Meeting of the Parliament

Meeting date: Wednesday, December 20, 2017

Official Report 926KB pdf

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Alcohol and Drug-related Deaths

The first item of business is a members’ business debate on motion S5M-09389, in the name of Monica Lennon, on alcohol and drug-related deaths. The debate will be concluded without any question being put.

I ask those members who wish to speak in the debate to press their request-to-speak buttons now. I have to tell members that the debate must conclude by 2 o’clock. I give warning to the three final speakers—Neil Findlay, Fulton MacGregor and Michelle Ballantyne—that I might have to cut their speeches to three minutes and I say to the minister that we have to conclude at 2 o’clock, as the Parliament’s business begins then.

Motion debated,

That the Parliament understands that 1,265 alcohol-related deaths, and a record 867 drug-related deaths, were registered in 2016, which were 10% and 23% more respectively than in 2015 and represented a combined annual increase of 276 deaths; notes that of the total 2,132 deaths that year, 715 of the people were under 44; recognises that Scotland’s alcohol death rate is one-and-a-half times that of the rest of the UK and that its drug deaths rate is two-and-a-half times; expresses sympathy to the bereaved families and friends of the people who have died, in so many cases at such a young age; acknowledges that stigma around addiction can make it difficult for people to seek the help they need; believes that alcohol and drug-related deaths are preventable, and notes the view that the refreshing of the alcohol and drug strategies presents unique opportunities to that ensure that an evidence-based approach can be put in place to reduce the number of deaths in Central Scotland and across the country.

13:15  

Back in September when I raised with the First Minister the worrying increase in the number of people dying as a result of alcohol and drugs harm, I wanted to draw particular attention to the issue of stigma. Stigma stops people from getting the support that they need and is costing people their lives. Stigma is also harming the families who are affected by substance misuse. Today, we have an opportunity to agree that we need to do much more to change attitudes and develop a new national conversation on drugs and alcohol. We must work together to achieve that.

Stigma stops us from having honest conversations with family, friends and colleagues about alcohol and drugs harm. Language contributes to that. For example, labels such as “alky”, “jakey” and “junkie” dehumanise people. Television characters such as Methadone Mick poke fun at some of the most vulnerable people in our communities, who are people with underlying mental health problems and people who are likely to have experienced trauma, neglect or abuse.

I grew up watching “Rab C Nesbitt” on BBC Scotland. Rab is best known as the string-vested alcoholic layabout who is the central character in what the BBC website describes as “Glasgow’s greatest ever sitcom”. His illustrious CV, according to the BBC, includes being a

“work shy slob and all round nutter.”

Rab and Jamesie Cotter and their working-class bampottery gave us the impression that drinking to excess was a lifestyle choice and certainly not one that the middle class would make. We even had “Rab C Nesbitt” Christmas specials.

Losing my own dad to alcohol harm in 2015 has perhaps tempered my sense of humour, but today I do not feel much like laughing along with snooty, class-based prejudice dressed up as entertainment. Perhaps that is because I have felt the suffocation of stigma—that cloak of shame that stops people from accessing treatment and support or walking through the door of Alcoholics Anonymous, Narcotics Anonymous or any 12-step programme—or because I know that stigma hurts the people who are affected by a loved one’s harmful drinking or drugs use.

I asked people affected by alcohol or drugs harm to get in touch and share their stories with me. I was especially struck by the testimony of Alan Brady, who grew up in Easterhouse with an alcoholic father. Alan was a traumatised youngster who witnessed violence and chaos that no young person should ever see. Later in life—in fact, quite recently—Alan wrote a play based on his experiences and he discovered that many of his childhood friends had gone through much the same as him, but none of them had talked about it. Alan is a proud member of Al-Anon and he welcomes this debate because he says that it is often worse for the families of alcoholics and especially for children.

We are all well briefed on the statistics and facts: 1,265 alcohol deaths and 867 deaths to drugs in 2016 alone, with a combined cost of £3.6 billion a year to the Scottish economy in dealing with the harmful effects of drinking. However, the very human costs of those cold, hard facts can be harder to convey. For every person who remains in the grip of alcohol or drugs harm, there are countless individuals—families and friends—affected. Alan put it perfectly when he said that there are women and men in Scotland today going to their work and the shops and trying to hold families together with

“their hearts blazing and their heads screaming.”

That has to change, because people need to feel able to talk and to know that they will not be laughed at. That is why I believe that we urgently need a national conversation about the role of drugs and alcohol in our society. I have already raised the issue with the Scottish Government in relation to a national information campaign, and I look forward to exploring it when I meet with the public health minister in the new year.

