Drug Deaths

– in the Scottish Parliament on 3rd August 2021.

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Photo of Alison Johnstone Alison Johnstone Green

The next item of business is a statement by Angela Constance on actions being taken to reduce drug deaths in Scotland. The minister will take questions at the end of her statement, so there should be no interventions or interruptions.

Photo of Angela Constance Angela Constance Scottish National Party

The loss of life in Scotland from drug-related deaths is as heartbreaking as it is unacceptable. It is our national shame. I offer my condolences to all those who have lost a loved one and my continuing commitment to do everything possible in our new national mission to turn the tide on rising drug-related deaths.

On Friday I attended a vigil in Glasgow. I talked to and heard from many people who have been directly affected by drug deaths—the very people who have been let down. Now more than ever, we need to ensure that the experience of those living with problematic drug use is at the very heart of solutions. That is why we are investing in local experience panels and a national collaborative of those with lived and living experience.

We know that drug deaths are preventable and avoidable. The publication of the 2020 drug death report on Friday was another stark reminder that the poorest communities suffer the most. That is why our national mission to save lives is linked to other work across this Government to improve the lives of those in mental ill-health, to address poverty and inequality, to prevent adverse childhood experiences, to build resilience through education and prevention, and to bring a public health approach to our justice system.

The 2020 annual report shows, for the first time, the terrible scale of inequality between our most and least deprived communities. The power of that analysis underlines the need for better information about the problems people face. We are making progress on that. Public Health Scotland is using a groundbreaking programme of data linkage, which will help to identify where actions are most needed. The report shows wide geographic variation in drug deaths. Areas such as Glasgow, Dundee and Inverclyde are the worst affected. However, even the least affected areas in Scotland still have a greater problem in comparison to anywhere else in England.

We know that people who are in services have better protection from drug deaths. We are focused on getting more people into protective treatment on the back of our long-term commitment to additional investment of £250 million, including £100 million for residential rehabilitation. In May, I announced that £18 million would be allocated through dedicated funds for providers, including third sector and grassroots organisations, to improve services, increase capacity and improve access to residential rehabilitation, and to support children and families impacted by problematic drug use. Those are five-year funds, and organisations can apply for multiyear grants. Since March, we have provided £3.5 million in new funding for around 80 projects. That new approach is already helping to make grass-roots and third sector organisations more sustainable.

We published the medication assisted treatment standards at the end of May. Those standards set out, for the first time, what people should expect and demand of services: in particular, same-day treatment and access to a wider range of options, including residential rehabilitation. I have given services a target this year to have the standards implemented by April 2022, although I expect many areas to have the first standard, including same-day prescribing, in place before then. I will meet with health board chief executives on 18 August to drive home the importance of the standards as a national priority in response to Scotland’s other public health emergency. To support implementation, we have provided an uplift in funding to alcohol and drug partnerships and, over and above that, £4 million for specific improvements to meet the standards this year.

The 2020 statistics show another rise in benzodiazepine-related cases. The drug deaths task force and the Scottish Government have consulted on changes to prescribing practice and guidance. An expert group will meet next month to build consensus on that. The role of prescribers, including general practitioners, will be crucial in helping to stop that number rising further in the future.

We also need to know more about who is using illicit benzodiazepines or street Valium, where they are using it, and how they are using it. I am commissioning a rapid evidence review on the use of benzos, so that we can take all necessary action to address it. I will continue to push the United Kingdom Government on allowing the checking and testing of drugs in Scotland as well as on the regulation of the possession of pill presses.

The 2020 report also shows that methadone was implicated in more cases than before, so I am also commissioning urgent research on the role and risks of methadone in drug-related deaths, albeit in the context of poly drug use. We need to understand more about the drivers behind that trend, including prescribing practice and the risks and needs of the most vulnerable. I also want to see alternatives to methadone and long-acting buprenorphine made more available to people.

