Drug Deaths

– in the Scottish Parliament on 12th September 2019.

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Photo of Linda Fabiani Linda Fabiani Scottish National Party

The next item of business is a members’ business debate on motion S5M-18420, in the name of Monica Lennon, on Scotland’s drug death public health emergency. The debate will be concluded without any question being put.

The debate is highly subscribed and members will have to keep tightly to their timings or some will have to drop off the speakers list. It is in members’ hands.

Motion debated,

That the Parliament considers problem drug use across Scotland, including in the Central Scotland region, to be a national crisis; is saddened and concerned at reports that 1,187 people lost their lives due to drug-related causes in 2018, which it understands is the highest level ever reported; further understands that the rate of drug-related deaths in Scotland is the highest in the UK and across the EU; believes that every life claimed by drug misuse is a preventable tragedy, and notes the calls on the Scottish Government to legally designate the crisis a public health emergency and to urgently direct councils, integration authorities, Police Scotland, NHS boards, the Scottish Ambulance Service and all other relevant public bodies to assess, prevent and address the consequences of the emergency, by working together to save lives and reduce drug-related harm.

Photo of Monica Lennon Monica Lennon Labour

Every seven hours, a life in Scotland is being lost to drug overdose. This is a national emergency, and it needs an urgent emergency response.

I am grateful to the members who signed my motion because, in doing so, they have made it possible for this debate to go ahead today and for Scotland’s drug death emergency to be recognised in our national Parliament. We are tight for time today, so we need to have a longer debate in Government time and to have regular updates. That is the very least we can do.

One drug-related death is a tragedy, so it is horrifying that almost 1,200 people died from drug overdose during 2018. The death toll has doubled in a decade and, if that was not shocking enough, Scotland's drug death rate is the highest in the United Kingdom, the highest in Europe and the highest in the world.

Thousands of grieving, trauma-stricken families are being left behind, and they feel ignored and abandoned by us and our public services. For the purposes of officialdom and statistics, those who have died are described as drug users or addicts, but they were people who, like all of us, once had hopes and dreams.

When I look around the chamber, I see members who are sincere in wanting to tackle this crisis. However, we must not kid ourselves that we are doing enough. When I picked up “Protecting Scotland’s Future: the Government’s Programme for Scotland 2019-20”, which was unveiled by the First Minister last week, I was shocked when I flicked to page 102 and read these words:

“We are doing everything we can ... to save lives.”

That cannot be serious. As someone who lost a parent to alcoholism, I have the self-awareness to know that I get a bit emotional about this and that I have a heightened emotional response. However, the First Minister is kidding herself on if she thinks that there is no more that her Government could do. Treatment and support services are underfunded and struggling to provide help to everyone who needs it, our prisons are rife with drugs, drug users are still called horrible and dehumanising names—whether on the streets or in newspapers—and stigma is real and stigma kills.

More than half of people in Scotland believe that, if someone goes through a hospital door because of drug or alcohol misuse, they should pay something towards their care. Mothers and fathers are burying their sons and daughters, children are being left without their parents and friends are losing multiple friends to drug-related illness and suicide—and the statistics probably do not even tell the full story.

During the lifetime of the Scottish Government’s 2008 strategy—“The road to recovery: a new approach to tackling Scotland’s drug problem”—6,418 families lost a loved one. Scotland’s drug death emergency is tragic, heart-wrenching and shameful, and it cannot be allowed to continue.

The programme for government clearly states that drug-related deaths are preventable; on that, ministers are absolutely correct. The motion that we are debating asks the Scottish Government to

“legally designate the crisis a public health emergency” and not just talk about one. The legislation that allows ministers to do that—and to bring forward regulations if so required—is the Civil Contingencies Act 2004. The Scottish Parliament’s highly respected and independent research unit, the Scottish Parliament information centre, or SPICe, has confirmed that. The Scottish Government’s “Preparing Scotland” document explains that the act is concerned with how to deal with consequences of emergencies, which it defines as events that threaten

“serious damage to human welfare.”

What would that legal designation do? It would allow ministers to direct, co-ordinate and monitor the response of our public bodies, such as health boards, councils and the police, to make sure that our communities and people are getting exactly what they need.

Photo of Monica Lennon Monica Lennon Labour

I am sorry, but I will continue.

The situation in Dundee, which my colleague Jenny Marra will address, is different from what is happening in other parts of the country, for example, Glasgow. We need to know that targeted action and progress are being achieved—there needs to be transparency and accountability.

I do not know whether I will get extra time to take an intervention. I say to Stuart McMillan that I am really sorry.

We know that alcohol and drug services have faced real-term cuts in recent years, which has made it very difficult for them to support everyone. An emergency response must be supported by the resources that are needed to address this.

This morning in Parliament, an event was held in partnership with the

Daily Record that gave people who have direct experience of substance misuse the chance to be heard and to be visible in Parliament. Many of them—there are a lot of them—are in the public gallery. I thank all of them, including my constituents who have come from Hamilton, and representatives of Blameless Charity, which is based at Hamilton Accies. I also thank the Minister for Public Health, Sport and Wellbeing for being there today, and the

Daily Record for its campaign to put the drug death emergency higher up the political agenda. In particular, I thank Mark McGivern, who is the journalist who has largely been driving that.

Today, MSPs from all parties signed up to a

Daily Record pledge board, which is very positive. I hope that all MSPs, including the public health minister, will sign it, because it is a pledge to recognise that Scotland faces a drug death crisis that should be treated as a national emergency. It is a pledge to do everything that we can to end the crisis of substance misuse in every part of Scotland and to campaign for significant new funding for harm reduction and recovery services. We cannot stand by and watch vulnerable people die every seven hours. We are supposed to be a progressive and compassionate country.

