Official Report 873KB pdf
The next item of business is a debate on motion S7M-01766, in the name of Maree Todd, on strengthening Scotland’s public health approach to preventing alcohol and drug deaths.
14:35
I open the debate on behalf of the Scottish Government by offering my sincere condolences to everyone in Scotland who has lost a family member, a friend or a loved one to alcohol or drugs.
I know that each and every one of us in the chamber feels acutely the tragic impact that alcohol and drug harms have had on families and communities across Scotland. In 2025, 1,133 people in Scotland lost their lives to drugs, and 1,152 people suffered an alcohol-specific death. Those numbers are devastating, and each and every death represents a person who should still be with us today. As minister, I will continue to dedicate myself whole-heartedly to taking every possible action to support recovery and save lives and, above all, to listening to and acting on the views of people with lived and living experience on the harms of drugs and alcohol.
Previously, I have spoken of my personal family experience of addiction. I know that there are members here today who have their own experiences of addiction and of loved ones who have been impacted by drugs and alcohol. To those members, I express my sympathy and support.
Addiction turns lives upside down, and it has a multitude of impacts on a person and on their loved ones. From my family, I know that there is no one linear route to recovery, and I know that every person’s experience is entirely unique. That is why it is important that we take the time to discuss the issue today, because addressing it requires a collective effort from us all.
As Sandra Holmes, founder of Families Campaign for Change, reminded us all clearly in September, political point scoring has to stop. This is everybody’s problem. Her message to us all as politicians was that we have to get round the table with families, who have the answers. That now is non-negotiable. I make a promise today to do that, and I have written to the Health, Care and Sport Committee to ask that we keep channels of communication open for members to share any ideas or views that they might have from their discussions with families.
Members have also been invited to a cross-party discussion on 17 November, which will be convened by families, on what more we should be doing. I ask colleagues across the chamber to work with me in the spirit of the motion to ensure that the voices of those with lived experience and their families are at the heart of the decisions taken.
Scotland continues to face a combination of significant challenges. Inequalities continue to drive poorer outcomes, with those in the most deprived areas 15 times more likely to have a drug-use death and almost five times more likely to have an alcohol-specific death than those in the least deprived areas. We also continue to face the impacts of stigma—people face judgment, exclusion or difficulties when navigating services and accessing treatment and support.
The drug market and patterns of drug use are changing rapidly, with increasing cocaine use, changes in the benzodiazepine market and the emergence of dangerous synthetic opioids. Substances such as nitazenes can be hundreds of times more potent than heroin, dramatically increasing the risk of overdose and death. We must respond quickly to that evolving threat by strengthening surveillance, improving early warning systems and ensuring that front-line services have the information that they need to act swiftly.
I do not disagree with anything that the minister is saying, but I am concerned about the pace at which the Government is dealing with the threat of nitazenes. I first raised it three years ago, when there were only nine deaths associated with synthetic opioids—there are now 247. I have raised the issue 10 times in the intervening years, and when I raised it with the First Minister, it sounded for all the world like it was the first time he had heard of them.
Let me be absolutely clear: nitazenes are very familiar to the health ministers in this Government, and to everyone in this Government, because they have wreaked such appalling harm on people in Scotland.
I agree that the member has raised those issues repeatedly. I am keen to hear from members today and in future about the changes in policy that we require to meet that need. I am keen to hear members’ ideas. I accept that there will be many descriptions of the problems that we face, but I am keen to hear solutions, too.
The minister gave a list of all the actions, with which I agree, that we should take in response to the evil trade in synthetic drugs. However, she did not mention organised crime gangs and the need for us to also have a strong arm of justice to deal with those evil organisations that are run as international businesses and make money from the misery, deaths and suffering of the people of this country who fall victim to their trade.
Let me be absolutely clear: it is not either a justice response or a public health response; it is both a justice response and a public health response. We need to tackle the criminals who are wreaking death and destruction on our streets, but we also need to take steps to reduce the demand. We need to take the whole-system actions that mean that people are less likely to take drugs in Scotland.
Even as we respond to nitazenes, the drug market continues to evolve. That is the frightening truth. New synthetic opioids are emerging with alarming speed, including orphines, which have begun to appear in the United Kingdom over the past year. That is why our RADAR—rapid action drug alerts and response—early warning system remains so important. It provides timely intelligence on emerging risks and equips people who are using drugs but also front-line services with harm reduction advice and practical actions to protect lives.
In addition to the new testing facility in Glasgow coming on stream shortly, does the minister agree that nitazene lateral flow tests should be routinely available and dispensed across Scotland?
I am certainly happy to hear that suggestion from Paul Sweeney, and I am happy to take that discussion offline and out of the chamber. We both know that there are limits to the safety and efficacy of those lateral flow tests, but they are being used in specific situations in some parts of Scotland.
There is no silver bullet to reduce alcohol and drug deaths. We need to take a person-centred, human rights-based public health approach that listens to people with lived and living experience and provides the right support at the right time in the right place. To prevent more avoidable deaths, we must work across organisational boundaries with compassion and dignity, and we must not reduce debate to a choice between different approaches.
We have taken forward a wide range of actions so far. We have improved residential rehab access and capacity, stepped up the distribution of life-saving naloxone and driven consistency and quality of care through the continued implementation of the medication assisted treatment standards.
I want to raise the issue of rural areas and access to naloxone. We have to look at the spread of access to naloxone in more rural areas if we are going to save lives.
The member is absolutely correct: we need to ensure that everyone who is at risk of overdose has access to naloxone, and we have been very successful at that initial step. We also need to ensure that people are confident about using naloxone and recognise that the risks from the new synthetic opioids mean that people might need to use multiple doses and for a period of time until help arrives. I am absolutely happy to work with the member on the issue.
We have introduced innovative and evidence-based interventions such as minimum unit pricing, the UK’s first safe drug consumption facility, the charter of rights for people affected by substance use, and the drug checking services facility, the opening of which is imminent. Earlier this week, I announced funding for a new alcohol care team pilot in NHS Fife, which will better connect hospital and community services to support people who are experiencing severe alcohol-related harm.
We also continue to invest in recovery in residential settings and communities. In August, we announced £1.7 million to fund new support for residential rehabilitation and detoxification in Inverness. Today, I am pleased to announce an additional £750,000 for the additional placement fund to support alcohol and drug partnerships in funding additional residential rehab places, on top of the initial £2 million that was already made available in the fund this year.
Our backing for the Scottish Recovery Consortium will help to strengthen recovery communities and the vital peer-led support that they provide. Our £36.9 million alcohol and drugs fund invited applications from organisations working with people affected by alcohol and drugs. I am pleased to report that, in view of the high number of very high-quality applications that we received, we are making another £5 million available. That means more projects in more communities providing support to people where and when they need it.
The minister knows that I am very interested in alcohol services and treatment. Do we have a clear picture right across Scotland, particularly in rural areas, of the need for services?
To be fair, I think that we have a good understanding, but it could always be better. It is absolutely vital that we continue our important work with local alcohol and drug partnerships. For example, in areas that have been particularly impacted by drug deaths as a result of synthetic opioids, services have carefully analysed those deaths and carefully worked on outreach opportunities and solutions that are local to the area. It is not for us in the chamber to make those decisions; it is for us to enable the local response.
The latest statistics are a painful and urgent reminder that the action taken is not yet enough. We must do more. Our new alcohol and drugs strategic plan, published jointly with the Convention of Scottish Local Authorities and backed by more than £160 million in 2026-27, sets out a clear long-term direction for addressing harms through an evidence-based public health approach. Our approach builds on the national mission and strengthens action in important areas. We will place a renewed emphasis on prevention and early intervention, tackling the drivers of harm before they take hold and reducing the risk of future harm.
In response to rapidly changing trends and emerging threats, we will strengthen surveillance to identify risks earlier and to expand the medication assisted treatment standards to cover all substances, including alcohol. We will also reinforce our whole-system approach, recognising that substance use does not exist in isolation, and drive co-ordinated action across health, social care, education, housing, justice and community services to tackle the factors that contribute to harm and support better outcomes.
We will underpin all that with a human rights-based approach, listening at every step to those with lived and living experience and their families. Our strategic plan provides a clear direction of travel, but no single party or organisation has a monopoly on good ideas. As I said from the outset of today’s debate, I ask party representatives to engage constructively in discussions with the Government. Where members believe that our action is not going far enough, I ask them to bring forward solutions and offers of support and, in return, I commit that the Government will listen to those ideas with an open mind.
This issue is far too important for anything other than a serious discussion that is focused on solutions. Families, communities and people who are at risk expect us to work together to deliver change. That means challenging our established views and considering alternative opinions, specifically on drugs. It also means that we must have a grown-up conversation about the limitations that are placed on our response by an outdated United Kingdom legal framework in the form of the Misuse of Drugs Act 1971.
Let me be crystal clear about that. My raising of the issue is not an attempt to shy away from the Scottish Government’s responsibilities on the issue. Too many people are dying preventable deaths as a result of alcohol and drugs, and we must do more to address that. However, it is a simple fact that the actions that we can take are heavily constrained by UK-wide legislation.
We need to accept that what works in one part of the UK may not work in another. We all know that the rate of drug deaths in Scotland is an outlier internationally, and it remains much higher than the rates in other parts of the UK. That means that we require solutions that are designed around Scotland’s circumstances and that will deliver the best outcomes for our communities.
This is not about the constitution or blame; it is about ensuring that the people who are most at risk of harm receive the support and interventions that can make the greatest difference to their lives. We will continue to work constructively with UK Government colleagues to try to bring about the changes to the 1971 act that are urgently required. Where evidence points to opportunities to save lives and reduce harm, I hope that members across the Parliament will support our efforts to secure the tools that are needed to act.
You must come to a conclusion, minister.
In conclusion, I hope that today’s debate will be the beginning of a series of productive conversations on the issue. We might not agree on every policy proposal, but we can all agree that the intolerable rate of alcohol and drug deaths in Scotland must end. The people who are affected by alcohol and drug harm care far less about who gets the credit than about whether help is there when they need it. Let us match the scale of the challenge with the ambition, determination and collective effort that are needed to save lives because, behind every statistic is a person whose life was cut short and a loss that continues to be felt by those left behind. We owe more than words to those individuals and those who love them. We owe them action and a shared commitment to do better.
I look forward to hearing contributions from members from across the Parliament on how we can save lives.
I move,
That the Parliament deeply regrets every life lost through alcohol and drugs and offers its sincere condolences to all those who have lost a loved one; agrees that the tragic numbers of deaths from alcohol and drugs in Scotland are preventable and require the Scottish Government to use every lever available to save and improve lives; affirms Scotland’s commitment to a public health and human-rights based approach; supports the expansion of evidence-based harm reduction initiatives as well as the expansion of recovery and rehabilitation both within residential settings and in communities themselves; agrees that an urgent response is required to tackle dangerously potent synthetic opioids and other emerging synthetic drug threats, including through optimising Scotland’s surveillance system and early warning response; further agrees that the Scottish Government should continue to work constructively with the UK Government on substance use policy, noting that the 1971 Misuse of Drugs Act currently limits the ability to address all of the challenges faced in Scotland with a full public health approach, and ultimately recognises the crucial role that families play in the support and recovery of those using substances, and agrees, therefore, to work collectively across the Chamber to ensure that the voices of those with lived experience and their families are at the heart of decisions taken.
14:53
I will start on a note of consensus. I agree with the minister that we owe people action. We have owed them that action over the past five years, since the drugs emergency was first declared. Last month, we recognised the grim reality that drug deaths had again risen and were 11 per cent higher than in the previous year—still the worst rate in Europe. Each of the 1,133 deaths is a personal tragedy and points to a succession of missed opportunities. More than 7,000 people have lost their lives since the Scottish Government declared the public health emergency, back in 2019.
The Government took its “eye off the ball” on drug-related deaths—those are not my words but those of Nicola Sturgeon. This week, we learned that alcohol-specific deaths have fallen by 3 per cent. Although that is absolutely welcome, because it is going in the right direction, it still remains high compared with the UK average. Deaths among women have risen, but men are still twice as likely to die from alcohol-specific causes. However, the inequality is truly stark. People in the most deprived areas are five times more likely to die from the overconsumption of alcohol than those who live in the most affluent areas. The disparity with drug deaths is even worse: people are 15 times more likely to die in our most deprived areas. Overall, one in six preventable deaths is related to alcohol or drugs. The case for doing more is self-evident.
I know that the minister is considering increasing the minimum unit price above the 65p level that was set in September 2024. Alcohol Focus Scotland and other organisations believe that that is necessary and will result in a continuing fall in the number of deaths. Whatever the Government decides, the minister must recoup the additional revenues raised from larger retailers to fund front-line alcohol intervention services, which we have asked for over many years. That would include, for example, the roll-out of alcohol care teams, which we called for in our manifesto. The estimated sum would be in the region of £65 million, which is not an inconsiderable amount when budgets are tight.
