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That is a really good question. I reiterate this often: it is absolutely about connecting emergency life-saving work with work that improves life chances. The statistics speak for themselves. We know that people in the poorest communities are 18 times more likely to suffer drug-related death than people in the least-deprived communities.

It is important to stress that drug-related deaths and drug use are an issue throughout Scotland. Drug-related deaths in the Highlands are the lowest in Scotland, but they are still higher than drug-related deaths in the north-east of England. That shows that this is an all-Scotland problem.

However, there is no doubt that the increase in drug-related deaths is being driven by an increase in the number of the poorest people in our communities dying such deaths. Therefore, work on child poverty, for example, is absolutely crucial. We have a £23 million tackling child poverty fund, a cross-Government child poverty action plan, and colleagues will be well aware of the Scottish child payment. That work must connect with drugs policy work.

There is also greater Government action, through which £2 billion of our resources are invested in low-income families. A proportion of that—half, I think—is focused on households with children. That £2 billion investment is intended to alleviate pressures on low-income households.

All that is connected with our economy, the fair work agenda and so on. We could talk about all those things in detail, as well as the work that is being done on adverse childhood experiences and trauma. ACEs, of course, have a huge link to people’s living environment.

For me, it is always about following the evidence and what works, and listening to the people who are most affected by drug deaths in their communities. That is people with lived experience, but also people with living experience.

When it comes to encapsulating where we are and the question of why our challenge in Scotland is so acute and severe, I have my own views. In the past, there have been many discussions about culture, patterns of drug use and concentrated levels of poverty. However, I always distil our challenge in Scotland into three areas.

We have a higher proportion of people who use drugs. I suppose that the reason why is quite an existential question, and much research has been done on it. However, we need to recognise that a higher proportion of our people use drugs, and therefore we have proportionally more people with problem drug use. The rate of drug use in Scotland is about double that in England.

Another issue is benzodiazepines. The use of illicit benzodiazepines is an issue across the United Kingdom, but it is more acute in Scotland—again, the facts show that. Since 2009, there has been a 450 per cent increase in Scotland in the implication of benzodiazepines in drug deaths. By comparison, south of the border, it is 53 per cent.

Again, to be frank—this is at the heart of the matter—we do not have enough of our people in treatment. That is the core of my assessment. We know that treatment is protective, and so we need a culture of change and a culture of compassion in our services. That will enable people to access those services more easily, and services can be more fleet of foot in following people up. People should be able to make informed choices about their services and treatment.

We have made progress around other preventable deaths. We must consider drug deaths not just as tragic but also as preventable. While the scale of the challenge is massive, we can and must turn it around.

That is certainly my understanding. A very high proportion of police officers will carry naloxone after they have undertaken the training. I speak to families—I am sure that many committee members do, too—and they will give many examples of how naloxone has saved the life of a loved one. When we speak to people about their lived and living experience, they talk about the range of services that have helped them on their journey. The key challenge for us now is to widen that distribution and for it not to retract. We will participate in a four-nations consultation about permanently widening the distribution of naloxone. Although it is safe to use, naloxone is a controlled drug.

The Lord Advocate, as a result of the pandemic, was able to use his discretion to give confidence to widen the distribution of naloxone to non-drug services, such as homelessness services. We now need the changes that the Lord Advocate made as a result of the pandemic to be made permanent. We are participating in a UK-wide, four-nations consultation. I had some concerns about some of the language used in the consultation and about its scope. Nonetheless, the Scottish Government has participated in that four-nations consultation, because we want a permanent change to the arrangements that are made, so as to widen the distribution of naloxone.

I do, convener. I am grateful to the committee for the opportunity to provide evidence on my priorities over the next five years.

The loss of life from drug-related deaths is as heart-breaking as it is unacceptable. I once again offer my condolences to all those who have lost a loved one, and I restate my continuing commitment to do everything possible during this parliamentary session and beyond to turn the tide on drug-related deaths.

This morning, the Scottish Government published the first of its quarterly reports on suspected drug deaths, which focuses on management information from Police Scotland and covers the first two quarters of 2021—the first six months of our national mission. Although that report is not a replacement for the national statistics on confirmed drug-related deaths, which National Records of Scotland publish annually, as those official statistics are based on death registration records that information from the Crown Office and forensic pathologists supplement, it will help services to respond quicker to what is needed and Parliament to monitor progress, and will provide a barometer of drug death trends over time.

We can cautiously take some encouragement from what appears to be a slightly lower figure of suspected drug deaths than for the same period in 2020, but I stress that there is a long way to go, because both suspected and actual drug-related deaths remain too high in Scotland today.

My priorities start with getting more people into protective treatment and recovery on the back of our commitment to an additional investment of £250 million, which includes £100 million for residential rehabilitation, over this parliamentary term. Information from quarterly reporting will allow me to set a treatment target for 2022, which is one of my main priorities.