It is not good enough to announce a ministerial task force in March, to count our dead in July and to wait until the middle of September to get people in a room. The task force is accountable to ministers and, in the end, ministers are accountable to the people. When the minister gets to his feet to speak, will he confirm whether he believes that the Government has acted quickly enough? Is there more that could be done? Does he expect to see a reduction in the number of drug deaths when the 2019 figures are published?

I ask, urge and beg the Scottish Government to show the leadership that I know it can show, to show compassion and to activate and co-ordinate an emergency response to this national tragedy. Our most vulnerable citizens cannot be left to die from this preventable disease.

The Deputy Presiding Officer:

I say to those in the public gallery that it is inappropriate for them to show appreciation or otherwise for members’ speeches. Perhaps they can speak at the end of the debate to those who have contributed.

Photo of John Mason John Mason Scottish National Party

I thank Monica Lennon for raising this important issue in Parliament today, and I welcome the extra £20 million that the Scottish Government has promised for this area in the programme for government.

I appreciate getting the opportunity to speak in this drug deaths debate, though I am sad that a debate on the topic is needed at all. Scotland has a serious drug problem, which is very evident in my constituency, Glasgow Shettleston, where drug addiction and drug deaths are highly visible.

I have two main points to make. First, we need to recognise that there are usually underlying reasons for drug use; it might be the result of something deeper. Secondly, I absolutely agree that we should treat drug use as a health issue, although I accept that there are impacts beyond health.

With most addictions, including drug addictions, people often have underlying problems, including the breakdown of family relationships, major financial problems, mental health issues and a lack of hope. Therefore, we cannot deal with drug usage on its own and must take a wider, preventative approach to the issue. In that respect, there is not one simple solution. It is urgent, but it will take time to turn around.

I note that the motion focuses almost exclusively on the public sector. The public sector is a major player but, on its own, it cannot prevent deaths linked to drugs. For a start, families and the third sector have a major part to play. They can give individuals the time and support that they need, which the public sector is unable to do.

Photo of John Mason John Mason Scottish National Party

I am sorry—time is too limited.

I was interested to read an article in the

Evening Times

—another paper that has been campaigning on this issue—on Monday that focused on the Family Addiction Support Service, or FASS. One of its volunteers was quoted, who said that her 50-year-old son had been involved with drugs for 30 years. She made the point that individuals have to want to change, which is an important point for us to remember when we talk about all drug deaths being preventable.

I agree that this is a health issue, and we should treat it as a health problem, crisis or emergency, as people see fit. Safe consumption rooms can therefore be part of the answer. If other parts of the national health service both look after the patient and provide the medication that they require, that should surely also be the case for treating drug addiction. A system that relies on people buying their drugs illegally from organised criminals—perhaps forcing a partner into prostitution to get the money, as happens in my constituency—and involves drug gangs, which leads to violence, cannot be a good system.

If this is a health issue, as it is, we need to emphasise the likes of heroin-assisted treatment as the preferred route. I understand that HAT is already legal, although there a number of conditions around it. Perhaps those are too restrictive and need to be reviewed.

I gather that Switzerland has a long history of providing HAT. The Swiss model of HAT combines prescribed supply, which has associated benefits, such as purity, with supervised use in a safe and hygienic facility. Since the introduction of HAT in Switzerland, health outcomes for heroin users have improved significantly, illicit heroin consumption has been reduced, medically prescribed heroin has not made its way into illicit markets and the medicalisation of heroin has reduced the initiation into its use by new users.

In the UK, medically prescribed heroin has been legal since 1926, yet programmes are not widely available. Glasgow city health and social care partnership is pushing ahead with plans to open a HAT centre in Glasgow, which I welcome. However, let us remember that this is a long-running problem and, sadly, the answers will not be quick or easy.

Photo of Miles Briggs Miles Briggs Conservative

I thank Monica Lennon and the Labour Party for today’s debate, which is the second opportunity to discuss drug deaths. The Conservatives had to use our business time for the previous one, and I hope that the minister has heard the message that we should have Government debate time on this issue as soon as possible.

Over the summer recess, I undertook a number of visits across Scotland to meet people who run drug services. We need to start by asking where we have gone so wrong. People who work on the front line are quite clear that this is a public health emergency, which they cannot deal with because of lack of resource. We need to be clear about that, too.

I visited the minister’s constituency and met people in the Lochee hub, who told me how their work with Addaction adult services makes a difference. However, they said that youth Addaction services had all been cut in Dundee’s secondary and primary schools after this Government cut funding, which has had an impact on services. I am concerned that services across Scotland are threatened and are closing. We need action from the Government now to prevent those service closures.

Mental health support is very important, and I hope that we will not wait for the task force to take that area forward. Everyone I have spoken to has made clear that people cannot start with holistic support around mental health until they are seen to be clean or under management. That is wrong, because most people want to start that support straight away. We must look at capacity. In our debates here on access to mental health services and the crisis for child and adolescent mental health services, it has not been clear where that capacity will come from or what it will look like, but we must look at where the third sector can step in to provide support.

We have welcomed the task force and those who serve on it, but it is clear that families and people with lived experience do not feel that they have adequate representation on the task force. They are not confident that they will have their voices heard when feeding in their experience, although lots of organisations do positive work—many are in the public gallery today. Will the minister at this stage consider expanding the task force and including more people with lived experience and families? They have put that forward; it is sensible and I think that it would attract cross-party support.

