National Drugs Mission

– in the Scottish Parliament on 24th November 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-06924, in the name of Angela Constance, on the national drugs mission: taking concrete action to tackle stigma.

I ask members who wish to speak in the debate to please press their request-to-speak buttons. I call Angela Constance to speak to and move the motion for around 12 minutes.

Photo of Angela Constance Angela Constance Scottish National Party

Scotland still faces a public health emergency and every single life lost to drugs is as tragic as it is unacceptable and preventable.

Today, Parliament will give voice and view to the work we can and must do in Scotland to end the shame of stigma, in advance of the Scottish Government’s stigma action plan, which will be published at the start of next year alongside our fuller response to the final recommendations of the Scottish Drug Deaths Taskforce.

People who use drugs have often experienced childhood trauma. Every week, I meet people with drug problems who have been burdened with the additional trauma of being stigmatised. This week, I met with a women’s lived experience reference group in Glasgow and heard of the specific challenges faced by women, particularly mothers, who use drugs. No one, be they a parent, child, friend or loved one, should be blamed, shamed or labelled. No one coping with a life-affecting health condition should have to fear losing their children because of stigma.

Let me be categorical: blame and shame have no place in our society or our system of care. No drug law, policy or practice should have the effect of undermining or violating the dignity of any person in Scotland. The truth is that stigma kills. Every day, it hurts and damages vulnerable people and those who love them. It stops people from seeking support and shoves barriers in their faces when they do. It stops people from thriving and prevents them from reaching their true potential.

Drug dependency is, in many cases, a long-term and life-affecting health condition that disproportionately impacts people in our most marginalised and vulnerable communities. We must therefore recognise that actively fighting stigma is a crucial component of a human rights-based response to Scotland’s drug death crisis.

Stigma is fed by the myth that addiction is a choice and that people can stop using drugs if only they try hard enough. Some people try drugs or use them occasionally; others use them to cope with trauma or pain. No matter the reason, no one chooses addiction.

We do have a choice, however. We must choose to actively fight stigma and not to view it as something inevitable about our country. Scotland can build a society that does not project our own fears on to people who use drugs. We can be a country that does not stigmatise or discriminate and that recognises our human duty to respond to the drug emergency with kindness and compassion. We can all learn.

Photo of Clare Adamson Clare Adamson Scottish National Party

Earlier this week, my staff and I attended Recovery Scotland’s inaugural football competition in Motherwell. It brought together organisations that work to support individuals and it celebrated people who are on the recovery journey and who took part in the tournament. More than 70 people took part and the event brought the community together with people who are on that recovery journey. It was wonderful to see so many families supporting those people. Does the minister agree that that is an excellent way to challenge stigma and to celebrate and support those who are on the journey to recovery?

Photo of Angela Constance Angela Constance Scottish National Party

I absolutely agree that visibility of the recovery community is vital in demonstrating that people can and do get better and that there is, indeed, hope. I congratulate Ms Adamson’s constituents on holding that football tournament.

Scotland has begun some crucial work. The recent social attitudes survey showed that, during the past decade, attitudes towards drug use have moved away from blame and criminalisation towards compassion and understanding. Sadly, the same survey also showed that fear continues to exist and that stigma is still a part of how we as a society respond to people who use drugs.

S tigma is not only about attitudes but about how those attitudes become embedded in public services that treat people differently, on account of their drug use, from how people with other health conditions would be treated. To end that discrimination, we must take a hard and uncomfortable look at ourselves. We must actively include people who use drugs, wherever they are excluded, by working together across all sectors, not only public services.

Photo of Claire Baker Claire Baker Labour

I will talk about this in my speech, but does the minister support a greater number of general practitioners becoming involved in care? Given that GP practices are located in communities, I think that that would be a way to help to address some stigma issues.

Photo of Angela Constance Angela Constance Scottish National Party

I think that GPs are crucial to providing stigma-free primary care. We can, of course, discuss that later.

I am committed to publishing a stigma action plan that will build on the principles that are set out in the Scottish Drug Deaths Taskforce stigma charter from 2021. The founding principle of our stigma action plan will be that this is everyone’s responsibility. I know that members are aware of the limitations of the disability regulations that have been issued under the Equality Act 2010, and the task force recommended that the exemption that singles out people with substance dependency be removed. Although the power to do that does not reside in this Parliament, and I cannot change the regulations, I can continue to call on the United Kingdom Government to remove that exemption, which excludes people with drug and alcohol dependencies from the protection of the Equality Act 2010.

However, we can go beyond that. The 2010 act lays out a base level of protections, but there are further steps that we can take. We can do more. We can understand that substance dependency is a health condition. We can accept not only that people who are experiencing dependency are deserving but that they have a right to equality, dignity, respect and good health. We can choose to acknowledge that substance dependency is not a moral failing but a health condition, and we can choose to support people with that health condition just as we support other people with long-term, life-affecting conditions.

Photo of Angela Constance Angela Constance Scottish National Party

I will, but I ask the member to be brief.

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

I absolutely support the minister’s efforts in that regard around the Equality Act 2010. Does she agree that identification is still key and that unresolved childhood trauma can lead to substance use in later life? Does she agree that we need to do more to capture and record adverse childhood experiences so that we can get help to people?

Photo of Angela Constance Angela Constance Scottish National Party

In short, yes. We may debate how best we can do that, but my short answer is yes.

I will now outline the basis of the stigma action plan as a step towards our vision. It will establish a national programme with four key stones in its foundation. The first will set out what we—each of us—can do now. We own our actions, learning and language, which means that we must recognise the ways that we other and exclude people. We must challenge stigma and discrimination whenever we encounter them. In short, we must become allies.

The second action will outline concrete actions that are under way in the Scottish Government to tackle stigma internally and in statutory services. We recognise that, as an organisation, we have a long way to go. I am committed to the Scottish Government becoming an exemplar as an anti-stigma organisation and leading by example, so we are reviewing and updating our policies and ways of working across Government.

The third cornerstone will be an accreditation scheme for organisations that will aim to break down structural stigma. Organisations will be challenged to identify and remove ways of working that exclude people with problem substance use. That will include taking defined, measurable and reportable actions to remove those barriers. We want to ensure that organisations treat dependency in the same way as any other long-term, life-affecting health condition.

Photo of Angela Constance Angela Constance Scottish National Party

I am almost out of time. I am so sorry.

The fourth platform is the delivery of a programme to tackle social stigma. We will build on the success of our stigma awareness media campaign, which took place in 2021. That work will include innovative and proactive ways of challenging public stigma and we will celebrate individuals’ success in their recovery in its many forms. The national programme will encourage us all to examine our assumptions and the harms that are caused by stigma.

The Scottish Government will set a high bar. We do not want those who are affected by substance use to be discriminated against because of their health condition and we will work towards becoming a nation that does not condone the blaming, judging or shaming of people because of their health.

Scotland has set out an ambitious way forward for respecting and enhancing human rights, and the forthcoming human rights bill will give effect to a range of internationally recognised human rights in Scots law. They include the right to the highest attainable standard of physical and mental health and the rights to adequate housing and an adequate standard of living.

The incorporation of those rights into Scots law, through the bill, will play an important role in tackling the stigma of substance dependency across Scotland, by ensuring that everyone’s human rights are respected, protected and fulfilled.

People who are affected by substance use should not be penalised if, as many health conditions do, it affects their ability to attend appointments or to meet arbitrary criteria for support. We cannot punish people because they do not fit into a service model.

Through the national collaborative, people with experience of problem substance use will set out how human rights can be better implemented in the sector. Applying a human rights-based approach is about empowering people to know about and claim their rights, as well as being about preparing organisations to fulfil their obligations. It will also ensure accountability when the system fails. That will set the vision for how human dignity and rights can underpin all services that are needed by people who are affected by problem substance use. It will help to bring about the necessary shift in power and culture.

At the start of my statement, I talked about meeting many people who have experienced trauma. I have also met many people who have overcome such trauma. The power of the visibility of the recovery community is inspirational and can be a catalyst for change, as people can and do recover. However, it also reminds us that those people have overcome significant stigma in order to achieve their recovery.

We must all ensure that everyone who uses drugs is afforded the human rights and dignity that they deserve, no matter where they are in their journey. We must ensure not just that everyone is given the opportunity to achieve the highest attainable standard of mental and physical health, but that they are supported, with compassion, dignity and respect, to do so.

I look forward to contributions from across the chamber.

I move,

That the Parliament acknowledges that stigma prevents people from seeking the help and support that they need and that using language that de-humanises people is harmful; recognises that tackling stigma is everyone’s responsibility and that the existence of stigma diminishes all communities as it creates unreasonable and unnecessary barriers for people in all aspects of their lives; agrees that problem drug use is a health issue and that people who experience it deserve parity of treatment as with any other long-term, life-affecting health condition; believes that every individual’s experience of recovery is unique and should not be stigmatised, and that people with experience of problem drug use and their families should be treated with dignity, respect and equity; recognises that treating substance dependence as if it were included as part of the protected characteristic of disability, would contribute to a more fair and just society; supports strengthening the meaningful involvement of people with experience of problem drug use in their local communities and wider society in the development and implementation of policy; calls on all MSPs to lead by example in challenging the stigma of people who use drugs and their families, and welcomes the planned publication by the Scottish Government of a Stigma Action Plan, which should embed these principles and drive action on the stated commitments.

Photo of Sue Webber Sue Webber Conservative

Under the Scottish National Party, the numbers of drug-related deaths have spiralled out of control. The SNP’s current strategies to help those who are struggling with addiction are failing. Despite multiple SNP action plans, Scotland’s drug death rate is still the highest in Europe, and it is 3.7 times higher than that of the UK as a whole. That scandal is Scotland’s national shame, and we cannot go on like this. Lives are being lost, and families are being torn apart.

Everyone is unique, with a specific set of circumstances and a background that may or may not have been involved in triggering their addictive behaviour.

Time and again, when speaking to constituents, patient advocate groups and families whose loved ones are desperately trying to access rehabilitation and recovery services, I hear at first hand about the implementation gap. That gap between the aspirations and plans that have been laid down by the Scottish Government and what has actually been delivered is vast.

