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| Scotland's drug deaths expected to remain worst in Europe | Scotland's drug deaths expected to remain worst in Europe |
| (32 minutes later) | |
| Scotland has seen high numbers of people dying from drug misuse for the last seven years | Scotland has seen high numbers of people dying from drug misuse for the last seven years |
| Figures to be published on Tuesday are expected to show that Scotland remains the drugs death capital of Europe for the seventh year in a row. | Figures to be published on Tuesday are expected to show that Scotland remains the drugs death capital of Europe for the seventh year in a row. |
| In 2023, there were 1,172 drug misuse deaths in Scotland, bringing the total in a decade to 10,481, according to official figures. | In 2023, there were 1,172 drug misuse deaths in Scotland, bringing the total in a decade to 10,481, according to official figures. |
| Although experts expect that number to have dropped slightly for 2024, they are warning that any fall will almost certainly be a blip. | Although experts expect that number to have dropped slightly for 2024, they are warning that any fall will almost certainly be a blip. |
| Kirsten Horsburgh, chief executive of the Scottish Drugs Forum says the arrival of deadly synthetic opioids known as nitazenes in the country is "a crisis on top of a crisis." | Kirsten Horsburgh, chief executive of the Scottish Drugs Forum says the arrival of deadly synthetic opioids known as nitazenes in the country is "a crisis on top of a crisis." |
| "Suspected deaths for the first quarter of this year are already higher than they were last year," she said. | "Suspected deaths for the first quarter of this year are already higher than they were last year," she said. |
| How did we get here? | How did we get here? |
| This is a crisis with deep roots in the social and economic changes which swept through Scotland in the latter half of the 20th Century as the country's economy shifted away from manufacturing. | This is a crisis with deep roots in the social and economic changes which swept through Scotland in the latter half of the 20th Century as the country's economy shifted away from manufacturing. |
| When the shipyards, steel mills and collieries fell silent, they left a generation of men, whose pride and identity had been bound up with the things they made, struggling to adapt. | When the shipyards, steel mills and collieries fell silent, they left a generation of men, whose pride and identity had been bound up with the things they made, struggling to adapt. |
| Society changed rapidly too. The old city slums were cleared, but many people were moved to damp, isolated tower blocks with limited amenities. | Society changed rapidly too. The old city slums were cleared, but many people were moved to damp, isolated tower blocks with limited amenities. |
| It was a recipe for joblessness, family breakdown and addiction. | It was a recipe for joblessness, family breakdown and addiction. |
| In 1972, in a famous speech at the University of Glasgow, the trade unionist Jimmy Reid said Britain's "major social problem" could be summed up in one word - alienation. | In 1972, in a famous speech at the University of Glasgow, the trade unionist Jimmy Reid said Britain's "major social problem" could be summed up in one word - alienation. |
| Men, he said, viewed themselves as "victims of blind economic forces beyond their control" leading to a "feeling of despair and hopelessness that pervades people who feel with justification that they have no real say in shaping or determining their own destinies." | Men, he said, viewed themselves as "victims of blind economic forces beyond their control" leading to a "feeling of despair and hopelessness that pervades people who feel with justification that they have no real say in shaping or determining their own destinies." |
| One way alienation found expression, said Reid, was in "those who seek to escape permanently from the reality of society through intoxicants and narcotics." | One way alienation found expression, said Reid, was in "those who seek to escape permanently from the reality of society through intoxicants and narcotics." |
| Trade unionist Jimmy Reid speaks to the press at the Marathon oil rig yard in Clydebank in 1976 | |
| Half a century after Reid's speech, Scotland is still grappling with alienation and still struggling with the scourge of alcohol and drugs. | |
| High unemployment in the 1980s was followed by cuts to public spending after the financial crash of 2007/8 and the skyrocketing cost of living this decade. | High unemployment in the 1980s was followed by cuts to public spending after the financial crash of 2007/8 and the skyrocketing cost of living this decade. |
