The public health crisis of Scotland’s drug use

Drug consumption rooms should be a part of the solution as Scotland looks to bring about a reduction in drug-related deaths, according to Scottish Drugs Forum CEO David Liddell

Tuesday 26th March 2019

Proposals for a supervised drug consumption facility in Scotland have proved politically divisive, but the chief executive of the Scottish Drugs Forum (SDF), David Liddell, advocates them as one aspect of the range of services needed to address an “ongoing tragedy”.

Mr Liddell, who has been with the SDF since its establishment, explained to healthandcare.scot how a drug consumption room proposal for Glasgow would address “a very particular set of circumstances”.

The SDF has been one of the stalwart stakeholders on this issue, providing expertise and resources on drugs and related issues, and seeking to improve Scotland’s response to problem drug use since 1986.

Supervised drug consumption facilities – proposals for which the Scottish Government supports – are spaces where illegal drugs can be used under the supervision of trained staff and have been operating in Europe for the last three decades.

Despite their prominence in recent debate, Mr Liddell explains they are only part of the solution: “The drug consumption room proposal for Glasgow is based on the research evidence that this service would address a very particular set of circumstances among a group of around 500 people.”

Those circumstances are likely to pertain in Dundee and Edinburgh but probably not elsewhere in Scotland on a scale sufficient to justify a room being opened. So Scotland could benefit from three services that would protect a very vulnerable group of people with significant drug and other problems.

These would only be part of a range of services that are needed – and, frankly, have been needed for years

The fact we do not have these services is part of the reason that we have high rates of problem drug use; high rates of deaths related to drug use and a huge toll in terms of the burden of disease.

As healthandcare.scot reported last week in party leaders clash over action to address drug deaths, the SNP and Conservative leaders stand on opposing sides when it comes to ways of tackling problematic drug use.

Little common ground can be found when attempting to bridge the ideological – or indeed any – gap between First Minister, Nicola Sturgeon, and interim leader of the Conservatives, Jackson Carlaw.

What should be done to tackle the rising number of drug-related deaths in Scotland has proved to be another point of contention between the two political forces.

During a recent round of First Minister’s Questions, Ms Sturgeon accepted the situation was “not one that any of us would consider to be acceptable”.

She went on to say the Scottish Government was “open to fresh thinking and new ideas” that could help to reduce drug misuse, including the establishment of supervised drug consumption facilities.

The Conservative interim leader, meanwhile, accused the First Minister of presiding over a decade of failed drugs policies, and criticised the Government over its support for supervised drug consumption facilities and funding of methadone programmes, saying it had failed to support other rehabilitation services such as support cafes.

Jackson Carlaw added: “[the Government’s] priorities seem to be spending millions on methadone and opening facilities to help heroin addicts take the drugs which have ruined their lives”.

He continued to criticise the Scottish Government over an addiction support service at Barlinnie prison that is facing closure and other support cafes that were under financial pressure.

But “methadone and recovery cafes are not alternative services,” Mr Liddell says.  

The vast majority of people who have had a heroin problem and attend recovery services like cafes will have been on methadone at some point when that was a way of supporting them and ensuring they minimised the harms they suffered.

The strategy has to be that we minimise what people have to recover from and maximise what they can recover to.

People in prison should have the same healthcare and other supports that they have in the community and when they are liberated they should be supported to transfer to community-based services.”

On the 14th March at First Minister’s Questions, Green MSP, John Finnie, highlighted the “public health crisis” that was unfolding as Scotland’s suffered an “increasing number of drug deaths”.

The Highlands and Islands representative called for Nicola Sturgeon to “urgently establish a statutory inquiry into Scotland’s drug death crisis and commit to acting on its findings in order to end this ongoing tragedy”.

Emphasising the scale of the issues, David Liddell highlights that “more deaths occur and more years are lived in poor health and disability are caused by problem drug use than diseases like diabetes”.