Above all, as the task force brings forward positive contributions on how we can turn this situation around, I hope that we will see on-going commissions of work. The minister has agreed to meet us monthly, as Monica Lennon said. We need to drive forward change and service reform as a Parliament. I hope that we can have a Parliament-wide view on this issue. Every party is committed to that, and we have all put forward policy suggestions. Last year, I published our life plan policy, and I hope that all the policy areas where we want to see change and reform will be looked at and not just put to one side.

This is a national emergency and the Scottish Government and every minister should look at portfolios collectively and take responsibility, with local government, the health service and education services all stepping up to make an emergency response. When we have a Government debate, I hope that all ministers will take part in it.

Photo of Emma Harper Emma Harper Scottish National Party

I thank Monica Lennon for securing the debate and express my condolences to any family that has lost loved ones who have died as a result of the effects of alcohol or drug use. Everyone who has experienced harm from alcohol or drug use issues must be treated with dignity and respect and must be supported.

I put on record my thanks to the minister for the work that he has done on the issue. During the recess, he visited Paris to observe and hear about the approach that is taken there. Documents have been published, and he has given the issue time.

As we have heard, the issue is claiming many lives and is complex. I have many notes in front of me just from attending the round-table session on the issue this morning and hearing about people’s lived experiences. As a nurse, I can talk about the complex physiological process that happens to people who overdose. Sometimes, folk who suffer the effects of harmful use are also smokers, and smokers often have issues related to poor lung health or chronic obstructive pulmonary disease, which can lead to baseline oxygen saturation levels that are perhaps not the healthiest. When other drugs are taken on top of that, that can lead to an oversedation issue in the body, which causes further oxygen saturation reduction, leading to critical events.

Even if we had safe consumption facilities, many people who take drugs in rural areas would not necessarily have access to those facilities. When people take drugs on their own, that is a real risk, and that has to be addressed and challenged, especially in rural areas.

I thank the minister for attending the river garden Auchincruive centre in Ayrshire with me just before the summer recess. The centre, which is run by the charity Independence from Drugs and Alcohol Scotland, has a great team of people, including service users. It is a peer-supported place, where people who have lived experience can live together, work together and support each other. From listening to the experiences of Natalie, Sharon and Darren at the round-table session this morning, I know that that approach can help. Following Darren’s apology for being so aggressive, the minister noted Darren’s passion and said that, if we lose our passion, it means we do not care any more. We need to continue that passion and continue to care so that we can help to save more Scottish lives.

I am interested in the Scottish Affairs Committee’s pursuit of the issue at Westminster, and I attended a meeting of the committee with my colleagues Dave Stewart and Brian Whittle. I see that Ged Killen MP, who is a member of the committee, is in the public gallery today. The committee’s inquiry has the simple aim of better understanding drug misuse in Scotland. In the meeting that I attended, the committee took evidence from many experts who are also asking for a radical change, such as Professor Iain McPhee from the University of the West of Scotland.

One challenge is that we cannot just change the policies and do what we want. I ask the minister to continue to lobby the United Kingdom Government so that we can do things differently, just as Portugal and other countries across Europe have done since the 1970s.

I will stop there, but the issue is worth further debate.

Photo of Neil Findlay Neil Findlay Labour

I thank Monica Lennon for bringing forward the debate, but it says everything about the Government’s approach to this national crisis that we are debating drug deaths only in Opposition time. Surely, a non-debate about a citizens assembly does not have greater priority than discussing how we end our shameful accolade as the drug deaths capital of Europe or how we end the HIV outbreak among homeless drug injectors in Glasgow. The last time that we debated drugs in Government time in the Parliament was 8 November 2012, which was seven years ago, and that was when half the number of people were dying on the street compared to now. That is simply not good enough.

People say that we must have consensus on the issue. I disagree with that, 100 per cent, because it is passive consensus that has got us to the situation that we are in. We need anger and direction to Government on the issue, because its response has been pathetic. In 2016, we had a 24 per cent cut in the budget for alcohol and drug partnerships. I am pleased to see the former Cabinet Secretary for Health and Sport here. I hope that she contributes to the debate, because she can explain why, on her watch, those ADPs had that massive cut in their budget, which resulted in poorer care and attention for people going through addiction and more people dying on the streets. A task force was set up, but it has not met during the six months since it was announced, which exemplifies the problem.

The fact that a paltry £10 million of additional funding will be provided over the next two years exemplifies the ambivalence that is being shown. Let me put that into context. We will spend £1.4 million a month to keep a hospital in Edinburgh closed, with no patients. We will spend an extra £76 million on an information technology disaster to deliver farm payments. We are spending £76 million on computers that dinnae work and millions of pounds on a hospital with no patients. However, we are spending a fraction of that money on our fellow citizens who are dying on the streets of Edinburgh and every other city and community every single day.

If the problem was bird flu, foot and mouth disease, another health threat to animals or another disease, there would be emergency meetings of the Government’s resilience division. Resources would be freed up immediately. There would be a genuine emergency response. If any task force that had been set up to deal with such emergencies had not met for six months, the minister would have been out the door a long time ago. However, we are, of course, talking only about drug users and people who are going through addiction; politically, those people are easy to ignore. To the Government, they are miles down the list of priorities.

