Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, January 20, 2021

Official Report 1060KB pdf

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Drugs Policy

Good afternoon. I remind all members that social distancing measures are in place in the chamber and across the campus. I ask everyone to observe those measures, including when you enter and exit the chamber.

The next item of business is a statement by Nicola Sturgeon on the updating of the drugs policy. The First Minister will take questions at the end of her statement, so there should be no interventions or interruptions.

14:30  

In 2019, the number of people in Scotland who died a drug-related death was equivalent to three people losing their lives each and every day. Every single one—1,264 in total—was a human being with dreams and aspirations, talent and potential. They were all someone’s mother, father, daughter, son, brother or sister. Each of them left a hole in the lives of those who loved them. They mattered, and although we cannot help them now, we must do much more to make sure that others do not suffer the same fate.

The fact is that all those people—and those who died in years gone by—were in some way failed by us. Responsibility for that rests first and foremost with Governments. The failure is not just a moment in time. Anyone who ends up losing their life as a result of drug addiction is not just failed at the time of their death; in most cases, they will have been failed repeatedly throughout their lives.

I believe that if we have the will, we can and will find the ways to stop that happening. Doing so requires a national mission to end what is currently a national disgrace. It is a reasonable criticism to say that this Government should have done more earlier. I accept that, and I am determined that we will provide that national mission with the leadership, focus and resources that it needs. To help with that, I have appointed Angela Constance as the minister dedicated to leading the work, and she will report directly to me. She will work with the drug deaths task force, which is already doing good work. I take this opportunity to thank everyone who is contributing their time and expertise to it.

Part of Angela Constance’s task will be to ensure that that work is embedded across all areas of Government, and particularly in our efforts to improve mental health, to tackle homelessness and to ensure that we have a humane and responsive justice system. She will also lead work with partners across the country—in particular, grass-roots and third sector organisations. She will ensure that we listen more to people who have real-life experience of drug addiction—to those who live or have lived with addiction, and to their families, who so valiantly try to support them.

We will work to tackle all aspects of the problem. The focus of my statement today is on treatment and support services, but many other areas require improvement. For example, I know, as many MSPs know, that widespread availability of benzodiazepines—street benzos—is scarring too many of our communities. That is why Angela Constance and Police Scotland are, with people from those communities, urgently considering what more we can do to address the issue. We recognise that it requires not just action to disrupt supply, important though that is, but improvements to treatment that are necessary to stem demand.

We will also do more to tackle head-on the stigma that is still too often associated with drug use. Stigma does not just affect people’s sense of their own value, although that is in itself damaging; it also discourages people from coming forward to get the help and services that they need. We must remember at all times that people who are addicted to drugs are family members, neighbours and colleagues. Addiction is, of course, very often linked to poverty and deprivation, but it can affect any family, including our own families. Stigma was, therefore, one of the issues that Angela Constance and I discussed with the drug deaths task force last week. By addressing stigma, and the silence and alienation that it causes, we will make it more possible for people to seek help. I think that that will benefit all of us.

Last week’s discussion with the task force, together with other discussions that we have had in recent weeks, was hugely helpful. The task force has provided us with a clear sense of the issues on which we need to work most urgently. We know that there is a lot of work ahead.

Today’s statement can only be a start to the process. It cannot possibly address all the issues that need work, and it cannot at this stage offer all the answers. I intend to outline five key areas that will be of particular and immediate focus.

First, I confirm that our actions will be backed by significant additional resources. In what remains of this financial year—until the end of March—we will provide an extra £5 million so that work gets under way urgently. We intend beyond that, from the start of the new financial year until the end of the next session of Parliament in 2026, to allocate an additional £50 million of funding each year.

That funding—a total of £250 million over the next session of Parliament—will support further investment in a range of community-based interventions, including primary prevention and expansion of residential rehabilitation. We will also commit additional funding, if required, to improve toxicology services and to enhance public health surveillance of drugs issues, which is essential to ensuring effective and timely interventions. A significant proportion of the extra funding will go directly to alcohol and drug partnerships. We expect much of that funding to flow to the grass-roots organisations that do so much vital work in our communities. More details on allocation of the funding will be set out by Angela Constance, in due course.

