25th January 2021
In a Ministerial statement on drugs policy to the Scottish Parliament on the 20th of January, the First Minister announced a potential £250 million additional funding over the next five years to address the current public health emergency of drug-related deaths.
The funding consists of an extra £5 million that will be delivered in what remains of this financial year, which is to be deployed for “urgent” initial work. Should the current Government return after May’s Scottish Parliament election, a further £50m per year will then be committed.
The First Minister covered a number of topics over the statement and in her responses in the following debate; key quotes from these can be found below:
A new ministry within Scottish Government
The new Minister for Drugs Policy will report directly to The First Minister
The Minister will ensure that drug policy work is ‘embedded across all areas of Government, and particularly in our efforts to improve mental health, to tackle homelessness and to ensure that we have a humane and responsive justice system’ to ‘tackle all aspects of the problem’.
Drug Deaths Task Force
The intention seems to be to maintain the Task Force which ‘has provided us with a clear sense of the issues on which we need to work most urgently’.
Stigma
‘We will also do more to tackle head-on the stigma that is still too often associated with drug use.’
‘The Drug Deaths Task Force has recently published a stigma strategy that makes a number of recommendations about tackling the issue. It is also taking forward an anti-stigma charter to challenge all of us to consider how we can work together and individually to create a stigma-free Scotland when it comes to issues of drug use. That is so important. It is important that we have strategies and charters, and the work that is being done is exemplary.’
Toxicology service
‘We will commit additional funding, if required, to improve toxicology services’
‘…delays are not acceptable and there is a real determination to ensure not only that they have been resolved but that they never recur. I said today that, if necessary, we will commit additional funding to that.’
Public health surveillance / data sharing / publication of statistics
‘We will commit additional funding, if required, to improve toxicology services and to enhance public health surveillance of drugs issues’
‘We want to see timely publication of those. My view—there is work to do in getting from what I am about to say to delivering it in practice—is that we need to have more regular publication of statistics in order to have more of a real-time overview of whether what we are doing is working.’
‘In my statement, I mentioned something I know that the task force is keen on, which is investment in more public health surveillance. That is needed so that we are not waiting for annual statistics to be published, but know, on much more of an on-going basis, whether there are problems with street benzos in a particular part of a country, or any other issue such as that. That would also allow for better assessment of whether the interventions that we are making are working.’
Grassroots organisations
‘…we value and support the work that is being done by grass-roots organisations…. they will receive part of the additional funding that I have announced today.’
‘Extra funding will go directly to alcohol and drug partnerships. We expect much of that funding to flow to the grass-roots organisations that do so much vital work in our communities. More details on allocation of the funding will be set out by Angela Constance, in due course.’
‘With extra funding, the work that they do will be more secure, and they will be able to do more of it and reach more people.’
Alcohol and Drug Partnerships
‘Extra funding will go directly to alcohol and drug partnerships. More details on allocation of the funding will be set out by Angela Constance, in due course.’
Benzodiazepines
Angela Constance, Police Scotland and people from communities affected by use of street benzos are ‘urgently considering what more we can do to address the issue.’
There is recognition that this ‘requires…action to disrupt supply (and) improvements to treatment that are necessary to stem demand’.
‘Using pill presses, it is all too easy to produce such drugs and distribute them to street level. The police have a big part to play in making sure that we are doing everything possible to disrupt that. The second issue, which has come out strongly in my discussions over recent weeks, is about stemming the demand and understanding why many people feel that they have to access street benzos, for example. That might be because they are not getting access to treatment as quickly as they need to or they are not getting the therapeutic dose of methadone that they need.’
Public debate – harm reduction and recovery
‘We will seek to overcome the divide that sometimes exists in public debate between harm reduction and recovery. Both are vital, but the most urgent thing of all is that we save lives.’
‘One issue that has come through my discussions is a frustration—we sometimes pick this up in relation to methadone treatment or residential rehab—from those with lived experience that the political debate often focuses on one aspect. That refers to all of us; I am not criticising anyone. Most recently, the focus has been on residential rehab. That is an important part of the issue, but we must not focus on it to the exclusion of everything else.’
Drug consumption Rooms
‘We will continue to explore how we will overcome the legal barriers that currently restrict us in that respect.’