We know that release from custody can be a vulnerable time for many individuals, with increased risk of drug-related harms and deaths. The Government will, as a priority, continue to mitigate any risks and consider ways to improve the circumstances of and the support that is available for individuals who leave custody. We will commit to reviewing the conditions around release from custody, including the issue of Friday liberations and wider issues of throughcare support, release from remand and access to services. We will work with stakeholders to consider the options that are available to us, including new models of care and procedural or legislative change that might be necessary.

Although men are more likely to use and experience harms from drugs, there has been a recent disproportionate increase in the number of drug deaths among women. We know that there is a strong link between women having children removed from their care and the risk of drug-related death. I have committed to getting more women into treatment and recovery and to tackling the issues around barriers to women accessing services and keeping families together. One of the priorities will be to develop and upscale women-specific services, particularly residential rehab, for which there are currently only limited options available.

I am therefore pleased to announce that Phoenix Futures has been successful, in principle, in its bid to the recovery fund to establish a new national specialist family service. The service, which will be located in North Ayrshire, will be based on an existing facility that is run by the organisation in Sheffield and will offer a family-focused programme of interventions for up to 20 families at one time.

I have also worked with Police Scotland, Public Health Scotland and National Records of Scotland to reach agreement on providing more regular reporting on suspected drug deaths in our pursuit of getting more people into treatment quickly. Starting in September, and for the first time in Scotland, quarterly reports on suspected drug deaths will be published, which will allow us all to respond to what is needed more quickly and will, of course, help the Parliament to monitor progress. Better information will allow us to set a treatment target for 2022. This year is about ensuring that same-day treatment is available and that the range of available treatment options is wider, as part of implementing the medication-assisted treatment standards.

Many actions have been taken for the first time during 2021, including the pilot project in which police officers have been carrying and administering naloxone. That will already have saved lives, and it builds on the way in which emergency services can contribute to our mission, with the Scottish Ambulance Service having led the way on naloxone carriage thus far. I am keen to see more, or all, police officers carrying naloxone kits as quickly as possible.

I have previously referred to media campaigns that the Scottish Government will be running. Today, I can announce that the campaigns will focus on the use of naloxone and on tackling stigma, which is still a barrier to accessing life-saving services.

The creation of a national care service will be the biggest reform in health and care since the creation of our national health service in 1948. Ministers have agreed to consult on the remit of the national care service and on whether to include alcohol and drug services in the systemic changes to the way in which people access services. In particular, we are asking whether residential rehabilitation should be commissioned on a national basis. The consultation, which opens next week, is an opportunity to consider how we can better support Scotland’s most vulnerable and marginalised people, and we are committed to listening to the feedback, including from those in the alcohol and drug sector.

No one should underestimate the scale of the challenge that we face. I certainly do not. We have made progress with other preventable deaths, such as those from alcohol, violence and some cancers, so change is possible. However, change will not always be comfortable, and I make no apologies for that.

Through the changes and the actions that I have set out today, we can improve and save lives, as part of the national mission, by getting more people into the protection of treatment and recovery. That will help to reduce the number of drug deaths in Scotland. We have had the humility to accept what has been wrong. Going forward, we will have the courage to do what is right.

The Presiding Officer:

The minister will now take questions on the issues raised in her statement. I intend to allow around 20 minutes for questions. It would be helpful if members who wish to ask a question could put an R in the chat function now.

Photo of Douglas Ross Douglas Ross Conservative

It was vital for Parliament to hear the statement today as thousands of Scots continue to die from drug abuse, but the crisis requires decisive action from the top. It demands leadership.

Where is the First Minister? She was not at the memorial in Glasgow on Friday and she has point-blank refused to stand up and speak for her Government today. It is not enough for the First Minister to admit that she took her eye off the ball. Words will not solve the crisis. People need action, and they expect to hear from the First Minister.

Drug deaths have peaked for the seventh year in a row. Our rate of drugs deaths is almost four times higher than that of any other country in Europe. If you live in a poorer part of Scotland, you are 18 times more likely to die because of drugs. Behind all of those shocking statistics, there are lost loved ones and broken families.