We will adopt, and expect our partners to adopt, a clear focus on what works. It is important to be clear that all interventions need to be well evaluated so that we know what works and what does not. As part of our approach, we will seek to overcome the divide that sometimes exists in public debate between harm reduction and recovery. Both are vital, but the most urgent thing of all is that we save lives.

Beyond funding—although the new funding will support all this—there are five key areas that we need to address urgently. They are: fast and appropriate access to treatment; residential rehabilitation; the creation of a more joined-up approach that supports people living with drug addiction to address all the underlying challenges that they face—of which drug addiction is often just the symptom—and which ensures better support after non-fatal overdoses; and the vital role of front-line, often third sector, organisations.

However, at the outset I will address the issue of safe consumption rooms. Let me take the opportunity to thank Peter Krykant for meeting Angela Constance and I a couple of weeks ago to share his views on that and other matters. There is strong evidence from other countries that such facilities help to prevent fatal overdoses and encourage people who use drugs to access longer-term help. That is why we are so keen to see that model being formally used here.

I can confirm that we will continue to explore how we will overcome the legal barriers that currently restrict us in that respect. Although I cannot report on our conclusions on that today, it is an issue to which I know Parliament will return.

However, as we do that, we will maximise what can be done now, within the current law, to reduce harm and to stop people dying. An example of that is heroin-assisted treatment. There is evidence from other places that heroin-assisted treatment reduces deaths. In addition, by taking away some of the chaos that drugs create in people’s lives, heroin-assisted treatment can create the space to address other issues, including homelessness and mental health problems.

Currently that treatment is available only to a relatively small group of people in Glasgow, where a pilot has been operating for the past year. However, I confirm that we will make additional funding available, starting in this financial year, to make heroin-assisted treatment services more widely accessible across the country.

The next important issue that I want to address is access to treatment. Currently, only around half—according to some estimates, even less—of the people who are most at risk of drug-related death are accessing drug treatment. That needs to change, and fast. Among the issues are availability, speed and consistency of help. We must ensure that anyone who needs it has access to the type of support that works best for them—whether it is medication-assisted treatment, psychosocial treatment, rehabilitation in the community or rehabilitation in residential placements. For most people it will be a combination of all those.

We will therefore rapidly implement across Scotland the new standards for treatment that have been developed by the drug deaths task force. Funding will be provided for that in this financial year. The new standards, which have been acknowledged as “a huge step forward” by the Scottish Drugs Forum, set out the help that people who use drugs should be able to expect, regardless of where in Scotland they live. Crucially, the standards make it clear that people must be able to start receiving support on the day that they ask for it.

The standards also stress the importance of people making informed choices from the types of medication and support that are available to them. Making help available and offering an informed choice are essential parts of respecting a person’s agency, rights and dignity. It is also an approach that is much more likely to be effective and to provide people with the help and treatment that they need.

We are also taking steps to widen distribution of naloxone—a drug that we know saves lives in the event of overdose. We will also further increase the availability of long-acting opiate replacement in prisons and in the community.

We will work as a matter of urgency with experts and people with lived experience, to develop firm targets in relation to treatment.

I mentioned earlier that, at most, only around half of those who need help currently get it. Undoubtedly, even fewer will be getting that help as quickly as they should. Significant improvement of that figure, so that a clear majority of people who use drugs get the treatment that they need when they need it, has to be central to any strategy for reducing drug deaths.

The final point that I want to make about treatment is that people should receive support for as long as they need it. Services must have the resources to allow them to stick with people even when, because of their addiction, that becomes challenging. At the moment, the number of people who drop out of support and treatment services is far too high, so we will work with alcohol and drug teams in order that we can significantly improve that over the next year.

