Chamber and committees

We need to have a robust evaluation process, which needs to be flexible and agile. At the same time, I do not believe that that should stop us exploring the possibility of other pilots that could be proposed while the initial Glasgow pilot is being undertaken. As is set out in information that I submitted to the committee, we have had conversations with the Crown Office and Procurator Fiscal Service about what it would be willing to consider.

It is clear that the Lord Advocate would consider a robust application from an area, provided that it followed the parameters of the initial Glasgow pilot. An application would need to be precise, detailed and specific, underpinned by evidence from that area and supported by those, such as Police Scotland, that would be responsible for policing such a facility. Any area that sought to make an application for a pilot would need to ensure that it satisfied the Lord Advocate in relation to everything that Glasgow did.

Conversations have already been undertaken in the city of Edinburgh about whether the council there would seek to have such a pilot in the offing. Officials in the Scottish Government are supporting that area to explore what that pilot could look like.

We do not need to wait for the full evaluation of the first Glasgow pilot before applications are put forward by other areas.

Absolutely. I anticipate that, by the time we go into the spring, we will have a lot more information about what the stigma action plan is going to be. We are co-designing a voluntary accreditation scheme that people who are working in services can sign up to. That means that they, as practitioners, and their service will adhere to looking at how they can reduce stigma and drive it down. That is really important.

We are also supporting organisations to launch campaigns such as “See Beyond—See the Lives—Scotland”, which is run by a few partner organisations, to get the stories behind the people. We have heard powerfully from MSP colleagues about the stigma that they and their families have faced. There is a lot going on in the background, but I will keep the committee and the chamber up to date on that.

Yes, and I absolutely take that point.

As for the case that was brought to our attention on social media, I asked officials to start looking into it straight away, because the story of the individual’s journey that it told did not reflect what an individual’s journey should be in that setting. Let us zoom out from that one person and think about the journey as it should happen. When someone transitions from any setting, whether it be a hospital setting, a prison setting or whatever, a cohesive plan should be in place to ensure that their medication or anything else does not fall between the cracks, that they do not present as homeless and so on. The individual in question should have had a seamless transition from the prison facility into the community setting.

I am still waiting to find out what some of the difficulties in that situation could have been. We know that Edinburgh has a named person standard operating procedure in place, which means that a specific patient is able to have the medication follow them, because you need to have a Home Office licence to store Buvidal. At the point of transfer, the person should have been able to have long-acting injectable buprenorphine set up for the next time that they were due to have that, so there must have been a breakdown in communication somewhere.

There has to be learning from that case, because it cannot be something that happens regularly across the country. That also harks back to the sustainable housing on release for everyone—SHORE—standards. When somebody makes that transition from a prison setting back into a community setting, their healthcare should follow, as well as support for their needs in relation to housing, access to welfare benefits and so on. I am happy to keep the member informed.

I will answer part of that and then see whether Susanne Millar wants to come in.

If we consider the running costs of such a facility, we can see that staffing it within that timeframe is reflective of the tariff that we know it will cost us. However, I recognise that people will use drugs at all times of the day, so there is need to look at how we can assess, as the pilot develops, what the real-time information is telling us about individuals’ habits and how individuals are engaging with the service. It is something that I have certainly thought about and I am sure that Glasgow has thought about it as well.

That is a really good point, because we need challenge and scrutiny of, and independent eyes on, some of these things. I will probably pass over to Susanne Millar to help us with understanding the evaluation process from a Glasgow perspective. Obviously, things will look slightly different from a Government perspective, as my scrutiny will be of the evaluation that Glasgow will take forward.

I am happy to hand over to Susanne at this point.

Presiding Officer, I am pleased to open this afternoon’s debate on drug law reform. I regret that I am unable to be there in person, due to being ill with Covid.

