Substance Use in the Justice System

– in the Scottish Parliament on 16th March 2022.

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Photo of Annabelle Ewing Annabelle Ewing Scottish National Party

The next item of business is a debate on motion S6M-03625, in the name of Keith Brown, on a person-centred, trauma-informed public health approach to substance use in the justice system. I invite members who wish to speak in the debate to press their request-to-speak button or to enter R in the chat function.

Photo of Keith Brown Keith Brown Scottish National Party

In January, we marked the first year of the national mission to reduce drug-related deaths and harms. The groundwork has been laid for addressing the issues head-on across Government in health, justice, housing and education and putting in place the investment and actions so that we can focus on delivering change on the ground. Change is urgently needed. Every drug-related death is a tragedy, and we are again reminded of the need for continued and collective action by the quarterly suspected drug death statistics that were published only yesterday.

Sadly, we know that many people in the justice system—whether at the point of arrest, in the community or in custody—have drug or alcohol issues. Therefore, I welcome the opportunity to reflect on the steps that the Scottish Government and its partners are taking across the justice system, and those that we have already taken, to reduce drug-related deaths and harms and how we will build on them in the future.

Those steps form part of the person-centred and trauma-informed approach that underpins our vision for justice and will be central to how we work with people who are in contact with the justice system, including people with drug or alcohol problems. We have a bold, transformative vision of the future justice system for Scotland that sets out clear aims and priorities, including a focus on rehabilitation and shifting the balance between the use of custody and justice in the community.

I want to be clear that this approach is not the easy option to take, but it is the right one. The Scottish Government is committed to focusing on what works—what evidence demonstrates makes a meaningful and lasting change. This is not about soft justice but is about what is most effective and what works to make communities safer and reduce victimisation and harm. It is not about building more prisons, putting more people in them and hoping for the best. That would be soft justice and the easy option.

A person-centred and trauma-informed approach begins with the recognition of the need to treat everyone with respect, regardless of their background, and to provide support to empower people to make positive changes in their lives. It is clear that 50 years of outdated drug legislation, which focuses on criminalising people with complex needs, rather than on how services can support them into recovery, has caused more harm than good. We have known for years that the police cannot simply arrest our way out of the current drugs emergency in Scotland. Many different groups of experts have looked at the Misuse of Drugs Act 1971 and concluded that change is needed.

Across Scottish Government and the Scottish Drug Deaths Taskforce, work is under way that is intended to change the way we work within the current law, and I appreciate the work that the task force has done on that to date. An action plan is being developed to respond to the proposals in the phase 1 report and take forward a second phase of drug law reform consultation, and to lead a national conversation in Scotland to show that the evidence is clear and it is time to act.

Ultimately, we believe that the best way to reduce drug-related crime and the associated harms is to provide opportunities to access appropriate treatment and support services at every point of the criminal justice system, and the Scottish Government and justice partners are actively working towards that.

An excellent example of the positive steps that have been taken to date include recorded police warnings. Last year, the Lord Advocate—I should emphasise that the Lord Advocate is not the Scottish National Party Government and does not speak on behalf of the Government when she acts in this area but is independent—announced that recorded police warnings may be used for all classes of drug possession. Although that was a decision for the Lord Advocate, I welcomed the change, which can help with a shift to a public health approach.

There are other encouraging examples of effective practice. The Drug Deaths Taskforce has developed a police referral peer navigator programme which is offering person-centred support to people who use drugs at the first point of contact with the police, facilitating entry to wider services and the help that those people need.

I very much welcome the leadership and progressive approach of Police Scotland in supporting that programme and in taking other operational decisions that help to save lives. For example, the recent decision by the chief constable to roll out the carriage of naloxone by all serving police officers up to the rank of inspector, and officers’ support of that, is helping to preserve life and keep people safe. The roll-out follows recommendations from an independent evaluation. I am delighted to be able to announce today that the Scottish Government’s drugs policy division will provide funding of £463,500 to Police Scotland to allow it to kit out all those officers with that life-saving medication.

Police Scotland is also playing an important role in advising on potential operational implications of establishing safe consumption facilities. As Parliament is aware, that is a sensitive but important measure to save lives within the existing legal framework.

Of course, Police Scotland continues to take action against the serious organised crime groups who traffic drugs and are exploiting some of our most vulnerable individuals and communities for their own profit.

Those preventative actions are helping to divert people with addiction out of the criminal justice system, where appropriate, and into treatment and support for their recovery.

Photo of Brian Whittle Brian Whittle Conservative

I associate myself with the minister’s words about treating the issue as a public health issue rather than a criminal justice one. Will he outline any measures that the Government is taking to prevent people from falling into the clutches of addiction in the first place, rather than waiting for them to become addicted?

Photo of Keith Brown Keith Brown Scottish National Party

There are elements of the justice system that seek to do that, including a number of programmes. My colleague Angela Constance will outline some of the ways that we are seeking to do that through the Drug Deaths Taskforce when she sums up. I am happy to provide the member with more information about what we do in justice, but the stuff that Angela Constance is doing will be of more interest to him.

Where cases are prosecuted in court, it is rightly for the independent judiciary to decide the most appropriate sentence. However, the Government is committed to shifting the balance from custody to more effective community interventions, where appropriate. We know that many of those who offend have experienced poverty, disadvantage, adverse childhood experiences and trauma and often have health problems, such as drug and alcohol dependency.

Given the damaging impact of imprisonment, our long-term aim is for custody to be reserved only for individuals who pose a risk of serious harm, and for some other categories, while ensuring that effective community-based support and interventions are available where needed. That is why we are taking concerted action, including through forthcoming legislation on bail and release, as well as providing support to transform community justice services. That is smart justice, because we know that reconviction rates are lower when we take that approach. If we have lower reconviction rates, we have fewer victims and less crime in Scotland. That should be the aim of everybody who is involved in this debate.

Photo of Baroness Katy Clark Baroness Katy Clark Labour

I asked the cabinet secretary earlier this afternoon why he thought it was that Scotland continues to have the highest rate of people in prison in Europe, and also the highest rate of people on remand. A survey showed that almost half of prisoners—about 45 per cent—reported being under the influence of drugs at the time of their offence. How do we ensure that we make the kind of systematic changes that are needed to address this issue? How does he think the Parliament should hold the Government to account on the issue? Does he think that we need to have targets? Does he have a plan for how we are going to make the system change?

Photo of Keith Brown Keith Brown Scottish National Party

There will be different elements in answering that question. On whether we should have targets, it is not for me to tell Parliament how it should hold the Government to account, but the justice vision has a one-year delivery period that has been put forward just now, which includes lots of existing performance measurements—if not targets—and other interventions. We are also working on a three-year delivery target or delivery programme. When that is published, members might wish to quiz the Government on it—I am sure that they will.

On Katy Clark’s other point, I have already mentioned that Angela Constance will cover some of the things that we can do in society to try and reduce dependency, alcoholism and drug abuse. Within the justice system, we have to do more, whether that is in prisons or in how we deal with people with those issues in police custody suites, for example. We are doing a number of those things, not least in relation to a conversation that we had today with police and health professionals on how we use the navigator system and one or two innovative approaches, such as that being taken in Fraserburgh. I am happy to provide more information on that if the member wishes. Those approaches include how we best use monitoring and support to improve outcomes. There are potential developments in relation to alcohol and substance monitoring, and I am committed to looking at options focusing on what works. In doing that, I am open to working with members from across the chamber—as, I am sure, is Angela Constance—and we welcome the engagement that we have had to date.

As part of our efforts to encourage greater use of community interventions, our programme for government makes it clear that we are committed to expanding community justice services and to supporting diversion from prosecution, alternatives to remand—that comes back to the member’s question—and community sentencing.

In 2022-23, we increased annual funding by £15 million to £134 million to reflect continued investment in supporting pandemic recovery work and the expansion and transformation of community justice services. Combining that with investment in the national drugs mission, we are enabling timely and effective interventions in communities to prevent harm and to improve life chances. Our measures will also support the delivery of the revised national community justice strategy, which is currently under development. The strategy will set out clear aims for partners, with an emphasis on early intervention, and it will encourage a further shift away from the use of custody.

Our approach is evidence informed, and it is important that we assess the impact of existing measures such as drug treatment and testing orders. DTTOs are an intensive disposal that is specifically targeted at individuals with entrenched problem drug use, chaotic lifestyles and a history of offending. They were introduced to combine justice and health approaches in a targeted way, and we know that individuals on DTTOs can have difficulty in fully complying with the requirements. I therefore welcome the Drug Deaths Taskforce’s consideration of DTTOs. We intend to carry out some initial exploratory work reviewing the evidence available in relation to the orders and how they align with what is known about good practice in this area.

It is imperative that access to appropriate support is available to everyone who is serving a custodial sentence in Scotland. The Scottish Prison Service is working tirelessly to eradicate unauthorised drugs in prison, and it is continuously adapting its security measures to prevent, detect and deter the introduction of contraband. In November 2021, we laid legislation that allows prison officers to photocopy correspondence as another means to prevent the entry of illicit substances into prison and to reduce the availability of those substances to prisoners. That can only help to reduce the risks that illicit substances present to those living and working in our prisons.