Achieving those objectives on treatment will, of course, be challenging, but doing so is essential. The basic aim is clear: we must empower more people to seek support; we must make that support more consistent, flexible and effective, and much faster; and we must help services to stick with the people whom they support. All that will go a long way towards reducing the number of people who die.

The third area that I want to cover is residential rehabilitation. In total, about 650 people from Scotland benefited from residential rehabilitation last year. At the moment, there are an estimated 365 rehabilitation beds across 18 facilities. We know that residential rehabilitation, although it is in no way the whole solution—that is an important point—can be an effective way of helping people who have addiction problems. However, it is not as readily accessible as it should be. Therefore, part of the £5 million that we are making available immediately in the remaining weeks of this financial year will support the opening of additional residential rehabilitation placements. Over the next session of Parliament, we intend to allocate an additional £20 million a year for residential rehabilitation and associated aftercare—which is often the bit that does not get the same attention.

We will continue to assess funding levels, going forward. A significant proportion of the extra funding will go towards developing sustainable capacity in regional centres across the country. Our considerations will be inclusive of different models of care. The aim is to ensure that residential rehabilitation is available to everyone who wants it—and for whom it is deemed to be clinically appropriate—at the time when they ask for it, in every part of the country. Furthermore, we must ensure that rehabilitation can be provided much closer to home for people, and therefore to the families and support networks on which they so often rely.

As Angela Constance said last week, we believe that those measures will bring provision in Scotland into line with that of other European countries and will, which is more important, help to reduce drug deaths and aid the recovery of hundreds of people each year.

The next area that I want to cover is how people working in drug services can work together better, and share information more easily. One area where that is urgently necessary is the support that is provided to people following a non-fatal overdose. It is a fact that many people who die as a result of their drug use will, in their past, have experienced non-fatal overdoses. If we can provide better support after those earlier overdoses—which are a clear warning that support is needed—we can save lives.

That requires better co-operation and data sharing between agencies and organisations. A good example of that approach is the work that is being led by the Glasgow overdose response team. It responds quickly for people after a non-fatal overdose, and helps to address immediate risks to their health while connecting them with community or clinical services in the area where they live. By making additional funding available this year, we can extend such outreach initiatives and ensure that similar support is provided in cities across Scotland.

In addition, by April, all alcohol and drug partnerships will have agreed a common set of steps that need to be taken to support anyone who suffers a non-fatal overdose. That will ensure that information is shared at the right time, and that support is made available quickly, when it is needed.

The final point that I want to address in the time that is available to me is support for grass-roots community organisations. As I said earlier, they will receive part of the additional funding that I have announced today. As I know from my constituency experience, those organisations, working on the front line, do vital and invaluable work, but often exist on shoestring budgets and are stretched to their limits. With extra funding, the work that they do will be more secure, and they will be able to do more of it and reach more people. Funding and support are important in themselves, but I hope that what is being done also sends an important message: that we value and support the work that is being done by grass-roots organisations.

This statement has set out a number of immediate actions; there are more to come in the weeks ahead. I hope that it also clearly signals our determination to make change and no longer to fail those who need and deserve our help, but instead to support them to live their lives to the full.

Right now, I spend most of my waking hours thinking about a virus—discussing and deciding on the interventions that are necessary to protect as many people as possible from Covid. The pandemic has been all-consuming for all of us, I a way that I hope no other issue will be in our lifetimes. However—this point has been made by others—it is time to bring the same resolve, focus, and common purpose that we have all shown in tackling Covid to reducing the loss of life that is caused by drugs. None of us should accept drug deaths—not a single one—as inevitable, nor should we accept the heartbreak or loss of human potential that they cause.

Today’s statement has set out new measures and confirmed additional resources. However, perhaps most important of all is that it reaffirms our resolve, and underlines our belief that every life matters.

There is a lot of hard work ahead, but we are determined to make a difference and to do so quickly. We will do so in memory of all those who have died. However, more important is that we will do so to ensure that more people get the support that they need to live.