We do wrong by persistently and consistently having static services, unclear care, complex pathways, and processes that are clunky and anything but flexible. Flexibility is key if we are to truly have person-centred care, with the person genuinely at the heart of the delivery of services.

Constantly, I hear of frustration, exasperation and the harsh realities of the difficulties, barriers and walls that are put in people’s way, preventing them from receiving quick access to rehabilitation services for alcohol or drugs. As the minister stated in her opening remarks, that reinforces stigma.

We must be clear. In March, Audit Scotland’s “Drug and alcohol services: An update” found that only 35 per cent of the 60,000 people with drug problems in Scotland are in treatment, compared with 60 per cent in England. A report from drug campaigners and recovery experts claims that Scotland’s politicians have “forgotten” about the drug death crisis. I want to make it clear that I have not.

The Faces & Voices of Recovery UK one-year report, published this week, states that there has been “almost no progress” towards reducing the rate of drug deaths in Scotland—the worst rate in Europe. FAVOR’s “Blueprint to Save Lives” makes six key recommendations to improve the current addiction, recovery and treatment system. The recommendations are:

“Introduce a clear definition of a residential rehabilitation place ... Introduce a centralised referral and funding system to end the postcode lottery to residential rehabilitation ... Introduce guidelines to ensure that psycho-social and mental health support is provided alongside substance management and pharmaceutical treatment ... Introduce statistics to measure the number of people waiting more than six months, 12 months and 24 months for residential rehabilitation places”.

Photo of Emma Harper Emma Harper Scottish National Party

The member talked about a person-centred approach. Residential recovery is one approach, but does she agree that a tailored approach might need to be taken depending on where a person is in Scotland—whether they are in a rural or an urban area?

Photo of Sue Webber Sue Webber Conservative

Yes. In the opening part of my speech, I said that everyone is unique. All individuals need tailored packages so that they are not left jumping through hoops to get support.

The fifth recommendation is:

“Introduce a Right to Recovery Bill to ensure that the Scottish Government MAT Standards are actually implemented”, and the sixth is:

“Return to community not centralised services.”

FAVOR Scotland’s chief executive officer, Anne Marie Ward, said:

“We hoped government investment and the introduction of new guidelines would improve things but unfortunately, the system remains as broken today as it was a year ago.”

Although there has been a slight decrease in the number of drug-related deaths, it should shock us all that a disproportionate number of women are included in the drug-related deaths, and that that number is increasing. Often, those women have children, which can stop them seeking help, as they do not want to be stigmatised or risk having their children taken away. A system to enable people to access services that suit their family circumstances has been poorly developed, but that is essential if we are to save the lives of those women.

Harper house in Saltcoats, North Ayrshire, was officially opened by the First Minister this week. Last year, it was awarded more than £8 million in Scottish Government grant funding to establish a family rehabilitation service that accepts referrals from across Scotland. The facility means that parents with problematic drug or alcohol use can now enter residential rehabilitation without the fear of being separated from their children. However, only two of the 20 beds have been filled, despite the facility opening for referrals on 5 October this year. The bed numbers at the facility were pitifully low to begin with, but for only one tenth of them to be used almost two months on is deeply concerning.

I would have expected that such a service would, in advance of opening, be well publicised to alcohol and drug partnerships across the country, and that those organisations would already have identified those most in need of the services. We would expect there to be a queue at the door, not an almost empty facility.

It seems that the SNP has learned nothing from its previous grave errors in cutting the number of rehabilitation beds across Scotland. Families whose loved ones are continuing to struggle with addiction are being let down at every turn by the SNP Government, which continues to take its eye off the ball. The implementation gap needs to be tackled urgently. The SNP needs to urgently back the Scottish Conservatives’ plan for a right to recovery bill, which would guarantee access to treatment for everyone who needs it.

It is all too easy for Nicola Sturgeon and Angela Constance to visit that facility, spin some nice rhetoric and take some photos, rather than take the bold action that is required to tackle the record numbers of drug deaths that have occurred on their watch. There continues to be an ever-widening gap between the SNP’s warm words on the drug deaths scandal and the reality.

Photo of Angela Constance Angela Constance Scottish National Party

As the member acknowledged, it is important that we sing the praises of such a wonderful therapeutic environment, but does she recognise some of the practicalities involved in opening a new facility that has been progressed at speed? I visited it at the start of the summer, when building work was still going on.

Does the member also recognise that, when populating a therapeutic environment, an organisation begins with a few families and then builds up? Of course, I very much welcome her encouraging people the length and breadth of Scotland to utilise the amazing service.

The Deputy Presiding Officer:

Ms Webber, I remind you that you have 30 seconds left, although I will give you some time back for taking that intervention, which will take your speaking time to nine minutes in total.

Photo of Sue Webber Sue Webber Conservative

Thank you, Presiding Officer.

I understand the minister’s point about it being a very complex environment and the fact that it takes time to get people in that position to come to such facilities. However, my point stands. Given the long period before Harper house opened, I would have hoped that a few more families would be benefiting from the critical service that it provides, which will save lives.

There continues to be an ever-widening gap between the SNP’s warm words on the drug deaths scandal and the reality of how little action it is continuing to take. As I have said, the gap between what is said and what is delivered when it comes to the processes that people have to go through to access such critical services is widening. The Scottish Conservatives believe that a different approach is needed to help people who are suffering from addictions, and we hope that the SNP Government will finally start listening to the front-line experts and back our proposed right to addiction recovery bill, which would guarantee treatment for those people who need it most.

I move amendment S6M-06924.1, to leave out from “calls” to end and insert:

“notes that FAVOR UK’s report,

One Year Report—Blueprint to Save Lives

, published on 21 November 2022, highlights significant challenges faced by those affected by a drug addiction, including many individuals being required to wait for years to access vital treatment; is concerned that, despite multiple action plans, Scotland still has the highest drug death rate in Europe, and 3.7 times higher than the UK as a whole; expresses concern that stigma is especially problematic amongst those with hepatitis C, with 90% of new hepatitis C infections occurring through sharing contaminated injecting equipment; urges the Scottish Government to implement the recommendations of the Scottish Drug Deaths Taskforce, particularly in regards to the ‘no wrong door’ approach, which will stop people struggling with drug use being turned away from service providers, and calls on the Scottish Government to back the Proposed Right to Addiction Recovery (Scotland) Bill, which would enshrine in law a right to treatment, so that all those affected by addiction in Scotland can get the support they need.”

Photo of Claire Baker Claire Baker Labour

I welcome this afternoon’s debate on the national drugs mission and the action that is being taken to tackle stigma. The planned publication of a stigma action plan is welcome, albeit that it is overdue. Addressing stigma is an important aspect of the work to address Scotland’s drug deaths crisis, but we cannot consider it in isolation.

Despite the fact that the drug deaths situation was declared a public health emergency more than three years ago, we have not had the pace or scale of change that is required. National Records of Scotland publications show that there have been more than 2,500 drug-related deaths in that time. If Police Scotland’s suspected drug death figures are confirmed, it is likely that, by the end of the year, well in excess of 3,000 lives will have been lost. I know that the minister shares our great concern and our shock at those figures, but we need quicker action. The responsibility for addressing the situation and delivering improvement lies with the Government.

I agree that substance dependence requires a public health response, and although I will push the Government on delivery, I support the policy approach. We have called for an urgent response that is worthy of the status of a crisis, but there is also an active debate to be had about human rights. How do we ensure that people can access help, be treated with humanity and be supported rather than discriminated against in society? The proposed right to recovery bill is a response to the frustration that exists with services, with the slow pace of change and with the barriers that remain to treatment and services.

We must think about the best way to secure rights to treatment and recovery. In its motion, the Government proposes the idea that substance dependence be recognised as a protected characteristic of disability under the Equality Act 2010. Section 6(5) of that act enables the Government—the UK Government, I should say—to set out exclusions, in which it has included addiction to illicit and prescription drugs. Removing that exclusion or taking action to disregard it would mean that substance dependence would be recognised as a substantial disability with a long-term impact. I support exploring how those rights can be realised in Scotland and extended to the group of people that we are talking about.

For rights to be exercised, services and treatment must be funded and accessible, with strong pathways to treatment. The best way to reduce drug-related harms, including stigma, is to ensure that people can access the full range of drug treatment services where they live. This week’s FAVOR UK report is the latest in a long line of reports that highlight the on-going problem of a postcode lottery of provision and a lack of mental health services. Rights can be seen as a way to drive change, but that is not always the case and progress can still be slow.

There are areas of progress, such as on the roll-out of naloxone provision. Along with my staff, I recently undertook training on how to recognise signs of overdose and administer naloxone in the event of an overdose. That training was provided by We Are With You at my office in Lochgelly. My office staff received the training, along with people in other organisations that use our building. The session helped to demystify and challenge some of the ideas that people have around drug use and overdose. If people are trained and carry naloxone, it becomes more normalised and something that people do not need to feel ashamed or concerned about doing.

Stigma is a significant barrier to people reaching out for help. There is the fear of not being listened to, the fear of losing children and the fear of being judged. I welcome this week’s focus on the new facility at Harper house in Saltcoats, which focuses on families and parents. As Sue Webber has recognised, for mothers who live with a substance dependency, the pressure and stress that often fall on them can be a huge barrier, and I welcome the establishment of facilities in which parents, including mothers, can be treated without being separated from their children. I also welcome the recognition that such facilities need to be diverse and cater for everyone who needs help. We must see more of them throughout the country.

We must recognise that all treatment options are valid and that people need different support at different times in their lives. Support must be responsive and person centred, and there must be no predetermination about the support that someone needs. The weight of expectation is also heavy; indeed, it can be overwhelming for some people who are looking to access treatment.

I know that my time is limited, but I want to share a comment that I saw on Twitter today about supporting those bereaved as a result of substance use, as they, too, can experience stigma that can prevent them from accessing services, as well as increasing isolation. I hope that the plan, when it is published, recognises that families, too, experience stigma.