Another key priority in prisons is mitigating against the known elevated risk of drug deaths at transition points such as release from custody, as well as ensuring naloxone provision and continuity of care on release. Prison officers and Department for Work and Pensions staff continue to offer assistance to prisoners to plan for their release, and the Scottish Government continues to support the work of throughcare services that support individuals to reintegrate back into their community after their release. That includes the excellent work that is done by Scotland’s third sector and justice social work services across the country.

The examples that I have touched on are making a real difference and will continue to do so. They are, however, just some of the steps that we have taken so far and which need to be taken. We know that this is a complex issue; it is not easy and it will require further action, further investment and a collective will to address the challenges ahead.

Although the approach that we are taking is not an easy one, we are absolutely clear that it is the right one to deliver lasting improvements. It is based on evidence of what works and is focused on actions that are effective in tackling drug-related deaths and harm and, ultimately, actions that make our communities safer.

The Scottish Government will continue to take this forward at pace and we welcome the opportunity to work with everyone across the chamber in doing so.

I move,

That the Parliament believes that every drug-related death is unacceptable and that drugs deaths are a public health emergency; commits to save and improve lives through the National Mission and supports the implementation of the Medication Assisted Treatment (MAT) standards; agrees with the Scottish Government’s long-term aim that imprisonment should be reserved for individuals who pose a risk of serious harm; determines that access to high-quality drug treatment, rehabilitation and recovery services at appropriate points in the justice system, including in prison and police care, is vital; recognises the stigma associated with services and service users and the need to tackle this; supports the transformation of community justice services such as bail supervision and community sentences; reinforces the commitment to continue to improve support for people leaving prison, including access to community services upon liberation, and throughcare; welcomes the decision by the Chief Constable to roll out the carriage of naloxone across Police Scotland and the support of officers to help preserve life and keep people safe; supports the exploration of options to deliver safer drug consumption facilities, within the existing legal framework, to help save lives, and agrees that the development of treatment targets will drive forward the expansion of protective treatment services alongside investment, and that further consultation is needed to gauge public attitudes and explore the limitations of a public health response restricted by the Misuse of Drugs Act 1971.

The Deputy Presiding Officer:

I call Russell Findlay to speak to and move amendment S6M-03625.1.

Photo of Russell Findlay Russell Findlay Conservative

One of the issues that unite the chamber is Scotland’s drugs deaths record, which is a matter of national shame.

Working as a journalist in the 1990s, before this Parliament existed, I recall the shock of an annual death toll that was in the low hundreds. Year after year, the numbers rose ever upwards, so it is important to pause and reflect that there were 1,339 drug deaths in 2020. Since this SNP Government came to power, more than 10,000 lives have been lost.

For reasons that I have never heard explained, the Scottish death rate is perhaps the highest in Europe, and is more than 3.5 times greater than the rate in the rest of the United Kingdom. Behind the statistics are real people and families. Each death is a lost son or daughter, brother or sister—vibrant lives that have been cruelly cut short.

It is proper that Scotland is treating the chronic drug problem as a public health emergency. and I expect that we will hear more about that from my colleagues Annie Wells, Jamie Greene and Sue Webber.

However, I have concerns about some of the language and, indeed, some of the actions of the Scottish Government. I worry that ministers are embracing a public health solution at the expense of robust use of criminal justice. I worry that they have become blinkered to the damage that is done by violent, wealthy and powerful drug gangs. In essence, I worry that greater store is being set by wishful thinking than is set by an approach that is based on evidence and pragmatism.

The fact is that we need to harness the resources and expertise of the health and justice systems—it cannot be either/or. Last month in the chamber, I discussed the Scottish Government’s newly published “The Vision for Justice in Scotland”. As I said then, it reveals much about the Government’s thinking—not least the blurring of lines between victims and criminals. The same mindset, in which criminality can always be explained and perhaps even justified, can be seen in the language of the cabinet secretary’s motion today. The following line stands out:

“the Scottish Government’s long-term aim that imprisonment should be reserved for individuals who pose a risk of serious harm”.

It seems that criminals who pose mere “harm” should never be imprisoned; to be imprisoned they must be deemed to pose “serious harm”. How, I wonder, does the cabinet secretary define “serious harm”? Does that include only inflicting of violence on people or does the cabinet secretary believe, as I do, that drug dealers cause “serious harm” to our most vulnerable people and should therefore be in prison?

I am happy to give way to the cabinet secretary if he is willing to answer those questions.

Photo of Keith Brown Keith Brown Scottish National Party

I am happy to do so. it is preposterous to allege that anybody in this chamber does not think that drug dealing presents serious harm to people. Surely we can have more elevated debate than that on such serious issues.

Photo of Russell Findlay Russell Findlay Conservative

I appreciate the cabinet secretary’s clarification that drug dealing constitutes serious harm.

What about the commonly held idea that some criminals should be sent to prison as punishment for their actions? On the basis of the above line in the motion, are we to understand that that concept is to be abandoned? Again, I am happy to give way if an explanation is forthcoming.

Photo of Keith Brown Keith Brown Scottish National Party

It would have been advisable for Russell Findlay to have listened to my statement, because, when I came to that matter, I mentioned that there are categories of prisoner other than those who present a risk of serious harm. Of course there must be a role for punishment in the criminal justice system, but what we are trying to say is that it must be trauma informed. It must be recognised where people are coming from when they present in the criminal justice system. That seems to me to be a sensible approach. It would be useful to hear whether the Conservatives can make any sensible suggestions in that area.

Photo of Russell Findlay Russell Findlay Conservative

The inclusion of that line is reason enough for my party to be unable to support the Government’s motion and Labour’s amendment.

I previously pointed out that there is no mention of organised crime in the cabinet secretary’s “The Vision for Justice in Scotland”. It is a subject that previous SNP justice secretaries used at least to talk about. I was heartened when UK drugs minister Kit Malthouse recently gave evidence to a joint committee of the Parliament. He spoke passionately about the need to give people help in beating their addictions. That same thinking motivates my party’s proposed right to recovery bill, which has won support from people who work at the coalface of the drugs crisis.

However, Mr Malthouse also spoke about the need for robust policing to hit the pernicious and dangerous drugs gangs that amass huge fortunes from dealing in death. I share his disappointment that the SNP Government rejected the opportunity to take part in project ADDER—addiction, diversion, disruption, enforcement and recovery.

Photo of Gillian Martin Gillian Martin Scottish National Party

Russell Findlay is talking about organised crime and putting people who are drug dealers in prison. Does he recognise that many people who are in prison and have problem drug use are not involved in either of those things?

Photo of Russell Findlay Russell Findlay Conservative

Absolutely. In the past few months, our policy gave voice to prison officers on the huge volume of drugs that come into prisons via mail. Only by agitating and pushing was action finally taken.

I wonder whether the Scottish Government’s rejection of the opportunity to take part in project ADDER was motivated—forgive me if I am wrong—by the cynical strategy of always seeking to differentiate its policy from UK policy.

I suspect that that same tactic might be the reason some SNP—

Photo of Angela Constance Angela Constance Scottish National Party

Russell Findlay might recall that in a previous debate, I advised that the reason why we do not participate in project ADDER is that it is really just rebadged work that we are already doing in Scotland. Also, ultimately, project ADDER is enforcement led, as opposed to being public health led.

The Deputy Presiding Officer:

Mr Findlay, I will give you a wee bit of time back. You have been generous with interventions, but you should focus your mind on concluding, rather than on taking more interventions.

Photo of Russell Findlay Russell Findlay Conservative

I point out to the minister that ADDER stands for “addiction, diversion, disruption, enforcement and recovery”, so it is not just about enforcement but about all those elements.

I am clearly running out of time.

Another issue is drug consumption rooms. As my party has already said, we are open minded about them, but we have yet to hear how they would work in practice. Would they be mobile facilities or bricks and mortar? If they are in buildings, I bet that they would not be in the postcodes where middle-class members of the Scottish Parliament live. Would addicts who lead chaotic lives be expected to book an appointment, turn up and stand in line? If the rooms are mobile, would they be like Post Office vans serving communities? At a time when the Government has presided over the closure of one in eight of Scotland’s libraries, what kind of message would that send out? “Never mind folks, we’ve shut down your library and your sports centre, but we’ve found the cash for a mobile heroin van.” What would that say to parents who are seeking the best for their children who are living in drug-scarred communities?

I share the concerns that have been expressed by Police Scotland about DCRs and the associated so-called tolerance zones. I declare an interest: I am married to a police officer.

I am conscious of the time.

Perhaps, as Nicola Sturgeon has previously admitted, ministers have taken their eye off the ball on drugs. My concern is that their eyes are still off the ball. Our amendment is grounded in reality, with the right to recovery at its heart. It acknowledges the shortcomings that were recently laid bare by Audit Scotland—not least of which are poor data, lack of transparency and the Government’s cuts to addiction services.

