THE head of Scotland’s Drug Deaths Task Force has warned that turning around the woeful fatal overdose record could take up to five years and even then may be thwarted by a blue wave of fake valium flooding the nation’s streets.
Professor Catriona Matheson said there is “no quick fix” to halting the nation’s dire tally of drug deaths, and confirmed she expects 2019 fatalities to outstrip the previous year when figures were the worst on record.
Reflecting on the task force’s first year of operation, she told how tackling the scourge of valium-type drugs that plague Scotland’s streets is proving to be “most challenging” and gives her sleepless nights.
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And she confirmed that controversial emergency opiate overdose medication naloxone is being increasingly used across the country, including ‘click and deliver’ postal kits being sent on request to families to administer at home.
While the medication is credited with saving lives, some suggest it can lead to addicts regarding it as a safety net for riskier behaviour. Others warn that it is merely a ‘sticking plaster’ and diverts investment from support programmes that could wean users away from drugs.
However, Prof. Matheson, chair of the task force, said wider availability of naloxone kits following a relaxation on their distribution by the Lord Advocate in response to the Covid-19 pandemic, alongside an imminent Police Scotland pilot programme which will see officers carry nasal spray versions of the treatment, means “Scotland is now well on its way to having world leading naloxone programme”.
Naloxone is delivered through injection or a nasal spray, helping to buy vital time for emergency help to arrive, potentially saving lives. A total of 12,135 take-home naloxone kits were issued in Scotland in 2018/19, a rise of 42% on the previous year, including 1,543 which were reissued to replace a kit used to treat an opioid overdose.
While naloxone was used more than 5,000 times by the Scottish Ambulance Service paramedics last year, the Scottish Police Federation has expressed concern over moves to hand it to police officers, arguing it would position them in the role of medics.
Scotland’s drug deaths task force was launched last summer after devastating figures for 2018 showed 1,187 lives lost: a 27% rise in deaths on the previous year.
It was the largest number of drug-related deaths in the country since records started in 1996 and more than double the figure recorded in 2008.
The figures put Scotland’s drug-related death rate at 218 per million of the population – more than three times that of England and Wales, and similar to the United States, where the impact of synthetic opioids such as fentanyl have been likened to a mass poisoning.
While Police Scotland data suggests 2019 numbers are on course to be even higher, the figures have been delayed following a dispute between the Crown Office and the toxicology unit at Glasgow University, which covers around 90% of Scotland’s drug-related deaths.
Another grim year for overdose deaths is likely to spark questions over the effectiveness of the task force.
It was handed a £9m budget in its first year with a further funds next year, with a remit to take “immediate action” to stem the deadly spiral and find long term solutions to overdose fatalities.
Instead, it has been accused of being a talking shop, with claims it has swallowed up money that could have gone to grassroots drugs services or residential rehab beds, and with too much focus on commissioning new research instead of tackling the drug use head on.
Glasgow, which has 23,500 known problem drug users, has just 13 rehab beds.
However, Prof. Matheson dismissed recent accusations of lengthy gaps between full meetings of the task force as “unfair” and added: “Some realism is needed.
“It’s nonsense to suggest we just throw money at rehab. We know that people can die coming out of rehab. They come out, are vulnerable and high risk.
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“Even if we want to set up many more rehab facilities, how could we do that quickly? It doesn't happen overnight.
“Putting people into rehab is not the answer.”
Instead, she confirmed that it is likely to take two years for the task force’s action plan - which includes tackling stigma surrounding drug users and rethinking support offered to people on medical treatment programmes like methadone - to begin to deliver results.
She added it would be even longer before its vision to dramatically overhaul Scotland’s drug care approach will be in place.
“In two years’ time we will know if we are starting to make an impact,” she said. “It is a five year programme of work to get all these things in play and working. There is no quick fix.
“Realistically the task force was never going to be able to bring the figures down straight away.
“The impact will be over the next two or three years, but Covid-19 has made it all the more challenging and set things back by around five months.
“Some of the entrenched underlying issues are going to take much longer to do much about.”
Last month the task force announced £800,000 for ten mainly university-led research projects.
A further £3 million is to be distributed to Scotland’s Alcohol and Drug Partnerships, while £5 million is to be spent on pursuing the task force’s Innovation and National Developments programme.
It includes work to identify ways for health authorities to capture overdose survivors and steer them towards further support, new standards to help tackle underlying issues affecting people prescribed Medication Assisted Treatment, and the development of a national Naloxone programme.
However, the focus on gathering further research on Scotland’s drugs problem has been criticised.
Scottish Labour’s health spokesperson Monica Lennon said: “On the basis that it had one very important objective, and that drug deaths appear to be still rising, the drug deaths taskforce cannot be considered a success.
“The momentum has turned the wrong way, with worrying signs that overdoses are increasing and that Scotland is set to beat its own shameful world record yet again as the leader in drug deaths.
“It will be upsetting for many people with lived experience to hear the taskforce chair dismiss the effectiveness of residential rehab, especially when the current approach of the group she leads is failing to make any positive impact.”
She added: “We need the Public Health Minister to take action before more lives are lost, including rapid investment in residential rehab.”
Annmarie Ward of campaign group Faces & Voices of Recovery UK (FAVOR UK) said: “It’s like Alice in Wonderland, they are going down the rabbit hole and studying the problems of addiction constantly instead of engaging with people who have recovered and who can talk about how they did it.
“We have been shocked that the task force seems to have so many sub-groups and so many meetings taking place.
“There seems to be a reluctance to help people get off drugs.
“The drugs death task force is completely out of control and has done nothing to stop the deaths.”
Prof. Matheson described criticism of the force’s work was “quite depressing”.
“All the people working in the field and in support services know what a big challenge it is,” she said. “It’s very disheartening; we know what needs done but it’s not going to happen overnight.”
She confirmed that tackling the flood of cheap fake valium sold on streets for pennies and often used in tandem with opiates, is a major problem.
She suggested one way to reduce demand for ‘street blues’ could involved increasing prescriptions for diazepam and benzodiazepine.
“Street valium is being produced in huge quantities, really cheap and the quality is variable,” she said.
“We have to think about how to reduce demand for it.
“It is the most challenging and is the one thing that keeps me up at night.”
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