Ms Baillie will be aware that the Government does not receive revenue from minimum unit pricing, so will she describe the mechanism by which the finances could be recouped?
I am aware of that and I want the Government to receive that money, because it would spend it effectively. We have previously set out the mechanism by which it would do that: taking that money—which is additional—back from large retailers. I am happy to talk to the Cabinet Secretary for Health and Care about that in more detail.
I welcome the minister’s decision to launch a pilot on alcohol care teams in Fife, where people presenting with alcohol-related problems can access the specialist care and support that they need. Scottish Health Action on Alcohol Problems has pressed for such teams for some time, and I am confident that they will prove effective in providing support.
The organisations that campaign to reduce alcohol harms also tell us that we need to restrict advertising and reform licensing. In the previous parliamentary session, the Government was forced to U-turn on its plans for alcohol advertising. We need to do more to protect children and young people from marketing, so let us consider how we can do that together pragmatically as well as improving drink awareness campaigning.
Another area that requires action is rehabilitation. Public Health Scotland has raised serious questions about the operation of residential rehab. In 2021, the Scottish Government committed £100 million over five years to its residential rehab programme. It set two ambitions: increasing capacity by 50 per cent to 650 places and ensuring that 1,000 publicly funded placements would be available each year. There has been some progress—it would be churlish to suggest otherwise—because the number of beds has risen by 35 per cent to 574. However, we are still 76 beds short of the target, and I am sure that the minister agrees that the existence of a bed does not mean that it is funded. Public Health Scotland’s evaluation, which was published last month, found that only 30 per cent of the 150 professional stakeholders surveyed agreed that residential rehab was easily accessible. Nearly half said that a lack of funding had become a greater barrier over the previous two years, while 53 per cent of ADPs continued to report funding constraints. We are five years on and £250 million has been spent on the national mission. That is not a great verdict.
People face long waits for rehabilitation and detoxification. There are gaps in aftercare and there is insufficient suitable provision for people who have caring responsibilities, have mental health needs or do not meet expectations of pre-treatment abstinence. The cost of placements also continues to rise much faster than inflation. The average cost of a residential rehab place has almost doubled, from just under £7,000 in 2021 to over £13,700 in 2024. In the context of roughly flat cash, that represents a substantial cut in provision.
The real test will be a lasting fall in the number of drug and alcohol-related deaths, and we are clearly a long way off that.
I recognise the part that safe consumption centres play in reducing harm, but we need to evaluate the model before it is rolled out more widely. Equally, we need to be more prepared for the challenges from deadly synthetic opioids entering the market, and the setting up of drug-checking facilities has been too slow to date.
It is clear that we need to work together across the UK to tackle this issue, stop the criminal gangs and target county line operations, and provide support and recovery for those on drugs, but it ill serves the people of Scotland to have this turned into a constitutional debate, especially when the level of drug deaths is higher here than it is in the rest of the UK, despite the law being the same.
Finally, resources for local services must match the scale of the challenge. There was a time when the Government inflicted real-terms cuts of more than £40 million on alcohol and drug partnerships. More recently, Audit Scotland found that funding had decreased in real terms by 8 per cent due to inflationary pressures. At a time of high drug deaths and deep inequalities, that raises serious questions about whether the funding models for front-line services are suitable or sufficient.
Behind every statistic is someone who might still be here—and someone who wanted them to be—and we can and must do more. I am happy to confirm that I will continue to work with the families as I have done for many years, since before I came into this Parliament. The Government recognises that it should be judged not simply on the money that it announces, the glossy new strategies that it publishes or the targets that it sets, but on whether people can access help when they need it. The measure of success must be that we start to see an improvement in the number of deaths prevented, of people helped into recovery and of families spared the loss of someone whom they love.
Scotland needs urgency, accountability and sustained action. We will engage constructively in that process, because we cannot continue to make promises that fail to reach the people that the work is most meant to help.
I move amendment S7M-01766.2, to leave out from “affirms” to “public health approach” and insert:
“regrets that over 7,000 lives have been lost to drugs since the Scottish Government declared a public health emergency, with drug-related deaths rising in 2025; affirms Scotland’s commitment to a public health and human-rights based approach; supports the expansion of evidence-based harm reduction initiatives as well as the expansion of recovery and rehabilitation both within residential settings and in communities themselves; agrees that an urgent response is required to tackle dangerously potent synthetic opioids and other emerging synthetic drug threats, including through optimising Scotland’s surveillance system and early warning response; further agrees that the Scottish Government should continue to work constructively with the UK Government on substance use policy and tackling the drug gangs, as well as simplifying oversight of substance misuse services; agrees that the Scottish Government should recoup the profits from minimum unit pricing from large retailers to fund frontline rehabilitation services”
15:02
Scotland’s drug and alcohol deaths are not simply statistics—they represent lives lost, families devastated and communities left asking why more was not done. In 2016, my dad was one of those lives, so, for me, this issue is personal, not political.
The latest figures make for devastating reading. In 2025, 1,333 people in Scotland died from drug use—an increase of 11 per cent on the previous year—and a further 1,152 people died from alcohol-specific causes. That is more than 2,200 lives lost in a single year. Behind every one of those figures is a human being—someone’s son, daughter, mother, father, brother or sister. We must never allow the scale of the crisis to make us numb to the individual tragedies that are involved.
We must also recognise that these deaths do not affect every community equally, and that is what my amendment seeks to do, because some of Scotland’s most deprived communities face a worse reality. In 2025, the rate of drug deaths in working-class areas—in areas such as the east end of Glasgow, where I come from—was 15 times higher than that in the least deprived communities. For alcohol-specific deaths, the rate was 4.8 times higher. Those figures expose a deep and persistent inequality in our country. For communities across Glasgow, this is not an abstract debate. Families in my city have experienced the devastating consequences of addiction, and too many people have watched loved ones struggle to access the support that they desperately need.
However, we need to be honest. This Government’s attitude has been slow and ineffective, with our nation now becoming numb to the pre-prepared press releases and media appearances each year by Government ministers. “Thoughts and prayers”, “Deepest condolences”, “Thinking of families”—to put it bluntly, working-class families do not want to hear such phrases any more. What we want is action, not political spin or media strategies. Those families see a Government that is more focused on grandstanding and international politics while people in our communities die. Hundreds—no, thousands—of working-class people have lost their lives at the hands of the Scottish National Party. A genocide of Scotland’s forgotten working class is taking place each year while this Parliament does nothing. As Faces & Voices of Recovery UK—FAVOR UK—says, “You keep talking, we keep dying.” We need a system that intervenes.
I welcome the constructive initial remarks in Thomas Kerr’s speech, but does he recognise that the use of the word “genocide” in the context of this debate will make people switch off and is really unhelpful? I wonder whether he will reflect on that and commit to engaging in the debate on a cross-party basis, as much as possible, so that we can work together to try to save lives.
As I said in my opening remarks, to me this is personal, not political. I used that language very carefully because that is what working-class people in my community consistently say to me. What else would we call hundreds of people dying every year, with the Government not taking action?
As I continue my speech, I think that Mr Harley will be pleased to hear that I will be constructive. I am happy to work on these issues on a cross-party basis, as I have done during the nine years that I have been a councillor on Glasgow City Council.
We need a system that intervenes early, provides effective treatment and supports people through recovery and rehabilitation. We need better access to residential rehabilitation, faster routes into treatment, stronger mental health support and more joined-up working between health services, local authorities, housing providers and community organisations.
We need a right to addiction recovery for all our fellow Scots. A bill that would have provided that was, shamefully, voted down in the previous parliamentary session, so I hope that members will support my amendment, which calls for such a bill to be reintroduced. Let us set aside politics and save lives.
We must also recognise the changing nature of the threat. In 2025, cocaine was involved in 589 drug deaths. That figure demonstrates the urgent need to improve prevention, public awareness and access to life support, and it shows why the police need the ability to support people by arresting those who sell drugs in the open air in cities such as Glasgow.
More than 1,000 people continue to die of alcohol-specific causes every year. Prevention, early intervention and accessible treatment must remain a priority.
I want the Scottish Government to be judged not simply on the strategies that it publishes or the funding that it announces but on whether the measures deliver tangible improvements to people’s lives. I am afraid to say that the statistics say otherwise. Are people getting treatment when they ask for it? Can families find help before a crisis becomes a tragedy? Are rehabilitation services available when they are needed? Are we measuring success by fewer deaths, fewer families being devastated by loss and more people being able to rebuild their lives? Most important of all, is the Scottish Government now prepared to accept that it is committing a mass death of ordinary Scots whose lives could have been saved if we had a minister who was properly in charge of the brief? Those are the questions that matter.
Does Thomas Kerr recognise that we also need more joined-up approaches? For example, City Property’s destruction of the Turning Point 218 service on Bath Street was a needlessly self-destructive act that has undermined our approach to dealing with drug-related deaths. Such organisations provide a rich tapestry of community-based support, which is critical if we are to divert people from problematic drug use and help people who are dealing with addiction.
I completely agree. As I said at the start of my speech, we need more joined-up approaches from various organisations, including local authorities and health boards, and other mechanisms to support people.
As I said, the questions that I asked are the ones that matter, and Scots deserve answers to them.
We should recognise the extraordinary work of front-line workers, recovery communities, charities and families who continue to support people through some of the darkest moments of their lives. They deserve more than warm words; they deserve a system that works alongside them and gives people a genuine opportunity to recover.
Every death from drugs or alcohol leaves behind people who must live with the consequences. We owe those families honesty and action. Scotland cannot accept thousands of lives being lost year after year as an inevitable part of life. We must do everything possible to prevent such deaths, support those affected by addiction and give people the chance to recover with dignity.
The test for the Parliament and the minister is not whether we can express concern about the crisis but whether we can work together to turn those concerns into results. Otherwise, the Scottish Government will continue to fail and we will continue to see more people losing their lives.
I have sought to be constructive in my amendment. I want to work alongside the minister and others to find a solution. We will not all agree on policies, but, as I said, this is personal to me, so I am willing to work together. I hope that the minister will be able to accept the amendment that I have lodged and that we can put politics aside to finally start to save lives.
I move amendment S7M-01766.4, to insert at end:
“; notes that the drug-misuse death rate, as reported by the National Records of Scotland, is over 10 times higher in the most deprived areas than in the least deprived areas; regards this as evidence that working-class communities are disproportionately affected by drug-related harm, and agrees that the right to recovery must be considered as part of the efforts to address substance abuse.”
15:09
As I have said before in the chamber, and as many have already said today, every death from alcohol or drugs is a tragedy. Behind every statistic is a person, family, community and life that should never have been lost. Although we rightfully speak about the scale of this public health emergency, we must never lose sight of the individuals behind the figures or the families who have spent years fighting for better support for their loved ones. I welcome the Scottish Government’s recognition that these deaths are preventable and that we must use every available lever to save lives, but recognition alone is not enough.
We need to ensure that our commitment to a public health approach is reflected in the services that are available to people wherever they live in Scotland. As an MSP for Edinburgh and Lothians East, I know that the impact of alcohol and drug harms is not felt equally across our communities. It is often those who already face poverty—which has been discussed—as well as those in insecure housing and those who face barriers to healthcare who experience the greatest harm.
Addiction is no doubt a public health issue and we have done the right thing by treating it that way. However, no single area of public policy exists in a vacuum. Addiction, mental health and housing all overlap and interact, and we cannot solve one issue of public policy without being cognisant of them all. Tackling Scotland’s drug and alcohol deaths must also mean tackling the inequalities that drive them.
We know that public health interventions work. Minimum unit pricing for alcohol is one of the clearest examples of Scotland taking bold, evidence-based action to reduce harm. The policy faced considerable opposition when it was first introduced, but the evidence has demonstrated its value in reducing alcohol-related deaths and hospital admissions. As SHAAP, which Jackie Baillie mentioned and which is an expert in the field, has argued, and as we argued in our 2026 manifesto, we could go even further by uprating minimum pricing with inflation every year. It is an example of what can be achieved when we are willing to put public health ahead of commercial interests.
In saying that, we cannot allow the success of minimum unit pricing to distract from the considerable work that remains. As has been said, yesterday’s data shows 1,152 lives lost and countless families and communities left grieving. Perhaps even more concerning is the widening gap between Scotland’s richest and poorest communities, which has already been mentioned by Thomas Kerr. Alcohol-specific death rates are now 4.8 times higher in our most deprived areas and, at the same time, access to specialist alcohol treatment has fallen by 40 per cent during the past decade. That should concern every single member of Parliament. We cannot claim to be taking a preventative approach while access to the services that help people address harmful alcohol use continues to decline.
The forthcoming alcohol harm prevention plan is an opportunity to change that, and I look forward to the Scottish Government publishing that plan as soon as possible, with clear timetabled commitments to address the price, marketing and availability of alcohol. Crucially, that must be accompanied by meaningful investment in treatment and support.
The same principle must guide our approach to drug deaths. For too long, drug dependency has been treated primarily as a criminal justice issue rather than the complex public health challenge that it is. Criminalising people who are experiencing addiction does not address the underlying cause of substance use. That is why the Scottish Greens have consistently supported a public health and human rights-based approach to drug policy.