When will the First Minister and this Government wake up? When will she stop abandoning our communities? When will she listen to those on the front line?

Like the minister, I attended the memorial in Glasgow on Friday but, while she wanted to quote song lyrics, I explained what Scottish Conservatives will do. We have published our proposal for a right to recovery bill; it is with the Parliament team and is being prepared for launch. The bill has been developed by front-line experts to guarantee that everyone gets the treatment that they need. It is backed by seven recovery organisations and, apparently, by Scottish National Party MSPs. It would cut through the broken system and save lives.

People who have lost family members and close friends to drugs deserve a straight answer. If the First Minister will not come to Parliament today to give a commitment, will the minister do so? Will the Scottish Government be bold and back our bill?

Photo of Angela Constance Angela Constance Scottish National Party

I was appointed by the First Minister, an appointment approved by this Parliament, to lead the new national mission to tackle our drugs deaths crisis. I report directly to the First Minister and I am accountable to Parliament for the work that I have done day in and day out since I was appointed seven months ago.

It is right that I should make a statement to Parliament today, and I am glad of the opportunity to do so. I wrote to the Presiding Officer before recess and last week to ensure that I conveyed my willingness and availability to respond to any parliamentary request. I was also glad of the opportunity to attend the vigil on Friday to pay tribute and to offer condolences in person to those who have lost loved ones.

I know that Mr Ross has not been in this Parliament for as long as I have, and I appreciate that he may not know me very well. I do not play games and I am not remotely interested in playground politics. I will again be clear regarding his proposal to enshrine the right to treatment in law. I will of course, as will the First Minister, give serious and fair consideration to any proposal.

I have never ruled out the need for further legislation, as I hope was demonstrated in my statement today by the comments that I made about a national care service and our justice system, but I say respectfully to Mr Ross that I have yet to see the bill. I will not give him a blind or blanket commitment. It is my job to look at the detail. Scrutiny works both ways.

I have made a number of detailed commitments to Parliament regarding investment and delivery, and I must also implement the Government’s manifesto. Mr Ross wants me to implement his ideas and his manifesto commitments. It is imperative that I see the detail of that work.

Some stakeholders are very supportive of the proposal. I have worked closely with some of those stakeholders on, for example, how we address the anomalies that are caused by housing benefit. If it was not for the action that this Government has taken, people would still have to make the harsh choice between accessing residential rehab and keeping their tenancy.

I am determined that we will take as much action as possible and that we will always give fair and serious consideration to detailed and serious work when it comes forward.

Photo of Anas Sarwar Anas Sarwar Labour

This is no reflection on the minister, but I am extremely disappointed that today’s statement was not made by the First Minister. Nicola Sturgeon cannot escape the fact that she and her party have been in Government for almost 15 years. She cut the budgets for drug and alcohol services, and under her watch the rate of drug deaths in Scotland is almost five times that of the rest of the UK, despite our having the same laws. The minister is right to say that this is Scotland’s national shame, but she must recognise that it is the Scottish National Party’s shame, too.

We need urgent action to save lives. We cannot ignore the link between Scotland’s higher drugs death rate and our suicide rate. We need a coherent strategy and a plan from this Government. More funding is welcome, of course, but it must do more than fill the holes that the Government’s cuts created. Yes, we need to look at drugs law, but that cannot be a cover for this Government’s failure.

The issue must be declared to be a public health emergency. In some age groups, people were more likely to die from drugs than from Covid over the past year, even at the height of the pandemic. We need a major effort—on the same scale—to confront the drugs crisis.

Will the minister commit to providing regular updates on the progress that is being made? Will she reform services, guarantee the availability of residential rehab, integrate substance abuse services and mental health services, and increase same-day prescribing? Will she back all that up with the funding that is needed?

If this really is a national mission, let the Government demonstrate that by its actions.

Photo of Angela Constance Angela Constance Scottish National Party

This is the fourth time since my appointment that I have appeared before the Parliament. Most recently, during the very good, cross-party debate, I made a commitment to give the Parliament regular updates on the detail of how we connect our emergency work with the longer-term work to improve lives.

