Chamber and committees

I will, if Mr Carson is quick.

Donald Cameron has said that farmers would welcome a national park, but does he agree that there has been a bit of a back-and-forward, as some members of NFU Scotland in Dumfries and Galloway are a wee bit sceptical until they get more information?

I welcome the opportunity to speak in the debate, and I congratulate my friend and colleague Collette Stevenson on securing it. I thank my office manager, Scott McElvanney, for his assistance and research that helped me to prepare. It has been interesting to hear directly about the impact on Cole’s life, and about Lisa’s experience, and it is important that the debate is being held.

Just as synthetic drugs can help some conditions and not others, it is important to note that cannabis is not a one-size-fits-all line of treatment. In addition, when it comes to discussing the legalisation of cannabis, it is important that we make the distinction between recreational purposes and medical treatment. In legalised forms of medicinal cannabis, the benefits come from chemical elements in the plant. I absolutely recognise and agree with Rona Mackay about the stigma that is associated with that. It is important that we highlight the medicinal effects—not the THC effects that other people might seek.

The benefits are becoming more evident through proper clinical trials and research, both globally and at the University of Glasgow. The research suggests that the benefits of cannabis come from some of its compounds, which are cannabinoids such as cannabidiol—CBD. Interestingly, Hilltop Leaf Ltd, which is a private medicinal cannabis cultivation and extraction business that aims to provide a plant-based clinical treatment as an alternative to synthetic pharmaceuticals, has opened a site in Dumfries and Galloway with South of Scotland Enterprise funding, and is growing cannabis for medicinal research and use.

Those compounds can translate to multiple physical benefits. When I worked as a post-anaesthesia care nurse, pain management and pain relief were a critical part of my job, whether I was giving, intravenously, morphine, diamorphine or paracetamol. That was acute pain management. However, a lot of those drugs are also used in chronic pain management, so I was interested in the evidence from the various clinical trials, which has generally agreed that medicinal cannabis reduces pain, by altering pain pathways in the brain.

The evidence from the studies shows the benefits of cannabis-based drugs for patients with arthritis, fibromyalgia, endometriosis and migraine. In some instances, those drugs are reported to help to replace the long-term use of non-steroid anti-inflammatory drugs—NSAIDS—such as ibuprofen, which also have negative side effects. That means that CBD can help to reduce inflammation. Clinical trials have been carried out for patients who live with Crohn’s disease and irritable bowel syndrome and rheumatoid arthritis. In every one of those studies, cannabis-based medication decreased inflammation and led to increased independence, and greater wellbeing for patients—which we should absolutely support and pursue.

Due to the effects on the limbic system, research is being carried out—including, in Scotland, by the University of Glasgow—on the ability of cannabis-based medication to treat anxiety, epilepsy, multiple sclerosis, Parkinson’s disease, post-traumatic stress disorder and even Tourette’s syndrome, and insomnia. Clearly, there is a body of international evidence on the benefits of medicinal forms of cannabis, and we should be further exploring regulated forms of medicinal cannabis for prescription here in Scotland.

Following the changes to the misuse of drugs legislation in 2018, cannabis-based products can be prescribed in cases of special need. I am aware of three products: Epidiolex, Sativex and Nabilone. Epidiolex is recommended for prescription in Scotland, but we there have been difficulties from general practitioners about the way that the drugs can or cannot be prescribed.

The Royal College of General Practitioners says that it has been pressurised into prescribing unlicensed medicinal cannabis products.

That happens because patients with life-limiting conditions read social media posts about the benefits of medicinal cannabis products. The RCGP has shared its concerns about the lack of availability of medical cannabis products. I encourage the minister to support GPs by taking forward clinical guidance and by looking at the education that is available to patients and clinicians about those products.

I am conscious of time. I agree that medicinal cannabis compounds and products have many benefits and I encourage the Scottish Government to continue supporting clinical research into those products to improve the outcomes for folk whose health conditions are totally life-limiting.

I have a quick question for Danny Boyle about vaccine hesitancy. I worked as a nurse vaccinator during the vaccination roll-out. A number of people—particularly Polish social care workers—talked about fertility issues or were worried about foetal development. How will we tackle fake news and support people in the future to understand that the vaccine is safe? I am sure that we will continue rolling out vaccines in the coming months.

I have a final wee question. Are we comparing how New Zealand handled the pandemic with how, for example, America handled it? In New Zealand there is a high level of social solidarity in tackling things, whether vaccine uptake, diversity or health inequalities. In the USA, there are challenges because healthcare is not available to everybody. Are we able to look at such comparisons to see how other people handled not just vaccine uptake but issues around diversity?