I therefore urge members to support the amendment in my name. I move amendment S6M-03625.1, to leave out from “drugs deaths” to end and insert:

“the high number of drug deaths in Scotland is a national shame; regrets that drug-related deaths are 3.5 times that of the UK as a whole; notes with concern that spending on drug and alcohol services is difficult to track and needs to be more transparent; agrees with Audit Scotland that more focus is needed on addressing the root causes of drug and alcohol dependency; supports Audit Scotland’s conclusion that more could be done to join up work and funding streams to demonstrate that they are collectively improving outcomes; agrees that the possession of class A drugs is a serious offence and should not be dealt with through warnings as it makes the police’s job tackling drug dealing more difficult; reinforces the commitment to continue to improve support for people leaving prison, including access to community services upon liberation, and throughcare; welcomes the decision by the Chief Constable to roll out the carriage of naloxone across Police Scotland and the support of officers to help preserve life and keep people safe; recognises that the Scottish Government’s effective decriminalisation of class B and C drugs in 2016-17 has resulted in an increase in the number caught possessing such drugs; understands that admissions to psychiatric hospitals among cannabis users has soared since the effective decriminalisation of that drug; determines that access to high-quality drug treatment, rehabilitation and recovery services at appropriate points in the justice system, including in prison and police care, is vital; welcomes Scottish Conservative and Unionist Party proposals for a Right to Recovery Bill, which would provide a statutory right to addiction and recovery treatment services; supports the principle that individuals seeking addiction and/or substance misuse treatment should be able to quickly access their preferred treatment option, and regrets the Scottish Government’s refusal to participate in Project ADDER, which is designed to tackle addiction and supply of illegal substances.”

Photo of Claire Baker Claire Baker Labour

I welcome the opportunity to open the debate for Scottish Labour. We agree that Scotland’s drug deaths crisis and the huge scale of drug-related harm must be addressed through a public health approach that extends to the justice system.

We support the use, where appropriate, of policies such as the recorded police warning system, to divert individuals away from the criminal justice system and towards support services. However, in our prisons, it is vital that individuals who experience drug-related harm are also offered appropriate treatment and support, and that we provide the personalised and trauma-informed care that they need in order to rebuild their lives.

The implementation of the medication-assisted treatment standards is an important step, and they must be fully implemented in prisons as part of the public health approach. Delivery is crucial and, as we approach a year since the introduction of the MAT standards, what measurable progress can we expect to see? The minister previously committed to updating Parliament, so I would like to know whether we are going to see publication of relevant data on progress. The majority of prisoners who are seen by drug and alcohol services also present with mental health symptoms, so integration of those services is key.

However, I am disappointed by the fact that the Government’s motion seeks to introduce constitutional politics into today’s debate. Although she has a view on those powers, the Minister for Drugs Policy has focused on building consensus and support for a change of direction, so I am disappointed that today’s approach presents a barrier to that consensus.

The Government is also asking for support for an undefined consultation; it is not clear what its aims or focus are, or whether it will be independent. Is it intended that the consultation will be led by Parliament? That would be a constructive approach. Any consultation that takes place must not delay action on delivery, because there must be a laser focus on delivery.

I remind the Scottish Government that all of the UK comes under the Misuse of Drugs Act 1971, but Scotland has three times the rate of fatalities that England and Wales have. I agree that the UK Government’s approach is wrong, because approaching the crisis from a justice perspective sets us up to repeat mistakes. However, there are diversion policies in the UK Government’s relaunched strategy; the Conservatives have highlighted project ADDER. The UK Government might not emphasise those policies, but they exist. That is another reason why I cannot understand the Conservatives’ rejection of that approach in Scotland, through our police recorded warnings system.

The Scottish Government cannot rewrite the history of drug deaths in Scotland and suggest that responsibility lies elsewhere. Over the past 15 years, while the crisis has grown and embedded itself in too many communities and families across Scotland, the response has been wrong, complacent and slow. Although it was driven by the Tories and introduced by the SNP, Parliament must take responsibility for the wrong-headed strategy in “The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem”, which set back progress in harm-reduction policies.

The Scottish Government must take responsibility for the cuts to alcohol and drug partnerships in 2016-17, which meant a reduction in support and services. When the drug deaths figures started to rise, the Government’s response was that the rise was generational and almost to be expected. That response delayed investment and the desperately needed political focus and will.

Mismanagement of the prison service and underfunding of key services, including mental health, cannot be swept aside. Prison numbers are still too high, and staffing pressures among healthcare staff continue, despite repeated warnings about the impact of overcrowding and lack of treatment services and throughcare. It is well evidenced that the period immediately after a person’s release from prison is a time of increased risk of drug-related death. The national drug-related deaths database records show that more than one in 10 people who suffered a drug-related death had been in prison in the previous six months. A recent Criminal Justice Committee round-table session highlighted the lack of support for prisoners prior to their release, but concerns about the adequacy of services including throughcare are not new.

We acknowledge the recent announcements from the Scottish Government, many of which are highlighted in its motion, but the true test will be in delivery. The indicative figures that were published yesterday suggest that—although they are at the early stages—some interventions might be starting to make a difference. However, the rise in drug fatalities among women is alarming, so we desperately need more services to be targeted at that group.

Although we do not support the Conservatives’ amendment, it is right that they highlight the recent report from Audit Scotland and the need for more focus on the root causes of drug and alcohol dependency. By using the extensive powers and resources that are at its disposal, the Government can make real and lasting impacts, including fully funding front-line services for drug treatment and prioritising policies that rejuvenate the most deprived areas.

Ministers have had 15 years in which to take decisive action. If they had chosen to act earlier by investing properly in mental health services, drug treatment services and social care, and by expanding residential rehabilitation—in order to create clear pathways and support for prisoners with drug problems on release—what impacts could we have seen in that time? The Scottish Labour amendment makes it clear that, without sufficient investment and action to address inequalities, that failure to make progress will continue.

The Conservative amendment also references support for specialist adult drug courts. Although that approach was trialled in Scotland, the Scottish Government stopped funding it. It was interesting that the cabinet secretary talked about DTOs and issues with full compliance. The evidence shows that drugs court work well and support people through the process.

In Scotland, a significant closure programme of local courts, which included closure of the Cupar sheriff court, meant that there was insufficient capacity in Fife to accommodate the drugs court there. There were two drugs courts, one in Glasgow and one in Fife, but now only the one in Glasgow is left. Although the courts showed positive results, the Government said at the time that there was not enough evidence of the results. However, it was difficult to create the evidence when the project was limited to two pilots.

The Glasgow court shows strong evidence that adult drug courts reduce both substance misuse and reoffending, but the model has been allowed to wither. Although I do not anticipate that the Government will support our amendment, I ask it to pursue drug courts as part of the diversionary approach to criminal justice and embedding of the person-centred approach to substance use.

I move amendment S6M-03625.2, to leave out from “, and that further consultation” to end and insert:

“; further agrees that sufficient progress will not be made until the preventative policies are backed by sufficient investment and the Scottish Government addresses Scotland's socioeconomic inequalities; considers that efforts to support and provide treatment to prisoners who experience problematic drug use have been undermined by ongoing overcrowding and pressures facing healthcare staff in prisons; notes the positive impacts made by the specialist drug court in Glasgow, and calls on the Scottish Government to expand access to these courts across Scotland.”

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

I start by extending my apologies to the chamber, as an urgent appointment means that I will be absent during the closing speeches.

I am grateful to the Government for securing parliamentary time for this important debate. As members know, the matter of drug deaths is of great importance to the Scottish Liberal Democrats. As we have heard already, Police Scotland has advised us that there were 1,295 suspected drug deaths in our communities in 2021—a dip from 2020, but still among the highest rates in the world. That is 1,295 lives needlessly lost, a wealth of potential dashed, and countless families and communities broken.

That situation cannot continue. This is a particularly Scottish problem of international proportions that has been a stain on our record for years. In recent times, Scotland has been taking, on paper at least, a public health approach to drug deaths, which was evident in the words of the new Lord Advocate when she addressed us a few months ago. However, the implementation of such an approach, particularly in the justice system, has been inconsistent.

That inconsistency is starkly evident in the use of fatal accident inquiries in relation to our prisons. My colleague Liam McArthur has worked particularly hard on that issue. The evidence on FAIs shows that drug-related deaths are not treated as the complex issues that they are; rather, such cases are labelled as “drug-seeking behaviour” or “death by misadventure”, as if it is a choice that one makes. As a result, those cases are not investigated properly. These are individuals, and their families are not treated with the dignity that they deserve and do not get the answers that they deserve. More crucially, lessons are not being learnt. The Scottish Liberal Democrats have long called for an overhaul of the FAI system in order to gain an understanding of how to tackle substance abuse properly in the justice system.

In addition, we must work faster and harder to introduce safe consumption rooms, which are crucial to lowering the risks of substance use and to preventing blood-borne infection and ultimately death. My party, through its work alongside amazing activists such as Peter Krykant, has been advocating for safe consumption rooms for several years.

The motion mentions that the Government supports

“exploration of options to deliver safer drug consumption facilities, within the existing legal framework”.

I want to believe the Government’s intentions, but I am anxious that that exploration might translate into further delay. I was intrigued by and echo Claire Baker’s question about the detail around the consultation that is mentioned in the last line of the Government’s motion, and I hope that we get further clarity on that point.

The law regarding this matter is not as set in stone as some might think. There is significant reason to believe that we could achieve, and the Government could do, much more to push the legal boundaries and break the legal impasses that we encounter.

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

I am afraid that I do not have a great deal of time; otherwise, I would.

The Lord Advocate confirmed all those points last year, following my party’s campaign for a review of the law.

