently run into a frustrating constitutional brick wall. As is so often the case, although we clearly have the political will to introduce safe injection facilities in Scotland, we do not have the powers to do so. The Scottish Government’s support for safe injection facilities is correct and welcome, but the power to act lies with the UK Government, so I add my voice to those calling for the action that is desperately needed, and I urge other members from across the chamber to do the same.
Every drug death is an absolute tragedy, not just for the person involved and for their family and friends, but for our wider community. We all have to do everything in our power to change that.
16:24
I agree with the introduction of safe injection facilities in Glasgow. The Scottish Government motion has been deliberately drawn narrowly, as we have heard from the minister, in order to garner cross-party support. That was the strategy for the motion and I am pleased that it has, with the exception of the Conservatives, achieved cross-party support. I thank all members across the chamber for the tone of the debate.
Will the member take an intervention?
I would like to make a bit of progress first, and then perhaps I will let Mr Whittle in.
I am also pleased that today has sparked a wider debate on drugs policy and its funding, as promulgated by Anas Sarwar and Alex Cole-Hamilton. That is important: it should be debated, so I welcome those comments.
Why do I support the introduction of safe injection facilities? NHS Greater Glasgow and Clyde alcohol and drugs partnership’s report, “Taking away the chaos”, makes compelling reading, and it contains a strong evidence base. The 400 to 500 people who inject publicly in Glasgow city centre are at risk and are vulnerable. I acknowledge that such people can be challenging and resistant to help—let us not forget that—but we must care for them.
There were 170 drug-related deaths in Glasgow in 2016, and there were 867 across Scotland in that year. As we have heard, there were 47 new HIV diagnoses the year before that. The really strong recommendation in the “Taking away the chaos” report on piloting and evaluating a safe injecting facility is overwhelming. I stress that because if the facility is evaluated and found not to work, we can change the strategy. However, the report is compelling and such recommendations need to be tried.
The facility will not fix the problem, but it will help. I believe that it will lead to fewer fatalities and fewer needles being discarded unsafely in parks, alleys and back courts, and prevent all the public health dangers that are inherent in that. I believe that it will also lead to fewer HIV and hepatitis C infections.
There will also be more opportunities to engage with a hugely hard-to-reach group, and it is that opportunity that I want to explore further. We should look at the example of engagement with another hard-to-reach group—there is sometimes an overlap—which is homeless people. Between December 2017 and January 2018, 356 people presented at Glasgow City Mission’s emergency winter shelter, which represented a 5 per cent increase. Glasgow City Mission’s website states:
“Conversations take place throughout the night and into the morning between staff and guests to ensure we are doing all that we can to help guests move forward into settled accommodation and that they can access the healthcare and other services that they require.”
A lot of those guests will not previously have been on social services’ radar, so that will be the first opportunity for them to engage with the services that are there to help them. The result was that the majority of people were given more stable accommodation within three nights of their appearing at Glasgow City Mission’s shelter, and did not need to remain at the emergency shelter. Ninety-four people were referred to Govan Law Centre and given specific help on accessing benefits, and 111 people were signposted to the NHS’s Hunter Street nursing facility. Because they had somewhere to go, real help was provided to vulnerable people who were off the radar of society and who were leading chaotic lives.
That is precisely the model that the safe injecting facility is trying to adopt in relation to some of the most vulnerable drug users in our society. There is a false debate between abstinence and safe injecting. It is vital that we understand that relapse is a normal part of recovery. Most people who recover in the long term relapse on several occasions. How do we support people who relapse and have chaotic lifestyles? We need places such as safe injection facilities so that they can re-engage with services. That is really important.
I admit that not everything is happy in “The Road to Recovery”, and I am sure that the Government will engage to improve things. In my constituency, I hear about long-term use of methadone and people not necessarily being able to move forward to sustainable recovery. I hear concerns about the moneys that are made by certain pharmacies, which relate to the business model of supplying methadone to vulnerable people. I am repeating concerns that I hear in my constituency.
