Inside Justice

To cut drug deaths we must look at how the victims lived, says Tom Wood

Some positive news in our long struggle with Scotland’s drug deaths. At last the First Minister has gripped the problem and her commitment of £250 million over the next five years is welcome indeed.

This significant sum will reinstate the monies stripped from our addiction services during the austerity years, and then some.

As importantly, for the first time in a decade, addiction services have a heavyweight political champion. It was refreshing to see a political leader with the guts to step forward and take responsibility for a ‘national disgrace’ that has been deteriorating under our noses for years.

So what now? We know throwing money at this problem does not work; we have tried it before. We cannot buy or arrest our way out, careful management and sustained investment in proven treatment plans is the only way.

We must avoid a free-for-all or simply pumping money into services and approaches that we know have failed in the past. But before we launch this new effort, we need a true appreciation of the problem.

A few years ago, while I was working with Edinburgh Alcohol & Drug Action Team, we had the opportunity to look at the lives of 20 people whose deaths had been recorded as “drugs-related”.

The toxicology reports identified the substances but a closer examination showed that drugs and alcohol were usually only one factor in their deaths. Mainly men in their 30s, most had a long history of addictions, drifting in and out of services.

Many had other complex physical and mental illnesses. All were isolated, most of their friends and families had long since been driven away. Some had no contacts other than their doctor, social worker or dealer. Depressive illness was common.

It was a small sample, but even so the evidence was clear. While combinations of alcohol and drugs were recorded on their deaths certificates, the real cause of these young people’s deaths was wider and deeper. Lonely and detached, many seemed to have simply given up the will to live.

I was reminded of that insight last week when reading about the excellent research by Glasgow University into the drug-related death of young women soon after their children had been taken into care. Once again the factors driving high-risk drug use were wider social issues. Drugs were the cause of death but not the reason.

That is why effective prevention of drug deaths must focus on the whole lives of users, not just their addiction. And that is why residential rehabilitation and aftercare is rightly being prioritised. Only aftercare and continued support will avoid the deadly game of snakes and ladders that so often attends addiction and ends in tragedy.

It’s expensive but we know it works. I have written before about the work of the Lothian and Edinburgh Abstinence Programme. For more than ten years this tough, abstinencebased residential regime has proved hugely successful, not only in helping people overcome their addictions, but in supporting them to stay in recovery.

Now with funding and political will, we finally have a real opportunity to tackle this ongoing calamity. The key will be to focus on drug users’ lives, not just their deaths.

Tom Wood is a writer, former Deputy Chief Constable and former chair of Edinburgh Alcohol & Drug Action Team