The eyes of the world are on Dundee as it sets out its plan to tackle drug deaths following a damning report earlier this year.
A 10-step action plan was unveiled by the city’s alcohol and drugs partnership (ADP) to improve the fortunes of those who access addiction services.
Among the changes to practices are a 72-hour emergency response to non-fatal overdoses to protect those at risk, and the “potential” for same-day prescribing of opiate substitute therapies (OST) like methadone.
Simon Little, the partnership chairman, detailed the proposals at a special meeting of the Dundee Partnership convened to respond to the findings of the city’s drug commission.
The commission’s August report fiercely criticised the ADP, its integrated substance misuse service (ISMS) at Constitution House and the “distant” links between drug and mental health services.
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In response, the ADP has committed to being the first in line to try “fresh approaches” to joining up addiction and mental health services, and to be an early adopter of a new Scottish Government plan to cut alcohol and drug use.
Mr Little said: “There are significant improvements that can be done quickly but more fundamental changes take time.
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“The recommendations have been accepted – the work has started. There is a lot to do.
“Some of it will take time, but time should not be elastic. Implementing a system of care must not be on the backburner.”
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The Scottish Recovery Consortium said that, despite the uphill battle, it was a “watershed moment” in the fight against substance misuse.
Jardine Simpson, CEO, said: “The eyes of Scotland, the UK and the world are watching”.
He added: “The conditions for the radical change that is needed are all present in Dundee.
“Dundee’s issues are not unique, in Scotland, the UK or the rest of the world.
“But if we get this right in Dundee it’s not just the experiences of treatment that will improve.
“The more people that we save from harm and get into recovery, the more everybody will benefit from that.”
Ways of making drug support more widely available are also being explored.
The ADP has recruited three extra prescribers and is carrying out more of its services beyond Constitution House.
It will also welcome councillors and people who have lived through drug addiction – both to bolster its ailing membership and to give it a grounding in the issues it is seeking to tackle.
Sharon Brand, co-founder of community group Recovery Dundee and a past critic of the ISMS, said: “(The change from) where the ADP was to now is amazing. I have faith in Simon Little.”
Grant Archibald, chief executive of NHS Tayside, said he was “genuinely optimistic” about the prospect of improving services.
Whether the drug commission’s recommendations have been acted on down the line will be relayed through the experiences of those who seek help.
Pat Tyrie, who has cared for someone with drug issues, told the forum: “The evidence will be when people with an addiction can go to a service and come out with hope.
“If someone goes to a service and says, ‘I have hope now,’ that would be what I would like to see.”
Council leader urges rethink on policy
The leader of Dundee City Council has suggested that the laws around drugs should be changed to help save lives in the future.
Councillor John Alexander, who chairs the Dundee Partnership, said national governments should pay attention to the calls made by the commission to open up drug laws to new approaches.
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In its August report the commission said it had been “highly impressed” by the approach taken by Portugal. The country decriminalised drug possession in 2001.
Mr Alexander said: “Dundee’s journey can influence the national situation and that is why we are asking the Scottish and UK governments to consider changes proposed by the commission.”
His comments came as a parliamentary group called for the UK to decriminalise drugs and take a Portugal-style approach.
Sarah Wollaston MP, chair of the Commons health and social care committee said the move could save “thousands” of lives.
However, the UK government has already said there are “no plans to decriminalise drug possession”.
Work of commission not finished, says Peat
The inquiry created to address Dundee’s drug death epidemic is “still needed” even now that it has published its landmark report, according to its chairman.
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Dr Robert Peat, former social work boss at Angus Council and chair of the Dundee Drugs Commission, says it is likely the group will meet for at least the next year to review how progress is being made on its 18 recommendations.
The commission was created by the Dundee Partnership – the joint forum where bodies such as Dundee City Council, NHS Tayside, Police Scotland and the city’s universities come together to find solutions to local problems.
However, the commission has been independent of the council and other bodies since its creation – and its tough-but-fair conclusions have led to it being hailed as a “critical friend” by those with experience of drugs.
Its final report – calling for drug issues to be tackled with “kindness, compassion and hope” was published in August.
However, Dr Peat says the work of the commission isn’t finished – and won’t be finished for quite some time.
Dr Peat said: “We still need to be here. We heard really positive statements today but we have heard this in the past.
“I’m not questioning the commitment (of the Dundee Partnership) – we want to be there as a resource and to actually bring them back to the recommendations.
“Our message to the partnership is that your collective leadership must show the determination to stick with what will be a difficult task in the months and years ahead.
“I anticipate initially doing this for a year, maybe reconvening for the next year and maybe a year on reconvening to see what has been met.
“Commissioners are coming from across the country to help with this so the partnership should take us up on this offer.”