Tackling drug deaths - Scotland's national disgrace

Scotland's drug-related death statistics are a national disgrace. In 2021, 1,330 people in Scotland died due to a drug overdose. That was more than three times the rate of the rest of the UK and the highest in Europe. As the chart below shows, this isn't a new problem.

This month I was looking at drugs policy when drafting a response to Paul Sweeney MSP's proposal for a Drug Death Prevention Bill. This will enable the establishment of overdose prevention centres, including establishing a licensing framework for centres to prevent death due to drug overdose; and create a new body for the oversight of drug policy development and implementation to improve health by preventing and reducing drug use, harm and related death. He argues that preventable death due to drug overdose has become one of Scotland's major public health emergencies. Urgent practical action is required to address this health crisis, and this Bill is intended to be part of the solution, one contribution to a multi-faceted effort to tackle the problem.

Drug use is inextricably linked to poverty; it is not simply a 'lifestyle choice'. People living in the most deprived communities in Scotland are around 18 times more likely to experience problem drug use compared to people in the least deprived communities. As the Poverty Alliance argues, "That means redesigning our economy so that people are able to access decent work, and investing in our social security system and public services, so that people have the income they need to live in dignity and security."

The Scottish Drugs Death Taskforce has called for more resources to be spent fighting Scotland's drug-related deaths problem after calling current resource levels "woefully inadequate". Their report (21 July 2022) outlines ten key principles and 20 recommendations underpinned by 139 actions. These call for greater funding, efforts to tackle the stigma of drug addiction, and a higher degree of responsibility for drug-related deaths in both health boards and Scottish and UK governments. The report states, "The First Minister has publicly recognised that her government 'took their eye off the ball'. The question now is whether the government will provide targeted funding to enable services to deliver transformational change – not a return to the funding of the past, but an ambitious and radical commitment to making people's lives better."

While there is a case to review the UK Misuse of Drugs Act and for devolving the legislation, we must focus on what we can do in Scotland using devolved powers. As the former head of Scotland's drug deaths taskforce (Professor Catriona Morrison) has said, Scottish Government ministers should stop blaming Westminster legislation for the high number of people dying through drug misuse and focus on what can be done to address the problem. 

Scottish Government cuts in funding for Alcohol and Drug Partnerships in 2015 resulted from the pervasive stigma and the demonisation of people with a drug problem. Cutting  £15 million of funding for the most marginalised and vulnerable people in Scotland is a classic example of ignoring the benefits of preventative spending as recommended by the Christie Commission. Scotland's drug strategy should focus first on keeping people alive, but we also need to help not just to stabilise their drug use but get help with the wider aspects of people's lives.

Paul Sweeney's Bill is not a 'magic solution' but could help as part of a range of measures. Drug consumption facilities have been introduced in at least 14 countries across more than 130 sites. They provide a safe environment for the most vulnerable to use drugs under the supervision of trained professionals. A study in The Lancet shows fatal overdoses decreased in areas where overdose prevention centres were introduced alongside other beneficial outcomes, including reductions in self-reported high-risk injecting practices and increased engagement with drug treatment services. They may also help reduce drug use in public places.

This Bill will provide a necessary focus on the drug crisis that has sadly been missing in recent years. It also focuses on what we can do now, in Scotland, to address these issues - always recognising that the drugs crisis is part of wider inequalities in Scotland that also need to be tackled.