Chamber and committees

Prior to 2007-08, this information had not been collected. That is why the Scottish Government invested in the research Assessing the Scale and Impact of Illicit Drug Markets in Scotland http://www.scotland.gov.uk/Publications/2009/10/06103906/0, which was published in October 2009. The report estimated that the total cost of illicit drug use to the health service in Scotland was £180,452,500.

Table 5.9.1 of this report breaks down the wider costs of drug misuse:

This report also offers some useful cost / benefit analysis of drug treatment in the context of preventative spend:

Prior to 2007-08, this information had not been collected. That is why the Scottish Government has invested in, and enhanced, the Scottish Drugs Misuse Database (SDMD) to include the collection of follow-up and outcomes based information from people as they progress through their drug treatment pathway. The Information Services Division (ISD) of NHS National Services Scotland will be publishing the first release of this follow-up information in December 2012, which will provide us with more information on people’s journey’s through treatment and the outcomes being achieved (e.g. around accommodation, family, employment/training, drug use and offending).

From the SDMD, we know that between 1 April 2007 and 31 March 2011 that there have been 39,458 recorded entries into specialist drug treatment.

The Scottish Government introduced the Scottish Drug and Alcohol Treatment Waiting Times Database, which went live nationally from 1 April 2011. This provides quarterly information on the length of time people are waiting for treatment and the treatment interventions started. Between 1 April 2011 and 31 March 2012, 19,043 drug treatments were started in Scotland and the interventions started were as follows:

Information from the waiting times database is published online by ISD Scotland on a quarterly basis.

The National Forum on Drug-Related Deaths established in 2005 meets on a quarterly basis each year. Between 2006 and 2008 the Forum met 10 times. Since January 2009 the Forum has met 15 times and produced two reports.

The forum has four sub-groups:

The Pathology Sub-Group explores forensic pathology practice, including toxicology, in Scotland when dealing with a suspected drug-related death. Since January 2009 this sub-group has met six times.

The Data Collection Sub-Group gathers information on drug-related deaths and analyse the findings of the national Drug-Related Deaths Database reports. Since January 2009 this sub-group has met 12 times.

The Volunteer’s Forum discusses issues raised at the National Forum on Drug-Related Deaths meetings and feedback issues they feel are important from a service user’s perspective. Since January 2009 the Volunteer’s Forum has met 19 times.

The Short-Life Working Group for Family Support explored what support services are in place for families following a suspected drug related death and how this can be improved. This Short-Life Working Group met for the first time in March 2011 and has met twice since then.

The forum has published four annual reports in total since 2005. The two most recent reports were the 2009-10 annual report published in July 2010 and the 2010-11 Annual Report published in October 2011. The reports can be accessed on the following links:

2009-10 Report: http://www.scotland.gov.uk/Publications/2010/07/30140320/0.

2010-11 Report: http://www.scotland.gov.uk/Publications/2011/11/6842/0.

Prior to 2007-08, this information had not been collected. To address this evidence gap the Scottish Government has:

(1) Invested in, and enhanced, the Scottish Drug Misuse Database (SDMD) to improve the information available on people entering and completing drug treatment in Scotland. This will enable us to understand more about people’s journeys through treatment and the outcomes they achieve. The first release of follow-up and outcomes-based information will be published by Information Services Division (ISD) of NHS National Services Scotland in December 2012.

(2) Developed the Scottish Drug and Alcohol Treatment Waiting Times Database, which went live from 1 April 2011. This provides quarterly information, which is published by ISD, on the length of time people are waiting for treatment and the treatment interventions started.

In April 2009, then Minister for Community Safety, Fergus Ewing announced the establishment of a Scottish Drugs Recovery Consortium (SDRC) whose role would be to advocate, catalyse and lobby for recovery to be the mainstay of drug services.