Turning briefly to approaches to treatment, I realise that some people will choose to be abstinent. However, although that approach benefits some people, others will benefit from medically assisted treatment and/or support relating to harm reduction. In any case, the aim is to stabilise lives and support people so that families can be kept together and that those involved remain part of their community and are not ostracised or diminished.

Our health services need to do all that they can to destigmatise services, too. GP practices are often central to communities, and those practitioners will have seen people grow up and, indeed, will have provided much of their care. The focus on centralised addiction services, which can provide crucial medical support, can be stigmatising, and I would welcome an increase in care delivered through primary care, as well as more community delivery.

When I was recently in Halifax in Canada, I visited the Direction 180 facility, a holistic centre on a high street that offers substance use services, GPs who can prescribe and other services such as wound care, peer group support and mental health services. It operates as a drop-in centre as well as a place for referral, and it has also funded a programme to recruit GPs to manage people with substance use issues in the community and to support them in continuing to deliver that care. We in Scotland should be considering that model.

Although we must act quickly to end the drug crisis, the scale of the drug-related harms in Scotland is likely to continue unless we address the underlying drivers that are highlighted in the Labour amendment. There is much that we can agree with in the Scottish Government’s motion, and we recognise that work to address stigma is being taken forward. However, the true test will be in delivery. That said, we will support the Government’s motion.

I cannot support the Conservative amendment. Although it makes many points that we agree with, we still await the publication of the bill that it mentions.

I move amendment S6M-06924.2, to insert at end:

“; recognises that drug deaths and wider drug-related harms disproportionately impact on the most deprived communities; believes that tackling substance use requires policies that address poverty, deprivation and Scotland’s wider health inequalities; agrees that people with an addiction should be able to access the full range of drug treatment and mental health services wherever they live; regrets the delays in fully implementing the Medication Assisted Treatment (MAT) standards, and agrees that the standards have an essential role to play in tackling the drug deaths crisis and wider drug-related harms; acknowledges that there is a need to know not only the number of people who have tragically lost their lives to a drug overdose, but also due to health conditions caused by long-term problematic drug use, including, for example, cardiovascular disease, end-stage liver disease, HIV or hepatitis C, and believes that such information is essential to inform policy, direct resources and save lives.”

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

It gives me pleasure to speak for my party on such an important and urgent issue. The minister knows that I want her to succeed in this matter, and I am grateful to her for the robust exchange that we had at this morning’s committee meeting.

The Scottish Liberal Democrats have been campaigning for decades for problem drug use to be treated as a public health issue, largely due to the misconceptions that, unfortunately, still surround the debate, many of which we have heard already. I am gratified to hear that there is, I think, consensus in the chamber on it being a public health issue rather than a criminal justice issue, but we still have some distance to travel before the same view takes hold in communities.

I fear that, although there has been huge progress in shifting attitudes, there are people who still view addiction as a choice rather than as a debilitating disease that is born out of circumstances that, more often than not, are entirely outside one’s control. As a result, those who are suffering can be ostracised from their communities, cut off from the help that they need and denied even basic human kindness. Imagine having a life-threatening illness and having to contend with all that on top of it. That would be unthinkable to most of us.

The Hepatitis C Trust has noted that, for people with hep C—which, as we know, is often contracted from sharing contaminated injecting equipment—stigma is still felt to be highly prevalent, and it makes people less likely to get tested or to present themselves for testing. As a result, the infection can go untreated for a long time, increasing its incidence or the chances of fatality. It is clear that stigma can have deadly consequences. I therefore find it positive that the Government has recognised the importance of tackling stigma, and I welcome the thrust of the motion and today’s debate.

However, there is still so much more that we need to do. After all, stigma cannot be combated until we have a universal understanding and response across Scotland and all our sectors. That will require decisive, urgent and radical leadership, but our Government has, I fear, been slow in delivering that leadership.

We cannot forget the context in which we are having this debate: this Government is presiding over the worst rate of drug deaths in Europe. The rate here is three-and-a-half times higher than the rate in the rest of the UK, yet all the while this Government slashes funding for rehabilitation services. We must make no mistake: this is a uniquely Scottish problem that has been made worse on this Government’s watch.

Looking forwards, our experts have long advised a shift in our public response, specifically a shift to methods of harm reduction. One such policy involves drug consumption rooms. Again, that is another issue that has galvanised political support across the chamber, in large part due to the heroic work of people such as Peter Krykant. Last year, when a drug consumption room opened in New York, trained staff were able to reverse two overdoses during its first official day of operation—those cases might otherwise have proven fatal.

The implementation of drug consumption rooms in Scotland could be game changing, which is why the Scottish Liberal Democrats continue to campaign for them. The matter now rests with the Lord Advocate, and I am gratified that the Government is persuaded of the case and is keen to find ways to implement drug consumption rooms within the terms of the Misuse of Drugs Act 1971.

I was glad to have an exchange on the matter with the minister in the joint meeting of the Social Justice and Social Security Committee, Criminal Justice Committee and Health, Social Care and Sport Committee this morning. We need urgent action, and I hope that, now that the focus of the Lord Advocate has moved away from constitutional matters, we can remedy the situation immediately, because every week that goes past when we do not pilot a drug consumption room, lives are lost. This is an important and life-saving policy, and that is why we should ask her to focus on it.

Although this year has marked the introduction of medication-assisted treatment standards into our public policy, which we welcome, there are still huge gaps in the delivery and realisation of those standards on the ground. There is a huge shortage of staff who specialise in assessing the needs of individuals and the distribution of services, and that remains a particular issue in areas of rurality, where we have empirical evidence to demonstrate that it is incredibly difficult for people to access same-day services. All that hinders the ability of staff to act quickly in providing treatment, which, again, potentially costs lives. As I mentioned earlier, it is crucial that harm-reduction strategies are adopted across all our public sectors and address all our communities, be they urban or rural.

A prevalent cause of drug-related death is the mixing of drugs with other substances that are dangerous and, often, toxic. The creation of facilities that test drugs is in the same sphere as drug consumption rooms. It recognises that a zero-tolerance approach—wishing the problem away—will not work and that, if people are going to consume drugs, we have a duty to help them to do so safely. We know that they work at large-scale social events, festivals and nightclubs, and that their use could massively reduce harm—harm that was visited on my constituency just two weeks ago, in a tragedy at a festival that took place there. What is more, those facilities have been used in parts of England and Wales, but they have never been tried in Scotland. It is crucial that we do all that we can to work with Police Scotland to provide those services. Again, that is something for the Lord Advocate to consider in terms of guidance to policing.

I conclude by noting that the reasons for drug misuse are often connected to underlying social causes linked to poverty and unresolved childhood trauma—we need to find that trauma and deal with it. In the worst cost of living crisis that our country has faced in decades, those underlying causes will have a devastating impact on those already suffering and could push more to the brink. It is, therefore, imperative that we include social care and welfare in our approach.

We need to implement policies that are empathetic and encompass the wider societal causes of drug use. Then and only then will we begin to eradicate the stigma.

Photo of Emma Harper Emma Harper Scottish National Party

Every life lost to addiction is a tragedy, and I know that the Scottish Government is absolutely committed to implementing approaches that we know work to save lives and reduce harm. We must remember at all times that people with a substance use disorder are family members, neighbours and people in our communities. Instead of criminalising people in our population, we need a public health approach that supports those with substance dependency and prevents unnecessary deaths.

The Scottish Government is under no illusion about the seriousness or scale of the challenges that we need to address as we pursue new, bold ideas and innovative approaches. In January 2021, the Scottish Government set out a national mission to improve lives and save lives, at the core of which is ensuring that every individual is able to access the treatment and recovery methods that they choose and which will work for them.

We must empower more people to seek support, and we must make that support more consistent, flexible and effective, and much faster. We must also help services to stick with the people whom they support.

I welcome that the Scottish Government is committed to listening to people who have real-life experience of harmful drug use, those who live or have lived with substance dependency and families who support their loved ones suffering from substance dependency. Indeed, an additional £250 million has been allocated over the next five years to improve and increase access to services for people who are affected by drug addiction. All of that is welcome.

I also welcome what the minister has just described in terms of the four pillars of a stigma action plan. Problematic substance use is a health condition, but the stigma that is associated with it can have detrimental consequences for the individual, their family and the wider community. This debate is about tackling stigma; doing so is an essential step in reducing drug-related deaths.

The Scottish Drug Deaths Taskforce’s paper, “A Strategy to Address the Stigmatisation of People and Communities Affected by Drug Use”, describes extremely well what stigma is and who is affected. It states that the

“association between substance use and personal deficit(s) allows substance use to be portrayed as a failure of character or morals. This is an ideological framing of (problem) substance use as a solely personal issue. This justifies and re-enforces stigma.”

The task force developed a stigma charter that all organisations, including businesses and community groups, can use. The charter aims to create a Scotland that is free from stigma in order to support a public health approach for problematic substance use. However, we need more action to deal with stigma and to raise awareness of it, particularly among healthcare professionals.

Members know that I worked in the Scottish national health service prior to coming to the Parliament. I have witnessed—and I have heard recent feedback from former colleagues—that the words “junkie”, “druggie”, “alkie” and “jakey” are still used in healthcare. The use of those words is not acceptable, whether in a clinical area or by professionals away from the professional workplace. We should call that out.

We also need to ensure that staff are properly educated. The minister will be aware that I recently wrote to NHS Education for Scotland to see whether a relatively short online module has been or could be created—the module would not just be for professionals who work directly in alcohol and drug front-line services—to address drug-related stigma. I was interested to know whether education could be targeted at all healthcare staff—pharmacists, nurses, doctors and allied health professionals. People with substance misuse health issues will encounter healthcare that involves not solely addiction services, so tackling stigma is essential for everyone.

The response that I received from NES was a bit disappointing. It said:

“currently there is no dedicated resource solely for addressing the issue of stigma related to alcohol and drug use. However, stigma is incorporated in a number of our other resources.”