Let me be clear that the Scottish Liberal Democrats are open to further discussion of the further devolution of drugs policy to Scotland. This devastating problem is not a deficiency of devolution, nor is it a product of UK Government policy. However, if devolution of the Misuse of Drugs Act 1971 would save lives, we, as Liberal Democrats, would not be closed off to that. That issue would bear further scrutiny and discussion.

We need to ensure that those who are in need of help are given it freely without suspicion, judgment or punishment. That is why we should work with the Scottish Sentencing Council to offer education and treatment services to those who are caught in possession of drugs. We must introduce such policies as a matter of urgency.

It is surely clear to everyone that, given that the situation has spiralled out of control to such an extent, we need as much expert advice as we can get. That is why I repeat my call for the World Health Organization to provide a specialist drugs task force to enable us to learn from international examples in Scotland. We cannot simply continue to talk about the issue—we need to act.

The Deputy Presiding Officer:

We move to the open debate. I invite speakers who have not yet pressed their request-to-speak buttons to do so.

Photo of Audrey Nicoll Audrey Nicoll Scottish National Party

I draw members’ attention to my entry in the register of members’ interests—I am a councillor on Aberdeen City Council and a member of the Aberdeen city ADP.

Today’s debate is bittersweet—it is another reminder of the pervasiveness of our relationship with drugs, but also an opportunity to take stock of the work that is being done, and the work that is still required, to address problem drug use and reduce drug deaths. I welcome the latest Police Scotland figures, which show a slight decrease in drug deaths, but every death is a tragedy.

The Criminal Justice Committee has been taking evidence on problem drug use, which we see as a defining challenge of the current session of Parliament. We recently joined colleagues from the Health, Social Care and Sport Committee and the Social Justice and Social Security Committee to consider the intersection between health, criminal justice and social justice in tackling problem drug use. I will highlight some key points that are linked to the Government motion, but first I will reflect on some witness testimonies to our committee, which shone a light on the factors that push and pull people into a relationship with drugs.

One witness was not a heroin user when he entered a young offenders institute, but after release, he became one. Another was born into the heroin epidemic of the 1980s, when, as she put it,

“crime and drugs took precedence over ... education and nurturing”.—[

Official Report, Criminal Justice Committee,

27 October 2021; c 4.]

Another was raised in poverty and experienced trauma in a violent relationship. By the time she got out, she was broken and using drugs to ease the pain in her head. Witnesses spoke of limited access to person-centred support; their addiction being seen as “not severe enough”; and treatment not being available for the drug that they used—all of which further marginalised them at a time of need.

We heard about the importance of trauma-informed interactions with police officers, court staff, sheriffs and prison officers, and we welcomed Police Scotland and Crown Office plans to develop trauma-informed training for officers and practitioners, with more solicitors and sheriffs now also trauma informed. We welcomed the task force’s stigma strategy to address the alienation and damage that are caused by the war on drugs, and its desire that distress brief interventions be developed. I know that local provision of DBIs in my constituency was curtailed significantly during the pandemic.

We also took evidence on diversion from prosecution. Although there are challenges with monitoring and attendance, there was real consensus that community-based remedies, where they are appropriate, are much preferable to prison sentences. I welcomed Dr Liz Aston’s contribution on the role of police officers in diverting people to drug services, and I welcome the development of programmes such as navigator, which will allow front-line staff to undertake first-point-of-contact referral to services and support.

Recently, the Lord Advocate announced her decision to extend the use of recorded police warnings to include class A drugs, as the cabinet secretary outlined. In her statement, the Lord Advocate highlighted the Inverness pilot led by Medics Against Violence, which supports referrals to a mentor who can provide support at the first point of contact with police. I would be interested to hear more about progress on that project.

Throughcare on liberation, including general practitioner access, opiate substitution therapy and take-home naloxone, was considered a priority, in addition to alternatives to remand and imprisonment such as bail supervision and residential rehabilitation. On naloxone, I welcome the chief constable’s commitment to a national roll-out to all police officers, and I commend the Scottish Ambulance Service for its work to develop carriage and use of naloxone.

Finally, the committee heard overwhelming support for law reform to facilitate safe consumption spaces, and the Lord Advocate commented that she would be willing to consider specific proposals that are presented to her on that.

I hope and expect that the committee’s work, including our recent joint sessions with other committees, will inform the national mission and the delivery of the new vision for justice to develop a whole-system approach that is public health based and has person-centred and trauma-informed practices at its heart.

Photo of Annie Wells Annie Wells Conservative

The problem with drug-related deaths in Scotland remains our national shame. The numbers do not lie. In 2020, around four people lost their lives each day to drugs. As the First Minister admitted, for too long, the Government had taken its eye off the ball. I recognise that estimated data from Police Scotland suggests that the number of drug-related deaths in 2021 was lower than the number the year before. However, it is clear that there is much more that we can do, particularly on bolstering rehabilitation facilities.

Only last week, an astonishing Audit Scotland report revealed clear shortcomings in the Government’s stewardship of our drug and alcohol services. For many vulnerable people, those services are the last resort to obtain the treatment that they need to get better. That is why the Scottish Conservatives have proposed our right to recovery bill, which has been developed in collaboration with front-line experts, to ensure that people have the statutory right to obtain the treatment that is right for them. I sincerely hope that we can continue to collaborate on that bill, because surely the time has come for us to stand up and say that tackling Scotland’s drug deaths crisis should be the defining mission of this session of Parliament.

Substance misuse is as acute a problem across Scotland’s justice system as it is in wider society. We must do our utmost to tackle the supply of drugs into Scotland’s prisons. By stemming the flow of deeply dangerous substances such as so-called spice, we will help to protect the wellbeing of Scotland’s prison officers, who work under extremely difficult circumstances, and those in custody.

Recent figures have suggested a fall in the quantity of drug-soaked mail that is infiltrating our prisons, which is to be welcomed. My colleague Russell Findlay pushed hard for the SNP Government to take seriously the threat of drug-soaked mail in our prisons and called for the introduction of photocopied mail procedures to disrupt the supply of illicit substances.

As Faces & Voices of Recovery UK has pointed out, not only has the UK Government’s project ADDER been effective in providing support to communities in England and Wales regarding treatment, but it has disrupted organised crime and its supply of illegal substances. As the UK Minister for Crime and Policing, Kit Malthouse, has revealed, project ADDER has already helped to seize up to 27 million benzodiazepine tablets that were destined for Scotland. The value of project ADDER is clear. As reflected in our amendment to the motion, it is deeply regrettable that, so far, the Scottish Government has not signed up to it.

Tackling the supply of such substances into Scotland’s prisons is only part of the solution. We must also focus on demand. We are clear that access to higher-quality drug treatment and rehabilitation for those across the justice system is vital, including in our prisons. Many people in custody are trapped in a cycle of substance misuse, harm and despair. Strengthening rehabilitation for those in custody will not only help to safeguard their wellbeing but give them confidence as they look to successfully reintegrate into society following their release.

Most members in the chamber are agreed that radical action is needed to stem the tide of drug-related deaths in this country. Although we make every effort to be a constructive Opposition, on this most pressing issue, it is also our duty to be up-front about where the Government is falling short, and we will continue to do that.

Photo of Gillian Martin Gillian Martin Scottish National Party

There is no escaping the fact that many in our prison population are in the criminal justice system as a result of situations that have been influenced by their poor socioeconomic situation. Many of them had a childhood filled with adverse experiences, often as a consequence of poverty, and many have problem drug use as a result of those often undiagnosed and certainly untreated childhood traumas.

Trauma-informed care is essential in all cases of problem drug use, but it is particularly so in our prison settings. People often arrive in our prisons with problems with substance use, Mr Findlay.

We have a duty of care to facilitate prisoners with problem drug use in getting well and back into society, with an improved chance of never returning to prison and of having a better life. If MAT standards—proven standards that get people well—are the goal across Scotland, they must also apply to those with problem drug use in our prisons.

Photo of Russell Findlay Russell Findlay Conservative

The member might be aware that the Scottish prison survey of 2017 revealed that 13 per cent of prisoners entered custody without a drug problem but left with one. However, it took many years for the SNP Government to finally act on drug-soaked prison mail. Does the member agree that action should have been taken sooner?

Photo of Gillian Martin Gillian Martin Scottish National Party

Mr Findlay seems to suggest that people who go to prison all come out with drug problems, but I am making the point that many people who go into prison already have serious problems with substance abuse and need help.

I will use my time to speak about prisoners with children and how effective treatment and MAT standards are particularly important in their case. MAT standards say that a person should

“receive support to remain in treatment for as long as requested.”

It is particularly important to ensure that support continues when someone is released. That is already a vulnerable time for any offender, and it is also a key time in ensuring successful rehabilitation in general.

That is particularly important for those who are returning to a family home with dependent children. I believe strongly that a key part of anyone’s rehabilitation is family support, so that they can recover from addiction and from the behaviours that led to their incarceration.

I have spoken in the chamber about how important it is that people maintain family connections while they are in prison. I have raised that issue particularly in relation to HMP and YOI Grampian and its family centre and help hub, which is run by volunteers and has faced cuts in the past, as Aberdeen City Council and Aberdeenshire Council have reduced financial support.

