Seòmar agus comataidhean

I gather that you are talking about safer consumption facilities.

Absolutely. I recognise everything that Alex Cole-Hamilton outlined. We invested in our rapid action drug alert system because we needed to know what was happening in real terms on the ground. The most recent rapid action drug alerts and response—RADAR—report talks about the fact that we are seeing synthetic stronger opioids making their presence felt in the UK and in Scotland. That gives me huge cause for concern.

Just this week, I was on a call with some of our international experts from Canada and the States to talk about what they would do differently now if they were able to do it again, and to ask about what we are doing in Scotland and what we could do that would help us to address what could potentially be coming down the line.

Thinking back to Russell Findlay’s question about serious and organised crime, it is far easier to get hold of and transport synthetics than it is to cultivate a crop that is dependent on so many other factors—never mind geopolitical ones. I am really worried about what we could potentially see, and that is why we need to ensure that we have the ability for drug testing and checking to be done.

People need to know what is in substances, and the Government also needs to know what is happening. The ASSIST—a surveillance study in illicit substance toxicity—project pilot, which is on-going at the Queen Elizabeth university hospital in Glasgow, does routine testing of individuals when they come in to find out what substances are at play. That information and surveillance will help us, but we need to ensure that we speak to the global leaders that are already dealing with the issue.

Shortly, I will convene a round table with other international experts on the issue, and the hope is that once that work progresses it can be opened up to allow other parliamentarians to be part of it, so that the whole Parliament can ensure that we understand what the threat is that is coming down the line and how quickly it could take hold.

We are giving people information about what a substance contains. We are seeing an increasingly toxic supply out there, and what an individual might think is Etizolam—street benzo—might come back showing that it contains some synthetic opioids.

I take your point about whether it actually contains the substance that the individual thought that it would, but it allows people to make decisions about whether they will continue to use a substance and how they will use it.

We have been rolling out our national naloxone programme for more than a decade, which is standing us in good stead already. We know that naloxone works on synthetic opioids. There may be a need for multiple doses; anyone giving naloxone will have to phone the emergency services at the same time, who must judge whether the person needs another dose of naloxone. The international evidence clearly shows that naloxone will still work, but that you need to have it in quantity in order to be able to react.

Drug checking should be rolled out at as low a threshold as possible. We need to work through what the pilots will look like, what they will tell us and how we will evaluate that, while operating within the Misuse of Drugs Act 1971. The ministers responsible for drug policy from all four nations will meet in a week and a half, and synthetics will be foremost in our conversation, because it is recognised across the whole of the UK that that is an increasingly important issue.

There are other things that we know could help. The safer consumption facilities will have professionals and supportive people on standby to respond to any crisis. Just this week, we have had the roll-out of safe supplies of naloxone to community pharmacies. We all recognise that those pharmacies are at the heart of our communities and are well placed to deliver that life-saving treatment, so it is a real boon to have that available everywhere.

That clearly demonstrates to me that if, in the UK as a whole, there was a move towards an array of different types of safer consumption facilities, or if we were given the ability, with devolved powers, to make such a move, that would allow us to be more flexible and agile in responding at the same time, and to have more third sector partners involved in providing and delivering those services. Although we know that the facility will save lives when we get the pilot up and running, that situation demonstrates some of the constraints that we are operating under.

On your first point, the resourcing of any other safer consumption project would be an on-going process between my officials and officials at Edinburgh council. That is not something that I can foresee, but I take your point about how pressed the budgets are.

We need to have a robust evaluation process, which needs to be flexible and agile. At the same time, I do not believe that that should stop us exploring the possibility of other pilots that could be proposed while the initial Glasgow pilot is being undertaken. As is set out in information that I submitted to the committee, we have had conversations with the Crown Office and Procurator Fiscal Service about what it would be willing to consider.

It is clear that the Lord Advocate would consider a robust application from an area, provided that it followed the parameters of the initial Glasgow pilot. An application would need to be precise, detailed and specific, underpinned by evidence from that area and supported by those, such as Police Scotland, that would be responsible for policing such a facility. Any area that sought to make an application for a pilot would need to ensure that it satisfied the Lord Advocate in relation to everything that Glasgow did.

Conversations have already been undertaken in the city of Edinburgh about whether the council there would seek to have such a pilot in the offing. Officials in the Scottish Government are supporting that area to explore what that pilot could look like.

We do not need to wait for the full evaluation of the first Glasgow pilot before applications are put forward by other areas.

Absolutely. I anticipate that, by the time we go into the spring, we will have a lot more information about what the stigma action plan is going to be. We are co-designing a voluntary accreditation scheme that people who are working in services can sign up to. That means that they, as practitioners, and their service will adhere to looking at how they can reduce stigma and drive it down. That is really important.

We are also supporting organisations to launch campaigns such as “See Beyond—See the Lives—Scotland”, which is run by a few partner organisations, to get the stories behind the people. We have heard powerfully from MSP colleagues about the stigma that they and their families have faced. There is a lot going on in the background, but I will keep the committee and the chamber up to date on that.

Yes, and I absolutely take that point.

As for the case that was brought to our attention on social media, I asked officials to start looking into it straight away, because the story of the individual’s journey that it told did not reflect what an individual’s journey should be in that setting. Let us zoom out from that one person and think about the journey as it should happen. When someone transitions from any setting, whether it be a hospital setting, a prison setting or whatever, a cohesive plan should be in place to ensure that their medication or anything else does not fall between the cracks, that they do not present as homeless and so on. The individual in question should have had a seamless transition from the prison facility into the community setting.

I am still waiting to find out what some of the difficulties in that situation could have been. We know that Edinburgh has a named person standard operating procedure in place, which means that a specific patient is able to have the medication follow them, because you need to have a Home Office licence to store Buvidal. At the point of transfer, the person should have been able to have long-acting injectable buprenorphine set up for the next time that they were due to have that, so there must have been a breakdown in communication somewhere.

There has to be learning from that case, because it cannot be something that happens regularly across the country. That also harks back to the sustainable housing on release for everyone—SHORE—standards. When somebody makes that transition from a prison setting back into a community setting, their healthcare should follow, as well as support for their needs in relation to housing, access to welfare benefits and so on. I am happy to keep the member informed.

I will answer part of that and then see whether Susanne Millar wants to come in.

If we consider the running costs of such a facility, we can see that staffing it within that timeframe is reflective of the tariff that we know it will cost us. However, I recognise that people will use drugs at all times of the day, so there is need to look at how we can assess, as the pilot develops, what the real-time information is telling us about individuals’ habits and how individuals are engaging with the service. It is something that I have certainly thought about and I am sure that Glasgow has thought about it as well.