Bill gets ball rolling to tackle drug death crisis ... but will it be enough?

Scotland’s drugs death rate dwarfs any other European country, coming in at more than triple the second worst hit nation, Sweden.

In 2020, 1339 people lost their lives to drug-related issues, up 5% on 2019 and the seventh year in a row which had seen the number climb.

The SNP government created a Minister for Drugs Policy in December 2020 in response to the issue. In the role, SNP MSP and former social worker Angela Constance works “directly alongside” the First Minister on a “national mission” to tackle the crisis.

But although the SNP say Constance’s work to try to deliver these facilities within the bounds of the current law is “at an advanced stage”, it is Labour MSP Paul Sweeney who last week got the ball rolling on a Drugs Death Prevention (Scotland) Bill.

The bill will seek to “enable the establishment of overdose prevention centres” by laying down a licensing framework and creating a new public body with oversight of drugs policy.

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Such overdose prevention centres (OPCs), also known as safe consumption spaces, have already been trialed in countries such as Australia and Canada, with a study in the latter suggesting enhanced access to such facilities was a viable strategy “to reduce mortality among people who inject drugs”.

Scotland has also seen one unauthorised pilot OPC, in the back of a van (later an ambulance) and run by Krykant.

“The van was a product of frustration at the lack of progress,” Sweeney says, “and the bill is again another expression of frustration at the lack of progress that there’s been in Scotland.”

The Labour MSP says that the hundreds of safe injections which Krykant’s OPC facilitated saw 10 overdoses reversed thanks to the rapid administration of the life-saving drug naloxone.

He says: “You could argue that there were 10 lives effectively saved by a fairly rudimentary intervention that was only operating for about six or seven hours a week. Scale that up and it gives you an indication of how positive this could be.”

What’s more, as Kirsten Horsburgh from Scottish Drugs Forum (SDF) told The National: “People do not die when using these facilities.”

No death has ever been recorded in any OPC worldwide, and experts say such spaces actually serve to reduce drug use, not increase it.

OPCs also bring a raft of secondary benefits, including cleaner neighbourhoods littered with fewer discarded needles, safer and more hygienic practices for drug users, and serving as a point of contact for some of society’s most marginalised people.

“You would be struggling to find a downside to it,” Sweeney says, although he is quick to caution that OPCs are far from a “panacea” that will fix the drugs deaths crisis overnight.

“Problematic drug use is a symptom,” he says. “It’s often product of poverty, trauma and desperation.”

Campaigners agree that a lot more work will need to be done in areas such as health, housing, and welfare to truly address these fundamental issues. The SDF suggested that a simple change could be to reverse the policy which blocks people who are undertaking medical treatment for addiction – for example through the prescription of methadone – from accessing mainstream mental health services.

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If a person manages to wean themselves off hard drugs without addressing any of the underlying factors which drove them to addiction in the first place, a relapse is highly likely.

OPCs must act as a gateway to other treatment to maximise their impact, campaigners say.

Krykant says there must be a combination of static and moveable OPCs in order to best reach the people who need help. As Horburgh says: “People will not travel to use this type of service.”

For such facilities to be set up over Scotland, broad support across the political spectrum would need to be secured. That, at least, shouldn’t be too difficult.

The SNP’s Kaukab Stewart said her party had “long” been pushing for OPCs, while Scottish LibDem leader Alex Cole-Hamilton added that his party believed there was “significant leeway” which would allow for them to be set up on a legal footing.

The Greens have pushed for a “public health focus on drugs” and said they would be closely scrutinising Sweeney’s proposal, and even the Conservatives said: “We will carefully consider the proposals outlined in this bill and in principle we are not opposed to a pilot scheme for drug consumption rooms.”

However, widespread support may not be enough for rapid change.

Krykant says: “When it comes to politics and putting legislation through, it’s never quick enough in terms of the people who desperately need that support now.”

There is another barrier to OPCs being set up freely – the inevitable criminal element. However, Sweeney says: “The only crime that really takes place in the context of these facilities is possession of a controlled substance.

“You can walk into one of these facilities holding a bag of heroin, and as soon as you’ve injected it the crime disappears.”

But Krykant’s pilot OPC faced no real legal issues, and Lord Advocate Dorothy Bain announced in September last year that possession of class A drugs need no longer result in immediate prosecution, suggesting a change in policing culture.

“I already know Police Scotland officers were seeing people injecting in alleyways and diverting them to my ambulance,” Krykant told Holyrood’s Criminal Justice Committee in January, underlining this change.

Asked if the Crown Office was considering an official shift in its policing policy to facilitate SCSs, a spokesperson said it “would not be appropriate for COPFS or the Lord Advocate to comment at this stage”.