It is estimated that 51,000 children in Scotland today are affected by a parent’s harmful drinking. In October, Dr Catherine Calderwood, Scotland’s chief medical officer, wrote in the Sunday Post:

“Those affected by parental substance misuse are among the most vulnerable in society and they need particular care and support.”

The chief medical officer is correct.

Cross-departmental working is vital, and I am pleased that the Minister for Childcare and Early Years is here today. I urge the Scottish Government to make this issue an urgent priority and to use the upcoming child and young person wellbeing strategy and the 2018 year of young people to mainstream the issues of alcohol and drugs harm to young people.

It is five days until Christmas. At this time of year it is human nature to want to be in the company of the people whom you love and who love you back, but for a child who is affected by alcohol or drugs harm, without the sanctuary of school, the festive season can be lonely and scary. A focus on the young people and families who are affected by alcohol and drugs misuse has to be central to the forthcoming strategy refresh. Giving support to those who are affected by substance misuse is vital to breaking the cycle of misery.

During the lifetime of the Scottish Government’s 2008 alcohol strategy and 2009 drugs strategy, 15,077 people have died from substance misuse. I will try to put that 15,000 figure into context: it is equivalent to the entire population of Larkhall, which is one of the towns that I represent. If we continue at this rate, in 10 years’ time—by 2027—the population equivalent of another significant town will have been wiped out too. That amounts to a national crisis. Of course I welcome the policy refresh that is under way, but when 15,000 people have died during the course of the current strategies, we have to be brutally honest and say that it is not simply a refresh that is required. It is time for a reality check.

I am optimistic that we can start to change the situation. I am very grateful to the members of all parties who signed the motion to make this debate possible. I also want to thank the many individuals and organisations that have provided briefings and all the organisations that are holding people up. I will not name them all, because I am watching the clock.

I want to conclude by extending a heartfelt thank you to members of the public in the gallery who have travelled from various parts of Scotland to be here today, and to everyone who has shared their stories with me. I say to those people that if you have recently lost a loved one due to drugs or alcohol harm, I realise that this will be a very challenging time for you. Those of us who have lived through it understand. I pray that you will find comfort and peace this Christmas. You are at the heart of this debate. If we listen and act on what we learn from you about alcohol and drugs harm, I believe that we can set Scotland on a journey of radical culture change that is urgent, necessary and possible.

Thank you. I am sorry to hurry people, but as I said, time is pressing. If you can all shave a little bit off your speeches, we will get in a reasonable speech for everybody.

13:23  

I thank Monica Lennon for bringing this important debate to the chamber. I also remind members of my entry in the register of interests, as I am a mental health nurse who holds an honorary contract with NHS Greater Glasgow and Clyde.

There can be no denying that Scotland continues to have a very troubled relationship with both drugs and alcohol. It is an uncomfortable reality, and one that we must not shirk from: the number of deaths from drugs misuse across the United Kingdom is rising, and the number of alcohol-related deaths is higher now than it was in the mid-1990s.

However, it is a problem that the Scottish Government is committed to tackling. At the start of next year, it is set to unveil a new alcohol strategy; in spring, it will unveil a combined alcohol and drugs treatment action plan; and in May, the minimum pricing policy will come into force.

During a statement to Parliament last month, I raised the issue of so-called drug consumption rooms with the Minister for Public Health and Sport. Otherwise known as safer consumption facilities, DCRs are places where illicit drugs can be used under the supervision of trained staff. Although having them is controversial, it is an initiative that I support as I fully believe that it could help to save lives.

Officially sanctioned DCRs have been in existence for over 30 years, and they currently exist in eight European countries, as well as Canada and Australia. Throughout the 1990s, Sydney particularly struggled in the fight against heroin and, knowing the demands of the drug, many businesses would rent out rooms to users so that they had a private place to inject. The practice continued, with police turning a blind eye to it, but it fuelled further criminal activity, as many businesses then started to sell drugs. To tackle the problem, Australia’s first safe consumption room was established in 2001, at a time when I actually lived near the city. In the 10 years after the room opened, ambulance call-outs to drug users near the facility reduced by a staggering 80 per cent. The success of the scheme has not gone unnoticed, and local government in Victoria, Australia has recently announced plans to pilot a safe injecting room in a Melbourne suburb.

