Scotland’s drug-deaths highest in Europe

 

There has been a 27% increase in drug-related deaths registered in Scotland since 2017, figures published recently show. The statistics, published by the National Records of Scotland, provide details of 1,187 drug-related deaths that occurred in Scotland in 2018.

 

A widely predicted rise, this is the largest number of such deaths since records started in 1996 and more than double the figure for 2008, when 574 people died. Although the way in which such deaths are recorded varies across Europe, the latest figures show Scotland has suffered the highest death rate for any EU country and a rate nearly three times that of the UK as a whole.

 

Public Health Minister, Joe FitzPatrick, has reiterated calls for the UK Government to allow the Scottish Government to establish safer drug-consumption facilities to try to bring down the number of deaths occurring north of the border.

 

“The number of people who have lost their lives because of drug use is shocking,” the Minister said.

 

“It is vital this tragedy is treated as a public health issue, and we are prepared to take innovative and bold measures in order to save the lives of those most at risk.

 

“Last week, I gave evidence to the Scottish Affairs Committee and I asked for help in persuading the UK Government to either act now to enable us to implement a range of public health-focused responses – including the introduction of supervised drug consumption facilities – or devolve the power to the Scottish Parliament so that we can act.”

 

Earlier this month, Professor Catriona Matheson – a leading drugs expert at the University of Stirling was appointed by the Scottish Government as chair of a new taskforce to combat the rising numbers of deaths linked to substance misuse.

 

“I want to ensure that the work of the new taskforce which I have established is driven by strong evidence and the voices of those with experience of using drugs, and their families, are heard,” continued Mr FitzPatrick.

 

“I am determined to shape our services in every walk of life to prevent harm and reduce the appalling number of deaths.

 

“So I will give consideration to any proposals they bring forward which may help to tackle this issue and, ultimately, save lives.”

 

Appearing before the Westminster Scottish Affairs Committee this month, the Public Health Minister said among the options the task force would consider, he fully expected decriminalisation to be included.

 

The largest proportion of deaths occurred within NHS Greater Glasgow & Clyde – 394 – while 152 died within NHS Lothian, 130 in NHS Lanarkshire, and 109 in NHS Tayside.

 

This story was supplied as part of our partnership with healthandcare.scot. 

What can Scotland learn from British Columbia’s approach to overdose deaths?

 

Part of the answer to mounting drugs-related deaths in Scotland lies in grassroots charities, community groups and experts with lived experience taking a lead role, a Canadian substance use researcher says.

 

Professor Bernie Pauly of the Canadian Institute for Substance Use Research was in Scotland last week to speak at a Dundee harm reduction event organised by the Scottish Drugs Forum.

 

In Vancouver, the setting up of unsanctioned ‘pop up’ overdose prevention sites to save lives in the face of a rising tide of overdose deaths led to the provincial government backing these sites across the province, Professor Pauly, who is also a nurse at the University of Victoria School of Nursing, tells healthandcare.scot.

 

Her comments come amid an ongoing standoff over a safe consumption room in Glasgow. The Home Office refuses to allow such a facility, which campaigners, local politicians and the Scottish Government say has been proven to “save lives”.

 

British Columbia is home to just over five million people, compared to just under five and a half million for Scotland.

 

Like Scotland, it has also struggled with drugs. In 2015, overdoses became the highest cause of unnatural deaths, outstripping suicides and traffic accidents.

 

Fatalities have remained stubbornly high, with more than 1,500 people losing their lives in 2018 and, for the first time in recent history, life expectancy is falling.

 

In Scotland, 934 drug-related deaths were recorded in 2017.

 

Professor Pauly explains how, in light of long processes for federal approval of drug consumption rooms, activists and campaigners moved to provide an “essential health service” themselves.

 

“There were people, particularly in Vancouver, who started by setting up unsanctioned sites – often called pop-ups, because they were in tents. One of the ones in Vancouver was basically a tent in an alleyway where people could be observed and Naloxone administered immediately in the event of an overdose.

 

“People knew there were evidence based-interventions that would save lives – so why weren’t we doing that?”

 

Following the declaration of a public health emergency in 2016, the provincial government sanctioned overdose prevention sites – a move opposition politicians in Scotland have been calling for.

 

Overdose prevention sites are small-scale, “welcoming and friendly” spaces typically staffed by harm reduction workers, including staff with lived experience of drug use.

 

As well as expanding access to overdose prevention, they created “a space that was safe, where people felt like they wouldn’t be judged, with opportunities to develop trust and facilitate opportunities to access other services.”

 

In Canada, larger drug consumption spaces – of the kind proposed for Glasgow – have a broader range of staff, including nurses and counsellors. But while British Columbia is held up as an exemplar when it comes to harm reduction policy, Professor Pauly says a comprehensive response is critical.

 

Alongside overdose prevention sites, there was rapid scale-up of the provincial Take Home Naloxone Program and Opioid Substitution Therapy – but, she argues, more is needed. While no deaths occurred at supervised consumption or overdose prevention sites, British Columbia still saw 104 suspected overdose deaths in March.

 

Ultimately, these spaces are still “emergency measures,” Professor Pauly says. The ‘real prevention’ is ensuring a safe supply.

 

One idea being proposed in Canada’s western-most province is ‘compassion clubs’, in which members would be able to access a safe source of heroin.

 

It’s hoped this would undermine the illegal market, reduce poisonings and overdose deaths caused by impurities.

 

Asked what lessons Scotland could draw from the Canadian experience, Professor Pauly says:

 

“One is engaging people with experience right from the start because so many innovations are driven by them. The establishment of safe consumption sites…were really led by people with expertise and lived experience.”

 

Ultimately, she returns to the issue of supply, which is “something that should be addressed from the start.”

 

“You can scale up things like overdose prevention,” Professor Pauly says, “but you really have to address the fact there is an unsafe supply and really focus on changing policy to ensure a safe supply – that’s the real prevention.”

 

This story was supplied as part of our partnership with healthandcare.scot.