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Scottish Drug Death Taskforce submission of 17 January 2022

PE1900/C - Access to prescribed medication for detainees in police custody

Thank you for providing the Drug Deaths Taskforce with the opportunity to respond to the Citizen Participation and Public Petitions Committee of the Scottish Parliament regarding PE1900: Access to prescribed medication for detainees in police custody: The petition calls on the Scottish Parliament to urge the Scottish Government to ensure that all detainees in police custody can access their prescribed medication, including methadone, in line with existing relevant operational procedures and guidance.

I am writing to you in the capacity of my recent appointment as Chair of the Drug Deaths Taskforce. I can confirm that the position of the Drug Deaths Taskforce is that all relevant individuals, including detainees in police custody, should have access to prescribed medication. This includes the consideration of opiate substitution therapy such as methadone. This should be in line with existing operational procedures and the Drug Deaths Taskforce notes that the relevant Guidance for Police Scotland and Health Care Professionals has been sent to the Committee in an earlier submission from the Scottish Government on this matter, outlining that; “As long as it is safe and appropriate to do so, people in custody should have prescribed medication continued, this includes opiate substitution therapy such as methadone.” The Committee will also note that that Appendix F provides an algorithm for determining how to proceed when someone enters police custody and is on a methadone prescription.

Police Standard Operating Procedure 18.4.3 also makes provision for providing access to methadone in custody and states that only NHS healthcare staff can administer methadone, although note that under 18.4.1, police can administer other medications. It may be helpful to learn more about the availability of healthcare staff to administer methadone in police custody as there may be some areas where healthcare staff have a significant geographical area to cover which could impact on availability to administer methadone, resulting in some people going through withdrawal in custody.

The implementation of Medication Assisted Standards (MAT) in Scotland will enable consistent delivery of safe, accessible, high-quality drug treatment across Scotland. A Sub Group of the Drug Deaths Taskforce led the work to develop these evidence-based standards. This diverse group included those who will deliver care and those who will benefit from that care. The intense period of consultation was strengthened by the active contributions of individuals and families with experience of problematic drug use. These standards make clear that an individual should “have the option to start MAT from the same day of presentation”, “are proactively identified and offered support to commence or continue MAT” and “will receive support to remain in treatment for as long as requested”. These standards continue to apply in Police custody and therefore support of the MAT standards would equate to support for “all detainees in police custody accessing their prescribed medication, including methadone”.

In addition, the Drug Deaths Taskforce notes that the Minister for Drugs Policy has made a commitment in the Scottish Parliament to embed these evidence-based MAT Standards by April 2022 and active participation from people with experience of problematic drug use will be central to this phase. Demonstrable commitment from senior leaders in NHS boards, Local Authorities and Health and Social Care Partnerships will also be critical and we welcome Scottish Government leadership in this respect. Effective implementation of the MAT Standards will help to reduce drug related harm, including premature death, but this needs to be supported by sustained funding, workforce development, system change and culture change. A key way to measure success will be the experiences of people and families that use services.

The Committee should also note that the Community Justice Annual Report on Community Justice Outcomes was published for consultation on 20 December 2021 and is based on returns submitted by the local authority areas to Community Justice Scotland. On Page 48 it outlines that the covid pandemic impacted the number of services and the type of service delivery models available to individuals. Face to face restrictions meant that in many areas, drop-in services had to be closed and group work (e.g. smart recovery) had to be stood down. Initiatives which aim to improve referral and early access to treatment and support for those who come into contact with the justice system were also stood down in many areas. Of the areas who provided data regarding delivery of Alcohol Brief Interventions, there seemed to be a general decline in the number of interventions delivered. A number of areas did some anticipatory planning for the MAT Standards for Scotland. Those who reference the new standard indicate that review and planning is already under way to ensure they meet and achieve compliance with the new standards. It should be noted that some rural areas have already highlighted concerns regarding their ability to meet same day treatment (standard one). Other areas highlight ongoing work to implement a Rapid Access to Drug and Alcohol Recovery (RADAR) service which aligns to the new MAT Standards for same day interventions and prescribing opportunities for those experiencing alcohol and drug issues.

If the committee would like any further information from the Drug Deaths Taskforce please get in touch.