Chamber and committees

On the latter point, we are on track in developing our public health surveillance system, which builds on existing warning systems and is broader than a traffic-light system or distribution of naloxone. We are also waiting to hear the results of the UK-wide consultation on naloxone. We will certainly endeavour to keep Mr Briggs and the committees informed about what is happening.

With regard to treatments, I say that it is crucial that they be based on evidence. That has to be a priority. On NET, we have corresponded with Mr Briggs about it and we have pointed people in the direction of the chief scientific officer with regard to pursuing trials.

Mr Briggs made a fundamental point about informed choice, which is a core part of the medication assisted treatment standards. All patients who receive a healthcare service make informed choices and are supported in that by clinicians and practitioners. People should be able to make informed choices around medication assisted treatments and other types of treatment. The whole purpose of MAT is to make the connection between the options and possibilities in pharmaceutical interventions and those in psychosocial interventions. Mr Briggs’s point about the need for a balanced approach and for implementation of what works, based not only on the evidence but on what meets individuals’ needs, is important.

I am very much aware of Ms McNeill’s work in the area; I frequently meet stakeholders who talk about her work and events that she has hosted in the past.

With regard to Mr Malthouse’s comments about services such as safe drug consumption facilities sending out the wrong message or encouraging drug use, I point out that there is simply no evidence for that. We hear people verbalising that concern, but there is no evidence for it, whereas there is evidence to show that safe drug consumption facilities reduce overdose deaths and save lives. They reduce transmission of blood-borne viruses, reduce infection in wounds and improve wound care, and they help in reaching people who inject drugs and who might not otherwise engage with, or be visible to, services.

Ms McNeill is a Glasgow MSP. Much of the campaign that is coalescing around safe drug consumption facilities came about because there is also a community benefit from reducing drug-related litter and drug use in public places. There is evidence that such facilities work and about their benefits. They are not a magic bullet—nothing ever is. However, in Scotland, we need all the options. I have views about the Misuse of Drugs Act 1971, but we want all the available options to help us to address this national scandal and crisis.

Some of the work that we are actively engaged in is on updating prevalence information. We need to update our understanding of the extent, or prevalence, of drug use in our society. There is some existing data; just before Christmas, I announced funding to update it. We need to understand more about prevalence in Scotland. That information is important because it is crucial to introducing our treatment targets.

In direct answer to Gillian Martin’s question—I think that this is a fair critique—I will say that we do not have enough of our people in treatment and we do not do enough to retain them in treatment or to follow them up if they fall out of it; hence, our investment in, for example, non-fatal overdose pathways and outreach. The new treatment target and the indicators that underlie it will therefore be crucial in improving and scrutinising the number of people who are in treatment. As I said to Parliament, we will announce that in the spring

With regard to capacity, much of our work on MAT standards and residential rehabilitation is about not just improving our ways of working but increasing capacity. Workforce capacity is important, so right now we are mapping the shape and size of the workforce in order to identify gaps and to look more at training needs.

The issue of stigma is very pertinent to the workforce; workers, too, often feel quite stigmatised. We will consider a recruitment campaign, but that has to be joined up with other big national workforce strategies across the Government.

I am really excited about the national collaborative. I was committed to bringing it forward—in part due to my experience in social security and the work that we did around lived experience with experience panels, and in part because of my days in education, where I saw the benefits of the early years collaborative.

I think that it is absolutely crucial that there is a vehicle that is owned by the voices of the experienced—that it is theirs. I am delighted that Professor Alan Miller, who is Scotland’s leading human rights expert, has agreed to chair the national collaborative. He comes with independence. He is well placed to understand the impact of trauma and has worked with survivors of in-care abuse, through which he brought forward a programme of work that amplified their voices and ensured that change happened. I am thinking in particular of the redress scheme.

I am very confident about the national collaborative. Professor Miller is now involved in a series of engagements—introductory and one-to-one meetings with the sector and with people with lived and living experience. He will work with them to develop a programme of work, including milestones and timescales.

The national collaborative is a very important part of the national mission, because we need to ensure that voices of experience are plugged in to every aspect of that mission. It is also about enabling those voices to inform and drive change, and about what we do being informed by a human rights approach.

That is a really important question, Mr Gulhane; I know that you are a former GP. I often talk about our life-saving work being connected to the work to improve people’s lives. You and I may take the role of primary care for granted in our own lives, but I know that many general practices are the front line of our communities and are already doing great work to support people and their families who are struggling with drug use.

We are finding across Scotland that there are different pictures of the organisation of services. In some areas, GPs can offer more services to people who are affected by drug use, while in others pathways and routes point more towards specialist services. Regional variation is fine as long as it works.

