Problem drug use in Scotland follow-up: Glasgow’s Safer Drug Consumption Facility

Summary

1. Scotland has the highest rate of drug-related deaths per head anywhere in Europe, with 1,172 lives lost in 2023 alone. There is a particularly acute concentration of people using drugs in Glasgow. Following significant legal obstacles, the first official Safer Drug Consumption Facility (SDCF) in the UK - ‘The Thistle’ - opened in Glasgow in January 2025, as a three-year pilot. An SDCF is a professionally supervised healthcare facility where people can consume drugs in safer conditions, designed to reduce overdose mortality, risk behaviours such as the sharing of injecting equipment, the transmission of blood-borne viruses and public injecting. The stated aim of The Thistle is to reduce the harms associated with injecting drugs. Whilst it is likely to reduce the number of drug-related deaths on a local level, it is not anticipated that the number will be reduced on a city-wide or national level. This may be contrary to the public’s understanding of the facility. There has been no change to UK legislation, with the UK Government being clear in its opposition to SDCFs. Instead, the opening of The Thistle came about through the Lord Advocate (Scotland’s most senior prosecutor) applying prosecutorial discretion to effectively exempt drug possession offences within the facility. While the legal footing has been pivotal in enabling The Thistle to open, our inquiry finds it to be an inadequate substitute for a considered legal framework to enable and regulate SDCFs.

2. Our inquiry has also considered whether The Thistle, which is currently only for the injection of drugs, can adequately meet the needs of the local population of people who use drugs. We have found that drug trends in Scotland have changed, and continue to change, as inhalation becomes an increasingly popular method of consumption. For The Thistle to be effective, it must be able to meet the needs of the population it is trying to help. In our view, it cannot do this without an inhalation room. We call for any future application for an inhalation room to be considered on its merits by the Lord Advocate and Scottish Government.

3. We have also heard concerns expressed by the local community about The Thistle’s impact on the area. Community support is of paramount importance to the success of The Thistle, and these concerns need to be taken seriously. A responsive communication strategy must be developed by The Thistle, agreed by the Community Forum, and put in place as soon as possible in order to support the community engagement and partnership working that is crucial to the success of the project.

4. The cost of The Thistle has been raised during our inquiry. We find that, while The Thistle is undoubtedly an expensive intervention, it could prove good value if it saves money elsewhere in the health service. However, future funding for The Thistle, or any other approved SDCFs, must not come at the expense of other recovery and harm reduction facilities. We also note that The Thistle is described as ‘gold standard’ and consider that a less sophisticated model of the facility could potentially offer corresponding harm reduction benefits, at a reduced cost. However, any discussion of the cost of The Thistle must be considered in the context of the scale of Scotland’s drug crisis.

5. Finally, while there is clear international evidence of the effectiveness of SDCFs in reducing drug-related harm, The Thistle’s future beyond its current three-year pilot will likely depend on the outcome of an independent evaluation. We call on the UK Government to adopt an evidence-based approach to policy, and to seriously consider the evaluation when it is published. If the evaluation outcomes are positive, we call on the Government to consider what action it needs to take to allow such facilities to be set up on a secure legal footing.

Introduction

6. The first official Safer Drug Consumption Facility (SDCF) in the UK opened in Glasgow on 13 January 2025.¹ The facility, known as The Thistle, opened on the basis of a three-year trial. This inquiry has examined the legal and policy challenges involved in establishing and operating the pilot facility, with a particular focus on the future of the site.

7. Our work follows up on an inquiry conducted by our predecessor committee into problem drug use in Scotland.² That inquiry considered multiple aspects of problem drug use, including its drivers, integrated policy responses, social security and the two different approaches of criminal justice and public health, some of which we touch on briefly in chapter one of this report. Of particular relevance to our current inquiry is the predecessor committee’s recommendation that the UK Government should support a pilot SDCF facility in Glasgow.³ The Government at the time rejected this recommendation.⁴ However, since then policy and legal developments in Scotland have enabled such a facility - The Thistle - to open.

8. Our inquiry spanned four oral evidence sessions, in which we heard from academic and medical experts in public health and addiction, the operators and stakeholders of the pilot facility in Glasgow, the Lord Advocate and both the UK and Scottish Governments. We also received written submissions from a range of stakeholders. We would like to thank everyone who contributed their time and expertise to this inquiry.

9. In February 2025, we visited The Thistle and saw the facility for ourselves. We were particularly impressed by the dedicated and expert staff we met.⁵ In March 2025 we travelled to Norway, where we visited fixed SDCFs in both Oslo and Bergen.⁶ Seeing well-established, permanent sites offered valuable context to our work, with the information derived from our conversations with stakeholders feeding into the recommendations of this report. During a brief visit to Lisbon, we were able to see mobile SDCFs in operation and heard about how different service models can be implemented to best meet the needs of a community. Finally, we gained an insight into the impact of The Thistle on its local community by attending a Community Engagement event, where residents and businesses shared their views and concerns regarding the facility.⁷

10. This report begins by discussing the background to Scotland’s drug death crisis, and why The Thistle was established. Chapter two examines the facility’s legal footing and recommends a more sustainable legal basis for the facility. Chapters three and four consider the cost of the facility, and its impact on the local community. Chapter five considers whether The Thistle has the full range of equipment and services it needs to be as effective as possible, before chapter six looks forward to the future of The Thistle, and the importance of the evidence-based evaluation of its operation, which is underway.

11. The opening of The Thistle represents a significant change in the application of drug laws in the UK and the facility could be instrumental in leading the way to address Scotland’s drug crisis. We hope the UK Government will consider our thorough examination of these issues carefully.

1 Problem drug use in Scotland

12. Responsibility for drugs legislation and the treatment of drug-related issues is divided between the UK and Scottish Governments. Drugs legislation is reserved to the UK Parliament, with the Misuse of Drugs Act 1971 regulating the production, supply and possession of “controlled” drugs. While the consumption itself of controlled drugs is not an offence, “possession” of them is.⁸ Other reserved legislation, including the Psychoactive Substances Act 2016, the Drugs Act 2005 and the Drug Trafficking Act 1994 amongst others, also contribute to the regulation of controlled substances.

13. Although drug legislation is reserved, health is a devolved matter, and the Scottish Government has full responsibility for the provision of drug harm policy, treatment and health services in Scotland.⁹ Other matters relevant to the handling of drugs and treatment of problem drug use, including social work, policing and the criminal prosecution system, are also devolved.¹⁰

Drug-related deaths

14. Scotland has the highest rate of drug-related deaths per head of population anywhere in Europe.¹¹ 1,172 drug misuse deaths were registered in Scotland in 2023, marking a 12% increase from 2022.¹² In 2024, drug misuse deaths decreased 13% to 1,017, or 19.1 deaths per 100,000, marking the lowest figure since 2017.¹³ However, concerns remain that this fall is not indicative of a downward trend in drug deaths and that deaths may increase in 2025.¹⁴ According to the most recent data, Estonia has the second highest levels of drug related deaths in Europe with 13.5 drug deaths per 100,000 in 2023.¹⁵ The comparable figures for 2023 in England and Wales show a drug poisoning mortality rate of 9.3 per 100,000.¹⁶ In 2021, drug deaths per 100,000 in Portugal was 1.1, and 8.6 in Norway in 2022.¹⁷ The Royal College of General Practitioners has described drug deaths in Scotland as “the most pressing public health issue facing the nation”.¹⁸

Source: National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024; National Records of Scotland, Decrease in drug misuse deaths, 2 September 2025

15. Professor Andrew McAuley, Professor of Public Health at Glasgow Caledonian University, explained that Scotland has a “prevalence of risk” from drug related harms which sits at a rate “much higher per head than you see in other countries, not just in the UK but in the rest of Europe”.¹⁹ The National Records of Scotland found the Greater Glasgow and Clyde health board had the highest rate of drug misuse deaths in Scotland.²⁰ Greater Glasgow and Clyde was also found to have the greatest increase in drug misuse rates over time.²¹

16. In 2023, there were 805 male drug misuse deaths, compared to 367 female drug misuse deaths.²² This trend has narrowed over time, as explained by the National Records of Scotland, as in the early 2000s, males were four or five times as likely to have a drug misuse death than females.²³ The age profile of drug misuse deaths has also become older over time. The average age has increased from 32 in 2000, to 45 in 2023.²⁴ Analysis carried out by Glasgow University and NHS Health Scotland concluded that the trends in over 35 drug-related deaths are:

[…] consistent with the hypothesis that economic and other policy decisions during the 1980s created rising income inequality, the erosion of hope amongst those who were least resilient and able to adjust, and resulted in a delayed negative health impact.²⁵

Public injecting

17. Beyond deaths, the transmission of blood borne viruses (BBVs) through the sharing of injecting equipment is a further harm caused by problem drug use. The most prevalent BBVs are HIV, Hepatitis C and Hepatitis B.²⁶ Since 2015, there has been a significant decline in new HIV infections among people who inject drugs in the UK as a whole.²⁷ However, an outbreak of HIV among those who inject drugs beginning in June 2014 was reported in the NHS Greater Glasgow & Clyde area, with 188 new diagnoses reported between then and December 2020.²⁸ This increase was linked to homelessness and injecting in public spaces.

18. That figure declined annually after peaking in 2015. The increase in HIV cases, as well as high rates of drug-related deaths and concerns of local communities explored later in this chapter, prompted Glasgow City HSCP to issue a health needs assessment to review the health needs of those who inject drugs.²⁹ The final report of that work, entitled ‘Taking Away the Chaos’, estimated that in 2018, between 400 and 500 people were injecting in public places in Glasgow city centre on a regular basis:

The high rate of homelessness observed locally in this population was corroborated by published research showing that public injecting is closely associated with a combination of social vulnerabilities, including homelessness and housing insecurity, offending, and destitution.³⁰

19. In written evidence, Professors Vittal Katikireddi and Andrew McAuley, who are part of the team evaluating The Thistle, explained that those who inject in public spaces “are often the most marginalised members of society” due to “high levels of homelessness and socioeconomic deprivation”.³¹ As well as the increased risk of contracting a BBV, people who inject in public “are particularly vulnerable to abscesses, wounds, deep vein thrombosis, as well as overdose and drug-related death”.³² Professor Catriona Matheson, Professor in Substance Use, University of Stirling, noted that high levels of public injecting are not seen in many cities other than Glasgow, except possibly Dundee.³³ Research published in 2020 found that 16% of people who inject drugs across Scotland reported public injecting, compared to 47% in Glasgow city centre.³⁴ While the spike in HIV infections passed after 2015, Professor McCauley noted that the “reservoir of infection” remains high in Glasgow city, with the risk of transmission still present “should individual circumstances change”.³⁵

Approaches to problem drug use and SDCFs

20. There are two general approaches to addressing problem drug use—criminal justice and public health. A criminal justice approach focuses on policing and law enforcement as the primary means of addressing and reducing drug use, though this does not prevent the implementation of public health initiatives.³⁶

21. Alternatively, a public health approach recognises substance use and addiction as a complex and multifaceted health disorder, which is preventable and treatable, and is not the result of moral failure or criminal behaviour.³⁷ Public health approaches recognise substance abuse as a brain disorder, meaning it can be treated, and emphasises that people with even the most severe forms of such abuse can recover through treatment. A public health approach does not “preclude the use of criminal justice” but focuses on reducing the risks to individuals and communities.³⁸

22. The Scottish Government is committed to a public health approach to problem drug use, with the responsibility for drugs policy sitting within the health portfolio since 2016.³⁹ In the UK Government, ultimate responsibility for drugs policy currently lies with the Home Office (rather than the Department of Health and Social Care), which reflects the Government’s criminal justice approach to drugs policy.⁴⁰ The UK Government implements some public health policies, such as early intervention schemes, and has a commitment to preventative public health measures, but has been criticised for not embracing this approach more fully.⁴¹

23. The use of Safer Drug Consumption Facilities (SDCFs) as professionally supervised healthcare facilities where people can consume drugs in safer conditions reflects a public health approach to problem drug use.⁴² SDCFs are designed to reduce overdose mortality, risk behaviours (i.e. sharing of injecting equipment), public injecting, and associated public disorder outcomes (such as drug-related litter).⁴³ Inside these facilities, medically trained staff reverse overdoses, provide injecting equipment and refer people onto key services such as drug treatment, counselling and housing services.⁴⁴ As well as reducing immediately harmful drug consumption practices, SDCFs seek to address the root drivers of problem drug use by establishing contact and building trust with hard-to-reach cohorts of people who use drugs. These relationships can be a pathway to engagement with other health and social services, such as housing support, which can help address factors driving individuals’ drug use.⁴⁵ SDCFs currently operate in 60 cities worldwide.

