- Why does Scotland have such a serious problem with drug and alcohol deaths?
- Do you think this is more of an urban problem than a rural one?
- What are the main drivers of drug or alcohol addiction that you come across in your work?
- Do you think that family, community or church support improves a person’s prospects?
- What is the most effective way to support a person to exit drug or alcohol addiction?
- Do you recommend harm reduction or abstinence-based approaches, or both?
- Do people face barriers in accessing support for drug or alcohol addiction?
- What should major investors prioritise to make a difference in years to come?
- What kind of infrastructure do we need more of in Scotland, and in which locations?
- Aside from prayer and giving, are there other ways that local churches could help?
- What actions should central and local government be pursuing to make a difference?
- If you could change anything about the state’s approach in this area, what would it be?
This summary was previously published on my substack, together with my answers to these 12 questions.
I realised that my answers had been forming over almost three decades of working alongside people affected by addiction, campaigning for policy reform and watching Scotland’s response evolve and, in many respects, lose its way.
The questions forced me to gather thoughts that had previously been scattered across countless articles, speeches, academic papers, campaigns and conversations into one coherent account of what I actually believe.
Looking back over my own writing, I noticed something else. My earliest articles tended to focus on individual policies. One week I would be writing about residential rehabilitation, another about drug consumption rooms, another about the Right to Recovery Bill, another about the misuse of language or the failures of commissioning.
Each piece examined one part of the puzzle. But somewhere along the way the subject or my understanding of it has changed. Addiction remained the case study, yet increasingly I found myself writing about something much larger: institutions, bureaucracy, civil society, family, faith, social cohesion, accountability, the meaning of compassion, and human flourishing.
I realised that I had slowly stopped writing only about addiction. I had been writing about the kind of society that either helps people recover or quietly teaches them to expect nothing more than survival. That matters because every addiction policy rests upon a much deeper question, whether we acknowledge it or not.
What is a human being?
Is someone struggling with addiction primarily a patient to be managed? A risk to be minimised? A service user to be processed? A permanent victim of circumstance? Or are they a person whose dignity is inherent, whose future remains unwritten and whose capacity for change should be the starting point of every public policy?
Everything else follows from how we answer that question. As I worked through the questions, another pattern became impossible to ignore. Almost every answer led me back to the same conclusion.
Over the past thirty odd years we have become remarkably good at constructing systems around addiction. We have produced strategies, commissioning frameworks, standards, performance indicators, action plans and increasingly sophisticated ways of managing crisis.
Yet somewhere along the way we forgot something far simpler: people recover through people. No government can commission belonging; no strategy can manufacture forgiveness; no funding stream can create love; no policy can produce hope. Those things arise within families, friendships, neighbourhoods, recovery communities and churches. They arise within what previous generations simply called civil society.
That is why I have become increasingly convinced that Scotland’s addiction crisis is not merely a healthcare problem, nor simply a policy problem. It is a crisis of relationships. It is a crisis of meaning. It is a crisis of the institutions that help human beings flourish.
That, I think, explains why the Church has such an important role to play. Not because churches possess better clinical interventions than the NHS: they do not. Nor because they should attempt to become miniature treatment providers: they should not. Their contribution is altogether different.
The Church begins with an understanding of the human person that modern public policy has too often forgotten. It sees each individual not as a diagnosis, a risk profile or a collection of adverse childhood experiences, but as someone whose dignity is inalienable, whose life possesses meaning and whose future always remains open to redemption.
Government has indispensable responsibilities: it should fund treatment, protect the vulnerable, and ensure that people have access to the help they need. But government cannot do everything: it cannot manufacture friendship; it cannot legislate for trust; it cannot purchase purpose; it cannot commission hope. Those things grow within families, communities, churches and the countless voluntary associations that together make up a healthy society.
Catholic social teaching has long understood this through the principle of subsidiarity. Strong societies are not built by replacing local relationships with central institutions, but by strengthening the families, communities and intermediary institutions in which people actually learn responsibility, service, solidarity and love.
One of the great mistakes of modern addiction policy has been to assume that professional services can substitute for the relationships that ultimately sustain recovery.
However, they cannot. Whilst treatment and professional expertise matters and harm reduction has an important role, recovery ultimately happens when people rediscover belonging, purpose, responsibility and hope. Those things cannot be prescribed.
Another lesson emerged as I wrote: much of our national debate is not actually about evidence at all. It is about language. Words such as recovery, treatment, rehabilitation, harm reduction, peer support and even lived experience have gradually become so elastic that two people can use exactly the same vocabulary while describing entirely different philosophies.
Unless we define our terms carefully, we often imagine we agree when we are, in fact, arguing from completely different understandings of what recovery itself means.
Perhaps that explains why our national conversation has become so confused.
Too much discussion about addiction now happens behind closed doors, inside consultation exercises, strategy groups and policy forums that few members of the public ever see. Yet the people with the greatest stake in these questions are not politicians, civil servants or academics. They are the parents who have buried children, the people still trapped in addiction, those quietly rebuilding their lives in recovery, and the communities living with the consequences of policy decisions. They deserve to hear not only our conclusions, but the reasoning that leads us there.
The addiction field has spent too long confusing consensus with truth, and compassion with the absence of challenge. Progress has always depended upon people willing to ask difficult questions, especially when the fashionable answers no longer match reality. If someone were to ask me today, “What do you actually believe about addiction?”, what I publish in the answers to the 12 questions above, which are on my substack is probably the closest answer I could give.
It is not intended to be the final word. It is simply the most complete account I have yet written of the principles that have guided my work for many years. If you only read one thing I publish this year, I hope it will be this. Because beneath every debate about drugs, alcohol, treatment, harm reduction or recovery lies a much more important question.
What kind of society still believes that broken people can become whole again?
