13. Short Debate: Fit for the 21st Century: How can Wales give better support to help people overcome substance addiction

– in the Senedd at 5:41 pm on 6 October 2021.

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Photo of Elin Jones Elin Jones Plaid Cymru 5:41, 6 October 2021

(Translated)

We will now move on to the short debate, in the name of Peredur Owen Griffiths. We will begin the short debate in a moment as Members leave the Chamber. The short debate—Peredur Owen Griffiths.

Photo of Peredur Owen Griffiths Peredur Owen Griffiths Plaid Cymru

(Translated)

Thank you, Llywydd. Luke Fletcher and Jenny Rathbone have asked for a minute of my time, and I've agreed to that. Thank you very much.

Photo of Peredur Owen Griffiths Peredur Owen Griffiths Plaid Cymru

It's been more than 40 years since the United States declared their war on drugs. Since then, various administrations across the world have copied this superpower and pursued a policy that has taken a tough approach to tackling drugs, but with little evidence that it tackles addiction, or tackles the hold that criminal gangs have on areas in which they operate. The fact that this so-called war is still being waged, with no end in sight, is somewhat telling. The UK, under various Governments over the years, has, predictably, followed the footsteps of its transatlantic ally with predictable results. Drug deaths remain stubbornly high in large parts of the UK. We have to remember that behind each death, there is a human cost that reverberates with friends and family of the deceased for years that follow. As with all statistics, we should never lose sight of the human cost to society and to our communities, nor should we forget about the havoc this policy is having on countries where production of drugs is fought over on a daily basis between rival cartels. Mexico is a prime example of a country that has been destabilised as a result of this drugs policy.

What am I here to do tonight is to advocate for a national conversation that looks to establish a better, more compassionate and experienced-led system of treating addicts. We need to understand the lived experience of all parties concerned, and give due consideration to all possible solutions. Whichever party you represent in the Senedd, or whatever your views are on substance abuse or addiction, I hope we can agree that the status quo is not working. If you remain unconvinced, perhaps ask yourself why the war on drugs did not end generations ago if it was working. 

To return to the statistics, the picture in Wales is not as bad as in parts of England, according to the latest statistics of 2020. According to the Office for National Statistics, Wales recorded its lowest rate of drug misuse deaths since 2014. The rate of 51.1 deaths per million was also lower than England's rate of 52.1 deaths per million. The ONS issued an important caveat on release of these figures, which was that the death registration delays in Wales may have had an impact on this figure. However, it was only a decade ago that Wales had a national rate of drug misuse deaths that was higher than any region in England. So, whilst drug deaths may be down in Wales after a horrific peak, they are still too high. Could a different approach, perhaps, produce better results? Could an alternative approach reduce deaths, reduce drugs consumption and reduce the damaging influence that drug gangs have on our communities in Wales?

One of the most startling international examples of good practice can be found in Portugal. They used to have a very serious drug problem. In the two decades since they decriminalised drugs, they have significantly reduced deaths and the harm associated with drugs. This conscious decision to develop a health-led approach has resulted in those caught possessing drugs for personal use being dealt with administratively, rather than with a jail term. This means it does not result in a criminal record. Drugs are still confiscated, and possession can end up with a fine or community service. How beneficial could such an approach be here in Wales, where we have some of the highest rates of incarceration in western Europe?

And how effective has the policy been in Portugal? As the Transform website pointed out in a recent article in May this year, and I quote,

'In 2001, Portuguese drug death rates were very similar to the EU average. While rates fell in Portugal following reform, they increased across the rest of Europe in the same timeframe. From 2011 onwards both Portugal and the rest of the EU have trended similarly, rising until 2015/6—however, the gap between the two remains considerably wider than it was pre-reform. In real terms, drug death rates in Portugal remain some of the lowest in the EU: 6 deaths per million among people aged 15-64, compared to the EU average of 23.7 per million (2019). They are practically incomparable to the 315 deaths per million aged 15-64 experienced in Scotland, which is over 50 times higher than the Portuguese rates.'

The end of the quote. It is no wonder that other countries and regions across the world are starting to take notice of the lessons that can be learned from Portugal.

I don't want this short debate to just be about illegal drugs, when alcohol causes so much misery in communities and families throughout Wales. It would be remiss of me not to mention alcohol when stats have previously suggested that around 10 people die every week in Wales from alcohol-related causes. It is also estimated that alcohol leads to around 60,000 hospital admissions in Wales, costing the NHS around £159 million annually. With the NHS creaking under the pressure, surely finding ways to deal with the adverse effects of alcohol misuse should be a priority. I want us to get to a position where people who take the brave step of asking for help to overcome addictions, whether that's for drugs or for alcohol, know that help will be forthcoming and comprehensive when they need it.