24. The Royal College of General Practitioners has described it as an indisputable fact that an SDCF will reduce the immediate health risks resulting from problem drug use.⁴⁶ Research into the effectiveness of these facilities by the European Union Drugs Agency (EUDA), formerly the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), has shown SDCFs provide benefits such as improvements in safer, hygienic drug use, reduced public drug use and associated nuisance and increased access to health and social services.⁴⁷

25. When considering drug-related death, a 10-year evaluation of a Safer Drug Consumption Facility in Sydney, which began in 2001, found that of the 3,426 overdoses that occurred in the site, no lives were lost. A more recent 18-month study of the same facility in 2018 found a 36% reduction in ambulance attendances involving naloxone - a medicine that rapidly reverses an opioid overdose - within 1km of the facility during operational hours.⁴⁸ Such a reduction suggests that there were fewer overdoses in the area surrounding the facility, whilst it was open, relieving pressure on emergency services.⁴⁹

26. In a rapid evidence review of SDCFs, Dr Gillian Shorter of Queens University Belfast noted that service users perceived staff at SDCFs as “less judgemental, more experienced with intravenous drug use, and less discriminatory than staff in conventional care settings, facilitating connection with health services for those who need it”.⁵⁰ Dr Shorter also noted that care provision and uptake of referred treatment options is enhanced due to the specialist nature of staff, and their “familiarity with healthcare needs affecting those who use drugs”.⁵¹ This has been seen in a Canadian study, which found that among 18% of those attending the Vancouver SDCF engaged in a detox programme, 57% engaged in an addiction treatment modality and 23% stopped injecting drugs altogether.⁵²

27. While international evidence suggests SDCFs are effective in reducing drug-related harm, their establishment often causes concern in local communities from residents, businesses and schools.⁵³ In particular, communities can be concerned about the facility driving an increase in the number of people using drugs in their area, sometimes referred to as the “honeypot effect”, although there is mixed evidence on this.⁵⁴

28. Other concerns have been raised regarding the efficacy of the underlying harm reduction approach SDCFs facilitate. FAVOR UK, a charity that advocates for people in recovery from addiction, suggests that they perpetuate dependency.⁵⁵ FAVOR UK has recommended that resources should instead be invested in recovery services like rehabilitation programmes, something we further explore in chapter three of this report.⁵⁶

29. The Scottish Government supports the use of SDCFs and has helped to facilitate and fund The Thistle, as part of its wider national mission policy to reduce harm and drug-related deaths.⁵⁷ In contrast, the UK Government opposes such facilities, with the Rt Hon Dame Diana Johnson DBE MP, Minister of State for Crime, Policing and Fire, Home Office, emphasising that the UK Government does not support SDCFs and would not be making legislative changes to facilitate them.⁵⁸ She emphasised that alternative interventions are available to combat problem drug use, including the distribution of clean needles and drug checking services.⁵⁹

The Thistle

30. The Thistle is staffed by a multidisciplinary team of nurses, harm reduction workers, social workers, psychologists and medical staff.⁶⁰ Staff can educate visitors of the facility on safer injection techniques and offer harm reduction advice to minimise the risk of overdose.⁶¹ When an overdose occurs at The Thistle, supervising staff are trained for medical emergencies and have the necessary equipment onsite to intervene.⁶² During our visit to the facility in February, we saw the range of services available in addition to the consumption space, including laundry and shower facilities, which staff emphasised was a key attraction for visitors.⁶³ The Committee’s visit was outside the operating hours of The Thistle, meaning we did not see the facility in action.

31. The initial recommendation for an SDCF in Scotland stemmed from the significant HIV outbreak in Glasgow in 2015 amongst those who inject drugs.⁶⁴ The negative impact of public injecting, including the high levels of publicly discarded injecting equipment, had also been raised by local residents and business for several years.⁶⁵ As a result of these issues and ongoing concerns regarding drug-related harms, Glasgow City Health and Social Care Partnership (HSCP) worked with NHS Greater Glasgow and Clyde (NHSGGC) and other partners to open The Thistle.

32. The Scottish Government has said that The Thistle aims to:

[…] reduce the harms associated with injecting drugs, including the risk of blood-borne viruses such as HIV, support people to get help to improve their lives and reduce the negative impact of outdoors injecting on those using substances, local residents, communities and businesses.⁶⁶

33. Neil Gray MSP, Cabinet Secretary for Health and Social Care, Scottish Government, told the Scottish Parliament that a reduction in drug-related deaths is one of the pilot’s aims.⁶⁷ However, Dr Saket Priyadarshi, Associate Medical Director of The Thistle, explained in evidence to us that while there is a likelihood the facility will reduce drug-related deaths, this impact would be highly localised.⁶⁸ As the population accessing The Thistle is relatively small, even in the context of the people who use drugs in Glasgow, it is unlikely The Thistle will reduce the number of drug deaths on a city-wide or national level.⁶⁹

34. Looking to the future of the facility, Councillor Allan Casey, City Convener for Workforce and Homelessness and Addiction Services, Glasgow City Council, explained that the pilot could be used as a proof of concept of SDCFs for the rest of the UK.⁷⁰ Key to considerations of this concept will be the results of the independent evaluation of The Thistle, which will “help inform whether the service should continue”.⁷¹ The independent evaluation is funded by the National Institute for Health and Care Research and is considering the impact of The Thistle on people who inject drugs, local residents and businesses and public services.⁷² The importance of this evaluation is explored further in chapter six.⁷³

2 The legal position of The Thistle

Current legal position of The Thistle

38. There are currently no exceptions within the provisions of the Misuse of Drugs Act 1971 which would enable an SDCF to open or operate in the UK. The Thistle opened on the basis of a statement of prosecution policy issued by the Lord Advocate. While the UK-wide law itself has not been changed, the Lord Advocate’s approach to prosecution means, in effect, people can consume drugs in the facility and not be prosecuted for possession.

First application

41. In 2017 Glasgow City HSCP approached the then-Lord Advocate, James Wolffe KC, for the necessary statement of prosecution policy. This was sometimes referred to at the time as a ‘letter of comfort’. This request was denied, with Mr Wolffe stating he could not “alter the basic quality of the activity as criminal law” and that an amendment to prosecution policy would be insufficient to allow the facility to operate on a legal basis.⁷⁵ Mr Wolffe explained that approving the facility would “be a matter for the UK Government” to decide and directed Glasgow City HSCP to “pursue discussions with the Scottish Government in the first instance to progress the necessary legal exemptions”.⁷⁶

Second application

42. In 2022 Glasgow City HSCP submitted a revised proposal to the current Lord Advocate, Dorothy Bain KC, “requesting that further consideration be given to a public statement of prosecution policy that would support the implementation of a Safer Drug Consumption Facility”.⁷⁷ As Glasgow City HSCP explained in written evidence:

The proposal outlined the delivery of a Safer Drug Consumption Facility alongside a range of specialist harm reduction and treatment and care services, with pathways into longer term recovery. Operational policies and procedures were provided.⁷⁸

43. The Lord Advocate has described this second request as “quite different in nature and scale” from the proposal sent to the previous Lord Advocate.⁷⁹ This was emphasised by Dr Saket Priyadarshi, Associate Medical Director of The Thistle, who explained how this second proposal was “much more specific”, as they had identified a site for the pilot facility, unlike the original application.⁸⁰ He explained that information on how “certain elements of the Misuse of Drugs Act 1971 breaches” would be avoided through “rules and standard operating procedures” was also included in this application.⁸¹

44. Following this second request, the Lord Advocate said in September 2023 that she would consider issuing the necessary statement of prosecution policy for a pilot SDCF in Glasgow, which was “near public injecting sites, was co-located with other relevant services, and which included a meaningful community engagement plan and an independent evaluation plan”.⁸²

45. In January 2025, “having been satisfied about the requirements” set out above, the Lord Advocate “published a statement of prosecution policy in relation to possession of illegal drugs at Glasgow’s Safer Drug Consumption Facility”.⁸³ The statement of prosecution policy specified that “it would not be in the public interest to prosecute an individual attending the Facility for an offence in terms of section 5(2) of the Misuse of Drugs Act 1971”, subject to certain limitations.⁸⁴ These limitations explain that the policy only applies “where the controlled substance is intended for personal consumption”, rather than when possession indicates a person’s intention to supply a controlled substance, and “where the controlled substance is recovered within the facility”.⁸⁵

46. In practice, this means that people found to have breached section 5(2) of the Misuse of Drugs Act 1971 within the footprint of The Thistle will not be prosecuted. The Lord Advocate has explained that she “cannot change the law” and does not have the power to “make possession of drugs within the facility legal”.⁸⁶ As such, possession of drugs within the facility will remain a criminal offence.⁸⁷ As explained by UK drugs charity Release, this statement “unlocked a key legal obstacle to a safer consumption facility”.⁸⁸ While the Lord Advocate’s statement of prosecution policy provides an exemption for possession offences, concerns remain regarding other potential offences which could be committed by people operating or visiting the facility, as we explore later in this chapter.

Policing

47. The Lord Advocate has been clear that the statement of prosecution policy “does not amount to an exclusion zone”.⁸⁹ An ‘exclusion zone’ or ‘tolerance zone’ is “broadly, an agreement on how the area surrounding a [Safer Drug Consumption Facility] would be policed”.⁹⁰ One example of that agreement could be an expectation “that police will not interfere with or arrest clients going to or immediately coming from a [facility]”.⁹¹ In Copenhagen, for example, local police established a “non-enforcement zone” around the Overdose Prevention Centre, “in which drug possession was effectively decriminalized”.⁹²

48. As an exclusion zone has not been established in Glasgow, Police Scotland has said that “the community around the SDCF continues to be policed in the same manner it was prior to the establishment of the facility”, and police interactions regarding “drugs offences will not appear any different”.⁹³ This means that people stopped by the police who are found to be in possession of drugs on their way to The Thistle cannot use their planned attendance at the facility as a defence.⁹⁴ Instead, any possession offence detected outside the footprint of The Thistle will be treated by Police Scotland in the normal way.⁹⁵ The Lord Advocate’s guidelines regarding the reporting of offences detected within The Thistle noted that the police “retain the ability to investigate all suspected offences as appropriate”.⁹⁶ Rather than altering the policing of the area, the Lord Advocate’s decision has instead resulted in a change in the way a report from Police Scotland is handled by the Procurator Fiscal.⁹⁷ If an officer detects a suspected controlled substance within The Thistle, for example while attending a separate incident, the matter would be reported to the Procurator Fiscal. It would then be for those in the prosecution service to apply the Lord Advocate’s statement of prosecution policy “as they see fit”.⁹⁸