Alex Cole-Hamilton mentioned budgets. A new budget process in the Scottish Parliament starts this year, which will allow much earlier constructive and positive engagement, before the numbers for the budget have even been set. The challenge to all politicians—in the Opposition and in Government—is to have constructive and positive discussions about what budgets should look like. I am not saying this to be defensive, but let us not get hung up on numbers. The point of the budget process is not just inputs; it is also about outcomes for all our vulnerable people.
Will the member take an intervention?
I am sorry, but there is no time.
I apologise for not having time.
The Conservatives said that safe injection facilities are about writing off or forgetting the most vulnerable people in society: quite the opposite is true. [Interruption.] Annie Wells said that; members can read the Official Report. It may be about only 400 to 500 people on the streets of Glasgow, but they are human beings who need help and support. Parliament should unite to reach out and try to help them.
We move to closing speeches. Alex Cole-Hamilton has up to six minutes, please.
16:30
Thank you, Deputy Presiding Officer. I think that I reached a new height in peer review in my career as a parliamentarian when, on the margins of this meeting, Adam Tomkins described my amendment as “completely bonkers”. However, that is quite the usual Tory response to radical change that is supported by a weight of empirical international evidence—[Interruption.] I thank Ben Macpherson for applauding. [Laughter.]
I welcome the motion and its stabling of the matter under public health, because for too long drugs policy has been rooted in criminal justice—both in our minds and in the public policy that we have made in Parliament. That misstep has cost us space in our prisons, police time, untapped revenue for the Exchequer and lives. We have the highest rate of drug-related deaths in western Europe, which is an unenviable honour to hold, so I welcome the debate and hope for more like it.
In the minister’s intervention on me during my earlier speech, there was a suggestion that ADP funding is actually at its highest level yet. That is risible. Workers, statisticians and third sector stakeholders have all seen that the inescapable corollary of the 23 per cent cut that we heard about in several speeches and closure of services to which it has led, is the 23 per cent increase in deaths that followed last year.
I thank the minister for the motion, but I wonder whether she will take the opportunity to state on the record that she accepts that a cut in funding services was not an appropriate response, if we recognise that drug deaths have increased across the country over the past 10 years. Will she also pledge to protect those vital budgets going forward? I am happy to take an intervention on that point, if the minister would like to make one.
I outlined that our commitment has been borne out by the funding that we have put into ADPs. The £20 million that we have earmarked in the current budget will enable us to do more to ensure that the new strategy will be delivered with impact, and to reverse some of the things that I think we share concerns about.
I am grateful to the minister for those comments, and I look forward to working with her to see them being realised.
Annie Wells, in her speech for the Conservatives, called for a radical overhaul of our approach to drugs and the drugs strategy, which was echoed by Brian Whittle. However, she failed to acknowledge that the drugs policy was initiated by her party as the price of Tory votes to support SNP budgets in the early days of the first SNP Administration. I absolutely agree that a whole-system approach is needed, but it strikes me that the Conservative approach to the matter is abstinence or incarceration. Gordon Lindhurst asked us what we want him to do. Changing the record would be a good start.
Will the member take an intervention?
I am afraid that I must make progress.
I want a whole-system approach. I want a whole-system review, but I start from fundamentally different first principles from those that the Conservatives would ascribe to a review. Those first principles recognise the hard brass tacks, which were well articulated by Anas Sarwar in his speech, that delineate our unique and destructive relationship with illegal substances in this country, which puts us ahead of so many European countries in terms of mortality. For my party, that starts not with the fruitless pursuit of abstinence or with strangling the world heroin supply, as Maurice Corry rather bafflingly suggested—it is not drugs’ widespread use but their legal status that is the problem—but with how we deal humanely with the people who use drugs.