The opening of Scotland’s first safe drug consumption facility in Glasgow was an important step forward. It recognises that keeping people alive must be our immediate priority, while also providing opportunities to engage with healthcare, treatment and recovery services.
I am very sympathetic to the point that Kayleigh Kinross-O’Neill is making, but can she accept that any decision to decriminalise possession of class A drugs should be made by the Parliament and should not be a de facto decision by the Lord Advocate?
I can agree with that. Holyrood should have more powers to deal with drug and alcohol deaths. That is a fantastic point, and I will get on to it in talking about Edinburgh’s consumption room, which is following a similar process.
My point is that access to harm reduction should not depend on where someone happens to live. We should also be pushing back on rhetoric that demonises users by calling the facilities “shooting-up galleries”. The success of the Thistle facility in Glasgow is clear and I am heartened that the City of Edinburgh Council has explored and consulted on plans to have a similar drug consumption facility in Edinburgh, but the truth is that we cannot wish away the existence of drugs and addiction and that they do exist.
Will the member give way again?
Yes.
I know that we want to have consensus in these debates because of the nature of the subject that we are talking about and the fact that many people are dying, but I must challenge the assumption that the safe consumption room in Glasgow is a success. There are no measurable outcomes and there has been no review of that. To assume that it is a success simply because it exists is not a fair assumption.
Might the member also agree that the idea of the safe consumption of drugs that kill people is a misnomer to begin with? I understand the emphasis on harm reduction, but does she accept that there is no such thing as safe consumption of those drugs?
The assumption that any consumption of drugs is unsafe is a fair one to make, but people do take drugs and will continue taking them, so the best that we can do for them is to make that as safe as possible.
I understand the member’s point about the Glasgow consumption room. There is a lot of reticence about the data, but the fact that there have been 93 episodes of cardiopulmonary resuscitation means that lives have been saved. Forgive me for forgetting some of the language, but people have gone in and taken drugs when, if they had done that in their own flats, they might not have been able to phone for an ambulance or to get medical assistance.
I thank Mr Kerr for his interventions and will continue with my point about Edinburgh. These facilities exist not only to offer pathways for treatment and support but, ultimately, to save lives, as I have just said. We cannot put our heads in the sand and hope that the issues will disappear, and addressing them primarily through justice avenues has also not worked. The process works by supporting people with health issues through health avenues.
We must consider how these services can be legislatively expanded across Scotland, including in Edinburgh and other communities where drug-related harms remain devastating. As many people have already said, that includes responding to the changing nature of drug supply. As the minister said, the emergence of potent synthetic opioids presents a serious and evolving threat. The impact of those new strains of drug across the world, perhaps most visibly in the United States, is extremely stark. We need effective surveillance, rapid early warning systems, widespread access to naloxone, and services that are equipped to respond to new substances.
I say at this point that we very much welcome the recent announcement of additional resources for alcohol support teams and drug services in Fife. When we are looking at public sector reform, those are fantastic examples of ways in which we can build up and share work across the country. We cannot have a postcode lottery on access to life-saving interventions and that support must include both harm reduction and recovery services, rather than presenting those as competing alternatives.
We must also recognise that the challenges of addiction and dependency are not confined to illegal substances. Our approach to alcohol, tobacco and—increasingly—vaping demonstrates why prevention must remain at the centre of public health policy. The growth of vaping, especially among young people—a description that I would still use for myself—should remind us of the importance of acting early to prevent nicotine dependency. Although vaping can play a helpful role in adults stopping smoking, we must be alert to the risks of creating a new generation that is dependent on those machines.
The lesson is the same across all areas. We must understand what drives the use of harmful substances, address the commercial and social factors that contribute to that and make it easier for people to access support without stigma. The Scottish Government must use every available power and continue to press the UK Government for the changes that are required to deliver a genuinely comprehensive public health approach to drugs.
Ultimately, as many have said, the measure of our success will not be the number of strategies that we publish or the commitments that we make. It will be the lives that we save, the families that are spared the devastation of losing someone they love and the communities that are given the support that they deserve. Those must be our priorities.
I move amendment S7M-01766.5, to insert at end:
“, and supports the further rollout of safe consumption rooms to other local authority areas as a health-saving intervention.”
15:19
Speaking in such debates is a very personal experience. I lost my dad to alcohol-related illness, and I know that the minister and other members, such as Thomas Kerr, have had similar experiences. I offer my thoughts and sympathy for all those who have lost their lives to drug and alcohol illnesses and the families and friends who have been left behind.
I have taken part in these almost annual debates on alcohol and drug deaths for the past decade and, today, it again feels as though nothing is changing. I have put forward many solutions and have tried to work with ministers, but it does not feel as though we are taking the issue as seriously as we should be. I think that the minister has too many responsibilities in her portfolio, which ranges from sport to women’s health. We need to be honest about the fact that an emergency response has not been forthcoming.
In preparation for today’s debate, I looked back at all the speeches and contributions that I have made and asked myself where we are going wrong as a country. Almost 20 years ago, pressure from the Conservative leader at the time, Annabel Goldie, resulted in the then First Minister, Alex Salmond, committing the SNP Government to the development of a 10-year drugs and recovery strategy. When that did not work, Annabel Goldie rightly called for a new focus on rehabilitation services, and, in the previous session of Parliament, my party leader, Douglas Ross, rightly worked to take forward his right to recovery bill, but it was not supported and then fell.
We know that recovery services should be at the heart of policy, but they have not been for the past 20 years. My concern is that policies are being supported that maintain people in dependency and create the drug deaths of tomorrow. Ministers used to talk about it being an ageing cohort.
Karen Adam made an excellent speech in yesterday afternoon’s debate, in which she made a point that should also be made in today’s debate—perhaps other members will talk about this later. We need to be honest about the fact that many people in our society are using alcohol and drugs to self-medicate because they have mental health issues and because long waiting times mean that treatment is delayed. Conservative members will continue to work with ministers to address that issue, but ministers must be willing to face some difficult issues.
I have raised the methadone programme on a number of occasions, but ministers have not reached out to say, “We need to review that now.” I hope that today’s debate will give ministers an opportunity to take away that message and to come back to Parliament to tell us that that is exactly what they will do. Today, it is estimated that there are 16,500 of our fellow Scots on the methadone programme. The statistics for 2025 showed that 338 people who died from a drug death had methadone in their system. The fact that 30 per cent of those who are in Government-funded treatment are dying is a sign of failure, but ministers are not willing to admit that the current system is not working. I hope that today’s debate will serve as a final wake-up call, the need for which I have spoken about for 10 years in a row.
Will the member give way?
I will let the minister in once I have read out this statistic.
Over the past five years, 2,373 people on methadone programmes have died with methadone in their system. That is shocking, and the policy needs to be reviewed.
Let me be clear: I am more than happy to work with the member on the issue. However, it is incorrect to say that every person who died with methadone in their system was on a methadone programme. Nothing in the statistics tells us how they obtained that opioid substitution therapy. It needs to be understood that people who take drugs sometimes obtain them through illicit means—in fact, that is mostly how they get them.
I do not plan to review the policy of opioid substitution therapy. On that issue, it is important that, as parliamentarians, we are extremely careful not to stigmatise treatments that are solidly based on evidence. The medical experts tell me that opioid substitution reduces the risk of death by 70 per cent.
I take on board what the minister has said, but I want to return to a speech that I gave in 2021. I hope that the minister will listen to this. My childhood friend Jamie Murray died from a drug-related death. His mum, Jane, bravely spoke out about the chaotic system that Jamie faced in trying to access support services and rehab. I used Jane’s words to make many of the points that I made, because it is vital that we understand the experience of people who support those with an addiction, rather than listening to civil servants or ministers who say, “This is our policy—we’re not willing to change it.”
As I said in that speech, Jane said:
“I used to go with Jamie to meetings, where he would be handed leaflets about methadone programmes, but when he’d beg to be sent to residential rehab, he was told there wasn’t any funding.
He’d ask to get taken off methadone as the side effects are so awful, but when he asked to have his dose reduced or to try a different treatment, he was simply told ‘no’.
It was soul destroying”.
It is easy to see how people end up on a roundabout way of living on those programmes. Jane continued:
“despite the fact that it was supposed to be family meetings we were attending, all the professionals ignored me and just spoke to Jamie, who clearly was very ill and unable to think”—[Official Report, 17 June 2021; c 82.]
and focus on what was needed.
Will Miles Briggs take an intervention?
I do not think that I will get the time back, so I am sorry, but I cannot take the intervention.
Families do not feel part of the system. It is now 10 years on, and I do not know why we are still having this debate. Why can families not be let in? Why are they not a key part of supporting their family member?
I want to thank all those who work in our drug and alcohol services across Scotland because, from the many visits that I have made over the past decade, I know that it is one of the hardest jobs in our health service today, dealing with people—and, often, families—who are chaotic. I pay tribute to them for the work that they are doing.
There have been many calls over the past number of years for a service redesign, but ministers really must not see this as just a debating point; we need a root-and-branch reform of our systems, which have not worked. Harm reduction is not working, either. We need an independent review of the programmes and a redesign of alcohol and drug services. We need more prison-based interventions, followed by transitional and long-term support.
Will Miles Briggs give way?
I do not think that I will be able to.
I am afraid that we are almost out of time.
That is why our amendment to the motion calls for the Government to set targets so that we can turn the situation around and ensure that the policies that we are pursuing are flexible enough to achieve that.
I move amendment S7M-01766.3, to leave out from “further agrees” to end and insert:
“recognises that preventing alcohol and drug deaths requires accessible treatment, effective public health measures and a strong justice response; expresses serious concern at the Scottish Government’s continuing shortcomings in access to treatment; regrets that the Right to Addiction Recovery (Scotland) Bill was not passed and calls for a legal right to timely and clinically appropriate treatment, backed by funded detoxification, residential rehabilitation, community recovery and aftercare; calls for a funded alcohol prevention and treatment plan with published targets and support for effective clinical harm reduction, alongside clear routes into recovery; further calls on the Scottish Government to review the effectiveness of the current methadone treatment provision and to report regularly to Parliament on access to treatment, recovery outcomes and the number of individuals assessed for rehabilitation who are not subsequently admitted to a programme, and agrees that the Scottish Government must use its existing powers, work constructively with the UK Government and involve people affected by addiction, their families and local communities in decisions.”
15:27
I welcome the debate and thank the Government for securing it. I express my condolences to everyone who has lost a loved one through an alcohol or a drug death, and I extend my condolences to members who have shared personal stories today.
Every death is a tragedy. Every life mattered. In 2025, 1,152 people died from alcohol-specific causes in Scotland, while 1,133 died as a result of drug use. Taken together, that is 2,200 lives lost in a single year. That should focus our minds on one thing: how do we turn the situation around?
As I see it, our responsibility is not to defend ideological or political positions; it is to save lives. That principle sits at the heart of the Scottish Liberal Democrat amendment. When it comes to drug deaths, both robust harm reduction measures and rehabilitation services are vital for saving lives. Harm reduction keeps people alive; rehabilitation and recovery helps people to rebuild their lives. Scotland needs both, and it needs more of both if we are to prevent yet more tragedy.
I know that I might be slightly repetitious and boring on this point, but although I agree with what Adam Harley is saying, he is missing the justice element: we have to deal with the supply. He is addressing the issues surrounding demand and use, but if we ignore the supply and are not prepared to talk openly about what we will do to stem the supply of these evil things, we will have to continue to deal with the human tragedy that we are discussing this afternoon.
I thank Stephen Kerr for taking the intervention—that is not what I meant to say. I thank the member for his intervention.
I entirely agree with what Stephen Kerr is saying. I note that I will cover the justice elements in my speech. As I see it, safer drug consumption rooms are there to stop people dying. Kayleigh Kinross-O’Neill made the point well that we would rather that people take drugs in a place where someone can save their life and then get them into services that can help them to turn their life around.
Adam Harley makes an important point about the synergy between harm reduction and rehabilitation services. The Thistle has demonstrated that there have already been 612 onward referrals, primarily to housing services, as well as drug rehabilitation services. That interdependence and the relationship building is key and is focused on the individual and their support network.
I entirely agree with Paul Sweeney. Some people who have been helped by those services would otherwise not have accessed any help, and that proves the point. I know that Alex Cole-Hamilton wanted to make the point that some data is available on that. We have heard about cardiac arrests and about deaths being prevented in the Thistle, so there is some evidence in that regard.
I believe that we should be wary of arguing about what such facilities represent politically. I note that we have not heard too much of that today. We need to be laser focused on what they are trying to achieve, which is, as I said, to prevent people from dying. We need to ensure that everyone has support that is tailored to them, and the test should be simple: does the intervention save lives and does it connect people with treatment and recovery? If the evidence suggests that it does, we should support it. That is why our amendment supports the continued development and evaluation of safer consumption facilities. We support that not because they will fix everything but because the crisis is far too serious for us to dismiss any intervention that has potential to save lives. We also want predictable multiyear funding for rehabilitation services so that they can plan ahead.