On all the work that Mr Sarwar mentioned and more—how we increase capacity in and access to residential care, how we support our workforce, how we implement our human rights obligations, how we turn our fine words into action, and how we can see the impact on the ground of this year’s considerable increase in funding—I have already committed to proactively update the Parliament.

I reassure Mr Sarwar that we have a plan. On his remarks about funding, it is factually correct to say that in the financial year 2016-17 there was a reduction. However, that was compensated for in later years. The bigger point is that, since 2008, we have invested more than £1 billion in drug and alcohol services, and it is clear that inputs do not always equal outputs, so, as well as making additional targeted long-term investment, it is crucial that we follow the evidence. It is a question of leadership and how we get a culture of compassion and change in our services and our society.

I am sure that Mr Sarwar welcomed my announcements this year about widening access to treatment, with £3 million for outreach services, and about our determination to implement the new medication-assisted treatment standards. For the first time, we have published new standards, with clear expectations and with an implementation plan and resources to back that up.

I hope that Mr Sarwar has heard today’s significant announcements, particularly about meeting the needs of families and children, the work for the rest of the year and the move from annual to quarterly reporting. We will announce the new treatment target. We will focus on the national collaborative and our work on the national care service; there will also be the important campaigns on tackling stigma and on naloxone.

Finally, as a former criminal justice and mental health social worker, I assure Anas Sarwar that his point about the far better integration of addiction services and mental health services is not lost on me.

Photo of Gillian Mackay Gillian Mackay Green

I extend my condolences to everyone who has tragically lost a loved one to drug overdose.

As others have said, we need action now to prevent further loss of life. In June, a majority of MSPs supported my amendment to the Government’s motion on drug-related deaths. That amendment called on the Scottish Government

“to investigate, as a matter of urgency, what options” it had, within the current legal framework,

“to establish ... safe consumption rooms”.

Will the cabinet secretary provide an update on what progress has been made on establishing safe consumption rooms as part of wider harm-reduction strategy and treatment options?

Photo of Angela Constance Angela Constance Scottish National Party

Gillian Mackay will be aware that the Government is firmly in support of the implementation of safe consumption rooms. That view is based on 30 years of evidence. There are 100 drug consumption rooms in 66 cities in 10 countries around the world. We know that they are not the only solution, but they help to save lives, and we are committed to implementing them irrespective of the constitutional constraints that we face.

I assure Ms Mackay that very detailed work is going on within Government. I am cautiously encouraged by that work and, although I do not yet have a proposition to put in front of the Parliament, I assure members that, when it comes to implementing evidence-based interventions that will save lives, I will leave absolutely no stone unturned.

Photo of Alex Cole-Hamilton Alex Cole-Hamilton Liberal Democrat

Last week, we learned that, in a single year, nearly 1,400 people had their lives cut short and their potential extinguished—many of them decades before their time. Apologies are hard to accept, because pleas were dismissed for years, and I will never understand why ministers surrendered services and expertise by cutting ADP budgets by so much in 2015-16 and 2016-17.

The drugs deaths crisis will be ended through compassion and treatment, but people who are gripped by drugs misuse are still regularly directed into the criminal justice system. Two hundred people a year are being imprisoned for possession. That situation has not changed in a decade, and the police say, rightly, that is pointless and damaging to lives.

In March, at the second time of our asking, the Scottish Government finally agreed to the principles of diversion and of stopping the imprisonment of vulnerable people. Now that decriminalisation is under consideration by the task force, how will ministers take that forward?

Photo of Angela Constance Angela Constance Scottish National Party

I hope that Mr Cole-Hamilton will recognise that I have always been clear that this is a public health emergency, that we cannot arrest our way out of a drugs death crisis and that we need to be reducing the demand for drugs as well as the supply.

