A bittersweet victory: Scotland’s battle against drug deaths

Scotland’s battle against drug deaths has been a long-standing issue, reflecting the nation’s larger grapple with substance abuse. The film Trainspotting, based on the book of the same name, sensationalised and portrayed the gritty reality of drug use in Scotland in the ’90s, but the issue has persisted for the last few decades. Both progress and setbacks have marked that time, and while recent data shows a glimmer of hope, the fight is far from over.

So what is the Scottish government doing to address the situation? And what are the country’s obstacles in its battle against addiction and preventable drug deaths?

Scotland flag and pills

A troubling portrait: Scotland’s drug use statistics

The number of drug-related deaths in Scotland rose steadily between the mid-nineties and the first decade of the 21st century but began to rise dramatically until 2021 when there were a staggering 27.1 drug poisoning deaths per 100,000 people, nearly triple that of the UK.

Drug misuse deaths in Scotland 1996 to 2022

(Image Credit – National Records of Scotland)

However, according to the latest figures from the National Records of Scotland (NRS), there was a significant decrease of 279 drug-related deaths between 2021 and 2022, marking a 21% drop – the largest year-on-year decrease on record. While this may seem like progress, this still means that there were 1,051 drug deaths in 2022, higher than any other European country.

In perspective: Comparisons to the rest of the UK

The issue’s magnitude in Scotland is further illuminated by a comparison with the other countries in the UK, where England, Wales, and Northern Ireland exhibit drug poisoning death rates per 100,000 of 8.3, 11.0, and 11.5, respectively. The stark divide highlights Scotland’s complex challenges in this battle.

However, it is important to note that England and Wales should not take too much heart from these comparisons. As can be seen below, drug deaths have also trended upwards in the rest of the UK for both males and females, showing that there is still more to be done south of the Scottish border too:

Drug misuse deaths by gender in England and Wales

(Image Credit – Statista)

Demographics in distress: Who is most affected?

Deaths due to drug addiction do not discriminate, affecting individuals from all walks of life. Yet, specific demographics within Scotland bear the brunt of this crisis. Glasgow City and Dundee City emerge as the epicentres of this distressing phenomenon, having experienced the highest drug misuse deaths over the past five years. In contrast, East Renfrewshire and Aberdeenshire stand at the opposite end of the spectrum, grappling with comparatively lower rates.

The substances leading this harrowing pattern are opiates and opioids, including heroin, morphine and methadone. These compounds have been implicated in more than eight out of 10 (867) drug-related deaths in 2022. Benzodiazepines (601) were also involved in significant drug deaths, with “street valium, ” five times stronger than prescription valium, blamed for many of these. Cocaine is another significant worry as it is now present in 361 drug deaths (almost a third) compared to only 6% of deaths in 2008, with experts pointing to more widespread use and higher potency levels.

One potentially alarming development is that campaigners believe hundreds of drug deaths could be missing from official figures as the data does not include “secondary” deaths related to drugs.

The complex tapestry: Factors fueling the crisis

The drug crisis in Scotland is not a simple story with a single villain. Rather, it’s a complex tapestry woven by multiple factors, including economic disparities, mental health challenges and social marginalisation. Many of Britain’s poorest communities are found in Scotland, and for some, substance abuse becomes a refuge from life’s hardships, driving them deeper into the clutches of addiction.

Additionally, the issue is exacerbated by the emergence of synthetic opioids in the heroin supply. This sinister addition to the equation has led to a new level of danger as synthetic opioids like Fentanyl are now responsible for most deaths in the US opioid crisis.

Political progress: Prevention measures and obstacles

After drug deaths in Scotland reached 1,187 in 2018, Richmond Davies, Head of Health, Wellbeing and Social Care at Public Health Scotland said:

“These preventable deaths are each individual tragedies that have a lasting effect on families, friends and our communities. It is, therefore, important and right that we take the time to fully understand the circumstances that have led to these deaths so that we are able to identify areas of increasing harm and provide evidence for interventions to be put in place that seek to prevent these harms.”

Three years later and recognising the urgency of the situation after further rises in deaths, former Scottish First Minister Nicola Sturgeon announced a “national mission”. At the time, she promised £250 million more in new funding for the next five years. £20 million of the first year’s £50 million was provided to residential rehab centres, long considered the most effective form of addiction treatment. This was an important step because less than 40% of the 60,000 people who required treatment were receiving it.

Recently, however, the Scottish government has found itself at loggerheads with their counterparts in Westminster over plans to decriminalise drug possession for personal use. When Scottish ministers proposed it in July 2023, Home Secretary Suella Braverman rejected the move, saying it would cause “untold damage”. This highlights the delicate balance that must be struck between addressing the crisis and avoiding unintended harm, which remains a critical challenge for Scotland.

Scottish person holding drug syringe

Breaking the chains of addiction: Effective recovery strategies

Addiction is a formidable foe, capable of entangling its victims in a web of despair. But rehab centres offer a lifeline, providing safe detoxification, tailored treatments and therapies and comprehensive aftercare support. UKAT has a number of rehab centres across England and has helped many people overcome addiction through a holistic approach that addresses the condition’s physical and psychological aspects.

In 2021, Scotland’s residential rehab centres were already very near capacity, with all but 418 beds available. This shows that Sturgeon’s decision to give 40% of the total budget to rehab was right, but whether this is enough remains to be seen.

Charting a course: From crisis to hope

While the decrease in drug deaths between 2021 and 2023 is a step in the right direction, there is no doubt that the road ahead is fraught with challenges. The demographics most affected by the crisis, the intricate factors fuelling addiction and the still unclear effectiveness of the Scottish government’s measures all weave together to form a complex narrative. At the heart of this struggle, rehab centres and other effective treatment and support can provide a lifeline for those ensnared by addiction and lessen the impact on the country. While it is important to be optimistic and hope that numbers continue to trend downward, every step must be taken to prevent the awful waste of life that Scotland has seen over the past few decades.