A message that comes consistently from clinicians, researchers and those working on the front lines is that they want more options, not fewer. We need a system that offers a wide range of evidence-based interventions and gives people the best chance of finding support, including medication assisted treatment. It is important that people can access long-acting treatments such as Buvidal where that is clinically appropriate. I see that the minister is nodding. The same principle applies to alcohol treatment.
Residential rehab has a vital role to play and it should continue to be supported, but most people who experience alcohol dependency are treated in community settings and in our hospitals. If we are serious about tackling alcohol harm, we need to expand both community and hospital alcohol treatment alongside residential rehab and not instead of it. We should place a greater emphasis on prevention and early intervention so that people can receive support before they reach crisis.
Scotland is fortunate to have some excellent academics, researchers and clinicians working in the field, as well as the fantastic people on the front line whom Miles Briggs paid tribute to. We should be investing in research that will help us to better understand what works for whom and why. We should be willing to embrace new ideas, test those ideas rigorously and then scale them up if they are proved to make a difference.
I also recognise the often hidden role of families. Family members are carers, advocates and sources of support through some of the most difficult circumstances imaginable, and we need to support them as well. During the summer, the minister and I attended the Scottish Drugs Forum conference, alongside other members in the chamber, and we heard directly from bereaved families. She will remember their pleas to be included in their loved ones’ drug death reviews, and I believe that she is open to addressing the issues around that. It would be good to hear an update on that in her closing remarks.
We must remember that substance use issues do not appear out of nowhere. They stem from individual circumstances, trauma and isolation and, as we have heard today, those from deprived backgrounds are more likely to fall into addiction. We need to tackle that inequality and to tackle the mental health crisis that we are facing in Scotland. We need to tackle the supply of harmful substances, especially new synthetic opioids, and we need to tackle the loneliness and isolation that are faced by far too many in our society. We need to take a pragmatic approach and use every evidence-based tool that is at our disposal to save lives.
I move amendment S7M-01766.1, to insert at end:
“; believes that robust harm reduction measures and rehabilitation services are both vital in saving lives; supports the continued development and evaluation of safer consumption facilities, and calls for predictable multi-year funding for rehabilitation services; supports the expansion of evidence-based medication-assisted treatment, including long-acting opioid substitution therapies where clinically appropriate; recognises the particular challenges faced by individuals experiencing both substance use and mental health problems, calls for improved access to integrated dual-diagnosis support, and acknowledges the often hidden role of families as unpaid carers, advocates and sources of support, recognising the need for appropriate support for families in their own right.”
We move to the open debate.
15:34
Every life that is lost to drugs or alcohol is a tragedy, and behind every statistic is a family grieving the loss of someone they love. I begin by offering my condolences to everyone who has experienced that devastating loss.
The latest figures show just how serious the challenge remains and why the Government must go further to reverse the rise in drug deaths. I welcome the minister’s recognition of that challenge today in her announcement of increased funding for rehabilitation services. However, it bears repeating that, in 2025, 1,133 people lost their lives to drugs, which was an increase of 11 per cent on the previous year. A further 1,152 Scots died from alcohol-specific causes, which was a fall of 3 per cent. Although that reduction is welcome, we must be honest that neither figure is remotely tolerable. We must devote greater attention to Scotland’s drug deaths crisis. The scale of the tragedy demands it, particularly with the growing threat of synthetic opioids.
That does not mean that alcohol harm should receive any less attention. As a younger person, I see the relationship that folk my age have with drink changing, and I genuinely feel that we are at a point at which Scotland is ready for a more open conversation, if we seize the moment. Given the minister’s considerable governmental, personal and professional experience, she of course has the ability to tackle both challenges in tandem. However, I wonder whether discussing drugs and alcohol together sometimes leads to overlooking just how different they are. The use of one involves illegal substances that are often hidden from public view and pushed underground, while the use of the other is entirely legal, deeply embedded in our culture and, in many circumstances, actively encouraged.
For most people, the conversation about alcohol is not about ending consumption altogether—that is neither realistic nor something that the public want. Instead, it must be about evolving our relationship with alcohol into a healthier one. Drinking is a huge part of Scottish life. For many, that relationship begins well before their 18th birthday. Alcohol is simply accepted as part of almost every social occasion.
However, the consequences of alcohol use are not felt equally. Men are more than twice as likely as women to die from alcohol-specific causes, and people in our poorest communities are almost five times more likely to die from those causes than are those in our wealthiest communities. We should all be concerned with those inequalities, and particularly with the impact on working-class men. Of course, women are also affected, through both direct alcohol harm and the wider consequences of harmful drinking, including domestic abuse at the hands of men.
I thank the member for giving way in what has been an excellent speech. He will be aware that the number of women who died last year from alcohol-related illnesses was up 3 per cent on the year before.
One of the biggest issues is that access to specialist alcohol treatment has fallen by 40 per cent over the past decade, so people’s ability to access services is not in a good place either. What would he suggest to ministers has to change in that regard?
I will shortly argue that we need to have more of a conversation with people experiencing alcohol harm in the communities in which they live.
We must recognise where progress has been made. Minimum unit pricing for alcohol has been an important intervention, with research estimating that there has been a 13.4 per cent reduction in alcohol-attributable deaths following its introduction. That demonstrates what evidence-based public health policy can achieve, but legislation alone cannot change a culture.
Since my election, I have spoken with alcohol harm campaigners. Some of them believe that a next step is removing alcohol from more settings. I understand the reasoning, but I remain sceptical that simply removing alcohol from certain places will necessarily change behaviour. We must consider whether we risk pushing drinking elsewhere, and potentially into less healthy environments. That does not mean avoiding difficult decisions; it means being realistic about how people live their lives. If we want to reach those who are most at risk—particularly working-class communities—we need to engage meaningfully where alcohol is part of everyday life. Whether, for men, that is at football, at pubs or at home, we need to have conversations rather than deliver lectures from this chamber.
Changing Scotland’s relationship with alcohol will take time, and we must bring people with us. I want Parliament to empower people to make healthier choices, rather than simply telling them what choices to make.
I appreciate where the member is going with his speech, because I also believe that it is particularly important that we take working-class communities with us. However, I would refer him to some of the citizens jury work, which shows that deprived communities recognise that being able to access alcohol very easily and readily is a problem. Some of that work is worth looking at.
I really thank the member for her intervention. In my role as deputy convener of the Health, Care and Sport Committee, I am willing to explore that issue much further—indeed, all members of the committee will do so.
I remain unconvinced that a top-down approach alone in solidarity will deliver the cultural change that we need. We must recognise that many people enjoy alcohol responsibly while being honest and up front about the harm that it can cause.
I know that my time is drawing to an end, so I ask the Government to ensure that that wider cultural challenge is reflected in its upcoming alcohol prevention plan. Alcohol harm deserves distinct and sustained attention and a national conversation. Ultimately, if we want to change Scotland’s relationship with alcohol for good, that change cannot come from Government alone; it must come through a genuine discussion with people in the communities whom we are elected to serve.
15:41
I remind members of my entry in the register of members’ interests: I am a mental health nurse in NHS Greater Glasgow and Clyde.
We know that drug and alcohol-related harms and deaths remain one of the greatest public health challenges that we face. Although progress has been made, there is no room for complacency. If we are serious about reducing harm and preventing avoidable deaths, our political will and leadership must remain firmly focused on interventions and supports that will shift the dial to prevention, save lives, reduce harm and help people to recover.
Regardless of how we express our condolences, those people who lose someone to drugs or alcohol will find little comfort in words alone, so what matters is what we do next. To achieve that, we must be candid about the reality that we face today, honest about the progress that has been made and the challenges that remain, and prepared to adapt our response as the nature of substance use changes and new threats emerge.
The member makes a valuable point about the need for evidence. Does she agree that, before we can properly assess whether one particular public policy or another is working, we should allow ourselves to be influenced by what the evidence suggests and not look at that evidence through a prejudiced or pre-decided position about what we think should work?
That pre-determined information has sometimes informed past policies but I think that we are learning and that the Government is taking that aspect seriously. Most importantly, it is about not only quantitative data but qualitative data and how it is processed. Mr Kerr is absolutely right, but the data is far more nuanced than what we usually process. The Government is taking a better approach to that work and the narrative is there—what has been said in the debate is about what is important—but it is also about the way in which policies are driven forward.
During my career as a nurse, I have cared for many people whose lives were profoundly affected by alcohol and drug dependency. I supported individuals during moments of crisis, worked alongside families living with crippling anxiety and constant worry and, sadly, witnessed far too many lives cut short. The reality for many families is heartbreaking: they watch someone they love become consumed by addiction, despite every effort to support them. They have had difficult conversations and pleaded with that person to accept the help, and they live with a constant fear that the next phone call could be the one that they have dreaded receiving the most.
One of the most persistent barriers to improving outcomes remains the stigma that is attached to addiction. There very much remain a societal bias and a discriminatory view—a perception of who that so-called type of person is. Too often, people who experience substance dependency are viewed through a lens of judgment instead of compassion.
The reality is that addiction can affect anyone. Some of the narrative that we have heard today in the chamber has demonstrated that. Addiction does not respect background, profession, income or circumstance. Although its harms are often felt most acutely in our most deprived communities, addiction can touch any family and any community.
We must also recognise that, for many people, the roots of addiction are deeply entrenched in trauma, adverse childhood experiences, poor mental health or other profound life-changing circumstances and challenges. Addiction is rarely simple and neither is recovery. For many, the chaotic and all-consuming nature of addiction can make it incredibly difficult for them to engage consistently with support, attend appointments or navigate systems of care that are often complex.
Families and loved ones might do everything within their power to help yet still find themselves feeling helpless as they watch someone struggle to accept or sustain the support around them. That is why stigma is damaging. When judgment replaces understanding, people are less likely to seek help, more likely to suffer in silence and more likely to experience poorer outcomes. If we are serious about reducing alcohol and drug-related harms and deaths, we must continue to challenge stigma and ensure that our services are compassionate, accessible and built around the realities of addiction and recovery.
I recently visited Abbeycare Scotland in Erskine in my constituency. It was an incredibly powerful experience to meet people who are at different stages of their recovery journey. I spoke with individuals who are currently receiving support, people who are continuing recovery in the community and people who now dedicate their time to helping others to navigate the same challenges. What struck me the most was not only the courage with which people shared their experiences but the sense of dignity, compassion and community that exists in the service.
The lived experiences that I heard about reinforced the importance of listening directly to those who understand recovery because they have lived it. There were many points of reflection. People spoke about taking ownership of their recovery, recognising the impact that addiction had on their lives and on those around them and the confidence that they have gained through residential rehabilitation. They also spoke about the importance of continuing support after treatment and about the value of services working collaboratively to help people to rebuild their lives.
However, one message came through particularly strongly. Although residential rehabilitation can be life changing, accessing the right support at the right time can still be challenging, and for some individuals and families, the cost of accessing suitable rehabilitation services can be a significant barrier. It is imperative that we continue to expand publicly accessible pathways into treatment and recovery so that access to support is determined by need and not by an individual’s ability to pay.
The member must come to conclusion.
As a nurse, I carry the memories of those who I cared for and who sadly lost their lives. As an MSP, I remain committed to ensuring that we never become complacent. Every preventable death is one too many.
15:48
I welcome the debate. As we approach the winter, a time of year when the harms from drugs and alcohol hit hardest, publication of the number of deaths from alcohol and drugs is a grim reminder of how they damage lives all year round.
It was welcome to hear the news on Tuesday that alcohol deaths have fallen, but alcohol and drug poisoning is still directly responsible for more than one in 30 deaths in Scotland. Lots of others suffer from worse health or have painful stories of addiction, which can complicate relationships with families and work. It is hard to know what we politicians can do about all this, especially as someone who does not drink. However, it is impossible to shrug off the data.
I want to dispel a common myth. The number of alcohol deaths in Scotland has not always been high. In fact, it has gone from being one of the lowest in Europe in the 1980s to becoming the highest at the turn of the millennium. In Glasgow in the 1990s, there was a spike when alcohol-related deaths trebled before being brought back down. That trend has parallels with the drug deaths crisis and is something that we can surely learn from. That rise was in part because of more alcohol licences and the sale of cheap alcohol, and the trend fell as drinks slowly became less affordable. Sadly, the cost of alcohol can cripple household finances.
Controls on pricing may be a blunt tool, but they have been effective in reducing harm. The evidence points towards changing habits among the heaviest consumers and a fall in alcohol deaths. I commend those efforts, but we still have work to do on alcohol marketing and the level of consumption.
At a time when it is much easier to stay home or spend time alone on our phone, I do not want to underestimate the social value of a trip to the pub. Pubs are amazing spaces and, let us face it, the trend towards the sale of alcohol to consume at home has not helped us. It is linked with rising harms, but pubs are not spaces designed for families, young teenagers or religious minorities such as mine, and we need those shared spaces, too.
