National Mission on Drugs: annual report 2021 to 2022

1. Introduction

1.1 Overview

On 20th January 2021, the First Minister made a statement to parliament which set out a National Mission to reduce drug deaths through improvements to treatment, recovery and other support services.

This annual report sets out the progress made from then to March 2022 by national government, local government, and partners in Health and Social Care and the third sector against the National Mission Plan. A separate report will be published which focuses on the progress and work of Alcohol and Drug Partnerships (ADPs).

The National Mission annual report is organised into chapters that relate to the six outcomes in the National Mission Plan; six cross cutting priorities; finance; reporting and monitoring.

Outcomes and cross cutting priorities chapters have the following format:

• An overview provides context, including data, to understand the scope and purpose of the outcome.
• Progress in 2021-22 sets out our activities related to the outcome throughout the reporting period - the projects being delivered across sectors, locally and nationally have been highlighted, including dedicated funding and case studies. High level plans for the period 2022-23 are also set out.
• Measuring Progress presents some of the latest data and potential indicators in relation to each Outcome. Where limited data currently exists to directly measure progress we present some of the relevant context and, where possible, potential indicators.

The finance chapter provides summary statements, by theme and area for the reporting period, and Government's commitment against forecasts.

Reporting and monitoring describes governance and reporting arrangements - how groups and boards work together, and how we are ensuring accountability of the National Mission.

National Statistics from National Records of Scotland (NRS) on drug deaths are the primary measure by which the success of the National Mission will be judged.^[a] In 2021, there were 1,330 drug misuse deaths registered in Scotland.^[1] This was a decrease of 1% (9 deaths) compared with 2020. It is the second highest drug misuse death figure on record. Drug misuse deaths have increased substantially over the past few decades – there were more than five times as many deaths in 2021 compared with 1996. 2021 is the first year since 2013 that drug misuse deaths have not increased (Figure 1).

Source: National Records of Scotland, Drug-related deaths in Scotland in 2021, National Records of Scotland, 2022 (National Statistics)

While drug deaths will be a key headline metric to monitor the success of the National Mission, a broad range of measures under each Outcome will provide a more detailed understanding of progress. In this report we present some of the latest data and potential indicators for each Outcome, summarising what the available data and evidence tells us about the direction of travel and providing an indication of how progress may be measured.

1.2 National Mission Partners

The National Mission is a collective endeavour. We work with key partners across public policy and beyond. Our key stakeholders and partners are detailed below.

Integration Joint Boards (IJBs) are responsible for the strategic planning of delegated functions, and for ensuring delivery of those functions through the locally agreed operational arrangements.

Integration Authorities (IAs) also known as HSCPs, are responsible for planning, designing and commissioning services and bring together HBs, LAs and others to ensure the delivery of efficient, integrated services.

Health Boards (HBs) are responsible for delegating functions and budgets to the IAs.

National Health Boards are specialised and include; Public Health Scotland, Health Improvement Scotland, Scottish Ambulance Service.

Local Authorities (LAs) are responsible for delegating functions and budgets to the IAs.

Alcohol and Drug Partnerships (ADPs) are multi-disciplinary groups tasked with tackling alcohol and drug issues through working in partnership with statutory and third sector organisations.

Core funded organisations (CFOs) provide vital expertise and services to support those with substance use problems and their families. This includes peer-led delivery of services and maintaining recovery communities.

• Crew (Scotland) is a nationwide public health charity that aims to reduce the harm and stigma associated with psychostimulant drug use.
• With You^[b] is a charity that provides free confidential support to people who are experiencing issues with drugs, alcohol or mental health.
• Scottish Families Affected by Alcohol and Drugs support families across Scotland who are affected by substance misuse, and raise awareness of the issues affecting them.
• Scottish Drugs Forum is a drugs policy and information agency, working to reduce drugs harm in Scotland and provide a wide range of training and support to people who use substances and to people working in the sector.
• Scottish Recovery Consortium is a recovery-oriented charity that builds and promotes recovery from addictions in Scotland.

Other Third sector organisations are also supported via grant funding and make an invaluable contribution to delivery.

Corra Foundation deliver funding programmes for grass roots and third sector organisations for the National Mission on behalf of the Scottish Government.

Police Scotland support reducing the supply of drugs and provide frontline emergency services.

Crown Office and Procurator Fiscal Service (COPFS) are Scotland's public prosecution service and death investigation authority.

1.3 Key commitments

Jan-21

First Minister announces the launch of the National Mission, supported by an additional £50 million funding per year for the life of the Parliament. £100 million to improve access to residential rehabilitation and aftercare. Emergency funding of £5 million was made available.

Feb-21

Digital connectivity initiative to help people at risk from drug-related harm stay connected to life-saving services during the pandemic and beyond, supported by funding of up to £2.75 million over two years.

May-21

Evidence based Medication Assisted Treatment (MAT) standards are published to enable the consistent delivery of safe, accessible, high-quality drug treatment.

May-21

Drugs Mission Funds, administered via Corra Foundation opened for round 1 of applications. These funds are to support third sector and grass roots organisations with a £65 million boost.

Aug-21

A nationwide Naloxone awareness campaign with Scottish Drugs Forum launched to help save someone's life in the event of an opioid overdose.

Sep-21

The Scottish Government commits more than £8 million over this parliamentary term to support the establishment of Harper House, a National Specialist Family Service run by Phoenix Futures, which will be the first of its kind in Scotland.

Nov-21

The publication of research pathways into, through and out of residential rehabilitation in Scotland.

Dec-21

A national campaign highlighting the damage caused by the stigma of problem drug and alcohol use is launched, supported by a webpage on NHS Inform with further information on how the public can help tackle the problem.

Jan-22

A National Collaborative is formed, ensuring the voices of people with lived and living experience are at the centre of policy and decision-making.

Mar-22

A national target was introduced to ensure more people with problematic opiate drug use are accessing life-saving community treatments. By 2024 there will be at least 32,000 people in community based OST treatment, an increase of 9%. An announcement that £5.5 million has been committed over this parliamentary term to support the establishment of two houses at Aberlour specifically designed to support women and their children through recovery. The first house is due to open in December in Dundee, with the second opening in 2023.

1.4 Outcomes Framework

The first year of the National Mission focussed on laying the foundations. This work included working with stakeholders to map out the aims and objectives of the National Mission. This work culminated in the publication of an Outcomes Framework as the foundation for a plan in the summer of 2022.^[2]

The National Mission outcomes framework (Annex A) articulates our aim to reduce drug deaths and improve the lives of those impacted by drugs and the underpinning outcomes and cross-cutting priorities we believe are necessary to achieve this aim. These are set out below:

Figure 2: National Mission outcomes framework

Reduce Deaths and Improve Lives

• Fewer people develop problem drug use
• Risk is reduced for people who take harmful drugs
• People at most risk have access to treatment and recovery
• People receive high quality treatment and recovery services
• Quality of life is improved for people who experience multiple disadvantage
• Children, families and communities affected by substance use are supported

Cross-Cutting Priorities

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

The framework is presented in more detail in Annex A.