49. Superintendent Joanne McEwan, Partnerships, Prevention and Community Wellbeing, Police Scotland, explained that officers policing the area have received guidance that someone being on their way to The Thistle would not give “an officer reasonable grounds to stop and search that person”.⁹⁹ This point was also emphasised by Glasgow City HSCP, who explained that the SDCF is not the only facility located at the site in Hunter Street, and so “entering the building will not necessarily identify anyone as an SDCF service user”.¹⁰⁰ Councillor Allan Casey also noted that, although there is no exclusion zone, Police Scotland “will not be stopping people simply accessing the facility, unless there is some other reason to intervene”, for example, if some other crime were being committed.¹⁰¹ Councillor Allan Casey said that the decision not to have an exclusion zone was the right one and that decision was key to balancing the needs of The Thistle with those of the local community. He explained that an exclusion zone could risk sending the wrong message that there had been some legal exemption made, when in fact “the law has not changed whatsoever”.¹⁰²

50. The Centre for Social, Health and Environmental Inequalities Research (SHEIR) from the University of the West of Scotland has explained that this lack of an exclusion zone was necessary to facilitate Police Scotland’s operational independence “to effectively police the facility and its surroundings to ensure the safety of the wider community, those operating the site, and those using the facility”.¹⁰³ However, SHEIR has also highlighted that this potentially “leaves service users open to prosecution for possession of a controlled substance before they enter [the SDCF], and after they leave if they have not used all of their substance at that visit”.¹⁰⁴ This view was echoed by UK drugs charity Release Scotland, which emphasised its concern that there is no way for users of The Thistle to get to the facility without risking prosecution:

You cannot concurrently invite the use of a facility for the consumption of drugs without risk of prosecution for possession and at the same time suggest that there will be no tolerance for possession offences whilst travelling to said facility.¹⁰⁵

51. To address this, the Royal College of General Practitioners (RCGP) has called for “consideration” about how to ensure a “consistency of application” in policing that keeps “with the spirit of the Lord Advocate’s statement”.¹⁰⁶

52. Neil Gray MSP, Cabinet Secretary for Health and Social Care, Scottish Government, voiced his support for the decision not to establish an exclusion zone, emphasising the need for local communities to trust the pilot facility and describing the current system as “a better approach” than an exclusion zone.¹⁰⁷

Potential offences

53. The Home Office has noted the “range of offences” which may be being committed by people using or operating an SDCF, including:

• possession of a controlled drug;
• production of a controlled drug;
• permitting premises to be used for the production of a controlled drug; and
• supply of a controlled drug.¹⁰⁸

54. Concerns relating to the possession of a controlled drug for users of The Thistle have been accounted for by the Lord Advocate’s statement of prosecution policy, but does not extend to any other offences under the 1971 Act or any other legislation. Glasgow City HSCP explained that this “external comfort” sought from the Lord Advocate was only necessary for service users of the facility.¹⁰⁹ For staff, it explained that standard operating procedures prevented any of the “identified potential offences” which could be committed at an SDCF.¹¹⁰ These potential offences are explored in greater detail below.

Production and supply of a controlled drug

55. Under section 4(1) to (3) of the Misuse of Drugs Act (MDA) 1971, it is an offence to produce or supply a controlled drug.¹¹¹ While the Misuse of Drugs Act does not define supply, it can be considered the “physical transfer” of a controlled substance “with the intention of enabling the recipient to use it” for their own purposes.¹¹² As mentioned, the Lord Advocate’s statement of prosecution policy does not provide an exemption for production and supply offences. However, UK drugs charity Release explained that “there is no reason” for people either visiting the facility or working there to be involved in the supply of a controlled drug at The Thistle.¹¹³ It noted that policies would be required to limit the risk that there could be the supply of a drug from one person to another on site, as is further explored below.¹¹⁴ Meanwhile production offences could relate to “any process that puts a substance into a form suitable for consumption”.¹¹⁵ This can include the addition of bulking agents or “adulterants”, such as caffeine or paracetamol, to a controlled drug.¹¹⁶

56. Staff at The Thistle do not assist service users with the preparation or administration of controlled substances, as stipulated in the facility’s standard operating procedures, so it is unlikely that supply or production offences could be committed by people operating the service.¹¹⁷ Similarly, service users are not allowed to share drugs or assist other people with injections.¹¹⁸

Permitting premises to be used for production or supply

57. Section 8(a) and 8(b) of the Misuse of Drugs Act 1971 creates a liability for the occupier or manager of a premises who knowingly permits the production or attempted production and supply or attempted supply of a controlled drug.¹¹⁹ The Centre for Social, Health and Environmental Inequalities Research (SHEIR) has highlighted the risk for staff and management of the pilot facility, as the Lord Advocate’s statement of prosecution made no exception for people operating The Thistle. SHEIR emphasises that, while local agreement between the facility and Police Scotland has been made, this remains “open to the vagaries of political and public opinion” and so offers little certainty to those operating the site.¹²⁰

58. In terms of the risk of supply, Release explained that such a risk is not exclusive to an SDCF, nor to drug treatment services. Instead, the risk of breaching section 8(b) of the MDA 1971 also applies to “any premises where there is a risk of supply occurring”, including nightclubs, hostels and bars.¹²¹ As such, “this is a risk that is already managed by those in the drugs sector and is one that could be easily managed by staff and managers” of an SDCF, through policies such as escalated warning systems, “being barred from a premises, or involving the police”.¹²²

Fragility and inconsistency

59. Concerns have been raised by stakeholders regarding the shortcomings of “depenalization approaches, such as non-prosecutorial policies” like the decision made by the Lord Advocate to issue a statement of prosecution policy for The Thistle.¹²³ Release told us that, while such prosecution policies have the benefit of faster implementation than legislation, they “leave considerable interpretation and discretion to various actors, creating vulnerability to inequitable application and uncertain outcomes for people who use drugs”.¹²⁴ Faces and Voices of Recovery (FAVOR) UK, a charity that advocates for people in recovery from addiction, similarly described the operation of the pilot facility as “subject to the discretion of authorities”, and claimed it is likely to prompt legal challenges.¹²⁵ FAVOR UK claimed that operating in this “legal grey area” poses “significant risks” to the facility’s “long-term sustainability”.¹²⁶

60. Both Police Scotland and the Lord Advocate dismissed concerns of inconsistent application of the statement of prosecution policy, with Dorothy Bain KC explaining that she does “not accept” such suggestions.¹²⁷ The Lord Advocate suggested that it was “unfortunate” that there are people with that view, and encouraged any concerns to be brought to herself or her officials, emphasising again that the statement of prosecution policy is “simple”.¹²⁸ Superintendent Joanne McEwan of Police Scotland also reassured us that the guidance for officers is “very clear” and that Police Scotland understood what was being asked of them.¹²⁹ Superintendent McEwan emphasised that, based on the feedback she had received from local officers, she is “confident there is a clear understanding of the guidance”.¹³⁰

61. During our inquiry we also heard concerns that the legal footing provided by the Lord Advocate is fundamentally precarious. Councillor Allan Casey, City Convener for Workforce and Homelessness and Addiction Services, Glasgow City Council, explained that the “fundamental problem” of the “fragility” of The Thistle is due to its legal framework being dependent “on the opinion […] of one individual in post”.¹³¹ He emphasised the need for a “sustainable framework for how safe consumption rooms can continue into the future and indeed can expand”:

[…] the most sustainable way to continue safe consumption rooms is an explicit change in the Misuse of Drugs Act to allow safe consumption rooms to operate.¹³²

62. Similar views were raised by Turning Point Scotland, which also described The Thistle’s legal position as precarious. It suggested the reliance on prosecutorial discretion rather than legislative change reflected a lack of commitment to reform and voiced concerns that a fall in political or public support could threaten the future of the facility.¹³³ This concern of fragility was shared by Release, which highlighted the risks of protections “being unwound by changes of government” or personnel.¹³⁴ It outlined the case of the SDCF ‘Insite’ based in Vancouver, Canada, which “initially came into being through an exemption provided by the federal government” and was nearly closed by a change in government, despite extensive evidence of its success.¹³⁵

63. Neil Gray MSP, Cabinet Secretary for Health and Social Care, Scottish Government, described the policy intent set out for The Thistle as “robust” and one that “should stand the test of a new Government, or indeed a new Lord Advocate”.¹³⁶ He nonetheless explained that a full legal framework would offer greater “certainty around the legal establishment of the facility”.¹³⁷ However, the Cabinet Secretary emphasised that he is “comfortable” with the legal position of the pilot, as “this allows the policy intent of The Thistle to be established and to operate”.¹³⁸

Other facilities

64. While welcoming the opening of The Thistle, Professor Catriona Matheson, Professor in Substance Use, University of Stirling, suggested that the establishment and evaluation of The Thistle does “not help other parts of the country where there is potentially a need for some form of facility”.¹³⁹ For example, the City of Edinburgh Council has recently commissioned a needs assessment and feasibility study for the implementation of an SDCF, which concluded that there “is a strong case” for such an intervention.¹⁴⁰ Professor Matheson explained that the limited nature of the Lord Advocate’s statement of prosecution policy, as well as the desire to wait for the evaluation of The Thistle to conclude, may delay potential interventions elsewhere in Scotland:

Waiting for the Glasgow evaluation will be good to learn about some of the nuances of what does and does not work, but it delays potential developments in other parts of the country. There are other levers available that could make those things happen, such as considering some reform to the Misuse of Drugs Act, which would enable other parts of the country, by which I mean the UK and not just Scotland, to be considering, and opening the door to being able to do, those types of services as well.¹⁴¹

A similar point was raised by Councillor Allan Casey, who emphasised the need for SDCFs elsewhere in Scotland and across the UK. He called for a “better and easier way” to facilitate such facilities, suggesting that “the best way to do that is through a change to the Misuse of Drugs Act”.¹⁴²

65. While stakeholders have called for changes to the Misuse of Drugs Act as the optimal way of enabling the opening of SDCFs, it is possible to open such facilities through prosecutorial discretion as was demonstrated by The Thistle. The conditions set out by the Lord Advocate in 2021 for the consideration of an application for an SDCF described an application that is “precise, detailed and specific, underpinned by evidence and supported by those who would be responsible for policing such a facility”, and with “careful consideration in and around how those consumption rooms would impact on communities”.¹⁴³ The Lord Advocate confirmed that any application for other SDCF facilities would be considered on the same basis as The Thistle for the necessary prosecutorial discretion.¹⁴⁴

66. In light of the UK Government’s opposition to SDCFs, the Rt Hon Dame Diana Johnson said that applications for further facilities in Scotland would have to be a matter for the Lord Advocate and Scottish Government, emphasising again that facilitating the opening of SDCFs is not UK Government policy.¹⁴⁵

3 A gold standard service

69. The question of cost has been an ongoing theme throughout this inquiry, in respect of both what standard of service is required for the pilot, and balancing this cost against pressures on other public services.

70. The Thistle is currently being funded entirely by the Scottish Government, which has committed up to £2.3 million per year for the development, set up and operation of The Thistle from 2024/25.¹⁴⁶ This funding has been confirmed to run for the duration of the pilot, which is set to last for three years. If the Scottish Government were to withdraw that funding, Kelda Gaffney, Interim Assistant Chief Officer, Adult Services & Chief Social Work Officer, Glasgow City Health and Social Care Partnership, explained that the Glasgow City HSCP and the Integrated Joint Board would “need to work up a model around how to manage that service” for it to continue.¹⁴⁷

A proportionate response

71. Professor Catriona Matheson, Professor in Substance Use, University of Stirling, explained in oral evidence that The Thistle offers “a gold standard-level service” to the people of Glasgow.¹⁴⁸ This standard has been praised by stakeholders, with Kelda Gaffney suggesting that a gold-standard service should be the aim of all NHS and social care services.¹⁴⁹

72. As mentioned earlier in this report, Councillor Allan Casey explained that the pilot could be used as a proof of concept of SDCFs for the rest of the UK, thus necessitating a high standard of care.¹⁵⁰ This point was also made by Cabinet Secretary Neil Gray MSP, who said that the intention for the pilot “is to gather evidence” as to the SDCF’s “efficacy regarding the stated aims of reducing harm, reducing drug-related deaths and allowing people to have access to a nurturing facility that hopefully allows them to then be facilitated to some form of recovery”.¹⁵¹

73. The level of care offered at The Thistle has also been described as a necessary response to the crisis of drug deaths in Scotland. This was underlined by Dr Priyadarshi, who explained that the situation requires “an emergency response” which is “commensurate with the level of the problem”:

The question is not so much how we justify spending this; it is question of how we justify not doing more and more.¹⁵²

74. Glasgow City HSCP emphasised this point, and also explained that SDCFs can “produce an overall cost saving” as they “reduce the impact of ill health on NHS services, cleaning of public injecting spaces and police and court time in handling issues which arise from injecting in public spaces”.¹⁵³ As explained by Glasgow City HSCP, the costs of “acute hospital admission” among people who publicly inject drugs is extremely high, as are the costs of treating BBVs related to such injections.¹⁵⁴ The estimated average lifetime cost of treating someone with HIV is between £280,000 and £360,000 per person.¹⁵⁵ Using those figures, preventing just over 6 to just over 8 cases of HIV per year could generate savings equivalent to the annual cost of The Thistle.

