Problem drug use in Scotland Contents

Conclusions and recommendations

Problem drug use in Scotland

1.Scotland is in the midst of a drug death crisis. The relentless increase in drug deaths in Scotland is a tragedy that cannot be allowed to continue. We call on the UK Government to declare a public health emergency, and to work with the Scottish Government to take urgent and radical steps to halt Scotland’s spiralling drug crisis. Both Governments must be open to implementing innovative evidence-based solutions with the scale and urgency required by Scotland’s drug crisis. (Paragraph 12)

2.People’s drug use often becomes problematic because of things beyond their control, rather than because of a proactive ‘decision’ to become dependent on substances. People who use drugs are a vulnerable group who require help and support, not prejudice and judgement. Both Governments must ensure that their approaches to problem drug use acknowledge and address the underlying causes, such as poverty and inequality, social marginalisation, trauma and the lack of strong family structures and support networks. (Paragraph 27)

3.Addressing the root causes of problem drug use requires radical, whole-system change, rather than piecemeal reform. We welcome the planned cross-government summit in Glasgow and encourage the UK and Scottish Governments to be bold, imaginative and evidence-based. Both Governments must work together to implement an integrated, cross-departmental, and cross-government approach to drugs, which fully utilises the potential impact of joined-up policing, justice, employment, welfare, housing, physical and mental health policies and services. The UK Government must also ensure that all departments are proactively engaging with each other, the health services and third-sector organisations, in order to help address problem drug use in Scotland. (Paragraph 38)

4.The welfare policies of the Department for Work and Pensions have a detrimental impact on people who use drugs, and often become a barrier for many people trying to enter recovery. The Scottish Government should also make full use of its existing powers to support people recovering from problem drug use. The UK Government must review the impact welfare sanctions have on people who use drugs, and outline steps it will take to make the welfare system less adversarial for people who use drugs who are trying to enter recovery. (Paragraph 42)

Approaches to problem drug use

5.The criminal justice approach to people with problem drug use has failed. Problem drug use is a health issue, and it should be treated as such by the UK Government. The Government must revise its strategy for addressing problem drug use in line with a public health approach. We support the call from the Health and Social Care Committee for the UK Government to transfer lead responsibility for drugs policy from the Home Office to the Department for Health and Social Care. This would demonstrate its commitment to a health-focused approach to drugs. (Paragraph 61)

6.The adoption of a public health approach must reflect the UK Government taking an evidence-based approach to drugs policy. The Home Office must commit to implementing an evidence-based approach to drugs policy. This includes the Government giving full weight to all reports and recommendations from the ACMD. Where the UK Government chooses to go against expert advice from the ACMD, the Government must publicly outline its reasons for doing so and set out its evidence base. (Paragraph 64)

7.We have heard that the Misuse of Drugs Act 1971 is outdated, its classification system is arbitrary, and that it is fundamentally incompatible with a public health approach. If the UK Government is to implement a public health approach as we have called for then the Misuse of Drugs Act must be substantially reformed. (Paragraph 68)

8.Throughout this inquiry we heard that there is more the Scottish Government could, and should, be doing to address problem drug use with the powers it already has, in areas such as mental health, housing, education, community regeneration, policing and justice. We were particularly concerned to hear of the impact that funding cuts, 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. (Paragraph 71)

Safe consumption facilities

9.Safe consumption facilities are proven to reduce the immediate health risks associated with problem drug use. These facilities do not come without their challenges. However, when effectively managed with appropriate levels of funding and cooperation from the police and other stakeholders, these risks can be mitigated. However safe consumption facilities should not be seen as a ‘silver bullet’, but 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. (Paragraph 85)

10.We believe there is a strong evidence base for a safe consumption facility in Glasgow, which would be a practical step to reducing the number of drug-related deaths in Scotland. Health is a devolved matter, and it is therefore deeply regrettable that the UK Government has chosen to block the proposed facility. 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. Under the devolution settlement, spending on health delivery is a matter for the Scottish Government. We recommend that the UK Government supports the proposed pilot safe consumption facility in Glasgow. (Paragraph 93)

11.We do not believe that it would be acceptable to try to open a safe consumption facility in Glasgow under the current legal framework. Doing so would risk putting clients, NHS staff, and governance bodies in legal jeopardy. We recommend that the UK Government brings forward the legislation necessary to allow for the lawful establishment of a pilot safe consumption facility in Scotland. If the UK Government is unwilling to do so, it must instead devolve competence for drugs legislation to the Scottish Parliament, so that it can implement the health approach it deems to be in Scotland’s best interest. (Paragraph 101)


12.Decriminalisation of the possession of drugs for personal use is an evidence-based solution to problem drug use. There is a strong case for doing this across the UK, as decriminalisation is proven to address the root causes of problem drug use. Decriminalisation would also allow the Government to focus efforts and resources on tackling the drug supply chain and providing services to support people who use drugs into recovery. (Paragraph 114)

13.We support the innovative approaches to decriminalisation taken by police forces across the UK, but believe that statutory decriminalisation is a preferable solution which removes the legal ambiguities inherent in non-statutory approaches. (Paragraph 125)

14.We also believe that decriminalisation should be implemented by elected and accountable politicians. Whilst we are encouraged to hear the Home Office minister tacitly supports de facto decriminalisation schemes in the UK, it is unclear to us why the Government has not implemented diversion as a UK-wide policy, and has chosen instead to leave this difficult issue to local police officials. It is also not clear why the UK Government is supportive of de facto decriminalisation, but will not support statutory decriminalisation. The UK Government must be clear on its policy and be accountable for its decisions. (Paragraph 126)

15.We recommend that the UK Government decriminalises the possession of small amounts of drugs for personal use across the whole of the UK and should consult on how this could be rolled out in practice. As a transitionary approach, the Home Office should encourage all police forces across the UK to introduce diversion schemes. If the UK Government does not decriminalise drugs, this will only strengthen the case for the devolution of drugs laws. (Paragraph 127)

16.We welcome the high level of co-operation between the UK and Scottish law enforcement agencies to address the supply of drugs, as well as the Organised Crime Partnership which has strengthened joint efforts to combat drug supply. However, we are not convinced by the minister’s argument that decriminalisation, in Scotland or the whole of the UK, would undermine these efforts, as the decriminalisation of possession for personal use would not alter the illegality of organised crime groups supplying illicit drugs, which this joint work seeks to address. Decriminalising drugs could free-up resources which could be put into efforts to combat supply and import of drugs. (Paragraph 132)

17.Whilst we heard that the legalisation of drugs would deliver more benefits than decriminalisation, decriminalisation alone would be a radical departure from the Government’s current approach to drug policy. We therefore believe that the Government should focus on delivering decriminalisation. (Paragraph 139)


18.The UK Government should be doing everything it can to reduce the stigma surrounding problem drug use. The UK Government must lead by example by ensuring it promotes appropriate and non-stigmatising language when discussing drugs. The Government should also be proactively challenging stigmatising language and misrepresentation, in order to improve the quality of public and political understanding of drug-related issues. (Paragraph 148)

19.It is unacceptable that drug dependence is excluded from the Equality Act 2010, despite it being fully recognised (in the UK and internationally) as a health condition. This can have damaging real-life consequences for many people who use drugs—often by preventing them fully accessing recovery services. The UK Government must immediately review the exemption of substance dependence from equality legislation and assess the impact it has on people who use drugs. (Paragraph 154)

Published: 4 November 2019