He is absolutely correct that we need to prevent people from going into the criminal justice system in the first place. It is important to recognise that diversion has existed in Scotland for more than 40 years, and work by Community Justice Scotland has been very important in helping to roll out more consistent practice on that. However, it is also important at every twist and turn of our justice system that we increase opportunities for people to get into treatment, because that will provide a protective factor and help people to turn their lives around.

On decriminalisation, I hope the member knows that the Government has an open mind. We will be led by the evidence, and we have made commitments in and around citizens assemblies. It is imperative that we take our communities with us in the direction of travel, but we also need to challenge ourselves and each other to be bold.

The member is right to point to the fact that the drug deaths task force is undertaking some work on drug law reform, and I assure him that it will make recommendations that will apply to both the Scottish Government and the UK Government, because there is no doubt that some of the UK-wide legislation puts limits on our public health approach, and we are determined to overcome that.

Photo of Emma Harper Emma Harper Scottish National Party

I would also like to offer my condolences to the families of all those who have lost their lives.

The Scottish Government has rightly identified tackling drug-related stigma as a priority in our national mission of reducing drug deaths and harm. Therefore, can the minister outline what education is being provided or is intended to be provided to healthcare professionals who do not work directly in drug and alcohol services, such as hospital and community staff, as well as to the wider public, to tackle drug-related stigma?

Photo of Angela Constance Angela Constance Scottish National Party

A wide range of work is going on. Ms Harper will have heard me speak about the importance of our national media campaign, which will be rolled out later this year. That will be important to raise awareness across society, including among those who work in the drugs field or in wider health and social care services. Work on a stigma charter is being led by the lived-experience community. Her point about workforce development is crucial, for the wider public service workforce as well as for those who are currently engaged in drug and alcohol services work.

On the work that was led by the Deputy First Minister and NHS Education for Scotland, she will be aware of the work around—[Inaudible.]—trauma-informed nation, which is, in essence, about asking people, “What happened to you?”, as opposed to asking them what is wrong with them. All that is important work in tackling stigma, because we know that stigma is a barrier to people accessing treatment. We must remove it and we must have a far better discussion about why language matters.

Photo of Annie Wells Annie Wells Conservative

I, too, was at the memorial in Glasgow last Friday, and I, too, could see the hurt, anger and frustration that was on display from those who have tragically lost loved ones. I would also like to send my condolences to those who have been affected.

As the minister has noted, the widespread availability of fake or street Valium continues to have a devastating effect on the victims of drugs, with benzodiazepines involved in a staggering 73 per cent of all Scottish drug deaths in 2020. Now, there is a worrying suggestion of a correlation between street Valium related drug deaths and the introduction of minimum unit pricing for alcohol. Will the minister commit to a review to discover whether there is a clear link?

Photo of Angela Constance Angela Constance Scottish National Party

Ms Wells might not be aware of this, but there is a regular review of the impact of minimum unit pricing on alcohol, and, thus far, that evidence shows that there is no relationship between minimum unit pricing and the increase in use of benzodiazepines. Nonetheless, as I said in my statement, I have commissioned a rapid review of current use of benzodiazepines, because we need to know or have better information about what is driving that. Is it that people cannot access the treatment that they need quickly enough, or is it that the treatment that they are in receipt of is not right for them?

On the work to tackle the street Valium crisis, I hope that Ms Wells will support my calls to the UK Government to introduce a pill-press regulation. It is not right that people can access pill presses and produce vast quantities of street Valium and sell it for pennies in the streets of Scotland. The production of street Valium is not happening elsewhere; it is happening in Scotland. Therefore, her support in seeking regulation of pill presses would be very helpful.

I also highlight the importance of drug-checking facilities. Again, there is a need for a licence from the UK Government for that. I am in discussions with the UK Government and, I have to say, it has been fairly constructive to date. There is a myth that drug-checking facilities encourage or increase drug use. That is not the case, judging from what we know elsewhere in the world. Things such as drug-checking facilities help to save lives. This is an example of where we must be bold and follow the evidence.