75. Neil Gray MSP, Cabinet Secretary for Health and Social Care, Scottish Government, also expressed his “panic and worry” at the scale of the drugs crisis in Scotland and emphasised that the Scottish Government “want to take every possible step that we can to see the levels of drug deaths reduce”.¹⁵⁶ The Cabinet Secretary recognised the financial benefits The Thistle could have in preventing BBVs and broader pressures on the NHS.¹⁵⁷ When asked about the future of funding to the facility, if it were extended beyond the pilot, Neil Gray MSP said that “those would be decisions that are taken at the time” and would be dependent on the evaluation of the facility.¹⁵⁸ For any future facilities which may wish to open, Neil Gray MSP stated that proposals would be considered on a case-by-case basis for funding, but emphasised that his “door is open to considerations and discussions”.¹⁵⁹

76. When challenged on the UK Government’s opposition to SDCFs in light of the crisis in Scotland, the Rt Hon Dame Diana Johnson DBE MP, Minister of State for Crime, Policing and Fire, Home Office, emphasised that “this is not the only thing that can be done to deal with drug misuse”.¹⁶⁰ She cited other interventions, including Heroin Assisted Treatment, which the UK Government supports.¹⁶¹

Balancing public services

77. While Glasgow City HSCP confirmed that The Thistle has not been funded by diverting investment from other services, concerns have been raised about the balance between investment in the pilot and funding of other treatment services.¹⁶² Our inquiry has explored whether The Thistle represents the intervention which will have “the biggest impact” relative to cost, particularly given the ongoing cost pressures public services are facing.¹⁶³ For example, concerns about the availability of rehabilitation beds in Edinburgh were raised with the Cabinet Secretary, and he was challenged as to whether too great a focus had been placed on the pilot facility, at the cost of recovery services.¹⁶⁴

78. We know that SDCFs are not the only tool available to handle problem drug use; rather, they are one part of a whole system approach to reduce harm, working alongside needle exchanges, naloxone intervention and treatment services, as explained by Professor Andrew McAuley, Professor of Public Health at Glasgow Caledonian University.¹⁶⁵ Similarly, Professor Matheson suggested that an SDCF should work as part of “a continuum of care”, including recovery services, which can work alongside treatment services, rather than overshadowing them.¹⁶⁶

79. However, FAVOR UK, a charity that advocates for people who are in recovery from addiction, said that SDCFs may “divert resources from vital addiction treatment services”, calling for funding to be provided instead to rehabilitation programmes.¹⁶⁷

80. Neil Gray MSP emphasised that he does “not believe there is any single answer” to problem drug use in Scotland and explained that this was why the Scottish Government has invested in a range of services to help people access recovery, including expanding the provision of residential rehabilitation beds.¹⁶⁸ The Cabinet Secretary pointed to additional resources that Alcohol and Drug Partnerships (ADPs) across Scotland have been given “to allow for additional publicly funded access to residential rehab”.¹⁶⁹

81. The Rt Hon Dame Diana Johnson DBE MP recognised that funding should be directed to “high-quality, stigma-free services” and that this is “where the focus should be”.¹⁷⁰ Through her repeated assertion that the UK Government is not minded to change the Misuse of Drugs Act, the Minister is effectively proscribing SDCFs for the UK outside Scotland.

Alternative service model

85. The Thistle is an example of one SDCF service model. Dr Gillian Shorter of Queens University Belfast outlined some of the different forms such facilities could take.¹⁷¹ For example, as a fixed site, we heard that The Thistle has an “approximate 10-minute radius ‘pull’” for service users, and so it is limited in the size of the population it serves.¹⁷² Dr Shorter drew our attention to mobile facilities, which she suggested could be particularly useful if there is a dispersed population as it is possible to “bring those services to the people in the community”.¹⁷³

86. As explained by the European Union Drugs Agency (EUDA), the key advantages of such mobile units are that they are less costly to set up and they allow greater flexibility in service delivery, being able to access multiple locations.¹⁷⁴ Such units are generally limited to injecting and the practicality of their operation can be affected by the weather.¹⁷⁵ Mobile facilities usually work as part of a wider local network of services, and staff can refer clients to other service providers, as required.¹⁷⁶

87. These points were further emphasised during our visit to Lisbon, where the city’s mobile facility operates alongside a fixed site, and has annual operational costs which are less than half of the fixed site (€118,000 compared to €280,000 per annum) although we recognise there could be shared costs between the two sites.¹⁷⁷ However, it should be noted that it is difficult to make like for like cost comparisons, due to the range of factors that can impact effectiveness and cost.

88. The capacity of the mobile facility we visited was much lower than that of comparative fixed sites, offering consumption space for two visitors at a time, for a maximum of 30 minutes each.¹⁷⁸ The mobile facility was highlighted as being particularly beneficial at reaching out to potential service users who had not yet been in contact with the local authorities, as the site can move to areas where there are spikes in consumption.¹⁷⁹ However, we heard that such relocation required approval from the local authorities, which was not always granted due to concerns of disruption.¹⁸⁰ It was also highlighted that it has not always been possible for the service in Lisbon to provide the outreach work which should ideally be conducted in each new site the mobile unit wished to visit due to time constraints.¹⁸¹ Overall, we learnt that local communities prefer mobile sites to fixed service models, and that these attract fewer official complaints than the fixed facility operating in the city.¹⁸²

89. However, as was discussed during our visit to The Thistle, while a mobile unit could have a broader geographic reach in Glasgow, it would not be possible under the Lord Advocate’s current statement of prosecution policy, which has a very narrow scope limited to the premises of The Thistle.¹⁸³

90. When asked about the potential for different service models of SDCFs to open in Scotland, Neil Gray MSP said that he recognised that alternative models could arise but emphasised that it would be for the “local partnership to determine what it feels is most effective”.¹⁸⁴ Crucially, he emphasised that the Lord Advocate must be comfortable with whatever service model is chosen.¹⁸⁵

4 Local community

Local engagement

92. Throughout our inquiry we have heard about the impact The Thistle is having on the community in which it is based. In a letter to the Scottish Parliament cross-committee on tackling drug deaths in 2023, the Lord Advocate emphasised that it was “particularly important that there is proactive community engagement in relation to the proposal” regarding the Safer Drug Consumption Facility.¹⁸⁶ This was emphasised to us by Dr Gillian Shorter, Reader in Clinical Psychology, Queens University Belfast. Dr Shorter described community consultation as an “essential part” of opening an SDCF.¹⁸⁷ Dr Shorter highlighted that the operators of The Thistle were likely to experience some “teething issues” to begin with, but that they must “listen very compassionately to people’s concerns” regarding the pilot and work to respond to those worries.¹⁸⁸ Pointing to successful international examples of community integration, Dr Shorter outlined a case of an SDCF in Sydney which, 18 months after opening, had blended into the high-street so much so that “half of residents and a third of businesses could not tell you where it was on the map”.¹⁸⁹

93. There is some evidence of localised opposition to SDCFs. For example, in Denmark, community resistance was expressed at the launch of an unofficial SDCF due to concerns the site could attract people who use drugs to a residential neighbourhood. Similarly, while some community members supported the introduction of an SDCF, they did not welcome one in their local area.¹⁹⁰ We heard similar local concerns about the community impacts of the facilities we visited in Lisbon.¹⁹¹ However, we have heard no evidence of sustained, long-term local opposition to SDCFs, beyond their initial introduction.

94. Glasgow City HSCP has emphasised the work it has done to engage the local community, highlighting its initial business case for a pilot SDCF published in 2017, which cited the minimisation “of the impact of public injecting on the wider community” as an aim of the facility.¹⁹² Specific reference was made to reducing the impact of drug-related litter as well as anti-social behaviour.¹⁹³ Councillor Allan Casey described the engagement activities undertaken as probably “one of the most extensive pieces of engagement work” ever conducted by Glasgow City HSCP for the implementation of a service.¹⁹⁴ Councillor Casey acknowledged that the “vast majority of the local community” did not engage with the consultation work, but suggested that that this is “generally the case with consultations”.¹⁹⁵

95. The ongoing engagement work was highlighted during our visit to The Thistle in February, where we heard about a regular Community Forum being run to sustain contact with the local community and to evolve practice at The Thistle as needed.¹⁹⁶ Lynn MacDonald, Service Manager, NHSGGC, emphasised that attendees at such engagement events include many who are not supportive of the pilot, which ensures that The Thistle’s team “hear[s] the reality about the impact of the service in the community”.¹⁹⁷ We heard these views for ourselves when we attended the Community Forum meeting in August.¹⁹⁸ Outside these events, Dr Priyadarshi has emphasised that the operators of The Thistle are in constant conversation with the community and relevant stakeholders “in a partnership approach”, which allows them to quickly respond to any concerns.¹⁹⁹ However, community members who attended the Community Forum in August said no updates are provided by the outreach team between meetings in relation to issues raised, which causes frustration for residents. Community members said that despite, for example, reporting problem areas around the facility, no one responds to advise when or if the reported issues have been addressed. Furthermore, when a community member suggested a simple mechanism for providing timely updates, it was stated that the service did not have the capacity to undertake such communication between meetings. The facility stated that staff will work to develop a communications strategy. We were surprised to learn that this was not already in place to support The Thistle’s engagement with the local community.