The family centre is a welcoming place where families can get help and support. It is also a place where visiting partners can get a cup of tea and something to eat, while kids have a wee play in the playroom, ahead of their visit to the prison estate. That environment means that soft interventions can be made, people can be signposted to services, and families are more likely to keep visiting and to maintain relationships with the family member in prison.

Outside the centre, I have spoken to families, who told me of good practice, with support being given particularly to fathers—who often had quite difficult relationships with their partners and children—so that they are assisted to play a more active part in family life. That support is facilitated by prison staff and the visitor centre, and it makes it more likely that a person will become a better parent who is ready to make a successful and permanent return to the family home. That shows that the cycle of adverse childhood experiences can be broken. MAT standards, complete with positive family access and support, are key to breaking that cycle.

I came away from speaking to families who were visiting the facility at HMP and YOI Grampian thinking that every prison in Scotland should have such a centre. I would be happy to speak to the justice secretary about the funding shortfall.

I will finish by saying how much I fundamentally disagree with the Conservative amendment, which seems to suggest that anyone in possession of class A drugs should be criminalised. Support for diversion from prosecution and the presumption against short sentences is not an ideological position; it is one that is backed up by expert opinion on successful rehabilitation. Our law enforcement resources should not be used to immediately criminalise victims of the illegal drug trade. They are often very ill and vulnerable people who, time after time, have been dealt a raw deal by society.

The “bang them up and throw away the key” ideology might play well with

Daily Mail readers, but when it comes to getting people well and improving the lives of families who are affected by problem drug use, particularly children, demanding that the state puts ill people into the justice system for possession is simply ill informed, backwards and, ultimately, the rhetoric of the angry mob.

Photo of Carol Mochan Carol Mochan Labour

I thank everyone who has spoken so far in this necessary debate for their contributions. I would like to focus on the problems that are evident in our prisons. When we talk about problems with substance misuse, we are really talking about people who have, for one reason or another, slipped through the net. In so many cases, they will encounter some form of the justice system along that path.

Fortunately, we now seem to be at the point at which the majority recognises that simply locking up someone with a serious addiction will not make that problem go away. Evidence shows that prison stays only exacerbate existing substance misuse problems, leaving a legacy of addiction and distress.

Whether prisons can be reformed to prevent that and provide the opportunity for more sustainable rehabilitation is perhaps a wider debate, but it is one that we dearly need to have. We will not be able to get through all that today, but we can say that the current model is not working.

Where there should be adequate support to get drug users back on their feet, there is far too often still more of a focus on abstinence and a lack of effective intervention to look at a person’s misuse from a long-term perspective.

Above all, the most significant barrier to any progress is the massive overcrowding within our prison system. The incredibly hard-working healthcare staff who work in prisons are already facing unimaginable pressures and, on top of that, they must manage time constraints that in any ordinary circumstances would be deemed to be completely unacceptable. There are so few of them, and so many people who need help.

As always, just like a vast number of the problems that we speak about in the chamber, we expect exceptional results, but we seem to be unwilling to fund them.

If we insist on sending so many people there, it is time that we viewed prison as a unique opportunity to address many of the health inequalities that blight the worst off in our society. However, because of the same pressures on the entire NHS, with the added problems of working in a fractious and poorly managed environment, that will always be difficult to achieve for staff who feel like they are not being supported. In order to give them that support, we need to be honest with the public that, if we are to tackle the drug problem in this country and make our justice system more effective, we will require greater investment and a much longer-term approach, which are two things that the world of politics is often poorly prepared to deal with.

If we continue to address each problem individually, it will take a great deal of time to make any headway. However, as members will expect, my position is a socialist one of understanding that the root of all these problems is socioeconomic inequality that has gone on for generations and will continue for generations to come if more is not done. If we do not seriously tackle the low-pay, high-debt, exorbitant-housing-cost society that we have built, reliance on substances to deal with the pressure will only get worse. The minute that someone is made homeless or put on the cusp of homelessness through losing a job or unaffordable rents, their mental and physical health will rapidly deteriorate and the likelihood that they will look to substances to alleviate that pressure will increase. Those are largely the people who end up in our prisons. I ask again, why are we not dealing with this problem at the source?

Scottish Labour believes that we must begin to look at the several decades in which drug misuse has spiralled out of control in Scotland, and we have come to the conclusion that that should be a top priority for every Government, not just here in Edinburgh, but also in London, and it needs to remain a priority for a long time to come.

Photo of Carol Mochan Carol Mochan Labour

There will be no overnight fix but I ask that we continue with this important work. Thank you, Presiding Officer

The Deputy Presiding Officer:

Thank you, Ms Mochan. I am afraid that we are now well over time, so I will have to insist that colleagues stick to their time limit.

With that instruction, I call Stuart McMillan to be followed by Sue Webber. You have up to four minutes.

Photo of Stuart McMillan Stuart McMillan Scottish National Party

At the outset, I remind members that I am a board member of Moving On Inverclyde, which is a local addiction service.

Like other members, I send my condolences to the families of people who have lost their lives because of drugs. Every life lost to drugs is a tragedy and one that society needs to address.

Turning substance abuse from a justice to a health priority is imperative, and that direction of travel is positive. It is vital that the treatment and recovery that is right for individuals is available at the right time. That is a crucial factor of the national mission.

It is also worth reminding members of the SNP manifesto from last year’s parliamentary elections that committed an SNP-led Government to developing a new national community justice strategy.

As the Government’s motion says,

“access to high-quality drug treatment, rehabilitation and recovery services at appropriate points in the justice system ... is vital”.

No one in the chamber can argue against that. We should all support the work that is done in our prison estate to help prisoners with addictions. Can we do more? Absolutely. We can always do more in all aspects of our lives. However, it is vital that we ensure that the cycle of reoffending is broken so that we can help to rebuild lives.

We can also all support the reinforcing of the commitment to continue to improve support for people who leave prison. One of the key ways in which we can do that is by tackling stigma. Over the years, I have spoken to various people whose lives have been blighted by addiction, and stigma has been a constant issue. If the Parliament genuinely believes that Scotland’s drug deaths situation must be dealt with, we must ask ourselves some genuinely hard questions; we must also put those hard questions to society.

Annie Wells mentioned reintegration into society. I agree with her on that, but it is crucial that we deal with stigma to help with reintegration.

It is clear that the national mission led by the Minister for Drugs Policy, Angela Constance, is leaving no stone unturned. It is essential that we work with people with lived experience. I welcome the creation of the national collaborative that will be chaired by Professor Alan Miller, and his commitment to ensure that the views of people with lived and living experience are reflected. The fact that people who have been affected by drugs are being brought together to make recommendations to the Scottish Government about changes to services can only help to improve and to save lives.

As part of the new vision for justice policy that was announced last month, the Scottish Government’s ambition, which is shared by the Convention of Scottish Local Authorities and many other partners, is to have a trauma-informed and trauma-responsive workforce across Scotland to address inequalities and improve life chances, and to ensure that services and care are delivered in ways that are informed by people with lived experience; that recognise the importance of wellbeing in the workforce; that recognise when people are affected by trauma and adversity; that respond by preventing further harm; that support recovery; and that can address inequalities and improve life chances.

Embedding trauma-informed practice will ensure that Scotland’s justice services recognise the prevalence of trauma and adversity, realise when people are affected by trauma and respond in ways that reduce retraumatisation.

Today and previously, we have heard from some members about their opposition to the new approach that the Lord Advocate has adopted with regard to diversion from prosecution. In Scotland, prosecutors are provided with a range of alternatives to prosecution, including diversion from prosecution, to respond appropriately to the facts and circumstances of each specific case. It is obvious that there is no one-size-fits-all approach and that there is a long journey ahead. However, despite the fact that there is a long journey ahead, I believe that we are now moving in the right direction.

Photo of Sue Webber Sue Webber Conservative

I draw members’ attention to my entry in the register of members’ interests: I am a councillor on the City of Edinburgh Council and a member of the Edinburgh alcohol and drug partnership.

This is a very important debate, and one that I am glad to have the chance to speak in as the shadow minister for public health, which is a role that includes drugs policy. I am just sorry that I am not in the chamber.

On the SNP’s watch, drug-related deaths have tripled, while rehabilitation services have trailed far behind. The number of drug deaths in Scotland continues to shame the nation and is a damning indictment of the First Minister having, in her words, taken her “eye off the ball”. Figures from Police Scotland show that there were 1,295 suspected drug deaths between January and December 2021, which is likely to remain the highest per capita figure in western Europe. Scotland’s drug death rate is also 3.5 times that of the UK as a whole. In addition, the latest report shows that the number of female deaths rose from 345 in 2020 to 356 in 2021, with women now making up 27 per cent of the victims. The number of women who are dying from drugs is especially worrying, and it is high time that the SNP got a grip of this sickening epidemic.

Angela Constance herself has said that the Scottish Government needs to do more to help female victims, including by providing more women-specific services. The treatment plans that are offered must be tailored to enable women to access them. For example, daytime recovery sessions need to be provided to women who have children to care for, because residential rehab programmes will not suit or be an option for everyone.