| By 2023, people in the most deprived parts of Scotland were more than 15 times more likely to die from drug misuse than those in the richest areas. | By 2023, people in the most deprived parts of Scotland were more than 15 times more likely to die from drug misuse than those in the richest areas. |
| For many years this was a particularly male problem. | |
| In the early 2000s, men were up to five times more likely to die of an overdose than women although that gap has since narrowed considerably. | |
| As demand for drugs rose, so did supply. From 1980, heroin from Afghanistan and Iran began to arrive in Scotland in large quantities, with deadly results. | As demand for drugs rose, so did supply. From 1980, heroin from Afghanistan and Iran began to arrive in Scotland in large quantities, with deadly results. |
| The sharing of dirty needles by injecting drug users and the arrival of HIV led to a public health crisis which was graphically depicted in Irvine Welsh's 1993 novel, Trainspotting, and its film adaptation. | The sharing of dirty needles by injecting drug users and the arrival of HIV led to a public health crisis which was graphically depicted in Irvine Welsh's 1993 novel, Trainspotting, and its film adaptation. |
| 'Drugs are becoming normalised' | 'Drugs are becoming normalised' |
| Drug overdoses are not the only evidence that Scotland is experiencing a crisis related to alienation. Other so-called deaths of despair are also high. | Drug overdoses are not the only evidence that Scotland is experiencing a crisis related to alienation. Other so-called deaths of despair are also high. |
| Scotland has a higher rate of suicide than other parts of the UK and some of the highest levels of alcohol-related deaths in Europe. | Scotland has a higher rate of suicide than other parts of the UK and some of the highest levels of alcohol-related deaths in Europe. |
| These too are often linked to poverty. In 2023, deaths directly caused by alcohol were 4.5 times higher in the most deprived areas of Scotland than in the least deprived. | These too are often linked to poverty. In 2023, deaths directly caused by alcohol were 4.5 times higher in the most deprived areas of Scotland than in the least deprived. |
| Taken together, says Annemarie Ward, of the charity Faces and Voices of Recovery UK, Scotland has a "penchant for oblivion". | Taken together, says Annemarie Ward, of the charity Faces and Voices of Recovery UK, Scotland has a "penchant for oblivion". |
| Annemarie Ward said taking illegal drugs was becoming normalised | Annemarie Ward said taking illegal drugs was becoming normalised |
| Illegal drugs, she argues, have become part of the national culture. | Illegal drugs, she argues, have become part of the national culture. |
| "It's become normalised," she said. "I don't think we have to accept that normality." | "It's become normalised," she said. "I don't think we have to accept that normality." |
| Of course, poverty and despair are not unique to Scotland. Other countries and other parts of the UK have also struggled with deprivation. | Of course, poverty and despair are not unique to Scotland. Other countries and other parts of the UK have also struggled with deprivation. |
| Clearly poverty alone is not a sufficient explanation for Scotland's situation. | Clearly poverty alone is not a sufficient explanation for Scotland's situation. |
| Various other theories have been put forward including the existence of a macho, hard-partying culture; a reluctance, especially among men, to seek mental health support; and even the country's long, dark winters. | Various other theories have been put forward including the existence of a macho, hard-partying culture; a reluctance, especially among men, to seek mental health support; and even the country's long, dark winters. |
| Another suggestion is that years of substance abuse are now catching up with the ageing Trainspotting generation - although this is disputed. | Another suggestion is that years of substance abuse are now catching up with the ageing Trainspotting generation - although this is disputed. |
| Between 2000 and 2023, according to the National Records of Scotland, the average age of a drug misuse death increased from 32 to 45. | Between 2000 and 2023, according to the National Records of Scotland, the average age of a drug misuse death increased from 32 to 45. |
| Another potential explanation is the ripple effect of trauma. | Another potential explanation is the ripple effect of trauma. |
| When more than 1,000 people are dying every year in a small country, the implications for their families and friends are enormous and potentially catastrophic. | When more than 1,000 people are dying every year in a small country, the implications for their families and friends are enormous and potentially catastrophic. |