Here are some of the suggestions that I have heard from people who are drug users, people who have been supporting them and people in their families. They have said that we should stop jailing people who are unwell and need help, and treat them instead. They have said that police, community and public health funding should be brought together to address the problems that people face. Mental health teams should be set up in police stations—that was the top ask from the police when I went out on a shift with them over the summer. Drug users who have not responded to other forms of treatment should be allowed to be prescribed heroin in a medical setting. The application of naloxone should be extended. There should be an early warning system for changes in behaviour on the streets. Cuts to alcohol and drug partnership budgets should be stopped, and we should properly invest in mental health services. The current services are completely and utterly swamped and inadequate. People talk warmly about the charities and voluntary organisations in their area, but all of them have had their budgets cut year on year. That is the reality.

We should extend the testing of ecstasy and other drugs. We should take long-term gradualist action against the prevalence of antidepressants, so that people do not go on to the streets to pick up counterfeit drugs.

The Deputy Presiding Officer:

You must close, please.

Photo of Neil Findlay Neil Findlay Labour

We need a concerted and co-ordinated drugs service. We need to stop discharging people from hospital on to the streets, and to address our homelessness crisis.

The Deputy Presiding Officer:

You must close, please.

Photo of Neil Findlay Neil Findlay Labour

There is so much more that I want to say. Please, let us not have any more guff about consensus; we need to get things fixed.

The Deputy Presiding Officer:

The first speakers from all parties—the Greens aside—have gone over their time. I cannot allow anyone else to go over their time, because business in the chamber must resume at the normal time for a Thursday.

Photo of Shona Robison Shona Robison Scottish National Party

I welcome Monica Lennon’s debate and the powerful speech that she made at the outset.

I also welcome the proposals that the Scottish Government set out in last week’s statement on tackling drug-related deaths. Everyone in the chamber—and those who are not in it—cares deeply about the issue, whether it affects our communities or many of our friends and families.

I echo the sentiment that the minister expressed when he met the new chair of the Scottish Government’s drug deaths task force. The group needs to identify areas for change or improvement quickly, rather than meet for months and then issue a final report. That is the right approach.

The task force will meet for the first time on 17 September. In his response, will the minister say whether a timescale for output, in relation to the task force’s remit, has been discussed and agreed? I understand that the task force will report to ministers and make recommendations for short, medium and long-term actions. Given the need to act now and the concerns that are shared by many members across the chamber, will the minister agree to allot time for the provision of regular updates on the progress of the task force?

In his statement, the minister acknowledged the work of the Dundee Drugs Commission, which recently published its report “Responding to Drug Use with Kindness, Compassion and Hope”, which was presented by the Dundee Partnership. I, too, thank those who were involved in the report—especially those who have been directly affected by drug use—for their work in highlighting the issues that are faced in Dundee and across Scotland and for their numerous recommendations, many of which have been acknowledged in the Scottish Government’s strategy documents. When I met some of the commissioners, I was impressed by the fact that they are looking at radical and different approaches, which is absolutely the right course of action.

One of the key recommendations in the report is the full integration of substance use and mental health services and support, which Miles Briggs touched on. There is a particular need in Dundee to join up and integrate those services, which have been far too siloed. Someone being unable to access services because of a possible underlying mental health issue is not the right approach.

Trauma, violence, neglect and social inequalities lie at the root of both mental health problems and substance use problems. We know that they are interlinked. I do not think that anyone would advocate the idea that there is one simple solution to this.

Photo of Shona Robison Shona Robison Scottish National Party

No, thank you—I have only four minutes for my speech.

The idea that there is one simple solution is not being suggested. We have to look at all the potential solutions, some of which are radical and may not even have been raised as a possibility 10 years ago in this place but are now being discussed openly and have support across the chamber. It is absolutely the time for radical action. We all need to look at those potential solutions and be willing to open our eyes to the possibilities. I am certainly willing to do that.

Given the potential of such an approach and the need for urgent action, I am pleased that the minister is meeting me later to discuss the recommendations—particularly those on dual diagnosis—in more detail. I would appreciate it if he could touch on how Dundee could be at the forefront of implementation, because we face complex issues. It is right that we have a strategy that looks at the needs of particular locations, because there is no one solution for the whole of Scotland. I would like the minister to reflect on that in his closing remarks.

Photo of Brian Whittle Brian Whittle Conservative

I, too, congratulate Monica Lennon on bringing the debate to the chamber, and I agree that it is about time that we had significant Government debating time on this topic. For far too long, too many people in society have not mattered. It is not just those who are caught in the web of addiction who are suffering, but the families, friends and local communities who suffer the emotional fallout from addiction and the trauma of losing loved ones to addiction.

I have been introduced to a very uncomfortable phrase: “a hierarchy of death”. The suggestion is that how the bereaved are treated depends on how the deceased person died. They say that, at the bottom of the hierarchy, are families and communities who have lost loved ones to addiction—and they are, of course, correct. When we are discussing drug and alcohol deaths, let us not forget the devastation that is left behind. No matter what is written on the death certificate, the pain and trauma left behind are the same, so we need to develop services accordingly.

I recently attended an event called “A matter of life and death—recovery in East Ayrshire”, in which 110 stakeholders took part. There were several presentations, including one from the leader of the Government’s drug deaths task force, Professor Catriona Matheson. Not one of the actions called for by those 110 stakeholders in the break-out sessions lies outwith the competency of the Scottish Government, so, when I reread the minister’s statement from last week on Scotland’s drug deaths, I was disappointed all over again. I do not question the minister’s commitment and desire to tackle the issue, but it is blatantly obvious that the Scottish Government is on the wrong road.

It continually talks about the levers that it does not have and keeps looking south, suggesting that its hands are tied. I think that the Scottish Government is hiding behind that excuse and that that narrow approach is strangling its options.

