With the recent publication of the official statistics from National Records of Scotland, we are now broadly aware of the scale and nature of the country's drug problem. Last year, there were 867 drug-related deaths, a sharp increase from 706 the previous year and incomparably higher than the 244 recorded only 20 years ago.
Three quarters of the most recent fatalities were the result of an overdose of one or more opioid substances – a 'family' of painkillers which includes heroin, morphine, codeine and methadone.
Strikingly, of these 867 deaths, no fewer than 626 – 416 men and 210 women – were of users aged 35 and over. It seems we are only now witnessing the consequences of high unemployment and poverty in the 1970s and 80s which produced 'Generation X' and the subsequent 'Trainspotting' generation, whose glamorisation of heroin was supported by 'heroin chic' in London fashion houses. A cheap supply of the drug, mainly from Pakistan and the Middle East, became widely available in Scotland's poorest areas, providing a euphoric feel-good release from the anxieties of life – and for as little as £5 a hit.
Back in 1996, three quarters of the 244 drug deaths were due to opioid abuse. Fast forward two decades and it's the same substance group which is producing the same proportion of deaths. It's just that there are many more of them.
Yet, the official narrative is that Scotland's drug problem is essentially historical in nature: that drug use among adults is actually falling and that the number of young users is low. This is the message favoured by the minister for public health, Aileen Campbell. In fact, though, it is almost impossible to estimate the numbers involved. Official data is patchy, over-reliance on sample surveys fails to give an accurate picture, and there is a possibility that people lie about their drug use just as they lie about alcohol
The minister's assurances are somewhat undermined by the evidence of
growing recreational drug use affecting council areas in urban Scotland. Twenty years ago, cocaine and ecstasy accounted for only 12 deaths; 10 years ago, 46 deaths; last year, 151 deaths – a 12-fold increase since 1996. Furthermore, little is known of the results of the easy access to benzodiazepines (psychoactive drugs including diazepam and amphetamine) and of the drugs formerly known as legal highs. There is a similar lack of reliable information about the impact of the growing use of apps in the marketing and distribution of drugs.
Despite the uncertainty over the extent of drug use, the Scottish government has cut funding to several multi-agency initiatives known as drug and alcohol partnerships. Funding to the Lanarkshire partnership, for example, has been slashed by £700,000 in the current year at a time when drug-related deaths in the area covered by NHS Lanarkshire have increased from 73 in 2015 to 113 last year. In Dumfries and Galloway, where the local partnership lost £233,000 of its funding, the number of deaths has risen from 11 to 17 in a single year. In Fife, where there has been a marginal increase in drug-related deaths – 45 last year – funding to the local partnership is down by £125,000.
These revealing figures only became available as a result of a freedom of information request. They tend to contradict an earlier assurance by the cabinet secretary for health, Shona Robison, that critical funding to tackle Scotland’s drug problem would be protected and that treatment would be maintained at existing levels.
This confusion may be symptomatic of Scotland's muddled approach to its drugs problem. The Scottish government's 'Road to Recovery' initiative,
established in 2008, stated: 'Recovery is a process through which an
individual is enabled to move on from their problem drug use towards a
drug-free life and become an active and contributing member of society.' The reality could hardly be more different. Heroin users seeking help in their local community enter the black hole of methadone treatment – and re-emerge only rarely. Reliance on one substance is simply replaced by reliance on another: scarcely the embodiment of that 'drug-free life' espoused in the 'Road to Recovery' prospectus nine years ago.
If 'Road to Recovery' has failed, so has the Naloxone Programme, which the Scottish government rolled out in April 2011. Naloxone is a substance which reverses the effects of an overdose and allows precious time – around 20 minutes – for the emergency services to arrive. Between 2011 and 2016, 29,000 'kits' were issued to users deemed to be at risk of overdosing, including people just released from prison. The benefit was strictly short-term: instead of taking responsibility for their addiction, and embarking on that path to abstinence propagated in 'Road to Recovery', users were effectively handed a get-out clause; an escape plan. It came as no surprise when the programme was abandoned nationally last year, although some
councils continue to fund it.
What of residential care for the most serious addicts? Its value is widely acknowledged. Yet the last time there was an official count of the number of NHS beds available for problem drug and alcohol users, there were only 329 in the whole of Scotland: a tiny proportion of the 60,000+ potential patients. Again, however, there is a strange absence of official data on which to base policy. That count was done as long ago as 2004.
One statistic does look fairly reliable. If this turns out to be an average day, another two people will have died of drug-related causes by midnight tonight.