| Drugs have scarred whole communities with abuse of substances continuing from generation to generation. | Drugs have scarred whole communities with abuse of substances continuing from generation to generation. |
| Dr Susanna Galea-Singer said people seeking treatment for drug addiction have often experienced trauma | Dr Susanna Galea-Singer said people seeking treatment for drug addiction have often experienced trauma |
| Nearly "every person who seeks treatment has been traumatised in some way," says Dr Susanna Galea-Singer, chair of the Faculty of Addictions at the Royal College of Psychiatrists in Scotland. | Nearly "every person who seeks treatment has been traumatised in some way," says Dr Susanna Galea-Singer, chair of the Faculty of Addictions at the Royal College of Psychiatrists in Scotland. |
| Last year, Public Health Scotland published a review of all drug deaths in 2020 which revealed that 602 children lost a parent or parental figure to overdose in that year alone. | Last year, Public Health Scotland published a review of all drug deaths in 2020 which revealed that 602 children lost a parent or parental figure to overdose in that year alone. |
| "You get social fragmentation when you have aspects of poverty, aspects of trauma," said Dr Galea-Singer. | "You get social fragmentation when you have aspects of poverty, aspects of trauma," said Dr Galea-Singer. |
| "You burn bridges with families, it's just extremely difficult. It does fragment society." | "You burn bridges with families, it's just extremely difficult. It does fragment society." |
| Trauma might explain a high or even rising level of drug deaths, but even it does not adequately account for a dramatic jump in the numbers a decade ago. | Trauma might explain a high or even rising level of drug deaths, but even it does not adequately account for a dramatic jump in the numbers a decade ago. |
| There appear to be two main reasons for the surge in deaths back then. | There appear to be two main reasons for the surge in deaths back then. |
| First, in 2015, the Scottish government cut funding for alcohol and drug partnerships, which co-ordinated local addiction services around the country. | First, in 2015, the Scottish government cut funding for alcohol and drug partnerships, which co-ordinated local addiction services around the country. |
| Kirsten Horsburgh, CEO of the Scottish Drugs Forum, warned of the deadly impact of synthetic opioids | Kirsten Horsburgh, CEO of the Scottish Drugs Forum, warned of the deadly impact of synthetic opioids |
| "We saw the start of a really sharp increase in drug-related deaths," said Kirsten Horsburgh of the Scottish Drugs Forum. | "We saw the start of a really sharp increase in drug-related deaths," said Kirsten Horsburgh of the Scottish Drugs Forum. |
| "There's no doubt that cuts to funding in this area reduces the amounts of services that people can access, reduces the staff that are able to support people and results in deaths." | "There's no doubt that cuts to funding in this area reduces the amounts of services that people can access, reduces the staff that are able to support people and results in deaths." |
| Ministers later boosted resources as part of a five-year "national mission" to tackle the drugs emergency, only for funding to fall again in real terms in the past two years. | Ministers later boosted resources as part of a five-year "national mission" to tackle the drugs emergency, only for funding to fall again in real terms in the past two years. |
| "Cuts to funding in this area is a disaster," said Ms Horsburgh. "Even with increased resource as part of the national mission, we can see it's still not enough. | "Cuts to funding in this area is a disaster," said Ms Horsburgh. "Even with increased resource as part of the national mission, we can see it's still not enough. |
| "We can't just have small pilots of projects to address a public health emergency. | "We can't just have small pilots of projects to address a public health emergency. |
| "We would not do that for any other public health emergency. We did not do for Covid. We should not be doing that for the drug deaths crisis." | "We would not do that for any other public health emergency. We did not do for Covid. We should not be doing that for the drug deaths crisis." |
| The second big change came around the same time as drug services were being cut. | The second big change came around the same time as drug services were being cut. |
| It was the arrival on Scottish streets of dangerous benzodiazepenes known as street valium. | It was the arrival on Scottish streets of dangerous benzodiazepenes known as street valium. |