Problem drug use impacts on many people in Scotland. It leads to lives ending prematurely and tragically. In 2022, 1,051 lives in Scotland were lost to drugs and, although the number was lower than the number in 2021, it is still far too many. More than 1,000 families have lost a loved one, and I extend my heartfelt condolences to each one of them. The drug deaths emergency in Scotland remains a priority for the Government.

The topic of the debate is drug law reform. It sets out evidence-based actions that we would take, were we empowered to change the legal environment in which we find ourselves. No one should infer from that that we are not doing everything within our current powers to address the crisis, or that we will not continue to learn and adapt to meet the challenges that we face in the current legislation. However, there is clear evidence to show that much more could be achieved if we had the authority to fully implement the public health approach to which we are committed.

The principles upon which our national mission sit are that problematic drug use is rooted in poverty and trauma and is a health condition. That is why we are committed to reducing the number of people who are dying of overdose and to improving their lives.

The £250 million that is being spent during the current parliamentary session has already contributed significantly to that goal. The medication-assisted treatment standards are improving access and service delivery to people who are in need of treatment and support, and the number of approved residential rehab placements has grown to 812. including facilities that are specifically targeted at families and women with children.

Our naloxone distribution programme has won international acclaim and we are progressing our commitments to safer drug consumption facilities and drug-checking initiatives within our existing powers.

I recognise the concern that the member has just intimated. Our whole-family approach, which our whole family wellbeing fund underpins, will help to secure additional resources and support for those front-line social workers because we recognise their value in the lives of our families and young people across the country.

We are supporting a broad range of community-based initiatives and looking upstream to understand how we can support people to avoid drug-related crises at a much earlier stage in their lives. We know that childhood poverty and trauma are often factors in later drug dependence. Our Child Poverty (Scotland) Act 2017, which sets out targets to reduce the number of children who are experiencing the effects of poverty and our Promise to care-experienced young people, aims to improve outcomes for those young people and help them to achieve their potential.

Stigma drives people away from help and creates a raft of additional problems for people who use drugs and for their families, and we are setting out a plan to address that long-term problem. Through our charter of rights, which was drafted by the national collaborative—a group that is made up of a broad cross-section of our community, including people with lived and living experience—we will directly support people who have or are affected by problem substance use to claim their rights to the highest attainable standard of health.

All that work and more is currently under way as part of our public health approach. The so-called deterrent approach has been shown to be completely ineffective in reducing drug use, and to be counterproductive in addressing the underlying causes of that phenomenon. The Misuse of Drugs Act 1971 is more than 50 years old and was designed against the background and political environment of the time. However, the landscape has changed and the amount of international evidence that is available has grown.

I have given examples of the significant progress that has already been made to this point through our national mission, but current laws hamper our ability to implement further measures that are known to save lives, which is why we published our drug law reform paper “A Caring, Compassionate and Human Rights Informed Drug Policy for Scotland” in July, with the support and endorsement of the Global Commission on Drug Policy, which comprises former heads of state from countries as diverse as New Zealand, Switzerland and Peru.

Our reform paper proposes immediate changes to the law that will allow us to implement fully a public health approach that has had significant results in a wide range of other countries by saving lives and encouraging people to seek support and treatment earlier than they do when they fear punishment. That approach includes: the provision of a clear statutory framework for supervised drug consumption facilities and drug checking across Scotland; increased access to life-saving naloxone through reclassification; changes to simplify and improve licensing to encourage use of the full suite of treatment options that are available to us, including heroin-assisted treatment; the removal of the stigmatising and discriminatory exemption in the Equality Act 2010 (Disability) Regulations 2010, which excludes drug dependency; and a commitment to full consideration of decriminalising drugs for personal use.

People are 16 times more likely to die of a drug death in Scotland in the poorest 20 per cent of the country than they are in the wealthiest 20 per cent. Criminalising our way out of a drug death crisis that is rooted in health and social issues often has the effect of punishing people from our poorest communities for being poor and having experienced trauma. The Government is clear. The war on drugs is over, no one won, and the main casualties were not organised criminals, but the poorest and most vulnerable people in our societies who need our help, not to be driven further into the margins of society.