On searching the online Turas education portal, I found a couple of modules with the word “stigma”, but they were not alcohol or drug focused. NHS Inform has some great and comprehensive information that could simply be lifted and used, maybe even for a mandatory module. I responded to NES to seek further information and to ask for specific education to be provided on substance misuse or alcohol harm. I have also asked the minister if she would consider meeting me to discuss whether a basic, short online learning module could or should be created and delivered.

The task force’s strategy document asks who should lead on the strategy to tackle stigma. Groups such as alcohol and drugs bodies are mentioned—for example, alcohol and drug partnerships, the Scottish Drugs Forum, the Scottish Recovery Consortium, Scottish Families Affected by Alcohol and Drugs and the third sector; NES is also mentioned. The document states that working with mainstream services is required. It specifically mentions front-line staff and management who

“need to understand the causes and drivers of problem drug use” and

“recognise their role in stigmatising people with a drug problem”.

That is a direct reference to mainstream services. I would be interested to hear the minister’s thoughts on that.

I welcome the steps that the Scottish Government is taking to tackle harmful drug use and reduce stigma, and I look forward to hearing the contributions of other members this afternoon.

Photo of Miles Briggs Miles Briggs Conservative

When I was preparing for this speech yesterday, I was thinking about a case that I had just before the pandemic. It was the case of a constituent who had been in and out of Saughton prison, who contacted me to say that he did not want to go back to his family here in Lothian.

On contacting public services, I was really shocked by their attitude towards that individual. Basically, I was told—I am paraphrasing—that I was unlucky that I had been landed with him. Specifically, he was described as a “problem junkie”. That attitude has to change in this country, so I hope that today’s debate can help with that. I welcome what Emma Harper had to say, because she made many positive suggestions on taking forward work in the area. It is not an easy thing to do, but it is something that we have to do.

I still think that homelessness and housing is an area that the Scottish Government is not building in to a solution to the drug deaths crisis. Figures that were released yesterday show that the number of estimated homeless person deaths across Lothian—my region—has, over the past three years, increased dramatically, from 26 deaths in 2019 to 63 deaths last year. The number of homelessness applications has also increased over the past three years across all the councils in my region, to more than 8,165, and the number of children in temporary accommodation in Edinburgh, as things stand today, is more than 1,000.

Those figures are nothing short of appalling, but we need to see them as part of the wider picture, because many people with problematic drug misuse are ending up in facilities where they are housed with other people with problematic drug misuse. If someone is trying to get off drugs—if they are trying to sustain their treatment—that approach does not work. That is something that the Parliament and the minister really need to consider. I raised the issue with the minister at the committees’ meeting this morning.

Six years ago, Alex Cole-Hamilton, Anas Sarwar, Monica Lennon and I, as our respective party spokespeople, called on ministers to declare a drug deaths emergency. Ministers dragged their feet for years, insisting that strategies were actually working. In the end, it was public outrage about Scotland’s drug deaths that really drove ministers to declare the public health emergency and to finally shift things. However, that happened after shameful decisions to cut funding, which had made the situation worse.

The Scottish Government’s approach to tackling drug deaths needs to be constantly improved and looked at and, as I have said, housing support and extra care need to be built in. That is lacking in current strategies.

Shelter Scotland has said, with regard to the situation—

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

I am grateful to Miles Briggs for recognising the work that we did collectively and collaboratively on the drug deaths emergency.

Does he recognise that the funding cut to ADPs in 2015-16 not only sent services to the wall, but meant that organisational memory was lost, it accounted for a £1.3 million cut in funding in our nation’s capital alone, and it led to an HIV outbreak in Glasgow?

The Deputy Presiding Officer:

I can give you some time back.

Photo of Miles Briggs Miles Briggs Conservative

I absolutely recognise that and, from speaking to people in services, I know that it destabilises them to this very day. Also, where services need to be redesigned, that work is still not taking place.

On the funding that has been delivered—this is something that the Audit Scotland report specifically points towards—we are not seeing the money trickle down to services and it is hard to follow the money, specifically with regard to the—

Photo of Angela Constance Angela Constance Scottish National Party

In the light of his remarks, I ask Mr Briggs whether he has referred to our “National Mission on Drugs Annual Report 2021-2022”

, which indicates where funding has been allocated.

Photo of Miles Briggs Miles Briggs Conservative

I welcome that. I was going to turn specifically to policy in relation to the “no wrong door” approach and how funding can then be allocated to various organisations, especially third sector organisations. That is not clear, so it is something that I want the Government to focus on.

There are so many things from this morning’s joint meeting of three committees that I want to raise; I will mention a few of them now. First, there was a great opportunity to look towards how stigma is addressed with regard to hepatitis C patients, especially those who are former injecting drug users. We need to do that. As one of the hep C champions, I am concerned that progress is not currently being made. Scotland was leading the world on the matter at one point, but we are falling behind, apart from in Dundee. I hope that we can address that issue, as well.

There are a few other issues. Alcohol treatment and services is one of my greatest concerns. We are seeing an increase in the number of people who are presenting with alcohol issues, and they are younger than ever before. The Scottish Government is also not taking on board medication-assisted treatment standards for alcohol, which I have raised with the Minister for Public Health, Women’s Health and Sport, and am raising now with the Minister for Drugs Policy. That needs to change: we need MAT standards for alcohol treatment, because we cannot take our eye off the ball in another crisis, which is the increasing amount of alcohol misuse in Scotland. The change in alcohol use might be because of the pandemic, but I hope that it is something of which ministers are mindful. Many charities and people who are working in the area are incredibly concerned about it.

Finally, the debate around stigma is welcome. We all need to address it in our language and our public services. Most important is that we need to do that for families because, as Claire Baker pointed out, families who are trying to support loved ones with alcohol addiction often face some of the worst stigma in our society. Public services need to consider that; we need to send a message that we are on their side, and that we will support families as they try to get their loved ones into treatment and secure a future for them.

Photo of Willie Coffey Willie Coffey Scottish National Party

As I start, I gently remind the Tories that there were 3,000 drug poisoning deaths in England and Wales last year, and nearly 5,000 drug-related deaths in total, which is the highest since 1993 in those areas. However, no one in Parliament will stand up and say that that is all the Tories’ fault: it is a little bit more complex than that. Forlornly, I wish that the Tories might recognise that from time to time, when they come to Parliament and blame the SNP for everything.

I will start my contribution by sharing a little of my experience when I visited an addiction support project that operates in Kilmarnock. I was invited to hear first-hand the lived experiences of people and their families—what their lives were like and, more important, what they felt would be the way forward for them.

I heard incredibly moving accounts of how people fall into taking drugs—sometimes by choice, which they freely admitted, and sometimes because of desperation and a feeling of hopelessness resulting from lack of opportunity and loss of self esteem. Those people had entered a world where false comfort was available to them, even for a few brief moments. Drugs helped them to ease the pain and to get to their next target, which was surviving until the next day. Not one of the people whom I listened to that day blamed anyone but themselves for the situation in which they found themselves: they said that it was their doing.

Family members around the table were almost living two lives—trying to cope with the normal day-to-day things that we all have to deal with and, at the same time, living with the horror of watching a loved one slowly succumbing to the overwhelming downward spiral that addiction metes out. Everyone who spoke that day had one common wish: they wanted hope that their lives could be turned around and hope that they could, even when things looked bleak, hold on and get help to save their lives at the moment when they needed it. It was as simple as that.

I have made several similar visits to other projects and the message was the same: “Please help by giving us hope that we can get through this.” The folk who came to the various meetings were well aware of the stigma, which has added more to their suffering. For them to be viewed by neighbours, friends and, sometimes, even family as an addict—someone to be watched, not trusted and to be kept away from—only added to their pain. However, those people still came to the project meetings and shared their stories.

Putting lived experience at the heart of what we do is essential if we are to have any chance of turning the problem around. My colleague Angela Constance came to a project meeting a little more than a year ago, and spent several hours listening to various accounts of lived experience, for which I am grateful. I am sure that that helped her to shape the kinds of services that I know we all hope will help to turn the situation around.

When I look at all the plans that are being put in place and the ideas that are being put forward by other parties, I am encouraged that we are tackling the problem head-on. No one group here has exclusive wisdom or all the solutions. We all need to listen to and look at what others around the world are doing, too.

The £250 million that the Scottish Government has earmarked over the course of the parliamentary session has to make a difference, and the residential rehab facilities will surely help to save lives—especially the facility in Ayrshire, which will be able to accommodate families for as long as six months.

I am grateful to the Royal College of Physicians of Edinburgh for its briefing and its helpful insight on and support for bold action being taken in key areas that could make a difference. Those include decriminalisation, safe consumption spaces and heroin-assisted treatment programmes. It cites the Portuguese experience since 2001 of decriminalising possession of all drugs, and notes that the annual number of deaths caused by drug overdose in that country dropped from 80 in 2001 to 16 in 2012. In Scotland last year, our figure was 1,330. I know that it is risky to make direct comparisons, but that experience surely points Scotland in a direction that would save lives, and I know that the Scottish Government is working on all options. However, we cannot do it alone.

As ever, I want to mention some of the good work that is going on in East Ayrshire—work that is providing much-needed support to local people and their families. The new Recovery Enterprises Scotland hub in Kilmarnock is staffed by people with lived experience and is open seven days a week for the people who need it. In addition, East Ayrshire health and social care partnership has established a recovery college, where people are gaining the skills that they need to give them hope for the better future—and employment—that they want. All the ingredients that people are calling out for are being delivered by people who care and who have lived experience. There is no judgment or stigma.

I end my speech where I began—by reminding members that what we need to do more than anything else is offer hope by providing the support and resources that are needed, when they are needed most. Funding and money make a big difference, but compassion is priceless.

Photo of Baroness Katy Clark Baroness Katy Clark Labour

I welcome the debate and the Government’s focus on stigma in its motion. As the minister knows, the creation of a national stigma action plan is one of 20 recommendations in the task force report, along with 139 actions, and the task force argues the importance of stigma as an underlying component in the drug deaths crisis.

