Scotland should declare a “public health emergency” to deal with the rising number of drug related deaths, according to experts tasked with shaping the Scottish Government’s response to the growing crisis.
Scotland now has the highest death rate in Europe, with 934 fatalities recorded in 2017, and the head of the Scottish Drugs Forum (SDF) – a national resource for drugs policy expertise – has revealed that number is likely to be over 1,000 in 2018. Director of the SDF, Dave Liddell, has urged the Scottish Government to set a target of zero preventable drugs-related deaths when politicians finally unveil a long-awaited national drugs strategy.
It is understood the draft strategy circulated before the summer was criticised by the sector, which has delayed the launch until the autumn. The original strategy, The Road To Recovery, has had £689 million invested in it since 2008, the year it was launched.
That same year it was announced that there were 455 drug-related deaths in 2007, a figure which has more than doubled in a decade.
Liddell said: “The situation around the country this year so far is actually even worse than 2017. We’re in an absolute crisis, in terms of the numbers of people dying. It’s sadly taken this level of deaths for people really to start to take notice of the issue.
“What we’ve been hearing is, in a number of areas, the figures compared to last year are significantly up. We are anticipating the figures will be higher this year and will be over 1,000.
“We shouldn’t be writing people off. The new strategy must send that message, particularly in the case of overdose deaths, they are all essentially preventable.
“There is far more we can do. If you’re in treatment you’re far more likely to survive than if you’re out of treatment. There are particularly risky times – when people are discharged from treatment either through planned discharges and particularly through unplanned, and what are described as disciplinary discharges.”
The SDF will hold a conference on Thursday entitled Working Together To Prevent Drug-Related Deaths, which aims to offer solutions to the crisis. It is being held the day before International Overdose Awareness Day.
Kirsten Horsburgh, SDF strategy co-ordinator for drug death prevention, said: “We need to see the number of drug-related deaths in Scotland as a public health emergency. If we were talking about almost 1,000 people dying of other preventable causes every year, there would be an outcry and there would be a full systems approach to address the issue. This is everybody’s business and it needs everybody’s attention. It’s a national travesty.”
Horsburgh said heroin addicts should be fast-tracked on to methadone. “At the moment we have waiting times,” she explained. “We need hub-based services where people can just drop in and receive opiate-replacement therapy the minute they walk in the door, without the mandatory conditions attached to that. So, if somebody isn’t ready to do motivational work, they should still be able to access prescribing without those conditions.”
She added that more must be done to end the stigma associated with drug addiction. “Stigma silences people and stops them accessing help,” she said. “It’s seen as some kind of lifestyle choice, which is a lazy moral opinion.”
Liddell said there is a growing consensus among politicians that more must be done but he insisted there must be a “clear aspiration” in the new drugs strategy to reduce the number of deaths.
“I think without that our response is not going to be scaled up as it needs to be to save lives,” said Liddell. “What we want to do is keep people alive so that they can recover.”
Liddell pointed to British Columbia, Canada’s westernmost province, where a public health emergency was declared following a spike in drug related deaths.
He said: “We need a really scaled up response, like the Canadian experience, particularly around British Columbia, and what they managed to achieve buy opening drug consumption rooms. And in countries like Norway where they increased the numbers on opioid replacement therapy, and stopped people being discharged.
“That’s one of the big issues we’ve identified in recent years – too many people in Scotland are not staying long enough in services. They are sadly falling out because they can’t engage appropriately. We need to look at why people can’t engage and look at delivering services differently so that when people do drop out they are chased up.
“Some of the treatment regimes are too harsh for people to engage effectively. I’m not saying it’s the fault of the services, there are some exceptional services, but we do need to all step back and look at how we do things differently. That involves a review of what we’ve done so far and the level of resources that goes into that.”
Liddell added: “If you look at the response to road traffic deaths, it can be massive for relatively small numbers of people dying.
“I’m not saying there’s anything wrong with that, but if you compare it to the scale of deaths we’re seeing among people with drug problems, surely we should be doing far more than we’re currently doing.
“As a society, surely we should have more compassion for our most vulnerable who are victims of society themselves.”
The Scottish Government minister responsible for the national drugs strategy, Joe FitzPatrick, was unavailable for interview. In a prepared statement provided by the Scottish Government, he said: “Addressing drug-related deaths is a public health priority of this Government.
“That is why our new combined drug and alcohol strategy, publishing later this year, will focus on how we engage those most at risk, and how services can adapt to help people most in need and best deliver support.
“There is no one simple answer, to what which is a part of a wider trend being seen across the rest of the UK and Europe.
"However, our strategy will provide a clear strategic direction to tackle the many challenges associated with problematic drug and alcohol use.”
CANADIAN ACADEMIC CALLS FOR INJECTING ROOMS FOR SCOTS DRUG USERS
The SDF conference on Thursday will hear from Canadian academic Dr Marilou Gagnon, Associate Professor at the University of Ottawa’s School of Nursing.
Gagnon, who will be the keynote speaker on Thursday, was on the frontline in hospitals during an unprecedented increase in overdose deaths in Canada, which led to authorities declaring a public health emergency, and opening drug consumption rooms where addicts were offered treatment.
Gagnon was the founder of the Coalition of Nurses for Supervised Injection Services, and on Thursday she will call on politicians in the UK to back a similar policy change to allow Scotland to set up sites.
The Scottish Government supports safer injecting rooms for drug users but the UK Government, which is responsible for drugs policy, has blocked the plan.
Gagnon said: “Overdose deaths are preventable. Canada has experience with that, implementing overdose prevention sites. The overdose crisis in Canada is very similar to the crisis in Scotland. What’s clear is harm reduction is not enough. You also need to provide treatment. They work hand in hand.
“It’s about caring about people and meeting them where there at rather than expecting them to stop. When you do that they tend to stop.
“We need to really encourage decision makers to shift their thinking and get going but if the government is very conservative it will block the exemption for safer consumption sites.”
The Scottish Government minister responsible for the national drugs strategy, Joe Fitzpatrick, said: “As demonstrated by our support for Glasgow’s proposals to introduce a safer medically supervised drug consumption facility, and offer heroin assisted treatment, we are willing to back innovative, evidence-based approaches that can make a real difference. And we call again on the UK Government to allow a safe consumption facility to be established.”
The Home Office, the UK Government department responsible for drugs policy, said there is “no legal framework” for drug consumption rooms.
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