The implementation of the medication-assisted treatment standards by April 2022 is a key priority as well. Those standards set out what people should expect and can demand from services—in particular, same-day treatment and access to a wider range of MAT options. That implementation is part of our overall approach to making people’s rights a reality. However, the options that we offer people must also include access to residential rehabilitation, which is clearly a priority for us all.

We recognise that the number of cases of poly-drug-use deaths involving methadone and benzodiazepine has risen. We need to understand how that situation is happening and be able to offer safer alternatives, such as Buvidal and new treatments, to reduce overdose cases. The role of prescribers, including general practitioners, will be crucial in that work.

In October, the Advisory Council on the Misuse of Drugs will have its first meeting in Scotland, and there will be a four-nations drugs meeting in Belfast later that month. I will use that opportunity to continue to press the United Kingdom Government on the evidence for drug-checking facilities and safe consumption rooms, while pursuing further action via our devolved powers.

I will continue to prioritise people with lived and living experience, through local panels and a national collaborative. That approach already plays a vital role in service design and delivery across Scotland, but my priority will be ensuring that we make everyone’s rights to the highest standard of healthcare a reality.

We will also continue to strengthen the links across portfolios. Our mission is linked to other vital work to improve mental health, to address poverty and inequality, to ensure that we are keeping the promise to our children, to build resilience through education and prevention and to bring public health approaches to our justice system. Another priority will be to develop and scale up women-specific services. I have announced that Phoenix Futures has been successful in principle in a bid to establish a new national specialist family service. That facility will be the first of what, I hope, will be many new residential rehabilitation facilities. I will soon set out to Parliament our milestones for further growth over the next five years.

I will continue to prioritise the use of naloxone. Those services have made great strides, but I want to see more. Last month, we launched a national naloxone campaign that has already significantly increased demand through our third sector partners. I am encouraging community pharmacists to be more active in the use of naloxone, too.

In November, we will launch a campaign to tackle stigma, which is still, for many people, a barrier to accessing life-saving services. I am also making it a priority for alcohol and drugs services to be featured in the proposed national care service. This is a real opportunity to consider how we can better support some of Scotland’s most marginalised and vulnerable people.

I am conscious that it is not possible to cover in detail every priority for the new parliamentary session in the time that we have available. I hope that this summary is helpful to the committee and is the start of a conversation that we will have over the years. I will, of course, continue to update Parliament regularly.

As you will have heard Mr Kevin Stewart often say, the national care service is the biggest reform of the national health service since 1948. Although it will be immensely complex and challenging to build such a service and deliver it over the lifetime of this parliamentary session, the proposition itself is also very significant and exciting. At a fundamental level, it is about how we care for people and how we value those who do so. Given that people with drug-related difficulties are amongst the most marginalised, excluded and stigmatised in our communities, it is important that we ask about the benefits of making drug and alcohol services part of the biggest change in our national service in over 70 years.

Some of the synergies in what we are trying to do to improve services have a strong connection with the work on the national care service and its focus on person-centred care and informed choice. It is not just about caring and treating folk but about helping them live their lives, and I therefore feel strongly that questions about drug and alcohol services should be part of that consultation. What we need to test and explore in the consultation are opportunities via the national care service to improve accountability, governance and, indeed, the status of drug and alcohol work. I know people working in and delivering these services who feel that it is not just those whom they serve who are stigmatised; sometimes they, too, feel a bit forgotten and that the service itself is somewhat stigmatised. I also believe very much in accountability at every level and I have an interest in and focus on governance in that respect.

The challenge with alcohol and drug partnerships is that partnership needs to happen at a local level—and sometimes at a very local level if we are going to reach into the most deprived and disadvantaged communities. Those are the issues that we are testing at the moment.

The national care service is about taking a rights-based approach, which fits with what we are trying to achieve in drug and alcohol services. It is in the consultation, and there are some quite deep and fundamental issues that we need to test out.

I outlined those in my previous answers. Perhaps Ms McNair’s connection is not very good. I talked about our work on Buvidal and naloxone. I did not talk about our £1.9 million investment in our work on prison to rehab.

The work and contribution of the lived-experience and recovery community throughout the pandemic should remind us well of the value of engaging meaningfully with—not just paying lip service to—the recovery community and those with lived and living experience. That is why we want to take that work further forward with our work on a national collaborative.

The £5 million in additional resource was released in the final quarter of the previous financial year, which was the first quarter of this calendar year. Of that, £3 million went to alcohol and drug partnerships—as I mentioned, we published their returns on how that was invested—£1 million was put into a grass-roots fund, and £1 million went into a service improvement fund.