96. Professor Vittal Katikireddi, Professor of Public Health & Health Inequalities at the University of Glasgow, has praised the “extensive amount of work” done by Glasgow City HSCP “in running community events to listen to people living in the area and hear their concerns, and to think about how best to address them”.²⁰⁰ He noted that a mixed response to that engagement work was inevitable.²⁰¹

97. Dr Shorter argued that those who use drugs are also members of the community and as such should be included in consultation work.²⁰² We saw evidence of such inclusion during our visit to The Thistle, where we heard about the role the Lived and Living Experience (LLE) Reference Group had in consulting on and designing The Thistle, a group representing people from across Glasgow with experience of problem drug use, including families and carers.²⁰³

Discarded needles

98. Concerns have been raised that the introduction of The Thistle could cause an increase in crime and anti-social behaviour. Social care developer and provider Turning Point Scotland noted this is a “key concern” for the local community in the immediate area surrounding an SDCF.²⁰⁴ We heard similar concerns about drug litter and anti-social behaviour in the area surrounding The Thistle when Committee Members attended the facility’s Community Engagement Forum in August.²⁰⁵ There have also been ongoing news reports about publicly discarded drug paraphernalia in the area surrounding The Thistle, and the negative impact this is having on the local community.²⁰⁶

99. On the other hand, stakeholders have emphasised that such issues are not a recent development and predate the opening of the site. This includes the Lord Advocate, who noted that the Hunter Street site was selected due to existing issues with public drug use “and the deleterious impact that that was having on the local community and the business community”.²⁰⁷ Dr Priyadarshi similarly cited these issues, noting particularly the impact of “discarded drug-related litter and visible public injecting” has had on the local community for a number of decades.²⁰⁸ Pointing to international evidence, Dr Priyadarshi explained that SDCFs have been seen to have a “positive effect on the social environment”.²⁰⁹ More specifically, Turning Point Scotland explained that SDCFs “are associated with a decrease in public injecting and discarded needles and are not associated with an increase in crime”.²¹⁰ Indeed, studies in Sydney found that the opening of the SDCFs resulted in a “significant decrease” in residents and businesses both witnessing public injecting and observing publicly discarded drug litter.²¹¹ Similarly, an SDCF in Barcelona saw a fourfold reduction in reports of unsafely disposed syringes being collected in its vicinity.²¹² In terms of crime, a study of an SDCF in Vancouver found no significant increase in the number of charges for crimes commonly associated with drug use, including drug trafficking, assault and robbery, in the year before and the year after the opening of the facility.²¹³

100. Professor Katikireddi explained that levels of discarded paraphernalia, as well as the broader “potential adverse impacts on the local community”, will be considered by the independent evaluation panel.²¹⁴ Changes to the levels of litter, which were also measured before The Thistle opened, will be analysed and compared to other areas of Glasgow where public injecting takes place as part of the evaluation.²¹⁵ However, community members at the August meeting of the Forum reported that some local residents had given up reporting issues, firstly, because they could not get through to Police Scotland on 101 in a timely manner and, secondly, because they were scared of any potential repercussions of reporting incidents. This gives rise to concerns regarding the accuracy of the data that will be used in the evaluation as it may not accurately reflect either the type or the volume of incidents in the local community. As will be discussed later in this report, the independent evaluation of The Thistle will be published after the three year pilot ends, but an interim report is likely to be published “around the two-and-a-half year mark”, to ensure there is evidence to “help inform whether the service should continue”.²¹⁶

101. During our visit to Norway, we heard about a scheme run by the SDCFs in Oslo and Bergen to encourage users of those sites to collect and safely dispose of their discarded needles. Both the SDCF in Bergen and Oslo were connected to a needle exchange service, which offers clean equipment to visitors.²¹⁷ In Bergen, 500 needles were distributed to visitors in 2024, with 50% of the needles distributed returned to the site for safe disposal.²¹⁸ In Lisbon, we heard that the fixed SDCF worked with users of the facility to clear up discarded needles in the immediate vicinity of the facility, which was noted as an opportunity for visitors to increase their sense of belonging in the community.²¹⁹

102. When asked about the reports of discarded needles, Neil Gray MSP reiterated the points made by other stakeholders that the location for The Thistle was chosen because of the long-standing issues of community injection levels in that area, emphasising that this issue had “not arrived alongside The Thistle”.²²⁰ The Cabinet Secretary explained that The Thistle was working to reduce the levels of public injecting but that “it is for the local authority, the local ADP and the facility to engage with the community and make sure that, where there is discarded paraphernalia, that is cleaned up”.²²¹

5 Expansion of services

106. Calls have been made for further services to be provided within The Thistle, including the addition of single-use tourniquets, an inhalation space and a drug checking service, all of which will be explored in this chapter.

Inhalation room

107. The Thistle is currently set up only to facilitate the injection of drugs, and does not have the capacity to support inhalation. In written evidence, several stakeholders, including Glasgow City HSCP themselves, supported The Thistle expanding its services to include an inhalation room, in order to “expand the reach of the service” as “the needs of people who smoke drugs are not met in [the current] model”.²²²

108. The Centre for Social, Health and Environmental Inequalities Research (SHEIR) of the University of the West of Scotland noted that there has been a shift in drug trends internationally, including in Scotland, which “indicate[s] a continued decline in injecting drug use towards other methods”.²²³ In Glasgow specifically, Dr Priyadarshi noted an increase in cocaine use, which is predominantly consumed via inhalation.²²⁴ SHEIR highlights research conducted by the University of the West of Scotland, which found that some people choose to inhale rather than inject drugs “as a personal harm reduction strategy” because it reduces “the risk of overdose, soft tissue infections and BBVs and other chronic health conditions”.²²⁵ That research shows “positive outcomes associated with inhalation spaces including improved health and safety of people who use drugs, decreased public drug use, and a high level of willingness to use the service”.²²⁶ This approach of changing consumption methods to reduce harm was also highlighted during our visit to the Prinsden Reception Centre in Oslo, where staff explained how visitors can be encouraged to change consumption methods, from injection to inhalation, in order to reduce harm.²²⁷

109. Whilst less harmful than injection, the inhalation of drugs still carries the risk of respiratory issues, particularly from the use of unsafe homemade pipes, as well as harms from pipe sharing and viral infections, prompting Turning Point Scotland to highlight the need for harm reduction measures “such as safe inhalation pipe provision and supervision”.²²⁸ This limitation in the service provision at The Thistle has prompted Turning Point Scotland to describe the facility as “a breakthrough that should be celebrated”, but one that is “already outdated”.²²⁹

110. An inhalation space cannot be lawfully provided at The Thistle, given current legislation.²³⁰ Smoking in enclosed public places and workplaces has been illegal in Scotland since 2006 under the Smoking, Health and Social Care (Scotland) Act 2005.²³¹ As will be explored later in this chapter, the provision of drug smoking pipes is prohibited under the Misuse of Drugs Act 1971, legislation reserved to the UK Parliament.

111. Dr Priyadarshi explained that the initial proposal, sent to the previous Lord Advocate in 2017, included plans for an inhalation room.²³² The legal challenges outlined above, as well as potential issues sourcing the required ventilation material and finding the necessary space within the footprint of the proposed facility, were highlighted as restraints on the feasibility of that proposal. As a result, plans for an inhalation room were not included in the subsequent application to the current Lord Advocate.²³³ Dr Priyadarshi explained that Glasgow City HSCP decided to install ventilation which would be “fit for purpose” if the necessary legal exemptions are granted.²³⁴

112. Campaigner and advocate for addiction recovery, Anne Marie Ward, has opposed the suggestion that smoking laws should be altered to allow an inhalation room at the Safer Drug Consumption Facility.²³⁵ Ward described the “suggestion that we should change these laws to encourage people to stop injecting and return to smoking cocaine” as “misguided” and “disconnected from the reality of addiction”:

It reflects a fundamental ignorance of the progression of the condition and the nature of addiction. For someone who has progressed to injecting drugs, the likelihood of them willingly switching to smoking is so rare that it’s akin to finding hen’s teeth.²³⁶

113. The Scottish Government recognised that the facility should be “best deployed in order to respond to the people who are using it”.²³⁷ It explained that an application for any legal exemptions regarding smoking laws would need to be submitted to both the Scottish Government, who would consider whether the application was “practicable” and the Lord Advocate, who would consider whether it was “appropriate”.²³⁸

114. The Lord Advocate said that she had not been asked about exemptions to allow for inhalation but explained that she would be reluctant to allow “an incremental widening” of the statement of prosecution policy she has issued. The Lord Advocate emphasised that it is the responsibility of the operators of the facility “to ensure that they keep within the confines of the law” and that it would not be appropriate for her to provide “shortcuts” for them.²³⁹ The Lord Advocate explained:

The question of what other legal changes are necessary to afford the facility a better way of operating is, again, something for the legislature and for parliamentarians to consider and legislate on.²⁴⁰

Equipment

117. During our visit to The Thistle, we heard about the need for the provision of equipment to service users to further reduce harm. This included single use tourniquets, which Lynn MacDonald, Service Manager, NHS Greater Glasgow and Clyde, explained would be valuable in helping to reduce the harm from injections.²⁴¹ Academic evidence shows that tourniquets can help people who inject drugs “find vein access in preferred, safer sites”.²⁴² Similar calls for tourniquets and smoking equipment, particularly pipes, were raised in oral evidence by Kelda Gaffney Interim Assistant Chief Officer, Adult Services & Chief Social Work Officer, Glasgow City HSCP, and Councillor Allan Casey.²⁴³ Turning Point Scotland highlighted the example of Victoria, Canada, where the provision of inhalation pipes alongside harm reduction information reduced the need for sharing equipment which limited the risk of infection.²⁴⁴ That case study also found the provision of safer smoking supply kits were “associated with an increase in demand for information about drug treatment, housing, welfare support, and naloxone kits”.²⁴⁵

118. Section 9A of the Misuse of Drugs Act 1971 prohibits the supply of drug using equipment where a person believes that equipment will be used for the administration of a controlled drug.²⁴⁶ Certain exemptions to Section 9A are found in Regulation 6A of the Misuse of Drugs Regulations 2001 (MDR 2001) which allow for the supply of injecting equipment and related specific items used for injecting, as well as foil.²⁴⁷ The exemption only operates when the supply is occurring as part of “the legal provision of drug treatment services”.²⁴⁸ No such exemption exists for inhalation equipment, such as inhalation pipes. As with all reserved legislation, an exemption to the Misuse of Drugs Act 1971 could be made by the UK Parliament.

119. The Rt Hon Dame Diana Johnson MP stated that allowing the provision of tourniquets and other such equipment at The Thistle “is a matter for the Lord Advocate”, as the UK Government does not support the addition of any facilities at The Thistle and so is unlikely to provide the relevant exemptions itself.²⁴⁹ The Scottish Government also said that in order to supply such equipment, Glasgow City HSCP would need to apply to the Lord Advocate for the necessary exemptions, which has not been done.²⁵⁰

Drug checking service

120. In August 2024, Glasgow City HSCP applied to the Home Office for a drug-checking service pilot, a separate service to The Thistle based at the same site.²⁵¹ Such a service would allow visitors to “to have their drugs chemically analysed and receive information on the content of submitted samples” confidentially and anonymously.²⁵²

121. Any drug testing or checking service requires a licence from the Home Office to cover the potential possession and supply of a controlled substance.²⁵³ In some exceptional circumstances, existing relevant exemptions under the Misuse of Drugs Regulations 2001 may apply, avoiding the need for a licence.²⁵⁴ The required licences have regularly been issued by the Home Office “under strict conditions to drug testing organisations to operate at some of the leading festivals in the UK” in an effort to prevent drug-related harm.²⁵⁵ These checks are only taken on confiscated and surrendered drugs as drug samples are not returned to an individual. Instead, public alerts are “cascaded to festival goers if extremely potent drugs are detected”.²⁵⁶ The first regular drug-checking service in the UK launched in January 2024, operated by harm-reduction charity The Loop.²⁵⁷ The free service is based in Bristol and aims “to reduce the consumption of adulterants and contaminated drugs and the risk of poisoning and overdose, while signposting service users to support services”.²⁵⁸ While no drugs are returned to service users, information regarding the substances submitted and professional healthcare advice are both offered.²⁵⁹

122. Councillor Allan Casey explained that “being able to test drug samples on site will give staff the opportunity to engage with service users about what they’re using and provide harm-reduction advice and support”.²⁶⁰ Dr Priyadarshi emphasised that such a service would help staff understand drug trends in the city as well as within the facility itself, which would “develop the service and make it even more fit for purpose than it is at the moment”.²⁶¹ Councillor Casey explained that the Home Office should conduct a compliance visit in order to complete The Thistle’s application for a drug checking licence, and said that the necessary visit had been delayed several times by the Home Office.²⁶²

123. The UK Government said that the delays in processing Glasgow City HSCP’s application for a drug checking licence were not caused by the Home Office and, regardless, have now been resolved.²⁶³ Rt Hon Dame Diana Johnson MP explained that the required visit has now taken place and expressed her hope that the application “should now proceed smoothly”.²⁶⁴

124. In written evidence, both the Centre for Social, Health and Environmental Inequalities Research (SHEIR) and the Royal College of General Practitioners (RCGP) Scotland highlighted their support for a drug testing service and expressed disappointment that the application was not accepted in time for The Thistle’s opening.²⁶⁵ SHEIR noted international examples, explaining that 12 European countries report drug-checking services at sites including SDCFs “which provide almost immediate results”.²⁶⁶ RCGP Scotland outlined the benefits of the drug checking service in Australia in detecting impurities and reducing harm:

Research gathered from the Australian Capital Territory showed that when drug testing indicated that a substance was not what the user expected it to be, contained an additional drug, or was inconclusive, users were 4 times more likely to report that they would ‘definitely not’ use the drug. This would be beneficial if implemented in Glasgow’s SDCF as it would discourage drug users from taking substances which have been mixed with other drugs or mistaken to be something else.²⁶⁷

125. The Scottish Government said that it would like to take forward the establishment of drug checking facilities as part of the wider work it is doing to combat the challenges of problem drug use in Scotland, and it is an area it would like to explore with the Home Office.²⁶⁸

6 The future of SDCFs in Scotland

129. Throughout our inquiry we heard about how important the independent evaluation of The Thistle could be in determining the potential extensions of the three-year pilot, and in influencing the prospect of other SDCFs in Scotland.

