Chamber and committees

You have outlined that some rights need to be brought into domestic law. Do you feel that the bill could be the vehicle to realise that? Could the rights that you mentioned, such as the right to the highest attainable level of health, be incorporated in the bill in order to realise those rights for people, or would we still need a human rights bill to incorporate those aspects?

I will explore some issues regarding treatment options. The bill as drafted outlines several treatment options that individuals who have a diagnosis of drug and/or alcohol addiction may access. Those include, but are not limited to, residential or community-based rehabilitation, residential or community-based detoxification, and stabilisation services.

Some of the written submissions that we have received from organisations, including from Social Work Scotland and from the Royal College of Psychiatrists in Scotland, express a little concern in their perception that the bill focuses on abstinence-based recovery rather than on harm reduction. I will explore that idea a little. The Royal College of Psychiatrists also has some concerns about unregulated rehabilitation services and how to better protect people in that space.

Does the bill, as drafted, effectively integrate harm reduction approaches with the range of treatment options that it proposes? We should recognise that people are sometimes not able to access residential rehab when that might be the thing that supports them in the long run, and looking back, they sometimes recognise that it could have supported them at an earlier stage. I am trying to square all that, and wonder whether you can speak to it. I will start with Peter Rice.

That speaks to my second question. People with lived experience have emphasised to us that it is all about wraparound support, and that recovery goes well beyond any rehabilitation that might occur. Things such as mutual aid and recovery communities, as well as that wider look across to housing and so on, are all important. Does the bill, as drafted, adequately promote the collaborative working that there needs to be between health, addiction services and broader support services? I will start with Dr Williams.

I guess that it is about the fact that recovery is not an event but a journey, and it is not linear. Any bill that seeks to address that needs to recognise that recovery is not a single thing but may be a multitude of things, and that it may come in fits and starts. Does it need to be explicit that the journey can be restarted at any point and that different options will be available?

We are short of time, but do the other witnesses have anything brief to add?

That is very helpful. Thank you.

In my constituency, we have several recovery hubs, which are instrumental in allowing communities to come together. We should help to roll them out across the country as much as we can.

We have heard about the roll-out of naloxone provision and the opening of the Thistle, Glasgow’s second—but its first official—safer consumption facility, which has already been having positive impacts. Since it opened, there have been more than 1,000 visits to the facility, although we have heard that, over the past few weeks, emergency services have been called out on several occasions. That tells me that the facility is helping to save lives, especially now, when there is a highly toxic drug supply in circulation. It is incumbent on all of us to make sure that people across the country realise that there is a really potent supply out there at the minute. If that safer consumption facility had not been there, I am sure that some individuals would have lost their lives.

I remain convinced of the need for more radical pilots, including more drug testing and different models of safer consumption facilities. The people’s panel recognised that in its recommendations and in its thoughts. As we have heard, it made 19 recommendations that provide a strong foundation for future policy discussions.

I will focus on a couple of the recommendations that chime with my thinking. The panel strongly supports the passage of the proposed human rights bill for Scotland and the incorporation of the charter of rights for people affected by substance use. That would ensure equal access to health and quality services. I whole-heartedly believe in the charter of rights that was drawn together by the national collaborative over many months. It should enable people to make their rights real, but, in order for it to do so, we need to have the underpinning of the human rights bill, which must be taken forward as soon as possible.

It is also imperative that we continue to scrutinise the Right to Addiction Recovery (Scotland) Bill. All ideas must be considered.

It is critical that more individuals with lived experience form a large part of the workforce. When I was the minister, I was privileged to attend graduation ceremonies for those who had completed their training, and they are now working on the front lines. That brings a depth of empathy and understanding that no policy can replicate. Empowering those individuals helps to reduce the stigma surrounding addiction and makes recovery journeys more accessible and sustainable.

I briefly highlight that there are dual frustrations that I have felt for ever: an implementation gap and an accountability issue. That can be heard loud and clear in the panel’s report. We have brilliant policies, brilliant ideas and consensus, but we need a framework to assess how policies are being implemented on the ground, because it does not always feel like they are to the people who access the services. There is still much more work to do in that area.

Will the member take an intervention?

I, too, thank the cross committee and the people’s panel for their work in this area. As Alex Cole-Hamilton said, we need to do more of that type of thing.

The people’s panel was tasked with answering a pivotal and crucial question: what does Scotland need to do differently to reduce drug-related harms? I thought about that question night and day during my time as Minister for Drugs and Alcohol Policy.

I came into that role two years into the Scottish Government’s national mission to save and improve lives. Coming from a background in which I worked directly with people who use drugs—and being an affected family member—I had already been able to see and tangibly feel the paradigm shift from treating drug issues as a criminal justice matter to seeing them through a public health lens, with an understanding of the underlying social determinants of health that are all too pernicious in our country.

I recognised the transformational power that lay in the full implementation of the medication assisted treatment standards, whereby people were to be empowered by immediate access to treatment, including by being offered a range of options and the right to make their own informed choices. That was a shift away from the all too often stigmatising nature of addiction services, where stigma and lack of autonomy had felt stubbornly baked in and intractable over many decades. I encountered that time and again when trying to help people to access vital services.

Although great strides have been made in culture change, access to same-day treatment and increasing capacity in residential rehab—we exceeded our target to provide 1,600 placements last year—I recognise that we need to do more. We need an increase in stabilisation provision, as well. We have seen flourishing recovery communities across the country, and we cannot understate the positive impact that recovery hubs have at the heart of our communities.

That is helpful. It is good to have a marker down in relation to the incentive schemes that you mentioned. Although the bill’s provisions may not address the issue, as you rightly point out, the committee needs to be very aware of the issue in the lowlands.