Scotland’s health inequalities are shameful. They are worse in places where the high streets are empty areas and where people are denied access to services and jobs. Our most deprived areas have 15 times more drug deaths and five times more alcohol-related deaths. Alcohol and drug deaths affect young men in working-class areas most. A man’s postcode in Scotland can predict their life expectancy—a man’s postcode can carry four times the risk of dying early.
However, we do not have a public health plan that deals with all the social issues that we face. In 2011, the Christie commission made us aware of ideas of prevention. Fifteen years later, are we further forward? That is 15 years of missed opportunities. It is 15 years when we have jumped from one emergency to the next—from alcohol harm to drug deaths to homelessness to violence against women and girls.
It is good to see the Scottish Government getting behind prevention, but it must be co-ordinated action that is backed by investment locally. I am worried that joblessness and mental health problems in young people could be the cause of substance misuse in the future, and I am worried that cuts to the charity sector will isolate people and force them to manage their problems alone. I will work with the Government on their prevention agenda and on making public health a priority.
15:33
Every life lost to alcohol and drugs is a tragedy. Behind every statistic lie a person, a family and a community affected by loss. We all offer our condolences to everyone who has lost a loved one, and we all must recognise our responsibility to prevent further deaths. Today’s debate has begun to bring that consensus to the fore.
I will use my opportunity to speak to focus on the importance of a human rights-based approach to the crisis and on the work of REACH Advocacy. It is based in my constituency of Coatbridge and Chryston, but it is a Scotland-wide service whose representatives the minister met fairly recently.
REACH Advocacy has developed its work around the straightforward principle that every person has rights that must be respected throughout their recovery journey. Its approach is grounded in lived experience. The organisation grew out of the experience of people who had navigated health, mental health support and other public services while facing challenges associated with substance use. They understood the difficulties that people can face when trying to access such support, and they recognised the importance of people knowing their rights.
REACH Advocacy was established 16 years ago and, since then, it has developed human rights education, advocacy training and practical support to help people understand their rights and advocate for themselves and others. I believe its work has important lessons for how Scotland now responds to alcohol and drug deaths.
A human rights-based approach places dignity, fairness and wellbeing at the centre of decisions. It recognises that people who use substances are individuals with rights, needs and aspirations, like anyone else. They deserve to be treated with respect, and they deserve to be able to access appropriate support. Such an approach also places responsibilities on public services. People must be able to understand their rights, exercise choice and access the services available to them. Public bodies must take those rights seriously and be accountable for their decisions.
REACH Advocacy helps make those principles practical. Through its workshops and its Scottish credit and qualifications framework level 7 advocacy practice award, it equips people with the knowledge and skills to apply human rights in everyday situations. Its training helps participants to understand legislation, recognise barriers to services and put human rights principles into practice. The feedback from participants who have engaged with its service is particularly encouraging. Overall, participants comment that the training has helped them to understand how human rights influence their work and has left them feeling more knowledgeable and better able to apply what they have learned to their role.
Such experiences demonstrate the value of human rights education. Knowledge can give people greater confidence to ask questions, challenge decisions and seek the support that they need. The same principle applies to people experiencing problems with alcohol or drugs. Their ability to access treatment, housing, healthcare and wider support can have a profound effect on their lives. These services must work together, and people must be able to navigate them with appropriate assistance.
REACH’s approach also recognises the importance of lived experience. People who have faced such challenges bring valuable knowledge to the design and delivery of services. Their experiences can help to identify barriers that professionals and policy makers might overlook. We should ensure that people with lived experience have a meaningful role in shaping Scotland’s response. Their contribution should influence decisions about treatment, recovery, harm reduction and rehabilitation. Families must also have opportunities to contribute, with appropriate respect for the rights and wishes of the person receiving support.
I really appreciate the member’s contribution. We are talking about the understanding of people’s situations, so can we do more as a wider group, across the housing, health and transport portfolios, for people who have drug or alcohol addictions?
Yes, that is exactly what a human rights-based approach is about: bringing people together across policies, sectors or whatever phrase you want to use. That is exactly what REACH Advocacy, which I am focusing on in my speech, undertakes to do.
The minister has met members of REACH Advocacy before, but I encourage her to revisit the frameworks around the funding for its work, which has come to me as its local MSP. I ask the minister to use the reset and the open-minded approach that the Government and members are taking to look again at that. The service would be delighted to have the minister or any of her front-bench colleagues visit it again.
We need accessible treatment, effective harm reduction and strong recovery services in communities. We need to respond urgently to dangerous synthetic opioids, through better surveillance and early warnings. We must also continue to improve access to naloxone and residential rehabilitation. These things are in no doubt, and they must be done through taking a human rights-based approach.
We must also continue to work constructively with the UK Government on the changes needed to drug policy—a point that was made earlier in the debate. The restrictions associated with the Misuse of Drugs Act 1971 create challenges for Scotland’s public health ambitions. That is not an excuse, and other members, including the minister, have made that clear today. However, it is a fact that the 1971 act creates challenges, and members should come together to pursue the powers and flexibility required to respond effectively to the needs of our communities here in Scotland who are suffering.
The lives lost to alcohol and drugs remind us of the scale of our responsibility. REACH Advocacy shows us how human rights can become part of everyday practice. Its work empowers people to understand their rights, strengthens advocacy and brings lived experience into decisions that affect people’s lives. We must carry that approach into our national response. Every person deserves dignity and access to appropriate support, and every person should have a voice in decisions about their future.
I support the motion, and I hope that the Parliament can work collectively to ensure that Scotland’s commitment to human rights is reflected in the services that people receive and the lives that we save.
16:00
Every life lost to alcohol or drugs is a tragedy. Behind every statistic are a person—a son, a daughter, a parent, a friend—and families left grieving. I am sure that most of us will have such a connection, through either friends or family.
I begin by offering my sincere condolences to every family in East Lothian and across Scotland who have lost someone they love. Their pain is real and it must drive us to act. Those deaths are preventable. That is not a slogan, but a fact. Because they are preventable, this Parliament and the Scottish Government have a duty to use every lever available to us—in public health, justice, housing, education and community support—to save and improve lives.
Scotland has chosen a public health and human rights-based approach, as Fulton MacGregor mentioned in his speech. That is the right approach. We treat addiction as a health issue, not a moral failing. I acknowledge Stephen Kerr’s point that it is also a justice issue.
We must recognise the dignity of every person affected and commit to finding evidence-based solutions. That means expanding harm-reduction efforts, providing safer supply options where appropriate, and engaging in naloxone distribution, drug checking and other interventions to keep people alive long enough to recover. I remember that, when I was Minister for Housing, I visited the Simon Community and saw somebody being given naloxone right on the floor in front of me, which saved their life.
Such an approach also means expanding recovery and rehabilitation, both in residential settings and, crucially, in our communities. Recovery does not end at the door of a treatment centre; it continues in places where people live, work and raise their families. Recently, I met representatives of Substances Support Scotland, which has taken on the substance use service in East Lothian, and I will visit it again to meet some of its clients who are also my constituents.
As we have heard, we face an urgent and growing threat from dangerously potent synthetic opioids and other emerging synthetic drugs. Those substances are changing the nature of the crisis. I acknowledge the point that was made earlier about what we know about them, but it is how we deal with them that is the key issue. We must optimise our surveillance systems and strengthen early warning responses so that we can act faster and more effectively, as delay costs lives—of course it does.
At the same time, we must continue to work constructively with the UK Government. However, the Misuse of Drugs Act 1971 remains a significant barrier to taking a full public health approach in Scotland. We cannot ignore that reality, and I hope that members can come together to recognise that more of the relevant powers—if not all of them—should be devolved to the Scottish Parliament. Reserving powers limits our ability to respond here as fully as the evidence demands, so we must keep on pressing for the tools that we need while working in partnership wherever possible.
I have sympathy with Jack Middleton’s points about the separation of drugs and alcohol approaches—he has made those in the Health, Care and Sport Committee as well. The Scottish Government has a commitment to publish an alcohol harm reduction and prevention plan later in 2026. The SNP manifesto pledged to treat tackling drug and alcohol harms as a public health mission, prioritise early intervention and prevention, and trial hospital alcohol care teams—ACTs. The recent Fife community-based pilot is a positive first step in that regard, but a clearer national commitment and timetable for hospital ACTs is now required. The forthcoming alcohol harm prevention plan will be the true test of the prevention agenda and must include firm, timetabled measures on price, marketing and availability.
I have intervened before to say something similar, but I note that, although there is a lot of emphasis on harm reduction, the real test of our public policy in this area is surely recovery. It is about taking people out of the grip of these addictive substances, whether alcohol or, especially, drugs—Jack Middleton spoke a lot of sense when he talked about the difference between alcohol and drugs. We have got to try to focus more on recovery. Does the member agree?
Yes, I agree with that point. I think that I mentioned using every lever in public health, justice, housing, education and community support to address the issue. When I was Minister for Housing, there was a particular issue with drug and alcohol misuse among homeless people.
To return to the issue of alcohol, the number of alcohol-specific deaths in 2025 was 1,152. It has been mentioned before that the death rate was 4.8 times higher in the most deprived areas, and that nearly 30,000 hospital admissions were attributable to alcohol in 2024-25. Those figures understate the true burden, as they exclude alcohol’s contribution to cancer, strokes and injuries. I note that Audit Scotland has reported a 40 per cent drop in specialist alcohol treatment over the past 10 years.
Alcohol harm costs Scotland an estimated £5 billion to £10 billion annually. In my opinion, that exemplifies failure demand on public services. We have heard the discussions about public sector reform and the emphasis on prevention. Alcohol harm is one of the areas for review in that regard. Minimum unit pricing has already reduced alcohol-caused deaths by an estimated 13.4 per cent, so the 65p level is only a modest real-terms increase. Automatic inflation-linked uprating is essential.
Most alcohol is sold cheaply in the off-trade sector. Policies should protect pubs while targeting supermarket sales. We urgently need marketing restrictions, including on sports sponsorship and alcohol-free brand extensions, and licensing reform that covers online-only delivery. I have met SHAAP on a number of occasions in my time in the Parliament. It is calling for a national roll-out of hospital alcohol care teams, restored community treatment and brief interventions, improvements in treatments in the justice system and a public health levy on large retailers.
Most importantly, we must put the voices of people with lived and living experience, and those of their families, at the centre of every decision that we take. Families are often the first line of support and the last line of defence. Their knowledge, resilience and pain must shape policy—there should be no decision about us without us.
Alcohol and drugs are not a party issue; they are a human issue. The issue is whether we are prepared to treat the crisis with the urgency and seriousness that it demands. I believe that we are. I believe that the Parliament can work collectively, across the parties, to reduce harm, expand recovery and give people and families the hope and support that they deserve.
16:06
I declare an interest as a serving councillor on Dundee City Council.
A number of years ago, I read a book entitled “Chasing the Scream: The Search for the Truth About Addiction” by Johann Hari. It explores the history of the so-called war on drugs from prohibition right through to decriminalisation of personal drug possession in countries such as Portugal. The author interviews incarcerated cartel bosses, police enforcement officers, family members impacted by drug use and many others as he tracks the increasing violence and fear dominating the international, national and very local drug trade. In the book, he challenges us to explore the range of options that we might pursue to deal with drugs production, but he also asks us to think about why there is such prevalence of drug use. One of his conclusions is that the opposite of addiction is connection.
Although the brutal exploitation of addiction through the illegal global trade is to be totally condemned, how we support the victims and the families and children dealing with the reality of addiction is for us to decide. I am proud that we are taking a humane and compassionate approach.
The Parliament knows that, in Dundee, we have seen more than our fair share of grief, trauma and loss caused by alcohol and drug use. Dundee has one of the highest drug-use mortality rates in Scotland.
At a recent meeting of my council ward community planning partnership, we discussed a grim table that showed that, in Coldside, there were the equivalent of 617 drug-related hospital admissions per 100,000 people, which is triple the Scottish average of 201. Although the number of drug deaths in our city has fallen from a peak of 72 in 2019, a further 47 people died in 2025. That mirrors the national increase.
It is also significant that, in Coldside, there were the equivalent of 1,131 alcohol-related admissions to hospital per 100,000 people. That is more than double the Scottish average, and, if we took into account all the other deaths caused by alcohol-related conditions, we would find the figure to be double that.
The figures mirror national trends, which show a 3 per cent decrease in alcohol-specific deaths, but there is a worrying increase in women dying. I am sure that we would welcome an alcohol care team in Ninewells hospital. I would be happy to assist the minister in ensuring that that happens.
Every death is a failure of prevention, and my thoughts and condolences are with all the people who grieve those lost lives. We have heard many times that people from the most deprived areas are 15 times more likely to lose their lives to drugs than those from the least deprived areas. We know that alcohol-specific deaths remain nearly five times higher in the most deprived areas. Therefore, we are very familiar with the scale of work that we have to do. However, as I have said before in the chamber, Dundonians are relentlessly resilient and compassionate and continue to do all that they can to tackle the problems that we share.