Evaluation of The Thistle

130. An independent evaluation of The Thistle is being conducted by a team of researchers “in collaboration with NHS and third sector partners”, funded by the National Institute for Health and Care Research. The evaluation will consider the impact of the pilot on those who inject drugs, local residents and businesses and public services.²⁶⁹ The evaluation will consider the level of engagement with the service and whether “it is reaching the right type of people”, as well as the costs of the service and long-term potential savings.²⁷⁰ The evaluation will include cost-effectiveness and lifetime cost-utility analyses, which will “quantify SDCF costs and value health outcomes from a health and social care perspective” and quantify costs and benefits holistically “including criminal justice, housing market, and local economy”.²⁷¹ This modelling will “consider the potential impact of implementing SDCF models in other UK settings”.²⁷² ‘Harder’ health outcomes such as the number of overdoses and ambulance call-outs will also be assessed, although Professor Katikireddi, co-Principal Investigator of the evaluation, warned those results may take “some time”.²⁷³

131. Specifically, the evaluation will:

• look at how the facility operates, whether it improves the health and social outcomes of service users, including onward referrals to recovery services, and whether changes are needed to improve the services offered;
• consider any changes in behaviours of service users who inject drugs, including changes in the user of emergency and other services, such as drug treatment services, compared to those who do not engage with The Thistle;
• consider measures of interest to the public, including changes in the numbers of discarded syringes, and compare those to other areas in Glasgow where public injecting takes place;
• engage with local residents and businesses to “measure changes in wellbeing, attitudes and perceptions of safety” and compare those to comparable areas in Glasgow;
• estimate the number of overdoses and “other harmful events” which the pilot has prevented, how those benefits could be changed if the services were delivered differently and how many drug harms could be prevented if other facilities were opened elsewhere in the country; and
• assess whether The Thistle “is a worthwhile investment for the NHS in the future”, whether then benefits outweigh potential costs for the community and government.²⁷⁴

132. The importance of the results of the evaluation when considering the future of The Thistle is clear. The Lord Advocate stated that she would consider extending her statement of prosecution policy, beyond the three-year pilot, if the evidence to do so “remains compelling”.²⁷⁵ The final report will be published after the three-year pilot ends, but an interim report is likely to be published “around the two-and-a-half year mark”, to ensure there is evidence to “help inform whether the service should continue”.²⁷⁶ As explored in chapter three of this report, the need for and interest in opening other SDCFs in Scotland has been expressed by stakeholders including Professor Catriona Matheson and Councillor Allan Casey.²⁷⁷

133. Neil Gray MSP confirmed that the Scottish Government considers it important to collect the determinative evidence on whether the pilot facility has been effective and stated that any decision about the long-term future of the site or any other SDCFs would be based on that evidence.²⁷⁸

134. The Rt Hon Dame Diana Johnson MP said that she would want the evaluation of The Thistle to be “done properly” and confirmed that the Home Office “would want to look at it”.²⁷⁹ Nonetheless, the Minister also simultaneously reiterated that the UK Government is “not minded to make any amendments to the Misuse of Drugs Act”, seemingly irrespective of what the evaluation shows.²⁸⁰ Without such reform “there is no legal basis under the Misuse of Drugs Act for drug consumption facilities to operate”.²⁸¹ The Minister explained that the Home Office “look[s] at evidence all the time” and receives expert advice, highlighting the work of the Advisory Council on the Misuse of Drugs (ACMD).²⁸² We note that the most recent mention of SDCFs in the ACMD’s published reports is from 2016, in which it recommended that consideration be given to the introduction of SDCFs given their potential to reduce drug-related deaths and harms.²⁸³ When asked if the UK Government would reconsider its stance if the evaluation of The Thistle demonstrated the pilot was successful at reducing harm, the Rt Hon Dame Diana Johnson MP reiterated that “it is not our policy and we will not be amending the Misuse of Drugs Act”.²⁸⁴

Conclusions and recommendations

Problem drug use in Scotland

1. We call on both Governments to adopt a balanced, evidence-based approach to problem drug use. (Conclusion, Paragraph 35)

2. We recognise that the opening of The Thistle on a pilot-basis presents an opportunity to test the effectiveness of SDCFs in Glasgow’s unique context. We believe the evidence provided by the independent evaluation panel should be determinative in discussions about The Thistle’s future beyond the three-year pilot. If the evaluation does not demonstrate the facility’s efficacy, it is difficult to see how The Thistle — or any other SDCFs in Scotland — could proceed. (Recommendation, Paragraph 36)

3. A range of rationales have been given for why there is a need for The Thistle and what effect it is intended to have. This has been unhelpful to public understanding of the facility and may result in unrealistic expectations of its impact. Moving forward, it is imperative that the rationale and objectives of the facility are clear, and articulated in a consistent, disciplined manner. (Conclusion, Paragraph 37)

The legal position of The Thistle

4. The current Lord Advocate’s statement of prosecution policy has been pivotal in enabling The Thistle to open. However, the Lord Advocate’s prosecutorial discretion is not a substitute for a considered legal framework to enable and regulate safer drug consumption facilities. The Thistle’s current legal position creates potential risks for people operating and using the facility. While the operators of The Thistle have reassured the Lord Advocate that the possibility for offences other than possession can be mitigated through strict standard operating procedures, only a full legal framework can offer certainty to the people who are operating and using the facility. (Conclusion, Paragraph 67)

5. There has been interest in establishing SCDFs in other parts of Scotland, and the Lord Advocate has indicated that she will consider any such applications on their merits. Rather than having multiple facilities with individual prosecution policy arrangements, it would be more appropriate for them to operate on a clear, legal basis, common to all. This would require legislative action from the UK Government and UK Parliament. (Conclusion, Paragraph 68)

A gold standard service

6. Given the severity of problem drug use in Glasgow, it is clear that decisive, radical action is needed. The Thistle is a gold standard facility and represents an intervention that is commensurate with the scale of Glasgow’s drug problem. However, it is also expensive. The Thistle could prove good value by saving money elsewhere in the health service, but it will be for the Scottish Government and Glasgow City Council to determine this following the evaluation, and to decide whether to continue The Thistle’s funding beyond the three-year pilot. We note that The Thistle is described as ‘gold standard’, and consider that a less sophisticated model of the facility could potentially offer corresponding harm reduction benefits, at a reduced cost. But, given that the pilot is being run as the stated ‘gold standard’ model, the effectiveness and therefore value for money and harm reduction capability of a less sophisticated model would remain untested and therefore largely unknown. (Conclusion, Paragraph 82)

7. However, any discussion of the cost of The Thistle must be considered in the context of Scotland’s drugs crisis, with 1,172 people having died from drugs in 2023 alone. While it is right that the cost of The Thistle is properly considered, it must be recognised that the scale of Scotland’s emergency inevitably requires a commensurate response that must entail significant investment. (Conclusion, Paragraph 83)

8. It is also clear to us that SDCFs must not come at the cost of funding current recovery services. It is not an ‘either/or’. Rather, SDCFs are just one tool available to combat problem drug use, which is complementary to, and works in tandem with, recovery services. (Conclusion, Paragraph 84)

9. The Thistle is an example of just one model of a safer drug consumption facility, and it is possible that others — such as mobile units — could provide more cost-effective solutions, or interventions better suited to the needs of local populations. There could be merit in exploring other service models, such as mobile units, which would complement The Thistle, or be an alternative to the facility, particularly if funding for the site becomes a challenge. Alternative operating models may also be better suited to serving communities elsewhere in Scotland and could be part of any discussion if additional locations are to be considered. (Conclusion, Paragraph 91)

Local community

10. Community support and the impact of the SDCF on the local community is of paramount importance to the success of The Thistle. While we are reassured that the ongoing independent evaluation is monitoring the levels of discarded paraphernalia and the wider impact on the local community, and recognising the international evidence suggesting that SDCFs reduce levels of publicly discarded drug litter and antisocial behaviour, the concerns of the local community need to be taken seriously. (Conclusion, Paragraph 103)

11. A responsive communication strategy must be developed by The Thistle, agreed by the Community Forum, and put in place as soon as possible in order to support the community engagement and partnership working that is crucial to the success of the project. (Conclusion, Paragraph 104)

12. It is vital that key stakeholders of The Thistle are engaged to address concerns about the impact of the facility and continue to work with the local community on how to address any concerns raised. We recognise that it may take time for the local effects of The Thistle to be fully understood and assessed. We therefore await the independent evaluation to objectively understand the impact on the local community. (Recommendation, Paragraph 105)

Expansion of services

13. Drug trends in Scotland have changed and are changing. For The Thistle to be effective, it must be able to meet the needs of the population it is trying to help, which it cannot do without an inhalation room. As well as making the facility accessible to those who inhale drugs, encouraging visitors to change their method of consuming drugs from injecting to inhaling can be an important harm reduction step. Legal barriers currently prevent an inhalation room operating at The Thistle. (Conclusion, Paragraph 115)

14. The Lord Advocate believes that widening the statement of prosecution policy to allow an inhalation room to operate is undesirable and we understand the reasons she has given. However, given that expert medical advice suggests that allowing the inhalation of drugs would increase opportunities for harm reduction, any future application for an inhalation room should be considered on its merits by the Lord Advocate and Scottish Government. (Conclusion, Paragraph 116)

15. Having access to equipment such as single-use tourniquets, testing drugs onsite, and allowing visitors to inhale drugs have all been highlighted as key to The Thistle achieving its maximum effectiveness. Without these, a full and fair evaluation of The Thistle will be inhibited. (Conclusion, Paragraph 126)

16. If an application for exemptions from the Misuse of Drugs Act 1971 to enable the provision of medical equipment at The Thistle were made by Glasgow City HSCP or the Scottish Government, the UK Government should consider such an application on its merits, as evidence suggests this could enable The Thistle to maximise its effectiveness. (Recommendation, Paragraph 127)

17. The Home Office should urgently complete its assessment of The Thistle for a drug checking licence and should ensure any necessary support is provided to ensure The Thistle is successful in its application. The Home Office should provide an update on the progress of the drug checking license in its response to this report. (Recommendation, Paragraph 128)

The future of SDCFs in Scotland

18. The Minister has stated that the UK Government will consider the evidence emerging from the pilot. However, it was clear from the Minister’s evidence that the Home Office will not make legislative changes, even if the evaluation finds that the facility has been effective in meeting its aims. The UK Government should not approach the evaluation having already made up its mind about the future of The Thistle. The UK Government should seriously consider the evaluation and, if the outcomes are positive, should consider the merits of SDCFs alongside consideration of other interventions to tackle problem drug use. (Conclusion, Paragraph 135)

19. The UK Government must demonstrate that it has an evidence-based approach to policy making and will consider the independent evaluation of The Thistle. Any intervention found to be effective at saving lives and reducing harm should not be dismissed. (Recommendation, Paragraph 136)

20. Without the UK Government’s approval or a change in legislation, The Thistle and potential other Safer Drug Consumption Facilities could, theoretically, continue to operate in Scotland indefinitely but this is not a desirable situation as their status would be precarious and uncertain. (Conclusion, Paragraph 137)

21. If the independent evaluation of The Thistle deems the pilot a success, and the Scottish Government proceeds to make The Thistle permanent, and perhaps to open further SDCFs, the UK Government should work with the Scottish Government to make the necessary changes to reserved legislation to ensure there is a full, sustainable legal framework for Safer Drug Consumptions Facilities in Scotland. (Recommendation, Paragraph 138)

Formal minutes

Wednesday 3 September 2025

Members present

Patricia Ferguson, in the Chair

Maureen Burke

Harriet Cross

Dave Doogan

Lillian Jones

Mr Angus MacDonald

Douglas McAllister

Susan Murray

Elaine Stewart

Kirsteen Sullivan

Problem drug use in Scotland follow-up: Glasgow’s Safer Drug Consumption Facility

Draft Report (Problem drug use in Scotland follow-up: Glasgow’s Safer Drug Consumption Facility), proposed by the Chair, brought up and read.