Robust evidence demonstrates that such facilities reduce street injection and decrease the number of discarded syringes on streets. The risk of needle sharing is minimised, the number of drug-related deaths is reduced and there is an increase in uptake of drug treatment. An all-party parliamentary group at Westminster recently commissioned a report from a drug policy think tank, which found that drug consumption rooms do not increase drug use, the frequency of injecting, drug dealing, drug trafficking or even drug-related crime in the surrounding areas. Furthermore, research also shows that not one person has died of an overdose in a DCR.

Ultimately, injecting in a safe environment gives the user the opportunity of life-saving interventions should they overdose. Users can also receive help from addiction services, social care staff and other healthcare professionals, which are opportunities that might not be readily available to those with chaotic lives or those who do not readily engage with such services. As it stands, the risk to the user and the public remains too high, so a change in thinking is required. Users often take drugs in alleys, hidden under bridges or elsewhere out of sight so, if they overdose, no immediate help is available. For the public, there remains a risk of coming across discarded needles, syringes and other injecting equipment. Safe injecting rooms are an obvious solution to those problems.

The issue of DCRs has become far more prominent over the past year, following a concerted effort to establish one in Glasgow. For a safer consumption facility to be granted legal permission to operate, the United Kingdom Government must grant an exemption from the Misuse of Drugs Act 1971, but it is not currently minded to do so. Therefore, the proposals put forward by Glasgow health and social care partnership have hit an impasse. If the UK Government is unwilling to grant the exemption, it must commit to devolving the powers to our Parliament.

I am afraid that you must conclude.

Scotland’s relationship with drugs must be changed and radical solutions such as DCRs must be considered.

13:27  

I congratulate Monica Lennon on securing this important debate and commend her for previously speaking so frankly and movingly about her personal experience of having a family member with an alcohol addiction. I also thank the organisations that are represented in the public gallery, which provided useful briefings ahead of the debate.

Like Monica Lennon, I share the concern that the 2016 alcohol and drug-related deaths statistics show such an increase on the previous year. In my Lothian region, there were 150 alcohol-related deaths last year, which was an increase of 20 on 2015 and which compares to 72 deaths recorded in 1980. Each and every one of those deaths is a tragedy for the individual involved, their family and friends and for our society more generally, and each was preventable. I hope that that is the message that we will send out from the debate.

The work of local drug and alcohol partnerships in our communities is vital, which is why the Scottish Conservatives expressed such concern at the Government’s almost £15.5 million cut to funding for those partnerships in the 2016-17 budget. Half of national health service boards in Scotland simply did not cover those cuts, which in many areas led to unacceptable pressures and constraints on local provision and the destabilisation of services that were already in place. The Scottish Government’s belated recognition of the error that it made in reducing that funding is welcome, but it is deeply regrettable that things happened in that way.

Alcohol Focus Scotland, in its briefing for the debate, rightly states that preventative measures have a pivotal role to play in preventing alcohol-related deaths. Education and information are key if we are to ensure that people can make informed choices and understand the risk of heavy drinking. We need a particular focus on Scotland’s most deprived communities, where people are six times more likely to die as a result of alcohol than those in the most affluent parts of our country.

We now have clarity over minimum unit pricing, which is a welcome policy intervention and which will be moving forward. A possible 10 per cent reduction in alcohol-related deaths by the end of a 20-year period is welcome, but minimum pricing is just one tool in a broad range of measures that we need to tackle alcohol misuse in Scotland.

The importance of preventative measures and education applies also to drugs, as does the need to reduce the huge health inequalities in drug-related deaths. The vast majority of drug deaths involve opioids, and it is alarming that the number of hospital admissions for overdoses of opioids increased substantially in 2016 and was running at almost 50 each week. We need to have an honest and open discussion about the effectiveness of some of the programmes that we have in place. That is why I was keen to call on the minister and the cabinet secretary to look at reviewing those programmes. I also support what Monica Lennon has said today.

We can all support individual measures to prevent and tackle alcohol and drug misuse—and all those measures are valuable—but I think that we need to recognise that we must develop a new and transformative approach to the huge challenges that our country faces from the misuse of both drugs and alcohol. We need to see the societal and cultural changes that Monica Lennon spoke about, in terms of how we depict people and the stigma that we attach to them.

In conclusion, I reiterate my call, and that of Monica Lennon, to both the cabinet secretary and the minister to commit in their statements on the alcohol and drugs strategies to convening in the new year a cross-party working group on alcohol and drug misuse, so that we can work across portfolios. That is something that the Parliament keeps hearing—that we need to look beyond the portfolios that each minister covers—and it should be the ministers’ new year resolution that we start to tackle the issue in that way. I believe that tackling the issue can unite the whole Parliament to work together to develop and implement the policy change that must be made to ensure that, in future years, we can demonstrate that our work has led to a continuous decline in deaths from alcohol and drug misuse.

