Scottish Government should consider using proceeds of crime to set up supervised injecting facilities, says drug expert

The next Scottish government should consider using proceeds of crime cash to fund supervised injecting facilities in a bid to reduce drug-related deaths, according to a leading drug expert.

Kirsten Horsburgh, who is responsible for the coordination of Scotland’s national naloxone programme, said there is a “clear need” for such facilities “wherever there are significant numbers of people injecting in public”.

The national naloxone coordinator at Scottish Drugs Forum urged an incoming administration to provide funding for a pilot site with a view to potentially setting up multiple facilities across the country.

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“The potential for utilisation of the confiscated proceeds of crime funds, as in Australia, should be explored,” said her report, which followed a visit to Australia’s first and only facility of its kind.

Drug-related deaths north of the border have reached their highest number on record, rising to 613 in 2014, according to figures published by the National Records of Scotland.

The national forum on drug-related deaths, which Horsburgh sits on, has long called for the introduction of drug consumption rooms, though ministers have repeatedly distanced themselves from the proposal.

Such facilities in other countries allow individuals injecting heroin and other drugs to do so under supervision in an environment designed to cut the public health risk.

Horsburgh spent two weeks in the Medically Supervised Injecting Centre (MSIC) in the King’s Cross area of Sydney. The centre supervised more than 930,000 injections and managed almost 6,000 overdoses without a single death between its opening in 2001 and May last year.

Almost 11,700 referrals to other services were made during the same period while ambulance call-outs for overdoses in the immediate surroundings of the centre dropped 90 per cent.           

“To visit the facility is to realise how much Scottish cities could learn and how much we could do,” said Horsburgh, who was also part of the World Health Organisation guidelines development group for the Community Management of Opioid Overdose.

“They are supported by initially sceptical business and other stakeholders and staffed by dedicated and skilled individuals. They not only save lives but encourage people to trust and engage with services to address issues in their lives.”

Horsburgh called for changes to the Misuse of Drugs Act, which is reserved to Westminster, and for the Scottish Government to request guidance from Scotland’s top prosecutor “to allow the legal operation” of supervised injecting facilities where public injecting is found to be prevalent.

Such sites should go beyond a simple injecting room and include the likes of inhalation facilities, she added, while consideration should also be given to the availability of heroin-assisted treatment on site.

The report also called for take-home naloxone kits - which help reverse the effects of an overdose - to be available free of charge and “promoted widely, to those most likely to witness an overdose”.

Kits should be distributed via third sector organisations and peers, added Horsburgh​, after regulations extending availability came into force across the UK last October. 

The report comes three months after a team from Turning Point Scotland visited Dublin to learn more about plans to allow medically supervised injecting centres in the city.

A Scottish Government spokeswoman said at the time: “The Scottish Government has no plans to introduce drug consumption rooms. Aside from the ethical issues raised by such proposals, there are clear legal issues that cannot be resolved easily.

“However, as with all aspects of drugs policy, we continue to stay informed of international developments on the effectiveness and impact of approaches to tackling drug use.”