Drugs Policy

Stuart C McDonald Excerpts

Tuesday 23rd October 2018 Westminster Hall

[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

I pay tribute to my hon. Friend the Member for Inverclyde (Ronnie Cowan) for introducing this debate and illustrating yet again the expertise he has developed by getting involved in policy discussions not just here but in other jurisdictions, where he has obviously learned a lot.

As my hon. Friend and others have said, our starting point must be the dreadful impact that drug misuse has on too many people, directly and indirectly. We have heard about the statistics for Scotland: 934 drug-related deaths were registered in 2017, up by 66 from 2016. The hon. Member for Moray (Douglas Ross) fairly pointed out that those numbers are particularly awful, but the causes are complex and some of them date back decades. There are economic costs associated with the problem—drug misuse costs £3.5 billion a year in Scotland, and alcohol misuse costs a further £3.6 billion—but they are nothing compared with the personal tragedies of each life affected. This debate has allowed hon. Members to focus on how we should respond to this huge challenge. I thank everyone for their contributions.

It is fair to say that the majority view is that the criminal justice approach is not working, as the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said. Some hon. Members argued eloquently that the way we regulate drug use through criminal law needs not just reform but fundamental reform. We should be open-minded about that, and I agree that our response should be evidence-led.

Regardless of how we respond, we should first and foremost see this as a public health issue—almost everybody who spoke in the debate said that, and I agree—albeit one that requires input from many Departments, including on housing, mental health, employability, education and justice. In Edinburgh, the drugs policy unit has been moved out of the justice directorate and into the health directorate. Like the hon. Member for Manchester, Withington (Jeff Smith), I think that is exactly where it belongs. The 2008 drugs strategy, which has been referred to, received cross-party support, but it is being updated.

That first strategy, “The Road to Recovery”, helped to shift cultural attitudes and challenge stigma. It established a broad recovery network, delivered locally through 30 alcohol and drug partnerships. It brought together health boards, local authorities, policy and voluntary agencies in each part of the country. National leadership was provided by the Scottish Recovery Network, the Scottish Drugs Forum and Scottish Families Affected by Alcohol and Drugs. It led to a new focus on harm reduction. For example, the pioneering naloxone programme was designed to reverse the effects of opioid overdoses. We have heard a bit of criticism of that programme, but a recent NHS Health Scotland literature review demonstrated that take-home naloxone programmes increase the odds of recovery from overdoses, and improve knowledge of overdose recognition and management in the community. We have also heard criticism of the substitution treatment that accompanied the strategy, but the NHS Health Scotland evidence review suggests that, overall, the health of opioid-dependent individuals is safeguarded while they are in substitution treatment.

The new strategy is set to be finalised imminently. We have not seen the final draft, but we know something of the direction of travel. We also know that it will be funded by an additional £20 million a year in each of the remaining three years of the Scottish parliamentary Session. It will contain policies that reflect a better understanding of the causes of addiction and substance abuse, including some that have been referred to today, such as deprivation, poverty and adverse childhood experiences. As has been highlighted, there will be a more holistic focus on the person, rather than simply on the addiction. Recovery remains the goal, but there will be a greater focus on tying that goal to work on homelessness, employability, mental health and family support. That is simply in recognition of the fact that, too often, the most vulnerable find it hardest to access the sustained support they need for those key issues.

The new focus will be on “seek, keep and treat”. It is acknowledged that the most vulnerable are sometimes the least likely to access the services that could support them. There will therefore be more proactive outreach and advocacy, and broader and more sustained attempts to keep people in treatment by responding to their broader needs. My hon. Friend the Member for Edinburgh East (Tommy Sheppard) rightly highlighted that keeping people in treatment is problematic and that we need to do better on it. Treatment must be tailored carefully to the person. We must recognise that some will not be ready yet to start on the road to recovery or abstinence, while others will start on that road but relapse. Support must continue and be sustained throughout the process.

A measure that would fit with that approach, which a number of hon. Members have referred to, is the establishment of a drug consumption room. My party is keen on that, and there is almost, but not quite, unanimous support for it in the Scottish Parliament. Work on piloting a safe drug consumption room would be hugely welcome. It has been driven by the Glasgow City health and social care partnership. It could serve an estimated 400 to 500 people who would otherwise be injecting unsafely and publicly, and who would experience high levels of harm. Such a facility could significantly reduce the risk of further outbreaks of blood-borne viruses.

Evidence from elsewhere shows that drug consumption rooms can make a significant difference in reducing drug-related deaths. A Sydney study linked such facilities to fewer emergency service call-outs, an increased uptake of detoxification and drug-dependence treatments, a decrease in public injecting, and a reduction in the number of syringes discarded in the vicinity. Similar studies from Barcelona have found similar positive results.

The question is: why on earth does the Home Office not want to pilot a drug consumption room? The evidence shows that it is likely to achieve significant benefits. In the unlikely event that it does not work, the fall-back will not be on the Home Office; we will accept full responsibility. There is no justification for such intransigence. The Home Office’s failure to act is endangering lives. I echo calls from my hon. Friend the Member for Glasgow Central (Alison Thewliss) for the Minister to meet the Public Health Minister in Scotland. She should visit Glasgow to hear from practitioners who are pursuing this cause.

Tackling drug addiction must be supported across portfolio areas. Ideally, we need education to try to help young people to become resilient to offers of drugs or pressure to take them in the first place. Where the criminal law is breached, diverting people—especially young people—from the criminal justice system can be effective if alternative interventions mean addressing the underlying causes of offending, including for drugs, with hugely beneficial lifetime implications. If drug users are in prison, a dedicated improvement fund is being used in Scotland to ensure that programmes there properly address health-related causes of offending, such as drug and alcohol misuse. Each of those drugs policies could be the subject of a separate debate in their own right.

Drug addiction is first and foremost a public health issue. Our key ask is for the Minister to look again at piloting a drug consumption room in Glasgow. She has absolutely nothing to lose with such a policy, and lots of people have lots to gain.

--- Later in debate ---

[Victoria Atkins]

One or two police and crime commissioners may say that—I know, because they write to me regularly—but the majority of them do not share that view. That is not to say that we cannot have a debate about this, but let us please not pretend that that is the view of the Association of Police and Crime Commissioners.

Recovery is a vital element of our approach. We are taking forward action to enhance treatment quality and outcomes. Here is perhaps where some colleagues have—inadvertently I am sure—fallen into error when talking about drug consumption rooms and heroin-assisted treatment. Sometimes, people may not understand the differences between the two programmes. We have run pilot heroin-assisted treatment programmes, where heroin users are put into an intensive support programme through their GPs or other medical professionals. They are prescribed diamorphine as part of an intensive programme of action. That is very different from drug consumption rooms, which support the illicit drug market.

[Stuart C. McDonald]

Will the Minister give way?

[Victoria Atkins]

I will not, as I am conscious of time. People wander into drug consumption rooms, having bought their fixes on the street. We have no guarantees on the safety of those substances. The Government simply cannot condone that sort of behaviour, not least because it falls foul of the Misuse of Drugs Act 1971, but also because it would not be responsible to support the illegal market.