Ordered, That the draft Report be read a second time, paragraph by paragraph.

Paragraphs 1 to 114 read and agreed to.

Paragraph 115 read.

Question put, That the paragraph stand part of the report.

The Committee divided:

Ayes, 7 Noes, 2

Maureen Burke Harriet Cross

Dave Doogan Lillian Jones

Mr Angus MacDonald

Douglas McAllister

Susan Murray

Eliane Stewart

Kirsteen Sullivan

Paragraph accordingly agreed to.

Paragraphs 116 to 125 read and agreed to.

Paragraph 126 read.

Question put, That the paragraph stand part of the report.

The Committee divided:

Ayes, 8 Noes, 1

Maureen Burke Harriet Cross

Dave Doogan

Lillian Jones

Mr Angus MacDonald

Douglas McAllister

Susan Murray

Eliane Stewart

Kirsteen Sullivan

Paragraph accordingly agreed to.

Paragraphs 127 to 138 read and agreed to.

Summary agreed to.

Resolved, That the Report be the Third Report of the Committee to the House.

Ordered, That the Chair make the Report to the House.

Ordered, That embargoed copies of the Report be made available (Standing Order No. 134).

Adjournment

Adjourned till Wednesday 10 September at 9.00 am.

Witnesses

The following witnesses gave evidence. Transcripts can be viewed on the inquiry publications page of the Committee’s website.

Wednesday 12 February 2025

Catriona Matheson, Professor in Substance Use, The University of Stirling; Andrew McAuley, Professor of Public Health, Glasgow Caledonian University; Vittal Katikireddi, Professor of Public Health & Health Inequalities, The University of Glasgow; Gillian Shorter, Reader in Clinical Psychology, Queen’s University BelfastQ1–41

Wednesday 5 March 2025

Kelda Gaffney, Interim Assistant Chief Officer, Adult Services & Chief Social Work Officer, Glasgow City Health and Social Care Partnership; Lynn MacDonald, Service Manager, NHS Greater Glasgow and Clyde; Councillor Allan Casey, City Convener for Workforce and Homelessness and Addiction Services, Glasgow City Council; Dr Saket Priyadarshi, Associate Medical Director, Alcohol and Drug Recovery Services, NHS Greater Glasgow and ClydeQ42–72

Wednesday 7 May 2025

Dorothy Bain KC, The Lord Advocate; Jenny Hamilton, Policy and Engagement, Crown Office and Procurator Fiscal ServiceQ73–106

Superintendent Joanne McEwan, Police ScotlandQ107–115

Wednesday 4 June 2025

Neil Gray MSP, Cabinet Secretary for Health and Social Care, Scottish Government; Laura Zeballos, Deputy Director, Drugs Policy Division, Scottish GovernmentQ116–142

Rt Hon Dame Diana Johnson DBE MP, Minister of State for Crime Policing and Fire, Home Office; Marcus Starling, Deputy Director for Drugs and Alcohol, Home OfficeQ143–166

Published written evidence

The following written evidence was received and can be viewed on the inquiry publications page of the Committee’s website.

SDC numbers are generated by the evidence processing system and so may not be complete.

1 Centre for Social, Health and Environmental Inequalities Research (SHEIR), University of the West of Scotland SDC0002

2 Dorothy Bain KC SDC0013

3 Faces and Voices of Recovery UK SDC0001

4 Glasgow Caledonian University; Glasgow Caledonian University; and University of Glasgow SDC0006

5 Glasgow City Health and Social Care Partnership SDC0010

6 Home Office SDC0012

7 Law Society of Scotland SDC0005

8 Police Scotland SDC0007

9 Release SDC0008

10 Royal College of General Practitioners SDC0004

11 Scottish Government SDC0011

12 Turning Point Scotland SDC0003

List of Reports from the Committee during the current Parliament

All publications from the Committee are available on the publications page of the Committee’s website.

Session 2024–25

Number	Title	Reference
2nd	2nd report - Scotland’s space sector follow-up: launch	HC 671
1st	1st report – The financing of the Scottish Government	HC 456
2nd Special	Scotland’s space sector: Government response	HC 801
1st Special	Science and Scotland: Government response	HC 800

---

1 Glasgow City Council, Glasgow opens UK’s first safer drug consumption facility, 7 March 2025; We also note relevant inquiries by other committees on this subject, including the Home Affairs Committee in 2023 and Health and Social Care Committee in 2019.

2 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 93, 101

3 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 93, 101

4 UK Parliament, Problem drug use in Scotland: Government response published, 7 September 2020

5 Scottish Affairs Committee, Visit note – Scottish Affairs Committee visit to The Thistle, 19 March 2025

6 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

7 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to The Thistle Community Engagement Event - August 2025, 3 September 2025

8 House of Commons Library, General debate - Misuse of Drugs Act 1971, 16 June 2021

9 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 69

10 Scotland Act 1998, Explanatory Notes, Section B1

11 Royal College of Psychiatrists, Drug and drink deaths in Scotland still among Europe’s worst despite new funding, 31 October 2024

12 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

13 National Records of Scotland, Decrease in drug misuse deaths, 2 September 2025

14 BBC News, Scottish drug deaths fall but remain worst in Europe, 1 September 2025

15 European Union Drugs Agency, Drug-induced deaths – the current situation in Europe (European Drug Report 2025), 5 June 2025

16 Office for National Statistics, Deaths related to drug poisoning in England and Wales: 2023 registrations, 23 October 2024

17 European Union Drug Agency, Overdose situation (FAQ drug overdose deaths in Europe), 20 August 2024

18 Royal College of General Practitioners (SDC0004)

19 Q2

20 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

21 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

22 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

23 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

24 National Records of Scotland, Drug-related deaths in Scotland in 2023, 20 August 2024

25 Medical Press, ‘Trainspotting generation’: Alarm as Scotland drug deaths spike, January 2018; University of Glasgow, Institute of Health & Wellbeing, Generation X at increased risk of drug-related death, study claims.

26 NHS Greater Glasgow and Clyde, Bloodborne Viruses; The number of HIV diagnosis amongst people who inject drugs in the UK as a whole has remained relatively stable since 2010, (see Aidsmap, HIV in the UK – then and now, October 2023)

27 Public Health England, Progress towards ending the HIV epidemic in the United Kingdom 2018 report, June 2019, p.19

28 Public Health Scotland, HIV in Scotland: update to 31 December 2023 (Revised), 24 September 2024

29 Glasgow City Health and Social Care Partnership (SDC0010)

30 Glasgow City Health and Social Care Partnership (SDC0010)

31 Glasgow Caledonian University (SDC0006)

32 Turning Point Scotland (SDC0003)

33 The Pharmaceutical Journal, Can drug consumption rooms reduce drug-related harm?, 15 November 2023

34 Kirsten MA Trayner et al, Increased risk of HIV and other drug-related harms associated with injecting in public places: national bio-behavioural survey of people who inject drugs. Int J Drug Policy, Vol 77, March 2020

35 Q22

36 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 43

37 Nora D. Volkow et al, Drug use disorders: impact of a public health rather than a criminal justice approach, World Psychiatry, Vol 16 No 2, June 2017, pp. 213–214.

38 Oral evidence taken on 7 May 2019, Q24 [Dr Emily Tweed]

39 Scottish Government (SDC0011)

40 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 43

41 House of Commons Library, Misuse of drugs: regulation and enforcement, 4 December 2024; The Home Office (SDC0012)

42 EUDA, Drug consumption rooms: an overview of provision and evidence, 7 June 2018

43 Wood E, Tyndall MW, Montaner JS, Kerr T. Summary of findings from the evaluation of a pilot medically supervised safer injecting facility. CMAJ. 2006;175(11):1399–404.

44 European Monitoring Centre for Drugs and Drug Addiction, Perspectives on Drugs - Drug consumption rooms: an overview of provision, 7 June 2018

45 Alex Stevens, et al., “Overdose prevention centres as spaces of safety, trust and inclusion: a causal pathway based on a realist review.”, Drug and alcohol review, Vol 43 No 6, 5 August 2024, pp.1573–1591.

46 Royal College of General Practitioners (SDC0004)

47 European Monitoring Centre for Drugs and Drug Addiction, Perspectives on Drugs - Drug consumption rooms: an overview of provision, 7 June 2018

48 Scottish Government, Safer Drug Consumption Facilities – Evidence Paper, October 2021

49 Scottish Government, Safer Drug Consumption Facilities – Evidence Paper, October 2021

50 Shorter, Gillian W., et al. “Overdose prevention centres, safe consumption sites, and drug consumption rooms: A rapid evidence review.” Drug Science (2023).

51 Shorter, Gillian W., et al. “Overdose prevention centres, safe consumption sites, and drug consumption rooms: A rapid evidence review.” Drug Science (2023).

52 Shorter, Gillian W., et al. “Overdose prevention centres, safe consumption sites, and drug consumption rooms: A rapid evidence review.” Drug Science (2023).

53 Shorter, Gillian W., et al. “Overdose prevention centres, safe consumption sites, and drug consumption rooms: A rapid evidence review.” Drug Science (2023).

54 Shorter, Gillian W., et al. “Overdose prevention centres, safe consumption sites, and drug consumption rooms: A rapid evidence review.” Drug Science (2023).