We have learned from evidence around the world and have committed to reducing the harms that are associated with drug taking by promoting agency, helping people to make better choices and giving them accurate real-time information about substances and their effects. We continue to progress our plans for safer drug consumption facilities because the evidence that supports their efficacy is extensive—16 countries currently operate legal drug consumption rooms, all of which are effective in saving lives and improving health outcomes.

The proposed facilities are designed to comply with our current legislation so they will still be restricted by the Misuse of Drugs Act 1971 and will not fully meet the lowest threshold criteria that we would prefer, but they will be a positive start on our journey towards protecting all our citizens. The facilities will help to demonstrate efficacy at the national level, as they have been shown to do in other countries.

No country offers a single template for tackling drug use, but I make no apology for proposing approaches that have been shown to make a positive difference. New Zealand and Canada in particular are investing in drug-checking services with as few barriers to access as is possible.

In the past two years, the University of Stirling has undertaken work to look at how we could roll out a drug-checking pilot within Scotland. During that research phase, several potential locations were identified. We know that Aberdeen, Glasgow and Dundee have expressed their wish to be part of the pilot. The research was published at the end of July and we are now helping those areas to apply for licences. We await a final communication from the United Kingdom Home Office that will help us to ensure that those licensing applications can go in and will be met with the most sympathetic ear possible. I will keep members updated on that.

Accidental overdoses often occur because people do not know what is in the substances that they are taking. Scotland faces a significant challenge with street benzodiazepines, which are extremely variable in their make-up and strength. We must therefore seek to implement drug-checking measures that will lower the risk and keep people safer, particularly with the potential of even more dangerous synthetic drugs reaching our streets.

I thank Jackie Baillie for giving way, and for her well-wishing.

I point out that once the new Lord Advocate took up her position, she laid out to the Criminal Justice Committee the parameters by which she would be willing to look at a proposal for a safer consumption facility. The Scottish Government, Police Scotland and Glasgow health and social care partnership then worked solidly for about six months to bring forward a proposal. That proposal went to the Lord Advocate in June 2022, and I thank her for taking the time to come to a decision on it. However, in response to the suggestion that nothing was done in the intervening time, that is simply not the case.

I share Alex Cole-Hamilton’s desire to see safer consumption facilities and drug-checking facilities being rolled out across the country. Once the safer consumption pilot is up and running in Glasgow, we will evaluate it as soon as possible. After that, and once we understand how the facilities are working in practice, we will have conversations with other areas that might want to have the same type of facility available. We are still constrained, because the pilot is for a specific area, but I am happy to have conversations with the Lord Advocate to see how we can progress that as swiftly as possible.

Our paper also proposes decriminalising all drugs for personal use, alongside holding a wider review of drug laws. The reaction to that proposal from certain quarters was as predictable as it was misinformed. Some have referred to a recent press report that paints a bleak picture of life in Portland, Oregon, where drugs were decriminalised in 2021 and have claimed that that wrought havoc in an already struggling city. I would say that that example indeed carries a lesson, which is that decriminalising drugs alone is not enough. A fully committed public health approach, such as the one that this Government has embarked on, is required to address the health and social problems of which drug use is a symptom.

When Portugal decriminalised drug use more than 20 years ago, it implemented a full range of treatment and support initiatives for people who use drugs, and that example has been followed by a number of other countries precisely because it works to reduce drug-related deaths and to increase take-up of treatment and support.

There are also people who claim that we already have de facto decriminalisation, which will be news to the police, who recorded 22,356 drug possession crimes last year—a figure that was 38 per cent of all crimes against society.