Photo of Willie Coffey Willie Coffey Scottish National Party

The minister’s announcement that there will be a specialist residential family service in Ayrshire is very welcome. Can she explain whether she sees that family approach as one that could be rolled out across Scotland to support families, especially women? Will she give further consideration to supporting other recovery settings and facilities as best she can, so that people can have genuine hope that they can find a better future for themselves after recovery?

Photo of Angela Constance Angela Constance Scottish National Party

I am absolutely delighted to make the announcement today of the national project for which Phoenix Futures has been successful in bidding for additional resource from our recovery fund. It is indeed a national project. I can say to Mr Coffey that we are expecting bids from other providers, both for filling the gap for women and women with children and for our work to take a more regional approach to improving capacity and access to residential rehab in every part of Scotland.

I highlight the £5 million recovery fund that is available for providers to access, and the £5 million service improvement fund is also available for service providers.

An important part of the project that we have announced today is about keeping families together. That is part of our promise, both to children who have had care experience and in tackling the rise in drug-related deaths that is being experienced among women. I am very proud to make this announcement today. This national service represents an important step forward in ensuring that we break down some of the intergenerational problems with poverty, improve life chances and help families and parents on the road to recovery.

Photo of Michael Marra Michael Marra Labour

After years of failure and so many lost lives, the Government’s rhetoric must at last be consistent with the decisions that the minister takes. Does the minister agree with me that the work of 12 staff providing wraparound intensive support cannot be replicated by four staff taking on that work on top of their existing jobs? That is what is happening to the housing first scheme in Dundee. It has a proven record of helping those with addiction to maintain stable lives, and it has been praised by the First Minister. Will the minister be led by the evidence and immediately refund the housing first project?

Photo of Angela Constance Angela Constance Scottish National Party

Let me give Mr Marra an assurance that I am more than happy to look in detail at the issue, and I would appreciate it if he would write to me with the full details. Like him, I am a big supporter of the housing first approach. My colleague Kevin Stewart, who is now the mental health minister, was pivotal, in his time as housing minister, in driving that forward. The housing first approach is crucial in meeting the needs of people with multiple and complex needs: people who not only have mental health problems and drug and alcohol issues but are experiencing homelessness. I can assure him that, if he writes to me in detail, I will look at that with some urgency, and I will seek to address matters with him and with colleagues locally and across government.

Photo of Gillian Martin Gillian Martin Scottish National Party

I listened to the minister as she outlined the welcome uplift in rehabilitation treatment availability. Yesterday, however, David Liddell, the chief executive officer of the Scottish Drugs Forum, said:

“There is huge support within the drug treatment services for policymakers’ moves to ensure more people get into treatment but this strategy will be undermined if the needs of people using high doses of benzodiazepines are not adequately addressed.”

The minister touched on that in her answer to Annie Wells, and I welcome the proposed review. However, I would like to ask her some further questions. How has the use of street benzos led to the tragic outcomes for the people behind the figures that were released? What is being done to tackle the availability and supply of those unprescribed substances in our communities and to help those who might be harmed by them?

Photo of Angela Constance Angela Constance Scottish National Party

I am grateful to Ms Martin. She is quite correct to point to the evidence that we need a far better treatment offer for those who are using benzodiazepines—in particular, street valium.

Of course, people are using benzodiazepines in the context of poly drug misuse, which makes treatment somewhat more complex, and the risks need to be weighed up with care. Nonetheless, I am committed to galvanising the clinical community in Scotland, because we have to find a way to make people safer. There is not necessarily an ideal solution in terms of how we treat benzodiazepine dependency, but we need a treatment offer that is far more person centred, whereby people have a wide range of options, are empowered to make an informed choice and, crucially, are able to access treatment quickly at the time of asking.

With regard to the work to address supply, notwithstanding my earlier comments that we have to focus on reducing the demand for illicit drugs as well as on reducing the supply of drugs, I obviously engage with the justice secretary and Police Scotland, who are very focused on serious and organised crime in this country. I refer back to my quest for pill-press regulation, as I know that not only the Royal College of Psychiatrists but Police Scotland are very much in favour of that. From my discussions with the UK Government in and around that aspect, I know that it is seeking advice from the National Crime Agency and expects further information this autumn.

