For International Overdose Awareness Day, Scottish Drugs Forum (SDF) held a conference in Scotland, uniting over 300 attendees – including people with living and lived experience, families, third-sector workers, researchers, politicians and more, in a powerful two-day campaign for change.
The conference was at a key moment, with the backdrop of Scotland’s continued drug death emergency, registering 1,017 deaths just in 2024.
Kirsten Horsburgh, CEO of SDF began the conference with a reminder: everyone gathered did so with “heavy heart and fierce determination”. She called on the room to join her in a one minute’s applause to recognise the lives lost, to reject stigma, and to affirm a shared commitment to change.
“We refuse to reduce these lives to statistics,” she declared. Those with lived and living experience are not just participants—they are “leaders, truthtellers, and reality checkers with insight.”
This year had a diverse range of sessions with presentations from people with living and lived experience, family advocates, and grassroots mobilisation. But these well-established organisations urgently need long-term funding, to deliver community care, conduct research and drive transformative change across housing, healthcare, and social services.
The Scottish Government’s National Drug Deaths Mission 2022-2026
Maggie Page, Head of the Drug Strategy Unit, outlined “what comes next” for The National Mission— a five-year programme that began in 2021 looking to reduce the Scottish drug death rate. It has had some successes: the National Mission rolled out new MAT standards, the Charter of Rights for People Affected by Substance Use, helped open The Thistle safer drug consumption facility, expand harm reduction distribution, increase care capacity, and improve treatment pathways.
Yet, despite improvements in certain medical standards, the government could be doing more. Page believed that the National Mission has been stuck in emergency-response mode, struggling to look forwards. She warned that a crisis-driven national mission, without the promise of sustainable, long-term funding, won’t change the future.
A new drug strategy is needed, one that deals with rising cocaine use, the influx of nitazenes in an increasingly unsafe drug supply, and shifting drug markets. A whole-system approach has been promised, one that addresses emerging trends and implementation gaps with stable, long-term funding. In an environment of high medicine costs, cuts to essential health services, a housing crisis and unstable funding for grassroots and advocacy programmes, a new strategy risks becoming just another reactive response.
Understanding the current Scottish context
Scotland’s drug policy progress has some strong opponents: from sensationalist media outlets to polarising anti-harm reduction figures, to Westminster’s repeated denial of any need for drug law reform. Understanding what is currently undermining the work of drug activist groups, frontline workers and the path to progress is critical.
Initiatives like safer drug consumption rooms, that have globally proven their efficacy in reducing drug-related harms, are purposefully stalled to avoid taking politically challenging decisions. This politics of delay is evident with The Thistle: with its evaluation set to take four years, waiting for it before deciding on action would be a fatal mistake, costing hundreds of lives.
Identifying a new champion for alcohol and drug policy in Scotland is a high priority. Since 2023, Scotland has lacked strong leadership in the space. The appointment of Maree Todd as Minister for Drugs & Alcohol may signal change, but will she deliver?
Across the UK, working-class communities struggle with deprivation. Poverty is not accidental or a ‘postcode lottery’: it’s geographical, and a political choice. Until policymakers stop framing drug use as a moral failing and a disease – and instead, recognise it as a symptom of social and economic alienation – drug policy will not improve outcomes. Problematic drug use does not come from a moral failing. It’s a result of deindustrialisation and community collapse in the face of austerity.
Who works for us: grassroots power and living experience in action
We have seen parliamentary resistance and stalling, but there are groups who are actively campaigning and working for change—who do not feel represented by a government they see as complicit in Scotland’s drug related death toll.
In one of the conference’s standout sessions, Jason Wallace, Programme Manager of Lived and Living Experience Work at SDF, set a galvanising tone with the statement of intent for the conference. It represented a collaboration of twelve engagement groups across Scotland, known as the Advocates for Change. Wallace announced the rejection of wanting to belong to organisations and political groups that continue to fail communities, the statement of intent called for the redistributing of resources and power to prevent further deaths.
“We’re not asking for permission, we’re not asking for a seat at your table, we’re building our own table.”
This refusal to engage with outdated systems was a call to usher in the new—calling for community spaces and people-oriented organising. While clinics are vital for healthcare and harm reduction, social spaces offer safety, solidarity, and power, and are equally important in a holistic and whole-system approach to care.
“Drug user union mobilisation doesn’t have to be formal, people can meet in cafes and community settings, not necessarily in the clinic.”
Other groups pushed for diverse peer support and international advocacy. The local Families Campaign for Change called for the creation of an 18th UN Sustainable Development Goal: Compassionate Drug Reform: this would be a global commitment to ending the stigma, criminalisation, and preventable deaths caused by outdated drug policies.
Compassionate clinical work
It’s possible to deliver existing services in new ways. Change in practice is possible and can be grounded in human rights – if they’re funded, supported, and properly evaluated. When Kelly Renfrew and Susie Duff, two Senior Addiction Nurses for Fife Addiction Services, observed that their patients lacked the skills to cope with the psychological difficulties that came from tapering off benzodiazepine prescriptions, they asked themselves: what does real support look like?
In response, they developed and presented “Increase the Skills, Reduce the Pills”, a new compassion-based clinical approach to benzodiazepines. Their work reflects a growing appetite for peer-to-peer support in situations where individuals’ rights may be at risk. The simple act of offering people a space to discuss their prescriptions should not be underestimated; it can be profoundly empowering.
Work presented by SDF’s Katy MacLeod and Sam Stewart on a peer-led research evaluation exploring people’s experiences of long-acting injectable buprenorphine displayed the need for wraparound services and person-led clinical support. Their report underlined the importance of speaking to people who are prescribed buprenorphine, to both empower individuals and provide choice and support in medication assisted treatment.
Building new structures for change: living experience at the centre of reform
Resources and access to influential positions must be available for those who are alive today. Across Scotland, people who use drugs and family activists are self-organising, and there is a growing appetite for new structures. From grassroots media ownership—such as the independent peer-led, Buzz magazine—to broader community initiatives such as the Advocates for Change, momentum is building.
Stopping deaths and saving lives is critical. Meaningful action demands empowerment, training, and funding for activists and their families to continue community care, research, and drive changes in housing, healthcare, and social service practices. To influence policy, resources for research and advocacy are needed for independent groups. The conference called for power-building among communities that have been systematically disenfranchised. Lived and living experience must be at the centre of reform—because just like harm reduction: it works, it saves lives.
Resources and presentations from the SDF #StopTheDeaths 2025 Conference can be accessed here.
