The Scottish Government’s Minister for Drug Policy, Angela Constance MSP, delivered this statement to the Scottish Parliament on 3rd August 2021.
The loss of life in Scotland from drug related deaths is as heart breaking as it is unacceptable. It’s our national shame. I offer my condolences to all those who have lost a loved one – and my continuing commitment to do everything possible in our new national mission to turn the tide on rising drug related deaths.
On Friday I attended a vigil in Glasgow. I talked to and heard from many people who have been directly affected by drug deaths – the very people who have been let down. Now more than ever we need to make sure the experiences of those living with problematic drug use are part of the solution. That’s why we are investing in local panels and a national collaborative of those with lived and living experience.
We know drug deaths are preventable and avoidable. The publication of the 2020 drug death report on Friday was another stark reminder that the poorest communities suffer the most.
That is why our national mission to save lives is linked to other work across this government: to improve lives in mental health; to address poverty and inequality; to prevent Adverse Childhood Experiences; to build resilience through education and prevention; and to bring a public health approach to our justice system.
The 2020 annual report, for the first time, shows the terrible scale of inequality between our most and least deprived communities. The power of this analysis underlines the need for better information about the problems people face. We are making progress on this. Public Health Scotland is using a ground-breaking programme of data linkage which will help identify where actions are most needed.
The report shows wide geographic variation in drug deaths. Areas such as Glasgow, Dundee and Inverclyde are the worst affected. However, even the least affected areas in Scotland still have a greater problem in comparison to anywhere else in England.
Enhancing Scotland’s services
What we do know is that people in services have better protection from drug deaths. We need to focus on getting more people into protective treatment on the back of our long-term commitment to additional investment of £250 million – including £100 million for residential rehabilitation.
In May, I announced £18 million would be allocated through dedicated funds – for providers, including third sector and grass roots organisations: – to improve services; to increase capacity and improve access to residential rehabilitation; and to support children and families impacted by problematic drug use. These are five-year funds and organisations can apply for multi-year grants.
Since March we have provided £3.5 million in new funding for around 80 projects. This new approach is already helping to make grass-roots and third sector organisations more sustainable.
Making Scotland safer
We published the Medication Assisted Treatment Standards at the end of May. These Standards set out, for the first time, what people should expect and can demand of services – in particular, same-day treatment and access to a wider range of options, including residential rehabilitation.
I have given services a target this year to have the Standards implemented by April 2022, although I expect many areas to have the first Standard – including same-day prescribing – in place before then.
I am meeting with Health Board Chief Executives on 18 August, to drive home the importance of the Standards as a national priority in response to Scotland’s other public health emergency.
To support implementation we have provided an uplift in funding to Alcohol and Drug Partnerships. And we have provided £4 million over and above that for specific improvements to meet the Standards this year.
The 2020 statistics show another rise in benzodiazepine-related cases. The Drug Deaths Taskforce and the Scottish Government have consulted on changes to prescribing practice and guidance. An expert group meets next month to build consensus on this. The role of prescribers, including GPs will be crucial in helping stop this number rising in future.
We also need to know more about who is using illicit benzodiazepines or “street valium” – where they are using this and how they are using this. Which is why I am commissioning a rapid evidence review on the use of benzos – so that we can take all necessary action to address this. I will continue to push the UK Government on allowing drug testing in Scotland and on regulating the possession of the pill presses as well.
The 2020 Report also shows that methadone was implicated in more cases than before so I am also commissioning urgent research on the role and risks of methadone in drug related deaths – albeit in the context of poly-drug use.
We need to understand more about the drivers behind this trend including prescribing practice and the risks and needs of the most vulnerable.
I also want to see alternatives to methadone and long-acting buprenorphine made more available to people.
We know that release from custody can be a vulnerable time for many individuals, with increased risk of drug related harms and deaths. The Government will continue as a priority to mitigate any risks and consider ways to improve the circumstances and support available for individuals leaving custody.
We will commit to review the conditions around release from custody, including the issue of Friday liberations, as well as wider issues of throughcare support, release from remand and access to services. We will work with stakeholders to consider the options available to us, including new models of care, as well as procedural or legislative change that may be necessary.
Whilst men are more likely to use and experience harms from drugs, there has been a recent disproportionate increase in drug deaths among women. We know that there is a strong link between women having children removed from their care and risk of drug related death.
I have committed to getting more women into treatment and recovery – to tackle the issues around barriers to women accessing services and keeping families together. One of the priorities will be to develop and upscale women specific services, in particular for residential rehab where there are currently only limited options available.
I am pleased to announce that Phoenix Futures have been successful in principle in their bid to the Recovery Fund to establish a new National Specialist Family Service. The service, which will be located in North Ayrshire will be based on an existing facility run by the organisation in Sheffield and will offer a family-focused programme of interventions for up to 20 families at one time.
I have also worked with Police Scotland, Public Health Scotland and National Records of Scotland to reach agreement on providing more regular reporting on suspected drug deaths in our pursuit of getting more people into treatment quickly. Starting in September, and for the first time in Scotland, quarterly reports on suspected drug deaths will be published. This will allow us all to respond to what is needed more quickly and will help Parliament monitor progress.
Better information will also allow us to set a treatment target for 2022. This year is about making sure same-day treatment is available and that the range of treatment options available is wider – as part of implementing the Medication Assisted Treatment Standards.
We have seen many actions being taken for the first time during 2021. This includes the pilot project where Police Officers have been carrying and administering naloxone. This will already have saved lives and builds on the way in which emergency services can contribute to our mission – with the Ambulance Service having lead the way on naloxone carriage so far.
I am keen to see more, or all, Police Officers carrying naloxone kits as quickly as possible.
I have previously referred to media campaigns the Scottish Government will be running. Today, I can announce that these campaigns will focus on the use of naloxone and on tackling stigma – still a barrier to accessing life-saving services.
Creating Scotland’s National Care Service
The creation of a National Care Service will be the biggest reform in health and care since the creation of the National Health Service in 1948. Ministers have agreed to consult on the remit of the National Care Service and whether to include Alcohol and Drug Services in the systemic changes to the way in which people access services. In particular, we are asking whether residential rehabilitation should be commissioned on a national basis.
The consultation, which opens next week, is an opportunity to consider how we can better support Scotland’s most vulnerable and marginalised people and we are committed to listening to the feedback, including from those in the Alcohol and Drug sector.
No-one should underestimate the scale of the challenge we face. I certainly don’t. We have made progress with other preventable deaths – from alcohol, violence, some cancers and so change is possible.
But, change will not always be comfortable. I make no apologies for that.
Through these changes and the actions I’m setting out today we can improve and save lives – as part of the national mission – by getting more people into the protection of treatment and recovery. This will help reduce drug deaths in Scotland.
We have had the humility to accept what has been wrong and going forward we will have the courage to do what is right.