Scotland consistently has the worst drug deaths figures in Europe. There are many reasons for that and, as Willie Coffey has just said, the lack of hope and opportunities in communities is clearly a major factor. In the last year that we have figures for, there were 14,310 drug-related hospital stays, and approximately half the patients with a drug-related hospital stay came from the most deprived areas of Scotland. The Labour amendment recognises the need for

“policies that address poverty, deprivation and Scotland’s wider health inequalities” as part of the strategy to address the issues.

Photo of Audrey Nicoll Audrey Nicoll Scottish National Party

In the context of the factors that are stigmatising for people, as Katy Clark has described, does she agree that one of the most stigmatising is the current misuse of drugs legislation, which is now more than 50 years old and which has been shown to have failed over those 50 years? Indeed, it frequently pushes people back into a cycle of offending and, as she said, impacts the most vulnerable people in communities.

The Deputy Presiding Officer:

I can give Katy Clark most of that time back.

Photo of Baroness Katy Clark Baroness Katy Clark Labour

Thank you, Presiding Officer.

I agree with the convener of the Criminal Justice Committee that the

Misuse of Drugs Act 1971 has failed. However, although that legislation is in place throughout the UK, in Scotland, we have a significantly higher drug deaths rate than the rates in the rest of the nations of the UK. Clearly, that is just one factor, and many other factors drive the very significant problems that we have in Scotland.

The system currently fails those who are seeking support with drug addiction, and the high levels of drug deaths in Scotland clearly highlight that failure. In total, 1,330 people lost their lives to drugs misuse in Scotland in 2021, which was the second highest annual total on record. We have a consistent problem with the worst death rates in Europe, and areas such as the west of Scotland have some of the worst statistics in the country.

In North Ayrshire, 39 deaths were recorded—the highest number in the NHS Ayrshire and Arran area. The minister has already spoken about the facility that has opened recently in Saltcoats. North Ayrshire has the fourth highest level of drug deaths in the country, but, when we look at some of the other economic drivers in North Ayrshire, unfortunately, the area often has some of the worst statistics, such as higher levels of domestic abuse, poor levels of employability and high levels of poverty and deprivation, and many of the other economic drivers highlight the lack of opportunity and hope.

Photo of Angela Constance Angela Constance Scottish National Party

Given North Ayrshire’s additional challenges, does Ms Clark welcome the additional benefits of having a national specialist facility within its borders?

Photo of Baroness Katy Clark Baroness Katy Clark Labour

As the minister knows, it is a national facility, so it will not be people just from North Ayrshire who use it. The facility is for families, so it will be suitable for people with young children in particular. The minister is perhaps highlighting the need for a range of different types of facility, suitable for the individual’s needs. Most important, such facilities must be available when that individual needs and is asking for assistance. The key to success is often that facilities are available when the individual is looking for them.

We understand that it is very common for people who experience problems with drugs also to have significant problems with mental health and alcohol abuse. A recent report from Public Health England highlighted that mental health problems are experienced by a majority—70 per cent—of users who are in community substance abuse treatment. Other research, such as that published in the

New England Journal of Medicine, concluded that pointing to examples of successful harm reduction programmes can reduce the stigma around drug use. Therefore, it is important that discussions are taking place in this Parliament not only about stigma but about what is and should be available.

I do not have a huge amount of time left. I welcome the Government motion. There needs to be a recognition that Scotland has failed and that the high levels of drug deaths are an indicator of that failure. However, I believe that many of the recommendations and action points in the report are part of the pathway that we need to go forward. I look forward to hearing in detail from the minister how the Government will respond to all the recommendations and recommended actions.

Photo of Collette Stevenson Collette Stevenson Scottish National Party

Whether it is peers calling you derogatory names and demeaning you, public agencies treating you with contempt or your own thoughts telling you that you are worthless, stigma against people with problematic drug use can be crippling.

I would argue that the UK Government’s failed war on drugs has exacerbated that stigma. Instead of criminalising large swathes of the population, we need a public health approach that supports those with addictions and prevents unnecessary deaths.

More than that, we need an integrated, person-centred approach to treatment, so I welcome the actions as part of the national mission to expand the services that are available to people, as well as the introduction of same-day treatment.

The motion talks about the importance of being respectful when dealing with people with experience of problem drug use. I absolutely agree with that sentiment. Such a change can go a long way towards eliminating stigma—both societal stigma and self-stigma.

With regard to social stigma, some individuals seem to find it easy to mock people with substance dependence and to resort to name calling. That must change; people must be more aware of the impact of their words to prevent maintaining the scourge of stigma against many of our fellow citizens. At the end of the day, people with an addiction have an illness and they deserve to get treated fairly under a public health approach. We must remember that people with a substance use disorder are our family members, friends, neighbours and colleagues. Drug and alcohol issues are very common here and they can affect anyone.

As well as the social stigma and self-stigma, a huge challenge for many people with experience of drug use and many other illnesses is the belief—which is sometimes backed up by experience—that the Government does not value them or that they are not a full member of society. However, whether or not someone has experience of substance use, everyone in Scotland has rights. A person has every right to live in their community, they have every right to medical care and they have every right to vote and have their say in how the country is run.

In that vein, the national collaborative is an excellent initiative. It will empower people in Scotland who are affected by drugs and alcohol to ensure that their voices and their rights are acted on in policy and practice, and they will serve alongside people who are responsible for delivering services. I wish everyone involved all the best, and I believe that the collaborative’s outcomes will be powerful.

From my own experience, I know that families, as well as service workers, are not immune to stigma. Stigma spreads, and sometimes becomes so pervasive that entire communities are characterised by stereotypes and myths. The fact that stigma can get so out of hand demonstrates the fallacy of it. That should make people reflect on their own words and consider whether we want to live in a society in which people get, and deserve, the chance of recovery and to just be the friendly, loving, kind or considerate mum, dad, brother, sister, son, daughter, friend or neighbour they are. For everyone’s sake, I think that that is the best approach.

The personal cost of stigma is huge. It can reinforce the helplessness that is felt by someone with problematic drug use or increase the guilt that they might feel for what they perceive they have done to family and friends.

As we all know, and as I know personally, the risks of not getting the treatment that is needed include early death. Stigma is damaging and a barrier to treatment. In my view, it plays a big role in the number of drug-related deaths that we see.

I welcome the stigma strategy that has been developed by the Scottish Drug Deaths Taskforce, which identifies actions that will help to reduce stigma. I also welcome the current work by members of the task force with lived and living experience, who are leading on a stigma charter. I understand that the charter will challenge us all to consider what we can do to create a stigma-free Scotland, which is something that we must do.

Stigma does nothing but hinder people with problematic substance use, their families and friends and, sometimes, whole communities. We should all consider the effects of our language and resolve to treat everyone with dignity and respect. That could be a life-saver.

I look forward to the Scottish Government’s publication of the stigma action plan, and I hope that it will be another step on the way towards supporting people to get the help that they want and creating a stigma-free Scotland.

Photo of Gillian Mackay Gillian Mackay Green

Stigma is dangerous. It fuels misunderstanding of addiction and it can prevent people from seeking and receiving help. It often marginalises people who use drugs and places them at greater risk. Stigma is not only unfair and unjust—stigma kills. It is dangerous, and I agree with the motion that

“tackling stigma is everyone’s responsibility”.

The stigmatisation of people who use drugs is difficult to tackle, given its pervasiveness. It is widespread throughout society as well as support services, and messaging from media and politicians often reinforces stereotypes. As the final report of the Drug Deaths Taskforce points out,

“discrimination is even enshrined in UK law, which actively discriminates against people with drug dependency in crucial areas of human rights”.

I was extremely disappointed when, in February, the former UK Government Minister of State for Crime and Policing, in giving evidence during a joint committee meeting on reducing drug deaths, used stigmatising language. When such rhetoric comes from people in positions of power and influence, it is very damaging. Those who are in positions of authority have a responsibility to consider any harm that may be caused by their language. I hope that everyone in this chamber feels the weight of that responsibility.

Stigmatising language sends the message that people who use drugs are somehow less deserving of support or should be regarded as criminals. It creates a narrative of us versus them, and can prevent the public from regarding people who use drugs with empathy and compassion. It makes scapegoats of people who use drugs and blames them for problems that are often a cause of drug use, not a result.

To challenge that, we need to focus on the root causes of problem drug use and shift the narrative away from drug use as a driver of crime. Time and again in Parliament, the point has been made by me and others that problem drug use is a public health issue, not a criminal justice one, and I hope that we can all agree on that. The task force report states:

“Evidence shows that unacceptable and avoidable stigma and discrimination towards drug use are increased by criminalising people. We have heard that the Misuse of Drugs Act 1971 is outdated and needs to be reformed to support harm-reduction measures and the implementation of a public health approach.”

The war on drugs has failed, and it has increased the stigmatisation and demonisation of people who use drugs, making them less likely to seek treatment. It is endangering lives. The UK must abandon this outdated and dangerous strategy. We need a new compassionate approach that seeks to uphold the rights of people who use drugs and support them into treatment—an approach that affords them their dignity, treats them like human beings and listens to what their needs are.

We also need to recognise the various ways in which stigma isolates people with drug use and prevents them from seeking support. Stigma does not only affect people who use drugs. Friends, families and carers may also have to suffer the trauma of seeing people whom they love and support being marginalised and diminished as being less than any other citizen.

People who work in front-line services will also be impacted by stigma, which is why it is essential that all those who work in addiction services undertake anti-stigma training. I am in favour of that being rolled out more widely, given that people who use drugs may be in contact with multiple services throughout their lives, including housing, mental health and social work services. Tackling stigma in the workforce will, I hope, initiate a culture change so that services are less punitive and inflexible and become more person centred.

There should be an understanding that a one-size-fits-all approach simply will not work for people who use drugs, as it does not take account of individual circumstances. People who use drugs might live chaotic lives, and they should not be punished for that. People who use drugs might also be stigmatised due to factors such as gender, ethnicity, disability, unemployment and homelessness. We need to recognise the multiple ways in which people are affected by stigma and how that reinforces trauma.

