Why is there a drug death crisis in Scotland?

Scotland is experiencing a “national crisis”, according to opposition members of the Scottish Parliament, as drug related deaths in Scotland have risen by 27% over the past year. Now on par with the United States in terms of per capita fatalities, with a death rate that has doubled since 2008, there have been frequent calls for the Home Office to allow Glasgow to open a Drug Consumption Room (DCR) in which long-term addicts can be monitored by health officials.

Over 1200 people in Scotland died due to a drug-related problem over the last year; the highest number ever recorded. More Scots died from drug related causes, rather than alcohol related causes, for the first time last year, and Scotland now has a drug death rate three times that of the rest of the UK: the highest rate in Europe.

Over 1,200 people in Scotland died due to a drug related problem over the last year

The Scottish Public Health Minister, Joe Fitzpatrick, described the number of people who have died from drug-related deaths as a “tragedy” .He stated that this needs to be treated as a public health issue , recently giving evidence to the Scottish Affairs Committee to persuade the UK government to implement public health responses to the crisis, or to devolve power to the Scottish parliament.

Meanwhile, Health Spokeswoman for Scottish Labour, Monica Lennon, has argued that “Scotland’s drug crisis is out of control,” as the Labour Party criticises the Scottish National Party for their health and justice policies, and, what they see, as an inability to bring about change.

72% of victims were male, alluding to a disproportionately male crisis. Despite drug taking being seen as a youth problem in the popular imagination, 37% of victims were aged between 33-44. 86% of deaths were caused by opiates – opium derived substances such as heroin, morphine, and codeine.

Why is Scotland so disproportionally affected in the UK? Poverty is one cause given – with one in five Scottish people living in poverty and over 1.03 million existing below the poverty threshold. Some point to the impact of the “trainspotting generation”, causing deaths of ageing long-term users who were active in the 1980s and 1990s, inspired by the acid house culture.

More Scots died from drug related causes, rather than alcohol related causes, for the first time last year, and Scotland now has a drug death rate three times that of the rest of the UK.

Drug use has been higher in Scotland than the rest of the UK since the aforementioned heroin epidemic of the 1980s and 1990s. Drug campaigners blame a “perfect storm” with more people using multiple drugs, stronger prescription drugs, and long-term addicts in fragile health. A lot of evidence points to the ageing population of drug addicts rather than a youth epidemic. In such conditions, how effective would much-called-for better education in schools about the harms of drug use be?

The Scottish government has renewed calls for more powers to be devolved to Holyrood to allow it to take measures to stop the fatalities. Roy Robertson, MP for Muirhouse, where the film Trainspotting was set, has said that “clinical services remain fragmented” and has argued that the focus of drug policy needs to be on improving treatment for addicts – pointing out that only 40% of people with drug problems are in treatment.

The Daily Record has launched a campaign for the decriminalisation of drugs. They argue that people are dying, and we should treat drugs as a health issue and not turn users into criminals. They support moves to prosecute the dealers who are at the cause of the problem. They argue, however, that the UK’s “war on drugs mentality” is harmful, as more resources could be devoted to disbanding drug gangs if police and court time were not dedicated to pushing addicts through the courts.

One in five Scottish people are living in poverty, with over 1.03 million living below the poverty threshold.

Changing the law to decriminalise the use of drugs has risen to the top of the agenda recently. This would not make taking drugs legal, per se, but would mean that people using them for personal use are no longer prosecuted. All of the witnesses who gave evidence to the Scottish Affairs Committee Inquiry said that putting drug users in prison was not a solution to the crisis. Dr. John Budd, a GP working with homeless people in Edinburgh, said that prison was destabilising for patients with drug issues.

Whilst harm reduction services are offered to heroin addicts at risk of overdose, for example, this is still controversial – heroin replacement drug methadone has been implicated in more drug-related deaths than heroin itself. Experts argue the way harm reduction services are delivered at the moment is ineffective and that an “integrated model of care” is what is needed.

SNP ministers have been supported by local councils, health officials and drug support charities to pilot a new DCR (Drug Consumption Room) in Glasgow. This would allow long term addicts to access clean needles, preventing the risk of HIV caused by sharing needles, in a controlled enviroment. This move has been opposed by Scottish conservatives and the UK government, which controls Scottish drug laws. They fear that decriminalisation and more support would portray an attitude of accepting criminal activity and deviance.

DCRs, according to the Daily Record, have saved lives around the world in Canada, Spain, France, and Germany. The zero-tolerance mentality regarding drugs is preventing us from adopting measures that would be more effective. Other nations that implement zero-tolerance policies, like the US and Sweden, also recorded the highest drug deaths. David Liddell of the Scottish Drugs Forum said that DCRs would be needed across the country if they were to make an impact.

Giving evidence to the Scottish Affairs Select Committee, Assistant Chief Constable Steve Johnson pleaded with politicians to decriminalise drugs, and he showed his support for the DCR. James Wolffee QC, the Scottish government’s chief legal officer, suggested that de-facto decriminalisation was already happening, as police begin to stop charging individuals for drug possession.

Drug use is seventeen times higher in Scotland’s poorest areas, compared to the wealthiest.

The right realist approach to crime, which conservatives in Scotland and Westminster seem to adopt, looks to tougher policies that will prevent the acceptance of, and potential to, commit crime by being tough on the causes of crime and criminals. They seek a tougher, zero-tolerance strategy over drugs, including a crackdown over possession and supply. This, arguably, unnecessarily puts people who are in possession of drugs and addicts into the justice system. Those supportive of decriminalising drugs argue that right realist crime solutions do not provide long-term success as addicts are not treated.

Left realist crime approaches, on the other hand, look to long-term solutions that tackle social and economic problems. Local outreach workers in Glasgow linked a rise in the number of deaths of homeless people to widespread use of illegal versions of prescription tranquilisers. Dr Budd argues that the criminal justice system acts as a “mopping up service” for people with mental health difficulties, for example, and that the solution to tackling drug deaths is to “eradicate child poverty”, as poverty was the source of so many issues surrounding addiction. The majority of his patients had experienced problems in childhood. Drug use is seventeen times higher in Scotland’s poorest areas compared to the wealthiest.

Solutions such as poverty reduction, decriminalisation and increased health funding are, however, unpopular with governments because they are expensive, and the effects cannot be seen for many years, unlike tougher policies. It is unlikely that the UK government will allow any kind of complete decriminalisation in Scotland.

There is no easy solution to the crisis. Substitution is not a long-term solution, whilst tougher legal penalties for users only appear to exacerbate the problem. Solutions that tackle the root cause of the problem would be much more effective, but these are expensive, and often unpopular. It is clear that a range of approaches are needed to tackle the issue of increasing drug fatalities in Scotland, but, perhaps, none of these can be executed until some sort of power is devolved to Holyrood.