We want there to be safe spaces where further conversations can take place. In East Ayrshire, attempts are being made to raise the cash—we are not talking about much money, in the scheme of things—to open a rehabilitation cafe that will serve as a safe space where medical interventions such as hepatitis and aids testing can take place, where mental and physical health advice can be provided and where dental health services can be accessed. Such interventions are successful around the country; we do not always need to reinvent the wheel. There are many organisations and people with lived experience out there in the front line who are doing fantastic work. Much of the solution is about supporting and developing what is already working.

The most effective tools that we have at our disposal to tackle the crisis lie in education, health and the third sector, the responsibility for which has been totally devolved to this Parliament for 20 years. The inability of successive Governments to give sufficient investment and focus to the issue or to create legislation to deal with it represents an abject failure of this Parliament. Make no mistake: the Scottish Government has a significant toolbox to radically alter the approach that is being taken to addiction and, therefore, the outcomes.

I turn to a point that was raised by Miles Briggs. If people are to regain control over any kind of addiction, they must have good mental health. We must stop the practice of withholding mental health treatment until an addict has stopped their habit, because many addicts are self-medicating to mask the pain of previous trauma and, without a mental health intervention, there would be no way to mask the pain that they seek to deaden. In many cases, a mental health intervention should be the starting point. We must treat the cause, not the symptom. It was Hippocrates who said that it is better to know the person with the disease than it is to know the disease that the person has.

I know that I must stop there, even though there are many more things that I would like to say. I again thank Monica Lennon.

The Deputy Presiding Officer:

Several members still wish to speak in the debate, so I am minded to accept a motion without notice, under rule 8.14.3 of the standing orders, to extend the debate by up to 30 minutes.

Motion moved,

That, under Rule 8.14.3, the debate be extended by up to 30 minutes.—[

Monica Lennon

]

Motion agreed to.

That does not mean that members have another 30 minutes. We are even tighter for time, so I ask the remaining speakers to aim for three and a half minutes.

Photo of Sandra White Sandra White Scottish National Party

I thank Monica Lennon for securing the debate and for her very informed contribution. I welcome the people in the gallery.

I represent part of Glasgow city centre. Unfortunately, drug deaths are rife in that area. I have spoken to the professionals in Glasgow City Council and NHS Greater Glasgow and Clyde, and it is obvious to everyone that a unified approach is needed. It is true that we need a drug consumption room, but that is just one aspect of what is required. There has been support in this Parliament, in Glasgow City Council and at Westminster for the setting up of a consumption room. I would like that to happen but, unfortunately, that is not the wish of the UK Government.

However, I do not want to get involved in the politics of the situation. The issue is about people—people I see every day in my constituency, whether in the city centre, the merchant city or other areas of the constituency. It is not just the use of drugs that we need to tackle; a holistic approach needs to be taken to addressing what is causing people to be driven to take drugs. Austerity is a factor—it means that people cannot afford to live. The actions of the Westminster Government mean that people with mental health problems are not being given any support or are being sanctioned. The whole situation needs to be looked at holistically; we must look at housing as well as health. It is absolutely a public health matter, and I thank the minister and others for recognising that.

Photo of Sandra White Sandra White Scottish National Party

I am sorry, but I do not have time.

The fact that we are talking about a public health matter means that we cannot concentrate on just one area; we must concentrate on all the relevant areas.

I do not have much time, but I want to give coverage to one aspect of the drug use situation that never gets covered. I am talking about the “Trainspotting” generation.

During the 1980s and 1990s, there was a significant increase in the problem of drug taking in Edinburgh, Glasgow and other cities. We obviously know about the film, “Trainspotting”, but it is not said often enough that a lot of those people are dying. Last year, more than two thirds of drug-related deaths were of people aged between 35 and 54. That is not just because of the drug that they were using; they had, at that age, developed multiple morbidities with respiratory diseases and so on. We have to recognise that, and we want to prevent people from getting to that stage.

I repeat that more than two thirds of drug-related deaths last year were of people aged between 35 and 54 and we should not forget those people when we are looking at other aspects of drug deaths.

Photo of Jenny Marra Jenny Marra Labour

This morning, the presenter on “Reporting Scotland” quoted the Scottish Government’s reaction to drug deaths, which was:

“The power to reduce drugs deaths is reserved to Westminster.”

It was simple, full-stop—the Government was washing its hands of the matter—and it was not completely true.

However, many people who watched their televisions this morning heard that line of blame, as will those who watch it throughout the day—that is many more than the number of people who will hear the complexity of this debate in the chamber and what the Scottish Government can actually do. My colleague Neil Findlay listed about 16 things that the Scottish Government can do. I think that that list is endless and that the minister appreciates that.

First, let me add a couple of small points to that list. Minister, why do we not know how many drug users are receiving treatment locally, given that we know that treatment can save lives? In some European countries, 80 per cent of problem drug users are in treatment. In England, they manage to treat 60 per cent. In Scotland, we manage to treat 40 per cent—less than half—but we do not even have the information to tell us how many people are in treatment in areas where there are particular problems.

Despite the fact that we represent Dundee and that area, the minister and I do not know what percentage of the problem drug users there are receiving treatment. Frankly, I think that that is a disgrace. My feeling, given all the other evidence that I have seen, is that we in Dundee have an even lower treatment rate, but the Government will not collect the information to allow us to discover that and to plan services properly for those people. The lack of data is a technical issue, but it is an important one that the Public Audit and Post-legislative Scrutiny Committee has raised many times. I hope that the minister will commit today to start collecting that information so that we can plan our drug services properly.

