 Hello, I'm Peter Sharrushy, I'm the editor of the Drug Reporter website and I'm sitting here with Angela Constance, who is the Minister of Drug Policy at the Scottish Government. Scotland has one of the highest rates of drug overdoses in Europe. Yes, so it's well documented that Scotland has the highest rate of drug-related deaths in Europe. That's why just over two years ago the First Minister of Scotland declared a national mission. That's a national mission to save lives but also to improve lives by taking a Team Scotland whole government approach by supporting and really advocating harm reduction but also supporting people into recovery too. Can you explain us what are the roots of this overdose crisis? What is behind, what are the social factors behind it? So the social factors are wide varied complex. You will be familiar with the link between drug deaths and deprivation so in Scotland you are 15 times more likely to die of a drug overdose if you are from one of our poorest communities. We also know the co-occurrence between substance use and mental health conditions. We also know that in Scotland in terms of the people we lose that we still primarily have an opioid crisis. However, it's poly drug use and opioids combined either with cocaine, crack cocaine or in particular benzodiazepines and we also have a higher proportion of people who inject drugs. So drug taking in Scotland you will see some higher risk factors. What is the explanation of the difference between Scotland and the other parts of the UK? It's a really important question so what we know about Scotland is that problematic drug use is about double the rate. So in Scotland maybe 1.6% of the population have problematic drug use. In England it's 0.8%. We also have a higher prevalence of opioid deaths but crucially deaths where benzodiazepines are implicated. So by comparison the implication of benzodiazepines in the lives that we lose in Scotland since 2013 has increased by 450%, whereas in England it's about 50%. And the third reason is we don't have enough people in treatment and that's where we all have to take responsibility and that's why we are introducing what we call medication assisted treatment standards. So that's about quick access to treatment. It's about choice and forum choice. It's about outreach, reaching out and also about retaining people in treatment that is right for them at the right time but also making those wider connections with the social determinants of good health too. Media reported that most of the victims are from the so-called trans-potting generations. It's like older people, right? Is that correct? So I think we need to have a bit of care about that because in some regards it can be a bit of a lazy narrative so the so-called trans-potting generation was back in the 1980s, we are now in 2023. So the average age of someone who dies of a drug-related death is 44. Now 44 is not old, not old, you should be at the prime of your life and what we also know about the people we lose is that many of them will have had very long histories of drug use. We also know that the majority of people we lose in the six months prior to their death, they have had contact with a service, whether that's a health service, whether it's contact with the justice system or whether it's another public health service. So we really need to be as well as reforming laws which aren't all in our gift in Scotland but we really need to be investing and reforming services and that's exactly what we are doing in Scotland is investing and reforming in our services but also tackling stigma and discrimination. How much autonomy and discretion Scotland has in this issue? Like how much can you shape your own drug policy in Scotland and how much responsibility lies in Westminster? So there's a lot we can do and it's important that we focus on what we can do in terms of the here and now, in terms of turning this crisis around. I describe it as both a sprint and a marathon. First and foremost we need to keep people breathing, we need to be preventing overdose but we also need to be improving lives and that starts in the early years. So it really needs to be that cross-portfolio approach where we are thinking about the needs of people who are at risk of drug use and drug overdose in terms of housing, education, employment and good health and good primary care as well. So in terms of the things that are within the gift of the Scottish Government we have control of our education, our health and our justice system and we have partial powers over our economy and over our welfare. The powers that remain reserved to the UK Government would be things like international relations but also those bigger macroeconomic powers and the bigger welfare powers and also crucially for the work that we do the UK Government continue to have control over the misuse of drugs act which is the broad legal framework in which everybody in the UK has to operate. So that has some implications for harm reduction services I would like the misuse of drugs act reviewed, we'll continue to engage with the UK Government based on the evidence, we'll continue to seek to have that evidence based discussion and debate and meantime we will work as hard as we can as constructively as we can to do everything that we can within the powers we have. That was a grassroots initiative in Glasgow to open a mobile consumption room, do you think there will be legal consumption room sewn in Scotland? So I am absolutely committed to doing everything possible I can, I will leave no stone unturned within the powers I have because safer drug consumption facilities save lives there are over a hundred safe consumption rooms services across the world many of them are in Europe I have visited one in New York and having had the privilege of visiting a service I'm more determined than ever this is a very detailed and delicate area of work because the misuse of drugs act remains reserved to the UK Government they have repeatedly said to me that they are not convinced of the evidence of safe drug consumption facilities I of course in the Scottish Government dispute that we have produced our own papers our own evidence based on European and international evidence so I've got no doubts that safe drug consumption facilities save lives and they're also an opportunity that to prevent people first and foremost from dying but also to have that richer discussion about what we can do to support people to improve their health and to improve their life chances so in terms of where we are at Scotland now there is a proposition a proposal where our partners in Glasgow have worked closely with Police Scotland and that proposition has been sent to the Crown Office what we call the Crown Office and Procurator Fiscal Service and they will assess that and then they will pass that to an independent Lord Advocate now what our Lord Advocate can't do is that she can't overturn a UK Government Act of Parliament but what her consideration will be is in terms of prosecution policy what is and what isn't in the public interest and we still await an outcome from the Crown Office and the Lord Advocate what would you say how is your relationship to Westminster right now in drug policy issues do you have a dialogue so we have a dialogue so it's fair to say that we have a dialogue and I engage with the UK Government absolutely every opportunity it's also a matter of public record to say that we have different views on drug policy particularly in and around harm reduction I would like to see a you know proper network of drug checking facilities for example I would like to see the more extensive rollout of heroin assisted treatment we have a project in Glasgow these projects are subject to home office licensing I've discussed at length the need for safer drug consumption facilities particularly in our Scottish cities so we have a different view and fundamentally I would like to see the misuse of Drugs Act which is nearly as old as me reviewed because it is over 50 years old that legislation and as we know from this conference that we're all attending this week that the world has changed a lot in 50 years and there is now more than ever a need to be following the evidence about what works to save and improve lives what do you think about the discussions here at the UN Commission on Narcotic Drugs was there any lesson learned or anything any impressions you had here so yes so it's really important for Scotland to be listening and learning to the very best of international experience and we have much in common with other countries so some of the work that other countries are focused on in terms of tackling stigma in terms of tackling discrimination there is a huge focus at this conference on harm reduction and overdose prevention so it's important to Scotland that we learn from international evidence it's it's also true to say that different cultures have different legal systems you know different approaches you know perhaps sometimes different values and cultural expectations so while you can't always shift and lift a solution in one country to your own but you can really listen really learn and adapt the evidence to the circumstances in your own country and that's what I seek to do according to recent data there was a small reduction in the number of overdose cases right in Scotland so is that a sign of success of drug policies so today we have published suspected drug deaths now the caveat here is suspected drug deaths are not confirmed drug deaths but we publish this information more regularly it's not official statistics it's police scotland management information but sometimes it can be a barometer so yeah cautious cautious welcome that suspected drug deaths in scotland for 2022 have reduced by 16 percent however I have to say drug deaths in scotland will remain too high and one life lost to drugs is one too many thank you very much thank you thank you