Chamber and committees

Yes, I continue to support the use of recorded police warnings, which were recently extended to cover class A drugs such as heroin and opioids. It is essentially a discretion that the police have, and it is based on a wealth of international evidence that shows that, at every twist and turn, our justice system should provide opportunities to divert people from the criminal justice system into diversionary activities or treatment.

I know that Ms Webber and I disagree fundamentally on that approach, but where I think that we can find common ground is on the increase in hospital admissions involving cannabis. Although cannabis is rarely implicated in drug-related deaths, statistics show that it features heavily in hospital and psychiatric admissions, often because of synthetic cannabinoids. The relationship between cannabis use and mental health is, I think, something that we can agree on.

The increase in hospital admissions because of cannabis use can be seen in all ages, but I have some concerns around young people in that respect. Young people have different patterns of drug use. Increasingly, they are moving away from risky behaviours. However, those young people who use drugs are far less likely to use opiates and more likely to use cannabis, MDMA or cocaine. Work is being done to develop bespoke services for young people. That feeds into our work on the prevention material for reaching young people not just in schools but in other settings.

We have a national mission to consider the harms and risks of all drugs, and the best way of reducing those harms and risks. Often, at its nub, that is about getting more people into the right treatment at the right time.

I apologise for the length of that answer, convener.

It is often important to work harder to engage with those with whom we disagree. It is no secret that Mr Malthouse and I have different perspectives on the implementation of a public health approach and on some harm reduction interventions—safer drugs consumption facilities being but one of those. In all fairness, I will say that I have had a number of discussions with him. I have participated and engaged in a number of four-nations meetings, through the British-Irish Council or the UK drugs summit, and we have had lots of correspondence—yes, I am a persistent correspondent of Mr Malthouse. My ethos is to engage him and his Government on the evidence. My correspondence with him on safer drugs consumption facilities has always been about the evidence that they work.

What has been useful about our more recent correspondence and, I suppose, Mr Malthouse’s appearance yesterday, is that he has spoken more, and in more detail, about what his concerns are, and that gives me the opportunity to refute those concerns with the evidence, because the evidence is crystal clear. Again, I can point to evidence from across the world that has been produced by other experts, as well as to our own evidence paper. He sees more obstacles to implementation than I do but, if there is a way for us to work together to overcome any obstacle, my door to that is open. I stress that I seek to engage on the evidence and not the politics.

There are a number of issues there. I hope that the convener will give me a wee bit of latitude in answering properly.

My view is that the Misuse of Drugs Act 1971 is old—it is nearly as old as me—and that it was written for another time. A lot of the evidence that the task force gathered showed that people feel that it is rooted in drug use being all about personal failings and in the need for punishment. A root-and-branch review is therefore needed because—in my view—the act impedes our taking a public health approach. Other people might argue that it is completely contradictory to a public health approach. It impedes not only work around safe drug consumption facilities, but other harm reduction work. I can give the committee examples, if need be.

The Lord Advocate made a very clear statement to the Criminal Justice Committee last year that she would be prepared to reconsider what is in the public interest, and making another application. However, she also scoped out what needs to be addressed and considered. She spoke about the need for evidence, which I think is the most straightforward part, because the evidence is clear cut. However, she also spoke of the need for detail and precision, and about how all the partners need to be on board, including the police. That is why we are working across all the boundaries.

There are issues and complexities—I will not make any bones about that. I will not rehearse the correspondence that I sent to Mr Malthouse and the correspondence that he sent me. However, I think that the committee will see that it was, in some ways, helpful that he put on the record his concerns, many of which I think can be rebutted. Nonetheless, there are issues around how safe drug consumption facilities are policed, in and around their vicinity.

There is also a need for us to work through all the potential scenarios with our partners. That is why we need to look in detail at operating procedures, at staff training and at information for service users on what is and is not permitted. This is detailed and precise work, and there are difficulties around it.

It would be easier if the UK Government were either to legislate on the matter or devolve powers; I will continue to pursue the matter on the basis of the evidence. However, I am actually more invested in doing absolutely everything that we can to find our own solutions. If we can get to a position where the police and the Lord Advocate are content, so be it.

