Here We Go Again

Kaitlin Dryburgh

Will the cycle ever be broken?

Police Scotland have released their drug death statistics for 2023, and it makes for some bleak reading. From the previous year there has been a 10% increase, rising from 1,102 to 1,197. For areas such as Fife deaths haven’t been this high since 2019. When is Scotland ever going to take meaningful steps to shake our reputation as the drug death capital of Europe?

In 2020 Joe Fitzpatrick former Public Health Minster was forced to resign over the increase of drug deaths under his watch. At the time the Government declared a drug deaths emergency and promised a more focused approach, they even established a Minister for Drug Policy, that position now covers alcohol as well. Since then we are on to our third drugs minister and yet, it seems the numbers are still not showing a steady downward trend. Of course in the space of three and a bit years there wouldn’t be a drastic reduction, however as a country we were within our right to expect more. We’ve had four years of a minister dedicated to reducing the numbers, yet they are still outrageously high. It is absolutely unacceptable that this is allowed to carry-on. For a country of a relatively small population size we are wasting lives at an unseemly rate. In comparison, the Scottish domestic death rate during World War Two was lower than that of the drug death rate during the last six years. Making it more likely that you will die from a drug overdose today in Scotland, than be killed via bomb during a world war.

An increase of 10% could be a fluke but there are reasons that could help to explain why deaths are on the rise. First off something that has been buzzing around for some time, the rise of synthetic opioids. These are drugs looking to mimic heroin and the like but can be multiple times stronger than the real thing. Thought to be developed in labs in China and being sent over here, these synthetic drugs are beginning to find themselves into other non-opioid drugs. They are extremely unstable and dangerous. The warning signs have been there for a while but as the question of the legality of drug misuse remains a reserved power and the UK government remains strongly on the side that drugs should be illegal and as such all harm reduction options have become side-lined. Now experts across the UK have shared their despair that authorities and those in charge have not acted fast enough. There has been little forward-planning, especially when it comes to testing. Testing current drugs in circulation provides a well-rounded view of what the present situation is. There is one key piece of data that seems to be missing on a national level through-out the whole of UK, and that is non-fatal overdose data. Top toxicology experts believe that sporadic data very much under-represents the extent of the problem and could be one of the crucial areas in gaining a more comprehensive understanding of the current state of affairs. What you then choose to do with that information is another thing, as the UK government has just banned 15 synthetic opioids, which will make a blind bit of difference. However, Scotland is very much capable of gathering data without the UK Government providing approval and at some point this year we should receive the metrics from the National Mission on Drugs, hopefully providing a better picture of the extent of the problem in Scotland. 

It is clear as day that the Scottish Government’s response to high drug deaths is not working. Although they wont be able to implement the policy they may want to due to reserved powers that is no excuse. Yousaf strongly claims that the Government is on track to meet their rehab bed target, yet it still isn’t enough. The lack of clarity concerning the number of drug treatment places, rehab beds, and services available is still baffling. But in this so called drug death emergency drug services have been closed down and like so many other vital services run by local authorities they’re facing drastic cuts that challenge their very existence.

Unfortunately, there are two warring sides to the drug policy debate. In one corner we have the harm reductioners who campaigned for Naloxone to be readily available in the community, and believe that we need to push forward with plans to open drug consumption rooms and testing centres. In the other corner we have the advocates for treatment and rehab. They would like to see the conversation pivot away from normalising addiction. Both admiral viewpoints in their own way.

Some aren’t ready to go through treatment as of yet, and rehab would be a genuine waste of time. For them preserving life is the best course of action. Additionally, to those who died not through addiction but through recreational use, take a student for example, they don’t require treatment. It’s too late for education in reality, harm reduction is the best way to stop an accidental overdose.

