Problem drug use in Scotland Contents


1.Scotland is in the midst of a drugs crisis. The rise in drug-related deaths in Scotland has been relentless, with the number of deaths increasing almost every year since the 1990s earning Scotland the title of “drug death capital of the world”.1 Some 1,187 people died from drug-related causes in 2018—an all-time-high for Scotland, higher than any other European country, and nearly three times that of the UK as a whole.2

2.Drugs policy is an issue on which the UK and Scottish Governments take divergent approaches. The UK Government treats problem drug use primarily as a criminal justice matter, whereas the Scottish Government believes it should be addressed as a health issue.3 This difference in approach has caused disagreements between the two governments, most notably with the Home Office blocking an application for a safe consumption facility in Glasgow, as criminal justice sanctions for drugs is a policy area currently reserved to Westminster. This led to calls from some for drugs laws to be devolved to Holyrood, to enable the Scottish Government to take all measures it deems necessary to address Scotland’s drug crisis. Others argued that, as health and justice are devolved matters, the Scottish Government already has the main powers necessary to address problem drug use.

Our inquiry

3.As the number of drug deaths in Scotland reaches record levels, and given the public disputes over powers and approaches, we decided to investigate why Scotland has such a severe drug problem, and whether changes are needed at a UK-level to halt the spiralling number of drug-related deaths.

4.The division between reserved and devolved competence has been a key consideration for how we have structured our inquiry. Although we have discussed devolved policy areas—such as prisons and the delivery of drug-related health services—it has not been the focus of our inquiry, and we do not make recommendations on policies exclusively within the Scottish Government’s competence. However, we have discussed and commented on areas of devolved competence and will be writing to colleagues in the Scottish Parliament to raise these issues with them. We have focused on reserved policy, which necessarily means many of the recommendations in this report would apply UK-wide. Whilst our focus has been problem drug use in Scotland, drug-related deaths are also at a record high in England and Wales too, and UK-level reforms to address the situation in Scotland could also benefit the rest of the UK.4

5.We held eight oral evidence sessions, hearing from; academics, individuals and families with lived experience of problem drug use, third sector and charity groups, service delivery organisations, UK and Scottish police forces, as well as the responsible Scottish Government minister. It is regrettable that it took the Home Office nearly 6 months to appear before us to give evidence, despite repeated invitations.5 We are also disappointed that the Home Office has not provided the Committee with written evidence.

6.We held several public engagement events in Edinburgh and Glasgow, where we heard from sector groups and individuals with lived experience of problem drug use in a more informal setting. We also visited Ottawa, Frankfurt and Lisbon, to see what the UK could learn from how problem drug use is addressed in other countries.6 We are grateful to all those who contributed to our inquiry. We are particularly grateful to the individuals who shared their personal stories with us both in person and in writing; these were often extremely moving and impactful, and we appreciate that they were sometimes difficult to share. We are also grateful to our two specialist advisers Anna Ross, and Professor Catriona Matheson, University of Stirling, who have provided invaluable assistance throughout our inquiry.7

7.We begin this report by exploring the key drivers and patterns of problem drug use in Scotland in chapter 2. We then examine and evaluate the criminal justice and public health approaches to problem drug use in chapter 3. In chapters 4 and 5 we turn our focus to the debate over safe consumption facilities and decriminalisation, before discussing the role of stigma as a barrier to recovery in chapter 6.

2 National Records of Scotland, Drug-related deaths in Scotland in 2018, July 2019

4 Office for National Statistics, Deaths related to drug poisoning in England and Wales: 2018 registrations, 15 August 2019

7 Anna Ross was appointed on 23rd April 2019, Professor Matheson was appointed on 12th June 2019

Published: 4 November 2019