The first member of staff joined the consortium in November 2009 and the first director joined in January 2010. The consortium was officially launched by Fergus Ewing in June 2010. The Scottish Government is the sole funder for the consortium (now called Scottish Recovery Consortium) and has provided £1,065,745 between 2009-10 and 2012-13. The breakdown is as follows:

The Scottish Drugs Strategy Delivery Commission has met 12 times since its first meeting in December 2009.

The commission produced its first year report and recommendations to minister in October 2011 which can be accessed at:

http://www.scotland.gov.uk/Publications/2011/10/10142851/0.

Methadone solution is purchased by community pharmacies who dispense it against NHS prescriptions and are then reimbursed for all dispensings. The purchase price varies by contractor, and over time, as they strive to achieve the best possible purchase price from suppliers on behalf of the NHS.

A reimbursement price is set for Scotland after consultation with pharmacy contractor representatives and published in the Drug Tariff. The current reimbursement price for generic methadone hydrochloride solution 1mg/ml 500mls, which is the most common prescribed form, is £4.70.

Pharmacy contractors dispensing methadone may also receive dispensing and supervision fees set by the relevant health board. These fees are agreed locally and vary between health boards.

Prior to 2007-08, this information had not been collected. To respond to this evidence gap, the Scottish Government has:

(1) Developed the Scottish Drug and Alcohol Treatment Waiting Times Database. This recorded that 15,600 people entered drug treatment (and that 19,043 treatments started) between April 2011 and March 2012. The treatments started in 2011-12 included the following:

(2) Enhanced the Scottish Drugs Misuse Database (SDMD) which is why Information Services Division (ISD) of NHS National Services Scotland is now collecting data on people’s pathways through treatment.

The purpose of the SDMD is to help us understand the needs of people with drug problems presenting for specialist treatment. It will help inform recovery plans and, over time, enable us to understand more about people’s journey through treatment and the outcomes they achieve (including paid and unpaid employment, support into employment and full-time education and training). The first release of follow-up information from the SDMD will be published by ISD Scotland in December 2012.

2011-12 information on new clients who presented to specialist drug treatment services and who received an assessment of their drug use and care needs is due to be published by ISD in late 2012/ early 2013 (ISD is yet to confirm the date for the reporting of SMR25a information from the SDMD).

We do have information, from the SDMD, on the employment status of new clients who received a specialist assessment of their drug use and care needs in 2010-11. This information was published by ISD on the 28 February 2012 in Drug Misuse Statistics Scotland 2011.

In 2010-11, 12% of new clients who received a specialist assessment of their drug use and care needs reported that they were employed (includes paid and unpaid employment, support into employment and full-time education and training). Information from the SDMD also told us that 67% of new clients in 2010-11 reported that they were unemployed (73% in 2009-10). This information from the Scottish Drug Misuse Database (SDMD) on the employment status of "new clients" presenting to specialist treatment via SMR25a has been published annually by ISD in Drug Misuse Statistics Scotland. http://www.drugmisuse.isdscotland.org/publications/11dmss/11dmssb.htm

The Drugs Misuse and Dependence – UK Guidelines on Clinical Management (more commonly known as the Orange Guidelines) advises clinicians to undertake random urine tests if and when appropriate. The guidelines further state that urine tests may be used to assess how a client is responding to treatment and to assess if they are failing to benefit from a specific course of treatment.

As this is a decision for the clinician to make in line with UK agreed clinical guidelines there is no, and never has been, any centrally held information.

Prior to 2007-08, this information had not been collected. That is why the Scottish Government invested in the research Assessing the Scale and Impact of Illicit Drug Markets in Scotland http://www.scotland.gov.uk/Publications/2009/10/06103906/0, which was published in October 2009.

The report estimates that the total economic and social cost of illicit drug use in Scotland is just under £3.5 billion. Costs associated with problem drug use accounts for 96% of the total cost and this equates to just under £61,000 per problem drug user. Recreational drug use accounts for 4% of the total estimated cost equating to £134 per user.

Table 5.9.1 of this Report Breaks Down the Wider Costs of Drug Misuse

This report also offers some useful cost / benefit analysis of drug treatment in the context of preventative spend: