Scotland's Drug Death Conversation

Kaitlin Dryburgh

Here I go writing about the same thing again. Every year it becomes more frustrating as inaction leads to more deaths, it makes it frustrating to write about it every year. Yet it's always predictable because the only thing that really changes is the number. The context stays the exact same.

The National Records for Scotland have published their 2023 Drug Misuse Deaths. It’s a 12% rise, increasing from 1,051 deaths in 2022 to 1,172 in 2023. Each year when these numbers are published interest and conversation peaks then it begins to dwindle until next year comes around.

Honestly, I could write the key points every year, they never change. Deaths in Glasgow higher than other places, men worst effective, those living in the most deprived areas multiple times more likely to die, synthetic drugs on the rise and the ages of those dying are increasing. As I said the only thing that changes is the number of lives unnecessarily lost. But before the numbers are even published you can expect that it’s astronomically high in relation to Scotland’s population size.

There’s probably a new minister in the position but they’re saying the same thing. ‘These concerning figures highlight the need to intensify our efforts to cut the harms and deaths associated with drug misuse’- or something to that effect.

The numbers are dissected at length, graphs showing the numbers going up and down but overall remaining too high. Rarely do they ever provide any names or personal stories behind the death rates, it’s just part of the political calendar at this point.

But what if we stopped focusing on the deaths? Stopped with the graphs that change ever so slightly every year and examined the context, the environment of these deaths. Because shouldn’t that be the bigger story. It would also provide a little more of a personal element to those who have lost their lives and just end up being a number in a BBC bar graph.

The Government has known for decades that drug deaths are more likely to take place in Glasgow, that currently those living in Scotland’s most deprived areas are 15 times more likely to die from drug misuse (this statistic is always around this number).

We get into a frenzy about numbers and whether we should be deploying harm reduction methods or looking at treatment and recovery as the best option. The groups involved have become so polarised that it’s starting to stall debates and action.

Why aren’t we talking about the cause? Because although we’d like to think this isn’t the case your environment can define you. Not always, and perhaps not all the time but its safe to say that in recent years the ability for people to not be defined by their environment has decreased.  

We cannot tackle drug deaths without tackling poverty. The links between poverty and drug addiction are incontestable. Of course there are other factors that play a part such as genetics, and early family life. But is there really a point in rolling out Naloxone and calling it a day when Scotland seems unwilling to tackle some of the root causes.

We could even go on to say poor mental health, poor housing, and education can be factors contributing to drug abuse, but I would argue again that all three of the above can and are somewhat caused by poverty. Just because someone is living in relative or extreme poverty doesn’t mean they will automatically turn to drugs but it’s the consequences of living in deprivation and the issues it brings that can at times push them towards it. I say “push towards” not because someone has literally taken them by the hand to drug abuse but because their environment has heightened level of drug use already existing.

Reducing inequalities, poverty and all the associated issues that comes with these realities will have an effect on problem drug use.

Scotland’s problem with poverty remains high as does our high drug deaths. Child poverty is so prevalent that almost a quarter of all children are growing up in poverty, in-work poverty is also on the increase, overall a million Scottish people remained locked in poverty and that hasn’t changed for some time. Just like high drug deaths.

The Government has been forced to acknowledge that the whole country is facing a housing emergency. Around 15,000 people remain stuck in temporary accommodation and this figure grows significantly larger when considering the number of homeless people.

This is yet another factor that contributes to the spiral of drug abuse. Homelessness can be both a cause and consequence of drug abuse and as such should be included in the actions to combat drug harms and addiction.

It is also no coincidence that Scotland having the highest numbers of drug deaths in Western Europe relative to its size also has the widest health inequalities in Western Europe. These again are spurred on by factors such as poverty, but health inequalities just add another layer to this spiral.

These issues are rarely a focus in the drug death discussion which is predictable yet disappointing considering all of these factors stay the same every year.

But when specifically examining the targeted options for lowering drug deaths improvements are just so slow and sluggish. On the harm reduction side, the implementation of Scotland’s first overdose prevention centre (drug consumption centre) has finally been given an opening date of this October. But it has taken too long to get to this point, even when considering the legal debate with the UK government. The treatment and recovery aspect is also far below the standard to enact meaningful change. This week the Scottish Drugs Forum published their findings from research surrounding experiences of using drug treatment services. Firstly, they point out their disappointment that the Medication Assisted Treatment Standards have not been fully implemented, even though March 2024 was the deadline. Unfortunately, they found from multiple interviews that many people are having to wait months before initial treatment beings. Service users also found a lack of choice or information surrounding their treatment, while many reported feeling judged by GPs and feeling stigmatised by pharmacies when having to que separately or take their methadone in view of the public. There is unfortunately, a long list of ways drug treatment services can be improved through-out Scotland, and it’s just as evident this year as it has been in the previous years.

The thing is, speaking about drug deaths is important, discussing the methods to curb deaths such as harm reducing measures and recovery treatment is also important, but why aren’t we including the environment that has led to this situation taking place? Stopping the deaths but being okay with the same numbers of addicts in Scotland is unacceptable. There needs to be the drive to stop and alleviate the conditions that allow for substance misuse to thrive.