 Welcome to the third joint meeting in 2023 of members of the criminal justice, the health, social care and sport and the social justice and social security committees to consider the progress made in implementing the recommendations of the Scottish Drugs Death Task Force. We have apologies from Gillian Martin. Paulo Cain will be arriving a little late due to another commitment. Agenda item 1 is to decide whether to take item 3 in private, which is to review today's evidence. Our members agreed. Our next item of business is an evidence session on tackling drug death and drug harm. I'm pleased to welcome our witnesses today. They are Elena Whittle, MSP, Minister for Drugs and Alcohol Policy, Orlando Hedjmar Mason, Head of Drugs Policy Division, Michael Crook, Drug Policy Team Leader, Harm Reduction Team, Scottish Government and Suzanne Miller, Chief Officer, Glasgow City Health and Social Care Partnership. I refer members to papers 1 and 2, and I thank the witnesses for their written submissions. I invite the minister to make some brief opening remarks of no more than three minutes, please minister. Thank you very much, convener, and thanks to all three committees for coming together to focus on this issue, which cuts across all of your portfolios. We are now at the midpoint of the national mission, and we have seen significant progress in many areas. There has been a huge increase in eloxone distribution, improvement in our surveillance and early warning systems, progress in the implementation of the medication-assisted treatment standards and an increase in residential rehabilitation referrals and capacity. As a Government, we have taken a truly whole systems approach to tackling drug deaths and the underlying drivers. Our response to the drug deaths task force set out bold actions, including in mental health and oral health, community pharmacies and developing a concessionary travel pilot. We recently published our second annual report, and I hope that members have had a chance to read to see the depth and the range of work that is being delivered. That progress is not due to our increased investment. It is very much due to a huge concerted effort by people and organisations right across the country, and my respect and thanks goes out to them. This truly is a national mission. 2022 saw the first annual reduction in drug deaths since 2017, and although I welcome the record fall, I also want to reaffirm my commitment to continue the national mission and recognise that we still have a lot of work to do. I will never underestimate the scale of the challenge that we continue to face, including responding to new threats such as synthetic opioids and an ever-increasing stimulant use. We will continue to implement evidence-based policies to reduce deaths and to improve the lives of people affected by substance use. We are continuing with our commitment to put people with lived and living experience at the heart of everything that we do. We recently had a debate in the chamber focused on drug law reform. That debate highlighted the limitations and the barriers that we still face. A key facet of drug law reform is the ability for Scotland to implement actions that we know will save lives. One example is safer drug consumption facilities, and I again welcome the position from the Lord Advocate and the confirmation from the UK Government that it will not seek to block or prevent the proposals in Glasgow. Safer drug consumption facilities are important, but they are only one small part of a much wider picture when it comes to supporting people wherever they are. I look forward to the opportunity today to provide wider updates through this evidence session. Thank you very much minister, and we are going to move straight to questions. The first question is from Audrey Nicholl. Thanks very much, convener, and thank you minister for that update. Can I just say at the last meeting, which unfortunately you were unable to attend, I thought it was a very positive meeting. Obviously, with the timing of the meeting, the focus was very much on the recent announcements around the safe consumption room facility pilot in Glasgow. We were very welcoming of that, as were our panel members. As an Aberdeen MSP, I am interested in the proposals to extend the provisions that are being developed in Glasgow to that of drug-checking facilities. I wondered if you could provide some details on perhaps extended timescales or expected timescales in and around that, and what exactly a drug-checking facility would look like. Thank you very much for your question, and also for the recognition at the beginning just about the work that this cross-committee does. I think that cross-committees really are invaluable, and I think that we should be doing more of them where we can do. With regard to drug-checking, there was a two-year study that happened that was funded by the drugs desk task force to look at what does Scotland's drug-checking facilities look like and what do we need. One of the things that it told us was that we need them to be situated with some of our bigger cities, and obviously Aberdeen City is one of such areas. It also told us that, on top of those three areas—we have Dundee, Glasgow and Aberdeen—we also had a need for a national hub, and that will hopefully be cited within Dundee's university. We recognise that, although we need to have those drug-checking facilities within communities with an easy access of individuals, we also need to have that national facility that will allow robust checking of the results found at a local level, but that, perhaps at one point in time, we will be able to move to the model that is in Wales with the Wedinoss service, where people are able to post in drugs for them to be checked on that basis. When it comes to timescales at this point in time, we have had some clarification from the Home Office with regard to some of the information that will need to be supplied and submitted by the local areas when they submit their applications. One of the issues that we are trying to work through at this moment is around about the legalities surrounding the transportation of those substances. Once we can get into a position where that is nailed down, I think that the applications are going to go in as quickly as we need them to go into. I am sure that the minister will be planning to keep the committee or the group updated on that, because it is good to hear that that work is under way. I wonder if, just in the short time that we have each for questions, I could turn to the issue of evaluation. At the previous meeting, there was a range of views in and around evaluation when that should perhaps begin, or at least when the evaluation will continue now that things are under way in terms of the Glasgow service. However, there was some commentary that, in the meantime, work can be taken forward in terms of other locations and other facilities. There was a range of views on what that might look like. I am just interested in your own views on whether or not the evaluation should be undertaken and then look at lessons learned and then make decisions around how we move that work forward. I am gathering that you are talking about safer consumption facilities. We need to have a robust evaluation process that needs to be flexible and agile, but, at the same time, I do not believe that that should stop us from exploring the possibilities of there