Alison Johnstone made an excellent speech and referenced the NHS Greater Glasgow and Clyde report “Taking away the chaos”, which was also referenced by Bob Doris. That link between vulnerability, social deprivation and substance use is vital to the debate. Alison Johnstone rightly referenced the closure of the needle exchange at Glasgow Central station, which is another example of a retrograde policy step, which we must prevent in the future.
The environment was mentioned by Emma Harper in her fascinating description of scientific experiments in this policy area.
There might be much in my amendment that members find instantly uncomfortable. I get that. However, I suggest that they find themselves on the wrong side of both history and the empirical international evidence that shows that safe injecting rooms lead to harm reduction. Brian Whittle expressed the need for caution and said that he was concerned about the lack of evidence, but there is 30 years of experience in the matter and there is evidence about heroin-assisted therapies, which I mentioned in an intervention on Neil Findlay. There is also evidence for decriminalisation and for a more liberal approach to drug use wholesale. We heard about the example of Portugal, in that regard.
The German writer, Sebastian Marincolo, said:
“The legalisation of marijuana is not a dangerous experiment—the prohibition is the experiment, and it has failed dramatically, with millions of victims all around the world.”
Nowhere is that more evident than in the case of my constituent, Murray Gray. Murray’s mum, Karen, is tenacious, and I am proud to know her. I am looking forward to our meeting with the cabinet secretary and I hope very much that she will be able to offer Karen some help.
I thank members for a robust and interesting debate. We have heard heartfelt contributions about local examples from Clare Haughey, Fulton MacGregor and many others. The debate underscores the human reality that unites Parliament: we all want to reduce the harm that drugs bring to our constituents, and we want to reduce the prevalence of drugs in our communities.
I finish by echoing Jenny Marra’s call for more Government time in which we can take the debate forward, and, indeed, legislate.
16:36
I will begin my reflections on the debate by highlighting Bob Doris’s speech, which, in many ways, went to the heart of what we are trying to do. He made a compelling argument about why we need to look at the issue of safe injecting rooms, but he was frank about some of the wider issues in this policy area. He also stated that we need a broad debate. That neatly sums up what we need to do. Although the debate has been focused on a particular policy—I understand the minister’s desire to have the debate in order to consider that particular policy—it is impossible not to think about the wider implications, because there are connections right across policy areas and the issue impacts on many others such as poverty, exclusion and deprivation.
Today’s debate has been honest, frank and, at times, emotional, and it had to be so. The minister clearly set out the case for safe injecting rooms, and that case was reflected by other members such as Alex Cole-Hamilton and Clare Haughey, who looked at international examples from places such as Australia, Spain and Switzerland. We have to do that, as we must have a frank and honest assessment of what works and of how we can make a difference.
In that regard, I appreciated Fulton MacGregor’s speech, in which he took a balanced, front-line view. He considered the option of safe injecting rooms but gave a frank assessment of what happens when people are on methadone. Members came back to the issue of methadone as a treatment time and time again, and it is something that the chamber should reflect on.
I will be clear: Labour will support the motion tonight because the case has been made for why we need to consider the use of safe injecting rooms, which provide clean, safe facilities and, importantly, can help us to connect individuals to other services, as the minister said. That is why the issue has to be thoroughly investigated. There is an issue about the community benefits that the proposal might have but, fundamentally, our action needs to be evidence led.
Annie Wells’s speech was powerful, and we must engage with some of the issues that she raised. Her speech was grounded in personal experience that brings home just how serious the issue is. She was right to question whether the policies around methadone are working. Many members talked about people being parked on methadone, and we need to be frank about whether that is happening and tackle it. However, I do not think that this is an either/or situation, and I certainly do not think that the policy proposal is necessarily about giving up—indeed, it must not be so.
I will reflect briefly on something that Sandra White raised. She asked what kind of facility there might be. Has the minister considered whether a clinically led facility, which might not breach existing laws, could be considered as an alternative, although that might be more expensive? I think that Gordon Lindhurst brought up that issue as well.
