Public health emergency declaration call over Scotland's drugs deaths crisis

A committee report published today criticises the UK Government for blocking a Glasgow trial of safe consumption rooms - places where people can use drugs with sterile equipment while being supervised by medical staff. The report says there is strong evidence that it would be a "practical step to reducing the number of drug-related deaths in Scotland".

And it said that if the UK government was unwilling to allow a trial facility, it "must" devolve powers over drugs legislation to the Scottish Parliament, so that it can "implement the health approach it deems to be in Scotland’s best interests."

The committee said Westminster must work with the Scottish Government to find 'urgent, bold and imaginative' solutions.

There were 1,187 drug-related deaths in Scotland in 2018, by far the highest death rate in the European Union and three times that of the UK as a whole.

READ MORE: Scottish Government should appoint 'minister for recovery' to tackle drug deaths

The report said: "The UK Government must declare a public health emergency and be open to taking radical steps to implement innovative evidence-based solutions if we are to stand a chance of halting Scotland’s spiralling drug crisis."

The SNP has already backed a move to decriminalise drugs use at its conference in Aberdeen last month.

And the committee said it felt decriminalisation can help deal with the root causes of problem drug use, such as stigma, and encourage people to seek treatment.

It heard that criminalisation “automatically makes drugs more dangerous and harmful” by pushing drug markets “underground”, where there is no way to monitor or regulate the quality and safety of drugs.

The new report comes after what was one of the most extensive inquiries ever conducted into problem drug use in Scotland the committee heard from agencies, health services, academics, governments, those with lived experience as well families who have been affected by problem drug use.

“Throughout our inquiry we heard tragic accounts of the pain and suffering that problem drug use is causing in Scotland. If this number of people were being killed by any other illness, the Government would declare it as a public health issue and act accordingly," said committee chairman Pete Wishart. "The evidence is clear – the criminal justice approach does not work. Decriminalisation is a pragmatic solution to problem drug use; reducing stigma around drug use and addiction, and encouraging people to seek treatment.

"We’re not the only ones calling for this change. The Health and Social Care have also said the Government should consider decriminalisation. It reflects the weight of evidence in support of this approach, and I hope the next Government takes this recommendation seriously.”

The Home Office has so far refused to give permission for a trial of "safe consumption rooms" in Scotland's largest city.

But the MPs say such facilities are "proven" to reduce overdoses, drug deaths, blood-borne virus infection rates, and public injecting, and witnesses told them that the case for such a facility in Glasgow is "amongst the most compelling in Europe".

READ MORE: Fears Glasgow GP practice could drive drug users to street drugs and criminality

The report said the rooms should be seen as a way to get people with problem drug use to engage in other services which can address the underlying causes of their substance use.

They said that while safe consumption facilities are "proven to reduce the immediate health risks associated with problem drug use, they "should not be seen as a 'silver bullet' ".

"Health is a devolved matter, and it is therefore deeply regrettable that the UK Government has chosen to block the proposed facility," the committee said.

A report by the Advisory Council on the Misuse of Drugs (ACMD) said: "In addition to preventing overdose deaths, they can provide other benefits, such as reductions in blood-borne viruses, improved access to primary care and more intensive forms of drug treatment. No deaths from overdose have ever occurred in such facilities."

But the Home Office highlighted evidence that the facilities create "honeypot effect", where people who use drugs travel long distances to access the service and claimed drug use increase in the area surrounding any facility. It also raised law enforcement concerns and ethical quandaries for medical professionals.

The Home Office was also concerned over the cost of such a facility, which in Vancouver was $1.5m (£880,000), and implied that such costs do not represent the best value for money.

But the report pointed out the estimated average lifetime cost of treating someone with the HIV virus is £360,000 per person. That equated to more than £28m for the 78 new HIV cases developed amongst people who inject drugs in Glasgow for 2015/16 alone.

The committee said this suggests that a safe consumption room in Glasgow "would be a highly cost-effective measure".

"We are not convinced by the UK Government’s argument that it will not give permission for such facilities because it believes that there are more cost-effective health care interventions," the committee said.

Mr Wishart added: "Every drug death is preventable, and these centres could play a vital role in addressing Scotland’s drug crisis."

MPs have also concluded that Government approach to drug use must be substantially reformed, treating it as a health issue rather than crime.

They have called for the Department for Health and Social Care to take over lead responsibility for drugs policy from the Home Office, to demonstrate that new approach.

And the committee felt Westminster must review the impact welfare sanctions have on people who use drugs, and outline steps it will take to make the system "less adversarial" for people who use drugs who are trying to enter recovery.

And it said that the Scottish Government "could and should" do more to address the problem with powers it has in areas such as mental health, housing, education, community regeneration, policing and justice.

The MPs said they were "particularly concerned" to hear of the impact that funding reductions, including previous cuts to alcohol and drug partnerships in the 2016/17 Scottish Government budget, have had on health services for people who use drugs.

"While it is not for us to make recommendations to the Scottish Government, we believe that if it wants to call for greater powers to tackle the drugs crisis it must demonstrate that it is doing everything it can within its existing responsibilities, including properly funding health services," the report said.

A Scottish Government spokesman said: “We welcome this important report from the Scottish Affairs Committee. It supports our view that what Scotland faces in terms of drug-related deaths is an emergency and that the outdated Misuse of Drugs Act 1971 should be amended to allow us to implement a range of public health focused responses, including the introduction of safe consumption facilities in Glasgow.

"We call on the incoming UK government to amend the Act or to devolve those powers to Scotland."