There's a moment during my interview with Annemarie Ward when a look of what can only be described as despairing weariness passes across her face.

The Chief Executive of FAVOR, the UK’s foremost addiction recovery charity, is discussing the Scottish Government’s attitudes to the swelling numbers of alcohol and drugs deaths north of the border. “So many aspects of their approach need to change,” she says, “but if I were to choose one then it’s this: get rid of all the addiction quangos that have grown fat on public money.”

She begins to describe a lucrative, self-serving sector which is in denial about the true nature of addiction and doesn’t really believe that people can actually recover. And so they specialise in ‘harm reduction’, which she says is “middle-class virtue-signalling at its worst”.  

Even if you access social media sparingly you’ll have noticed Ms Ward; it’s impossible not to. FAVOR is an acronym for Faces and Voices of Recovery and her clarion call ‘You keep talking; we keep dying' haunts the Twitter accounts of the politicians and a swollen platinum class of apparatchiks who have made rewarding careers from Scotland’s burgeoning addiction economy.

She doesn’t mess around and is often targeted by those she holds responsible for years of policy failure and strategic incontinence in this area. She begins naming the addiction quangos and says she’ll soon be compiling a list of them to show how crowded the field is.

This is where Scotland’s public sector gravy train can be seen at full tilt, driven by a vast array of political actors who attend all the right networking events; leadership seminars and lobbying dinners.

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“They’ve become a shadow state,” she says. “They’re policy actors with at least one organisation employing 70-odd staff. There’s no equivalent to them south of the border because England got rid of them years ago. They simply de-funded them as part of a structural change leading to more funding for front-line services.  

“All of these Scottish quangos think they’re doing something, but they’re little more than the government lobbying government for no other purpose than to maintain funding levels.”

When I last interviewed her two years ago she made the rather bracing claim that more than a quarter of adults living in the Greater Glasgow area are “problematic drinkers”. Even given Glasgow’s wretched reputation as the planet’s drunk uncle these numbers seemed startling, yet she continues to stand by them.

“They come from the Health and Social Care Partnership’s own research conducted by social workers and NHS service providers. I wouldn’t define them all as having addiction levels of dependency, but they’re people who have reached out for help because it’s beginning to impact on relationships, finances, health. It directly leads to premature death rates.”

She believes you can’t formulate an adequate response to Scotland’s ruinous relationship with alcohol unless you factor in a class element and the stoicism of working-class families and communities in dealing with alcohol dependency. “Families move the goalposts when confronted with addiction,” she says. “We insist you must be fine if you can go to work. It’s a perverse sort of working-class pride.

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“One of strongest reactions I got when this was affecting me was ‘Och, you’re fine: I drink more than you’. When someone says they’re in trouble, others start comparing themselves. It’s a form of collective denial.”

Scotland seems to have specialised in talking about the nation’s alcohol issues periodically over several decades. We’ve been here before and many times: the stark headlines; the documentaries; the grim case studies; the cultural and civic leaders discussing it sonorously and seeking an explanation in a familiar suite of causes: de-industrialisation, climate, geography. So, what needs to change if we’re to break this pattern?

“It goes back to that collective denial,” she says. “We don’t want to look too closely at it as it means we’d need to take collective responsibility. From a cultural, spiritual, mental and emotional perspective this comes back on us all. It means saying unequivocally that those communities where addiction is most prevalent have been totally decimated by inequality and multi-deprivation.

“I’m frightened by how fast inequality is rising and at a rate faster than any other time in our history. And since Covid, there’s been a profound shift in favour of the asset class. The political classes don’t see it at street level. The only way this will shift is if we begin to address inequality and the profound spiritual decay that underpins it.”  

When she talks about the spiritual disconnection, she cites a constant need to be distracted which has become worse since Covid. “I was talking to a friend who told me she’d binge-watched 18 episodes of a drama on Netflix in one weekend. This is a spiritual dislocation, yet we don’t talk about it in these terms as ‘spiritual’ is too big a conversation for people to have in modern Scotland.”

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She despairs of the Scottish Government’s refusal - and that of its favoured agencies - to recommend the 12-step programme of AA. “It works for many people,” she says, “and it doesn’t require government expenditure. It teaches all the best bits about religion such as forgiveness; healing and perseverance, but it’s in no way religious at its core. Yet in Scotland, the addiction sector thumbs its nose at it. In England, they have no such hang-ups.”