Let me reflect on Labour’s position. It is important not to look at substance misuse solely through the lens of intravenous drug use and the particular cases—acute as they are—of people who use heroin and opioids, because the problems of substance misuse are much wider than that. As Anas Sarwar said, we must not kid ourselves that substance misuse and addiction are confined to a particular demographic or age group.
I seek clarity on the Labour position. Is Labour advocating that we move away from criminalising users to treating the issue as a public health issue?
We must treat addiction as, first and foremost, a health issue. Labour member after Labour member has made that very clear.
If I have time, I will touch briefly on criminal justice issues. First, though, I will refer to what Neil Findlay said. He put things very well in speaking about having to look at the local reality. There is a vital need to take a global perspective while looking at what works. I think that Jenny Marra reflected those comments.
Scottish Labour is committed to having an open and frank discussion in the weeks and months that lie ahead of us and to using a summit to consider the wide range of policy options and approaches that can be taken to tackle substance misuse and addiction in the round. There has been a failure of policy, because there is a failure in trying to criminalise individuals—that is fundamentally flawed logic. We are not dealing with people who are rationally looking after their own interests; they are addicts and they cannot do that. By definition, they are incapable of doing that.
We also have to consider the particular failure in Scotland. As many members have pointed out, the number of drug deaths in Scotland has doubled. The level here is two and a half times the level in the rest of the UK and eight times the level in the rest of the EU. We have to consider why that is and what has happened here.
We see some of the most acute issues in the criminal justice system. The Justice Committee recently visited Serco, and the experiences that it heard about there were quite horrific. I do not have time to go into them, but I urge all members to consider the experience of addicts in the criminal justice system and to look at the issues that they face, why the system is not an appropriate context for them and the changes that we need to make in our prisons to provide the support that those people need. It is unavoidable that addicts will come into contact with the criminal justice system. No matter how much the emphasis is placed on health, first and foremost, which is right, that will never be completely avoided.
We must have a broad and frank debate and holistic solutions, and we must be evidence led.
16:43
A few months ago, my Lothian colleague Alison Johnstone and I visited the Edinburgh alcohol and drug partnership as part of the substance misuse inquiry that the Parliament’s Health and Sport Committee was conducting. That was one of the most valuable visits that I have undertaken since becoming an MSP, but it left me concerned that we, as a country, are failing to address the drug crisis that too many of our fellow citizens face.
On that visit, we met a number of service users who were being supported through a peer-led, tailored approach in order that their addiction could be stabilised and that counselling and other forms of support could be delivered. In our conversations with several people, it was clear that early intervention had failed them and that the opportunity to access early pathways to support and recovery were simply not good enough or not available.
The story that an individual told Alison Johnstone and me about how she had ended up where she was will stick with me. She is now 40. When she was just 12, her father introduced her to heroin, which led to a spiral of addictions over the course of her life. That was a real example of adverse childhood experiences, which we increasingly talk about in the Parliament. As my colleague Brian Whittle said, it is important that we look at that side of how we can prevent people becoming addicts in the first place.
I asked a specific question about when and how people had sought early help to address their drug addiction. In a number of cases, visits to GP surgeries or other support services had been met with the response that the individual was not a problematic enough drug user to merit a referral to specialist support services.
We need a new approach similar to the Government’s aspiration on mental health. The Scottish Government needs to develop an ask-once, get-help strategy for drug addiction.
That is helpful. I wonder what the Tory position is on safe injection rooms, because that has not been clear in the speeches so far. Will you clarify that one way or the other?
I do not know whether you were here for the opening speeches. Annie Wells outlined clearly that we do not consider that there is a case for the facilities to be put in place now, as the services that are currently in place support people.
I pay tribute to and praise those who work in our drug and alcohol partnerships.
Will Mr Briggs take an intervention?
No, I want to make progress.