55 Faces and Voices of Recovery UK (SDC0001)

56 Faces and Voices of Recovery UK (SDC0001)

57 Q116

58 Q147

59 Q147

60 Glasgow City Council, Glasgow opens UK’s first safer drug consumption facility, 7 March 2025

61 Glasgow City Council, Glasgow opens UK’s first safer drug consumption facility, 7 March 2025

62 Scottish Affairs Committee, Visit note – Scottish Affairs Committee visit to The Thistle, 19 March 2025

63 Scottish Affairs Committee, Visit note – Scottish Affairs Committee visit to The Thistle, 19 March 2025

64 Glasgow City Health and Social Care Partnership (SDC0010)

65 Glasgow City Health and Social Care Partnership (SDC0010)

66 Scottish Government, Safer Drug Consumption pilot, 10 January 2025

67 Scottish Parliament Official Report, Medication Assisted Treatment Standards, 5 February 2025

68 Q42

69 Q50

70 Q65

71 Q40 [Professor Katikireddi]

72 Glasgow Caledonian University; University of Glasgow (SDC0006)

73 Q40

74 House of Commons Library, The law officers: a constitutional and functional overview, 14 February 2025

75 Glasgow City Health and Social Care Partnership, Safer Drug Consumption Facility and Heroin Assisted Treatment, 24 January 2018

76 The Herald, Lord Advocate urged to provide prosecution immunity for drug consumption facility, 14 April 2019; Glasgow City Health and Social Care Partnership (SDC0010)

77 Glasgow City Health and Social Care Partnership (SDC0010)

78 Glasgow City Health and Social Care Partnership (SDC0010)

79 Scottish Parliament, Letter from the Lord Advocate to the Convener, Criminal Justice Committee, 11 September 2023

80 Q43

81 Q43

82 Glasgow City Health and Social Care Partnership (SDC0010)

83 Glasgow City Health and Social Care Partnership (SDC0010)

84 Crown Office & Procurator Fiscal Service, Drug consumption room statement of prosecution policy, 10 January 2025

85 Crown Office & Procurator Fiscal Service, Drug consumption room statement of prosecution policy, 9 January 2025

86 Crown Office & Procurator Fiscal Service, Lord Advocate’s Guidelines in relation to the reporting of offences detected within the Glasgow Health and Social Care Supervised Drug Consumption Facility, 9 January 2025

87 Crown Office & Procurator Fiscal Service, Lord Advocate’s Guidelines in relation to the reporting of offences detected within the Glasgow Health and Social Care Supervised Drug Consumption Facility, 9 January 2025

88 Release (SDC0008)

89 Crown Office & Procurator Fiscal Service, Statement on pilot safer drug consumption facility, 11 September 2024

90 D Falzon et al, “Challenges for drug checking services in Scotland: a qualitative exploration of police perceptions”, Harm Reduction Journal, Vol 19 No 105, 23 September 2022

91 TM Watson et al, “Creating and sustaining cooperative relationships between supervised injection services and police: a qualitative interview study of international stakeholders”, Int J Drug Policy, Vol 61, November 2018, pp1–6

92 Alex Stevens, “Opioids in Europe: Preparing for a third wave”, Brookings Institute, 2024

93 Police Scotland (SDC0007)

94 Q107

95 Q107

96 Crown Office and Procurator Fiscal Service, Lord Advocate’s Guidelines in relation to the reporting of offences detected within the Glasgow Health and Social Care Supervised Drug Consumption Facility, 9 January 2025

97 Police Scotland (SDC0007)

98 Q107

99 Q111

100 Glasgow City HSCP, SDCF - Service user information

101 Q70

102 Q70 [Councillor Casey]

103 Centre for Social, Health and Environmental Inequalities Research (SHEIR), University of the West of Scotland (SDC0002)

104 Centre for Social, Health and Environmental Inequalities Research (SHEIR), University of the

West of Scotland (SDC0002)

105 Release (SDC0008)

106 RCGP (SDC0004)

107 Q126

108 Home Office (SDC0012)

109 Glasgow City Integration Joint Board, Implementation of Safer Drug Consumption Facility, 27 September 2023

110 Glasgow City Integration Joint Board, Implementation of Safer Drug Consumption Facility, 27 September 2023

111 Misuse of Drugs Act 1991, s4

112 Rudi Fortson, “Setting Up a Drug Consumption Room Legal Issues”, Queen Mary School of Law Legal Studies, No 262, 20 October 2017

113 Release (SDC0008)

114 Release (SDC0008)

115 Release, Production

116 Rudi Fortson, “Setting Up a Drug Consumption Room Legal Issues”, Queen Mary School of Law Legal Studies, No 262, 20 October 2017

117 SPICe, The Thistle: Glasgow’s New Safer Drug Consumption Facility, February 26 2025

118 SPICe, The Thistle: Glasgow’s New Safer Drug Consumption Facility, February 26 2025

119 Misuse of Drugs Act 1991, s8

120 The Centre for Social, Health and Environmental Inequalities Research (SHEIR) (SDC0002)

121 Release (SDC0008)

122 Release (SDC0008)

123 Release (SDC0008)

124 Release (SDC0008)

125 Faces & Voices of Recovery (FAVOR) UK (SDC0001)

126 Faces & Voices of Recovery (FAVOR) UK (SDC0001)

127 Q104

128 Q104

129 Q112

130 Q108

131 Q68

132 Q68

133 Turning Point Scotland (SDC0003)

134 Faces & Voices of Recovery (FAVOR) UK (SDC0001)

135 Faces & Voices of Recovery (FAVOR) UK (SDC0001)

136 Q122

137 Q124

138 Q124

139 Q40

140 J Nicholls et al, “The implementation of safer drug consumption facilities in Scotland: a mixed methods needs assessment and feasibility study for the city of Edinburgh”, Harm Reduction Journal, Vol 22 No 6, 13 January 2025

141 Q40

142 Q44 [Councillor Casey]

143 The Lord Advocate (SDC0013)

144 Q92

145 Q161

146 Glasgow City Council, Glasgow opens UK’s first safer drug consumption facility, 10 January 2025

147 Q67

148 Q40

149 Q66 [Kelda Gaffney]

150 Q65

151 Q118

152 Q66 [Dr Priyadarshi]

153 Glasgow City HSCP, SDCF - Frequently asked questions

154 Glasgow City HSCP, SDCF - Frequently asked questions

155 Scottish Affairs Committee, First Report of Session 2019, Problem drug use in Scotland, HC 44, para 88

156 Q136

157 Q139

158 Q138

159 Q141

160 Q147

161 Q147

162 Glasgow City HSCP, SDCF - Frequently asked questions; Q66

163 Q66

164 Q135

165 Q17 [Professor McAuley]

166 Q30 [Professor Matheson]

167 Faces and Voices of Recovery UK (SDC0001)

168 Q129

169 Q135; ADPs are multi-agency groups tasked by the Scottish Government with tackling alcohol and drug issues.

170 Q152

171 Q12

172 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

173 Q12

174 EUDA, Health and social responses: drug consumption rooms, 23 April 2024

175 EUDA, Health and social responses: drug consumption rooms, 23 April 2024

176 EUDA, Health and social responses: drug consumption rooms, 23 April 2024

177 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

178 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

179 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

180 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

181 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

182 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

183 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

184 Q134

185 Q134

186 Crown Office and Procurator Fiscal Service, Statement on pilot safer drug consumption facility, 11 September 2023

187 Q29 [Dr Shorter]

188 Q29 [Dr Shorter]

189 Q29 [Dr Shorter]

190 Esben Houborg and Vibeke Asmussen Frank, Drug consumption rooms and the role of politics and governance in policy processes, International Journal of Drug Policy, Vol 25, January 2014

191 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to The Thistle Community

Engagement Event - August 2025, 3 September 2025

192 Glasgow City Health and Social Care Partnership (SDC0010)

193 Glasgow City Health and Social Care Partnership (SDC0010)

194 Q48

195 Q48 [Councillor Casey]

196 Scottish Affairs Committee, Visit note – Scottish Affairs Committee visit to The Thistle, 19 March 2025

197 Q48 [MacDonald]

198 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to The Thistle Community Engagement Event - August 2025, 3 September 2025

199 Q48 [Dr Priyadarshi]

200 Q27

201 Q27

202 Q29 [Dr Shorter]

203 Scottish Affairs Committee, Visit note – Scottish Affairs Committee visit to The Thistle, 19 March 2025; Glasgow City Council, Reference Groups

204 Turning point Scotland (SDC0003)

205 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to The Thistle Community Engagement Event - August 2025, 3 September 2025

206 Sky News, Living beside the UK’s first drug consumption room, 26 May 2025

207 Q93

208 Q42

209 Q42

210 Turning point Scotland (SDC0003)

211 Glasgow Caledonian University; University of Glasgow (SDC0006)

212 European Monitoring Centre for Drugs and Drug Addiction, Drug consumption rooms: an overview of provision and evidence, 5 November 2018

213 European Monitoring Centre for Drugs and Drug Addiction, Drug consumption rooms: an overview of provision and evidence, 5 November 2018

214 Q21

215 Glasgow Caledonian University; University of Glasgow (SDC0006)

216 Q40

217 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

218 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

219 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Lisbon - July 2025, 16 July 2025

220 Q142

221 Q142

222 Turning point Scotland (SDC0003); Glasgow City Health and Social Care Partnership (SDC0010)

223 The Centre for Social, Health and Environmental Inequalities Research (SHEIR) (SDC0002)

224 Q51 [Dr Priyadarshi]

225 The Centre for Social, Health and Environmental Inequalities Research (SHEIR) (SDC0002)

226 The Centre for Social, Health and Environmental Inequalities Research (SHEIR) (SDC0002)

227 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to Norway - March 2025, 2 April 2025

228 Turning Point Scotland (SDC0003)

229 Turning Point Scotland (SDC0003)

230 Glasgow City Health and Social Care Partnership (SDC0010)

231 Smoking, Health and Social Care (Scotland) Act 2005

232 Q51

233 Q59 [Dr Priyadarshi]

234 Q59 [Dr Priyadarshi]

235 Scottish Daily Express, Madcap SNP councillor suggests smoking ban tweak to allow addicts to smoke cocaine and heroin legally, 6 February 2025

236 Scottish Daily Express, Madcap SNP councillor suggests smoking ban tweak to allow addicts to smoke cocaine and heroin legally, 6 February 2025

237 Q127

238 Q127

239 Q97

240 Q97

241 Scottish Affairs Committee, Visit Note – Scottish Affairs Committee visit to The Thistle, 19 March 2025

242 Alyssa M. Peckham and Erika H. Young, “Opportunities to offer harm reduction to people who inject drugs during infectious disease encounters: narrative review.”, Open forum infectious diseases, Vol 7 No 11, 20 October 2020, p4

243 Q55 [Councillor Casey], Q59 [Kelda Gaffney]

244 Turning Point Scotland (SDC0003)

245 Turning Point Scotland (SDC0003)

246 Misuse of Drugs Act 1991, s9A

247 Misuse of Drugs Regulations 2001, s6A

248 Misuse of Drugs Regulations 2001, s6A

249 Q165, Q163

250 Q127

251 Glasgow City Council. Glasgow bids to run drug-checking service at Hunter Street, 12 August 2024

252 Glasgow City Council. Glasgow bids to run drug-checking service at Hunter Street, 12 August 2024

253 HL770 [on Drugs: Misuse], 30 November 2023

254 HL770 [on Drugs: Misuse], 30 November 2023

255 Home Office, Licensed drug testing continues at music festivals this summer, 24 May 2024

256 Home Office, Licensed drug testing continues at music festivals this summer, 24 May 2024

257 The University of Liverpool, The UK’s first regular drug checking service launches in Bristol, 26 January 2024

258 BBC News, Bristol to host first regular drug checking service, 26 January 2024

259 The University of Liverpool, The UK’s first regular drug checking service launches in Bristol, 26 January 2024

260 Glasgow City Council. Glasgow bids to run drug-checking service at Hunter Street, 12 August 2024

261 Q55 [Dr Priyadarshi]

262 Q58 [Councillor Casey]

263 Q162

264 Q162

265 RCGP Scotland (SDC0003), Centre for Social, Health and Environmental Inequalities Research (SHEIR), University of the West of Scotland (SDC0002)

266 Centre for Social, Health and Environmental Inequalities Research (SHEIR), University of the West of Scotland (SDC0002)

267 Royal College of General Practitioners (SDC0004)

268 Q129

269 Glasgow Caledonian University; University of Glasgow (SDC0006)

270 Q24

271 Glasgow Caledonian University, Evaluating the impact of the UK’s first saNctioned sAfer drug Consumption faciliTy (ENACT): A mixed-methods natural experiment study.”

272 Glasgow Caledonian University, Evaluating the impact of the UK’s first saNctioned sAfer drug Consumption faciliTy (ENACT): A mixed-methods natural experiment study.”

273 Q18

274 Glasgow Caledonian University; University of Glasgow (SDC0006)

275 Q90

276 Q40

277 Q44 [Councillor Casey], Q40 [Professor Matheson]

278 Q138

279 Q143

280 Q143

281 Q157

282 Q144

283 Home Office, Advisory Council on the Misuse of Drugs, Reducing opioid-related deaths in the UK, December 2016

284 Q144