Dundee drug treatment system ‘fractured’ and better leadership needed

Dundee’s system of drug treatment and support is “fractured” and “not fit for purpose”, a report has found.

The Dundee Drugs Commission research, released today, calls for the city’s leaders to show “strong and dedicated leadership over many years” to implement its recommendations.

“This will require an honest and transparent acknowledgment of the failings that have taken place in the delivery of drug treatment services (in a ‘no-blame’ environment), and the willingness and determination to learn and exploit the lessons that are evident from these failings,” the report said.

The commission’s chair, Robert Peat, said it began investigating drug use in Dundee in May 2018 and spoke to more than 1,000 people “either directly or indirectly affected” affect by drug use.

The report makes 16 recommendations for the Dundee partnership to address. If adopted, Peat said the changes could “turn around” the situation and lead to a reduction in drug-related deaths in Dundee.

He said Dundee’s leaders must “show the determination to stick with what will be a difficult task over the coming months and years ahead”.

“We found a system of treatment and support which we describe as fractured,” he said.

“All of the services in Dundee must work with a concerted effort to implement the necessary changes. The problems of the past must be left behind, and a culture of openness, honesty, respect and trust must be central to the partnership as it takes forward this work.”

The primary recommendations were for the Dundee Partnership to “do all that is necessary to achieve the required standard of leadership”, and to “challenge and eliminate the stigma” towards drugs users and their families across Dundee.

The recommendations spanned from a need for “cultural change across drug treatment services, related disciplines and communities of Dundee”, to implementing a holistic model of care via joint partnership between primary care and third sector and addressing causes and effects of drug use.

The report noted “national considerations” that it would take to the Scottish Government, including considering an equal regulation of the whole “substance use services/treatment sector” and petitioning the UK Government for increased devolved powers to allow for a full Scottish review of drug laws.

“In the short-term the commission would ask the Scottish Government to consider how they can make the most of the powers that they already have (including policy) – such as police and enforcement practice,” the report said.

“The time is now right to hand back the evidence and findings of our work to our elected leaders and ask them to set the standard for the leadership and accountability that is going to be required in Dundee (and beyond) to turn around the national emergency that is epitomised by the severe rates of drug-related deaths across Scotland.”

Scottish Health Secretary Jeane Freeman thanked to commission for its work “which is not only important for Dundee, but also has relevance across Scotland”.

She said the Scottish Government would consider the recommendations “carefully, and work with partners to implement them”.

“Each and every death from drugs is a tragedy and we are extremely concerned by the continued rise. We know there is no simple answer to this challenge and know that more needs to be done to meet the needs of those who are most at risk from substance use,” she said.

“This is a public health issue and our national alcohol and drug strategy ‘Rights, Respect and Recovery’ sets out a number of measures focused on people’s needs and their families.”

Freeman said the government's Drug Death Taskforce would focus on the findings in the Dundee report, and a “key aspect of its work will be to look at ways in which treatment services can adapt to better meet the needs of those most at risk”.

Scottish Tories shadow health secretary Miles Briggs said the findings pointed towards the need for “cross-sector working” to support drug users and their families.

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He said a “Cinderella” approach to drug and addiction services in Scotland was “something SNP ministers have been consistently challenged on”.

“I have spent the summer listening to those at the front line of drug and addiction services in order to develop the new cross-portfolio approach that is needed to turn this national public health emergency around,” Briggs said.

“It’s now time the SNP did the same, and they need to take action on the recommendations contained within this report.”

Scottish Labour urged for more funding for alcohol and drug partnerships and for the “full force of government” to be focused on the crisis.

“The health secretary and public services must take on board the findings of this report and act urgently to make improvements,” said Scottish Labour health spokesperson Monica Lennon said.