13:31  

I thank Monica Lennon for bringing this important topic to the chamber. I am sorry that we appear to be short of time.

Stigma remains a huge problem when it comes to addiction and recovery. When speaking on this subject before, I have mentioned that my heart sinks a little bit when I receive media requests for a response to a drug or alcohol-related story, because I know that what they are looking for is a sensational or judgmental comment. It is incumbent on all of us to challenge that and to do all that we can to tackle stigma because, in reality, problematic alcohol and drug use is something that we are all impacted by. It is not something that can be othered—it is not other people’s problem. Alcohol and drug abuse affects us all, and every life lost is an absolute tragedy not just for the family and friends of the person we lose but for our whole community.

It is in all our interests to work together and to do our very best both to prevent the damage and loss caused by addiction and to aid recovery. Not only is that of immeasurable benefit to individuals who will go on to lead to healthier and happier lives, but it is of benefit to us all, as we will have happier, healthier, safer communities, too.

I would like to use the time that I have to let Parliament know about a programme unique to North Ayrshire that was created and developed by two young persons drugs workers, Claire and Donna. The Charlie programme is a 30-week group work peer support programme for children aged between eight and 12 who are affected by parental substance use, and I have been privileged to see it in action and to meet the young people a number of times over the years.

The programme gives the children space in a safe environment to speak about parental substance use with other young people who know exactly what they are experiencing. The peer support aspect has been consistently cited by the young people in evaluations as one of the most valued aspects of the programme. The programme also incorporates mindfulness and emotional regulation as well as first aid and basic drug awareness. Evaluation consistently finds that young people have a significant reduction in self-reported levels of anxiety—or worries, as they describe it—and an increase in feelings of inclusion and respect. Young people on the Charlie programme regularly feed back as positives that greater understanding of substance use and the ability to freely speak about it without fear of repercussions.

A Charlie teen film was made by some of our young girls in North Ayrshire who were affected by parental substance abuse. The workers, Claire and Donna, brought them together in a peer support group. Throughout the group’s work, the girls were clear that they wanted to get their own stories out. They wanted young people like them to know that they were not alone—the girls had felt so alone themselves and did not want others to feel that way. They decided that a film was the best way to do that, and they told their stories.

One of our girls speaks about losing a parent to overdose when she was very young. Tragically, during filming, she lost her grandmother, whom she was living with, due to alcohol misuse. Also during filming, one of the other girls lost her mother—again, due to alcohol abuse. The video has been used in training on child protection, some of which was facilitated by the girls. They are young women now; they are in training or employment and are all doing very well.

I thank the girls’ workers for the vision, care and love that they showed our young people in North Ayrshire, and I thank the girls for their honesty, creativity and kindness in making their film, which has undoubtedly helped others. I am really proud of them.

13:35  

Like other members, I thank my colleague Monica Lennon for lodging this incredibly important motion.

Last year, there were more than 2,000 drug and alcohol-related deaths in Scotland. There was an increase of 10 per cent in the number of deaths that were caused by alcohol, which reached its highest point since 2010. The number of deaths related to drugs hit an all-time high, increasing by 23 per cent. The rate is two and half times that of the UK as a whole and is the highest in Europe.

Those numbers are not just statistics; they represent real people, real lives and real families, needlessly destroyed. We owe it to each of those victims of drugs and alcohol to have an open and honest debate about why we are failing both those who needlessly lose their lives and the loved ones they leave behind. We need to take bold and transformative action to tackle addiction, and we should start by focusing on the causes of addiction.

All too often, the burden of alcohol and drug addiction falls disproportionately on those from our most deprived communities. Just yesterday, the latest report on the long-term monitoring of health inequalities in Scotland revealed that those from our most deprived communities are more than nine times as likely to die an alcohol-related death than their better-off counterparts. Although the alcohol-related death rate among the wealthiest has remained fairly static, the rate among those from our most deprived areas has increased in each of the past three years. The record is no different when it comes to the impact of drugs. Last year, drug-related general hospital admissions were more than 16 times higher among those from our most deprived communities than they were among those from our wealthiest areas.

A recent NHS report on drug-related deaths in Scotland highlighted the profound impact that an austerity-driven agenda can have. It said that

“the social, economic and political context of the 1980s”

and, in particular, “rising income inequality” and “the erosion of hope” contributed to a rise in drug deaths. The report, which looked at drug-related deaths from 1979 to 2013, found that the risk of death from a drug addiction was 10 times higher among men living in the poorest neighbourhoods than among women living in more affluent areas. It is no coincidence that many of the deaths from substance misuse today are among older people whose addictions first took hold in the 1980s and are only now facing the multiple health problems that those addictions have caused.