being other pilots that could be put forward whilst the initial Glasgow pilot is being undertaken. In information that I submitted to the committee, we have had conversations with the current office around what they would be willing to consider, and it is clear that the Lord Advocate would consider a robust application from a local area that followed along the parameters of what the initial Glasgow one did. If we think about that an application needs to be precise and detailed and specific, it would need to be underpinned by evidence from that local area and supported by those who would be responsible for policing such a facility such as Police Scotland. Any local area that would seek to put an application in for a pilot to be considered would need to be made sure that they are satisfying their Lord Advocate of everything that Glasgow did. I know that there are conversations already being undertaken in the city of Edinburgh about whether it would seek to have such a pilot in the offing, and officials within the Scottish Government are supporting that area to explore what that could look like. However, we do not need to wait for the full evaluation of the first Glasgow pilot before perhaps other considerations could be put forward from other areas. I am going to ask a couple of questions on stigma, if I may, and my particular raison d'etre, which is being trauma aware. That is something that gets me out of bed in the morning. Can the minister provide an update on the work that has been undertaken with part of the stigma action plan? I will roll the two questions into one, which will cut for time. Can the minister outline the engagement that has taken place with the third sector to assess its experience of attitudes and whether that has indicated any improvement in those attitudes over time? Thank you very much for that question. Like yourself, I have been trauma informed in making sure that we have services that are also trauma responsive is something that I am very passionate about. We need a full systems and cultural change if we are truly going to tackle stigma. Part of the Government's response to the drugstaff task force report was that we were going to launch a tackling stigma action plan, but whilst we are in the process of rolling that out, we really need to co-design what that looks like. We are making sure that we work with our third sector partners, our partners in local government and the health and social care partnerships, but also with those people who are experiencing the services. For them to be supported by and large by the third sector is really important. I think that it is going to take a little bit of time for us to co-design what that stigma action plan is going to look like. Co-design is not simple and it is not easy and for it to be done really effectively, we need to take that little bit of time to make sure that we can really hear from the voice of lived and living experience. If we think about our processes just now, you probably heard this from witnesses last week, sometimes we can design stigma into our services by accident. We need to make sure that we hear from what people who are living through substance use are telling us. We need to make sure that we think about some of those groups who are often not thought of when it comes to the designing of services. I am thinking about people from Black and Minority ethnic groups who face substance use issues just the same as everybody else. I am thinking about services that we need to make sure that are there for women and the specific needs of women. All too often, when it comes to stigma, it can actually drive people away from the services. I am really keen that we hear from all of those voices. The voices that we talk about have been unheard, but a lot of the time they are talking very loudly and we are just not listening to them. That co-design process for me is vital in terms of getting it right, and that will take a wee bit of time. Thank you very much. That is a very full answer. My only concern when anyone ever says that we have to take time is that it becomes never-ending and it cannot be never-ending when it comes to trauma. Would you be willing to give an indication of how long you would anticipate in some way? I am not trying to hold anyone to it, but I do not like the idea of it being a never-ending process. Absolutely. I am anticipating that by the time we go into the spring, we are going to have a lot more information round about what that stigma action plan is going to be. We are co-designing a voluntary accreditation scheme that people who are working in services can sign up to, so that means that they themselves are a practitioner, but also that they are service. We will hear to looking at how they can reduce stigma and actually drive it down, so that is really important. We are also supporting organisations to launch campaigns such as the CBNC, the Lives Campaign, which is run by a few partner organisations to get the stories behind the people. We have heard really powerfully from MSP colleagues about the stigma that they faced as a family. There is a lot going on in the background, but I will keep the committee and the rest of the chamber up to date on that. I was mentioned about the evaluation methodology, and I am glad that the chief officer from Glasgow Health and Sovereignty is here today. You spoke about it being robust, flexible and agile, and I suppose that I am looking for some reassurance that it might also be very independent. That is a really good question to ask, because we need to have challenge, scrutiny and independent eyes on some of those things. I would probably pass to Susanne just for her to help us with understanding what the evaluation process from a Glasgow perspective on it is, because obviously from a Government perspective that will look slightly different. My scrutiny would be on the evaluation that Glasgow would be taking forward, so I am happy to hand over to Susanne for that. The process in terms of evaluation at this point is being led by the director of public health with Angrita Glasgow and Clyde Health Board, Dr Amelia Crichton. We are working with an expert academic group, and what we are looking for is that there are two universities that are working together to look at a bid in relation to the evaluation and that being entirely independent. That is how we operated the enhanced drug treatment service, so we have got experience of that independent evaluation. We have a lot of interest, as you can imagine, in the evaluation of the safer drug consumption facility, so I am confident that we will be successful, that the universities will be successful in terms of their bids, and we will work with them in terms of that evaluation. Public Health Scotland is already funded to do some baseline study work prior to the service opening, so that, at the point where the service operates, that evaluation can start almost immediately. That was a learning from the enhanced drug treatment service evaluation that we had to spend quite a bit of time on baseline once the service was open, so that is something that we can do in preparation. Public Health Scotland are doing that on our behalf, so that that element is independent as well. Thank you, Susanne. I suppose that it is not hidden that our party has a different, perhaps perspective on the safer drug consumption facilities in others. We are very much looking forward