When I stepped into the role of CEO two years ago, I knew I was taking on more than a job. I was stepping into a legacy, a movement, and a fight that has always been bigger than any one person or organisation.
Succeeding someone who had led this charity for nearly four decades came with its own gravity. They were a constant through political cycles, shifting public attitudes, evolving drug trends and strategies. The responsibility of picking up that baton was both a privilege and a pressure. I was determined to honour the history of our organisation while also guiding it into a new chapter.
Change Is Slow and Painful – But Still Worth Fighting For
Drugs policy reform is a long, hard slog. We are challenging decades of punitive thinking, political point-scoring, and deep-rooted stigma. But when people are dying every day from preventable overdoses, the slow pace of change isn’t just frustrating – it’s unacceptable. Every delay costs lives, and that urgency must drive us, even when bureaucratic inertia slows everything down.
What I didn’t fully appreciate was just how personally difficult it would be when the challenges weren’t just political – they were organisational. Immediately into my tenure, we faced a significant loss of funding for our Sexual Health and Blood Borne Virus work. It meant restructuring, and ultimately, making valued colleagues redundant. It’s the hardest part of leadership – making decisions you wish you never had to. These weren’t just roles – they were people with dedication, lived experience, and heart. Losing them was really tough – and I knew it wouldn’t be the last time I’d have to face such a difficult decision.
At the same time, during these past 2 years I’ve seen the determination that drives this work. Even in hard times, our team showed resilience and resolve. We continue to show up – for people who use drugs, for the evidence, and for the principle that health and human rights must never be compromised by stigma, criminalisation, or discrimination – harms that should have no place in drugs policy.
Building for the Future: Leadership, Strategy and Care
One of my goals from the start was to lift our gaze from the day-to-day firefighting and carve out time and space for longer-term thinking. That meant developing our leadership team – not just to manage the work, but to shape the future.
We’ve spent time creating a more strategic, forward-looking approach to our mission. Alongside that, I’ve tried to embed a workplace culture that genuinely values staff wellbeing. We’ve introduced new benefits and ways of working that reflect our belief in compassion and care – not just for the people we advocate for, but for each other. We can’t campaign for dignity and health while burning out the people doing the work. Looking after our team isn’t just good practice – it’s a reflection of our values.
As part of this renewed approach, we launched a new strategic plan, refreshed our branding, and introduced a new website – to give our work a clearer voice and a more confident, modern presence. These changes are about more than just aesthetics; they reflect the clarity of our purpose and the ambition of our vision.
We’re also investing in the foundations of our wider movement. That includes development work to improve our membership offer – ensuring that we’re giving real value back to our supporters, collaborators, and allies. They are a vital part of our work, and we want to build a membership community that feels engaged, respected, and connected to the change we’re striving for.
The uncertainty of funding has been a quiet, constant pressure and one that weighs heavily when you know the urgency of the work. We have to think beyond survival and be bold enough to build for the future even when the ground can feel shakey. Leading through that uncertainty has meant staying grounded in our values, trusting our vision, and never losing sight of the people who are counting on us.
Trolling, Extremes and the Need for Nuance
Leadership in this space inevitably brings scrutiny. Constructive criticism is part of the job – and welcome. But over the past two years, I’ve also experienced something more insidious: persistent efforts to erode trust in our work through unfounded online accusations and antagonism.
In some cases, it’s come from individuals with a rigid abstinence-only agenda – those who deny the legitimacy of harm reduction entirely. It’s one thing to hold a different view. It’s another to spread misinformation or attempt to discredit an evidence-based, public health approach.
The reality is this: people need different things. Some will pursue abstinence. Others need harm reduction. Many need both at different points in their lives. Denying that reality doesn’t help anyone – it just drives people further from support.
We must also be clear that our role is not to push people toward specific outcomes, whether that’s abstinence, treatment, or any particular definition of recovery. Everyone’s relationship with drugs is different, and so are their needs, goals, and circumstances. True support means meeting people unconditionally where they are at – not where we think they should be – and offering a range of options grounded in autonomy, dignity, and evidence. Choice is central to both harm reduction and human rights, and we must protect it fiercely.
Stories Change Minds More Than Stats
Scotland has always had data. But in my time with SDF, what’s created real shifts in policy and perception hasn’t just been statistics – it’s been meaningful inclusion. When people with lived and living experience are properly engaged – not just to share their stories, but to shape research, influence standards, design services, and lead advocacy – the impact is transformative.
I’ve seen policymakers and service providers rethink entrenched views after listening to someone speak – not just about an overdose or criminalisation but about navigating broken systems and surviving in spite of them. I’ve seen public support grow because someone chose to speak out, and because that voice was given the platform and respect it deserved.
This isn’t just about storytelling – it’s about embedding lived and living experience into the very structures of our work. Our peer research on medication-assisted treatment standards is a clear example of that: people with direct experience leading the way in defining what effective, respectful care should look like. When that kind of knowledge is taken seriously, it drives better outcomes – and builds a more just, person-centred system for everyone.
We must continue to centre real life experience – not just in our messaging, but in our leadership, strategy, and vision.
That means recognising the full spectrum of experience. People in long-term, abstinent-based recovery have valuable insights to share, but so do those who are currently using drugs – and too often, their voices are excluded or diminished. If we only listen to those who’ve stopped using drugs, we miss critical truths about the realities of stigma, exclusion, and unmet needs. Families, too, carry powerful stories – of loss, of love, of navigating systems that failed their loved ones. All of these perspectives matter. All must be heard.
At the same time, we have to recognise that not all voices, regardless of experience, automatically challenge stigma. Lived experience is powerful, but it doesn’t always align with a rights-based or harm reduction approach. Sometimes, personal journeys or deeply held beliefs can lead to narratives that unintentionally reinforce shame or exclusion, particularly towards those still using drugs. That’s why it’s so important to hold space for a diversity of perspectives while also being intentional about the values we amplify. Compassion, respect, and a commitment to dignity must guide how we listen – and how we platform voices – so that no one’s experience is used to silence or judge another’s.
The Legacy and the Future
Taking over from someone who led this organisation for 38 years taught me something fundamental: legacy matters, but so does evolution.
I’m not here to replicate what’s been done – I’m here to protect the values that shaped this charity, while preparing it for what comes next. That’s meant making tough decisions. Facing criticism. Staying rooted in harm reduction when it would be easier to drift toward neutrality.
But it’s also meant building something fresh. A team that collaboratively looks ahead. A culture of care. A commitment to evidence and equity that doesn’t flinch under pressure.
Two years in, my resolve has only deepened. This system must change. I believe more than ever that change is possible and that we’re on the right side of history. We’re not going anywhere until it does.
–Kirsten Horsburgh