The relationship between health and wealth inequalities could not be more stark and the lessons of the 1980s could not be clearer. If we continue with the current policies of austerity and the loss of hope that they bring, we will be back here again in 30 years’ time debating how many more lives were needlessly lost.

Recent research by Niamh Shortt of the University of Edinburgh found not only that those from our most deprived communities are more likely to die due to alcohol, but that they have access to considerably more places to buy alcohol than those in our most affluent areas. The research highlighted a range of reasons, including a higher reliance on resources in the local vicinity and an increased use of alcohol as a coping mechanism, and it concluded that those from lower socioeconomic groups bear a double burden of low income and higher-risk environment. The research was clear: we require radical policies that address inequalities, the social, political and economic drivers of poverty, and alcohol availability.

Changes to alcohol licensing, labelling and advertising need to be part of any future strategies on alcohol, and there must be an acceptance that one of the consequences of minimum unit pricing will be an increase in income for retailers, who will no doubt use some of that extra income to boost advertising. Those strategies will also need to address the impact of online alcohol sales and the way that online retailers can bypass local licensing.

Any strategy must also be properly resourced. I have seen at first hand the heartbreaking impact on my community of the Scottish Government’s 24 per cent cut in funding for alcohol and drug partnerships in recent years. If we are serious about tackling the impact of drugs and alcohol in Scotland, we can never again turn our backs on those with addictions who rely on the lifeline services that are provided through our alcohol and drug partnerships.

Speeches of three minutes, please.

13:39  

I congratulate Monica Lennon on lodging the motion and her on-going work on the issue. I particularly welcome her reference to stigma, which is an important factor, as other members have said. I am also grateful for the briefings that we have been provided with.

As others have said, we are talking about people. The figures that are outlined in Ms Lennon’s motion are mind boggling. We have to ask why. In my second period in the Parliament, I have spoken many times in such debates, and I will undoubtedly repeat much of what I have said previously. I do not want to keep coming back to the issue.

It must be accepted that the present situation is unacceptable. There are many reasons for that. Strategies are very important, but we are talking about people. There is no doubt that the influence of alcohol in our culture is deep seated. I am a keen football fan and I listen to football on the radio. I am apparently one of the few people who do not have a bet on the game or go for a drink after the game. I am not being a killjoy; I am just commenting on the normalising of such behaviour.

One of the briefings talks about an issue that I have mentioned previously in the chamber. We had a fascinating speech from a professor at Cardiff University—forgive me; I forget the gentleman’s name—who talked about the influence of social media. It is not people of my generation that the alcohol industry is trying to influence; indeed—I say this with the greatest respect—it is not anyone in the chamber that it is trying to influence. It is trying to influence teenagers. There is a process of normalisation. The professor gave an example whereby it was such-and-such a day, so such-and-such a product was being promoted. The drip feeding of that message has a significant effect on our communities.

I want to contrast the alcohol industry with the drugs industry. The alcohol industry, which is a legal industry, has huge implications for the public purse: the state derives income from it, but it also incurs great expenditure in respect of health, social care and justice. The drugs industry is criminal. The question must be asked: given that it has exactly the same implications as the alcohol industry, why we are not taking a different approach?

I welcome the change in the approach of the Scottish Government, which is now looking at drugs as more of a health than a justice-related issue, but we must—as others, such as Colin Smyth, have said—ensure that the support mechanisms are there, because all the evidence suggests that people need support. Lapsing is an important issue.

Among the other important issues that have been discussed is that of safe consumption rooms. They are an integral part of the approach that needs to be taken. There are not the answer, but they must be part of the answer.

As far as the refreshing of strategies is concerned, I do not believe that we need a refresh; I think that we need a fundamental change, and I hope that we will listen to practitioners and people who have suffered from such addictions.

13:42  

I thank Monica Lennon for securing the debate and enabling us to discuss and highlight the important issue of alcohol and drug-related deaths.

The statistics for Scotland make stark reading. Scotland has the unwanted tag of the drug and alcohol-related death capital of Europe, and the figures are on the rise. Perhaps the most telling statistic is the fact that Scotland’s alcohol death rate is one and a half times that of the rest of the UK, while its drug death rate is two and a half times that of the rest of the UK. However, for me, the most powerful part of the motion is the assertion that

“alcohol and drug-related deaths are preventable”.