to seeing the evidence before we take a position on consumption facilities being set up more widely across the city, but I am aware that the council in Edinburgh is considering those things. I am also very aware that the service in Glasgow has been funded by the Scottish Government. The IGB in Edinburgh is in critical financial strife at the moment, and I would have grave concerns if their consumption facility was to be funded from their existing budget, so I am looking for a bit of assurance on that. The minister and I have shared some correspondence more verbally recently around the priorities that I think some of the IGBs and the AADPs need to be having around the MAT standards, and specifically with that one case of the constituent from my area, who was in prison in Edinburgh prison and was on Bovedal. Then, when presented at the South West Office within Edinburgh, I was told that they couldn't have that. I would have to come back within two weeks and potentially have to result to go back on to methadone. There is a mix match here in terms of the harm reduction versus the real embedding and investment that is needed at the local level to really help our individuals. I do not want a cart before horse here. I want the services to help people to recover there before those who prevent the harm. On your first point with regard to resourcing, the resourcing of any other project that would come forward in terms of safer consumption would be an on-going process that would happen between my officials and officials within Edinburgh. That is not something that I can foresee, but I take your point in terms of the presness of the budgets that are within a safer drug consumption facility being funded at the expense of other critical services in Edinburgh, because we cannot afford to cut any of those. That is my main point, minister. I absolutely take your point on that. With regard to the case that was brought to both our attentions on social media, that was something that straight away I asked officials to start looking into. It told a story of an individual's journey that does not reflect what an individual's journey should be from that setting. If we zoom out from that one person and just think about the journey as it should happen, when somebody has a transition from any setting, whether that is a hospital setting, a prison setting, there should be a cohesive plan in place that means that somebody does not see their medication or anything else fall between the cracks, whether that is presenting his homelessness, et cetera. That individual should have had a seamless change from the prison facility and to the community setting. I am still awaiting to see what perhaps could have been some of the difficulties in that situation. What we do know is that, within Glasgow, they have a named person-standard operation procedure in place, which means that the specific patient has the ability for the medication to follow, because he needs a home office licence to store that buvidol medication. At the point of transfer, the person should be able to have a long-acting injectable buprenorphine be set up for the next time that they are due to have that. There has to have been a breakdown in communication somewhere. There has to be learning from that, because that cannot be something that happens regularly across the country. It also harks back to, if we think about the shore standards in terms of when somebody makes that transition from a prison setting back into the community setting, their healthcare should follow, their support needs in terms of housing, et cetera, should also follow, their support needs in terms of access to welfare benefits should also follow. I am happy to keep the committee informed just about what could be learned from this once I get a fuller picture back. That is very helpful. Of course, then we can make sure that there is no other person who follows through to the system like that. Just to the point that you are making earlier about evaluation. Obviously, we would all want any evaluation of the consumption of citizen class go to be so robust that it does not matter whether you are sceptical or passionate about it to be able to recognise its findings. Just to let the committee know that at official level, we have been speaking to the Home Office as well, and I have made an offer to the Home Office that their questions they might have about evaluation will make the introduction to Glasgow so that any questions they will have, and there is a lot of interest across the UK, including in the Home Office, about the outcome of the pilot, are reflected in the evaluation and that they get from it what they would like to see as well. That is very helpful. Thank you. I just wanted to touch upon one thing in relation to the safe consumption rooms in the pilot scheme, and then I am going to move on to the national specification. It says in one of the recommendations from the drug task force, currently many drug services do not operate in evenings or at weekends. We must provide emergency care 24-7 without our referral points for people to access if needed, but I note from the pilot scheme that it is only available from 9am to 9pm. Is this something that is getting looked at or will that come out in the evaluation that you touched upon? Yes, I will first answer part of that and then I will see if Susanna also wants to come in. I think that if we think about the running costs of such a facility, staffing it from that time frame is reflective and I guess the tariff that we know that it is going to cost us, but I do recognise that people will use drugs at all times of the day so that there is a need as well to look at how we can assess as the pilot develops what the real-time information is telling us about individuals' habits and how individuals are actually engaging with that service, but it is something that I have certainly thought about and I am sure that it is something that Glasgow has thought about as well. Just to add to that, it is 9am to 9pm, seven days a week, 365 days a year and in terms of one of the pieces of work specifically that we are doing just now is its connection into those wider services. I will come back to the earlier question, we very much see the safer drug consumption facility as part of the wider offer in Glasgow City and there are a number of integrated addiction services. A couple of them are the crisis outreach that are specific to your question, the crisis outreach team and our mental health assessment units, which operate through 24-7 also have an alcohol and drugs component to them. What we are working on just now is what the pathways would be for people using those existing services, but the minister rightly says that to run 24-7, seven days a week, 365 days a year was not something. It is not how the other safer drug consumption facilities across the globe operate either, so we have looked at other places in terms of the evidence base, but your question is entirely correct about making sure that the pathways into those other services that we have in place needs to be really clear for people and that would be something that we will work on. Okay, that is pretty reassuring, especially for people with addictions being signposted out with those hours as well. Touching upon the national specifications as well, the committee has obviously heard previously that some of the difficulties that people face by accessing