A Scottish drug and alcohol charity responds to the minimal decrease in drug related deaths in 2021 and the release of the National Mission on Drugs Deaths Plan from the Scottish government, urging Ministers to aim for zero. Currently, there is no target percentage drug deaths reduction published in the government’s updated plan.

Scottish Families affected by Alcohol and Drugs (SFAD), a national charity supporting people concerned about a loved one’s drug and alcohol use, have issued a call for the government to commit to a target of zero drug deaths.

Justina Murray, CEO of SFAD, said she expected better results a year since the National Mission was launched, and that the heart-breaking toll of drug deaths in Scotland is ongoing despite Ministers’ sympathies:

“Anything less than a zero target is an insult to the thousands of families who have lost loved ones over the years, and to those who continue to struggle hour by hour to keep their loved ones safe and alive.”

As the Scottish government announces its update to its five-year mission to reduce drug deaths, the charity’s call comes in response to statistics revealing just a 1% drop in deaths in 2021. Entering year two, Drugs Policy Minister Angela Constance says that the government will build on these foundations and deliver on the outcomes.

Although treatment targets are outlined in last week’s updated plan for opioid substitution therapy and increasing the number of statutory rehabilitation placements by 300% by 2026, no target for a reduction in drug deaths has been set.

Ms Constance responded to healthandcare.scot’s request for comment, saying the government will continue to deliver investment to reduce drug deaths:

“One life lost to drugs is one too many and my heart goes out to all those affected by the death of a loved one through drugs.

“We’re putting the voices of lived experience at the heart of the National Mission to reduce drug-related deaths. We’ll continue to listen to those views and draw on evidence from around the world as we strive to improve and save lives – taking action and delivering new investment to get more people into the treatment which works for them.”

A representative from the Scottish government clarified the National Plan update is not in response to recent news from the Drugs Deaths Taskforce on “unacceptable” drug deaths figures, but a commitment made by Ms Constance in a statement earlier this year.

Ms Murray explained that ahead of the statistics, SFAD were concerned about overly positive coverage of a small decrease detracting from work still needed and began thinking about the importance of the government acknowledging those affected by each drug-related death:

“We're a long way from that [target] but surely you do want to get to zero because if they’re preventable then you can get to zero.

“We just thought it’s probably something that needs to be stated. Some think it’s unrealistic, but I think for the families who’ve lost loved ones, they want to see something like that – to say you’re never going to accept another death.”

She continued, saying it’s good going forward with the recent publication that other targets are being set for treatment and hopes to see the related reduction in drugs deaths.

Implementation Gap

Ms Murray explained that accountability needs to be built into the system, agrees the foundations are important but SFAD has observed an implementation gap:

“I think it’s fair to say that first year was spent distributing additional resources – and we [SFAD] also received a lot of that funding. But if that is not converted into posts, activity, and delivery around what’s actually needed, then we’re not going to see that impact.”

Ms Constance said the establishment of a National Collaborative will also to ensure a human rights-based approach, informed by lived experience, is taken to tackle Scotland’s drugs crisis while an oversight group comprised of experts will ensure that government is held to account:

“Our new Oversight Group includes people with lived experience, and will provide scrutiny, challenge and expert advice on the National Mission and hold us to account on the published plan.”

The oversight group – which Ms Murray also sits on – next meets in October and Ms Murray said it will also play a role in overseeing the implementation of the National Mission at a local level.

“Taking a broader look from drug deaths to drug harm is important – and they are trying to do that, with the outcome framework and coming up with more measures.

“I think the measure that really matters is what the families are saying on the ground. They're still finding it's really hard for loved one to get into treatment that they need or it's easy to get ejected out of that treatment.”

People still face a lack of choice of treatment, despite this being part of the National Mission, she continued. Another key challenge is to align the treatment pathway with the government’s public health approach:

“There doesn't seem to be a clear pathway through treatment as you would have with cancer or any other health condition. And families are routinely excluded rather than included.”

Ms Constance said that government has implemented many recent recommendations from the Drugs Deaths taskforce and are focused on delivering change on the ground. The government has committed to increasing the number of patients in family rehabilitation centres, with a new centre secured in North Ayrshire earlier this year.

Ms Constance said:

“Last year we funded 511 residential placements across Scotland – I’m determined to ensure that by 2026 there are at least 1,000 publicly funded rehab places.

“I’ll also continue to use all the powers at my disposal, including holding local leaders to account in implementing Medication-Assisted Treatment (MAT) standards, to drive improvements across Scotland.”

Going forward, Ms Murray says it’s all about implementation and accountability, including in changing the culture and underlying causes of drug deaths at a local level.

Read more: Oversight group for government drug action; RADAR system to spot drug death risks; Pharmacists reassess role in preventing drug deaths