I recently visited the River Garden Auchincruive charity in Ayrshire. It is a training and social enterprise development centre that offers a residential programme for people in the early stages of recovery from drug and/or alcohol addiction. Its model has up to an 80 percent recovery rate globally on completion of the programme. The visit was fascinating and I was heartened to hear that the centre is expanding and building a women-only residential block. The feeling of calm that I experienced on arriving was noticeable, and left me in no doubt that the location and surroundings are key to the programme’s successes. Those types of facilities and programmes have been shown to be successful and should be properly funded to ensure that they continue to make strides in this difficult and challenging field.

Although not specifically related to drug misuse, I will mention an insightful study that was carried out in South Korea. The study revealed that a therapeutic community-oriented day programme resulted in continuous abstinence rates at six months that were nearly eight times higher than those in the control group. The treatment group and the control group were women. When it comes to treating dependency, we know instinctively that men and women have different needs, so we must ask ourselves what more we can do to address the needs of women.

This week, Annemarie Ward, who is a leading drugs campaigner in Scotland, expressed doubt over the latest drug death figures, warning that some overdoses may have been wrongly classified as Covid fatalities. The SNP Government said yesterday that there had been an 8 per cent fall in suspected drug deaths last year, but the head of one of the country’s top recovery charities said that reports from the front line suggest that the crisis has not improved. Remember that the numbers are still higher than in 2019.

Our focus should be on improving access to rehabilitation and treatment, and that is just as valid for prisoners. That is why I once again urge the SNP Government to back our right to recovery bill, which is backed by experts in the addiction field and would enshrine in law the right of everyone in Scotland to receive potentially life-saving treatment.

Photo of Maggie Chapman Maggie Chapman Green

I begin by restating what others have said: every drug-related death is a tragedy, and my sincere condolences go to all those who have been affected by such a death. The drug deaths crisis is a public health crisis, but it is not inevitable. We are at last seeing a shift in political positioning, from most in the chamber at any rate, about how we tackle the issue—it is high time.

As I have said before, we need a culture of care not a war on drugs, because the war on drugs has been an abject failure in restricting the use of drugs and in protecting individuals and communities from their harm. Criminalising users and petty suppliers rather than seeking solutions to the deeper problems that underpin substance use has not worked.

We need to understand and tackle the underlying causes of people using drugs and developing addictions if we are to deal effectively with a crisis that is not inevitable. That means having holistic interventions that do not treat the substance use or dependency in isolation but consider all the person’s experiences and challenges, including their economic conditions, housing situation, family relationships and much more.

Drug dependency is like the canary in the mine for trauma, poverty and other social ills. It is a long-term and complex issue and can be fully tackled only when recovery happens at every level of a person’s life. Addressing substance abuse issues in that context can bring significant co-benefits in terms of better stability, health and so on, and it means, as the cabinet secretary outlined, rethinking our approach across the justice system.

Prison is not a good place to be; I get that that is the point, but when it comes to dealing with substance dependency issues, prison might be the worst place for someone to be. There are high levels of drug use among people arriving at prison, while they are incarcerated and on leaving prison, including many whose substance use begins for the first time in prison. Drug deaths are especially high while people are incarcerated and after they are released.

People in prison need support that meets their individual needs and focuses on their challenges in a trauma-informed and person-centred way.

We must consider issues to do with demand. Isolation, long periods of being locked in a cell and a lack of appropriate activity all make it more likely that people in prison will turn to substance use. Rigid drug testing in prisons might dissuade people from seeking help or encourage them to use less detectable and perhaps more dangerous substances.

Levels of reoffending are directly related to the level of post-release support that is available, so co-ordination between and across agencies is vital, including links to appropriate community support.

There is significant evidence that interventions in prison tend to be less effective than those in the community. They are definitely more costly. That is one of the reasons why community justice and other alternatives to prison are so important in our collective, cross-departmental efforts to tackle drug deaths and substance addiction, as well as the causes of criminal behaviour.

Addressing people’s substance abuse problems requires work at community as well as individual level, using a wide range of policies and systems. We need to ensure that approaches take account of people’s age, gender, race and so on. Strict treatment orders might not work for some people, especially young people. Residential treatment might not be suitable for people who have caring responsibilities or concerns about losing their tenancy.

We must ensure that appropriate resources are available in the community sector, as well as in our police and prison services. We must acknowledge the connections between all Government departments and the importance of a whole-Government approach. Only then can we tackle what is a public health issue with care and humanity.

Photo of Elena Whitham Elena Whitham Scottish National Party

I live beside a church that has a very old cemetery, which contains several covenanter graves. Despite the sterling efforts of the church and local authority, there are times when the cemetery needs extra attention to ensure its upkeep and preservation.

Last year, as I walked past on the way to the shops, I could hear chattering voices, accompanied by the sound of power tools and lots of activity. I keeked in the side gate and saw a group of folk hard at work tending the cemetery and engaging in jovial conversation. “Great to see”, I thought.

On my way back from the shops a wee while later, I found myself on the lane behind a woman who was carrying a shovel over her shoulder and singing to herself as she made her way to the workers’ vehicle. She blushed when she saw me and said, “I was having such a good day that I just had to sing.” She went on to say that she was doing community service. She was almost apologetic about it. The stigma that she felt was writ large across her face. She had gone from being so happy that she was singing to being embarrassed about why she was there that day.

I responded positively. I said thank you to the entire crew for making such a wonderful job of the cemetery. I said that she should be proud of what she had achieved that day and that she should never let anybody stop her singing.

I walked home thinking about how it is the small things that make all the difference to an individual’s feeling of self-worth and about just how much stigma impacts on a person’s ability to enter and sustain recovery and avoid repeated interactions with criminal justice services.

Later that evening, I posted photos and a thank you on social media. The posts were positively received by the wider community and I hope went a wee way towards breaking down the layers of stigma.

I worked for many years supporting people who face addiction, homelessness, grinding poverty, mental health issues and multiple and complex trauma, so I fully understand that someone’s self-worth all but disappears when they face a world full of chaos and repeated periods of incarceration that make any chance of entering and maintaining recovery seem almost impossible. I saw that time and time again.

There is no doubt that trauma and poverty, exacerbated by stigma, can lead someone to self-medicate as they seek to blot out things that they are unable to work through. Those can be the people who enter the revolving door of incarceration, liberation, problem drug use and homelessness.

Although not everyone who experiences trauma ends up in that situation, just about everyone in that situation has experienced trauma. That is why the issue must be seen as a public health emergency and a national mission.

We must move away from a justice system that retraumatises people, which is why I fully support the Scottish Government’s new vision for justice, which has at its heart a trauma framework, in which staff are given the knowledge and skills that they need if they are to embed trauma-informed practices.

Recognition of the prevalence of the trauma and adversity that people who interact with the criminal justice system have experienced will help us, as a nation, to tackle repeat offending and—importantly—our drug deaths. Those deaths are a national loss. The enormity of that loss is felt keenly by the families who are affected, but we need to recognise that, as a country, we have lost far too many people and, with them, all their hopes, dreams and talents.

There is no one-size-fits-all approach to this, but a combination of access to same-day treatment by embedding the MAT standards, widening access to rehab, diversion from prosecution, the navigator programme, a nationwide naloxone roll-out, meaningful and funded community justice options and funding facilities such as the River Garden centre in my constituency, which Sue Webber mentioned, gives us the best chance of preventing the worst outcomes. Members should make no mistake: community justice and diversion from prosecution are not soft justice; they are smart justice.

Photo of Michael Marra Michael Marra Labour

In recent years, there has been an unacceptable increase in drug-related harm in our prisons, with an eighteenfold increase in drug seizures within a year. There has been an increase not only in street Valium and synthetic cannabinoids but in psychoactive substances and cocaine. Synthetic cannabinoid and benzodiazepine mixes are emerging in prisons and, to be frank, we have no idea what they do to people.

Like Scotland’s streets, Scotland’s prisons are awash with drugs. I do not say that for controversy or headlines. We must accept the reality of the situation if it is to be dealt with. The latest Scottish prisoner survey sets out that four prisoners in 10 had used drugs during their time in prison.

The research group that I ran at the University of Dundee analysed children’s drawings that were soaked in psychoactive drugs, dried, posted to prisons and then smoked. The Government has taken action to deal with that by enabling the photocopying of mail. However, for every solution, there will be another cunning means of dealers accessing a captive marketplace where losing yourself from the daily reality of a limited life is a premium product. For example, photographs being received in the mail are being used in the same way but are classified differently—as personal possessions rather than mail.

I ask the cabinet secretary to consider piloting a waste water analysis scheme in the prison estate in Scotland to best identify the types of drugs that are in circulation. The Scottish Environment Protection Agency certainly has the capability to work with analysts to put that in place in short order. Rapid analysis could help with health measures. Understanding what someone has taken is vital to ensuring that they receive appropriate healthcare and can also help with behaviour management, as some substances result in higher levels of aggression towards staff and other inmates. I would welcome the cabinet secretary’s response on that suggestion.

Just as on Scotland streets, that all equates to an incredible loss of human life and potential and it tears families and communities apart.

In preparing for the debate, I asked the Scottish Parliament information centre for information on the number of citizens who enter prison clean of drugs and emerge with drugs problems. It told me that that data does not exist. Mr Findlay quoted a figure of 13 per cent from 2017. It is my understanding that that relates to England and Wales, not Scotland, and that no analysis is captured here. Perhaps we can compare notes on that after the debate.

