(Glasgow Central)
(SNP)
I beg to move,
That leave be given to bring in a Bill to make provision
about supervised drug consumption facilities; to make it
lawful to take controlled substances within such facilities
in specified circumstances; and for connected purposes.
On Monday, one of my constituents mentioned to me that
Glasgow already has drug consumption facilities: they are
behind the bushes near his flat and in his close when it
rains. Right now, they are also in bin shelters, on filthy
waste ground, and in lonely back lanes. They are in public
toilets and in stolen spaces where intravenous drug users can
grasp the tiniest modicum of dignity and privacy for as long
as it takes to prepare and inject their fix. Often they are
alone, and, far too regularly, drug users will die as a
result. As a society, we can and must do much better than
that.
There is a real and persistent issue in Glasgow. In 2016,
2,593 opioid-related deaths were registered in England and
Wales. In that same year, 867 were registered in Scotland,
and of those, 257 were in the city of Glasgow. We have an
ageing population of people with long-term problem drug use.
They are increasingly vulnerable and require particular
interventions to reduce harm and encourage them to engage,
and remain engaged, in health services. The largest cohort of
drug users in Scotland are currently aged 35 to 44. This
ageing population—people who have survived since starting to
take drugs in the 1980s and 1990s—are in deteriorating
health. Due to their sustained opiate use, they are assessed
as having a physiological age 15 years greater than their
actual age. They have complex co-morbidities, with above
population-level instances of conditions including
COPD—chronic obstructive pulmonary disease—and asthma,
hepatitis C, liver disease, epilepsy, deep vein thrombosis
and pulmonary embolism, skin infections and cellulitis,
depression, and psychosis. This population are vulnerable to
overdose and to emergency hospital admission.
The Scottish Drugs Forum has carried out research interviews
with a large group of older people with a drug problem. This
group feel very strongly that they have been left behind—that
they are seen as a waste of space. This House needs to
recognise that abstinence-based programmes will not
necessarily work for everyone, and that harm reduction and
support will be better and more worthwhile interventions for
a group of people who have not managed to eliminate drug use
in the preceding decades. Evidence shows that long-term
engagement in treatment is a positive protective factor. The
people in Glasgow who would use this facility are not in
treatment. The facility would get them through the door and
would provide a range of other social and medical support to
help them to stabilise their lives.
The report, “Reducing Opioid-Related Deaths in the UK”,
published in December 2016 by the Advisory Council on the
Misuse of Drugs, recommends that
“consideration be given—by the governments of each UK country
and by local commissioners of drug treatment services—to the
potential to reduce”
drug-related deaths
“and other harms through the provision of
medically-supervised drug consumption clinics in localities
with a high concentration of injecting drug use.”
The report cites evidence demonstrating that such facilities
reduce injecting risk behaviours and overdose fatalities.
Furthermore, it says:
“They have been estimated to save more money than they cost,
due to the reductions in deaths and HIV infections that they
produce…Such facilities have not been found to increase
injecting, drug use or local crime rates. In addition to
preventing overdose deaths, they can provide other benefits,
such as reductions in blood-borne viruses, improved access to
primary care and more intensive forms of drug treatment. No
deaths from overdose have ever occurred in such facilities”.
Glasgow has a proposal—a well-worked-through business case
produced by Glasgow City Health and Social Care Partnership,
which is supported by the Scottish Government. Drugs law
remains reserved to Westminster, and Scottish Ministers have
requested permission from the Home Office to allow for the
proposal to go ahead. This has not yet been granted. This
proposal has the real potential to reduce drug-related
deaths, and ongoing harm. It is for an integrated service, as
also recommended by the ACMD—not just a “shooting gallery”,
as some have suggested. It will allow for engagement with a
population who at the moment are not being assisted very well
at all. There will be medically trained staff who can
supervise and administer life-saving naloxone should it be
required.