Recognising that people who use drugs are human beings, that they are not at fault and nor should they be punished is the very minimum that we can do for them. I completely agree that treating substance dependence as if it were included as part of the protected characteristic of disability would contribute to a fairer and more just society. What good comes of denying people access to adjustments that might make their lives easier and help them to engage with support and treatment services?

Equality Act 2010 regulations state that

“addiction to alcohol, nicotine or any other substance is to be treated as not amounting to an impairment” unless it is

“the result of administration of medically prescribed drugs or other ... treatment”.

The task force’s report calls for that exemption to be removed, stating that it

“is stigmatising and discriminatory. It prevents people from receiving reasonable adjustments that may assist their engagement with treatment and ongoing recovery.”

I echo that call and urge the Scottish ministers to continue to engage with the UK Government on that matter.

Education is key to tackling stigma, and we need to centre the voices of living and lived experience—of those who know the reality of life while using drugs. We need to empower people to speak about their experiences and raise their voices in protest when stigma is perpetrated or services are failing people. However, I reiterate the point in the task force report that

“while peer programmes and advocacy can be an important part of recovery for many, it is not the responsibility of a person with lived or living experience to educate others unless they choose to do so, in which case they should be compensated for their work accordingly.”

As I said, it is the responsibility of all of us to tackle stigma and ensure that people who use drugs are treated with compassion and understanding.

In conclusion, stigma isolates people who use drugs; it shuts them off from avenues of support and prevents them from reaching out; and it is dangerous and costs lives. We must all be part of the joint effort to eradicate stigma and treat people who use drugs with the compassion, respect and dignity that they deserve.

Photo of Annie Wells Annie Wells Conservative

This has been said many times before, but I will keep on saying it until meaningful action is taken: Scotland is experiencing a drug deaths crisis. For many people in communities such as mine in Springburn, families continue to be devastated by drugs and are left to suffer in grief.

It is true that, in broader society, stigma exists, which might in part explain why some people do not seek the help that they need, and I agree with the Government’s emphasis on the point that stigma creates unnecessary barriers for some of the most vulnerable people in our society.

On Monday, I attended the launch of FAVOR UK’s one-year report, “Blueprint to Save Lives”. I was struck by the staff’s passion, dedication and, frankly, deep frustration over how little progress has been made in supporting some of the most vulnerable people in our society. The launch at Bluevale Community Club marked one year since Douglas Ross and the First Minister met at the same location in Glasgow, attending a meeting alongside charities, experts, and people with lived experience of drug addiction.

Following the First Minister’s admission that her Government had taken its eye off the ball, that meeting was supposed to signal a turning point in combating the drug deaths crisis in Scotland. However, it is abundantly clear from Monday’s launch that front-line experts believe that the SNP Government continues to fall short in supporting people in their road to recovery from drugs.

There has been a very modest reduction in the number of fatalities recorded last year. That, of course, has to be recognised, but let us be crystal clear that progress remains painfully slow. The figures do not lie: Scotland still has by far the worst drug deaths record in Europe with, tragically, 1,330 Scots losing their lives to drugs in 2021. Each person behind those statistics is someone’s mum, dad, son, daughter or friend.

As I touched on, FAVOR UK’s report states that the current treatment system is broken, with almost no progress having been made in reversing the crisis that has engulfed communities across Glasgow and Scotland. Despite the Government’s promise of new funding, significant shortcomings in the current framework include the fact that some of the most vulnerable people have been left in limbo, cast adrift in the system and waiting years for their treatment programmes to begin.

I strongly encourage MSPs from across the chamber to read FAVOR UK’s report, which is available on its website, to get a sense of the significant obstacles that vulnerable people face in accessing the vital treatment that, to be blunt, they need to survive.

As I have said repeatedly, I recognise that there is no silver bullet that will end the drug deaths crisis in Scotland. To that end, I agree with the Government that meaningful action to tackle stigma will be important in encouraging people to seek the treatment that they need. However, that treatment must be readily available to access in the first place.

Given the hurdles that individuals must jump to get the treatment that they need, I have repeatedly called on the Scottish Government to back Douglas Ross’s proposed right to addiction recovery bill. A key strength of that bill is that it has not been developed in a vacuum; it has been developed in conjunction with charities and front-line experts, with many of those individuals having direct lived experience and truly understanding the impact of stigma on seeking treatment. They have contributed to the development of the bill at every stage of the process so far and I sincerely thank them for their input.

The insight and expertise of organisations such as FAVOR UK and SISCO—Sustainable Interventions Supporting Change Outside—is invaluable, because they understand what it takes to guide someone to success in their recovery from substance abuse. It is no wonder that the bill received overwhelming support at the consultation stage.

The right to addiction recovery bill would guarantee access to treatment for everyone who needs it. Front-line experts, and those with lived experience, have been clear that providing reliable pathways to treatment, including rehabilitation services, is crucial in saving lives. The proposed law would provide a statutory right for individuals to access addiction treatment and recovery services, including the community-based residential rehab that experts have stressed is so important.

The bill has the backing of front-line experts and has generated widespread support. I hope that the minister and the SNP Government will back it when it comes to Parliament early in the new year. Following years of presiding over the drug deaths crisis, ministers should understand better than most that a radical solution is required to end that shameful record and ultimately to save lives.

We are done with warm words, and we are done with platitudes and lip service. As those in FAVOR UK say, “You talk, we die.” The crisis has been allowed to worsen for far too long. I urge members to back Sue Webber’s amendment and to back the right to addiction recovery bill when it comes to Parliament.

Photo of Michael Marra Michael Marra Labour

The minister is absolutely right to open today’s debate by saying that stigma kills. Stigma raises barriers to accessing support and treatment and extinguishes the hope that is necessary to seek that support and treatment. It dehumanises; it others. It makes us all deaf to calls for help and blind to our neighbours; it closes our minds and hardens our hearts. Stigma means that more and more Scots will die.

Stigma is based on misunderstanding and on the preconception that those who suffer with problem substance use are not victims of circumstance or of grotesque poverty, violent abuse and continued exploitation by unscrupulous dealers in misery.

A culture change is necessary, and nowhere more than in my home city of Dundee. The five-year rolling average death rate for Dundee from 2017 to 2021 was the highest in Scotland, standing at more than 45 deaths per 100,000 of population. This is a rolling crisis, with little progress evident.

Nicola Sturgeon announced a national mission on drugs on 20 January 2021—673 days, or nearly two years, ago. The Dundee drugs commission launched its first report, “Responding to Drug Use with Kindness, Compassion and Hope” in August 2019. That title showed the importance that the commission placed on tackling stigma in our city and, crucially, in our services. The report highlighted the need to tackle stigma and called on the authorities to

“challenge and eliminate stigma towards people who experience problems with drugs, and their families, across Dundee to ensure that everyone is treated in a professional and respectful manner”.

However, in its follow-up report more than two years later, the commission recognised the efforts of the third sector in tackling stigma but went on to admonish key public services for their failure to tackle stigma, saying:

“we have seen or heard little evidence to indicate that ... the ... recommendations have been progressed”.

The Government has been talking about tackling stigma for over two years. Its Drug Deaths Taskforce published a strategy on 30 July 2020 to address the stigmatisation of people and communities that are affected by drug use. What progress has been made on the delivery of that strategy? How is progress being measured? Two years on, I am afraid that the motion for today’s debate could be read as little more than platitudes. The lack of progress can only really be measured in deaths year on year, person by person.

I suggest that an indicator that could be measured is those who are actually accessing services, because the most direct form of stigmatisation is how people feel when they try to access services. Are they welcome? Are they treated as equals?

The central critique of the Dundee drugs commission was that substance misuse services are punitive, that they treat clients as incapable and lesser, and that they structure policies and treatment plans accordingly. Tackling stigma requires fundamental service reform, but where are we on reform in Dundee? We have no independent chair of the ADP. The previous one resigned months ago, and no one has told us why. Perhaps the minister has asked him and can tell Parliament. The lack of leadership from ADPs was criticised by Audit Scotland in March. The problem is not unique to Dundee, but our local ADP is literally without any of the independent leadership that we were promised.

There has been no response from the ADP, the city council or NHS Tayside to the second report of the Dundee drugs commission. That response should have appeared in the summer, yet here we are with nothing. I remind members of the contents of that report: it said that almost nothing had been done to implement the commission’s first report. It had to recommend again that

“all core and funded services should be tasked” by the drug and alcohol partnership

“with developing a plan for combating stigma and discrimination based on the core values of kindness, compassion, and hope.”

However, we have nothing—no strategy, no delivery plan, not even a response.

Adverts on Dundee bus shelters are not enough to tackle stigma. They are nowhere near enough. The motion for this debate is not enough. Dundee City Council is not doing enough, NHS Tayside is not doing enough and the Scottish Government is not doing enough.

To be frank, it would be of far more use if the minister, in her closing speech, could give us a proper update on those health boards that are, like NHS Tayside, under ministerial direction. What are the names of the single figures of people who are now in place and are responsible for MAT standard delivery, as highlighted in Labour’s amendment? Where are the delivery plans? Where are the timescales? When will those individuals be held accountable in front of councillors and MSPs? When, when, when will we see change?

The Deputy Presiding Officer:

The final speaker in the open debate will be Stuart McMillan, who joins us online.

Photo of Stuart McMillan Stuart McMillan Scottish National Party

I refer members to my entry in the register of members’ interests. I am vice-chair of Moving On Inverclyde, which is a local addictions service. I invite the minister once again to go and visit the service.

I note that Paul O’Kane visited it earlier this year and was impressed by the work of the staff, their expertise and the organisation as a whole. That went down very well with all the staff and board members.

Like others, I have raised the issue of stigma in the chamber before. It is undeniably one of the key barriers to helping people who are living with addiction. I welcome the planned stigma action plan and I will read it carefully when it is published. I am sure that I and others will have questions about it, and I trust that it will help with challenging the stigma that people with problem drug use face.

Fundamentally, I believe that a societal change is needed when it comes to the issue of stigma. As the Parliament has heard in debates before, it is vital that stigma is tackled head on so that people can move towards recovery. Problematic substance use is a health condition, but the stigma that is associated with it can have detrimental consequences for the individual, their family and the wider community. For example, people may not acknowledge their problem for fear of being judged and, as a result, they may not want to seek the help and support that they need.

