Politicians key to beating Scottish drug habit

With addiction rates at an all-time high, we need policies that tackle poverty – the root cause, writes Luke Dale-Harris

SCoTLAnD is back in the seat as whipping boy of UK drug policy. The statistics look grim: drug deaths in Scotland are at historic highs; Scots use more illegal drugs than any other country in Europe; methadone use is out of control; alcoholism endemic.

Last month, the Scottish Government came under fire, with the Conservatives demanding it “gets a grip on this spiralling problem”, while Labour called for a “crackdown on the abuse of methadone”. Against the statistical backdrop, the government’s assurances that the drug strategy was on course seemed steeped in denial.

only a few years ago, the Scottish Road to Recovery drugs strategy was heralded for its progressive and humane stance on addiction. With its focus on recovery, holistic treatment and social support for addicts, it was held up as an example the rest of the UK should follow. Record amounts have been invested in front-line services to treat addiction since 2008, and the motivation among addicts to get clean is high, with 76 per cent of problem drug users in Scotland claiming a wish to kick the habit.

Yet drug policy cannot function in isolation and drug addiction cannot be removed from the political context in which it exists. It is no coincidence that today’s drug problem found its feet in the recession of the 1980s and grew to maturity in the areas hit hardest by Thatcherism, and that drug deaths have again spiralled since the economic downturn of 2008. Drug use comes as the result of many things, but most common among them are poverty, social stagnation and an entrenched stigma against drug users. Unless politicians take this into account and treat addiction as the sum of its social causes, drugs policy is bound to failure. Today’s government has either lost sight of this fact or wilfully ignores it.

The addiction debate flutters between specific treatment methods –opiate substitutes, such as methadone, versus abstinence models such as narcotics Anonymous – while state support for the disadvantaged is systematically savaged around them. David Liddell, of the Scottish Drugs Forum, sees it as an ideological hijacking. “It falls between the predominantly private rehabilitation model and the state-backed opiate substitute therapy approach. The reality is that neither will work unless the wider social problems are taken into account.”

Methadone was brought in as a response to the threat of HIV in the 1980s, a means to prevent the threat of blood transmission that comes with intravenous drug use. It was successful – HIV rates plummeted and, as an added bonus, it helped to keep addicts off the streets and away from crime. But, though conceived as a short-term solution, throughout the Labour years methadone became a crutch that both the government and users increasingly relied on. Doctors used it as a catch-all prescription (often for cases where heroin wasn’t even the addict’s drug of choice), while users interchanged between methadone and street drugs.

“We now have a situation where you get three generations of addicts in a single family,” says Liddell. “The drug culture has become entrenched in the poorest pockets of our society.”

For many, Conservative politicians included, the solution lies in moving away from substitute drugs to a focus on getting addicts off drugs. This was a central premise of the Road to Recovery strategy and recent years have seen concrete moves to implement it. Community recovery groups have sprung up across the country, often in the poorest areas, with programmes to build the hope and aspiration that is so vital to recovery. Attempts have been made to integrate prison rehabilitation with recovery programmes on the outside. Residential rehabilitation programmes, though still minimal, are receiving more support than they did five years ago.

Permeating these progressive moves though is a distinct flavour of David Cameron’s “Big Society”. The emphasis for recovery is on self help, while recovery programmes tend to run parallel with state services, often carried out by voluntary groups, rather than integrating with other health services.

GPs, the first point of contact with the healthcare system for the vast majority of addicts, have been found by the University of Aberdeen to be ill-trained in addiction issues and hold “negative attitudes to drug users”, often refusing them treatment at all. As a result, only 6 per cent of addicts find their way into treatment through their local healthcare system.

This is expected to worsen with the introduction of the payment-by-results policy, which encourages doctors to treat the easiest patients first. For addiction – undeniably costly and frustrating to treat – this is bad news.

Meanwhile, the impacts of austerity measures are already hitting Scotland’s most deprived areas. A report from the University of Glasgow documents a large rise in chronically-ill patients turning to drink and drugs as self-medication as social services withdraw their support. Addiction workers are complaining of funding and access barriers to detox services and saying that they don’t have time or funds or to carry out structured addiction work, forcing them to refer patients to charities instead. Social work and housing services are chronically understaffed. Addicts and the chronically ill are being deemed “fit to work” and having their benefits withdrawn.

“The welfare reforms hit the addicted and the chronically ill the hardest’, says Dr Catriona Matheson, a researcher into drug misuse at the University of Aberdeen. “They are being pushed outwards from society, increasingly stigmatised by the public and the politicians.” These are the politics from which drug addiction is born, not tackled, and until this assault on the most deprived is stopped, the problem will continue unabated.