SCOTLAND’S drug death crisis rages on, with another 1330 lives lost in 2021. In July 2019 – in response to deaths jumping by 27% in 2018 to a record of 1187 in a year – as some Scottish politicians called for a public inquiry, then health minister Joe FitzPatrick set up a taskforce.
Three years have passed, and death rates have not improved but got worse. For the last two years, more than 1300 people have died each year. FitzPatrick came into office in June 2018 when we were halfway through the worst year on record at that point and the year of the highest annual increase since records began. He inherited the 2016 Scottish Government drug treatment budget cuts and a post that was split across health, sport and wellbeing, talking about drug deaths one day and football the next.
Where are we now? I didn’t think I’d be defending FitzPatrick, but after he had been in post for two-and-a-half years, a new role of Drug Policy Minister was created with one remit – reduce drug deaths and harms. Twenty months have passed since Angela Constance was appointed. An extra £250m investment was committed, and Nicola Sturgeon, after admitting she “took her eye of the ball”, took personal responsibility, promising she would meet with the taskforce and that reports would flow straight to her.
The First Minister met with I and fellow activists who have campaigned tirelessly for change. The question was: how long does the Drug Policy Minister get with a specific remit and the extra investment to turn the tide on what has been described as Scotland’s “national mission” to reduce drug deaths, with no sign of any real reductions despite coming up on two years in post?
READ MORE: 'I had tears in my eyes': Peter Krykant on the new Scots drugs rules
If drug deaths can increase by 27% in a single year, they can decrease by the same amount. Anything less in 2022 is another failure. With the right treatment, compassion, collaboration and commitment, this is possible - but we have only seen more reports, more talking and no action - and comments from some that no real change will be seen for at least five years.
After a bumpy ride, the resignations of chairs and vice-chairs, the taskforce set up by FitzPatrick has now produced yet another report containing recommendations that myself and others have been making for years. On January 20, 2021, Nicola Sturgeon, in her address to the Scottish Parliament, said: “I can confirm today that we will make additional funding available – starting in this financial year – to make heroin-assisted treatment services more widely accessible across the country.”
Eighteen months on, this treatment is not more “widely accessible” – in fact, it is not more accessible at all. The same amount of treatment exists – but for just 19 people in Glasgow.
Scottish third-sector drug charities have their hands tied, unable to prescribe substitute medication. In England and Wales, drug charities see prescriptions as the best way of approaching harm reduction. Yet in Scotland we have an ineffective fully medical model, no more apparent than in Glasgow, where heroin-assisted treatment is estimated to cost £2m for just 19 people.
The same treatment is being delivered through the third sector in England – led by social justice charity Cranstoun’s clinical director Danny Ahmed – for one-third of the cost.
My hope is that we can work with the Scottish Government to make this treatment more accessible, as it is desperately needed. Evidence shows it engages people where other treatments have failed. With around 10% of heroin users consuming up to 60% of the heroin market, it is also cost effective because it reduces demand for the illicit supply demand and cuts crime rates.
We must remember every death is someone’s someone. The current response isn’t enough. Deaths are linked to areas of poverty in Scotland with studies saying the chances of a fatal overdose are 15 times higher.
As a project lead for Cranstoun, I know that it does not need to be this way. We deliver drug treatment in Sandwell in the West Midlands, which has some of the highest levels of UK poverty and the lowest drug death rates. It has 2.2 deaths per 100,000 people, compared to Dundee at 45.2 per 100,000.
TO reduce deaths quickly, we need a whole system approach. Cranstoun has presented a model to the Scottish Government and is actively seeking to work in partnership with it. We have a blueprint that is working across the entire West Midlands. Cranstoun’s DIVERT model – a pre-arrest drug diversion programme for those caught by the police in possession of small quantities of a controlled substance – is saving taxpayers an estimated £15m, operating across multiple local authorities and treatment providers.
Others and I, such as Glasgow Labour MSP Paul Sweeney, have also proven that overdose prevention centres can be operated within the current laws. An unsanctioned service in Glasgow has saved eight lives in just 10 months, while the £50m extra investment this year along with a “national mission” saved just nine lives in a whole calendar year. A reduction from 1339 to 1330 is not good enough.
We are using the best international practice to bring world-class drug treatment to England. We want the same for Scotland. Our conversations are ongoing but so are drug deaths. We need action, not more reports or words. They are of small comfort to people who have lost loved ones to preventable drug deaths.
I’ve been quoted saying Boris Johnson and the UK Government have “blood on their hands” for failing to change outdated drug laws. But with no sign of deaths reducing - and broken promises of setting up overdose prevention centres and getting diamorphine-assisted treatment rolled out across the country and increasing the number of people in treatment from a dismal 40% of those who have problematic drug issues - do we now have to be saying the Scottish Government has “blood on its hands”?
Heartbreakingly, it has followed the UK Government’s rhetoric of a drug-free utopian society, dating back to 2011 when we stopped prescribing benzodiazepines after creating a need by prescribing them readily for years. We then left people at the mercy of criminal gangs, who are supplying deadly, powerful “street benzos” for as little as 20p a pill.
The Tories, both in the UK and Scotland, pitch this same narrative. The UK Government’s new white paper – Swift, Certain, Tough: New Consequences For Drug Possession – wants to further punish people, and the Scots Tories are pitching abstinence as the biggest answer through their Right to Rehab bill consultation, sadly backed by two Scottish Labour MSPs.
OTHER countries, such as Switzerland and Portugal, have not solved their drug death crisis this way but through comprehensive prescribing of medications and wraparound social support.
I would urge the Scottish Government to resist the narratives that often play well with the public about getting everyone off drugs and follow the evidence of harm reduction playing a key role.
READ MORE: Drugs deaths figures show slight decline – but 2021 was second worst year ever
All pathways are valid, and residential rehab should be available for those that want it. However, we also need to look at outdated models sending people to a manor house in the countryside, wrapping them in cotton wool for three months and then sending them home to where they have a heroin dealer next door.
Rehab should include a reintegration plan, be based in the cities and include access to basic skills that many need – such as education, volunteering and job applications – rather than being based primarily on prayer and meditation. This works for the few, not the many.
There is no doubt in my mind about the sincerity of Angela Constance and Nicola Sturgeon, but words mean little when more than three families on average each day get the news of a loved one dying, then have to wait months on toxicology reports to confirm how they died then, after all the grieving, need to watch our annual day of shame plastered all over national and international media.
I dedicate this to the 1330 people who died unnecessarily last year, the four family members and countless friends I have lost, and all those struggling to access the support they need, as well as the hundreds who have already died in 2022.
Peter Krykant is an activist and a Cranstoun project lead
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