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.

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.

Absolutely. International evidence is crucial, because many other countries around the world have a far higher drug deaths rate than that in Scotland, and we should be looking at the very best practice not only in Scotland and across the UK but internationally. We have a lot to learn, and I make no bones about that.

I am sure that Mr Findlay will have discussed in detail with the justice secretary things such as Rapiscan scanners. The safety and wellbeing of prison staff and prisoners is of the utmost importance.

It is reflective of what we know about the wider community that we cannot arrest our way out of a drug deaths crisis. It has to be about addressing the root causes of people’s substance use and the bigger and broader agenda of homelessness and poverty. It is also about ensuring that people have access to the treatment that is right for them. Access to treatment and support in prison is crucial when it comes to healthcare. An important survey of prisoners’ health and social care needs will be completed by the spring, if I recall correctly.

Really important work is being led by the recovery community in our prisons. I have visited a number of recovery cafes. We must be focused on addressing the needs of individuals.

There are also broader issues about overcrowding in prison. I think that most commentators would be of the view that our prison population is too large.

Yes, I am. Sorry, Ms Mackay, but I do not think that I caught all of your question, but I am sure that it is about safer drug consumption rooms and the evidence that Mr Malthouse gave to the committee yesterday.

It is a matter of public record that work is being done on a pilot for a safer drug consumption facility in Glasgow. A proposition for that pilot has been made by the health and social care partnership in Glasgow. Very extensive work is being done between the Crown Office, the police, us—the drugs policy division—and our local partners in Glasgow.

Mr Malthouse and I come from different positions on this. I am strongly of the view that there is no disputing the evidence that safer drug consumption facilities can save lives. I refer members to the evidence paper that the Government produced not long ago and that I am sure that we shared with the Criminal Justice Committee at the time. I have also shared an exchange of correspondence between Mr Malthouse and me. He sees more problems than I see. There are undoubtedly issues that need to be resolved, and that is what we are actively engaged in doing.

There are three avenues to pursue with regard to drug consumption facilities. The UK Government could introduce primary legislation, perhaps in the way that Ireland did a number of years ago. It could devolve powers to Scotland and enable us to introduce legislation. The third option is for us to pursue what we can within our powers to bring forward a proposition that is clinically and legally safe for those who use and work in the service.

It is delicate and detailed work, and it has its difficulties, but it is progressing. We are absolutely committed to doing everything that we can, where possible within our powers, to implement evidence-based interventions that save lives.

There are three aspects to that. I will deal with the devolved aspect first; there is also a reserved aspect.

The point about the recommendation on single records needing to be addressed is well made. I have met Community Pharmacy Scotland and the Royal Pharmaceutical Society, and they rightly point out that, with better linkage of records, they could do more. My officials have raised that issue with the chief pharmacist and the health division. I absolutely accept the point. The pharmacists are absolutely correct to raise it, and I want a resolution to be found, because I think that pharmacy services can bring much more to the table.

That links to the issue of naloxone being registered as a controlled drug, on which our engagement with the UK Government is important. If naloxone was classified differently, different options would be available. It could be provided as part of a pharmacy service. People can have an individual consultation with a pharmacist about a range of medications; they could do that in relation to naloxone and kit that involves a needle, in particular.

The pharmacists also make the argument that if nasal naloxone was reclassified, it could be sold in chemists in the same way as decongestion products are sold. That would require changes at UK level, but it would help in widening distribution and acceptance of naloxone.

Over and above that, the task force has done really good work. The reach of naloxone is up to about 59 per cent. If you would like a technical explanation of how that is worked out, I will hand over to Morris Fraser. As a result of our naloxone campaign, 4,000 kits have been distributed. The work of Scottish Families Affected by Alcohol and Drugs on the click and deliver service is first class, as is the work of the police. The Scottish Ambulance Service has given out 1,000 kits. As well as distributing take-home naloxone kits, its work in connecting people to services is also relevant.

The task force has done good work in and around naloxone—naloxone is also becoming available to people in prisons, prior to their release—but there is more to do on pharmacy. There is also much more that we could do on mental health services. There are areas in which there can be improvement; the point about pharmacy was well made.

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.