Citizens are at their most vulnerable when they emerge from the prison estate. Many have no real home to go to or productive way to spend their time and, with the stigma that surrounds them, which we have heard about frequently in the debate, they are very susceptible to falling back into drug usage with reduced tolerance levels. Overdose is common.

In preparing for the debate, I asked SPICe for information on the number of citizens leaving prison who rapidly overdose. That data does not exist either. Data that is now five years old shows that Scotland’s drug deaths have an inherent connection with prison, with more than half of the people who have lost their lives having been in prison before. It is such a common factor and readily identifiable, but nothing is done to identify the people for whom the impact is immediate and severe. That is an intolerable dereliction of the state’s duty of care, but it is being tolerated daily across Scotland.

The figures that we have seen in recent days on suspected drug deaths show that there is the possibility of some very limited progress, but we must know why and where. If something has worked, how can it be replicated? If change is driven by external factors in the drugs market—whether issues of purity, supply or myriad other possibilities—what controlled analysis can be undertaken so that those factors can be acknowledged? If we do not do that, we cannot lock in any progress.

The Deputy Presiding Officer:

Stephanie Callaghan is the final speaker in the open debate and joins us remotely.

Photo of Stephanie Callaghan Stephanie Callaghan Scottish National Party

I thank Keith Brown for bringing this important Scottish Government debate to the chamber.

A public health emergency currently ravages Scottish communities. A Police Scotland report shows that there were 1,295 suspected drug deaths in 2021. So many mothers and fathers, brothers and sisters, friends, neighbours and colleagues—all gone too soon.

The Scottish Government and everyone in the chamber knows that we can and must do better. Funding is hugely important and we need to better understand where and how that money is spent, and what difference it is making to people’s lives. Audit Scotland recommended greater transparency and the Scottish Government has taken that on board, because we need to understand what is working well and what is not, and the impact that policies have on lived experience.

We all want to see our national mission dramatically cutting drug deaths—and quickly. I am sure that I am not alone in often feeling that we are not going fast enough but, at the same time, I understand that we need all the research, strategic thinking, data collection, targets, and systems for measuring progress—all the number crunching and stats—to help us to save lives.

The role of the justice system is a critical pillar of our mission, and people who face the justice system and have challenges around substance misuse need and deserve access to the treatments that work for them. Our priority must be to divert vulnerable people away from prisons and into treatment, wherever that is possible. Continuing to embed the new medication-assisted treatment standards reinforces a rights-based approach to treatment, and the standards help to frame our entire response, encouraging flexibility and urgency. There is no one size fits all, and equal rights to access treatment are key. High-quality drug treatment, rehabilitation and recovery services must run through our justice system, including prisons and police care, as members have said.

International evidence is clear. Prison damages people: people lose their homes, and imprisonment weakens social ties, limits employment, breaks up families and creates a stigma that can be hard to escape. Ultimately, prison sentences increase the likelihood of continued drug use.

Stigma does not stop with people battling drug misuse—at times, it extends to those working to support and help them. Why? It is because stigma is cumulative and long lasting, and society has treated substance users with disdain and disgust for a very long time, often viewing them as worthless. Although Scottish Government policy now frames drug use as a health issue, many in society too often regard vulnerable people as criminals, rather than people who need help. The time to remove stigma is now, and we in this chamber have an important role to play. We can highlight how providing access to different forms of justice, including non-legal solutions, and following up with personalised drug, alcohol and mental health services really helps to address the underlying causes of offending, which helps to keep our communities safer places.

We must celebrate the success of people who move beyond problem drug use. Just over a week ago, I attended the funeral of an amazing woman—my friend’s mum—who struggled with drugs misuse for decades and later became very involved with church life and helping others. I joined her children, grandchildren and other family and friends to celebrate her life. The eulogy was beautiful. It faced her struggles with drugs head on and pulled no punches around trauma. More than anything, it captured how she made people feel: warm, accepted, supported and valued. She was a real character and free spirit until the end, but she made you feel comfortable in your own skin. She struggled with drugs, but she also had an amazing heart. She was not a bad person.

We need to help people to rebuild their lives. We need to normalise helping people in need. We need to be leaders in policy and break away from convention. We need to do whatever it takes to tackle this public health emergency—for all our sakes.

The Deputy Presiding Officer:

We move to closing speeches.

Photo of Baroness Katy Clark Baroness Katy Clark Labour

All in this chamber know the statistics that say that Scotland has by far the highest drug death rates recorded anywhere in Europe, and that last year there was a record number of deaths for the seventh year in a row. The number of drug-related deaths is now almost three times higher than it was a decade ago, but we discuss the problem as if it is new.

We have been here before. Damning reports are published, strategies are announced, working groups are established and recommendations are made. As Alex Cole-Hamilton said, the problem is implementation.

The cabinet secretary is correct to say that a trauma-informed and person-centred approach is not a soft option and that individuals must be treated with respect. As Claire Baker, Maggie Chapman and many others have said, we need a public health approach.

It is right that we question why Scotland has the highest drug death rate in Europe. It is clear that tackling substance use will require policies that address poverty, deprivation and Scotland’s wider health inequalities, which Carol Mochan spoke about. As Elena Whitham said, we know that people with serious drug addictions often also have mental health issues. More often than not, they have also experienced trauma. Many of them have faced grinding poverty and the knock-on effects of a lack of hope or aspiration for a decent future. Scotland has almost 60,000 people with a drug problem, and every person with a drug problem has many friends and relatives who are also affected by that drug use.

We need to listen to what the experts are saying. Many members have highlighted the action that needs to be taken. Audrey Nicoll spoke about the work of the Criminal Justice Committee and the need for alternatives to custody. Annie Wells spoke about the importance of access to rehabilitation. We simply do not have enough people in treatment. Scotland has only about 40 per cent of people in treatment at any one time, whereas the figure in England, for example, is 60 per cent.

There is a clear link between drug taking and committing offences. In the past 10 years, the percentage of people testing positive for illegal drugs on entering prison has ranged between 70 and 78 per cent. As Michael Marra discussed, new psychoactive substances have become an increasing problem, and many believe that they are now dominant in prisons. We know that drug use continues to be a significant problem in prisons. The latest drugs survey, which Michael Marra also referred to, identified that about two fifths of people had used illicit drugs in prison at some point.

As a number of speakers highlighted, there is a lack of support in prison. Prisoners need support to come off drugs—support that must continue when they are released, as Stuart McMillan said. Back in April 2020, the Drug Deaths Taskforce recommended that there should be

“adequate throughcare provision ... available to prisoners on liberation”.

We all accept that those who leave prison and are relocated in communities are not receiving throughcare in the numbers required. It is important to address not only the risk of death from overdose in prison but the risks in the months after prisoners leave custody.

We know that we face major challenges that will only be addressed with policies that are underpinned by sufficient investment. We also know that prison is more expensive than the alternatives to custody, but Scotland continues to send the highest number of people to prison in western Europe.

I believe that the Scottish Government has many of its policies in this area in the right place, but that it simply has not been implementing those policies. It has the support of Scottish Labour to implement them. If the disconnect between what is said in the chamber and what actually happens in reality in the justice system was addressed, that would make a massive difference to thousands of people in the prison system and to many more in communities up and down Scotland.

Photo of Jamie Greene Jamie Greene Conservative

There is a depressingly familiar ritual in Scottish politics that takes place, most often in the chamber, when drugs statistics are released. There is cross-party shock and horror; there is an acceptance that we should all do more; there is even an acceptance that we could work a little bit more constructively and collaboratively; and there are promises from the Government of more action and more money. Today’s debate has followed that very predictable tone.

However, the debate is repeated every year because although the scale of the problem is immense, the scale of the solution has never matched it. Had it matched the scale of the problem, the numbers would have already been falling.

Last year, according to Police Scotland, we lost 1,295 lives to drugs in Scotland. Of course, if there has been a reduction from the record high that we saw in 2020, that is very welcome, but there are two brief notes of caution in relation to the statistics. The first is that the Parliament has previously used National Records of Scotland figures as the metric for comparison rather than Police Scotland figures, so let us wait until the NRS figures are published. We should tread carefully before then.

Secondly, even if there is that welcome reduction—I really hope that there is—the number still remains the highest in Europe, and it still remains 3.5 times the rate in the rest of the UK, even against the backdrop of the same legislative environment, which is a point that Claire Baker made.

Of particular concern is the rise, according to those figures, of 3 per cent in female drug deaths last year. Of course, most drug deaths involve men, but there is a real and damaging effect on women across Scotland—not just on women who suffer from addiction, but on women whose partners or family members do.

We need to make sure that our response is tailored to individual needs. Sue Webber made the important point that residential rehab programmes, for example, are not always suitable for women, mothers or those with childcare responsibilities. I was struck by the example that she shared of good work and good practice at the River Garden centre in Ayrshire. In helping constituents and others, I have seen the good and the bad of rehab services. It can be a game changer; it can literally be a life saver as well.

Audit Scotland’s review of drug and alcohol services, which was released just a few days ago, must have made difficult reading for the Government. The review is not just worrying; it paints quite a grim picture of services in Scotland. High-risk alcohol use and problematic drug use remain stubbornly high; drug-related deaths and hospital admissions are increasing; and, as we already know, problematic alcohol and drug use disproportionately impacts our most deprived communities.