Photo of Sue Webber Sue Webber Conservative

I thank the minister for taking the time to make such an extensive statement today. My question builds on the answer that she has just provided to Ms Martin. The SNP has said that it will do everything that it can to tackle Scotland’s drug deaths crisis. However, the UK Government has invited the Scottish Government to work with it on project ADDER—addiction, disruption, diversion, enforcement and recovery—three times, and three times the SNP has snubbed it.

The SNP’s persistent refusal to work with the UK Government is costing lives. The First Minister admitted that she has let Scotland’s drug deaths crisis spiral out of control, and the SNP’s obsession with independence has come at a high cost. The Scottish Government must focus on the devolved public health and justice systems that it controls. When will it accept the UK Government’s invitation and start working constructively with it to solve this national crisis?

Photo of Angela Constance Angela Constance Scottish National Party

I assure Ms Webber that I work constructively with everyone—it is just unfortunate that that is not always reciprocated. The Scottish Government has, indeed, had a close look at project ADDER, and the drug deaths task force participates in the project ADDER learning network, so we are keeping our ear to the ground with regard to any learning from that.

However, the harsh reality is that alhough the Scottish Government wants to implement a public health approach to the drug deaths crisis, project ADDER is, I suggest to Ms Webber, not entirely replicable as a good public health approach. It is not that we do not look at evidence of what is happening elsewhere; it is just that project ADDER does not fit our needs. We have a particularly acute problem in Scotland and we need to fully implement a public health approach. I cannot emphasise that enough.

I point Ms Webber in the direction of Dame Carol Black’s second report, which was also commissioned by the UK Government and which has much more synergy with the work that we are doing in Scotland. It is about investing in treatment services, promoting recovery, making links with housing and tackling poverty. It is about a culture and systems change, and having joined-up Government.

We look around and learn from wherever. I am sad that that is not always reciprocated in regard to some of the reasonable requests that I have made of the UK Government, such as that it is now high time that we had a review of the Misuse of Drugs Act 1971.

Photo of Jackie Dunbar Jackie Dunbar Scottish National Party

Every drugs death is a tragedy, so it is critical that the Scottish Government continues to invest in tackling the epidemic by ensuring quick access to treatment and community interventions. Will the minister provide assurances that the Scottish Government is doing all that it can to improve the situation while working within the limitations of devolved powers?

Photo of Angela Constance Angela Constance Scottish National Party

I assure Jackie Dunbar that, as I am a pragmatist, my focus is always on doing as much as I can as fast as I can with the powers and resources that are at my disposal. In addition, I continue to work with and persuade others to do what they can to help us.

The core aim of our national mission is to get more people into treatment—to be frank, not enough of our people are in treatment. When people ask for help, we must respond quickly to their request. We should not miss those golden opportunities when people seek help and support.

An example of where we are connecting our emergency and life-saving work with broader work to get people into treatment and to improve their life chances is our work on what are called non-fatal overdose care pathways, which recognises that people who tragically die of an overdose often—more than half of them—have a history of overdose. We of course need to prevent people from having an overdose in the first place, but when people reach such a crisis point, it is imperative that we offer them help as quickly as possible.

There are a number of mechanisms and services that we fund to improve the situation. For example, in hospitals, we use peer navigators—people with lived experience—to reach out. The Scottish Ambulance Service, which has been pivotal in developing non-fatal overdose care pathways and in the roll-out of naloxone, is part of the emergency response, and it does sterling work in connecting people to local services. We have invested in outreach services, because we need to do far better at proactively identifying the people who are most at risk. To increase the chance of people remaining in treatment, we must provide services that offer wraparound care and that are less judgmental, and when people fall out of treatment or relapse, we need to follow up on them.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

On the roll-out of naloxone to the police, I note that, if someone injects a substance into someone else’s body against their wishes, they are subject to being charged with assault. How will the Scottish Government ensure that police officers are not sued for administering naloxone?