However, in taking a public health approach, GPs can play an absolutely core role. Part of my job is to engage with clinicians from all backgrounds—psychiatrists, GPs and clinicians from specialist addiction services. The connection between the important issue of harm reduction and immediate access to treatment for a drug problem and primary care is made in standard 7 of the new medication-assisted treatment standards. People should have choice with regard to the connections between their MAT and primary care.

There are two important strands to that question, but the committee will appreciate that my work on reducing drug-related deaths focuses primarily, although not exclusively, on illicit drug use. My colleagues in public health focus more on how we reduce dependency on prescribed drugs.

The issue is of interest to me, however, because we know—I am not telling you anything that you do not know—that people can, and do, become addicted to prescribed drugs. A consultation took place on the recommendations of the short-life working group, and health colleagues are implementing an action plan about prescribing guidance and assessing, monitoring and recording prescriptions.

It is a side issue, but the Royal Pharmaceutical Society is interested in how it could work with Government to implement a tool that better records the amount of over-the-counter medications that people buy, because that is an issue for some people as well.

The prescribing guidance around proscribed drugs is complementary to the prescribing guidance around illicit benzodiazepine use. For the drugs policy division, the work to reduce dependency on and the use of illicit benzodiazepines in our communities is connected to the work around prescribed benzodiazepines, for example. We are involved in a range of work—in devolved and reserved areas—to tackle the issue around street Valium as well. I will stop here, convener. Someone might want to pick up the benzodiazepine issue later.

You are quite correct to be making all those connections. It is important that strategies and approaches complement and connect with one another. There is a lot to learn from other campaigns and approaches.

One example is the use of Buvidal, which was introduced into the prison estate during the pandemic. Buvidal is a long-acting buprenorphine that can be administered as an injection weekly or monthly; it does not require a daily dosage. The use of Buvidal in prisons was evaluated very positively. It will not suit everybody—it is important to stress that no treatment will meet the needs of everyone—but it had some benefits in terms of clarity of thought and of not tying people to daily dispensing. It is also rarely associated with overdose, because it is a protective factor in relation to how opioids attach to brain receptors. It is a bit like a blocker: if you take an opioid on top of your Buvidal, you do not get the high from the opioid.

Having looked at the results of Buvidal in some of our prison estate, I was keen to find out how we could introduce it to the community and widen access to treatment. That is why this financial year there is a £4 million investment in widening choice to people, and that includes Buvidal. Widening that choice of treatment is a change in practice that occurred in response to the pandemic, but it is one that we want to continue and to implement further.

The committee has already spoken about our work around naloxone as well and how its distribution has widened during the pandemic. We do not want to detract from that change.

I outlined those in my previous answers. Perhaps Ms McNair’s connection is not very good. I talked about our work on Buvidal and naloxone. I did not talk about our £1.9 million investment in our work on prison to rehab.

The work and contribution of the lived-experience and recovery community throughout the pandemic should remind us well of the value of engaging meaningfully with—not just paying lip service to—the recovery community and those with lived and living experience. That is why we want to take that work further forward with our work on a national collaborative.

The £5 million in additional resource was released in the final quarter of the previous financial year, which was the first quarter of this calendar year. Of that, £3 million went to alcohol and drug partnerships—as I mentioned, we published their returns on how that was invested—£1 million was put into a grass-roots fund, and £1 million went into a service improvement fund.

At the turn of the financial year—after Easter, on 18 March—I announced four new funds totalling £18 million. I hasten to add that they are multiyear funds. Those four new funds opened in May. There is a £5 million recovery fund; a £5 million service improvement fund; a £5 million local fund, which again is geared towards grass-roots organisations; and a £3 million families and children fund. Those are available via the Corra Foundation for all non-profit organisations to apply for. We have worked really hard to make the application process accessible and quick. To date, we have funded in excess of 50 projects through that. Adding in other funding—for example, through work that the task force has done—I think that we have funded over 80 specific projects.

This year, we will invest around £13.5 million in residential rehab. That money will come from ADPs and from the recovery fund and other sources of funding within Government. I will outline to the Parliament in more detail the profile of that funding, because we have a commitment to provide £100 million for residential rehab and aftercare over five years.

On the £50 million for this year, there is also the specific £13.5 million uplift to ADPs that I have mentioned, and around £14 million is going on £3 million for outreach, £3 million for non-fatal overdose, £4 million on widening the distribution of Buvidal, and £4 million on implementing the MAT standards. I hope that that gives an overview.

A small amount of resource is going on research. Resources have also been set aside for the national stigma campaign and our lived and living experience strategy work on establishing the national collaborative.