22nd December 2020
On Friday 18th December it was announced that there would be a new Scottish Minister for Drug Policy and that Angela Constance MSP would hold this post.
Here SDF’s CEO, David Liddell, responds to this welcome and significant development.
SDF welcomes the creation of a new Scottish Government post of Minister for Drug Policy and the appointment of Angela Constance MSP to the role. We look forward to working with her.
This crucial post will help drive the response to the ongoing public health emergency of drug overdose deaths and wider drug policy.
Scotland’s drug strategy is key to setting both the detailed specifics and, crucially, the tone of Scotland’s response to problem drug use.
The root causes of our present crisis lie in deprivation and inequalities and a lack of support to children, families and young people who are dealing with trauma and loss. The prevention of problem drug use lies in these policy areas.
In responding to problem drug use, it should now be clear to all that Scotland needs a new drugs policy direction. This should be based in a change in the way people with a drug problem are viewed and treated. The stigmatisation of people with a drug problem is a key barrier to addressing very obvious issues in terms of the way people are treated by services and others.
Scotland must aspire to become like other European countries where there are lower rates of problem drug use and drug-related deaths. To do this, Scotland must provide a comparable range of services and enjoy similar outcomes from treatment services. There is a lot of change to be made to achieve this.
In Scotland, stigma has allowed mainstream services to exclude people with a drug problem. Commonly, people with a drug problem and people in drug treatment are denied access to healthcare and so many have no GP or dentist; have no access into specialist mental health services and are not engaged by regular health screening services. In other words, so called universal healthcare is denied to this group of people. In Scotland, in practice, having a drug problem is still a barrier to accessing housing. Having a drug problem can mean you don’t receive the social security to which you are otherwise entitled.
Scotland has a very low rate of people with a drug problem in treatment – less than 40% compared with 60% elsewhere in the UK. Scottish drug services have high rates of unplanned discharge from treatment – far too many people fall out or are pushed out of treatment. This needs to change as a priority and unplanned discharges should end.
In terms of medication assisted treatment, people should have access to medication on the day they present for treatment. Implementation of same day prescribing should be a priority.
Unplanned discharges, staff working with large numbers of people and a general lack of person-centred care prevent the development of the therapeutic relationships that are crucial to people staying engaged with treatment and making progress.
Specialist drug services have become detached from wider service systems and remain underinvested. Over the longer term, there should be a plan to develop smaller units of care and better integrate health, social care, addiction and peer/recovery support services through the co-location of staff.
Overall, we must destigmatise problem drug use, stop marginalising and alienating people with a drug problem and find the leadership and resource commitment to provide evidence-based service provision that is in place elsewhere.
Change is desperately needed and long overdue. Systems will not change themselves. Change will require the involvement and commitment of all stakeholders including people who use services and people who have a drug problem.
Our hope is that in this new post Ms Constance can show the necessary courageous leadership to initiate and support change. All stakeholders should work with her to help achieve a drug policy based in evidence and the international examples of effective service provision that have been ignored for so long.