Drug deaths have been a growing national tragedy for more than a decade, but, in the past few years, they have become Scotland’s worst shame. We are now known as Europe’s drug death capital. Our problem is more acute and heartbreaking than in the rest of the continent and most of the world, and more should have been done earlier. Families have been failed and entire communities have been let down and left broken. Although today’s statement will not mend all those broken families, we welcome it. We welcome what the Government is bringing forward because, finally, we might be able to start turning the tide and making sure that far fewer families are broken in the future.

We welcome the appointment of a drug deaths minister, and we will work constructively with Angela Constance because we all want her to succeed. We are extremely pleased that Scottish Conservative calls for £20 million for residential rehab have been listened to. That funding is long overdue and is absolutely vital in tackling the problem. However, will there be additional funding to encourage people to access rehabilitation programmes in the first place and to make medical professionals aware that extra places will be available? Will the funding that has been announced today restore the publicly funded bed numbers to previous levels? Can the First Minister estimate how many places will be available by the end of 2021?

I accept that there are a number of different treatment pathways, including medication-assisted treatment and psychosocial treatment, but there was no mention in today’s statement of abstinence-based community treatment. Will the First Minister confirm that abstinence-based treatment and recovery is part of her Government’s vision and that funding will be made available for abstinence-based treatment in general, including the many projects that are at threat of closure, such as Glasgow’s Second Chance Project, which does such important work?

In my statement, I said that, when the latest statistics were published, I recognised that more should have been done, and I will not shy away from that. We cannot turn back the clock, but I am determined that we will bring leadership and resolve to the issue. More should have been done; it is not because we do not care that more has not been done, but problems, particularly of that nature, often fail to get the attention that they deserve. My view is clear: that can no longer be the case, and it will no longer be the case in the Government that I lead.

I do not want to—and I will not—make party political points, but all of us across the political spectrum should reflect on policies that our respective Governments and parties have followed in recent years and ask ourselves whether some of those have contributed to the situation that we face and whether others that we should have followed might have made a difference. Into that category, I have to put policies that have driven austerity and welfare cuts, which exacerbate rather than alleviate poverty and deprivation. Despite that collective need, I recognise and do not shy away from the primary responsibility of Government.

On the questions around rehab, we will restore bed numbers and, in due course, Angela Constance will set out the precise allocation of the resources and what that will deliver. We want to have further discussions with experts and those with lived experience before making the final decisions on that and on everything that I have said today. However, given that the question was particularly about residential rehab, I will answer it in that context.

We will work with the drug deaths task force and others in drug and alcohol partnerships to ensure that there is an awareness of the increased provision and the service changes that we are making. From the discussions that Angela Constance and I had with the task force last week, I know that it and the drugs community understand what is needed and will want to raise awareness of that.

On abstinence-based community treatment, we want to make available and support what works for people. It has been obvious to me for a long time through my constituency experience that we cannot prioritise one approach over another. That point has come through strongly in the discussions that I have had in the past few weeks. I made the point about not giving in to distinctions between harm reduction and recovery because it is about being person centred, working out what makes the difference for individuals, ensuring that that is provided and ensuring that organisations that support people are also provided for. That is the right approach to take.

First and foremost, we have to stop people dying from drugs. We cannot support them in their recovery—through abstinence-based community treatment or otherwise—unless we first stop them dying. That is the priority that we have set out today.

I welcome the First Minister’s statement, but it is tragic that it has come to this. I welcome her acknowledgement that more needed to be done previously.

When she was the health secretary, the First Minister presided over the road to recovery strategy, which the Scottish Drugs Forum describes as a significant contributory factor to our present situation. When the Scottish Government cut the budget for alcohol and drug partnerships, it was warned that that would lead to more deaths. Now, there have been 1,200 deaths in a single year.

I very much welcome the additional funding. The existing £20 million a year for treatment and support services runs out in 2021. Is the £50 million that the First Minister has announced in addition to the existing £20 million or is there £30 million of extra funding? In terms of outcomes, what assessment has been made of the impact on reducing the number of deaths?