We need to have a consistent and targeted funding strategy, but, as we know, funding for the alcohol and drug partnerships was cut in 2016-17 and the allocation for this year remains unchanged. Now, we are having a refresh of the strategy. How on earth are the ADPs supposed to create a long-term and cohesive strategy for treatment and prevention under such ever-changing conditions?

The costs of an ineffective strategy are high, not just in monetary terms, as manifested in the health, welfare and justice budgets, but, more importantly, in the unseen human costs for those in the family network who have to live with and support a loved one who has an addiction. There is an impact on people’s quality of life, and the long-term costs for the most vulnerable in those situations—the children—are sometimes overlooked. Having to grow up in that environment, whereby they go home dreading the situation that they might find when they get there, has a hugely detrimental effect on their mental health, their confidence and even their ability to just be children and have their friends over. That inevitably spills over into the need for mental health interventions, interventions to address behavioural issues and educational attainment, and contact with the judicial system. In turn, that creates potential barriers to long-term integration into society.

That leads me to the need for a joined-up approach when we consider our health strategies. Alcohol and drug addiction has a huge footprint on mental and physical health issues. In pulling together the refreshed strategy, what consideration was given to the mental health strategy, the educational support and judicial strategies or the obesity and diet strategy? Government departments must start speaking to one another and recognise that those strategies are linked.

I am fed up of hearing prevention and early intervention talked about in this chamber and seeing only lip service paid to those ideas when it comes to policy. If the issue is about budgets, it is time for the money that we would not need to spend if a cohesive and comprehensive strategy were implemented to be investigated and entered into the balance sheet.

Most important is that the issue is about the human cost to those who have to live with the disease—the addicts and those who have to support them, who face long-term implications.

13:45  

Because of time, I will focus my comments on drugs.

Supply and demand changes over the decades. Today, the streets are awash with cheap cocaine, which was previously affordable only to the middle classes, and new psychoactive substances are the latest drugs phenomenon. It is an undeniable fact that some drugs can cause death, and Scotland has an appalling record on drug deaths. Figures that were published by National Records of Scotland show that the rate of drug death in Scotland is two and a half times that of the rest of the UK. That rate is the worst in Europe.

In 2016, 867 of our fellow Scots died from using illegal or prescription drugs, which was 23 per cent more than in the previous year and 106 per cent more than in 2006. Those are shocking statistics, and they should shame us all. Imagine the reaction if we saw a 106 per cent increase in the number of deaths from heart disease or strokes. There would be outrage. There would be an action plan. Budgets would be allocated and working groups set up. However, this is about drug addiction, so there is no outrage, little media coverage, no task force and no mention in Derek Mackay’s budget. Indeed, last year, the budget for drug and alcohol partnerships was cut. Why? Cynically, I suggest that there are few votes in addiction.

In my work, I come into contact with a number of families who are affected by drugs and addiction. The issues can affect any of our families and any of our friends—indeed, they can affect any of us. However, the reality is that drug and alcohol deaths impact disproportionately on the poorest communities. Drug and alcohol deaths are overwhelmingly a class issue, because poverty, unemployment, poor housing, isolation and despair, alongside cuts to essential services, create a yawning gap that leads to people turning to drugs and alcohol in an attempt to take away the pain and misery of life or of past trauma.

A few weeks ago, I attended a seminar that was hosted by Scotland’s Futures Forum. The purpose was to look back at the report on drugs policy that the forum published 10 years ago. The sad reality is that much of that good work failed to shift policy in any meaningful way. That has to change. We must face up to the fact that our drugs policy has failed. People are dying in record numbers. The streets are awash with drugs. Cocaine is now affordable to many. The war on drugs has failed and is contributing to a public health crisis. We will never arrest our way to a drug-free society, and we cannot criminalise all the dealers and users. We must stop people taking drugs in risky environments, politicians have to face up to the fact that their policy has failed, and we have to put treatment and public health at the heart of our approach to the issue.

I do not have all the answers—no one does—but I want to see a major review of drug policy. A real, genuine and brave national debate must start now. I know that parliamentarians from all parties share that view. I say to the minister that we need action now, and we need to have that national debate. The issue is too important to be party political; it has to involve all of us, now.

13:48  

I thank Monica Lennon for securing the debate, and I quickly remind members that I am the parliamentary liaison officer to the Cabinet Secretary for Health and Sport.