| Street drugs being sold as valium have been blamed for causing more drug-related deaths | Street drugs being sold as valium have been blamed for causing more drug-related deaths |
| These blue pills were a fake and powerful version of the anti-anxiety medication, Valium, and they were deadly. | These blue pills were a fake and powerful version of the anti-anxiety medication, Valium, and they were deadly. |
| Nicola Sturgeon, who was First Minister at the time, would later admit that her SNP government had taken its "eye off the ball" on the matter. | Nicola Sturgeon, who was First Minister at the time, would later admit that her SNP government had taken its "eye off the ball" on the matter. |
| The issue of funding to reduce drug deaths remains contentious. | The issue of funding to reduce drug deaths remains contentious. |
| Many public health experts support a harm reduction approach involving the provision of substitute drugs such as methadone, clean needles, and a drug consumption room which has been set up in Glasgow. | Many public health experts support a harm reduction approach involving the provision of substitute drugs such as methadone, clean needles, and a drug consumption room which has been set up in Glasgow. |
| "Harm reduction has to be the core of any effective evidence-based drugs policy approach," said Ms Horsburgh of the Scottish Drugs Forum. | "Harm reduction has to be the core of any effective evidence-based drugs policy approach," said Ms Horsburgh of the Scottish Drugs Forum. |
| There are also calls from some quarters for decriminalisation of all drugs and a transfer of powers from Westminster to Holyrood. | There are also calls from some quarters for decriminalisation of all drugs and a transfer of powers from Westminster to Holyrood. |
| Harm reduction | Harm reduction |
| Annemarie Ward of Faces and Voices of Recovery UK agreed that harm reduction should be part of the mix but said the balance needed to tilt towards rehabilitation. | Annemarie Ward of Faces and Voices of Recovery UK agreed that harm reduction should be part of the mix but said the balance needed to tilt towards rehabilitation. |
| "When government ministers talk about treatment in Scotland, what they're talking about is harm reduction," she said. | "When government ministers talk about treatment in Scotland, what they're talking about is harm reduction," she said. |
| "When the general public hears the word treatment, they're thinking detox, rehab, people getting on with their lives." | "When the general public hears the word treatment, they're thinking detox, rehab, people getting on with their lives." |
| Ms Ward also wants a shift away from NHS provision of drugs services in favour of organisations, such as her charity, which focus on rehabilitation and recovery. | Ms Ward also wants a shift away from NHS provision of drugs services in favour of organisations, such as her charity, which focus on rehabilitation and recovery. |
| "Our treatment system is delivered through the public sector, which means it's incredibly bureaucratic. So you can't just walk into a service and get seen that day, for instance, the way you can in England." | "Our treatment system is delivered through the public sector, which means it's incredibly bureaucratic. So you can't just walk into a service and get seen that day, for instance, the way you can in England." |
| Ms Horsburgh and Ms Ward may have different priorities for tackling the crisis but both agree that it is almost certainly about to get worse. | Ms Horsburgh and Ms Ward may have different priorities for tackling the crisis but both agree that it is almost certainly about to get worse. |
| "Nitazenes are a whole new ball game," warns Ms Ward. | "Nitazenes are a whole new ball game," warns Ms Ward. |
| "These are the synthetic opioids that are 100 times stronger than your average hit of heroin, and they're also ending up in the coke supply." | "These are the synthetic opioids that are 100 times stronger than your average hit of heroin, and they're also ending up in the coke supply." |
| She predicts an exponential rise in deaths "unless we start to help people get clean and sober again." | She predicts an exponential rise in deaths "unless we start to help people get clean and sober again." |
| If that is the case, it appears Scotland has not yet got to grips with this emergency. | If that is the case, it appears Scotland has not yet got to grips with this emergency. |
| The causes of the drug deaths crisis are multiple and complex. | The causes of the drug deaths crisis are multiple and complex. |
| But the fear is that they are producing a cumulative and compounding effect from which it is proving almost impossible to escape. | But the fear is that they are producing a cumulative and compounding effect from which it is proving almost impossible to escape. |