‘It is important that I do not trample on the independent terrain of the Lord Advocate. When Angela Constance and I recently met Peter Krykant, I undertook to continue discussions with the Lord Advocate and to look, almost from first principles, at how we can overcome the challenges.’
Heroin assisted treatment
‘We will make additional funding available, starting in this financial year, to make heroin-assisted treatment services more widely accessible across the country.’
Medication Assisted Treatment (MAT) Standards
‘… rapidly implement across Scotland the new standards for treatment.’
‘Funding will be provided for that in this financial year.’
Naloxone
‘We are also taking steps to widen distribution of naloxone.’
Long-acting opiate replacement medication
‘…further increase the availability of long-acting opiate replacement in prisons and in the community.’
Targets for treatment
‘We will work as a matter of urgency with experts and people with lived experience, to develop firm targets in relation to treatment.’
‘…a clear majority of people who use drugs get(ting) the treatment that they need when they need it, has to be central to any strategy for reducing drug deaths.’
Unplanned discharge from treatment
‘…people should receive support for as long as they need it. Services must have the resources to allow them to stick with people even when, because of their addiction, that becomes challenging. At the moment, the number of people who drop out of support and treatment services is far too high, so we will work with alcohol and drug teams in order that we can significantly improve that over the next year.’
Residential rehabilitation
‘Part of the £5 million that we are making available immediately in the remaining weeks of this financial year will support the opening of additional residential rehabilitation placements.’
‘Over the next session of Parliament, we intend to allocate an additional £20 million a year for residential rehabilitation and associated aftercare—which is often the bit that does not get the same attention.
‘A significant proportion of the extra funding will go towards developing sustainable capacity in regional centres across the country. We must ensure that rehabilitation can be provided much closer to home for people, and therefore to the families and support networks on which they so often rely.’
‘The aim is to ensure that residential rehabilitation is available to everyone who wants it—and for whom it is deemed to be clinically appropriate—at the time when they ask for it, in every part of the country.’
‘…we believe that those measures will bring provision in Scotland into line with that of other European countries.’
Non-fatal overdoses
‘One area where that is urgently necessary is the support that is provided to people following a non-fatal overdose.’
‘…requires better co-operation and data sharing between agencies and organisations. A good example of that approach is the work that is being led by the Glasgow overdose response team.’
‘By making additional funding available this year, we can extend such outreach initiatives and ensure that similar support is provided in cities across Scotland.’
‘In addition, by April, all alcohol and drug partnerships will have agreed a common set of steps that need to be taken to support anyone who suffers a non-fatal overdose.’
Opiate Substitution Treatment Regimes – lessons from COVID-19 pandemic restrictions
‘…this point has been made by others—it is time to bring the same resolve, focus, and common purpose that we have all shown in tackling COVID to reducing the loss of life that is caused by drugs.’
‘…changes to pharmacy arrangements mean that people have been assessed as not having to attend daily for medication-assisted treatment. That has proved highly effective. It has also reduced some of the stigma that people feel and has shown trust in people at the same time as it has reduced the risk of spreading COVID. It is important that we retain arrangements of that type and work with leadership across health—pharmacy colleagues, in particular—to learn from that experience and make the most of every opportunity to improve the services and care that are offered to people.’
‘Part of the additional funding that we have announced will also give delivery partners the resource and encouragement that they need to make and maintain further positive changes.’
Decriminalisation of possession
‘One of the strands of the drug deaths task force is to look at the justice system approach and at legal changes, so, yes, I think that that is very much on the agenda. I will take away the suggestion of having an independent look at decriminalisation. I know that there are very mixed views—no doubt across the parties and society—about whether that would help or hinder, but I am certainly open-minded about further consideration of all that.’
‘If I were to stand up here and announce prosecution policy, I would rightly be criticised because that is not my role but that of the independent Crown Office and Procurator Fiscal Service. My view on how we should treat drug addiction and people with issues of drug use from a public health perspective and not a criminal justice perspective is well known, and I hope that it is well understood. We will continue to look at all different approaches to treatment and services and all opportunities and ways in which we can overcome any legal challenges that we face. We will look to learn from any other countries, where we think that that is appropriate.’