The money that I have set out today is additional new money for drug treatment and services and for various important initiatives, which will be provided partly through grass-roots organisations.

We have not done a crude calculation or analysis of the impact on the number of deaths, because I do not think that that would be appropriate right now. We need to get right the interventions, the approaches and the support in different services, and the improvement will then flow from that.

As everybody knows, the most recent drug deaths statistics were for 2019. The next ones that we will get will be for 2020, which has already passed, so what we are doing now will clearly not impact on those statistics. We are talking about the impact from here on and about saving lives literally one by one.

On the point about past policies, I am not shying away from things that we have got wrong or times when we have not done enough of the right things. However, we all have to reflect on the nature of the debates that we have. I was guilty of this in Opposition, too, but when it comes to drugs, in particular, we should not suggest that, if only we adopted or stopped one policy, everything would be solved. For example, some people might say that, if only we stopped people being on methadone, the problem would be solved. We need to understand the complexities, as many do already, and ensure that we have in place the commensurate responses. I am committed to that, and I hope that members across the chamber are committed to it, too.

There are a lot of questions to get through—members should bear that in mind.

Practice innovations that have been forced by our response to the pandemic—for example, people not being required to attend a pharmacy to have their medicine consumption supervised—illustrate clearly that, when there is the leadership, will and resources, culture and practice can be changed promptly and safely even in large systems such as our health service. Does the First Minister agree on that front? If so, how will the Government ensure that any gains that have been made for people requiring treatment are maintained and expanded throughout the country?

I agree very strongly with that. There are not many silver linings to the Covid situation—I struggle to think of any—but it is true, in this case and more generally, that some of the things that the pandemic has forced us to do are changes that we should have made previously. It has forced virtue out of necessity, if you like.

There is no question but that people have benefited from some of the changes to previous practice that have been made because of Covid. In particular, changes to pharmacy arrangements mean that people have been assessed as not having to attend daily for medication-assisted treatment. That has proved highly effective. It has also reduced some of the stigma that people feel and has shown trust in people at the same time as it has reduced the risk of spreading Covid. It is important that we retain arrangements of that type and work with leadership across health—pharmacy colleagues, in particular—to learn from that experience and make the most of every opportunity to improve the services and care that are offered to people.

Part of the additional funding that we have announced will also give delivery partners the resource and encouragement that they need to make and maintain further positive changes. That kind of change is part of ensuring that people get access quickly to the treatment that they need and that they are able to stick with in a way that sometimes proves very difficult right now.

The First Minister will be aware of project ADDER—addiction, disruption, diversion, enforcement and recovery—which is a whole-system approach that has been launched by the UK Government to tackle the cause of drug deaths, with support for law enforcement, treatment and recovery. The Welsh Government has signed up to that programme, but the Scottish Government has not. Can the First Minister explain why and whether she will reconsider that?

The task force is taking forward aspects of project ADDER. We are not, in any way, ideological about these things; we will seek to work with and learn from others and collaborate when that is appropriate. We will continue to keep that under active consideration.

It is right that our approach focuses on public health. There are aspects of the criminal justice system that inevitably come into play, but the more we can make it about public health and less about criminal justice, the more success we will have in meeting the objectives that we have set out.

As the statement outlined, the stigma that is associated with drug use can prevent many people from coming forward to get the support that they so badly need. Can the First Minister expand on the work that the Scottish Government and its partners are undertaking to tackle the stigma surrounding drug addiction?

Angela Constance and I heard a very moving presentation on the work that is being done through the task force when we attended its meeting last week. It has recently published a stigma strategy that makes a number of recommendations about tackling the issue. It is also taking forward an anti-stigma charter to challenge all of us to consider how we can work together and individually to create a stigma-free Scotland when it comes to issues of drug use. That is so important.