Ms Ward believes that lying at the heart of this reluctance to recommend the 12 steps is what she calls “The God Word” and a deep-rooted antipathy to religious faith. “Harm reduction is the ideology of the Scottish Government which it preaches with a religious fervour,” she says. “When they see “God” in the Third Step they get jittery. This is where AA asks you to explore you’re own concept of God. The premise is one of ‘you got yourself into the problem but you may not have the tools to get out of the problem, so it might be an idea to seek help from somewhere outwith yourself.

“It’s also an intellectual snobbery. People who believe in God are a bit deluded and thick. I’ve experienced that a lot. They also come at me with the predictable “she’s raging because she’s not got one of their big jobs. But I know who they are: they’re all Scottish Government stooges.”

Ms Ward has already been approached by senior figures in Scottish Labour seeking some guidance on formulating their own anti-addiction policies. It makes sense. If the party does form the next Scottish Government they could probably do without being regularly spanked by Ms Ward about a supine approach to alcohol and drugs deaths.  

“I’m willing to work with Labour. I want to contribute positively; I don’t want to be the one who’s always screaming. But if they don’t get rid of these quangos then I know they’ll just continue with the grift of government lobbying government.”

The Herald: Those making policy have no clue about the reality of the lives of those who are worst affected by alcohol addiction.”Those making policy have no clue about the reality of the lives of those who are worst affected by alcohol addiction.” (Image: Colin Mearns/The Herald)

What is actually meant though, by “front-line services”? She begins to list them: “Community rehab, actual rehab, detox services; helping those communities worst afflicted in general. Devising a way of plough back some of the alcohol industry’s vast profits. They could put it to good use in youth clubs, local sports facilities. These communities are often the first to lose their libraries and swimming pools.”

In recent weeks, she’s become a harsh critic of the Scottish Government’s Minimum Unit Pricing policy which seeks to discourage people from buying alcohol. “It simply doesn’t work,” she says, “because those making the policy have no clue about the reality of the lives of those who are worst affected by alcohol addiction.”

She points out something that the Scottish Government and its advocates don’t want the public to hear, that the dramatic hike in alcohol prices have done little more than boost the profits of the alcohol industry to the tune of about £70m.

“It’s not the alcohol that’s attractive,” she insists, “it’s the oblivion. In the face of alcohol price rises people will simply turn to the cheapest methods of oblivion. The political actors and their middle-class policies have no idea of the inadvertent consequences of these actions, which is people turning to cheaper alternatives for oblivion. And why are they looking for that? Because they’re in pain. And why are they in pain? Because of grinding poverty and inequality.

“I read 40 studies around this and only seven were looking at health-based outcomes. Then I looked at who commissioned the research on all the studies and the only one that was positive about MUP was a researcher from Public Health Scotland. And it was Public Health Scotland who were writing the report. So you wonder if there’s some jiggery-pokery going on here. 

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“These people don’t live in the real world. If they were, they’d looking at the correlation in the rise in drugs deaths since Minimum Unit Pricing was introduced in 2018. It doesn’t need a genius to work out why. And in the meantime, I’m still burying my friends.”

She believes that the alcohol industry has a part to play in addressing problem drinking and that if the Scottish Government and its client policy actors in the addiction sector were serious about doing so they’d be partnering with the the big drinks players. It’s a controversial view and one that would scare an administration obsessed with the optics of every step they take. Yet, from a social responsibility perspective there are benefits accruing to the drinks firms from such an approach. 

“I think they’d step up if they had the chance. But the government and their acolytes are frightened to be in bed with the alcohol industry. Yet the whole of Scotland is already in bed with the alcohol industry. Even half of one per cent of their increased profits could make a huge difference to communities worst affected by alcoholism if they were re-invested there.

“I don’t even see the problem with booze adverts. I don’t care about ‘the optics’ of a swimming pool sponsored by Tennent’s lager. The Government thinks the people in these communities are stupid and that we’re easily influenced. They’re obsessed with channelling ethics but what they’re doing in facilitating the already vast profits of the booze industry is grievously unethical.”