I don't pretend to have all the answers—I don't think anybody has all the answers—but I would like to start a discussion here today on how we could tackle substance abuse more effectively and ensure addicts get the support they need to get their lives back on track. I want the various agencies charged with assisting substance abusers to come together on a regular basis and speak about their problems and observations with Members of the Senedd. This is why I'm taking steps to start a cross-party group on substance misuse so that we can develop best practice. I have the support already of key agencies like Kaleidoscope, but I hope many other organisations and figures will come on board. I also have the support of more than two Members of the Senedd from different parties to form the cross-party group; I hope many more of you will join.

It is my preference, and that of my party's, that Wales eventually sees devolution of justice powers, and, when we do, that we draw up a system that is compassionate, reduces harm and releases the stranglehold that many criminal gangs have upon the weak and vulnerable in our communities. To that end, I hope we can count on your support, Minister, to engage with this group and develop policy that seeks to achieve these aims and start a wider conversation that leads to a more effective approach to tackling substance abuse, substance misuse and substance addiction. Diolch yn fawr.

Photo of Luke Fletcher Luke Fletcher Plaid Cymru 5:49, 6 October 2021

I'd like to thank Peredur for bringing forward this short debate, and I can confirm that I will be very much looking forward to joining his CPG. Peredur is right; the war on drugs is not working and it has never worked. We've remained at this crossroads for more than four decades. The reality is that our inability to have a grown-up conversation around drugs has led to suffering globally—the suffering of users, the suffering of communities torn apart by both Government agencies and crime cartels vying for power over the market.

I fully support the decriminalisation of drug use. The hard-line approach we have taken as a society for decades only criminalises people who may use drugs medicinally or recreationally without harming others, and criminalising those with an addiction does nothing to help them turn their lives around. It's important to remember that decriminalisation does not legalise any drug. Instead, it changes how authorities deal with minor drug possession and treats users as potentially vulnerable, rather than as criminals. Decriminalising drugs removes that stigma and gets help to people when they need it the most. 

We have examples, like Portugal, which Peredur rightly raised, that show us how we can make this work. And we know exactly what we need to make it work. And, again, I'd like to reiterate that Plaid Cymru will support and seek the devolution of further justice powers so that we can tackle this problem now. We need to get on with it. It is quite as simple as that. Diolch. 

Photo of Jenny Rathbone Jenny Rathbone Labour 5:51, 6 October 2021

Very interesting statistics from Portugal, but I'm not convinced that in this country we actually incarcerate people for using drugs; I think we incarcerate people for dealing in drugs. And I remain committed to doing that, simply because of the damage that is done to our young people by pulling them into the county lines and absolutely destroying their lives is really, really damaging. And therefore I'm not yet convinced about the case for decriminalisation.

And I wonder whether it really is going to be that magic bullet anyway, because addiction is a symptom of distress. There really isn't much difference between addiction to gambling, to alcohol, prescription drugs, pornography or substances that are currently illegal. All of them are a cry for help, and it's really about better understanding how we can have more emotionally resilient individuals to enable them to resist the addiction that causes them to try and drown their sorrows but can actually consume their lives, literally, and those of their family members as well. So, I think we have to make sure that we have the services to help people overcome their addictions, which is perfectly possible. And I think we should pay tribute to all the people who work with addicts of all varieties to ensure that they are able to become better citizens and live better lives. 

Photo of Elin Jones Elin Jones Plaid Cymru 5:53, 6 October 2021

(Translated)

The Deputy Minister to reply to the debate—Lynne Neagle. 

Photo of Lynne Neagle Lynne Neagle Labour

Thank you, Llywydd. Can I thank Peredur for tabling this debate today and for his very thoughtful contribution, and also thank Luke Fletcher and Jenny Rathbone for their contributions, and also confirm to Peredur that I'm very happy to engage with his new cross-party group and am looking forward to working with him?

Repairing the ravages of substance misuse for those struggling with addiction is vital if we are to help people live a life beyond it. We must provide support and treatment, but also work to break down stigma and give hope to those who, in the grips of addiction, will feel at their most hopeless. 

Since I came into post, I've met a number of people and organisations involved in the substance misuse field, and have been genuinely impressed at the work and levels of commitment in this area. During the pandemic, huge efforts were made and continue to be made by those running substance misuse services to ensure that vital help and support continues to be delivered to some of the most vulnerable individuals in Wales. Substance misuse services have responded rapidly to adapt to the challenges of the pandemic, and I want to place on record my thanks to our public and third sector partners for this tremendous effort. 

Our substance misuse delivery plan 2019-22 was revised in January, in light of coronavirus, to ensure the work that was being undertaken and continues to be undertaken is meeting the evolving level of need. Our area planning boards and other partners strive to deliver the actions within this plan, and I'm committed to supporting them to do so. And Welsh Government has a strong track record of commitment to this area. We invest almost £55 million in our substance misuse agenda per annum. Over £25 million of this is allocated to our substance misuse area planning boards and almost £21 million is ring-fenced to help boards in Wales. Area planning boards work in partnership with key agencies to commission substance misuse services in their local area, based on local need.