Over the past months, I have been fortunate to visit some of the services that we are discussing, to talk to those providing and receiving treatment, and to witness first-hand the difference that those services make.
Like Michelle Campbell, I visited Abbeycare. In Jericho house in Dundee, there is a residential rehabilitation service, where residents living with substance misuse are provided with a dedicated support worker—often a peer support worker—as well as group therapy, counselling and clinical support. Those services are very clear that we cannot have recovery without rehabilitation. Jericho house’s motto is:
“Let us choose to believe that something good can happen.”
Through an abstinence approach, Jericho house is ensuring that, for men receiving treatment and support, something good is going to happen.
I am planning to visit Aberlour’s Cowan Grove services in Dundee, where pregnant and young mothers are offered 24/7 intensive support with tackling addiction. Aberlour ensures that these women and their young children remain together while they address their substance use at their own pace and without judgment. Scotland currently has only eight recovery and rehabilitation beds for women and their children, and Cowan Grove has half of them. The women accessing those services are vulnerable: most are victims of domestic abuse; their children have previously been removed into care; or they have grown up around addiction.
We also know that mothers suffering addiction are six times more likely than fathers to have their children removed, and 100 per cent of the women receiving support from Aberlour were at risk of losing their children. The service, like many others in Dundee, focuses on breaking that cycle of intergenerational addiction. We know that children raised in families that experience addiction are already having adverse childhood experiences that will impact them in the future, and we can never count the cost of a childhood lost.
Could the member start winding up? Unfortunately, we do not have a lot of time today.
Of course we need to crack down on organised crime, illegal drug cartels and county line dealers, who both create and exploit addiction. The criminality makes it very difficult for mums to seek support for their children, but let us work compassionately with the victims of addiction. As a Jericho house resident would say,
“Let us choose to believe that something good can happen.”
I call Helen McDade to speak for up to four minutes.
16:12
I will take the leeway that everyone else has, if you will allow that. I am sorry, but I was told five minutes, Presiding Officer.
That is not a problem. We all have to accept and stick to the time limits and not comment on them—four minutes was agreed with your business manager—but I hear what you say, in that you thought you had longer.
Thank you. I will make sure that I stick to time.
I thank the minister for bringing the debate to the chamber and, as convener of the Health, Care and Sport Committee, I also thank her for her invitation to a round table that is coming up soon. I look forward to taking part in that.
Of course, we all want to be collegiate, but we all have evidence to bring forward. The evidence base has been mentioned often, and I thank Irshad Ahmed for reminding people that Scotland had one of the lowest rates of addiction in the 1980s, so something has changed, and we need to look at that.
I will look at a few things in particular, and one of them is methadone. I have one thing in common with the minister, as she is a pharmacist, and I was a veterinary surgeon: I look at the medical aspects of this issue, but also at some of the other aspects, such as availability and what happens in relation to that.
We have talked about evidence base, and I look forward to being convinced that people being on methadone for up to 30 years is evidence of success. I think—and my party thinks—that we have to look at this again. The evidence is not there if people are still on it. If we look at the numbers, we see that a third of the deaths last year had methadone involved. The minister mentioned that it might not have been legally given but, of course, the more available it is, the more likely it is that somebody is selling it.
Will the member take an intervention?
I thank Ms Anderson, but I certainly cannot take her intervention.
New drugs have been mentioned, but they are also available in other countries—and, again, we are the worst in Europe, so we need to look at what is happening there. I look forward to being presented with the evidence about that from the experts.
Ketamine has not been mentioned. I was appalled to discover that young women and men are losing the use of their bladders because they are on ketamine. The minister said to the health committee that action is being taken to publicise what is happening in that regard. There is a specialist centre in Aberdeen for that issue, and it would be good if more young people were told about the dangers.
I agree with Stephen Kerr that we must not forget the criminal justice aspect. Of course we want to take a non-judgmental view of people, but we need to help children and young people who are living with people with addiction issues, and, if folk are stealing, we need to deal with those issues, too.
We should consider the areas in which there have been fewer deaths. People are keen on safe consumption rooms, so I look forward to seeing the evidence on them. If people take drugs in front of someone and then get naloxone, I do not accept that they have been saved. That is a spurious argument, but we can consider the evidence in that regard. The evidence shows that the number of deaths went up, not down, in Glasgow. On the other hand, over the past few years, there have been fewer deaths from drugs in the area covered by NHS Fife, so we should certainly hear from that health board on what it thinks has worked.
It has been mentioned several times that the number of alcohol-related deaths is similar to the number of drug-related deaths, but I agree with Jack Middleton that we should consider the two issues separately, because alcohol is legal and has a place in our society. I would suggest that we might not want to sell or, indeed, hand out alcohol at all the lobbying events in the Parliament. That is just a thought, but I mean it seriously. We are saying to people, “Do as I say, not as I do,” which is what we say to our youngsters.
I would also like to mention advertising, but I see the time, so I will finish by saying that advertising is a big problem and that we should have a right to recovery bill.
Speaking times are agreed with business managers, and some members’ speaking times in debates are very different from other members’ speaking times. That is why, as a courtesy, we let the member who is about to speak know how many minutes they have—and, indeed, let other members know, so that they know whether interventions are appropriate.
I call Stuart McMillan, to be followed by Alan Brown, both of whom have five minutes.
16:17
I remind members that I chair Moving On Inverclyde, which is a recovery organisation in my constituency.
I put on the record my condolences to all those across Scotland who have lost a loved one through substance use, including the 17 people who lost their lives due to drugs and the 29 people who died due to alcohol in Inverclyde in 2025. As the Scottish Government’s motion highlights, such deaths are preventable.
I welcome the national mission programme, which has delivered record investment in alcohol and drug services. However, as has been said, we are talking about deep-rooted issues in our society, which are often connected to issues of poverty, deprivation, inequality and, as Heather Anderson touched on, connection.
I welcome the Scottish Government’s new alcohol and drugs strategic plan, which reaffirms that the use of drugs and alcohol should be treated as a public health issue. Third sector organisations across Scotland, many of which are small grass-roots groups, are key partners when it comes to recovery services. Recovery can look different for every person, so we need a variety of approaches to ensure that everyone gets the support that is right for them.
The motion references the crucial role that families play in providing their loved ones with support during recovery. Often, family members are the main support network for a loved one living with substance use issues. Families in the know, which is a local group in my constituency, was set up a few years ago to provide a safe space for mothers whose children had been living with substance use issues. That relates to the point about connection that Heather Anderson made. The group has told me that mothers often become the main caregivers for children affected by drug and alcohol use, but they feel that their voices are often missing from conversations about recovery—the point that Miles Briggs made regarding methadone is one that I have heard consistently from constituents over many years, and I sympathise with it.
I am pleased that the motion recognises the vital role that families play. That ties in with the information in the briefing for today’s debate from Scottish Families Affected by Alcohol and Drugs.
Although my Inverclyde constituency recently recorded a reduction in drug deaths, we have witnessed an increase in alcohol-specific deaths. I have reflected again this week on Audit Scotland’s 2024 report into alcohol and drug services, which states that
“Alcohol consumption and binge drinking are a deep-seated part of Scottish culture”
but that increased focus on drug harm has shifted
“the balance of attention from, and effort on, tackling alcohol harm.”
We cannot lose sight of the specific issues and challenges related to alcohol-related harm, and I welcome the Scottish Government’s commitment to expand treatment standards to include alcohol and all drugs. I respectfully disagree with colleagues who think that they should be treated separately, because there has been improved partnership working in Inverclyde when the alcohol team and the drugs team were brought together about seven or eight years ago, which was not the case before.
I also welcome the new alcohol care teams pilot in Fife, which will provide intensive support for people beyond hospital and into the community. I have previously been contacted by constituents about the lack of aftercare following a period in hospital and rehabilitation for alcohol use. I put on record that I ask the minister for that to be expanded to Inverclyde, as Inverclyde has the second-highest level of alcohol-related deaths in the country.
There is also a third part that needs to be considered, which Michelle Campbell touched on earlier, and that is poor mental health. Poor mental health goes hand in hand with substance use, but, sadly, untreated mental health illness can be why someone develops a dependency on alcohol and drugs.
In Inverclyde, crisis mental health services have deteriorated under NHS Greater Glasgow and Clyde. Too many of my constituents are struggling to get the mental health support that they need, which does not help them if they are also living with alcohol and drug dependencies. It does not help the families who are trying to get their loved one the help and support that they need, but for those needing crisis interventions or specialist acute mental health support, engaging with recovery services can be difficult. I urge NHS Greater Glasgow and Clyde to rethink its approach to crisis mental health support in my constituency, which is why I raised that directly with the chief executive of the health board only four or five weeks ago.
If people cannot get that appropriate mental health support, they will struggle to properly engage with recovery services, which leads them to being at greater risk of alcohol and drug-related harms. A public health approach to substance use must also have mental health at its heart.
The final speaker in the open debate is Alan Brown.
16:22
In East Ayrshire, in 2025, there was a welcome reduction in the number of alcohol-related deaths, but East Ayrshire also bucks a trend in that drug-related deaths in 2025 considerably exceeded alcohol-related deaths. Sadly, East Ayrshire had the single biggest increase in recorded drug deaths in a local authority area. There were 21 recorded drug-related deaths in 2024, and that figure increased to 48 in 2025. That increase was bigger than those in Glasgow, Edinburgh and Dundee combined, and more than double the number of families and friends were impacted by the death of a loved one in East Ayrshire during that one-year period than they were in the previous year. Neighbouring North Ayrshire’s increase means that those two local authorities combined effectively make up 44 per cent of the Scotland-wide reported increase in drug deaths.
It is critical that detailed analysis is undertaken to understand local spikes and underlying causes and so that resources are targeted appropriately. I believe that the increase might partly be because people who have been on methadone and/or hard drugs for going on 35 to 40 years now are at a stage where their bodies have taken enough punishment. That is a reminder of how long this has been an issue—it goes all the way back to deindustrialisation in our constituencies.
As others have said, methadone is important for stabilisation, but it must go hand in hand with ongoing recovery support with the aim of fully ending drug dependency. It is a stark fact that across Scotland, methadone was present in 30 per cent of recorded drug-related deaths in 2025.
To support people towards a full recovery, we have to make use of the third sector, which can reach people who might not otherwise engage fully with regular services. Organisations such as Each Recovery Matters, which is based in Kilmarnock, provide drop-in services, peer support and, importantly, volunteering and coaching opportunities. Those are life-saving opportunities that can turn people’s lives around.
We can look at drug dependency and drug deaths as being primarily health related, but, as others have said, poverty is a key issue, as is hope, or, in too many cases, a lack of hope. For some people, predominantly younger males, that can manifest in a vicious cycle of mental health issues, the use of drugs, exacerbated mental health issues; and, in some cases, suicide. I have been at three funerals for young men who have taken their own lives. That is another cycle that needs to be broken, which means ensuring better access to mental health support, particularly at the point of crisis.
For those reasons, there is no one-size-fits-all solution. That is why we need intelligent debate about the provision of safe consumption rooms and about decriminalisation. There is a legitimate debate about the concept of a right to recovery, but I find it incoherent to be against decriminalisation and safe consumption rooms and to demand cuts to the benefit system while expecting a right to recovery bill to be a silver bullet.
Despite what people have said, there is clear evidence that safe consumption rooms can be a transition towards engagement with relevant services. There is proof from other countries around the world that safe consumption rooms have helped to bring down dependency and drug use and to prevent deaths. To my mind, being against decriminalisation means wanting people to go to jail, which is clearly self defeating.
The member referred to evidence about safe consumption rooms. While I was at a project in Auchinleck that the member will be familiar with, we discussed whether there is any evidence from rural settings around the world. Has the member read anything about that?
I wish I could come up a perfect example, but I cannot. I refer the member to a report from the UK Parliament Scottish Affairs Committee. Its members visited Portugal and Ottawa in Canada, but I am not aware of evidence about rurality. I would be happy to work with the member to look into that.
Will the member give way on the issue of decriminalisation?
Yes.
I was disappointed to hear what Alan Brown said about the decriminalisation of drugs, because he was automatically drawing a straight line between breaking the law and going to jail. There are many other possibilities that exist if someone needs help and is given the opportunity to get the help that they need. That help might well come through a court, so dismissing that, as Alan Brown has done, is deeply disappointing.
It is no surprise that I have disappointed Stephen Kerr. Decriminalisation means that there is no possibility of a criminal conviction. Being in the criminal justice system is not a cure or a form of recovery. Regarding Mr Kerr’s earlier wish that this Parliament could make decisions, if we were to make such decisions properly we would have to devolve the Misuse of Drugs Act 1971. That is a fact.