I have been hugely impressed with the Lothians and Edinburgh abstinence project. LEAP is a programme for up to 20 people who want to stop using drugs, and people who take part in the programme can access supported housing run by City of Edinburgh Council. Access to Industry also works with people on the programme to help them to start training or education or to get a job as part of their tailored recovery plan—and it is on delivering those plans that we must focus.
Perhaps most important, people who complete the programme can get support for up to two years after they finish. Sadly, service users told us that the limited number of places available means that it is difficult to get on to the programme, although it was an aspiration that they all wanted to achieve. We should be encouraging and delivering investment to expand initiatives such as that.
Will the member take an intervention?
No, I want to make progress—I have a lot to say about the issue.
I have visited a number of drug and alcohol partnerships across Scotland, and I am sorry to say that they continue to highlight that they are the Cinderella service of our NHS. As Alex Cole-Hamilton stated, that was demonstrated to them most recently when the Scottish Government looked to cut £20 million of funding from the partnerships before undertaking a U-turn on its decision, which I think we have all welcomed.
This Government and Parliament have a record on drugs and substance misuse policy on which both must be judged, but I cannot honestly stand here today and say that the country has got the issue right or that the SNP Government’s proposal simply to refresh the strategy is what is needed or is good enough for most vulnerable people in our society.
Jenny Marra and Neil Findlay made excellent speeches and I agreed with their sentiments. We have a national crisis and we need national action, but not just in one policy area in which the Government is interested.
Will the member take an intervention?
Very briefly.
I sat beside Mr Briggs on the Health and Sport Committee for more than a year and a half, and I respect him. I do not believe that the position that he has put forward as he stands at the Conservative’s front bench is his view. You should be honest with the chamber and tell us what your real view is.
Before you do, Mr Briggs, I remind everyone in the chamber that members should always speak through the chair and not directly to each other when making interventions and delivering speeches.
I very much welcomed the opportunity that the new SNP Government took back in 2008 to develop its road to recovery strategy. Today, we should be focusing on that strategy, which was intended to focus on recovery. I welcome and pay tribute to the fact that my former party leader, Annabel Goldie, and the Scottish Conservative group at that time put so much work into trying to make the strategy a success. However, we need to be honest and accept that, by all measures, the strategy has not delivered.
The strategy has been in place for 10 years, during which time, as we have heard, the number of drug deaths has increased by more than 50 per cent. Recent figures show that the rate of drug deaths in Scotland is running at two and a half times the rate in the rest of the United Kingdom.
I have spent a number of months researching and looking at different models of care and support for drug and alcohol addicts, as Neil Findlay has outlined. The Conservatives want to be part of forming a new, overarching national strategy, and I have written to ministers, calling for the review to be extended. However, the first time that the minister spoke to me about the issue was when she phoned me yesterday evening ahead of the debate.
In 2007, the then First Minister, Jack McConnell, visited a trial of neuro-electric therapy, a drug-free addiction treatment invented by a Scottish neurosurgeon, Dr Meg Patterson, and saw at first hand how addictions can be treated differently. The treatment is used today in drug rehabilitation services across the world but not in Scotland—at least, it is available only in private clinics. I accept that the most effective treatment will always depend on the circumstances of the individual. There cannot be—and there is not—one size that fits all, but we need a recovery-focused strategy that aims to reduce the number of addicts. The use of opiate replacement and heroin-assisted treatment should be limited and used only as a short-term route to recovery.
It is clear that we need more than just the policy refresh that SNP ministers are proposing today, and that is what our amendment seeks to deliver. We need a sector-led review of all drugs policies in Scotland. We must look at how we can truly create a recovery-focused network—which is the focus that the Scottish Conservatives envisaged “The Road to Recovery” would deliver over a decade ago—and embed recovery models in all future delivery arrangements.
The Conservatives believe that it is time for the Parliament to truly make this a major priority and for a full sector-led, cross-party review of drugs. I support the motion and the amendment in Annie Wells’s name.