Some may say that this is an unnecessary expense. I say to
Ministers on the Front Bench that it will certainly cost them
nothing. For Glasgow, there is a significant cost in not
doing this. There is a cost in treating the latest HIV
outbreak and in treating hep C and other conditions. There is
a cost in emergency hospital admissions and ambulance
call-outs and in police time dealing with complaints. There
is a significant cost in cleaning up discarded needles, with
residents being charged by their factor for a problem not of
their making and the council picking up the tab for public
spaces. A housing association told me how it is regularly
paying to clear up areas of hundreds of discarded syringes. A
constituent tweeted me today to say that there are syringes
on her doorstep. There is an ongoing public health risk to
residents, who at any time could be pricked by a contaminated
needle, and of course, there is the intangible cost in human
lives. We should consider all those costs that we are
currently paying in a situation that helps no one.
Heroin-assisted treatment has been mentioned as an
alternative to a supervised drug consumption room, and I
would like to touch on some of the limitations of that. The
Glasgow proposal includes provision for heroin-assisted
treatment, but I would like to stress that while it can be a
treatment for those for whom many other interventions have
failed, it is not suitable for everyone.
There are also capacity and cost issues. Glasgow city centre
is thought to have a population in the region of 500
injecting drug users. The Glasgow city health and social care
partnership believes that it would only have capacity for 40
to 60 individuals for heroin-assisted treatment, and only
when the service was running to full capacity, which will not
happen for some time. I understand that the service also
requires two separate licences to operate: a premises
licence, which is in the gift of the Home Office, and a
prescriber’s licence, dependent on the premises licence, for
individual doctors directly linked to the site. It is not a
simple process, but it has been developed very much alongside
the proposal for a supervised drug consumption facility.
To operate a supervised drug consumption facility requires
the consent of the Home Office. Those operating, working in
and using the facility require protection in law, hence my
Bill seeks to exempt staff and those using drugs within the
facility from prosecution and remove liability for
prosecution from the operators of the facility—in this case,
the Glasgow city health and social care partnership.
The supporters of the Bill come from a range of parties:
Labour, the Liberal Democrats, Plaid Cymru and even the
Conservatives. A letter that I wrote to the Home Secretary
earlier this year, ahead of the debate led by my hon. Friend
the Member for Inverclyde (Ronnie Cowan), garnered similar
cross-party support from MPs right across Scotland. I am
particularly grateful to the hon. Member for Stirling
(Stephen Kerr), who said in giving his support that
“we should reach out to help those in the grip of drug abuse
and do what can be done to help them escape the vile grip of
the gangster pushers and dealers.”
This facility is very much a step in that direction.
In my 11 years as an elected member in Glasgow, the issue of
drug taking has been a constant. I have seen various police
initiatives shunt people around, from bin shelter to close to
waste ground. I have seen the council clear up the mess at
significant cost and significant risk to its workers. I have
seen residents at their wit’s end, worried about what they
will open the door to in the morning, with blood, excrement
and used syringes on their doorsteps daily. I have seen
vulnerable and desperate women and men injecting into their
groin in hidden but still public places; they have nowhere
else to go. I have listened to the heartbroken families who
have lost loved ones. If it was their choice, they would not
have their loved one die alone in a filthy back lane. They
would want a medically supervised facility where treatment
could be given and help could be sought.
The status quo serves none of these people well. I cannot
accept that this is the best we can do. It is unacceptable.
We must try something different. I accept that it may not
work, but we must at least try. Today is International Ask a
Question Day, and my question of the UK Government is this:
Glasgow has a plan that could reduce drug-related nuisance to
residents, reduce harm to drug users and save lives, so will
the UK Government let Glasgow get on with the job? I commend
the Bill to the House.
Question put and agreed to.
Ordered,
That , Mr , , , , , , , , Mr and Dr present the Bill.
accordingly presented
the Bill.
Bill read the First time; to be read a Second time on Friday
27 April, and to be printed (Bill 184).
