‘Far too little is being done to save lives in this emergency’

Every drugs-related death is a tragedy for that person and their loved ones. Sadly, an increasing number of families in Scotland are now affected by such tragedies.

In 2018, 1,187 people died as a result of drugs. Ministers admit it’s a public health emergency – but far too little is being done to save these lives.

The loss of life, particularly among those aged between 35 and 55, is such that drugrelated deaths are affecting life expectancy trends for Scotland. Although76 per cent of deaths recorded last year were of older drug users, there is a worrying increase in the number (282) of deaths below the age of 35.

The number of deaths among women has also risen rapidly in recent years to 327, which is 189 per cent higher than in 2008. Opioids, such as heroin, morphine and methadone, are involved in most (86 per cent) drug deaths, but they are rarely taken in isolation.

The use of more than one substance is a factor in 85 per cent of all fatalities. This is heavily influenced by street drugs, such as cocaine and illicit benzodiazepines, which are increasingly implicated in drug deaths, and also prescribed drugs, such as pregabalin and gabapentin.

Deaths are highest among working-class people in deprived areas, who have often been ignored in British drug policy making.

There is a lot to learn about the causes and solutions of Scotland’s epidemic of drug-related deaths. But we already know some steps that could be taken.

These include providing more and better substitution therapies for people who use heroin, with optimal dosage and duration of methadone treatment, providing heroinassisted treatment, and expanding other harmreduction services.

The controversy over the stalled idea to open a safer drug consumption room in Glasgow is not the only example of the lack of progress in implementing these recommendations.

This latest bout of political inertia contrasts with Scotland’s world-leading approach to take-home naloxone (the antidote to

opioid overdose), which was implemented nationally in 2011 and cited as an example of best practice by the World Health Organisation. Without this, the latest drugrelated death figures may well have been even higher.

Extra investment of £20m per year until 2021 in drug and alcohol treatment is much needed, but this was announced in response to a widely criticised £15m cut in 2016-17. It falls far short of what is required to address a public health crisis.

A new drug and alcohol treatment strategy published in November 2018 received widespread acclaim for adopting a public health approach to reduce harm, but an action plan to support its implementation is still awaited eight months on.

We cannot go on like this. Every year since 2014, steep annual increases in drugrelated deaths have been met with promises to look into causes and propose solutions. Meanwhile, people continue to die, as evidencebased and life-saving solutions are left on the shelf. l Alex Stevens is a professor in criminal justice at the University of Kent. l Andrew Mcauley is a senior research fellow at the school of health and life sciences at Glasgow Caledonian University