The other week I watched a video of someone who does outreach work in areas such as this. They were an ex-addict who looks to support others experiencing some of the worst that life has to offer. He details the moment when he was in prison for the umpteenth time and another ex-addict came in to deliver a talk about turning his life around. Up until that point this man had not been aware that it was possible to get clean, he had no idea that there were ways to break the cycle. He had assumed that his life would consist of him going through prison like a revolving door or he would die. It hadn’t occurred to him that getting clean was an option.

This too is a failure. Drug consumption rooms and the like are something to be celebrated but they should not be in place of rehabilitation. If we are truly to treat drug addiction as a health problem there should always be an option to be cured. Funding for effective drug treatment programmes and rehabilitation placements should also be prioritised. Why must we pick a side? Why can we not see the value in both options, after all we are dealing about people with different needs, abilities and histories, there isn’t a blanket approach that will work for everyone. Just like any illness, we need to be flexible and offer different treatments that are applicable to that individual.

Yet at the crux of it all still remains the core reasons addiction is so prevalent in Scotland. Poverty, poor housing, inadequate healthcare, failing public services, and inequality. Without addressing these we will never be able to cut addiction off before it takes hold.

5 thoughts on “Here We Go Again”

  1. I agreed with all the article until the very last paragraph. If the core drivers of addiction are “poverty, poor housing, inadequate healthcare, failing public services and inequality”, then it should follow that the country which has the worst statistics on all these aspects will have the worst addiction problem. Are we really saying that Scotland is the worst country with the worst poverty in Europe? Does Scotland have the poorest housing in Europe? Has Scotland the poorest healthcare in Europe.Are public services in Scotland failing worse than every other country in Europe? Is Scotland the country with the greatest inequality in Europe?
    So why, for example, is Scotland doing so much worse on addiction and drug deaths than England?

  2. lindsay simpson

    I think caution is needed in making comparisons with other countries, including England, as the policy on cause of death indication differs, which while not wanting to minimise the issue nevertheless results in a higher statistical count under the methodology used in Scotland (i.e. any indicator of drug abuse even if not proven as cause of death).

  3. Alasdair Macdonald

    Despite what GW above states, “poverty, poor housing, inadequate healthcare, failing public services and inequality” are core reasons for the drift into addiction by some people. However, On many other measures, Scotland is a comparatively good place to live. So, there are other ‘reason’ factors which need to be considered to give a fuller explanation of why the numbers of deaths in Scotland and accepting Lindsay Simpson’s caution about making comparisons. I think some of these are historical and cultural, and, by historic I think we do need to take a multi-century perspective.

    But, that is only one strand. We need to try to do something more successful now. Jettisoning, as Ms Dryburgh, correctly, does, the false dichotomy between harm reduction and rehabilitation is essential: both are required, as she describes. It comes down to deploying sufficient resources to do so and that requires political will. And that, in turn, requires the opposition parties at Holyrood abstaining from going into the performative rage of blaming.

    1. Hi Alasdair, the claim about the core drivers of addiction needs unpicking. There is no doubt that poverty and poor housing can both create despair which would correlate with some people turning to drug use as an ‘escape’. Inadequate healthcare would not cause people to start using drugs unless we are considering those who may be seeking to use drugs as a way of self-medicating, though poor healthcare would be a factor in those with addictions not receiving the help they need to get clean. Failing public services could lead to some people becoming addicted such as in situations where vulnerable young people are becoming involved with drug users or even dealers and social services either do not have the capacity to intervene or lack of care alternatives prevents the young person being removed from their situation. As for inequality – as opposed to poverty – I’m not sure why merely living in a society that is unequal should contribute to people turning to drugs.

  4. Michael Smith

    Why does Scotland have higher levels of drug deaths? Is this explained by any research?

    Do we have higher levels of addiction?
    Do we have a higher mortality rates from similar levels of addiction?
    Addiction is often talked about as a disease of despair, are our addiction / mortality rates consistent with poverty rates?

    If we don’t know why more people are dying here, how can we ever have successful policies to tackle it?

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