The Drug Death Taskforce, which the minister spoke about, developed a stigma charter that all organisations, including businesses and community groups, can use. It aims to create a Scotland that is free from stigma, in order to support a public health approach to problematic substance use.

I welcome the national mission and the £250 million funding over this parliamentary session. In particular, I welcome the move to a five-year funding cycle for eligible third sector and grass-roots organisations, which are at the forefront of saving lives. I, and others from across parties, have highlighted that in previous debates. Partnership working is vital in providing solutions to help those with addictions, and I know that third sector organisations—not only the organisation that I am involved with but other local organisations—are crucial in that service delivery across Scotland, including in Inverclyde. The five-year funding cycle will be hugely important in helping organisations to plan their services and their help with the issue of dealing with stigma.

Every drug death is a tragedy, and I put on record my condolences to families who, sadly, have lost a loved one. During recovery month, in September, I attended a number of local events, the most poignant being the candlelit vigil that was held in Greenock. While that was primarily about providing a space for people to remember those who have lost their lives through problem substance use, attendees heard at first hand some of the real-life stories of those who are in recovery or are still living with drug dependency. I mention that event because one of the key points that were raised that evening was the issue of dealing with stigma.

Not only is stigma damaging—as I said a few moments ago—to the individual’s mental health and sense of self-worth; it discourages them from coming forward. The Drug Deaths Taskforce stigma strategy identifies actions that will help to reduce stigma. Task force members with lived and living experience are also leading the development of a stigma charter, which will challenge all of us to consider how we can work, together and individually, to create a stigma-free Scotland.

Dealing with stigma is one of the key issues that we as a society face in dealing with problem drug use and how it affects every community in the country. I do not disagree with Labour’s amendment when it comes to the fact that stigma disproportionately impacts on the most deprived communities, and I agree that tackling poverty, deprivation and health inequalities is also crucial.

However, I highlight that drug dependency can affect anyone. We know that certain factors, such as adverse childhood experiences, can impact on someone’s likelihood of developing problem substance use, but it is not always as clear cut. In recent months, a growing number of people who live with alcohol dependency have presented at Moving On Inverclyde.

I welcome the reported reduction in drug deaths in Inverclyde from 33 to 16. However, that is still 16 too many.

Locally, I have witnessed a growing partnership approach. Much of that came about a few years ago, as the Inverclyde drugs strategy changed. It has become far more inclusive and recognises what the public and third sectors can bring to the table, together, to help to save lives. That can be only positive in dealing with the many economic and social challenges that Inverclyde faces. However, I am concerned that, given the cost of living crisis and the many economic challenges ahead, we may see a return to an increase in deaths. I certainly hope that I am wrong about that.

Finally, when it comes to the Tory amendment, I highlight the proposed bill, which has been spoken of today and in the past. Instead of playing politics on such a vital issue, I suggest that the member who wishes to bring the bill forward goes through the parliamentary process—that they publish the bill so that all MSPs can read it and make up our own minds. The detail of any bill is important. Frankly, to ask for blanket support of something without allowing people to read the details is to take for granted the public and those who need assistance.

Angela Constance has been consistent since she became the minister. The drug deaths crisis that Scotland faces was not going to be solved overnight. The roll-out of the national mission and its local implementation are vital to saving more lives. Tackling stigma will play an important role in delivering that outcome.

The Deputy Presiding Officer:

We now move to the closing speeches.

Photo of Paul O'Kane Paul O'Kane Labour

In rising to close for Scottish Labour, I reflect that today’s debate has been an important opportunity to discuss a range of issues related to the national drugs mission and the progress that we all want in eradicating stigma around these issues. We know that stigma has an impact on the likelihood of an individual asking for the help they need to start the process of rehabilitation following a period of addiction.

As we have heard from so many colleagues across the chamber, it is crucial that we work to eradicate stigma around drug addiction and drug deaths, as well as shifting attitudes to ensure a more meaningful, open and compassionate discussion as we seek to help prevent more drug deaths and to aid more people on their recovery journey.

In doing that, we must recognise at the outset the tragic loss of so many lives. Let us all remember again that they are not just numbers; they are people who lived in our communities, and they are often family, friends and neighbours. We must start with that at the core of our approach. I was heartened to hear so many colleagues mention that. I thought that Collette Stevenson spoke particularly powerfully in that regard.

We must take a different approach when it comes to stigma. We must take a root-and-branch look at where stigma and wider issues around drugs arise. Our approach must be focused on treating the deep-rooted socioeconomic factors that lead to drug use. It should be a holistic approach that is rooted in public health. The evidence is clear that the most deprived communities are those that are most impacted, and that they have many issues to deal with. We heard from Katy Clark and other colleagues from across the chamber about the sense of endemic poverty and the real structural challenge that exists in so many communities. Most public health experts would say that we must tackle those issues at their very root in order to make the most change. Data from National Records of Scotland has shown that people are 15 times more likely to die of a drug-related incident if they live in one of the most deprived areas, compared with the least deprived areas. Tragically, more than 12,000 people have lost their lives to drugs since 2007, leaving thousands of parents, children and friends behind, heartbroken.

We have heard contributions on the importance of services to support recovery, and particularly the importance of rehabilitation that is person centred and flexible in order to meet people where they are. As we have also heard, it can often be contradictory to assert commitments to tackling stigma and to help people access support services. In reality, there is a reduction in the support services that are available, due to budgets in health and social care reducing and budgets in local government being cut.

Claire Baker was right to highlight the need for greater investment and for greater pace of change from the Government. It is indeed the Government’s responsibility to demonstrate that progress, so that everybody can have confidence in the work of the national mission.

Photo of Emma Harper Emma Harper Scottish National Party

I really appreciate Paul O’Kane giving me time. We havenae really talked about the role of the media and journalists in tackling stigma. For me, it is about stigmatising images that have been used in print media. Does the member agree that that is something on which we could seek support from journalists?

Photo of Paul O'Kane Paul O'Kane Labour

I thank Emma Harper for that important intervention. That is absolutely crucial. We know that, over many years, the media have got it wrong, and Emma Harper is right to raise that point about the images that are used around drug use, particularly those of syringes, spoons and so on. There is also an issue around the language that is used. Emma Harper spoke earlier about educating people, about the words that we use and about how we refer to people, trying to look at everyone as a human being, seeing and respecting their innate dignity. That is absolutely important, and it is something that we would all want to reflect on and encourage all parts of our society to move forward with.

We have heard contributions today about the importance of the voluntary sector and the organisations that are embedded in communities delivering vital support to help people with addiction. Alex Cole-Hamilton was right to refer to the many campaigners and community organisations that work in this space, including on the provision of safe consumption.

Stuart McMillan mentioned Moving On Inverclyde, which I know is extremely important to him. He has served on its board for many years. I had the pleasure of visiting Moving On Inverclyde in the summer. It is a community-based support service that helps people who have been affected by problematic drug use. Speaking to people over a cup of tea about their lived experience and their journey was hugely powerful for me and, in many ways, it helped to open my mind to the different experiences that people have. I am sure that Stuart McMillan will continue to work with Moving On Inverclyde for many years, and I hope to work with him in that regard.

It is clear that our third sector needs more support. The Scottish Council for Voluntary Organisations has revealed that third sector and voluntary organisations are facing funding crises when it comes to the support that they can offer, and we need to ensure that they can keep the lights on and the doors open so that they can offer that vital support.

I think that that is true, more broadly, of public services. My colleague Michael Marra spoke powerfully about the need to ensure that people feel respected and valued, that they are met as human beings and that they are not perceived simply on the basis of their frailties or their failures, because they often feel stigmatised in that space. Crucially, we must have public services that are person centred and person focused.

Miles Briggs made an important contribution about housing. The principle of housing first is right, but that cannot be only a headline; there needs to be meaningful support behind that, to ensure that people are not stigmatised where they live. I am sure that we all know from our casework that concerns can be raised about extremely problematic language in that space.

I am conscious of time. If we are all serious about tackling the drug crisis in Scotland, we must take a public health approach. We need a response that meets the need that exists, that mobilises finance and resources quickly to meet the challenges and that acknowledges the scale of the emergency. At its heart, we need a response that puts compassion and humanity at its core.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

We often discuss and debate Scotland’s terribly sad and shameful record on drug-related deaths. Last year, we lost 1,330 Scots—those lives were cut short and families were torn apart.

Scotland still has the highest drug death rate in Europe. As Sue Webber reminded us, Scotland’s rate is 3.7 times higher than the rate for the UK as a whole. It is no exaggeration to say that, under the SNP, drug-related deaths have spiralled out of control. It is clear that the SNP’s strategies to help people who are struggling with addiction have failed. We cannot go on like this.

The drug death statistics expose serious inequalities. As Paul O’Kane said, in 2021, people in the most deprived areas were more than 15 times more likely to die from drug misuse. Sadly, last year, half of the deaths of people who were experiencing homelessness were drug related. Scotland’s polydrug habit, which involves street drugs being mixed with alcohol and prescription pills, is causing 92 per cent of all drug deaths.

We agree with the minister that stigma is a problem. Stigma can prevent people from seeking the help and support that they need. Using language that dehumanises people is harmful. I agree with Gillian Mackay, who said that stigma can kill. To remove stigma, we must have a compassionate approach and an effective strategy that provides solutions to what is a health issue.

I am not convinced that having drug consumption rooms located in our communities will help to remove the stigma. In fact, I wonder whether it could do the opposite. That said, I am open to a pilot project, so that we can observe and measure the effectiveness and acceptance of consumption rooms in a Scottish context.

Photo of Paul O'Kane Paul O'Kane Labour

Would Dr Gulhane accept that consumption facilities can take many forms and can be based around the community supports that I mentioned? There is a holistic model whereby people can receive different levels of support and use a safe consumption facility.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

Yes, but my worry is that drug consumption rooms could increase stigma. However, as I said, I am open to a pilot, so that we can find out how they might work in a Scottish context.