I turn to the Dundee drugs commission. It reported last month and the report made for grim reading. It said that the NHS drugs service in Dundee was not fit for purpose, and I understand that an earlier draft had even proposed shutting down the NHS service altogether, because it was failing so badly, and starting again.

The commission said that the service is entirely unaccountable, has no oversight, has been making maverick policy decisions without reference to best practice for years and has, at times, wilfully ignored national and regional policy on prescribing and drugs policy. The commission said that there is almost no data to understand the impact of the Dundee drugs service’s actions. Finally, the service refused to co-operate with the commission, despite the fact that the commission had the support of the council, the NHS and all of us politicians to do its work. The drug service blocked access to the information that was vital to the commission. Frankly, that is an utter disgrace and I would like to hear the minister’s reaction to that.

The Dundee drugs commission did not take any evidence on safe consumption rooms. As the minister knows, Scottish Labour has voted to support the transfer of powers, but I believe that we need to debate some issues around the technicalities that have been raised with me by Police Scotland.

Unfortunately, there is not even time today to raise those issues, so I again urge the minister to have a week-long debate on drug deaths. If he cannot agree to do that, we must at least have one debate.

I see that the Presiding Officer wants me to close. Please let me say this first, Presiding Officer: this is a public health crisis; this is a human crisis. Fellow citizens my age and mums and dads are dying in their droves. I think that, at the very least, the Government owes it to them to debate the issue properly.

The Deputy Presiding Officer:

I let you say that, Ms Marra, but doing so may affect your colleagues’ speaking time.

Photo of Alison Johnstone Alison Johnstone Green

I, too, thank Monica Lennon for bringing the debate to Parliament today. It is truly a national shame and scandal that so many people have had their lives destroyed by drugs. The Greens have always been clear that it is a public health issue rather than a criminal justice issue. It is now a public health emergency.

When it comes to drugs, criminalisation has caused more harm than it can claim to have prevented. The “war on drugs” approach has clearly failed. That is no wonder—addiction is a complex illness that is clearly better tackled by trained medical professions than by the courts. Contributors at today’s event said that

“We all need to take responsibility” and that

“We need to help Scotland to get better.”

Portugal used to suffer from drug-related death rates and HIV infection levels such as Scotland currently experiences. A radical change in its law in 2001 decriminalised use of all drugs, but not their production and supply. Subsequent years have seen dramatic drops in problematic drug use, in HIV and hepatitis infection rates, in overdose deaths, in drug-related crime and in incarceration rates. The success of the model clearly demonstrates that decriminalising possession, while adopting a health-based approach to substance-use problems, can dramatically reduce drug deaths.

I am heartened that we are discussing the Portuguese model. With a drug death happening every seven hours in Scotland, we need action and proper funding for that action. The United Nations High Commissioner for Human Rights said that the Portuguese model on decriminalisation

“was based on humanism, courage, evidence base and participation.”

In the face of our public health emergency, we need all those elements.

Greens support the introduction of safe consumption rooms, which have been operating in Europe for the past 30 years. It is disappointing that Westminster is resisting that potentially life-saving change. It is clear that such rooms alone are not a solution. Addiction has a root cause—not just addiction to a particular drug—that needs to be addressed and treated. We need to address the trauma that causes addiction in the first place, so having a trauma-informed workforce is key.

It is a cruel paradox that as drug problems worsen, drug users become even more maligned. We need to address the stigma that continues to surround drug users, and we need to treat addiction as an illness and not as a personal failure. We need to respond to the emotional pain and shame that addicts and their families and friends experience. No one should ever be ashamed of being ill.

Treatment-wise, we need intervention by multidisciplinary health teams; we also need intervention by the third sector. Pharmacists have an important role to play in intervening and reducing drug dependency. In the past two years, community pharmacists in NHS Greater Glasgow and Clyde have saved 15 lives through administration of naloxone to patients who have overdosed on opiates. That medicine must be made widely available.

We must address the wider health and social inequalities that Sandra White mentioned. Health and social care is one aspect of that, but we need also to consider housing, employment support, financial advice and care for prisoners. We need to care for people who are coming out of prison. They sometimes come out at the weekend and are being left on their own when they leave. That is simply unacceptable, and leads to a cycle of addiction. The Health and Sport Committee had an inquiry on the issue, and we know what needs to be done.

Drug deaths affect people of all ages and stages of life. I want to make sure that we hear the proper voices and have the right people in the task force. We need lived experience; we need, for example, the voices of families.

We need to make sure that beds in rehab facilities are not lying empty while people are desperate to access them. The Edinburgh access practice in my region does a fabulous job. We need non-judgmental services to be there when people need them. Workers in the access practice have told me that they know on which sofas the people whom they need to find will be sitting. At the event this morning, one contributor said that if nothing changes, then nothing changes. We need change now.

Photo of Bob Doris Bob Doris Scottish National Party

I thank Monica Lennon for giving us the opportunity to debate the self-evident public health emergency of drugs deaths in Scotland. Unity of purpose across Government and Opposition parties will be crucial. We must consider solutions and the consequent funding that will be required.

We must listen carefully to people who have direct experience of drug use and addiction. It is such people’s experience that I will use as the base for my comments this afternoon.