It is important that we have strategies and charters, and the work that is being done is exemplary. However, stigma is one area that comes down to all of us. It is about how we talk about people who have drug addictions, how we think about them and how we discuss the complex issues that are required to be progressed.

Each and every one of us has a role to play in remembering that every person with an addiction, and anyone who dies because of one, is a human being. It could be any one of us—that is only a cruel twist of fate away. Those people are fellow human beings. They are of our communities, and they are of us. We need to see it that way and ensure that we do not allow stigma to stand in the way of the help and support that they need.

Drug deaths in Scotland have doubled in a decade. Last week in Parliament, during the members’ business debate on the drug deaths crisis, I was proud to lead a minute’s silence in remembrance of all those who have died. That debate showed that the political will exists across Parliament to support the national mission that the First Minister outlined today.

Many people who are living with substance misuse will feel that they are finally being seen and heard by both the Government and Parliament. So that we can keep our eye on the ball, will the First Minister commit to a fuller debate during Government time, and can we get regular updates from the minister?

I also want to make a very particular point about toxicology, which I am glad was mentioned. Can we please get a commitment that never again will people who have lost loved ones to substance misuse—and to other illnesses and in other situations—be forced to wait up to a year to find out why their loved one died? People need answers a lot quicker than that.

I would be keen to lead a fuller debate in Government time. I will ask the minister to take that forward with our business manager and to arrange that as soon as is practical. I am sure that we will come back to the issue regularly to ensure that the actions that I have set out today and those that we will set out in the coming weeks are scrutinised and are appropriately taken forward.

Not least because Monica Lennon knows them in detail, I will not rehearse the reasons behind the delays in the toxicology service. Those delays are not acceptable and there is a real determination to ensure not only that they have been resolved but that they never recur. I said today that, if necessary, we will commit additional funding to that.

There is an associated issue. Monica Lennon rightly talks about the delays in individuals learning the reasons for the death of their loved ones. Issues in toxicology have also had a knock-on impact on the publication of statistics. We want to see timely publication of those. My view—there is work to do in getting from what I am about to say to delivering it in practice—is that we need to have more regular publication of statistics in order to have more of a real-time overview of whether what we are doing is working.

In my statement, I mentioned something I know that the task force is keen on, which is investment in more public health surveillance. That is needed so that we are not waiting for annual statistics to be published, but know, on much more of an on-going basis, whether there are problems with street benzos in a particular part of a country, or any other issue such as that. That would also allow for better assessment of whether the interventions that we are making are working.

It is important to ensure that the issues with toxicology do not recur and that we have far more information and surveillance on an on-going basis to help us to tackle the issues better. That is at the heart of what I set out.

I thank the First Minister for early sight of her statement. I welcome the acknowledgment that the Government has failed, the additional funding and the recognition of the importance of community-based interventions, grassroots organisations and the knowledge of those with lived experience. We must see support from across the chamber for the Lord Advocate to exempt life-saving services from prosecution.

There will be three more drug-related deaths today, tomorrow and every other day this week and next. Long-term action is welcome, but will the First Minister outline what immediate action will be taken to save lives?

I set out a number of actions in my statement. I will come back to the issue of safe consumption rooms, but we will continue to try to overcome the challenges and the barriers.

I have said that we will make funding available in this financial year—which does not have long left to run—to rapidly expand heroin-assisted treatment services so that more people in more parts of the country can access those. Part of the immediate funding in this financial year will help to immediately open up more residential rehab placements. I set out plans for data-sharing agreements that will better support people after non-fatal overdoses, and we are investing funding here and now to quickly roll out the standards that the task force has developed for quick and safe access to treatment. Those things will all happen quickly.

On safe consumption, everyone who has been involved with that knows the complexity of the issue. It does not help to over-simplify these issues and I do not think that anyone would do so. We all want to see progress on that. It is important that I do not trample on the independent terrain of the Lord Advocate. When Angela Constance and I recently met Peter Krykant, I undertook to continue discussions with the Lord Advocate and to look, almost from first principles, at how we can overcome the challenges in order to do the life-saving work that all of us want to do.