To return to the issue of rehabilitation, I welcome the increase in access to rehabilitation accommodation and the further funding announced by the minister today. However, we must ensure that there is equitable access to rehabilitation and not a postcode lottery. Also, too many organisations claim that they are not running at full occupancy and have been only 50 per cent full. That means that opportunities for rehabilitation and recovery are being lost. Not only that: it makes financial sense to run at full occupancy because that reduces overheads and therefore reduces the cost per patient. There should be some kind of central audit of the facilities available so that we can look at the opportunities to maximise any spare capacity.
Post-recovery support is equally important. Too many people may return to, or remain in, the same environment—
The member must begin winding up.
—where they face too many challenges and risk relapsing. That is why ongoing support is critical. The strapline of the charity that I referred to earlier is, “Each person matters.” I agree.
The member must wind up.
Each person needs a chance to fulfil their future, to turn their own lives around and to help to improve the lives of others.
We now move to the closing speeches. A number of members who spoke in the debate are not present in time for the beginning of closing speeches and the same thing happened yesterday. I remind members that if they speak in any debate they must be present for all of the opening and closing speeches.
16:29
Like Miles Briggs, I have been attending such debates for the 10 years for which it has been my privilege to serve in the Parliament. I intend to keep attending these debates for as long as we have them, despite having handed over the health brief to my excellent colleague Adam Harley. There was a time in my early years as an MSP when such debates would be held only in Opposition time, so I welcome the fact that we are now debating the subject in Government time. That is really important, and it is a measure of how seriously the Government is taking the issue. I recognise that it wants progress to be made, and I want it to succeed. Preventing alcohol and drug deaths is an issue on which we should all get behind the Government’s efforts. What we are debating today is the Government’s choice about the direction to take.
Although the profile of drugs in our society has changed fundamentally, the body count, sadly, has not. In my early years as an MSP, I had never heard of fentanyl, synthetic opioids or nitazenes, yet they are now fast becoming the go-to drugs for many people who just want a temporary departure from the trauma that they face in their daily lives. This is real. It is happening now, and we need to get wise to it. We must surveil the situation and offer drug-checking services to help to reduce the harm.
Harm reduction is such an important aspect of the work in this area, but it seems to be unnecessarily politicised. Harm reduction is an approach that recognises that there will be people who we have not yet helped to heal who will want to counter the agony that they face by taking drugs to mask their pain. We can save those lives by making naloxone available. That is why my party was keen for naloxone kits to be installed next to defibrillators right across the country. The provision of such life-savings stations, along with bleed kits, would mean that people would automatically know where to find naloxone if they found somebody who was experiencing an overdose.
When I visited McDonalds on Princes Street in my constituency, I was shocked to hear that, every year, there is a death in the restaurant toilets of someone who has gone there to use heroin. I asked whether naloxone was available and whether the staff were trained in how to use it, and I was told that they had never heard of it. That is an example of the low-hanging fruit that the Government should be getting to.
There has been a lot of talk about safe consumption rooms. I would be happy to give way to Stephen Kerr if he can tell me what it is about the Thistle centre in Glasgow—which I assume that he has visited—and the 200 overdose events that it has prevented that he is so upset about.
I am more than happy to take the opportunity to intervene. My objection to the Thistle centre is based on the fact that a proper evaluation has not been carried out. Random statistics are fine, but we need to look at the role of that public policy initiative in helping with recovery and reducing drug deaths. Neither of those things is happening.
It would be much easier to listen to Stephen Kerr’s pearl clutching on the Thistle centre if he had taken the time to visit it, to meet the clinicians on site and to hear about the evidence that they have gathered on the lives that they have saved.
How many community groups has Mr Cole-Hamilton met? How many public meetings with local residents in the Calton area, where the Thistle centre is, has he attended? How much evidence has he heard from local constituents in Calton, who have raised concerns about prostitution, the needle tree and the drug dealing that takes place in the area? How many local people has he met?
All those negative social outcomes would have happened irrespective of the opening of the Thistle centre. We are talking about harm reduction, and that unit is saving lives. We need more such centres, because the Thistle centre has intervened in 200 overdose events, and very many of the people concerned would not be walking around today were it not for that centre.
Of course we need stabilisation centres. Jackie Baillie was right to talk about rehab. We cautiously supported a right to rehab, but it is not a silver bullet. The availability of a right to rehab will not matter a jot unless comprehensive wraparound services are available to help people to change the track and course of their lives. That is vital.
My time is limited, but I want to make one final point. The impact on children is an issue that we have not heard much about, other than in Heather Anderson’s excellent speech, in which she spoke about Aberlour, for which I used to work. Since 2017, 1,500 babies have been born addicted to drugs. That is why Liberal Democrats were fiercely determined for money for Aberlour’s mother and baby recovery houses to be included in last year’s budget. We will be asking for money for that to be included in this year’s budget as well. Five hundred and ten children have lost a parent to drug use. That is a ripple effect that we are not paying enough attention to, and I want to see more policy initiatives that deal with the impact on those young lives.
We are short on time, so I ask front-bench speakers to stick to their time limits. Extra time will of course be given for interventions.
16:35
I am disappointed—not, of course, with what you have just said, Presiding Officer, but with Alex Cole-Hamilton’s attitude to evidence-led policy making. One might believe that something is the right policy, but one must still be prepared to allow it to be weighed in the balance of evidence.
Evidence-led policy making is about taking the data, interpreting it and then extrapolating it. The Thistle centre has peer-reviewed evidence that shows that its staff have intervened in 200 overdose events. Does Stephen Kerr mean to tell me that, had those people not gone into the Thistle centre, they would not have taken drugs, would not have overdosed in the street and would not, in all probability, now be dead?
All that I am asking is that we look at the issue in the round. I do not think that that is an outrageous thing to ask, as a politician who is responsible for scrutinising the Government and the public policies that are applied to such a serious problem. One visit and a set of statistics are one thing, but we need to see the total—[Interruption.]
Alison Thewliss is laughing, so let me say this. When we were both MPs, Alison Thewliss came to me and asked me to sign a letter asking that the UK Government sanction a trial of a consumption room in Glasgow. I was the only Conservative MP who signed that letter, because, as an individual, it is my determination that whatever we can do to save a life is the right thing to do. However, when we try something, we should be prepared to look at the cold hard realities of its effect in terms of saving lives.
Will Stephen Kerr give way?
As I mentioned Alison Thewliss, I am of course happy to give way to her.
I would be happy to go with Stephen Kerr to the Thistle, which is in my constituency, to hear the evidence. There is a tremendous amount of evidence, which is being thoroughly evaluated. The staff there would be more than happy to present it to him if he would come and visit.
I will be happy to discuss that invitation with Alison Thewliss after we conclude the debate.
There are many privileges to being an MSP. There are highs and there are lows. In the five-plus years that I have been a member of the Parliament, there has not been a lower low than last October, when SNP and Green members combined to vote against giving people the right to recovery from drug or alcohol addiction. It was a very low moment, and no member of the parties that voted against the Right to Addiction Recovery (Scotland) Bill was able to articulate exactly why they did it. That was incredibly disappointing.
I have deliberately intervened in the debate to make two specific points. One is about the importance of justice in the response to the flooding of this country with drugs by organised criminal gangs or international businesses—that is what they are, and they must be dealt with by the strong arm of the law. We must be prepared to give the police and justice authorities in this jurisdiction and jurisdictions across the western world the powers that they need to break up the gangs and convict those people, who are nothing less than merchants of death. Supply is an important aspect of the debate.
The other reason why I have intervened is to talk about what our policy objective should be in this, which is recovery. I accept that harm reduction is important, but the bottom line is how many people our public policy interventions can save from being in thrall to those vile people and the products of death and misery that they sell. That is the ultimate measurement and is what our debate should be about. We have talked about the numbers of people who have died, and colleagues have given sincere condolences to those who have been impacted by the death of their loved ones. I understand and accept all the human emotion behind the statistics.
However, the reality is that I am an Opposition member of this Parliament and my job is to hold the Government to account. I do not want to disrupt any consensus on the minister’s statement that we have to bring an end to the intolerable level of deaths arising from drug and alcohol abuse, because surely no one could dispute that. None of us could possibly disagree with what the minister said very sincerely. I support what she said, but the reality is that my job, and the job of many of us in this chamber, is to hold up to scrutiny the Government of the past 19 years, in which we have seen the drugs issue spiral.
The Government cannot claim that it has had a lack of time. The situation has been ongoing for years. Miles Briggs mentioned an esteemed former colleague of ours and member of this place—Annabel Goldie. The Government has had many opportunities to deal with the issues and there has been no shortage of resources in respect of them.
I come back to the killing of the Right to Addiction Recovery (Scotland) Bill at stage 1 and the blight that we face in this Parliament. I recognise that many members were not here last October, but why were no SNP or Green members then able to articulate why they voted against such a simple measure to give people a right to recovery treatments?
It was party political.
Graham Simpson is exactly right. It is because that bill was brought to this place by Douglas Ross, the then leader of the Scottish Conservatives. That is the only real reason why it was voted down.
It was despicable.
Craig Hoy says from a sedentary position that it was despicable, and it was. I am afraid that SNP members cannot run away from accountability for that.
Will the member wind up?
I think that I have said everything that I wanted to say. The Government has an obligation to make the road to recovery—the treatments that lead to recovery—accessible. Alcohol Focus Scotland and many other bodies have pointed out how difficult it is to access those treatments, and that must change.
16:42
I follow others in paying tribute to all those who have lost their lives to drugs or alcohol and the families who are living with the pain and trauma of that loss. I pay particular tribute to those who have shared their personal stories in the chamber this afternoon.
Carol Mochan raised the issue of access to naloxone in rural areas and how we can ensure that people who need it have access to it. I take the opportunity to highlight to members the ability to order naloxone and take an e-learning course on it on the Scottish Families Affected by Alcohol and Drugs website. Naloxone can then be sent to people’s homes. We should continue to normalise carrying naloxone and make it as easy as possible to save lives.
On the back of Alex Cole-Hamilton’s point, I note that we talk about that in this place all the time and we think that everybody in every corner of Scotland knows about it. How do we get the message out, particularly to people in rural areas such as my South Scotland region?
I take that point on board. It is difficult to reach some communities, including in my Central Scotland and Lothians West region. When we go and explain what our work in Parliament is about to community groups and youth groups, we can take the opportunity to raise the profile of the interventions that they can take at a community level, which they can use alongside defibrillators, as Alex Cole-Hamilton mentioned. It is crucial that people know that such things exist. We have not resolved that issue and we will have to work together to raise awareness on a continuing basis in order to do so.
Returning to a point that Stephen Kerr made about safer consumption facilities, I note that one of the difficult aspects of having a preventative health policy is how we can measure what we have prevented and the lives that we have saved. That is a very difficult metric and one that we have struggled with in a number of other health policies. It is difficult to get data on what we have prevented so that we can then plan other services.
I agree with what Gillian Mackay is saying. However, the ultimate measurement must be the number of people who have recovered from drug addiction and the number of people whose lives are lost. If we can increase the number of people who are in recovery and reduce the number of deaths, which are rising annually, that would be a measure of success, would it not?
Absolutely. Adam Harley and others have mentioned helping people into recovery. As I am sure that other members have, I have been to many recovery cafes and spoken to families and individuals who are living with addiction. Many have said to me that their recovery is never complete in the way that we would understand with other health conditions. Given that people live with addiction their whole lives, I do not know that presenting recovery as the end of a journey is useful. It is potentially better to talk about recovery as a journey that is not linear, and about there being multiple possible interventions to be used when people require them in order to assist them to have the best standard of living that they possibly can. Keeping people well is the ultimate goal in what we are all trying to do.
The no-wrong-door approach can always be strengthened. One thing that no one has mentioned in the debate is how we can use the public service reform agenda as a tool to embed some of the culture and practices that we would like to see more of. I hope that that is being considered in the context of addiction issues, and I would be grateful if the minister or the cabinet secretary—whoever closes the debate—could touch on that.
Michelle Campbell, like others, made a point about the devastating effects that stigma can have. I believe that I have heard the minister say in a previous debate in Parliament that stigma in itself kills. I think that that is correct and that we need to keep an eye on stigma—we certainly have not won that battle yet.
Stuart McMillan made an important point about the outcomes of aligning the drug and alcohol teams in his constituency. We should do more work on sharing good practice and, crucially, on understanding in which communities a given practice works, so that we can have a spread of interventions across the country and have the right interventions in the right places and communities.
The minister has challenged us to make suggestions. In the previous session, the joint committee work on drugs provided an important cross-portfolio focus on the issue, allowing deeper exploration and the hearing of lived and living experience. I know that the Government cannot take that specific action, so I think that Parliament should consider doing so going forward.
Other issues that I wanted to cover include safer inhalation equipment. The Scottish Government’s alcohol and drugs strategic plan, which was published in March, explores the provision of that. The Misuse of Drugs (Amendment) Regulations 1998 stand in the way of that, but if any progress has been made in that regard, I would appreciate an update from the cabinet secretary or the minister.