I acknowledge Monica Lennon’s story, which she bravely relayed to the chamber. My experience of working in social work for 12 years backs up a lot of what she said. I worked for a time in the child protection team, and a lot of child protection cases—if not the vast majority—involved alcohol and drugs to some extent. When I worked in the justice area, too, I saw that the vast majority of folk who come through the justice system have some form of substance misuse problems. John Finnie mentioned that, too. I welcome the recent changes to the community payback orders, which allow treatment orders to be put in place as part of that process, in order to help people. I also welcome the refresh of the strategy that the minister unveiled and the minimum unit pricing policy. Those initiatives will go some way towards addressing the issue.

Brian Whittle talked about Scotland being the drug and alcohol capital of Europe. Coatbridge forms half of Monklands, which, at certain points, has been known as the drug and alcohol capital of Scotland, so it would be remiss of me not to stand up and speak to that. In August this year, shocking statistics revealed that the number of alcohol-related deaths in Lanarkshire was at its highest for some time. At the same time, NHS Lanarkshire was cutting its drug and alcohol partnership by approximately 10 per cent. I wrote to Calum Campbell about that and I received support from the minister.

This is a multilayered issue. As other members have said, we must leave party politics at the door. We need to be innovative in finding ways to deal with the problem.

In the minute that I have left, I will talk about Reach Advocacy Scotland, which is based in Coatbridge and works to promote practice within the addiction and mental health fields on a dual-diagnosis basis, which, as other members have said, is important. Reach encourages the recognition of the client’s right to health and works to put the person before the label and to understand a person’s history and life.

Poverty, social inequality, trauma, abuse and the environment are many of the common themes that contribute to the unfair differences between people across social groups. The unequal distribution of income and life chances, for example, means that factors that promote good health and wellbeing are not equally available. We need to reduce those inequalities.

Reach is one of the first organisations of its kind to use the World Health Organization’s quality of life survey in its approach to assessing someone’s perception of their position in the context of our culture and value system. It works to enable the skills and talents of people who are in recovery and to create opportunities for people to undertake accredited learning. Its intention is to promote a sense of social inclusion through a Scottish Qualifications Authority level 7 advocacy practice award.

I could say a lot more about that service but I see that my time is up.

It is, indeed. Please remember to use full names in the chamber, Mr MacGregor.

13:51  

I thank Monica Lennon for bringing the debate to the chamber today.

This is probably one of the most frustrating subjects that I have ever had the pleasure of being involved with. Twelve years ago, I took over as the head of a drug and alcohol service, and we were having the same conversations then. We were worrying about the drug death rates and how we were going to change things. Here I am, 12 years later, still having that discussion.

I agree that this is a shared problem and we should be apolitical about it. We need to get a grip on it and we need to do it now. It is too late to keep saying that we should have a debate on it; now is the time to take action.

On that basis, I thank the Scottish Government for introducing minimum unit pricing and getting the policy through. I supported and fought for it then in the context of young people. Today, I will talk about what we need to do to change the next generation—I have to do that in two minutes, so it will be amazing if I achieve it.

I am going to talk about the three pillars of alcohol and how we change that culture, because that is what we need to do. We knew it back then, we have talked about it for at least 12 years and we now need to get a grip on it.

Price is the first pillar, and minimum pricing is happening.

Availability is the second pillar, and it is something that we have struggled with for years. I chaired the local licensing forum and debated the point endlessly. We must accept that, as long as alcohol is available, particularly in our poor communities and deprived areas, we will have a problem. There are 16 times more licences than there are general practices—that says it all. We can buy alcohol almost anywhere we go, whether it be a garage or the local corner shop. It is at our convenience everywhere, and why? Because it provides an income for the people who sell it.

We must redress that situation. I know that it is tough and that people are not going to like it, but we have to look at it again and think about how alcohol should be made available. We must start to get tough on availability and minimise the number of places where alcohol is accessible.

The third pillar is something that we can do something about more quickly—marketing. The marketing of alcohol is now aimed at young people. It is particularly devised to do that subliminal thing of making people think that alcohol is about making their lives better. We all say to each other, “God! I’ve had a hard day. I need to go home and have a large glass of wine,” or, “I’ve had a great time, so let’s go out and have a drink to celebrate.” Everything is associated with alcohol—commiserating, celebrating and reviewing things. How many times do we all say that we are going to have a drink to celebrate or commiserate over what has just happened?

We must change that whole culture, and we must start with marketing and those subliminal messages. My challenge to the Government today is to address those three pillars.

That has to be it—I am sorry.

It has done well on price; now it must tackle availability and marketing.

I am sorry; the time is just not available. I call Aileen Campbell to close for the Government. You have until 2 o’clock, which is just five minutes.

13:55  

Oh right; just five minutes. Thank you, Presiding Officer.