Photo of Angela Constance Angela Constance Scottish National Party

I assure Sandesh Gulhane that the Lord Advocate has given robust assurances on that matter. The evidence from across the world will show that naloxone can save lives. As a serving clinician, Dr Gulhane will be very focused on evidence-based interventions and treatments. In British Columbia in Canada, the authorities did three things: they introduced same-day prescribing, they introduced safe consumption rooms and they widened the distribution and roll-out of naloxone. Today, a very important four-nations consultation on widening distribution of naloxone has been launched. In response to the pandemic, our previous Lord Advocate was able to make some exceptions, so that we could safely, medically and legally widen distribution of naloxone to non-drug services, and we need to continue that work. I hope that the consultation will lead to permanent changes in the regulation and legislation across the UK, because it is beholden on all public servants to do everything that we can to help with that emergency response. I was never a clinician, but I am a former social worker and I can say hand on heart that, when I worked in prisons or communities, if I had had the opportunity to carry naloxone, I would have been more than happy to do so.

Photo of Collette Stevenson Collette Stevenson Scottish National Party

I thank Angela Constance for everything that she has said today. Can she outline what assessment has been made of the success of overdose prevention facilities elsewhere in the world? Can they play a part in reducing deaths from drug use? Does she agree that it is vital that family members are also able to access the support that they need?

Photo of Angela Constance Angela Constance Scottish National Party

Yes. As I said earlier to another member, there are 100 safe consumption rooms around the world, and there is a massive evidence base showing that they work. They help to save lives and help people with their onward journey into recovery. They provide an opportunity to connect with people where they are at a moment in time and to give them other information and support to address issues that underlie their use of drugs in the first place.

As I hope Collette Stevenson knows, I am absolutely committed to tackling the plight of families. We fund Scottish Families Affected by Alcohol and Drugs, and there is a £3 million children and families fund that local grass-roots and third sector organisations can apply for. We have also provided additional money and uplift to alcohol and drug partnerships and been very clear that a proportion of that must be invested in whole-family approaches and family inclusive practice.

Photo of Paul Sweeney Paul Sweeney Labour

I thank Angela Constance for her statement today. She announced some constructive measures, particularly around benzodiazepines, which, as we know, have been a key driver in the tragic increase in deaths. What approaches is the minister considering, particularly around policing? In different parts of the UK, in particular in the Thames Valley and the West Midlands, the police and crime commissioners have led good innovations to adopt more enlightened methods of policing. With political leadership from the justice secretary and others in the Government, we should force Police Scotland to look at that approach more seriously, because, in England, police and crime commissioners have shown the way, including—as the minister mentioned—around drug testing. In Bristol, that has progressed with the Loop project, which has been really successful on the ground. Will the minister consider looking at those benchmarking opportunities and perhaps leading more active delegations, including MSPs, to those places of innovation, so that we can learn from them?

Photo of Angela Constance Angela Constance Scottish National Party

Now that there are fewer travel restrictions, there will be more opportunities for me and other ministers, in partnership with MSPs, to see for ourselves innovation that currently exists in Scotland or elsewhere in the UK.

I assure Mr Sweeney that I have engaged with police and crime commissioners. It strikes me that they are wrestling with many of the same issues and some of the same frustrations that I experience with the UK Government. As I do, they want to work in partnership and constructively with all tiers of government to implement evidence-based solutions.

I will certainly look at the Loop project. In relation to drug-checking facilities, my understanding is that there was a licence for a particular event in England a few years ago. There is a reticence in the UK Government to issue such licences, but it has said to me that, if I provide information and evidence on areas of particular need in Scotland, it will look at that, so I will press the UK Government at every twist and turn.

Police and crime commissioners have different powers and responsibilities from those that we have in Scotland. They look at how they can use the powers, resources and opportunities that they have at their disposal. Likewise, we must look at the opportunities that we have to make every aspect of our criminal justice system more evidence led and more humane.

Meeting closed at 17:01.