Drugs crisis: Global attention on potential for reforms in Scotland

Some 500 years later – despite devolution of powers to locally determine the shape of the country’s health, education and legal systems – the battlefield between Scotland and England for the former’s sovereignty has shifted to the realms of drug policy, which Holyrood seeks to liberalise in the face of intransigence in Westminster.

At the end of last year, Scotland’s top legal official, lord advocate Dorothy Bain QC, indicated her support for drug consumption rooms (DCRs), in defiance of a UK Prime Minister “instinctively” opposed to the potentially life-saving facilities. She invited proposals, supported by the police, which are understood to be in development, with the Scottish drug overdose death crisis showing few signs of significantly easing without radical action amid consecutive record death tolls.

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The increasing politicisation of the crisis, and the acceptance by the Scottish National Party that serious reform is crucial, has ministers scrambling to save lives – and face. The chair and vice-chair of a national drugs strategy task force recently resigned over government interference, blaming a “demand for speed” for reforms. But campaigners say this is long overdue, and that the solutions are relatively simple.

“For too many years we have followed a Westminster drug free utopia approach, symbolised by a 2008 Scottish Government strategy defining recovery as ‘a drug-free life’,” says Peter Krykant, who arguably forced the SNP’s hand on seeking reforms after establishing a mobile and possibly illegal DCR in a van parked in Glasgow.

Drugs campaigner Peter Krykant has been vocal in his campaign for safe consumption rooms

But while the Scottish Government has sought to position itself as a more compassionate power centre to Westminster, it has been a year since First Minister Nicola Sturgeon announced heroin-assisted treatment (HAT) would be “widely accessible across the country” from April 2021 – it is still only available in Glasgow to a small number of people, he adds.

Nearly six months have also passed since drug policy minister Angela Constance announced drug consumption rooms would open – but despite their establishment seeming inevitable, nothing concrete has yet been agreed. Naturally, there are claims that Sturgeon could be using the issue as a political football even as Scotland’s drug death rate remains the highest in Europe and more than three times higher than in the rest of the UK.

“With so much of the new funds for treatment ring-fenced for residential rehabs, what is left must be spent wisely to allow our front-line staff the opportunity to deliver evidence-based harm reduction,” Krykant, who now works for treatment and support charity Cranstoun, adds. “All drug deaths are a tragic failure of both UK and Scottish Governments but what happens now, this year, will lie solely at the feet of the Scottish Government. They must be brave and act now.”

Considerable international attention on the potential for crusading reforms in Scotland is only gathering steam. The Wall Street Journal last month harked back to the movie adaptation of Irvine Welsh’s novel Trainspotting and noted Johnson’s opposition to reform – despite Scottish Tory leader Douglas Ross saying he would not oppose a DCR trial.

The paper said the race was on to introduce sufficient new measures – such as DCRs similar to those recently opened in New York City which followed the lead of Switzerland, Germany, Denmark and elsewhere – to help bolster public health before fentanyl and other synthetic opioids arrive in larger amounts. Former NYC mayor Bill de Blasio has said several lives have already been saved by the facilities, which also test drugs for contamination. Elsewhere, well over 100 DCRs across more than 60 cities in the world provide health, social and housing advice to people while offering a range of services from haircuts to counselling.

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“DCRs have proved their worth in saving the lives of people who use drugs in a range of settings around the world,” says former New Zealand Prime Minister Helen Clark, the chair of the Global Commission on Drug Policy. “Scotland is in the invidious position of having far and away the highest rate of deaths related to the use of drugs in Europe. It is therefore highly appropriate that the Scottish Government should seek to implement best practice in harm reduction to reduce that death rate radically. This is a noble cause and one which Scotland should be encouraged to pursue.”

She is among reformers encouraged by the willingness in Scotland to explore wider options for harm reduction. At the end of last year it also moved to decriminalise possession of personal amounts of heroin and cocaine – seemingly paving the way for DCRs. Clark hopes to see the effective implementation of DCRs and other measures that could increase pressure for changes across the UK to secure a more humane drug policy. “Moves by Scotland in this area will encourage all those seeking to meet the needs of people who use drugs for effective harm reduction services,” she says.

Scotland’s chief legal officer Bain in December said it could be against the public interest to prosecute “those using drug consumption facilities”, as long as safeguards were in place. The statement came despite her predecessor having ruled out providing prosecutorial immunity for those using drugs in a DCR, claiming in 2017 he could not “alter the basic quality of the activity as criminal in law”. But the government is publicly behind the proposals and has said “it is widely agreed by experts and key groups with lived experience that there is a clear need for a facility like this, for example in Glasgow.”

Scotland's chief legal officer Lord Advocate Dorothy Bain QC

Paul Sweeney, a Labour MSP who volunteered at the van with Krykant, says that while progress has been painstakingly slow, it should nonetheless be applauded. However, he remains anxious for swift changes. “Thus far the emphasis of the government seems to be on setting up a pilot project but frankly that is just not good enough when we need a national infrastructure governed by licensing frameworks,” he says.

Following the resignations of Scottish drug death taskforce members aggrieved at an apparent demand for swift reforms, Sweeney calls for it to be replaced with a far more democratic body — “one with genuine authority and fiscal autonomy and free from ministerial control”, with members approved by parliament. “Radical change is required now and I would strongly encourage the Scottish Government to move at pace before it is too late.”

It seems if the government in Scotland does sincerely wish to save lives, it must risk potential legal action against a DCR and pushback from down south. But it also needs to get its house in order and sort out the current treatment options, says Martin Powell from Transform Drug Policy Foundation.

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“Only 40% of Scots who need it are in treatment – even the 60% in England is too low – yet treatment is the gold-standard way to reduce deaths. There are far more people dying because they are not in treatment, than remain in it longer than they might ideally need to be,” he adds.

Ultimately, however, Scotland needs something only Westminster can deliver, Powell contends – gold-standard formal decriminalisation, where personal drug use is taken out of criminal law altogether and made a civil issue. “This would prevent a postcode lottery over how drug use is treated, encourage people to come forward for help, and release lots of money to boost treatment,” he says.

It could be a significant step towards even more fundamental changes to safeguard public health. “Scotland should explore legal regulation of drugs to take them out of the control of organised crime, while ensuring access is only for over 18s, and people know what they are taking - as Canada, the US and the new German Government is planning to do for cannabis,” he says. “But that is something only Westminster can do. And with Keir Starmer now toeing the Conservative government’s regressive, failed line on drugs, that seems a long way away at a UK level.”