Photo of Lynne Neagle Lynne Neagle Labour 5:55, 6 October 2021

In 2020-21, we also made almost a further £4.8 million available to support our pandemic response. Over £3 million of this supported the rapid implementation of long-lasting injectable buprenorphine, or Buvidal as it is known, for at-risk ex-heroin users, something I will talk about later. The remainder included funding to support PPE requirements, extra residential rehab placements and a digital inclusion fund for service users who are potentially digitally excluded.

The Welsh Labour Government has protected and enhanced the substance misuse budget in Wales, and the same cannot be said for Governments in other parts of the UK. The Dame Carol Black review of treatment services in England was published in July, and, like in England, we are already at an advanced stage with many of her recommendations. Our substance misuse delivery plan, I'm pleased to say, is firmly based within a health and harm reduction approach. We've also protected and ring-fenced our substance misuse funding, and are working closely with housing and across mental health to address the challenge of co-occurring and complex needs.

On the co-occurring agenda, with both mental health and wider well-being in my portfolio, I am clear that there are good opportunities for continued improvement in joint working both here and across Government, and I'm determined to do what I can to achieve this.

I'm also committed to supporting the work of the Minister for Climate Change as we build on the success over the past year in ensuring an 'everyone in' approach to homelessness, and that wraparound mental health and substance misuse support can be provided. This was a huge undertaking, initially housing over 2,000 people, with over 800 needing to access substance misuse services, and that was just in the first months of the pandemic. Some of these were new to services and had the most complex needs.

In total, over 13,300 people have been housed since the onset of the pandemic, with over 3,000 referrals to substance misuse services. I'm really proud of our substance misuse and mental health services, who work tirelessly to support the most vulnerable, and we are now engaged in developing the future approach to rapid rehousing. We've already invested an additional £1 million per year to tackle complex needs, both substance misuse and mental health, for those individuals within homelessness services.

The introduction of Buvidal, which I mentioned earlier, has significantly reduced the need for service users to attend community pharmacies and clinics, thereby protecting their health and that of key workers. Over 1,000 service users are now benefiting from this treatment, and there is significant anecdotal evidence that many are experiencing significantly improved outcomes.

In Cardiff, we saw the first person in the UK to have this support through their GP practice, and Wales is leading the UK, if not the world, on this groundbreaking new treatment. I had the opportunity recently to meet a young woman who'd benefited from this treatment, and heard first-hand the absolutely transformational impact it has had for her. A rapid review of this new treatment, its benefits and value for money, is being undertaken to inform future policy.

Whilst even one substance misuse-related death is a tragedy and one too many, I was encouraged to see that the August 2020 ONS data referred to already by Peredur showed the lowest rate of drug misuse deaths recorded in Wales since 2014. Wales was the only nation in the UK to see drug misuse deaths drop during 2020. Although it is pleasing to see the number of deaths reduced, we will be evaluating the statistics for Wales, taking into account geographics, substances and situational factors, and we'll work closely with harm reduction groups and area planning boards in order to formulate an appropriate policy response to ensure a further continued reduction in future.

Another key part of our harm reduction agenda is our national naloxone initiative, where we have made excellent progress. An important development in naloxone is the work we're undertaking with the police to enable officers to carry nasal naloxone on duty. We've also funded a pilot whereby peers distributed take-home naloxone on the streets. This has been highly successful and has resulted in all areas of Wales looking at replicating this model.

We allocate £1 million ring-fenced annual funding for the provision of tier 4 residential rehab and detoxification services. In April 2020, we launched our new residential treatment framework, Rehab Cymru, which offers over 30 settings, including three in Wales. Rehab Cymru provides an approved list of residential rehab providers and the availability to see types of treatment, pricing schedules, location and inspection reports in order to assist in service users' and professionals' choice. Since the introduction of our residential rehab framework, there has been a total of 238 referrals made through Rehab Cymru, from inception in April 2020 to July 2021.

I am concerned, though, that provisional data for alcohol-specific deaths during 2020 in England and Wales, published in May 2021, shows a significant rise. There may be many factors that have contributed to this, which we are considering. However, while we await final figures, I hope that through the implementation of minimum unit pricing for alcohol, and actions such as developing the soon to be published alcohol-related brain damage treatment framework, we can more effectively tackle this issue.

While I welcome the opportunity to respond to this debate and outline the positive work and outcomes being delivered, I am not at all complacent; there is still a lot more to do. Still, I am committed to making a difference, will continue to progress our commitments in the substance misuse delivery plan and, of course, consider what more we may need to do as we continue to respond to the pandemic and its wider impacts. Diolch yn fawr.

Photo of Elin Jones Elin Jones Plaid Cymru 6:01, 6 October 2021

(Translated)

That brings us to the end of our work for the day today. Thank you very much, everyone, and good evening. 

(Translated)

The meeting ended at 18:02.