Thirty countries have recognised the harm that is caused by criminalisation and have moved to change their laws. That gives us more than a hint that a change in the law in Scotland would be consistent with the conclusions that experts across this area have reached. The fact is that decriminalisation is no longer a novel proposal. It is a transition that is supported by the chief executives of all 31 United Nations agencies, and it has been their position since 2018, when the United Nations System Chief Executives Board for Coordination agreed the first UN common position. It committed to

“promote alternatives to conviction and punishment in appropriate cases, including the decriminalisation of drug possession for personal use, and to promote the principle of proportionality, to address prison overcrowding and overincarceration by people accused of drug crimes”.

In our drug law reform paper, we propose further exploration of drug law with a focus on evidence and the reduction of harm. That means having a drug classification system that reflects the evidence of harms caused and not the political or moral judgments, as well as facilitating a conversation about reforms such as the regulation of substances in partnership with the public and the subject matter experts.

As with many things that we now see as common sense, that would have been radical once, but no more. Multiple committees, experts and independent organisations have already called for an urgent review of the Misuse of Drugs Act 1971, including the independent drug deaths task force, so there is a compelling case for changing our drug laws. However, we are currently unable to change those laws in line with international evidence. There are three possible roads out of that impasse.

It will surprise no one when I say that Scottish independence, which would allow us the freedom to make our own laws with, by and for the people of Scotland, is my preferred route to change. However, we know that the need for compassionate evidence-based drug laws transcends political alignment. It is about saving lives.

The second route would be for further powers to be devolved. Given that our two Governments disagree on the issue, the devolution of the necessary powers would allow Scotland to develop laws that properly reflect our different public health approach. That kind of devolution is not unheard of, as regional variations exist in other countries. Canada, Australia and even the United States have different legal frameworks on drugs operating within their countries.

However, the fastest and simplest way forward would be for the UK Government to review and change the Misuse of Drugs Act 1971 to support a public health approach across the UK.

We would welcome meaningful engagement on the proposals but, despite many attempts, that has not been forthcoming. Up to this point, our proposals have been rebuffed despite the cross-party Westminster Home Affairs Committee just last month recommending a review of the current drug laws and endorsing our position on safer drug consumption. We have long called for agreement from the UK Government to allow us to do that, whether to support us in establishing a full pilot or through devolving the necessary powers to do so.

First and foremost, people who are affected by drugs are people. They are deserving of kindness, respect and dignity. Our drug laws are, quite simply and literally, from another century. We need something that reflects what is required now, and that is laws that are not rooted in prejudice, assumption and moral judgments but are instead based on research, evidence and best practice from around the world. We need laws that reflect lived experience and the experience of families who are affected by drugs. We need caring, compassionate and human-rights-informed drug laws that will save and improve lives.

I end with a thank you and a plea. My thank you is to everyone who has contributed to the national mission, including many in this Parliament, and everyone who has helped to shape our approach to reducing the impact that drug use has on far too many lives and communities in Scotland. My plea is to those who remain to be convinced that drug law reform is required. I ask those people to look at the evidence of what works successfully elsewhere. Why should we not seize the opportunity to improve the life chances of so many people in Scotland?

I move,

That the Parliament believes that every life lost through drugs is a tragedy and recognises that behind each statistic is a grieving family and community; agrees that the scale of the drug deaths emergency in Scotland requires the Scottish Government to use every lever at its disposal to save and improve lives using the best available evidence; further agrees that the principles of the Scottish Government’s national mission should be rooted in a human rights informed, public health approach, not a criminal justice one; believes that the support for people with substance dependency should be in parity with other health conditions, removing unnecessary stigma and discrimination; supports the calls for an urgent review of the Misuse of Drugs Act 1971 to fully align the law with the public health response outlined in the Scottish Government paper, A Caring, Compassionate and Human Rights Informed Drug Policy for Scotland, of which decriminalising drugs for personal use is one part, and agrees that the Scottish Government should work constructively with the UK Government to either amend the Misuse of Drugs Act 1971 or devolve the powers to Scotland to draft its own drugs legislation that better reflects international best practice.