At the turn of the financial year—after Easter, on 18 March—I announced four new funds totalling £18 million. I hasten to add that they are multiyear funds. Those four new funds opened in May. There is a £5 million recovery fund; a £5 million service improvement fund; a £5 million local fund, which again is geared towards grass-roots organisations; and a £3 million families and children fund. Those are available via the Corra Foundation for all non-profit organisations to apply for. We have worked really hard to make the application process accessible and quick. To date, we have funded in excess of 50 projects through that. Adding in other funding—for example, through work that the task force has done—I think that we have funded over 80 specific projects.

This year, we will invest around £13.5 million in residential rehab. That money will come from ADPs and from the recovery fund and other sources of funding within Government. I will outline to the Parliament in more detail the profile of that funding, because we have a commitment to provide £100 million for residential rehab and aftercare over five years.

On the £50 million for this year, there is also the specific £13.5 million uplift to ADPs that I have mentioned, and around £14 million is going on £3 million for outreach, £3 million for non-fatal overdose, £4 million on widening the distribution of Buvidal, and £4 million on implementing the MAT standards. I hope that that gives an overview.

A small amount of resource is going on research. Resources have also been set aside for the national stigma campaign and our lived and living experience strategy work on establishing the national collaborative.

Our commitment to increasing the capacity and the reach of drug services and to improving access to residential rehab applies very much to aftercare, too. We must recognise that drug addiction can be a chronic condition—it should be no surprise to anyone who is involved in the provision of drug services that people sometimes relapse. Progress in life is rarely linear, and it should not be that people run out of chances; we should give people as many chances as they need to get onto the road to recovery. The work that we do with local services and that integration with aftercare is crucial.

We also need to think about rehabilitation in a community context, as well as in a residential one. We know that risk can be elevated in times of transition, such as when someone leaves residential rehab, so people must have wraparound person-centred support that meets their needs. That approach also applies to people who leave prison or move from, or leave services. Our work and investments around outreach are particularly important in that area. We also need to be far better at following up when people disengage from services.

There is a lot in that question, but the member is quite right to make all of those connections. The point about access to residential rehabilitation is important. The work that the residential rehab development working group has undertaken is about the development of clearer pathways, because pathways vary across the country. I think that I am on record as saying that sometimes, pathways into residential rehab are as clear as mud, which is neither right nor acceptable.

There is also an issue about access to community services. There can be many barriers to people getting into treatment: you have to do this; you have to be on this level of treatment; you have to be abstinent and so on. With regard to residential rehab, which is an abstinence-based model, there are certain expectations around people’s personal commitment, detox and lowering substances to facilitate the process, but it is fair to point out that there are perhaps too many barriers to accessing other services.

An early action that I took was the result of information that Shelter provided. There is a bit of confusion about housing benefit rules. Anyone who knows anything about housing benefit will know about the minutiae of detail that often have to be unravelled. Different things were happening in different local authority areas to apply rules. I was not going to put up with people having to choose between keeping their tenancy and going into residential rehab. Funds have been allocated and are available to address that while we sort out the complexities of regulation or whatever. That is one example of how we can invest resource. We will sort out the situation, but we are not putting up with people facing that choice.

I have always been a big fan of the housing first approach and other housing models that do not put up barriers. We should take people as they are; the priority is to get them into a home, and we will work out the rest, whether that involves people’s drug use, health problems or other issues. I have spoken about parents and in particular mothers with caring responsibilities, so I will not repeat that.

The naloxone issue is important. Naloxone helps to save lives; it buys time for the emergency services because it temporarily reverses the impact of an opioid overdose. It is safe and easy to use. Because of the pandemic, the previous Lord Advocate issued guidance that enabled us to widen the distribution of naloxone to third sector settings.

I must give a shout-out to Scottish Families Affected by Alcohol and Drugs. As a result of our national naloxone campaign and people going to the Stop the Deaths website, more than 460 people have applied to that organisation for the naloxone kits that it provides through its click and deliver service. Families who have a loved one at risk can have naloxone to hand. More than two thirds of ambulance technicians are trained in naloxone use and can give out take-home kits to people they come across. It is important that people who distribute naloxone in non-drug services make the connections, support people and refer them to drug services.

I apologise for the length of my reply, but I hope that I have at least outlined some important connections.

The police have been carrying naloxone in three areas—the east end of Glasgow, Falkirk and Dundee. That pilot has been successful and the police have used naloxone 40 times. We have entered a review period and we will want to discuss with justice colleagues how the programme could be extended. It is important for statutory services to play their part, which also helps us to communicate with wider communities and the wider population that a tool can be used to help to prevent people from dying when help has been called for.

Of course we need to prevent people from having an overdose in the first place—we have covered that extensively. Naloxone is one piece of the jigsaw; other pieces involve preventing people from getting into crisis in the first place and how we connect people with support services when they survive an overdose.