"The drug-related deaths figures were not a surprise. There was a depressing inevitability about them continuing to be so high.
"Given that 2017 was a historic high, to jump another 27 per cent is quite exceptional.
"What’s really struck us with the data is what’s making drug users in Scotland at so much risk of drug-related death and there’s no single explanation for that; there are lots of different reasons interacting to cause the rate to be so high.
READ MORE: Scotland's drug death toll rockets as rethink is demanded
"From a quantifiable point of view, we have many more people – around 60,000 – in the problem drug user group than in other countries, so by definition we should expect to have a lot of drug-related deaths because we have a huge number of people at risk.
"We’ve known this for a while.
"It’s not like it’s a new infectious disease that we don’t have treatment for; the evidence base is very, very clear on what works and we don’t seem to be very good at implementing that.
"The fundamental cornerstone for drug-death prevention is drug treatment – all the evidence tells us that drug treatment is the most protective thing.
"To get people engaged in and retained in drug treatment – and by that I mean an optimal dose of opiod substitution therapy because we’re talking about a population whose main drug of choice is heroin, usually alongside alcohol and cocaine – if you can get them retained in treatment then you’ve got a much better chance of a) keeping them alive and b) giving them the best opportunity for recovery.
READ MORE: ‘It’s not just been my own recovery but all of my family’s’
"Intelligence suggests a lot of the estimated 50 per cent of people in recovery at any one time are on sub-optimal doses and they’re cycling in and out of treatment regularly. When that happens your risk of overdose increases, so it shouldn’t be a surprise when we look at these death figures."
Dr Andrew McAuley is a senior research fellow at Glasgow Caledonian University’s School of Health and Life Sciences.
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