I, and my Scottish colleagues, often pick our way through discarded needles and excrement in places people are forced to inject as they try to escape from misery and suffering.
Sound grim? It’s not as depressing as picking through Scotland’s drug death statistics for a sixth horrific record breaking year. In 2019 there were 1264 families bereaved by a drug death. That’s 23 per 100,000 people, making Scotland the drug death capital of the world - a dark crown no country wants.
It doesn’t have to be like this. Numbers dying from heart disease in Scotland fell by a third in a decade, because it was made a national clinical priority. The same focus needs to be given to stopping people dying from drugs. And we know what works.
More people will die in Scotland between now and New Year's Day, than in Portugal in a whole year, which once had a similar drug death crisis. Until they focused on health, not criminalisation, and funded treatment properly.
READ MORE: Scotland's grim drug death statistics spark demands for action on consumption rooms
I’ve also had enough of watching the Scottish and UK Governments refusing to cooperate. Responsibility is shared, so are the answers. We must do the following now.
Increase funding for treatment, make it easier to access, and harder to be dropped from. In Scotland just 40% those who need treatment are in it. If and when people are ready, enough rehab beds should be available so they don’t have to wait.
But many who die aren’t ready to stop taking drugs, and existing treatment options like methadone don’t work for them. How do we keep these people alive?
1: Roll out “Naloxone” further. Good work is already being done to get this heroin antidote into the hands of those who can treat an overdose - police, medics, family and friends of people who use drugs.
2: Fund a wider roll out of Glasgow’s heroin prescribing programme. These clinics are for vulnerable people that other treatments don’t work for. I’ve seen them in Europe - no one overdoses because they know how much heroin they are taking. People stop using illegal drugs, their lives stabilise, so they engage with support to address why they take drugs at all. And people stop committing crime to fund use.
3: Open “Overdose Prevention Centres” (aka Safer Drug Consumption Facilities) to supervise people injecting their own drugs. No one ever died from an overdose in one - anywhere - and Scotland does not have to wait for permission.
Peter Krykant has been running an unofficial one for months, proving police can use discretion to allow these facilities. I, and lawyer colleagues, will happily meet the Lord Advocate to explore how he can formalise permission for a pilot. But Westminster should allow these life-saving interventions because we need them UK-wide.
READ MORE: We can't just keep talking - we need visionary action to stop drug deaths
4: Stop criminalising people who use drugs - it drives them from help, and doesn’t reduce use. Again, yes, Westminster should change the law to do this across the UK, as Portugal did. But the Lord Advocate and Police Scotland should (and I hear are) moving towards “police diversion” schemes. Instead of arresting people caught with drugs for their own use, they are directed to education, treatment and support. These schemes improve health, and reduce reoffending.
Longer term? Scotland and the UK Government must reduce the entrenched poverty that underpins much problem drug use.
No part of the UK should be the drug-death capital of the world. The UK and Scottish Governments need to act now, before this catastrophe gets even worse.
Martin Powell is head of partnerships at the Transform Drug Policy Foundation
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