Like others, I am grateful to Monica Lennon for bringing the debate to the chamber; I know that this particular subject has real personal significance for her. I am grateful, in particular, for the way that she raised and articulated the issues around stigma, as did Ruth Maguire in her comments.

It is timely to debate the issue in the run-up to Christmas. For many, it is the time for family and happiness, but for far too many it is lonesome, isolating and further confirmation of the often chaotic circumstances in which many children and families are living. As Monica Lennon described, those people can be suffocated by stigma, even though there is nothing for them to be ashamed about. That is why stigma will be a key element of the refresh of the strategy.

Work on stigma is on-going, because it is a focus of our partnership for action on drugs in Scotland group. Indeed, shifting the corrosive narrative that embeds stigma was the reason for Scotland’s first gathering of our recovery communities to celebrate the journey that folk have been on, their commitment and achievement, and the support that has been brought to them by dedicated teams across the country. That is also why I have been engaging directly with families who are impacted by addiction, whether that has been through Scottish Families Affected by Drugs or the Family Addiction Support Service, both of which do phenomenal work to support others.

As Ruth Maguire said, it is clear that addiction is not something that happens to someone else, somewhere else; it can impact any one of us. That is why I announced the recovery initiative fund, to help families working with SFAD to help grow family networks of support. It is also why it is important that we listen to the voices of children. I commend the work of the Corra Foundation and its publication, “Everyone Has a Story”. We support that work, which was recently celebrated here in Parliament.

Members are absolutely right to look behind the statistics of drug-related deaths. Each drug or alcohol-related death represents lives lost, potential unfulfilled and families devastated. We must endeavour to do what we can to avoid that where we can. In my recent statement to Parliament, I set out my intention to publish a new drug and alcohol treatment strategy. I highlighted the need for a change in the quality of treatment and its consistent application, and that it must be trauma informed and patient centred.

Our current drug strategy, “The road to recovery”, had cross-party support and I am very keen to work with others to build on that for our refresh. Nevertheless, the challenges of tackling substance misuse have changed and our new approach must reflect that. Looking specifically at alcohol, we have taken bold action to tackle and reduce the damage that it causes through our alcohol framework for action, which includes a package of more than 40 measures to reduce alcohol-related harm. Given the clear and proven link between consumption and harm, minimum unit pricing is one of the most effective and efficient ways to tackle the problem of cheap high-strength alcohol that causes so much damage to many individuals and families. I am delighted that the United Kingdom Supreme Court agreed with us and that we are now pressing on with our plans for implementation.

Given that we have talked a lot about the availability of alcohol, is the minister able to say whether a review of licensing policy will form part of the important refresh?

There is an opportunity for us all to work out what more needs to be done. In response to Miles Briggs, in particular, I say that minimum unit pricing was only ever one tool. When we are talking about drug-related deaths, I remind members that it is estimated that minimum unit pricing at our preferred rate of 50p will prevent 58 deaths and 1,299 hospitalisations in its first year alone. It is important to recognise that while it is good that we got the policy through, that has taken five years during which we have not had that positive impact on people’s lives.

Will the member take an intervention?

The minister is just closing.

I have only a couple of minutes left to finish my remarks. The other thing on which we have the opportunity to work together is our new approach to drug misuse. That is why the central aspect of our new treatment strategy will be to meet the needs of a particular cohort of hard-to-engage individuals, which will specifically be addressed through the development of our new seek, keep and treat framework. That will examine explicitly the operational implications of engaging with older drug and alcohol users, how we encourage them into services and how we keep them there as a means of promoting protective factors associated with being in treatment.

The strategy has to be mindful of the points that Colin Smyth raised about the relationship between inequality and the impact that that has on poor health, and it has to be bold in the way that Clare Haughey outlined, through safe consumption, which is very important.

Will the minister give way?

I have only 15 or 20 seconds left to talk about this.

It is important that we recognise Clare Haughey’s authoritative account of her Australian experience and the robust evidence that shows that a rational public health measure to deal with a public health issue must be seen as such. That is how we will help this vulnerable cohort of people, who have experienced deep inequalities and have probably suffered adverse childhood experiences, too. There are a host of other aspects to this issue, and we need to make sure that there is not just a health portfolio response, because the issue touches on education, housing and the wider inequality work that the Government is doing. I hope that the refreshed approach that we are outlining will have the impact that it needs to have and that we do not just continue having conversations; we need to make sure that we take action, too. This issue that Scotland faces will not go away, so we need to ensure that what we do is effective and appropriate and helps to tackle it.