Scotland drugs policy minister resolves to reduce horrific death toll | UK news

Scotland’s new minister for drugs policy, Angela Constance, has said she is determined to see a reduction in the country’s horrific drug-related death toll and significantly more people in treatment within the year.

“I’m talking about the full range [of treatment]: residential, in the community, harm reduction, recovery services, medication where it’s appropriate … I’m not punting my preferred option,” Constance said.

Expectations are high following the appointment of Constance – a Holyrood veteran and former social worker – to the newly created role, which reports directly to the first minister, Nicola Sturgeon.

In December, Scotland’s drug-related death toll rose to another grim record, as long-delayed figures revealed a death rate more than 3.5 times that of the UK as a whole and higher than those reported for all EU countries.

It was condemned as a “national tragedy and a disgrace” by experts at the time. Now Constance speaks of a “national mission”.

At the end of January, Sturgeon announced more than £250m in new funding over the next five years in a Holyrood statement that many observers believed signified a change of tone in recognising the level of crisis the country faces.

There has been growing anger among charities and specialists at what they see as political inertia beyond the high-level talk on both sides of the border. Many are frustrated that improvements that could be made immediately are overshadowed by wrangling about Westminster’s intransigence in refusing to devolve drug laws to Scotland.

With fewer than 40% of the 60,000 people in Scotland with a drug problem now in treatment, how does Constance imagine this changing in a year’s time? She said she won’t set “arbitrary targets”, then noted that England has 60% in treatment, adding “our aspiration has to be greater than our nearest neighbour”.

As for residential rehab, which will receive £20m of the annual £50m, latest data shows there are now 418 beds available, but Constance wants this increased by 50%, adding there is more capacity within the system than previously thought.

Since her appointment, Constance has met a range of interest groups, from campaigners with experience of abstinence programmes pushing for more grassroots support, to Peter Krykant, the community activist who risked arrest last year to set up a safe injecting facility in the back of a van for addicts in Glasgow, in a personal crusade to break the political deadlock around drug consumption rooms.

“This isn’t either/or, residential rehab versus harm reduction,” she said. “I believe in the power of residential rehabilitation but we need a vigorous emergency response as well.

“What you need to do to save someone’s life this week can centre around quick access to naloxone [the potentially life-saving drug that reverses the effects of opioid overdose] or medication to stabilise them.”

She acknowledges that opioid substitute therapy (OST) has “a good evidence base” but said “no one is advocating medication on its own”. One of the key criticisms of OST is when it is delivered without sufficient wraparound support.

The involvement of those with lived experience of addiction is “crucial”, she said, to addressing stigma. Attitudes need to change within services as well as among the wider population, she said.

Practically, measuring progress over the first 12 months will require “a forensic focus on where the money goes and what it achieves”.

Safe consumption rooms, like Krykant’s van, have been credited with saving lives around the world, but it remains illegal in the UK to facilitate drug use in this way. There are those who would like Constance to go further in testing the limits of devolved competence over drugs. “I don’t have a solution to that today,” she said.


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