I will not stand here and say that there is an instant or easy solution to some of these issues, but there is a real determination to try as hard as we can. Having some of the powers devolved to this Parliament would not be the quickest way to do that, but it would be a longer-term solution. We will progress all of this as firmly and as urgently as we can.

By rights, we should not be here today. The statement could have been given, and its actions promised, in any one of the 14 years in which the Scottish National Party has been in Government. Opposition members have been crying out for many of those actions throughout that time.

We have been pleading with the Scottish Government to undertake a number of the actions that were announced today, particularly since the disastrous 22 per cent cut to ADP budgets in 2016. It is right that the ambitions of this Government have finally been laid out.

Please come to your question.

I will.

We know that Peter Krykant has been saving lives and should not be forced to work in fear of prosecution. The First Minister says that she is looking to international evidence.

Please come to your question.

I am coming to my question.

Will the First Minister accept the principle that people who are caught in possession of drugs for personal use should not be sent to prison and that treatment and education is the answer? Will she look again at the Portuguese model?

If I were to stand up here and announce prosecution policy, I would rightly be criticised because that is not my role but that of the independent Crown Office and Procurator Fiscal Service. My view on how we should treat drug addiction and people with issues of drug use from a public health perspective and not a criminal justice perspective is well known, and I hope that it is well understood. We will continue to look at all different approaches to treatment and services and all opportunities and ways in which we can overcome any legal challenges that we face. We will look to learn from any other countries, where we think that that is appropriate.

We will not get through all the questions. We have had quite long answers, but we have also had statements prior to questions. All that that does is disadvantage colleagues, but I will do the best that I can.

Will the First Minister clarify how strategies on adverse childhood experiences and care-experienced young people tie into the Scottish Government’s prevention strategy? Those have been identified as major causes in pushing younger people into the path of drugs. The First Minister said in her statement that, for a clear majority of people who use drugs, getting the treatment that they need when they need it has to be central to any strategy for reducing the number of drug deaths. Will that include same-day treatment, as motivation can fluctuate and waiting can be demotivating?

A statement after a question has the same effect as a statement before a question.

I heard two questions, to be honest, but I will try to keep my answers as brief as I can, while doing justice to the questions.

On same-day treatment, yes—I think that I said specifically in my statement that at the heart of the standards is the absolute acceptance that when people come forward to access treatment, they must get it quickly. That means same-day treatment because, for the reasons that Kenny Gibson rightly set out, if that does not happen, somebody can be lost from the ability to access treatment. Same-day treatment is therefore absolutely at the heart of what we are setting out.

Secondly—and briefly, Presiding Officer—adverse childhood experiences are some of the root causes of many of the long-term challenges that we face, whether that is with drug addiction, alcohol addiction or many of the other problems that we know we have to overcome. The thinking around ACEs and the learning and expertise around that must be absolutely crucial to what we do in trying to tackle drug misuse.

Many of the most vulnerable and marginalised in our society are unlikely to walk into a medical facility to ask for help, but they are more likely to build a trusting relationship with a community-based, third sector organisation. How can such organisations access the funds that the First Minister announced in her statement and will the Scottish Government ensure improved collaboration between the third sector and statutory services so that finance flows to those crucial third sector organisations?

The minister will set out shortly more detail about the allocation of the funding, which will include how community organisations can access the funding. However, that will be done largely, if perhaps not exclusively, through alcohol and drug partnerships. I believe strongly that the statutory sector has a big part to play here, but third sector community organisations, which already play a big role, have a much bigger role to play and can help us much more in resolving some of the issues if we better support and resource them. That is why that was a key part of what I set out in my statement today.

The First Minister mentioned the huge problem of street benzos. What actions are being taken to tackle that issue, which is partly responsible for so many tragic drug deaths in Dundee, and when is the work on that, which was mentioned in her statement, likely to come to fruition?