We need to bring the public with us. I believe that we can achieve that if we are also more effective at tackling those who prey on people with addictions. We need more compassion for people who are addicted to drugs and more convictions of those who profit from misery. We must strengthen our response across the drug supply chain and make Scotland a significantly harder place for organised crime groups to operate.

It saddens me that the SNP Government refused to sign up to project Adder, a UK Government scheme to help tackle drug dealing and organised crime. It has already helped with the seizure of 27 million benzodiazepine tablets that were destined for Scotland.

As for health interventions, what are the Scottish Conservatives proposing? We are calling on the SNP Government to listen to front-line experts and back our Right to Addiction Recovery (Scotland) Bill, which would guarantee treatment for those most in need. The key principle of the bill, which Stuart McMillan will be glad to know is heading through the parliamentary process, is to ensure that everybody who seeks treatment for addiction can access the addiction treatment that they require. There are many options available, including community-based, short and long-term residential rehabilitation, community-based and residential detoxification, stabilisation services and substitute prescribing services, and the approach will ensure that individuals can access a preferred treatment option, unless it is deemed harmful by a medical professional.

I turn to other points that have been made in the debate. Sue Webber referred to the huge gap between what is said and what is delivered on the ground, and she also highlighted the fact that, because everyone is unique, we need tailored support packages, especially for women with kids.

Claire Baker pointed out that we have a postcode lottery with regard to treatment. Commendably, she has started to help with the situation herself by undertaking Naloxone training.

Alex Cole-Hamilton mentioned the SNP Government’s slashing of funding, which has exacerbated the situation with regard to the postcode lottery of treatment, and asked about the sort of drug testing that I believed was considered at Glastonbury this year, while Miles Briggs and Emma Harper talked about how the use of derogatory terms contributes to stigma. Mr Briggs also went to talk about the huge difference that extra support and care would make, in light of Shelter Scotland’s comments about the situation pointing towards people being failed by public services and a broken housing system.

With regard to the specific mention of hepatitis C in our motion, Miles Briggs, who is also our hep C champion, pointed out that Scotland was once a world leader in eradication. However, we seemed to have lost our way.

Perhaps Willie Coffey, given his misjudged comments, needs to listen to the words of his leader, who said that the SNP took its “eye off the ball”, and to Michael Marra’s passionate description of the lack of action in Dundee.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

I think that we have heard all the misjudged comments that we need to hear. Annie Wells rightly reminded us that Scotland is suffering a drugs death crisis. [



Photo of Sandesh Gulhane Sandesh Gulhane Conservative

Thank you. She visited FAVOR UK for the launch of its report, and we all share its frustration about the lack of action, the current broken system and the barriers to treatment. FAVOR UK says “You talk—we die.”

Here in Scotland—in fact, across the UK—we need to create a system that treats addiction as a chronic health condition. No one should fall through the gaps and miss out on the treatment they need; moreover, there should be no stigma attached to addition, and I note that the Scottish Drug Deaths Taskforce’s approach would stop people struggling with drug use being turned away from service providers.

As a result, we are calling on the Scottish Government to back the proposed Right to Addiction Recovery (Scotland) Bill, which would enshrine in law a right to treatment, so that all those affected by addiction in Scotland can get the support that they need.

Finally, I remind members of my entry in the register of members’ interests as a practising NHS doctor.

Photo of Angela Constance Angela Constance Scottish National Party

In my opening remarks, I talked about the consequences of leaving stigma unchallenged, and members from all around the chamber have done the same in the debate. We all acknowledge the risks of stigma becoming embedded not just in society but in services, and that tackling it is key to public service reform—by which I mean, reform not just of drug and alcohol services but of the wider public sector response. Of course, one of the actions that will flow from our proposed stigma action plan is to really get underneath the skin of the issue and interrogate policy and practice with regard to what is being delivered on the ground.

Today, I can accept the amendment from the Labour Party. I acknowledge the wider range of harms of drugs beyond those where drug overdose is the cause of death. My officials will, of course, liaise with the National Records of Scotland and Public Health Scotland in and around the linkage of drug-related health data and public health intelligence, and we will report back to colleagues on that.

This is quite difficult terrain, given the impact of stigma. Sometimes, for understandable reasons, people with particular conditions do not acknowledge their drug or alcohol use and, sadly, the problem is established only when it is too late. Of course, I have taken action to start work on introducing the treatment target, and members will be able to see—through the national mission plan, which we have published, and the annual report—how we are measuring, tracking and monitoring progress, with the central aim of getting more people into treatment.

Photo of Miles Briggs Miles Briggs Conservative

I hope that the member has had time to read FAVOR’s report. It is an excellent report, and I congratulate FAVOR on it. It asks for a clear definition of residential rehabilitation to be introduced, and for the introduction of a centralised referral pathway and funding system. Is the minister considering that recommendation?

Photo of Angela Constance Angela Constance Scottish National Party

I read many excellent reports drafted by our diverse third sector community and the drug and alcohol sector.

I politely and kindly say to Mr Briggs that we have a clear definition of residential rehabilitation. Work on that was undertaken before my time as Minister for Drugs Policy, under the leadership of Dr David McCartney, and the work of the residential rehabilitation working group is still going on.

On the point about working towards more national approaches, particularly around what is possible in relation to national and regional procurement frameworks, that is something that we are actively engaged with.

I agree with much of what is in the Conservativesamendment. I am glad that they have expressed support for the recommendations that were made by the Scottish Drug Deaths Taskforce, and I hope that that support extends to all of the recommendations, including that our criminal justice system must take a public health approach to drug use, and that we cannot punish people out of addiction, particularly those people with multiple and complex needs.

As I have always said with regard to any member’s bill, I will give the proposed right to addiction recovery bill a fair and sympathetic hearing. I have no reason to do otherwise. Of course, as is the case with any bill—a member’s bill or a Government bill—the parliamentary process must be gone through.

In the meantime, the consultation on the proposed human rights bill will take place next year. That bill will be introduced during this parliamentary session, and it will give effect in Scots law—as far as possible within devolved competence—to a range of internationally recognised human rights, such as the right to the highest attainable standard of physical and mental health, and the right to adequate housing and an adequate standard of living. Of course, the national collaborative will set out how the rights that are to be included in the human rights bill can be effectively implemented for people who use drugs, because the solutions very much lie with the lived experience community.

I am pleased that members have acknowledged the Scottish Government investment not only in Harper house but in other endeavours to increase provision for women, such as River Garden Auchincruive in Ayr and the Aberlour Child Care Trust. I am sure that we will all be positive advocates for Harper house and do our bit to raise awareness of that fantastic therapeutic facility, which is part of the commitment of this Government and this Parliament to keep the Promise and keep families together.

Funding is important. It was, of course, the Auditor General for Scotland who said—admittedly, earlier this year—that, as a result of the national mission, there had been an increase of 67 per cent in real terms in allocated funding. We are, of course, all living with the consequences of inflation.

We have ensured that there are residential care pathways in every local area, and we have very much taken a belt-and-braces approach to funding.

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

My party and I are very grateful for the investment that the Government is making in residential care pathways and rehabilitation and, in particular, the investment for mothers with small children who are affected by substance use. However, residential care pathways are meaningless unless stabilisation services are adequate to get people into those pathways. Can the minister tell members a little about the investment that she is making there?

Photo of Angela Constance Angela Constance Scottish National Party

I remain absolutely committed to filling that gap. In our current service provision, we invest around £1 million in existing stabilisation services. Stabilisation services are very distinct from residential rehabilitation. We will come forward with an updated proposition as part of our overall response to the task force.

I was making a point about a belt-and-braces approach to funding. As well as giving continuity to local areas, we are directly funding 200-plus projects throughout Scotland. A wide range of funds is available for our wonderful voluntary sector to tap into. Some of the funding that is attached to the implementation of MAT standards directly supports nearly 100 additional posts in the sector.

Photo of Angela Constance Angela Constance Scottish National Party

I am going to move on because I am really short of time. I have to reply to a number of members, including Michael Marra.

As a number of members have acknowledged, we have laid groundwork for safer drug consumption facilities. There would have been an easier way to do all of that, of course, but we are where we are, and we are looking at capturing that within our existing powers.

I say to Claire Baker that families will absolutely be part of the stigma action plan. There is, of course, the investment in action that we are already taking around family-inclusive practice and the whole-family approach.

I would be delighted to engage further with Emma Harper, because she has raised important issues around supporting the workforce within and outwith drug and alcohol services, whether that is around trauma-informed approaches or stigma modules.

Miles Briggs—and, I think, Michael Marra—spoke about the flexibility of housing policies. It is an important point that policies need to be flexible when it comes to the allocation of accommodation. Through our work on stigma, when people say, “Oh no, we don’t discriminate,” our challenge to them is to say, “Well, demonstrate it—prove that you don’t discriminate against the most marginalised and stigmatised community in Scotland.” The matter is one of equality and equity. Different people need different levels of support. We will say, “Show us your policy and show us your data,” but we will also want to know what the lived and living experience community is saying on the ground about their treatment, how services make people feel, and how they are or are not supporting people into treatment or recovery.

Willie Coffey generated a bit of debate, but he said it well in many ways. This is about hope. I remember very well the visit to Recovery Enterprises Scotland and the time that we had together there. I remember the recovery walk in Kilmarnock, on which I saw for myself some of the projects, including the recovery hub, which has received funding as a result of the national mission endeavour.

The visibility of the recovery community is absolutely essential, because the evidence shows that the best way to reduce stigma is through contact with people with lived and living experience. That has the best long-term effect on reducing stigma.

I genuinely thank all members for their contributions. Although no one aspect of the national mission to save and improve lives should be considered in isolation if we are to secure that all-Government and all-Scotland response to tackling drug deaths, I brought this debate to Parliament to ensure that all members were involved before we finalised the stigma action plan and our response to the Drug Deaths Taskforce. The two documents will be published together to demonstrate exactly how we are turning words into action, because tackling stigma is cross-cutting—that is core—and we are going to get under the skin of the many challenges that we face.