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Drugs: we need to talk.

It’s time to get real about drugs and alcohol in Scotland. A National Statistics Publication for Scotland in 2020 reported that 10,757 people are on the Scottish Drug Misuse Database.

What’s the fuss about? Well… at first glance, this number may not seem that high.

But hold up… the truth about Scotland’s drug problem may be far grimmer with some estimates suggesting that the number of folk in Scotland with drug problems is somewhere closer to 60,000 according to Public Health Scotland.

In 2017, Slovakia – a country roughly the same size as Scotland – had nineteen drug-related deaths. Meanwhile, Scotland had a total of 1187 in 2018.

Shocking, aye, but this shouldn’t be that surprising considering pretty much every single person in Scotland has either directly or indirectly been affected by drugs or alcohol in some way.

Scotland has the highest number of people suffering fatal overdoses in Europe... a staggering statement for a country like ours that views itself as progressive, equal and built upon ideals of justice. Comparing ourselves to our European neighbours provides us with some useful insights. Holland and Sweden have very different ideas about how to come with the issue of drug and alcohol abuse but what they have in common are that they both have very low rates of substance misuse.

What is different about these two countries then? One of the most striking similarities that these two countries share is the low levels of poverty they have and the more fairly opportunity is spread throughout society. Meanwhile, in Scotland, a million people – including a quarter of a million children – are considered to be in poverty as per Joseph Rowntree. They also estimate that those living in the most deprived areas in Scotland are eighteen times more likely to suffer a drug-related death than the least deprived areas.

Wow. Let that sink in.

It’s not like we don’t know that there’s a problem. As I said, everyone has been affected in some way, but to see the inequality laid bare like that is heartbreaking.

To make this worse, usually chucked into the mixer is a heavy dose of mental health problems stemming from trauma and abuse in those suffering from substance abuse. Without exception, every person who suffers from addiction has suffered some form of abuse. This can be physical, sexual, emotional or a combination of any of the three. Gabor Mate, a leading expert in trauma and addiction, suggests that addiction can be viewed as compensation for something lost in childhood, meaning addiction is a way of dealing with neglect and an attempt to try and find relief after harsh childhood experiences.

So, not only do we plunge large portions of our population into poverty and harsh living conditions, but we also punish those who have universally suffered abuse in early childhood by putting them in prison, stigmatising them and depriving them of the support they need to recover. All of these issues combined – a lack of resources and trauma – make recovery for a lot of people nearly impossible.

It’s time to start considering new approaches. The old model is broken or, maybe it never worked in the first place. Focusing on harm reduction and giving people the tools to recover is the only way to tackle the issues. Ridding ourselves of our prejudice and stripping back the labels of those who have had “junky” or “jakey” slapped across their forehead without a second thought. Let’s try seeing the very real human being beneath. We can start by investing in our communities and making sure welfare is at an adequate level so people aren’t needlessly rammed into poverty and unable to get themselves back out. Following this government policy should aim to ensure mental health services are fit for purpose and make use of treatments which are trauma-informed as “Every addiction starts with pain and ends with pain” (Eckhart Tolle).

Extremely promising results from other countries such as Canada, Australia and Denmark have resulted in Scotland looking to them for inspiration in terms of drug and alcohol policy. For example, in Syndey since the opening of a medically supervised injecting site in 2001 there have been one million supervised injections and 8500 overdoses that have occurred without any fatalities.

Despite the growing body of evidence of success stories in groundbreaking drug and alcohol policies adopted by foreign governments, any change in policy direction suggested by the Scottish Government has been met with huge difficulty up until now. This is largely a result of legal barriers presented by the Misuse of Drugs Act 1971, which is a reserved issue for Westminster. Proposals for progressive change such as the creation of drug consumption rooms have been resisted by the UK Government and rejected on the basis that they promote drug use, drive people away from other means of recovery and are still illegal under current law.

This means that although there is a desire from the Scottish Government to move towards a more health-focused drug and alcohol policy, and health is a devolved issue under the remit of the Scottish Government, there is still significant tension between the Scottish Government and the UK Government on the issue, causing delay, a lack of progress and an inability to implement innovative policies.

However, innovation is growing in the face of this challenging environment. The once functioning drug consumption room in Glasgow, for example, managed to establish itself as a place where addicts can inject and consume drugs safely under supervision. It made sure of clean needles, lowering the rate of disease transmission and overdose.

Considering the level of political opposition in Westminster it is unlikely that the UK Government will be likely to change path any time soon. However, there is some leeway as it is possible for there to be legal exemptions made at the discretion of the Lord Advocate in Scotland. This means that the Lord Advocate has the power to change police procedures and ensure that specific offences are not prosecuted.

In light of this, the drug consumption room that opened in Glasgow went unchallenged by local police. Pursuing harm reduction and health-orientated drug and alcohol policies may still be on the table for the Scottish Government.

Policies with harm reduction at their core are still possible but it requires a level of boldness on the part of decision-makers at the local level. So far, nobody has been willing to fully commit themselves to this course of action. I hope that this will change.

Our priority needs to be saving lives but by doing this we are, at the end of the day, only dealing with the symptoms of a deeply neglected society.

Hopefully, through forward-thinking policies, we can begin to take the weight off some of the most misunderstood and vulnerable people who have, quite frankly, suffered enough.

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