In the ten years since the publication of Scotland’s previous alcohol and drugs strategies we have seen a lot of positive change. I am proud of the successes achieved over this period, driven by Alcohol and Drug Partnerships, our nationally-commissioned organisations, Health Boards, Councils, Integration Authorities, Third Sector Organisations, Mutual Aid Organisations, but also, crucially, by individuals, their families and wider communities.
A key success to improving outcomes for individuals, families and communities has been the introduction of minimum unit pricing for alcohol, the establishment of recovery oriented systems of care, and the growth of over 120 recovery communities throughout Scotland. The introduction of a waiting times standard is also a worthy achievement, as is the introduction of the world’s first take home naloxone programme, an initiative which we are confident has saved lives. We have also provided a vision that recovery is possible, recognising that each recovery journey is unique. But we also recognise that through an increasing visibility of recovery, we can begin to tackle some of the issues of stigma and discrimination that affect so many individuals and family members.
Despite our other successes, over the last five years we have, tragically, seen a sharp increase in drug related deaths across Scotland. Although alcohol deaths are not rising at such a rate, any loss of life weighs heavily on me personally, but it also takes a toll on Scotland’s communities and all of us as a nation.
Everyone has the right to health and to live free from the harms of alcohol and drugs. Everyone has the right to be treated with respect and dignity and for their individual recovery journey to be fully supported. This strategy is, therefore, about how we best support people across alcohol and drug issues - taking a human rights-based, public health approach to ensure we are delivering the best possible care, treatment and responses for individuals and communities.
There is a growing awareness that those experiencing problematic alcohol and drug use are often carrying other burdens such as poverty, inequality and health challenges. This means they need to be supported rather than be stigmatised. Treatment services and organisations in Scotland are already jointly tackling the harms caused by alcohol and drugs and this new strategy reflects that - bringing together our approach to tackling the problematic use of alcohol and drugs for the first time.
We live in a changing landscape in which fewer young people are using alcohol and drugs. However, a significant number of the group of people who need our urgent help are older and less healthy. Consequently, they are more vulnerable. That’s why the commitment of additional investment of £20m a year mustn’t simply lead to more of the same – it must unlock innovation and ways of opening up services and making them attractive to those for whom the current support isn’t right. All our investment must be seen to be working for the benefit of the people we serve.
It is vital that we recognise the challenges still faced by people and families. We know that quick access to treatment is crucial and that, for the huge majority, being in treatment has a protective effect. It is, therefore, important that we have a range of services for different people with different needs - from harm reduction measures which can help the most vulnerable, through to treatment and recovery services that support not only individuals, but also their children and families.
It is also vital that we recognise the challenges that services and frontline workers are meeting in 2018. The dedication and commitment of front-line workers needs to be celebrated and commended. Together we need to build on that, to reduce the numbers of people who require services and to achieve better outcomes for those who are currently using them.
Achieving the outcomes set out in this strategy will be a challenge and one we can only achieve by working together – people with lived and living experience, delivery partners, service providers, decision-makers, funders and the research community.
Adopting a public health approach also requires us all to think about how best to prevent harm, which takes us beyond just health services. This, requires links into other policy areas including housing, education and justice. It also means supporting responses which may initially seem controversial or unpopular, such as the introduction of supervised drug consumption facilities, but which are driven by a clear evidence base.
Supporting a better response to those harmed by alcohol and drugs is one of the hardest and most complex challenges we face as a country. The harms are real and will persist alongside the often inspiring stories of lives saved. It ought to be the work of all of us, together, to improve our response – recognising: the rights of people, their families and their communities; the need to treat people with respect; and that all individuals will be supported on their own, unique, recovery journey.
Joe FitzPatrick, MSP
Minister for Public Health, Sport and Wellbeing
Email: William Doyle