My comments will echo the thoughts of various individuals in my constituency who I have met in recent times, many of whom have lost loved ones. When I met constituents ahead of the drugs deaths vigil that was organised in George Square, the testimony that I heard was challenging and harrowing, and cannot be ignored. I met them again this morning at Monica Lennon’s event. I have also visited the Springburn addiction recovery cafe and spoken to several volunteers there. They all have direct lived experience and have progressed through recovery.

People are dying in Maryhill, in Possil, in Springburn and right across my constituency. It is not just a tragedy: it is also a public health emergency. I have been told stories about people who have been pursuing recovery being refused lower doses of methadone by their general practitioner despite the fact that they are trying to move into recovery. I have heard about people who have suffered a relapse but were still committed to recovery finding themselves being put on even higher doses of methadone than they were on before they sought recovery, when their GP found out about the relapse. They did not want that.

I have heard similar stories about constituents’ experiences with addiction workers. On occasion, addiction workers have actively discouraged individuals from moving into recovery or into abstinence-based programmes, and it has been unclear why. The explanations that have been offered to me by people who have lived experience include that that is the addiction service’s culture; that not enough people who have been through recovery are part of addiction services; that support pathways are weak, do not exist, or are not joined up; that addiction services are poorly resourced; and that addiction workers have too many clients and are not able to give the required individualised support.

I stress that I also heard good things about GPs and addiction workers: I want to put that on the record.

Photo of Bob Doris Bob Doris Scottish National Party

I do not have time—I am sorry.

The drugs task force will meet shortly. I welcome that. It will not be judged by its meetings but by its actions, so the jury is out on it. It would be remiss of me not to mention the concerns that have been expressed about the lack of lived experience of addiction and recovery on the drugs task force. We need more direct representation on the task force; we will have to do something similar to what we did with the Social Security (Scotland) Act 2018. There needs to be an addiction and recovery experience panel, and it should not meet just once as a gimmick; it should meet regularly and feed in the lived experience of people who are in recovery to the task force’s work. I hope that the Government can agree to that.

I also want to talk about the Rev Brian Casey of Springburn parish, in my constituency. I commend him for the love and support that he has sought to show to people who are in recovery. In the past five years, one third of all the funerals that he has conducted have been for people who have died drug-related deaths. That is one third of 500 funerals in Springburn. That is not acceptable. Something has to change. It is self-evident that what we are doing is not working. Families need policy-makers and public agencies to act to stem the tide.

Street Valium is killing my constituents right now, and we need a direct strategy for that as soon as possible.

Finally, we need a new consensus, and it will have to come at budget time. The bun-fighting between parties must end, and we must decide the resource that is required and the outcomes that we want to drive. We must come together as a Parliament.

Photo of James Kelly James Kelly Labour

I thank Monica Lennon for bringing this important debate to Parliament, and I congratulate the

Daily Record on the campaign that it has run to raise awareness of this national crisis.

When we examine the statistics and hear about people’s experiences, there is no doubt that this is a stark issue. In Scotland, one person a week is murdered, three people die on the roads, 15 people take their own lives, but 22 people a week die drugs deaths. That figure is absolutely stark and shows how serious the problem is.

Earlier in the year, we all gathered to celebrate 20 years of the Scottish Parliament, and everybody made nice speeches and said what a great institution it is. However, this particular area is a failure of devolution. It really is. We all have to take responsibility for that, but responsibility starts at the top.

Ten or 12 years ago, the Government launched its strategy, “The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem”. I supported it, as an MSP at the time, and I spoke about it at events and in the chamber, but we must acknowledge that it has not worked. Since that time, drug deaths have more than doubled. There is a real problem and there is a big challenge for all of us, as a Parliament, but especially for the Government, to do so much more.

The Government needs to draw in more expertise from people—both internationally and in Scotland—who know more about the issues. We need to acknowledge that that expertise has not been drawn on in the past 10 to 12 years. I also find it astonishing that the task force that has been set up includes only one person who has lived experience of drug use and addiction. That is a real failing.

What needs to happen is for every spending priority and every policy to be tested against how it will assist in tackling the crisis. For example, during the summer, the Government suspended throughcare from prison, although it is known that there is real vulnerability when prisoners leave prison and go into society. They are vulnerable and, sadly, some succumb to drugs again and end up passing away. By suspending the throughcare service, the Government has increased the number of vulnerable people who leave prison and go into society. Even now we do not have a date when the throughcare service will be reintroduced.

I appeal to the Government to listen to the speeches. The matter was raised at First Minister’s question time, but the Government is far too defensive. I agree with and support the call for consumption rooms, but that is such a small part of the debate. The Government needs to interact so much more with the other parties—with the people who are in the gallery. It really needs to up its game, because if it fails to do that and we fail as a Parliament, people and communities will continue to suffer, which will be totally unacceptable. As MSPs, we will be letting them down.

The Deputy Presiding Officer:

I call on Joe FitzPatrick to respond to the debate in no more than seven minutes, please.

Photo of Joe FitzPatrick Joe FitzPatrick Scottish National Party

I thank Monica Lennon for securing the debate and for organising this morning’s meeting. I also thank those folk who spoke this morning and who are in the gallery now. It is unfortunate that the forum here does not allow their words to go on the record in the Scottish Parliament. Perhaps we need to think about how we can make sure that that happens, because I genuinely value the voice of lived experience and family members; it is crucial. I thank Monica for making that happen.

The number of people who died last year, who died in previous years and who continue to die is a tragedy. It is important, however, for us all to remember that it is not just about big numbers. Whatever the numbers are, the death of every single person is a personal tragedy, for them and for their family and friends. It is important that we put it in that context. However, when we put the numbers together, there is no question but that this is a public health emergency.