I cannot give a particular date for that yet. Angela Constance will keep Parliament updated. I have seen particular problems in my constituency with street benzos and the dreadful, tragic consequences flowing from them.

There are two related issues, and we must ensure that we tackle them both. One of those issues is to disrupt supply. Using pill presses, it is all too easy to produce such drugs and distribute them to street level. The police have a big part to play in making sure that we are doing everything possible to disrupt that.

The second issue, which has come out strongly in my discussions over recent weeks, is about stemming the demand and understanding why many people feel that they have to access street benzos, for example. That might be because they are not getting access to treatment as quickly as they need to or they are not getting the therapeutic dose of methadone that they need. We have to understand what the reasons are, so that we can reduce the need of people with drug addictions to access drugs in that way.

This is very much about taking a two-pronged approach, and the issue is one of significance.

Some of us have been pointing out the failings of the Government’s approach for years and were arrogantly dismissed and attacked for doing so. Did no one in Government think that a huge cut in ADP budgets might end up with more people losing their lives? Will the First Minister launch an immediate look at the bigger picture and at decriminalisation, allied with a public health approach, and instruct that we have a full independent inquiry into decriminalisation?

One of the strands of the drug deaths task force is to look at the justice system approach and at legal changes, so, yes, I think that that is very much on the agenda. I will take away the suggestion of having an independent look at decriminalisation. I know that there are very mixed views—no doubt across the parties and society—about whether that would help or hinder, but I am certainly open-minded about further consideration of all that.

On the point about past policies, if people decide that they want to keep going back to the mistakes or, to use the term that was mentioned, the “failings” of the Government, that is perfectly legitimate; I am not complaining about that, because I am not trying to stand here and defend things that I think that we have not got right in the past. People are perfectly entitled to continue to talk about those things, and I have no complaint about that. However, we have an alternative, which is to accept that we have, I think, a consensus about what we must urgently do. That is what I will focus on, and I know that there is an appetite and willingness across the parties to do likewise.

The residential rehabilitation working group report published last month said that Scotland lagged behind other European countries in the provision of residential rehab and associated aftercare. Can the First Minister confirm whether the funding that was announced today will help address that gap and provide additional residential space, such as that at River Garden Auchincruive in Ayr, in my South Scotland region?

The funding that I announced today for rehab beds and, crucially, for aftercare, is explicitly to help end the gap that Emma Harper mentioned. I think that that will bring benefits not only to people with drug addiction, but to services, such as the one in her region that she mentioned.

One issue that has come through my discussions is a frustration—we sometimes pick this up in relation to methadone treatment or residential rehab—from those with lived experience that the political debate often focuses on one aspect. That refers to all of us; I am not criticising anyone. Most recently, the focus has been on residential rehab. That is an important part of the issue, but we must not focus on it to the exclusion of everything else. That is why my statement today and the actions that I have set out are balanced in the way that they are.

Residential rehab will be important for some but it will not be appropriate for everyone. I have heard some people say that not having aftercare and community support for those coming out of residential care often makes things worse, not better. We must see the issue in the round, and that is what we are seeking to do.

I have a short time left for Miles Briggs. This will be the last question.

The First Minister said that she wants to see new and different treatments. Will the Scottish Government agree today to undertake an independent study of other treatments that are available, including neuro-electrical treatment? For the families watching today who have been forced to sell cars, and houses—to sell anything—in order to get their loved ones into treatment, will she also look at establishing a families fund for those affected by drug deaths?

I think that a families fund is a very good suggestion. There is an organisation in my constituency that I have known over the years that is particularly focused on support for families. Without giving an absolute commitment to any particular funding to any particular aspect of this today, I think that that is well worth giving consideration to.

On the first point, I will certainly take that away and ask the drug deaths task force to consider whether such an investigation of other treatment would be helpful over and above the work that it is already doing. I am happy to feed back once I have had feedback from the task force.

That concludes questions on the First Minister’s update on drugs policy. I apologise to Bob Doris and Pauline McNeill for not being able to get to their questions.