services. I wonder if the minister can provide an update on what is happening with the national specification and provide any details on what the national specification will include. Thank you very much for that question on the national specification. It is something that is clearly there from the drugs desk hash force and their report. That speaks to the variation of services that we do see throughout the country and perhaps the need to roll some things into a national specification. However, although there is work on going with stakeholders through various working groups already in place to consider what type of more formal service specification would benefit people relying on services, we are at this moment making sure that we are pushing with the roll-out of the medication assisted treatment standards, which is one part of a national specification of treatment. If we are also thinking about residential rehabilitation and we are working towards a national commissioning protocol for that so that we can make sure that local areas are able to effectively get people on their journey into residential rehabilitation and then back into the community, because that has been proven to be quite difficult for local areas to do that. If we look at Scotland XL, which those of us who have ever been in local authority know, as the kind of—I see lots of rai smiles there—body that helps with that kind of procurement work, we are now at the point where we will be looking to go out to the tendering process, where organisations that are providing residential rehabilitation facilities would actually be able to get themselves onto a national framework. That will provide a directory for local areas, but also a directory for individuals. Right now, as it stands, people do not know what residential rehabilitation is out there for them. They do not know what each of the types of services might provide for them. By actually bringing that into a national oversight of it, it means that, hopefully, that journey and that access to those facilities will be easier for individuals. I think that when we think about the kind of governance structures around this as well, a national specification when we get to that point of understanding what the working groups are telling us will also help to have a read across both spheres of government and all of the partners and their actual individual responsibilities and how we can quantify what that should look like in practice, and so that there are clear lines of accountability. I obviously have accountability on a national level, but I also need to look to local partners in terms of their accountability. I think that national specification will help us to do that. I know that that is very helpful. Thank you very much. The only thing that I was going to add was about the service directory, which we will be launching shortly, which is just a website where people can find out what residential rehab services are available to them. Russell Findlay Thank you, convener. I have, I think, forgot about five minutes, so I have a few or four questions. I will try my best to rathle through them. I suspect that drugs deaths are up again in the first six months of the year, 7 per cent, which equates to, I think, 600 lost lives. It is absolutely correct that we are treating this as a public health approach, but there remains a serious problem with organised crime groups preying on vulnerable people. I have raised concerns of organised crime influence in mainstream sections of the society, including football and boxing, which I find obscene and outrageous. What I am seeking from the Government is some kind of explanation or assurance that the police are continuing to have the resources that they need to tackle those parasites? I think that all of us can recognise across this room at the moment that serious and organised crime is very harmful to our communities. In cities, it is in all different levels, where people do not think that serious and organised crime is. Whilst it would be for the Cabinet Secretary for Justice to comment on the funding situation of the police, I think that, in a cross-government look at it, I would be seeking to make sure that police send their response to the areas that I am responsible for and our resource for that. I think that we need to recognise that, when we have situations where we can interrupt county lines activity, where we can take vast quantities of drugs off our street by actually interrupting those gangs, and also where our police in Scotland can work with the UK, serious and organised crime professionals and, indeed, across the whole of Europe and beyond. Where those supplies sometimes are interrupted, as a minister responsible for drugs and alcohol policy, I need to be also aware about where the harms transfer at that point. In my experience, where we have a huge quantity of substances sometimes taken off of the streets, we then end up with harm diverted to a different area. I think that there is a dual aspect to that. I will absolutely support the Cabinet Secretary for Justice and colleagues in terms of making sure that police are resourced, but I will also think about the unintended consequences. I have a quick question about drug consumption rooms of Pilate and Glasgow. Dr Sackett, Priya Darcy, told the BBC that crack cocaine or any other substances that smoked or inhaled were removed from the original plan because of the smoking ban. As far as I can see, there is very little pickup. Is that being reviewed? Is it likely to be included in substances of that nature? If so, does it then raise potential questions around staff safety? It is a very interesting question, Mr Finlay. There are a few parts to that. The smoking ban plays a part in terms of smoking indoors. We know that, but the misuse of drugs act actually has a part in it that prevents people from supporting the consumption of smokable substances. I think that that shows how outdated that might be because that was thinking round about opium. We know that there is going to be a challenge in terms of how that facility could operate. There are more and more people using crack cocaine that are going to be free-based in that, and it is not going to be able to be used within the facility as it stands, but we also know that there are a lot of people who are injecting cocaine, so people who are injecting cocaine would be able to do that within the facility, but I am going to pass to Susanne really quickly just to bring her in if she is getting anything to add to that. That is okay. Yes, and being careful, what we say publicly, we had really detailed legal advice. Glasgow City had really detailed legal advice in relation to that, and that precisely, as the minister said, that made it far too complex to put something in front of the Lord Advocate with Scottish Government support that would have been likely to get the outcome that we did. Also, our population that we are most concerned about are far more likely to inject cocaine. Very quick question on the locks on. Scottish Fire and Rescue Service have secured an agreement with the Fire Brigade Union to, in principle, all firefighters to carry this. There has been some resistance. Some firefighters are doing so voluntarily. That proposal is with Scottish Government. I just wonder what is happening with that. Again, if we think about broadening the firefighters role, there are some complexities