Families who have lost loved ones to substance abuse have said they feel excluded, stigmatised and let down by medics, the Scottish Government and alcohol and drug services. 

In an open letter published as Scotland recorded 1,172 deaths from drugs misuse in 2023 – and increase of 121 from the previous year – the families said they had lost ‘children, partners, siblings, and parents’. 

They described a broken system where help was not available when it was most needed, medication was not supported and mental health treatment hard to obtain - leaving the police as the only possible port of call in an emergency. 

The group, represented by charity Scottish Families Affected by Alcohol and Drugs (SFAD), said that their voces often went unheard, and final goodbyes in hospital were rushed and impersonal.  

Deaths at home, the letter states, saw their houses treated as crime scenes.  

The families said that some had been living with a bereavement for many decades, while some had lost a loved one in the past few months.  

The familes said hospital care needed to improve The familes said hospital care needed to improve (Image: Peter Byrne)

The letter states: “When our loved ones were alive, GPs were dismissive of our concerns and the severity of the situation. Our experiences with many alcohol and drug services were unreliable and stigmatising.  

“They made us feel excluded. 9am-5pm appointments did not provide help when it was most needed. Our concerns about treatment and prescriptions were not accepted.  

“Our loved ones whose substance use couldn’t be treated with medication had no support, while others who received medication didn’t receive much else. It was hard to get help for mental health, so often our only port of call in a crisis was the police.” 

It continues: “Being left out of our loved ones’ care meant that some of us didn’t know where they were for months at a time – even if all we wanted to know was that they were ok. Hospital discharges were unplanned and unsafe, harming the whole family.  

“Our input as family members was not heard, even though we could share real insight into what our loved ones needed.  

“Many of the decisions made without our involvement greatly affected us.” 

The families released a bullet-point list to agencies calling for better support.  

The said NHS Scotland needed to listen to their ‘lived experience’ when decisions were being made, the Scottish Government should set up a 24-hour crisis helpline, while Police Scotland needs dedicated family liaison officers experienced in dealing with deaths through substance abuse.  

Many felt final goodbyes were rushed Many felt final goodbyes were rushed (Image: PA)

The families also called for an end to the “judgment” faced by addicts and their loved ones, which often left them unable to talk about their trauma and the tragedies they faced.  

The letter says: “Better understanding about what addiction is, and how it has impacted our families, would help get rid of stigma around substance use.  

“Talking about mental health and suicide without judgment would help with the isolation caused by substance use. 

“Each of us who has been bereaved through alcohol or drugs has had our own experiences. Not all of us have gone through all of the experiences mentioned. But we need to have our collective voice heard to bring awareness of the magnitude of this issue. It affects thousands of families and every community across Scotland.” 

The letter concludes: “Everyone, both within services and in our communities, has their role to play.” 


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Justina Murray, CEO of SFAD said: “I would ask everyone to take a few minutes today to read this powerful and passionate letter from family members bereaved by substance use. They have desperately struggled to keep their loved ones alive, with practically no support or recognition.  

“So-called helping services have excluded, judged and shared nothing, then expected families to pick up the pieces when support and systems fail.  

“They have been left in the dark about their loved one’s care and treatment when they were alive, about exactly how they died, and about what happens next. The pain of their loss is heart-breakingly clear. Our national drug deaths crisis is far from over, Scotland can and must do better.”