This week the National Records for Scotland released the latest figures for drug deaths in the country, revealing that tragically 1,051 people lost their lives in 2022. Whilst this marks a decrease of 21% – and the lowest figure in half a decade – the need to guard against complacency is stark, and much more needs to be done to address the drugs crisis in Scotland and the United Kingdom as a whole.
Scotland remains the drug death capital of Europe and just last month the Scottish Government backed a report calling for a host of globally-evidenced harm reduction measures to be implemented. The major caveat is that the foreword from Drugs Minister Elena Whitham indicated that measures could only be implemented with further devolutionary powers – drugs policy is reserved to Westminster. This has only furthered calls for Independence as a route to achieve this change, when the current UK Government seems resistant to evidence based changes to drug policy.
Whilst the report makes sound recommendations which would reduce the tragic number of preventable drug deaths, there is concern that drug policy is once again becoming a staple of a Westminster-Holyrood battle. There are several policy solutions to reduce harm, suffering and fatality which could be implemented within the existing legislative framework, but the focus remains on legislative change that simply will not happen overnight.
It is undeniable that the SNP have gone further than the Conservatives in Westminster, and further than Labour in the Senedd when it comes to drugs, but there is no excuse for the numbers of preventable deaths after 16 years in power. Minister Whitham admitted in an interview on Channel 4 that the Scottish Government’s 22% cut to alcohol and drug partnerships in 2016 have directly contributed to the tragic rise in deaths. After just a few months in the role, her frank, honest and direct response is welcomed.
Furthermore, whilst deaths decreased by over a fifth, the figures related to deprivation did not decrease. You are 16 times more likely to die from a drug related death if you live in the most deprived parts of Scotland, compared to the poorest areas of Scotland. Glasgow and Dundee consistently rank highest for the number of deaths, and the Scottish Government must tailor their approach to address these areas, and the underlying reasons why people living in deprivation may be more susceptible to dying from drugs.
A reduction in deaths compared to the previous year is positive, but the numbers must be viewed within the context of unprecedented increases in drug deaths preceding this, having nearly doubled over a decade. Deaths have now reduced in two successive years, but the rate is too slow, and the need for immediate, holistic action is enormous. Each life lost is someone’s brother, sister, father or daughter and the human cost of this crisis must never be overlooked.
The need for immediate action is escalating across the UK, despite this week’s figures showing at least some improvement. This is due to alarming reports of synthetic opioids emerging in the United Kingdom’s drug supply. Drug support services across the country are noticing a rise in extremely worrying clusters of highly potent synthetic opioids called ‘nitazenes’, which has led to warning being issued by police forces and public health chiefs.
Given that drug related death data is only released 18 months after the 12 month recorded period, Cranstoun is urging policy makers not to sleep walk into a potential public health emergency.
Nitazenes are synthetic opioids estimated to be between 50-300 times stronger than heroin. In the United States, where synthetic opioids are more common in the drug supply, the rate of overdose deaths involving synthetic opioids in 2021 was nearly 22 times the rate in 2013. Fentanyl is one of the biggest killers of people under the age of 50, with over 100,000 people dying from the drug in 2022. The rise in prevalence in the United Kingdom is linked to a Taliban clampdown on opium poppy cultivation in Afghanistan (an essential precursor for synthesising heroin), who are thought to have been supplying 95% of the market here.
The US has declared the crisis a public health emergency, and there is growing anxiety that the UK is heading down a similar path. No single solution put forward will eradicate the lethal dangers of synthetic opioids, but a joined-up, whole system approach to managing the crisis will reduce the level of suffering. Scotland, and the UK as a whole, must consider evidence based solutions such as drug checking, overdose prevention centres (OPCs), and diamorphine assisted treatment.
The UK still has the opportunity to get ahead of the curve on this developing public health emergency, but the window of opportunity is closing quickly and the consequences will be devastating.
Drug checking – facilities where people can test what is in their drugs – has existed in various forms in the UK for a number of years to great effect, but the Home Secretary Suella Braverman recently blocked such facilities – without costly and prohibitive licences – from operating at festivals.
Overdose Prevention Centres, facilities where people who use drugs can do so under more sterile conditions and under medical supervision, has already been shown to work in the UK, albeit unsanctioned and operated by leading activist and colleague Peter Krykant.
Diamorphine Assisted Treatment involves giving people suffering with long-term addictions a safe supply of medical grade heroin twice a day, and is proven to deliver excellent results – including reducing the use of street drugs significantly, as evidenced by an evaluation by Teesside University.
Additionally, pathways into treatment, and reaching the cohorts most at risk of overdose, is essential. All three proposals highlighted ensure that people using drugs are regularly seen by trained professionals. A recent Lancet report analysing the opioid crisis in Scotland highlighted how people in treatment are nearly 3.5 times less likely to die from drugs, compared to those who are not. [JS1]
An array of evidence-based solutions, encompassing a whole system approach, already exists, yet the United Kingdom lags behind European and North American neighbours on rolling out initiatives that are proven to work.
The SNP already back many of the evidence-based proposals highlighted, as per the aforementioned report released last month, and to some extent they are somewhat hamstrung by the UK Government in regards to the Misuse of Drugs Act 1971. However, as opposed to talking about what cannot be done without devolution, they must focus on the range of measures which can be implemented now – and at pace.
The drug crisis in the UK is further complicated by a desperate need for both the Government and the Opposition leaders to be ‘tough’ on drugs, as well as the financial implications of the cost of living crisis and a sharp rise in inflation. In spite of this, leaders across the United Kingdom must take bold action and work constructively to mitigate this developing public health emergency.
The preservation of life, protection of communities and capacity on stretched emergency services must usurp political posturing. 1,051 people have tragically lost their lives in just 12 months. Each one a tragedy, leaving behind broken families and friends, and we simply must do more to tackle the crisis.