As Audit Scotland also points out, in 2015, there were 706 tragic drug-related deaths; by 2018, that number had risen to 1,200; and by 2020 it had almost doubled. At the same time, there had been a 20 per cent cut in funding to ADPs, from £70 million in the previous two years down to £53 million in 2016-17. I am sorry, but if funding to ADPs is cut, it cannot be a huge surprise that, in the years that follow, there will be a rise in these horrific statistics. That is not taking your eye off the ball; it is taking your pen off the cheque book. That has been the problem, which is a point that many of us have raised consistently, year after year.

That is why our right to recovery bill is important. It is not just a press release; it would provide a statutory right for addicts to receive addiction services and would ensure that our recovery services are best equipped, resourced and funded to meet individuals’ needs. Currently, only one in seven residential rehab beds is publicly funded. No one in Scotland should be denied treatment because a place is not available to them or because they do not have enough money to fund it themselves. That is a shocking situation to be in.

I say to Gillian Martin that our right to recovery bill would cover those who are in prison, because they have just as much of a right to recovery as anyone else. On a committee visit to HMP Edinburgh, I met some inmates who had been getting addiction services. That was great—it was positive to hear those stories of recovery. Equally, it was shocking to be told that it is easier to get drugs in prison than it is to get them on the streets. In fact, we heard that there are people who enter prison with no drug problem—people who had never even tried drugs—and who leave with a drug problem. That is shocking.

I welcome the Government’s commitment to improve access to support and throughcare for those leaving prison. I am happy to work with the Government in a positive and constructive way on all of that. However, we cannot agree with every step that it has taken. I think that there has been a wrong turn in relation to the changes in how front-line officers deal with class A drugs. I think, arguably, that the changes have made it difficult for law enforcement to stop criminals both supplying drugs to vulnerable people and using vulnerable people to get their drugs on to the streets.

Photo of Jamie Greene Jamie Greene Conservative

If I had any time to give, I would love to have a proper debate. I apologise to the cabinet secretary, although I would be happy to have the conversation with him

We have not heard today about getting drugs off our streets in the first place. They do not magic themselves there. There are wholesale factories in the UK and across Europe that are making pills by the millions. Heroin and cocaine are getting out of the continent and into our islands. Tackling that at the highest echelons surely must feature somewhere, yet we have heard nothing about it in the debate.

I will give members some statistics Since diversion from prosecution started to be used for possession of class B and C drugs in 2016, the number of people who have been caught in possession has increased. In 2016-17, the number was 21,300. Following the change in policy and in policing approach, in 2019-20, the possession rate went up to 22,900—so nearly 23,000. Is that approach working? If the premise of diversion from prosecution is that it leads to reduction in usage, why are the numbers increasing rather than decreasing?

We have heard many good speeches—I do not have time to go into them in detail. Brian Whittle talked about diversion from prosecution. Annie Wells and Michael Marra spoke about stopping drugs getting into our prisons. When one door is closed, surely another one will open, given that serious organised criminals will do what they can to ensure that their product is still punted to those who want it.

I will close with the words of Stephanie Callaghan, whose gave a notable, emotional speech in which she reminded us that behind every statistic is a person—a friend, a colleague, a family member. We could and should remember that a little more.

The scale of the challenge must be matched by the scale of our response and of our ambition, as well as the scale of Government investment, top down and right to front-line services.

I say to the cabinet secretary and to the Government that it is too late for some, but it is not too late for others. They need to get that money to where it needs to be, because if that does not happen, the figures are never going to drop.

I thank members for their contributions today.

Photo of Angela Constance Angela Constance Scottish National Party

I will start by quoting a mum called Libby. I do not know her, but she replied to one of my social media posts on the suspected drugs deaths figures for 2021. She said quite simply that

“one life lost is one too many.”

To reflect on the reduction in reported suspected deaths by Police Scotland, we know that we can overread the statistics. That information is being published more regularly, at the request of the Parliament, for more timely reporting, but of course, we wait for the confirmed drug death statistics that will be published by the National Records of Scotland in July.

The harsh reality is that the death toll is heartbreaking and every life lost will always be one too many. There is no complacency, there can never be any conceit or acceptance that the status quo is hopeless or that it cannot be changed, because it can be.

Our priority in the national mission is to be relentlessly focused on getting more people into treatment that works for them. In addition to our work to embed MAT standards and invest in and expand residential rehabilitation, I am pleased to announce a new target to get more people into protective treatment. Again, that is something that I promised the Parliament.

Around 90 per cent of all drug-related deaths involve opiates; therefore, the first phase of our challenging new target will be to get people into community-based opiate substitute therapy. Currently, 29,500 people are in receipt of OST, and we have a new target to increase that by almost 10 per cent to 32,000 people by 2024. For some areas, such as Glasgow, that will mean that they will have to get 500 more people into treatment.

There is a wealth of international evidence that supports OST and we need to be fearless in challenging the stigma around it. Equally, I want to be clear that prescribed drug treatment is not, and cannot be, the only treatment option that is available, hence our commitment to standards on options and choices, including abstinence-based recovery.

Photo of Claire Baker Claire Baker Labour

I welcome the target that has been set. Can the minister confirm that that would include access to Buvidal? An update on progress with heroin-assisted treatment would also be helpful.

Photo of Angela Constance Angela Constance Scottish National Party

That is an important point in relation to MAT standards and choice. We know that some of the work on the introduction of Buvidal that took place in prisons during the pandemic showed that, for some people, that was a more optimal treatment choice.

We continue to engage with health boards that have shown interest in heroin-assisted treatment, but we need to turn that interest into a commitment to expand that treatment option. I recently had the great pleasure of visiting the heroin-assisted treatment project in Glasgow; its evaluation is due soon and I am really hopeful that we can use that to get other projects over the line. We have some financial resource committed to that.

Phase 2 of our treatment target will be to expand the target to include all drugs, including alcohol. I have written to the Health, Social Care and Sport Committee, to offer to brief its members in much more detail on the treatment target and to talk about the Audit Scotland report.

We have started—and will continue to pursue—a wealth of work around accountability, governance, value for money and better use of data. I welcome the Audit Scotland report, paragraph 16 of which acknowledges that, from 2015-16 to this financial year, there has been a 67 per cent real terms increase in funding.

As well as the gathering and publishing of more information than ever before, and the record investment made this year, of equal importance are accountability, transparency and measuring impact, in order to ensure that we make every penny count. Part of the planning work for my officials and me is to bring forward that cross-cutting plan to ensure that the national mission is kept on track, that it is of sufficient breadth and depth, and that it cuts right across the areas of prevention, early intervention, recovery-orientated care, the public health approach, justice, mental health, family support and the reduction of social harms.

Photo of Angela Constance Angela Constance Scottish National Party

Absolutely—I was going to get to the member’s point.

Photo of Brian Whittle Brian Whittle Conservative

On the point about transparency, I know that the minister agrees with me on the importance of the third sector, but perhaps the money that the Government intends to get to the third sector, does not always get there. Is there a way that we could track the money better, to make sure that it gets to those third-sector organisations that do so much good in this area?

Photo of Angela Constance Angela Constance Scottish National Party

In short, there is a way. We have made significant commitments and we have significant funds to support the voluntary sector, but we can do much more to assist that work and improve transparency, particularly in relation to the funds that are routed through alcohol and drug partnerships.

I was also really pleased that Sue Webber has visited the River Garden project in Ayrshire. She might recall that, the last time that I was on the front bench in the Parliament, we made an announcement of significant funding for the River Garden project to assist it, among many other things, to accommodate more women.

I will say a quick word about young people, because there is a relationship between increased hospital admissions—whether they are to accident and emergency or psychiatric wards—in relation to the use of drugs such as cannabis that are involved in a deterioration in the mental health of young people. That is why we need more age-appropriate services. Work is under way, and I have answered many written parliamentary questions on the point, tabled by Claire Baker. However, we also have to be clear that it does not help young people if we push them up tariff in the criminal justice system, with convictions in and around the possession of drugs. Instead of debating what is best for young people, some of this debate has been about a mischaracterisation of the option of recorded police warnings. We need to be prepared to debate drug law reform at both a Scottish Government level and a UK Government level. I am interested in pursuing discussions with Claire Baker and Alex Cole-Hamilton about ensuring that we do that in an evidence-based way and in a collaborative fashion.

The international evidence is clear that excessively punitive measures increase harms. Harm reduction is effective in reducing deaths and diversion works in reducing reoffending. On a more collegiate note, with regard to project ADDER, we participate in the learning networks, so we monitor and keep an eye on developments elsewhere.

The issue with the Misuse of Drugs Act 1971 is that it limits the full implementation of a public health approach and the re-orientation of practice. There needs to be a much wider cultural change. The focus needs to be on not criminalising people with multiple and complex needs who have experienced serious disadvantage, but tackling the underlying causes, whether they are adverse childhood experiences, trauma, poverty or inequality. The Government invests around £2.5 billion of its budgets to support low-income households.

Photo of Angela Constance Angela Constance Scottish National Party

We all accept that jail is for serious offenders who cause serious harms. For others, prison is an expensive means of making matters worse.

The Deputy Presiding Officer:

That concludes the debate.