16:50
As Daniel Johnson articulated, this debate has been challenging. Members have been divided at times and the debate has been incredibly emotional, but that is entirely appropriate as we as a Parliament need to consider maturely how we bring our collective thoughts and opinions to bear in order to effectively tackle the problems that Scotland is currently facing with substance misuse.
On the subject of safe drug facilities, the motion seeks Parliament’s agreement to ask the UK Government to enable us in Scotland to respond to a public health challenge with a public health solution. It is not an easy solution—it is not an easy issue—and it might not be immediately popular or comfortable. Therefore, aside from some points made by colleagues, I have genuinely appreciated the general tone and articulation of Opposition members’ views on the safe drugs facility—particularly those from colleagues in Labour, the Greens and the Liberal Democrats. I welcome their openness to considering the issue and working together on it.
As Neil Findlay said, this issue is
“too important to be a party-political dogfight”.
It requires us to work together and to put aside party-political point scoring to focus minds and roll up our sleeves to tackle the problem.
As Neil Findlay and Clare Haughey reminded us, the 867 deaths represent a huge and untimely loss of life and devastation for the families and loved ones who are left behind. Those people are mothers, daughters, sons, fathers and friends. Like many others in the chamber, I have met many of the families who have been impacted by problem substance use and drug deaths. I have attended remembrance services and I have seen the hurt and trauma caused and listened to the stories of helplessness from families who felt unable to help their loved ones or keep them safe.
In listening to those stories, each and every MSP here should be thinking, “There but for the grace of God go I.” Addiction is not something that impacts only some people some of the time; it can and does affect us all. Clare Haughey summed it up simply by saying, “they are people.” Those people deserve to get the help and support that they need in order to cope with or recover from their addiction.
That is the premise on which we must base our approach. That is why a public health approach based on respect, tolerance and solidarity is needed.
As I said in my opening speech, we in the Government have chosen to treat problem substance use as a public health issue, which naturally implies that we will seek a public health response where possible in order to address some of the harms posed. What we are currently seeing in Glasgow—a rising number of drug deaths and increasing numbers of individuals infected by HIV—clearly falls into that category. An evidence-led response seems not just sensible but essential.
I should be clear, however, that that does not mean that the Government is losing sight of the criminal elements associated with some of the illegal drug trade. I say in response to Sandra White’s points that, although we are clear that we want to help and support those who are affected by problem substance use, we are still committed to doing everything that we can to tackle the scourge of illegal drugs and the dealers who cause the misery that blights the lives of so many.
Let us also remind ourselves why the safe consumption facility is necessary. The facility is designed to service the needs of an estimated 400 to 500 individuals who inject publicly in the city centre and experience high levels of harm. There have been outbreaks of HIV, with more than 100 new cases since 2015, of anthrax and of botulism. The proposals would help reduce the risk of future outbreaks. In 2016, there were 170 drug-related deaths in the Glasgow City Council area, up from 157 the previous year.
The British Medical Association, the European Monitoring Centre for Drugs and Drug Addiction and the Advisory Council on the Misuse of Drugs have indicated their support for pursuing safer drug consumption proposals in order to promote harm reduction. Those efforts are all based on evidence.
At this time, the Misuse of Drugs Act 1971 is reserved legislation and, as the Lord Advocate indicated in his response to Glasgow HSCP in November last year, the lawful operation of such a facility could be secured only through changes to the existing legislative regime.
It is on that point that I seek the support of Parliament. I reach out to colleagues from parties across the chamber to allow us to seek agreement from the UK Government to do something on the issue. That support would enable me to say that we—politicians, professionals, practitioners and the people who are most affected—have a united voice.
This is not a constitutional spat. I am very clear how I would like to deal with the constitutional arrangement of Scotland, but I know that that view is not shared by all of Parliament. However, the constitutional arrangement is not what is motivating me to make my plea. My motivation is to do the right thing. As the minister responsible, I do not want to waste the privilege of ministerial office by doing nothing, just doing the simple thing or simply hoping that the issue will go away. We need to unite behind something innovative and bold, such as safe facilities, to tackle the problem effectively.
