National Drugs Mission Plan: 2022-2026

4. Our cross-cutting priorities

We have identified six priorities which cut across all our work.

Cross-Cutting Priorities

• Lived Experience at the Heart
• Equalities and Human Rights
• Tackle Stigma
• Surveillance and Data Informed
• Resilient and Skilled Workforce
• Psychologically Informed

4.1 Lived and Living Experience at the Heart

Everyone has the right to participate in public life. This includes the right to meaningful participation in the design, implementation, and assessment of drug laws, policies, and practices, particularly by those directly affected. In 'Rights, Respect, Recovery' the Government committed to 'make the voices of lived and living experience central to develop, design and delivery of treatment and recovery services and interventions.'

We want to see lived and living experience at the heart of the conversation about tackling this problem – at local, national and international level. We have established a National Collaborative as a mechanism to empower people affected by problem substance use to have active and informed participation in policy and decision-making at a national level. This will build on existing approaches that have been central to the National Mission so far, for example the involvement of people with experience of problem drug use in the development and ongoing monitoring of the Medication Assisted Treatment (MAT) Standards. The Collaborative will also seek to support Alcohol and Drug Partnerships (ADP) to develop a more meaningful way to involve people affected by substance use in local decision-making and commissioning processes.

4.2 Equalities and Human Rights

People with problem drug and alcohol use and the people who support them (including family members, friends and support workers) have the same human rights as everyone else however, they can face cultural, social and economic barriers to fulfilling these rights.

Professor Alan Miller – as chair of the National Collaborative – will bring forward a vision for the integration of human rights in drug policy. This will draw on international guidance to ensure on developing a human rights-based approach to policy development.^[7]

The proposed Human Rights Bill will bring into Scots law the internationally-recognised human right to health and other relevant rights which can help address the social determinants of problem substance use such as the right to an adequate standard of living, including adequate housing and food. The National Collaborative will set out how these rights can be effectively implemented to improve the lives of people affected by problem substance use.

Everyone has the right to equality and freedom from discrimination. Despite this, people may experience disproportionate harm, inequities, and intersecting forms of discrimination on grounds of race, ethnicity, nationality, migration status, disability, sex, sexual orientation, economic status, and the nature and location of livelihood.

There is a cultural dimension to drug use and clear specific challenges and barriers faced by different equalities groups. It is important that equalities are considered in service design and delivery, data collection, and assessing outcomes.

We are establishing a new National Collaborative to ensure that the voices and rights of those with lived and living experience are at the centre of both policy and practice. The National Collaborative will promote and support the participation of those with lived and living experience, and their families, in the design, delivery and regulation of drug and alcohol services.

4.3 Tackling Stigma

We know that stigma can stop people accessing the support they need. And that stigma can manifest in many ways and in many settings. That is why Scottish Government recently facilitated a campaign to challenge the stigma which too often negatively impacts upon those who use drugs. We will also seek to roll out a stigma charter which encourages organisations to consider how we can work together and individually to create a stigma-free Scotland. Where services have a charter people accessing these services, and their families, should be assured that they will not be stigmatised because of their circumstances or their health condition.

4.4 Surveillance and data informed

We are committed to taking an evidence-based approach, evaluating, learning as we go and continuously improving. This requires accurate, relevant and timely data – both in terms of quantitative statistics and qualitative research. Public Health Scotland (PHS) will continue to develop their public health surveillance system to ensure we have a robust early warning system for drugs and develop their reporting and data linkage to gain a richer and more holistic understanding of the context for problem drug use. We expect to see evaluation built-in to any new initiatives we are funding and good data collection is at the heart of this work.

4.5 Resilient and skilled workforce

A wide range of professions are involved in supporting people who use drugs and they are fundamental to the success of the National Mission. From front line treatment services – in both the NHS and third sector, to the broader health services, social care and the wider public sector it is vital that these services attract, retain and support their staff to have the right skills and knowledge to support people with drug problems.

Workforce planning will play a crucial role in delivery of the commitments and ambitions of the National Mission. A recent programme of research found significant challenges relating to recruitment; retention; and service design. Workforce planning will play crucial role in delivery of the commitments and ambitions of the National Mission.

The Scottish Government is currently working with experts across the sector to identify how this evidence will inform future policy development. An expert group is currently being established to develop effective and appropriate policy responses to tackle workforce shortages, strengthen service planning and support new ways of working. All workforce planning efforts will align with the National Workforce Strategy for Health and Social Care in Scotland.

4.6 Psychologically Informed

People struggling with drug problems have often experienced trauma and have co-occurring mental health challenges (often termed co-morbidity or dual diagnosis). Therefore psychosocial support is a fundamental part of a recovery orientated system of care. This type of support is a leading component in the treatment offered to people who have problematic use of substances for which there is not yet a medicinal intervention, such as MAT.

The Lead Psychologists in Addiction Services Scotland (LPASS) Report and the Orange Guidelines indicate that to be fully effective, substance use services need to be psychologically informed in everything they do.

MAT Standard 6 is focused on building a system that is psychologically informed which ensures psychosocial interventions are routinely delivered alongside this. This Standard is being implemented in communities across Scotland and will also apply to those people in custody such as in prisons.