SDF Statement on Scotland’s Public Health Emergency

Scotland has made an inadequate response to the on-going public health emergency and now faces the emerging threat of a drug supply containing new synthetic opioids.  This situation demands the urgent implementation of the full range of evidence-based practice and policy now.

All individuals and organisations must work to deliver the National Mission to Reduce Drug Deaths.

It is evident that Scotland needs to adopt the practice and policy measures developed in other countries to address the very issues we now face. Therefore we must, without further delay, implement an emergency plan to:

  1. Support positive health-focussed engagement with people who use drugs through a process of decriminalisation of the possession of drugs for personal use through the use of alternatives to prosecution for ALL people, for ALL drugs in ALL circumstances.
  2. Monitor changes in drug supply – including dangerous synthetic opioids – and ensure people involved in drug use know the risks associated with the substances being supplied through street supply.  This can partly be achieved by providing drug checking services where people can submit small samples of drugs for analysis and then receive a list of the substances these street drugs contain.
  3. Ensure that people experiencing drug problems and using drugs in street-based environments and other people particularly vulnerable to harm, including fatal and near-fatal overdose, can have immediate support in case of an overdose and access to information and support services through the provision of safer drug use facilities wherever in Scotland there are people who would be protected and supported by using them.
  4. Ensure people most vulnerable to fatal overdose involving opiates (the vast majority of fatal overdoses in Scotland) are able to access effective means to prevent death in the event of overdose through maximising Scotland’s national naloxone programme which includes ensuring people are supplied with naloxone at every opportunity, with a strong emphasis on peer-led distribution.
  5. Attract a far higher proportion of people who could benefit from treatment into treatment by delivering accessible and acceptable treatment services grounded in connection and compassion for all people experiencing drug problems.

This is not a campaign. We are not asking people or organisations to commit to supporting this statement. We regard this statement to be self-evidently true and to represent both the rational response to the challenge Scotland faces and the broad consensus on what should be done.

Those who need to respond to the emergency should not be distracted from the purpose of delivering the National Mission.

There has been much discussion of the need to make an adequate response to Scotland’s public health emergency and what might be done and there has been some progress towards this.  However, we need a step change in approach to address what has been clearly lacking and continues to hinder progress – Scotland needs leadership, co-ordinated action and a driving will to change. There is a need for the necessary focus and an innovative and creative approach to addressing barriers to change. We need a can-do attitude and the willingness to change demanded by this current emergency. The word ‘emergency’ becomes meaningless when we don’t see a true emergency response.

SDF commits itself to supporting the delivery of the national mission to reduce drug-related deaths and improve lives of people whose lives are affected by drug problems.

Kirsten Horsburgh, CEO of SDF says

“We are now well beyond the need for urgent action.  The emergency demands action now and by all means possible. There can be no further delays.

“Everyone seems to know that Scotland has an astonishing rate of drug-related deaths and that was before we saw this emerging trend of new synthetic opioids within the heroin supply.  Alarm bells should be ringing all over Government and all through the treatment and support services because we are not prepared.

“In truth, we all know exactly what the evidence tells us we should be doing.  The question is do we have the collective will to implement the necessary change. Talking on behalf of SDF, we will continue to work to reduce drug deaths and advocate for and with people who are vulnerable to these preventable deaths.  We are well positioned to contribute to and support the implementation of change and we re-state our commitment to doing so.

“SDF are ensuring that the insight of people experiencing drug problems influences the development of policy, practice and service development. We are working to develop and diversify the workforce. We have contributed substantially to the implementation and expansion of the national naloxone programme. We are fighting to keep funding for harm reduction posts in our own organisation and elsewhere.

“There is some progress but the only real measures are both a substantial reduction in deaths and a sustained process of improvement in Scotland’s wider response. We have a long, long way to go.”