The fall in the number of alcohol deaths is, of course, welcome; however, that number remains higher than it was before the pandemic. Although deaths from alcohol are still far more common among men, deaths among women have risen. That comes while the industry continues to target marketing campaigns at women that encourage them to drink. There also continue to be wide inequalities between Scotland’s poorest and richest areas. People living in Scotland’s most deprived areas are now almost five times more likely to die from alcohol harm than those in the least deprived areas are, and that is completely unacceptable. There are complicated structural issues that fuel those inequalities, such as the overprovision of alcohol licences in deprived areas. I hope that, through the public sector reform agenda, we are able to look at how licensing works. I have previously raised issues around licensing for selling tobacco and vapes, such as how we ensure that it is not a drain on local authorities.
It is vital that we act for both current and future generations. Exposure to alcohol marketing increases the likelihood that children and young people will start drinking, or, if they already consume alcohol, will drink more. Surely our young people deserve to grow up without being bombarded by advertisements for products that will harm their health.
Taking cross-portfolio action and a no-wrong-door approach for those who are in the grip of addiction is essential to ensuring that we realise our desire to provide the best possible standard of health for all people across the country.
16:49
I begin by saying something that I fear that the Parliament has become far too comfortable avoiding: Scotland is facing a drug deaths crisis and the Parliament has failed to meet it with the urgency that it demands.
Sadly, I have seen both alcohol and drug addiction in my family. As has been said, in 2025, 1,133 people died from drug use in Scotland—that is an increase of 116 deaths in a single year, with lives lost and families heartbroken. How many more people must die before the Government accepts that its approach is not delivering the results that Scotland desperately needs? For almost 20 years, SNP Governments have announced strategies, declared emergencies and promised action, yet the number of deaths continues to rise. The Government cannot keep asking people to judge it by its intentions; it must be judged by its results, and those results are indefensible.
That failure also exposes the deep class inequalities in our society. In 2025, people in Scotland’s most deprived areas were 15 times more likely to die from drugs than people in the least deprived areas. Our poorest and most vulnerable communities are paying the highest price. Those are people whose lives mattered and whose deaths should never become a routine from which we simply move on to the next parliamentary debate.
As we have heard, it is not only about drugs. In 2025, 1,152 people died from alcohol-specific causes in Scotland. Once again, people in our most deprived communities were almost five times more likely to die than people in the least deprived areas. Those are not just statistics but parents, children, friends and neighbours, and families devastated and communities left behind.
The Government talks repeatedly about leading with compassion, but where is the compassion in a system that continues to fail the people who need the help most? I have watched a family member be ravaged by alcohol and, sadly, die at the age of 50, leaving behind a 16-year-old daughter, whose whole life was so unpredictable and who had to grow up quickly and become the parent. Alcohol addiction is an illness, and it needs more support, not failed promises.
Drug and alcohol deaths must not be treated as less worthy of outrage simply because the suffering happens on our doorsteps. Where is the political urgency? Where is the insistence that this cannot continue? Where are the flags, the pin badges and the chants? People are dying in numbers that should shame us all in the Parliament.
Not everyone takes drugs for fun; many people do it to block out trauma, and there needs to be more support. Condolences do not reverse a death and strategies do not save lives unless they are delivered. Promises mean nothing to a family whose loved one is gone. I agree that we need more severe punishment for dealers—a life sentence such as the one that they have dealt to another human being and their family. We must make sure that these numbers never grow.
Something that I have not heard mentioned in the debate is the need for better education—I have spoken to my children, who told me that there is very little drugs and alcohol education in school. We also need more rehabilitation, which we need to follow up with opportunities that provide a future for people, where a door is always open. I have heard very little about that.
Although we all need to sit down with all our experiences and come up with solutions, clearly and most importantly, we need action. I hope that the minister really means it when she says that she wants to meet and discuss the matter with everybody who has information to share and to work across parties, because we cannot be in the same situation in the years to come.
16:54
As the minister did, and as so many members have done, I offer my sincere condolences and sympathies to the families and friends of people who have lost their lives to alcohol and drugs. Not only is it a tragedy that so many people lose their lives in that way, but it is even more painful to know that those deaths could have been prevented—Kayleigh Kinross-O’Neill and Paul McLennan reminded us of that.
We have actually had a real debate this afternoon, which is helpful. Some of the contributions, including those from Stephen Kerr, Alan Brown, Kayleigh Kinross-O’Neill and Paul McLennan, were very powerful and welcome.
The Government’s motion says that the Parliament “regrets every life lost”, and rightly so. I absolutely believe the sincerity of the motion, as Alex Cole-Hamilton mentioned, and it is excellent to have the debate in Government time. However, it is the Government’s duty not to simply acknowledge loss but to ensure that fewer families experience such loss in the future and to deliver change. If I were to recommend that people listen to one of the speeches on that point, it would be Miles Briggs’s speech. He explained that the Government and Parliament have had time to make changes, but we have not seen that happen. It is important to acknowledge that.
As the Opposition, it is our job to hold the Government to account, and I believe that a lot of the exchanges in the debate have been about just that. How do we hold the Government to account? With the Labour amendment, that is what we are trying to do. We have some joint policy objectives, but we believe that we must raise the issues of delivery and the urgency of that delivery, given how long we have been focusing on this matter.
As I have said, the debate presented an opportunity for us to have a proper debate, which has happened, and to work together across the chamber to refocus and to push the Government’s and Parliament’s ambition on the issue. As other members have mentioned, the debate has given us a good opportunity to talk about working with our partners, as the minister suggested, and with colleagues across the UK. That is important, which is why we talk about it in our amendment.
Other members, including Adam Harley, Stephen Kerr and Gillian Mackay, made good points about the need for real evidence. We have had good discussions about how we make sure that that is our focus.
People who know me know that I am very concerned about alcohol harm in Scotland. We should pay much more attention to the issue. I will not go over the figures again, because others have mentioned them, but this is a problem in our most deprived communities. If we are serious about reducing the number of alcohol and drug deaths, we must be serious about narrowing Scotland’s inequality gap. Fulton MacGregor and I had a discussion during the debate about how we work across portfolios on that.
I also want to talk about the threat of the drugs that are coming in just now. I spoke to people involved in a project that is close to where I live, and they said, “Make no mistake—these are dangerous drugs.” Therefore, our early-warning systems, data sharing and front-line services must be ready to tackle that. We must collaborate with our UK Government partners on how we make drug policy work in Scotland and across the UK.
Recently, a number of constituents have spoken to me about the fact that people can now get alcohol delivered to their homes, which can present a great risk. I hope that the minister will acknowledge and consider that point.
I am aware of the time, so I will move on. Many members focused on our drug policies. As Jackie Baillie said, we must look at the scale of the challenge and ensure that our funding models reflect that. Paul Sweeney also talked about taking a joined-up approach, but that needs funding.
I must conclude, but I made some of the other points that I wanted to make in interventions. It is the responsibility of Opposition parties to highlight the degree of urgency in relation to this matter, and that is why we have raised those issues today.
I call the Cabinet Secretary for Health and Social Care to respond to the debate. Business is running late, so I ask that she respect the nine minutes that was agreed with business managers, although extra time will be given for any interventions.
16:59
Here we are, in a new parliamentary session and in hope of a new conversation that leads to a new consensus on new action.
Can we all, for a moment, try to put ourselves in the shoes of people who battle with drugs or alcohol and consider what society and services ask of them when we ask them to step away from drugs or alcohol? We are asking people to step away from a coping mechanism. We are asking people to step away from the blurring of pain or trauma. We are asking people to step away from what may be an enabler to their being the person they think they want to be. We are asking them to step away sometimes from associates, sometimes from families and sometimes from their community and to start again.
I make that point merely to state that, for people who need to make long-term change or forever change, that requires something that is beyond determination and beyond courage. It also means that we need to change and that our services need to continue to evolve. We need to change as politicians, because change should never be a one-way street. We all know that change is possible—recovery is possible. Many people up and down our land are living evidence of that.
What is the measure of success? We can debate that, but the nub of it is about improving and saving lives and remaining laser focused on reducing deaths. Is it supporting more people into abstinence? If that is someone’s recovery, I am full square behind it. However, we know that abstinence from drugs or alcohol is one thing but that it is very different from recovery. As Heather Anderson said when she quoted Johann Hari, the opposite of addiction is connection.
We have had a good debate this afternoon. It has been a wee bit spicy in parts, but that is fine. We always need to be open minded to the evidence about what works, when it works and with whom it works. We need to remember that, at the end of the day, it is people’s lives that we are trying to save. We cannot pigeonhole people and their needs into neat treatment boxes in order to tick a box. We all know that there is not one solution to the issue. Many of us will have preferences, but we should know that there is not one solution. We need to be focused on each and every evidence-based solution to make that difference.
In my time as a minister, I not only have advocated for the expansion of residential rehabilitation but have ensured that the Government has invested in it. We have the first national family rehabilitation centre, in Saltcoats, in Ayrshire, and there are services for women in Falkirk and Dundee. The focus now needs to be on building on and increasing detox services and working with our partners to increase stabilisation services, crisis care and long-term support, particularly for people who have brain damage. The 2026 survey of residential care will be out very soon, and it will evidence the additional places that have been secured since the start of the national mission.
I am a big advocate for residential rehabilitation. It fits with my world view. It is about bringing people together in a place of safety, and it is a protected time for people to resolve the root causes of their issues. However, we have to—even I have to—recognise that it is not for everyone and that people need to be ready for it. As members from across the Parliament have said, if we want to prevent people from dying, we have to prevent people from dying, because it is only by preventing people from dying that we will get them into recovery.
I do not mind saying that some of my views on issues such as drug law reform have changed over the years. When I started my career as a social worker in the criminal justice system, I had colleagues who were very much in favour of drug law reform, but I have to say that, at the time, it was certainly not for me. Looking at the international evidence on drug law reform—we have not had much discussion about international evidence—I think that most of us could accept that the 1971 Misuse of Drugs Act, which is nearly as old as me, needs to be looked at. Whether we do that at a UK level or through the powers being devolved to Scotland—I would absolutely prefer the latter—it is a piece of legislation that talks about opium dens, for goodness’ sake. It limits our public health approach because the restrictions around what the act refers to as paraphernalia create issues around how, without contravening the legislation, someone can provide a tourniquet or safer inhalation equipment. Those are very practical reasons to review the legislation. I absolutely concede that that would not be a magic bullet, but it would be another tool to really push forward with a public health approach.
I take on board what the cabinet secretary said about having an open mind. Across parties, several members have outlined their concerns about the methadone programme, which has been operational for a similar time to the 1971 act. The Government has not agreed to review that over the past decade, but I think that it must do so. Will the cabinet secretary look at the issue? We know that 30 per cent of drug deaths involve the use of methadone, and some of that use will be outwith the programme, but the vast majority will be within it.
I appreciate that people have different views on opiate substitution therapy. There is a heft of international evidence behind it. However, I have also heard—Miles Briggs touched on this in his contribution—about the lack of choice and the lack of real qualitative engagement with people about what treatment works for them. The approach cannot be the easy option; it is not just about writing somebody a prescription. However, I will not be doing a review, because I am not a clinician.
On the changing challenge, the bigger challenge that we now have is a result of the change in substances. For example, when I was appointed as the Minister for Drugs Policy, five or six years ago, the emerging threat was synthetic benzodiazepines, and we worked with colleagues across the UK and this Parliament to put in place pill press legislation and action on that.
However, as Stephen Kerr rightly said, the criminals are often one step ahead of us, and the emerging threat over the past few years has been synthetic opioids. Now, the threat is the growing emergence of cocaine in drug deaths. So, where is the treatment for cocaine, other than psychotherapeutic interventions? What is the treatment for the use of synthetic opioids? Where is the medication assisted treatment for a synthetic opioid, which can be 100 or 1,000 times more lethal than street heroin? I will never dismiss the role of medication, but it must be part of a patient’s choice, and it cannot be just about medication if we want to keep people connected in their community and if we are serious about preventing our young people from experimenting with drugs and alcohol.
I am also very cognisant of the fact that we must deal with the world as it is and not as we want it to be, which is why I am in favour of the work on drug testing. It is an example of where the UK Government changed its mind—the change of Government helped to progress the work on drug checking facilities.
I am conscious of the time, and there are so many points that I have not had the opportunity to respond to. I agree with Adam Harley in that I do not dismiss anything that makes a difference and believe that we need more options as opposed to fewer. We should not have this false debate about whether it is harm reduction or recovery. Surely to goodness it must be about both.
I will end my remarks by joining colleagues across the political divide in saying that we absolutely recognise the tragic loss of life to drug and alcohol use in our country. That can only serve to increase our resolve to do more. I offer my condolences to those who have lost a loved one, but I always know—I know this from the parents with whom I have engaged—that the bereft want far more than our condolences. They want accountability and they want action. They want collective action and they want accountability at every level.
In the words of Sandra Holmes from Families Campaign for Change, drug and alcohol deaths are everyone’s problem, because these are our people—these are our folk, our families and our communities. I know that what the people we serve want most is for us, as a Parliament, to be focused on prevention and pragmatism and to dial down just a wee bit on the politics.