It is a good thing that I am seeing nodding across the chamber, and agreement that this is a public health emergency. That is important. We would not get that consensus in all parts of our democratic system, because there are parts of the UK where this is considered to be not a public health issue but a justice issue. That is one of the challenges that we have in taking this forward.

I agree with just about everything in the motion. There is just one bit that I cannot do—it is not that I do not agree with it, but I cannot do it. The motion mentions

“the calls ... to legally designate the crisis a public health emergency”.

I assure members that, if I had the necessary levers within my powers, I would absolutely use them to do that. However, it is good to see that there is support across the chamber for that.

Monica Lennon is absolutely correct to identify the Civil Contingencies Act 2004 as the legislation that would allow such an emergency to be declared. I do not want to make the debate about a constitutional issue, but unfortunately the specific power to do that rests with the UK Government. I will continue to look for other ways within my existing powers to do so, but—

Photo of Monica Lennon Monica Lennon Labour

I do not want to get into a legal argument right now, but is the minister telling the chamber that he cannot co-ordinate and liaise with and direct public bodies to do X, Y and Z—whatever that might be? We are looking for there to be an emergency response that we will all know about and on which the minister can report back to the Parliament daily, weekly, monthly—whatever it takes—until we can see that lives are being saved.

Photo of Joe FitzPatrick Joe FitzPatrick Scottish National Party

That is an entirely different point. I do not have the power to declare a legal emergency—that rests with the UK Government. We all agree that the situation represents a public health emergency. Let us use the powers that we have. We can call on our colleagues elsewhere to engage in the debate and make a legal emergency happen. That would be helpful, but it is not the only answer.

Getting agencies together is exactly what we need to do. I do not need to declare a legal public health emergency in order to take that forward. That is what we want to do and it is what the strategy that was launched last November aims to do. I was very pleased by the range of support for the strategy that emerged not only across the Parliament, but from people with lived experience and others working with them across Scotland. It is important that we take—

Photo of Joe FitzPatrick Joe FitzPatrick Scottish National Party

I do not think that I can. A number of important points have been made and the Presiding Officer will get on to me if I do not manage to get through as many of them as I can. Although we might want to extend the debate, the Presiding Officer will not be able to allow that, because members have to come back to the chamber for this afternoon’s business.

Monica Lennon made an important point about stigma. I have spent a lot of time speaking to as many people as I can who either have lived experience or support others who are going through treatment. It is clear that stigma is one of the barriers for them. Part of the challenge will be for politicians to lead by example, be careful about our language and respect people who are in treatment. They should not be stigmatised, no matter what that treatment is. I know that there is some debate about the appropriateness of some forms of treatment as opposed to others. Whichever treatment is deemed appropriate for someone to receive as part of their recovery, it is crucial that they are supported in that in the round.

Bob Doris, Jenny Marra and others made a point about people’s experiences with such treatment. I have heard similar comments from people with lived experience. I have also had constituents coming to me to seek support in getting the treatment that they want, whether that be methadone or other forms of support. Their experience has not been what it should be.

That is why it was good that the Dundee drugs commission was so frank and gave such clear direction. It also made points that will be important for the whole of Scotland. The programme for government therefore includes a commitment to develop a national pathway so that we can ensure that best practice in relation to treatment is followed across the country.

I have also heard members’ calls on the subject of respite, regarding which people have said that they are not being given a choice. I do not feel that we should be putting one form of treatment above others; we need to offer what works for the individual who is involved. We need to understand the level of complexity and the driving factors behind many addiction problems, which were mentioned by a number of members including Shona Robison and John Mason. Often, a severe trauma that has happened in a person’s life will have been part of the process, so we need to be as supportive as we can in that respect.

Shona Robison also mentioned the Dundee drugs commission in relation to its recommendation on mental health issues and drug use. She is right that the approach in Dundee was highlighted as a particular problem, but I have spoken to people across the country and I understand that people who are in treatment for drug use or seeking treatment are finding that having a dual diagnosis is a barrier. The additional diagnosis is not always a mental health issue; it can be something else. We need to treat and support the person. That is why there was an announcement in the programme for government in relation to dual diagnoses, including regarding mental health issues. I would be pleased to discuss that further with Shona Robison after the debate.

I am conscious of time and there are a few points that I really want to cover.

The Deputy Presiding Officer:

The minister is just finishing, Ms Marra.

Photo of Joe FitzPatrick Joe FitzPatrick Scottish National Party

James Kelly made a very important point that we have not really discussed. I was equally concerned when I heard about the decision on the throughcare service. I am keen to ensure that we get some alternative support in place. It is probable that the support that was previously in place was not ideal. From what I have been hearing, if throughcare support is provided by people with peer experience, it might be far more useful. It is an area of vulnerability.

Alison Johnstone made the point that most of the people we are talking about should not be in prison anyway, so we should not be having to have that throughcare. However, while we still have people in prison and leaving prison, that care is a crucial part of the jigsaw.

On the drug death task force, I am happy to engage further. It is crucial that the task force can hear from the widest range of lived experience. I know that Professor Matheson is considering how she can do that. I hear the point that it is vital that such experience is heard.

I have tried to get people in the task force who are not just talking, but can hear that lived experience and then go and make things happen. We need action. I get the point that there has been a lot of talking—and I hear that people want more discussion, which is fine; we will have further debates—but it is important that we look at how we can take action.

I thank members for the way in which they have approached the issue in the debate. We can make a difference here, and it will be easier for us to make a real difference if we work together.

13:57 Meeting suspended.

14:30 On resuming—