Chamber and committees

Absolutely. I anticipate that, by the time we go into the spring, we will have a lot more information about what the stigma action plan is going to be. We are co-designing a voluntary accreditation scheme that people who are working in services can sign up to. That means that they, as practitioners, and their service will adhere to looking at how they can reduce stigma and drive it down. That is really important.

We are also supporting organisations to launch campaigns such as “See Beyond—See the Lives—Scotland”, which is run by a few partner organisations, to get the stories behind the people. We have heard powerfully from MSP colleagues about the stigma that they and their families have faced. There is a lot going on in the background, but I will keep the committee and the chamber up to date on that.

Yes, and I absolutely take that point.

As for the case that was brought to our attention on social media, I asked officials to start looking into it straight away, because the story of the individual’s journey that it told did not reflect what an individual’s journey should be in that setting. Let us zoom out from that one person and think about the journey as it should happen. When someone transitions from any setting, whether it be a hospital setting, a prison setting or whatever, a cohesive plan should be in place to ensure that their medication or anything else does not fall between the cracks, that they do not present as homeless and so on. The individual in question should have had a seamless transition from the prison facility into the community setting.

I am still waiting to find out what some of the difficulties in that situation could have been. We know that Edinburgh has a named person standard operating procedure in place, which means that a specific patient is able to have the medication follow them, because you need to have a Home Office licence to store Buvidal. At the point of transfer, the person should have been able to have long-acting injectable buprenorphine set up for the next time that they were due to have that, so there must have been a breakdown in communication somewhere.

There has to be learning from that case, because it cannot be something that happens regularly across the country. That also harks back to the sustainable housing on release for everyone—SHORE—standards. When somebody makes that transition from a prison setting back into a community setting, their healthcare should follow, as well as support for their needs in relation to housing, access to welfare benefits and so on. I am happy to keep the member informed.

I will answer part of that and then see whether Susanne Millar wants to come in.

If we consider the running costs of such a facility, we can see that staffing it within that timeframe is reflective of the tariff that we know it will cost us. However, I recognise that people will use drugs at all times of the day, so there is need to look at how we can assess, as the pilot develops, what the real-time information is telling us about individuals’ habits and how individuals are engaging with the service. It is something that I have certainly thought about and I am sure that Glasgow has thought about it as well.

We are giving people information about what a substance contains. We are seeing an increasingly toxic supply out there, and what an individual might think is Etizolam—street benzo—might come back showing that it contains some synthetic opioids.

I take your point about whether it actually contains the substance that the individual thought that it would, but it allows people to make decisions about whether they will continue to use a substance and how they will use it.

We have been rolling out our national naloxone programme for more than a decade, which is standing us in good stead already. We know that naloxone works on synthetic opioids. There may be a need for multiple doses; anyone giving naloxone will have to phone the emergency services at the same time, who must judge whether the person needs another dose of naloxone. The international evidence clearly shows that naloxone will still work, but that you need to have it in quantity in order to be able to react.

Drug checking should be rolled out at as low a threshold as possible. We need to work through what the pilots will look like, what they will tell us and how we will evaluate that, while operating within the Misuse of Drugs Act 1971. The ministers responsible for drug policy from all four nations will meet in a week and a half, and synthetics will be foremost in our conversation, because it is recognised across the whole of the UK that that is an increasingly important issue.

There are other things that we know could help. The safer consumption facilities will have professionals and supportive people on standby to respond to any crisis. Just this week, we have had the roll-out of safe supplies of naloxone to community pharmacies. We all recognise that those pharmacies are at the heart of our communities and are well placed to deliver that life-saving treatment, so it is a real boon to have that available everywhere.

That clearly demonstrates to me that if, in the UK as a whole, there was a move towards an array of different types of safer consumption facilities, or if we were given the ability, with devolved powers, to make such a move, that would allow us to be more flexible and agile in responding at the same time, and to have more third sector partners involved in providing and delivering those services. Although we know that the facility will save lives when we get the pilot up and running, that situation demonstrates some of the constraints that we are operating under.

That is in the Drugs Death Taskforce’s report, which speaks to the variation of services throughout the country and perhaps the need to roll some things into the national specification. Work is on-going with stakeholders, through the various working groups that are in place, to consider what type of more formal service specification would benefit people who rely on services, but we are pushing ahead with the roll-out of the medication-assisted treatment standards, which is one part of the national specification of treatment.

We are thinking about residential rehabilitation and we are working towards a national commissioning protocol for that, so that we can make sure that local areas are able to effectively get people on their journey into residential rehabilitation and then back into the community. It has proven to be quite difficult for local areas to do that. Scotland Excel, which those of us who have been in a local authority know—I see a lot of wry smiles here—is a body that helps with that kind of procurement work.

We are now at the point where we will be looking to go out to the tendering process, and organisations that provide residential rehabilitation facilities will be able to get themselves on to a national framework. That will provide a directory for local areas, but also a directory for individuals. As it stands, people do not know what residential rehabilitation is out there for them. They do not know what each type of service might provide for them, and we hope that bringing that under national oversight will mean that individuals’ journeys and their access to those facilities will be easier.

On the governance structures around that, a national specification, when we get to the point of understanding what the working groups are telling us, will help us to read across both spheres of government and all the partners and their individual responsibilities. That will help us to quantify what a national specification should look like in practice, with clear lines of accountability. I obviously have accountability on a national level, but we also need to look to local partners’ accountability, and a national specification will help us to do that.

I do not know whether Orlando Heijmer-Mason has anything to add.

I think that everyone in the room recognises that serious and organised crime is very harmful to our communities and is insidious. It is in every level of society, including places where people do not think that it will be. Although it would be for the Cabinet Secretary for Justice and Home Affairs to comment on the police’s funding situation and look at the issue across Government, I would seek to make sure that the police are resourced to respond in the areas that I am responsible for.

We need to recognise situations where we can interrupt county lines activity and, where we can, take vast quantities of drugs off our street by interrupting those gangs. We must also recognise when our police in Scotland can work with UK serious and organised crime professionals, and indeed those across Europe and beyond.

As the minister responsible for drugs and alcohol policy, I need to be aware of where the harms transfer to when supplies are interrupted. In my experience, when a huge quantity of substances is taken off the streets, we end up with harm being diverted to a different area. There is a dual aspect to that. I absolutely support the Cabinet Secretary for Justice and Home Affairs and colleagues in making sure that the police are resourced, but I also think about the unintended consequences.

That is an interesting question. There are a few parts to the issue. The smoking ban plays a part in terms of smoking indoors, but the Misuse of Drugs Act 1971 prevents people from supporting the consumption of smokable substances. That shows how outdated it might be, because that was based on thinking about opium.

We know that there will be a challenge with how the consumption facility will operate, because more and more people are using crack cocaine and freebasing it. That will not be able to happen in the facility as it stands, but we also know that a lot of people are injecting cocaine. People who are injecting it would be able to do that in the facility.

I ask Suzanne Millar to say whether she has anything to add to that.