When I asked Gerry McCartney about the living wage last week, he said that we needed to remember the difference between the living wage and the minimum wage. Thinking about the Scottish Government’s mitigating of impacts by encouraging employers to implement the living wage, I wonder whether there is an opportunity to continue to ask for employment law or further benefits to be devolved, so that we have better fiscal control and can deliver public funding in the way that the Scottish Government chooses.

I have a quick supplementary question about a rent deposit guarantee scheme that I have heard about and which is being used to support people going into private tenancies. In social housing, you get your accommodation and that is it, but, in private accommodation, there has to be a rental deposit. Will the rent deposit guarantee scheme help in Scotland more widely? Right now, I have knowledge of it working only in Dumfries and Galloway.

That has been one of my concerns as well, as I learn more about the issue. As part of the eating out, eating well framework, there will be an option for out-of-home menus not to have calories on them, for people who have concerns.

The eating disorder charity Beat has concerns about the matter, and the Scottish Government is working closely with it. I am sure that that will inform the evidence as we move forward. Is Beat one of the charities that is involved in developing the process?

Okay. Thanks.

I have a long-standing interest in drug policy and the work to reduce the number of drug-related deaths across Scotland—not only as a registered nurse, but as a member of the Health, Social Care and Sport Committee during this session and as a member of the Health and Sport Committee in the previous session of Parliament. I also participated in the joint inquiry into drugs deaths in Scotland, which was carried out by the Scottish Affairs Committee at Westminster and led by Pete Wishart.

I will, in my short contribution, make three points. They will address the evidence-based action that the Scottish Government is taking, using the powers that are available to us to reduce drug-related harm; the importance of continued action to reduce drug-related stigma, which others have mentioned; and the response of the UK Government to the tri-committee inquiry.

First, since the national mission to reduce drugs deaths was announced in 2020, the Scottish Government has taken action to transform our approach to drug policy, within the constraints of the outdated Misuse of Drugs Act 1971. We have changed our approach, and are moving away from one that focuses on criminalisation to one that puts first the health and medical needs of those who are impacted by drugs. In health, that has included roll-out of carrying naloxone to save the lives of people who experience a heroin overdose; development of better outreach services; increased provision of rehabilitation beds; and development of non-fatal-overdose pathways and MAT standards.

Another form of unintended overdose that occurs in Scotland is one in which benzodiazepines—whether illicit or prescribed—are taken and mixed with other substances, including alcohol. It is worth highlighting that those overdoses are a cause of death, especially in rural areas.

Naloxone works only for reversal of opioid overdoses. From my experience as a nurse, I know that there is a reversal agent for benzodiazepines called flumazenil. There can be side effects to use of flumazenil. Can the minister tell us whether any work is being done to pursue a naloxone-type reversal drug that would apply to use of benzos, especially in rural areas?

In education, the Government is bolstering teaching on drug and alcohol harms, thereby ensuring that children are educated at an early age about drug safety and the harms that addiction causes. By taking forward those and other measures, the Scottish Government is creating a new whole-system approach, and is implementing an integrated person-centred and medical, rather than punitive, approach to tackling drug harm.

I also welcome the work of project MATCH—matching alcoholism treatments to client heterogeneity—which takes a person-centred and client-centred approach to recovery. Harm reduction is also part of recovery, because we must remember that recovery includes relapse as well as support.

I turn specifically to stigma. By addressing stigma and the silence and alienation that it causes, we make it easier for people to seek help. Stigma is not only damaging to an individual’s mental health and sense of worth; it also discourages them from coming forward to seek the help that they need.

The media have an important role in addressing stigma. For example, in my South Scotland region, when I put out a press release welcoming drug funding and the progressive approach that is being taken in Scotland and the focus on stigma, a local newspaper used a stereotypical picture of a metal spoon with powder on it, next to a used syringe. The paper has agreed to consider changing the images that it uses in the future. I would welcome other print media also addressing addiction sensitively in order to help to tackle, and possibly eradicate, stigma.

It is welcome that the drug deaths task force has developed a strategy that identifies actions to help to reduce stigma. However, I often hear from constituents and others that an issue with stigma still exists among a minority of health, social care and allied health professional staff.

In a debate in January, the minister agreed to my request that the possibility of an e-learning module on drug stigma be explored—for example on the NHS learning system Turas—for our healthcare professionals, including pharmacists. I ask the minister, when she closes the debate, to give an update on whether that e-learning model to tackle stigma is progressing.

There is strong evidence from other countries that safer drug consumption facilities help to prevent fatal overdoses, and that they encourage people who use drugs to access longer-term help. The European Monitoring Centre for Drugs and Drug Addiction and the Advisory Council on Misuse of Drugs both support use of drug consumption rooms and have said:

“The effectiveness of drug consumption facilities to reach and stay in contact with highly marginalised target populations has been widely documented.”