around about how that would operate in practice. We will consider their proposal back to us in terms of carrying it. I am grateful for those firefighters that now are carrying it on a voluntary basis. Unlike the police force before that, there were a lot of things to work through to get the confidence for those front-line workers to carry it. I think that the nasal spray of naloxone has made that much easier for them to do. We have been doing it for quite some time. The Fire Brigade has not yet reached an agreement. Do you know that you have any sense of when that might happen, when the likelihood of an agreement might be reached or otherwise? I do not know if officials do. I do not have any insight into that at the moment, but Michael might do. Thank you. No, it is not something that we have any information on at the moment, but we have been working with the Fire and Rescue Service for a while and we have provided them with funding around naloxone, carriage of naloxone, but we can certainly check back on that and come back to the committee with further information. A very final question in relation to drug checking services. Audrey Nicholl has already talked about those. In a recent debate, you correctly said that there is no such thing as a safe consumption room. It is safer consumption room. Some of those substances are inherently dangerous and there is no getting away from that. What I do not understand and it is maybe just naïvety in my part is what would the purpose of a drug's testing or checking facility or service be if you are checking for the purity or the identity of the substance. Then what happens if you are telling people that that is the substance that you believe it to be? Is that essentially giving a green light to take it when in itself it could pose a danger to them or if you give a red light? It just seems all very confusing. A bit of a legal minefield. I wonder what works being done to establish what the actual purpose of those would be. I am very clear in my mind what a purpose for drug checking would be. That is about furnishing individuals with information. I think that all of us would recognise that information is power in every single aspect of our life. If you are somebody who is— You are taking a substance and you believe that you have bought the substance in question and you get it tested and they say that that is indeed the substance. The authorities are therefore potentially directing people to take something that could harm them. I think that we are giving people the information about what the substance contained because I think that what we are seeing just now is an increasing toxic supply that is out there and what an individual might think as a tislam, as a street benjal, might come back to show that it is containing some synthetic opioids. I take your point about whether it contains the substance that that individual thought it would, but that in itself allows them to still make a decision about whether they continue to use it and how they use it. That might be beneficial to people. If we have time at the end, I will come back to you for a second. Thank you very much. I thank you for allowing me to join your committee's deliberations today. Minister, you know that I am supportive of the Government's approach to harmful substance use and deaths caused by the same. I am going to ask a question about something, a topic that we have not discussed before between us. That is something that you touched on briefly in your remarks and briefly in an answer to Russell Finlay there and that is synthetic opioids. I have here in front of me a graph from the United States that says that in 2012, just over two and a half thousand people died from the substance known as fentanyl or predominantly fentanyl, but last year that had jumped to 73 and a half thousand. There is an epidemic of opioid misuse in synthetic opioid misuse in the States, which has not yet been realised on our shores, but that time may be changing. I understand the metrics that speak for themselves, but since the Taliban took control of Afghanistan in April 2022, they instituted a national ban on the growth and sale of the opium poppy. As a result, opium export from Afghanistan has dropped right off, and stakeholders are concerned that there may only be 18 months left in the illicit global heroine supply, which means that the vacuum that that creates may well then be filled by synthetic opioids, like fentanyl predominantly, but also captagon coming out of countries like Syria. I just wonder first and foremost what work is your government preparing in terms of the surveillance as to what people are taking so that we can get early warning of this if it hits our shores, because the death rates from fentanyl are far, far worse than heroin. Absolutely. I recognise every single thing that Alex Cole-Hamilton has just outlined there, and I think that we invested in our rapid action drug alert system because we needed to know what was actually happening in real terms on the ground. If we think about the most recent radar report, it actually does start to talk about the fact that we are seeing these synthetic stronger opioids actually make their presence felt within certainly the UK but also within Scotland. That gives me huge cause for concern. Just this week, I was on a call with some of our international experts in Canada and from the States to actually talk to them about what would they do differently now if they were able to do that again. What are we doing in Scotland that is actually going to help us and what could we be doing in Scotland that might help us to address what potentially could be coming down the line. If I think back to Mr Finlay's question about serious and organised crime, it is far easier to transport the substances and to get hold of the substances for synthetics than it is to cultivate a crop that is dependent on so many other factors, never mind the geopolitical factors. I am worried about potentially what we are seeing and that is why I think that we need to make sure that we have the ability for drug checking and testing to be done. People need to know what is in the substances but we also need to know ourselves what is happening in terms of when we have hospital admissions. We have the pilot assist project that is actually on-going within the Queen Elizabeth hospital in Glasgow that actually does routine testing of individuals when they come in to find out what substances are at play. That information and that surveillance will help us but we need to make sure that we look to speak to those global leaders that are already dealing with this issue. Just shortly, I will be convening a round table with other international experts around that and the hope is that once that work progresses that that can be opened up to other parliamentarians to be part of so that as a whole parliament we can make sure that we are understanding just what the threat that is coming down the line and how quickly that could possibly take hold. In terms of crisis response and overdose mitigation, are we confident that the processes and interventions that we have at our disposal, whether that is in our oxone or other interventions, are applicable to the synthetic opioids coming in? Are we learning from our North American colleagues as to what efficacy, what interventions prove efficacious in those countries? Are we ready to adopt them fast because this