I thank the minister for her comments and I welcome the tone that she has used. I repeat that the Labour Party will support the Government motion today. In the spirit of consensus and bringing our Parliament together and recognising that we face a challenge that is historic—not just for this Government, but for previous Labour Governments as well—will she support the Labour amendment to the motion?
Unfortunately, because of the approach that has been taken in the amendment in calling the current strategy a failure, supporting the amendment would not sit comfortably with us. I understand and appreciate the content of many of the Labour speeches today, but I cannot agree with the amendment on the basis that it says that the strategy has been a failure. Many things have been achieved and we have delivered many improvements.
However, we are not losing sight of the shortfalls and the gaps that need to be plugged, which is why we want to renew our approach.
One thing that has come out of today’s debate is that many members are uncomfortable with the current strategy. Will the minister agree to a sector-led, cross-party review of the strategy, which all parties have now called for?
I am absolutely willing to work with other members from across the Parliament. We will continue the dialogue after the debate and ensure that we seek the ideas, thoughts, views and considered opinions that many members have expressed today to ensure that they inform our strategy. We are refreshing our strategy for the reasons that have been articulated—there is a need to understand the changing landscape of drug addiction and we need to address the ageing group of people who are becoming the drug death statistics that we have to grapple with every year. [Interruption.]
I ask members to call a halt to their private conversations.
It is important to recognise that the safe consumption facility that we are discussing today is not the totality of our ambitions to tackle problem substance abuse. That is why we are renewing our strategy to reflect the changing landscape of drug taking in Scotland, taking on board all the views and opinions that we have heard today, and ensuring that we consult and engage with those who work in the sector. I reassure members that our approach is far reaching: our strategy will ensure that wider health and social needs are taken into account as part of people’s treatment and support. That will include joining up with a range of work across Government to tackle poor mental health, loneliness, social isolation, employability, homelessness and the issue of children affected by parental substance misuse. In response to the calls from Neil Findlay and Clare Haughey, I say that it will tackle the issue of stigma to ensure that we can support people and change the culture and stories and articulation around people who are in desperate need.
Our strategy will recognise that the nature of Scotland’s drug problem has changed and that there is a need for a greater focus on harm reduction measures for the ageing group of long-term drug users who are the major contributors to the increase in drug-related deaths. We should also recognise that significant progress has been made since 2008: drug taking overall is falling and drug use among young people remains low. We have also achieved significant reductions in treatment times for those who need help with drug and alcohol problems.
I take on board the concerns that were expressed by Neil Findlay, Ruth Maguire and others around some of those statistics. We will continue to build on our achievements and we intend to plug the gaps that we know need to be plugged.
Several other members raised issues that I want to address. The motion is seeking to unite the Parliament behind safe consumption facilities. However, to respond to points raised by Sandra White and Daniel Johnson, Glasgow is looking to introduce a combined facility to allow safer consumption facilities and heroin assisted treatments to coexist. Glasgow health and social care partnership is looking to locate the facility in the city centre—the area that currently sees the majority of public drug-taking behaviour. There will be robust consultation with residents and businesses in advance of that.
I absolutely share the views and the disappointment that have been expressed about the decision by Network Rail. We will continue to work with Glasgow health and social care partnership to find ways in which we can enable it to cope as best it can.
I conclude by again thanking members for their views. I understand that there are differences along the edges but, today, I commit to all parties that I will endeavour to work with everybody on this issue to ensure that we can unite behind a refreshed and renewed drugs strategy that deals and copes with the changing landscape of drug taking in Scotland; which does not lose sight of the need to be bold and innovative and to challenge uncomfortable feelings about some of our approaches; and which is always motivated by a wish to tackle drug-related deaths and their impact in our communities, which we all feel a sense of disappointment and devastation about. I reach out to other parties and will continue to work with them to make it a success.
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