Across Scotland, unacceptably high levels of drug and alcohol related harms continue to have profound impacts on our communities. Behind each life lost is a person, their family, friends and colleagues. As a small but diverse country, many of us will know personally how the effects of drug use pervade our lives and affect whole communities.

Earlier this year, COSLA Leaders agreed the new Strategic Plan for alcohol and drugs, Preventing Harm, Promoting Recovery – the first time Local and Scottish Government have agreed shared ownership over this critical challenge we face as a nation. The Strategic Plan builds on progress made during the National Mission but recognises that we need sustained leadership to tackle ongoing and emerging harms from alcohol and drugs.

While a shared policy direction at a national level is important, ultimately it is the local delivery of support that will make a difference to people’s lives. These solutions will lie in our communities, shaped by people, and delivered through trusted local services.

At the launch of the strategy at a rehabilitation facility in Inverclyde, I met with people in recovery and who told me how important it is to have pathways of care that bridge different services, bringing together specialist care with appropriate housing and ongoing wellbeing support.

Councils are well placed provide wrap-around support for people affected by drugs and alcohol and their families which fosters sustained recovery. Housing, social work and social care and community justice support some of the most vulnerable in our communities. This holistic support, meeting the needs of the whole person, act as the foundations for more specialist care. Meanwhile, our partnership working third sector organisations enable greater reach into communities, including outreach with people who face additional barriers to accessing services.

If we are serious about reducing harm from alcohol and drugs, we need strong local knowledge to understand why communities in Scotland continue to be deeply affected by drugs and alcohol. The stark reality is that the harms are not evenly distributed; rather, they are closely aligned to the prevalence of deprivation. Experiences of poverty and trauma can act as an underlying driver of harms, while drug and alcohol issues can perpetuate deprivation.

COSLA has long championed this preventative approach which tackles these root causes because our councillors witness firsthand how interconnected these inequalities are with wider outcomes. As much as 80% of what determines our mental and physical health comes from outside of health and care services. Our health and wellbeing starts long before a person speaks to their GP. It starts with a warm, safe home, with whole-family support in the critical early years and access to opportunities through high-quality education and secure local jobs. As set out in the Population Health Framework, these are the wider determinants of health, the underlying social, economic and environmental factors that have a greater impact on our health outcomes that access to health and social care services. The preventative and universal services that councils deliver every day are the embodiment of these determinants: our schools, transport networks, leisure and culture facilities.

Indeed, no other part of the public sector has such depth or breadth in people’s daily lives. Our joint approach to reducing harms from alcohol and drugs rightly places prevention at its heart, maximising these local opportunities to shape healthy, resilient communities.

As the form of government which is closest to people, councils have the local knowledge to understand where services are working well, where gaps exist and how to make the best use of a community’s strengths. Differing demography and geography mean that our communities can vary. Post-industrial communities in the central belt have different challenges and opportunities to remote, rural and island communities. Flexibility in the delivery of services is vital to meet the needs in a range of local contexts.

Key to developing place-based solutions are the insights from people with lived and living experience of drug and alcohol issues, so services are developed with people, not for them. Last year, COSLA Leaders endorsed the Charter of Rights for People Affected by Substance Use which empowers people to know the human rights that belong to them. Since publication, a range of emerging local practice has focused on meaningful engagement and participation, promoting more inclusive and accessible services, and enabling people to shape services through what matters most to them.

As we move forwards with this preventative, rights-based approach, I recognise the significant pressures that the system is under. Alcohol and Drug Partnerships, which coordinate a range of services to meet local need are often led by very small teams of committed individuals working to tight budgets. The wider workforce is delivering preventative, wrap-around and specialist support in challenging circumstances due to high and complex levels of need in communities.

Many of us continue to feel the effects of drugs and alcohol issues in our communities – in the unacceptably high numbers of lives lost and the families affected, and through the wider impacts of organised crime, including trafficking. New substances, increased toxicity and changing patterns of drug use add further challenges which require expertise and bespoke solutions.

Strong leadership in all parts of the system is essential to recognise the role that we all have to play to promote good health wellbeing and reduce harms. This will involve culture change, tackling stigma and promoting human rights in everything we do. We have already clarified the governance arrangement for Alcohol and Drug Partnerships through the Partnership Delivery Framework. This affirms the importance of a range of statutory services, not just local authorities, but also health boards, police and the prison service. Further work is required to ensure all partners understand their roles and responsibilities.

At a national level, our joint approach with Scottish Government will enable local and national leaders to work together to prioritise action that will make the greatest impact and hold each other to account. Working with the Minister for Public Health, Mental Wellbeing, Sport, Alcohol and Drugs, I look forward to inviting a diverse range of individuals and organisations, including third sector colleagues, clinicians and people with lived and living experience, to provide advice, insight and challenge to support the delivery of the Strategic Plan.

By combining a shared national ambition with strong local leadership, we can consider drugs and alcohol not in a siloed fashion but across the broad range of services that councils and their partners provide. We can deepen partnership working, build a culture of learning, listening to those most affected. Through a collective commitment to prevention and wrap-around support, to reducing inequalities and to improving outcomes, we can create resilient communities and support people to live longer, healthier and more fulfilling lives.

22nd September