is something that could happen very fast? Are you confident that we are in a good place on that? I think that our national oxone programme roll-out that has been on-going for over a decade is actually standing in good stead already in terms of that. We do know that naloxone does work on the synthetics. It might be that you need to have multiple doses but you certainly will have to phone the emergency services at the same time and continue to see whether that person needs another dose of naloxone. That is something that we are clearly seeing from international evidence that says that it will still work but you need to make sure that you have quantities to be able to react to that. When it comes to the drug checking, I think that we need that to roll out as low threshold as it can do but we will need to work through what pilots are going to look like, what they are going to tell us and how they evaluate and we have to operate within the misuse of drugs act at the same time. I am meeting in two weeks, a week and a half, with all four nations in terms of those ministers that are responsible for drug policy and I think that the synthetics are going to be one of the things that are foremost on our conversation because it is recognised across the whole of the UK that this is an incoming issue. As for other things that we know that could help, safer consumption facilities are one of those things where you will have professionals and supportive people on standby to make sure that they can respond to any crisis. Just this week, we have had the roll-out of safe supplies held of naloxone within community pharmacy and I think that we all recognise community pharmacies at the heart of our community and they are really well placed to deliver that life-saving treatment. Having that available everywhere is a real boon. You have made clear that you have been in discussion with the Crown Office and the Lord Advocate has stated that it would not be in the public interest to prosecute users of drug consumption rooms for simple possession offences and that she would be prepared to draft a prosecution policy along those lines. Have you engaged with the Lord Advocate on that point and what legal protections will be in place for staff at drug consumption facilities? What we do know is that Police Scotland has created an operation procedure that will dictate how they police any such facility. That is something that is for Police Scotland to communicate. When we think about the staff, it is absolutely your 100 per cent right to bring up how they would feel protected within such a facility. I guess that it is for Suzanne to reassure us to the advice that Glasgow has taken on that. As a minister, I am keen that I believe that the individuals that are going to be supporting some of our most vulnerable citizens are protected themselves, so I will handle the cases for that. Clearly that is of significant consideration and concern for ourselves and has been for some time just understanding the legal parameters that we would need to operate within. It is our understanding at this point, but we are refreshing that advice that we have the standard operating procedures in place and we have a clear training and support plan for our staff and we have systems through clinical and care governance that assure us that our staff are following those standard operating procedures. That is the protection for the staff that they operate within those expectations, which have to be clearly set out in formal standard operating procedures that are part of the induction and on-going training. That is the advice that we had at the stage that was under consideration by the Lord Advocate, but clearly before we would open any service for refreshing and reassuring ourselves, that advice remains current. That is an on-going matter that you have under active consideration. My next question is to the minister. It is estimated that there has been a cut of around £19 million to the funding of Scotland's drug and alcohol partnerships. Given the role that those partnerships play in trying to address the drug's death's public health emergency, clearly funding is quite an essential issue. I am not going to ask the minister to make an undertaking in terms of what will be in the budget, but what I am going to ask that she does is make a commitment that she will make the case in the strongest terms as to why those cuts need to be reversed and there needs to be further funding devoted to those partnerships. Is that something that she would feel able to commit to? I will always make robust representations when it comes to the portfolio and the individuals that my portfolio policy seeks to support right across the country. I think that what I need to refute at this point is that there is any notion of any reduction in the forthcoming budget historically? In the past budget as well. If we think about what happened last year in terms of funding going to the ADPs, the money that was made available to ADPs never changed. What we did ask ADPs to do, which is ffiscally prudent to ask any organisation to do when you are publicly funding it, is to make sure that any unspent reserves that they were carrying were used in the first instance and that they sought to draw down after that. There was provision made for any non-recurring spend that ADPs had perhaps earmarked against projects that they were doing and that they needed that funding for, but the full envelope of the money was there. If we think about the total drugs and alcohol budget, it steadily increased over the past few years. In 2021-22, it was £140.7 million. In 2022-23, it was £141.9 million. Again, for 2023-24, that is projected to be £155.5 million. I will always seek to make those representations in the most strongest of terms. What I could also seek to reassure the full committee is that we have baselined, as of next year coming, approximately two-thirds of ADP funding will be baselined. That means that that funding is there and that funding is committed and it is going to be recurring, which hopefully will allow ADPs to feel more comfortable in their long-term spending commitments and their planning, but I absolutely guarantee that I will make robust representations for the budget. Paul O'Keein It's easy to mix us up, but it's the glasses, I think. I went along to the community council consultation event on 28 September in the Calton. It's fair to say that it was fairly confrontational. What lessons have been learned from that exercise? Do you want to direct that to the system? I'm used to robust community consultation in terms of the services that we deliver in Glasgow City Health and Social Care partnership, and we're committed to that on-going honest conversation with the local communities and beyond. Since then, we've been talking to the community council about how we keep that discussion going. We've also spoken to, had a discussion with three of the local housing associations. We've met the local business developer, and we had previously met the local elected members from Glasgow City Council. We've got an engagement plan that takes us all the way through to the turn of the year in terms of that local engagement and taking us slightly beyond the immediate. In terms of what would be learned, those conversations are difficult conversations. I would expect them to be. They're honest conversations. It's my observation, because I did speak