Chamber and committees

The Scottish Government expects all patients, regardless of their condition, to have timely access to the full range of healthcare services they require following clinical assessment. The chronic pain waiting times are developmental data to assess the issues in access to chronic pain clinics and pain psychology services.

We continue to work with NHS National Services Scotland’s Information Services Division and NHS boards to improve the consistency and completeness of the information collected.

The Scottish Drug Misuse Database (SDMD) collates data on individuals undertaking specialist drug treatment in Scotland from their initial assessment (SMR25a) and follow-up assessments 12 and 52 weeks after commencing treatment (SMR25b). SDMD does not currently collect follow-up data for the period 26 weeks after starting drug treatment.

Information Services Division Scotland reported on the number of people who remained in treatment 12 weeks after starting treatment in: Scottish Drug Misuse Database (SDMD) Report on People in Treatment – 2011/12, published in December 2012.

Information on how many people with drug and alcohol misuse problems remain in specialist treatment after 12, 26 and 52 weeks will be collected by the new Drug and Alcohol Information System.

In 2014-15 and 2015-16, the overall Scottish Government allocation for the treatment of alcohol and drug misuse to Alcohol and Drug Partnerships (ADPs), distributed through health boards, was £69.2 million per year.

The responsibility for the drugs element of this funding was transferred to the health portfolio as part of the budget setting process for 2016-17, and in response to requests from sector stakeholders, and this has taken place against the backdrop of the toughest public expenditure conditions we have yet faced. However, we have allocated £53.8 million to health boards for the treatment of alcohol and drug misuse in 2016-17, outwith their baseline budgets, and boards are expected to supplement this resource, where necessary, from within baseline budgets to ensure the overall alcohol and drugs services and resources for ADPs are maintained at existing levels.

The Scottish Government published the research paper Assessing the Scale and Impact of Illicit Drug Markets in Scotland in 2009. This paper provided estimates of the size and value of the illicit drugs market as well as estimates of the economic and social cost of illicit drug use in Scotland for the year 2006.

The paper estimated that the costs to the criminal justice system per year for problem drug users not in treatment is £12,713, reducing to £6,524 after one year in treatment, then £1,536 after being in treatment for more than one year. The estimated costs to the health service per year for individuals not in treatment is £3,005, reducing to £1,536 after one year in treatment then £1,173 after being in treatment for more than one year.

Our national drugs strategy, The Road to Recovery, aims to ensure that those who need treatment get it as soon as possible. The Local Delivery Plan Standard, formerly HEAT Standard, for drug and alcohol treatment waiting times expects that 90% of people receive access to appropriate drug and/or alcohol treatment within three weeks of referral to support their recovery. The latest national figures for July to September 2015 show that for those seeking drug treatment, 93.8% of the 4,406 people in need of treatment waited three weeks or less to receive treatment.

The Scottish Government has invested £254 million between 2007 and 2015 in front line drug treatment, care and recovery services. In August 2014, we published a set of quality principles that set out the expectations of care and support for people, and their families, accessing treatment. The on-going implementation of these principles, supported by the Care Inspectorate, ensures that recovery is accessible, visible and sustainable for all who want it.

Drug overdose deaths can be reduced through two main methods, firstly through interventions aimed at preventing overdoses taking place, and secondly through reducing fatal outcomes when overdoses do occur.

Overdoses can be prevented by providing drug users with education around prevention and harm reduction measures. The Scottish Government has commissioned the Scottish Drugs Forum to work alongside our Alcohol and Drug Partnerships (ADPs) to develop and improve local death prevention strategies, in order to take a broader view of drug deaths and lead to improved responses. Retention in drug treatment services is also a recognised factor in reducing the number of overdose deaths and we are working with ADPs to improve retention rates while also engaging with drug users who have dropped out of service use for whatever reason.

In a step to reduce fatal outcomes when overdoses do occur, Scotland was the first country in the world to implement a national take home naloxone programme, funded by the Scottish Government, which empowers individuals, family members or friends to intervene in an overdose situation and use the product to reverse the opiate effect. This programme has now been in place for five years and has will result in over 33,000 kits being distributed by the end of 2015-16.

On 4 March 2016, Information Service Division Scotland published revised data that indicate there may be an estimated 61,500 individuals resident in Scotland in 2012-13 who were problem drug users. Of these, 21,314 individuals (35%) were reported as being in specialist drug treatment at some point in 2012-13.

Problem drug use is defined as the problematic use of opiates (including illicit and prescribed methadone use) and/or the illicit use of benzodiazepines and implies routine and prolonged use as opposed to recreational and occasional drug use. This definition excludes some illicit drugs (e.g. cocaine).

The most recent National Records of Scotland report (August 2015) states that in the last five years (2010-14) there has been a gradual upward trend in drug-related deaths (compared with much more rapid growth in earlier years) although, as previously acknowledged, in 2014 there was a significant increase in the annual total of drug-related deaths from 527 to 613 and we remain concerned to ensure the medical needs of an ageing cohort with complex needs are met. The following table provides a summary of the totals for the last five years, however these are drugs-related deaths not drug overdose deaths.

Year	Drug related deaths registered	Three year moving average (2008-10 onwards)
2010	485	535
2011	584	538
2012	581	550
2013	527	564
2014	613	574

Our national drugs strategy, The Road to Recovery, focuses on the needs of the individual, provides a range of interventions and is based firmly on the concept of recovery. The development of a recovery oriented system of care, as part of this strategy, also has a much wider approach than just treatment services to support those with problem drug use. The strategy recognises that, when ready, individuals can exit treatment services and move on to gain support from recovery networks and services that will continue to support their recovery in their own community.

The Scottish Government has invested £254 million between 2007 and 2015 in front line drug treatment, care and recovery services. In August 2014, we published a set of quality principles that set out the expectations of care and support for people, and their families, accessing treatment. The on-going implementation of these principles, supported by the Care Inspectorate, ensures that recovery is accessible, visible and sustainable for all who want it.

The drug and alcohol information system (DAISy) will provide data on retention in treatment for services delivering tier 3 and tier 4 drug and alcohol treatment and support interventions.

DAISy is a new development which will collect the data required for reporting on drug and alcohol treatment and outcomes at a local and national level. DAISy will provide services with a single data collection tool, replacing two existing systems a) the Scottish Drug Misuse Database that collects SMR25a/b and b) the drug and alcohol treatment waiting times database. It will also collect information on alcohol treatment and outcomes which is not currently collected.

Further information on DAISy is available from the Information Services Division website:

http://www.isdscotland.org/Health-Topics/Drugs-and-Alcohol-Misuse/Drug-Alcohol-Information-System/.