to the community council after the chair. It's my observation that once we had set out our stall that people did actually go away and think about what we had said to them. Again, part of that experience is that we'll repeat that and go back to them, because people do need a lot of time to absorb that information that we are steeped in it. Their anxieties are entirely understandable and reasonable, and we will need to spend quite a bit of time on that dialogue with them, and we're absolutely committed to it. However, robust consultation is something that we would expect not only in this area of work but across our work. Do you anticipate using examples from other countries or lived experience from other countries and our jurisdictions who have experienced the roll-out of those facilities in your communication plan with the local community? Yes, and I should have mentioned another critical element of the consultation engagement as our own. It's the people that we work with, lived and living experience, and that is going well. Also with families. We've got a number of family groups affected by addictions, as you would know, in Glasgow City. We've got really strong work and relationships with them. We've had some offers from them to be part of the consultation engagement, so that the story that's told is a Glasgow story, and that resonates. We've previously had contact, particularly with Bergen in Canada, who have some really powerful stories from lived and living experience, but our first port-of-call would be our own people, if that's the right way to put it. That's really helpful. One of the major concerns raised in the meeting was the role of the police. There was a lot of anger that the police hadn't been present. That's a fair point, because they haven't been present at all in this public discussion beyond platitudes. Is there appetite from Police Scotland to be more engaged in this, particularly around the concerns about dealing and how dealing will manifest itself within the local community as a result of this facility? That was one of the specific actions that we picked up from the Community Council meeting, so we have raised that with Police Scotland. We have a new divisional commander who is absolutely committed to the engagement plan that we've shared with him, and he has committed that Police Scotland colleagues will be involved in that. Sorry, I should have mentioned that. That's a lesson that's learned. You're absolutely right. That's very helpful. I also wanted to ask—I went to visit the H17 facility in Copenhagen on 12 October. One of the key points that was raised in the discussion with them was the strength of the co-location of services, but they also had some concerns about the direct co-location of the enhanced drug treatment service with the OPC. Do you potentially see that as a potential error for concern? It was one of the recommendations of the Taking Away the Chaos report back in 2015-16, which was the genesis for the work that we did in relation to both the enhanced drug treatment service and the start of our work on a safer drug consumption facility. Actually, the recommendation from that report was that they were co-located. We're cognisant of the fact that the co-location in particular assists the clinical leadership to make sure that we've got a really good support system for staff who are involved in providing those services. We're cognisant of the fact, for example, that there need to be very discreet services in terms of their access, because they're very different. It's self-referral. It needs to be really low-threshold access to the safer drug consumption facility. It's quite different. I'm doing that because they're going to have very different entrances and different ways to get in, so that's why I'm using my hands to explain that. We're cognisant of the fact that they have to be separate in terms of the understanding of people using them, but from our perspective, in relation to that clinical oversight, there are real overlaps. It was one of the recommendations that they were co-located. It's just about the ability to adjust in real-time during the pilot as well. One of the lessons from Copenhagen was 20 for coverage. There's two centres within about 200 metres of each other. They operate 23 hours a day. They close for an hour for cleaning. You're concerned that there might be an issue with the opening hours and there's an opportunity to potentially extend that quickly within the pilot if it's deemed obvious that that's a need. I think that it relates back to the question. I think that we've got an evaluation. What we're looking to do is to be agile but cognisant of the fact that we're working. We need to take the Lord Advocate's view and the framework that we're operating really seriously, so we need to make sure that we don't adapt to anything that actually cuts across that. The evaluation will be reported on an on-going basis and we will be able to make operational changes, again, as we did in the enhanced drug treatment service, but we need to be crystal clear that we continue to adhere to the expectations that the Lord Advocate has given us. I think that that clearly demonstrates to me why, as a UK as a whole, if we actually saw a move towards looking at how we could have an array of different types of safer consumption facilities available or indeed give us the ability with devolved powers to do that, then that would allow us to be more flexible and more agile in terms of responding at the same time and also having perhaps more third sector partners involved in providing and delivering those services. I think that, although we know that it's going to save lives when we do get this pilot up and running, that demonstrates again some of the constraints that we're operating under. I'm very grateful, convener. I apologise to you and colleagues for having to come to the committee late. I'm interested in match standards and I know there's been perhaps a touch on this and other questions, but the recent benchmarking report from Public Health Scotland I think found patchy progress, it's fair to say, and challenges that I think were identified around a bit of a postcode lottery of what's happening in different parts of the country. I wonder if, firstly, the minister might be able to speak to progress on the match standards and why she thinks that that kind of outcome is patchy at the moment. Yeah, I think that if we think back to the first year when the match standards were first discussed and remember that these came from the drugstaff's force himself, that concerted effort working with people with lived and living experience and partners to create what those 10 standards should look like, you were talking about an entire systems and culture change of services to try and deliver at pace on the ground and I think what makes it difficult from the beginning was the fact that ADPs are all set up in different ways, health and social care partnerships are set up in different ways, so we started from a really difficult and complex start and possession and whilst I will keep pushing for local areas to deliver on the match standards because we need them to because we know that it's going to save lives, I think that the fact that we managed to get to two thirds of the areas having delivered one to five last year was a big step change. I am really conscious of the fact that standards 6 to 10 or where we really start thinking about the advocacy work, the trauma informed work, the psychological support, the mental health support, how we actually start to embed the match standards within primary care and those are going to be really tricky and for me it's about actually still having those robust conversations with local areas, so some areas have moved into monthly reporting which is really important and others where we've seen progress have went back to quarterly reporting and where I think there's going to be specific tricky situations where we've seen areas where the drugs deaths perhaps did not start to decline or we're seeing that there's still issues that are perennially raising their head, that means that I need to have a sit-down conversation with the areas in a very supportive way as opposed to I'm telling you and what I think you should do way because that's not how we need to work. We need to actually make sure that we take areas with us and I think there has to be a recognition despite the progress not being as fast as I want it to be or any of us did. I think that people have pulled out all the stops across the country by and ours to try and really push expansion of it where we're going to find it tricky as well just because of the way that healthcare operates is in our justice sentence. Just last night I had a cross ministerial meeting with other ministers responsible for what healthcare should look like in the present sentence and of course knowing that 76% of people upon admission test positive for illicit substances and have significant substance use issues, MAT standards has to work in justice sentence so I'm going to continue to push on that so that the time we get to the end of 2025 all 10 are fully implemented and the time we get to the end of this Parliament they're sustained and it's business as usual and how we operate. I would recognise a lot of what the minister said in terms of the progress that we've made on one to five and I think the challenges that exist in six to ten. Is the sense that one to five was perhaps slightly more straightforward in terms of trying to work to change culture and change attitude and approach and that six to ten will be more challenging in terms of actual implementation and delivery and I noticed just at the end there you mentioned the timescale so you know are you committed to 2025 as a point where all 10 should be should be implemented? All 10 should be implemented and operational by then absolutely and by the end of the Parliament they must be sustained and we must find a way forward that that means that beyond this Parliament and this Government that it's business as usual for for mat standards and what people should should be expecting I think that the decision in the way that it was split off after the first year predated me but having a conversation with officials around about that it perhaps spoke to what was more easy to measure so that the first five of them were kind of measures that officials within government and officials within local areas thought that it would be perhaps easier to actually benchmark against and we can't underestimate the the work that the mat standards implementation support team that's based within public health are doing at the minute because they've created entire systems around about data capture that didn't exist beforehand and there's a massive amount of work in capturing experiential data which is more difficult to quantify and I think that's why if you look at the mat standards some areas are provisionally green and they're provisionally green because it's the experiential data which will be led by people with lived experience as peers that are actually capturing it and that's information that tells us this is what says the service says they're doing but actually how am I experiencing that service and I think setting up that data collection was quite tricky too and so I think we need to to recognise the sheer amount of work that that's been undertaken there as well. Thank you. We have an absolute hard stop at five past two so I'm going to go to Sue Weber for a very brief supplementary and a very brief response please minister. It may even be more directed towards Suzanne Miller because I was curious about the community engagement that you were talking about and the community councils and you're having to go back to them. What will change ultimately from any community consultation? Are you not going ahead with this irrespective and therefore is the engagement not a bit disingenuous? Thanks to the question absolutely not. The engagement with the local community and arranger stakeholders is critical to the success in our opinion of the safer drug consumption facility. We did engage with, there was engagement up to the point of the proposal previously but we weren't able to engage with anyone specific because we didn't have a specific location nor agreement from the Lord Advocate so the engagement plan is very detailed and an answer to Mr Sweeney's question that we are well aware of the level of anxiety and the questions that require to be answered by us. That's something we work through. It's something that we are very used to doing. We will take the local community with us. We know that we have to do that in order for us to be successful. So it's our intention to do that. It's not a one-off and we're very clear with that particular community council who are the local community council that we would be back in touch with them but it's on-going engagement. It wasn't a one-off consultation exercise, it's on-going engagement. The people that safer drug consumption facility of support are the citizens of Glasgow and they are the sons, daughters, brothers and aunts of the people that live in our city and that's what we will work with local community council on. I think if I may be able to stand it. I don't know if we will have tanks. Russell Finlay also wants a very brief supplemention as we have an absolute hard stop at five past two. It was just to say that the Lord Advocate won't proceed with a prosecution statement unless she's satisfied herself as well about. Mr Finlay. Thank you very much. I was just in response to the issue raised by Paul Sweeney about the criticism of Police Scotland around drugs consumption rooms. I was quite surprised because my understanding was that Police Scotland have engaged with the Government and have been quite supportive of the proposal, so I'd be quite keen to hear your view on that. I would just briefly say to that, I would ask yourselves as a cross-committee to reach out perhaps to Police Scotland and put questions to them as well, maybe take some evidence from them because I think that that will help you to form that bigger picture. Police Scotland has been very supportive in understanding the need for such a facility. The ACC, Richie, was really behind this from the beginning. I think that Police Scotland has come on a journey in terms of where they can play their role here. I think that it probably was an oversight that none of them were available at the community council meetings, but I don't think that either of us can speak for Police Scotland except to say that over the course of the last, since 2016, they have certainly supported the endeavors. I thank the minister, her officials and Ms Miller for their attendance today. We are now moving to private session and I'll pause briefly till our witnesses to leave.