Poverty & deprivation driving drug misuse in Scotland

Experts claim public health approach needed to tackle ‘deaths of despair’ as Westminster inquiry into problematic drug use begins

Tuesday 7th May 2019

Health Protection Scotland and NHS Health Scotland have called for a ‘whole-system response’ to reduce the number of people living with, or dying early from, ill health caused by drug use, in a joint submission to a Westminster committee inquiry into drug use.

The public health approach supported by the organisations that form part of NHS Scotland, emphasises the importance of addressing poverty and deprivation – ‘the main structural drivers contributing to problematic drug use’.

Dr Diane Stockton, acting director of Public Health Science at NHS Health Scotland, says that “no-one chooses to become dependent on drugs. Deprivation and inequality create difficult conditions in which people live, and problematic drug use is commonly a sign of these complex social circumstances.

“The numbers of people living with, or dying early from, ill health caused by drug use is 17 times higher in our poorest areas.

Described as deaths of despair, these figures are tragic and they tell us something about the nature of drug use. We need to look beyond the substances themselves to solve this problem.

The sixth leading cause of early death in Scotland, drug use disorders and how to reduce them is the current focus of a Scottish Affairs Committee inquiry which begins taking oral evidence on the issue today.

“We have to address the factors that cause drug use and dependency in the first place,” adds Dr Stockton.

This means a focus on tackling poverty, reducing childhood adversity, improving housing, creating positive employment prospects and addressing mental ill health. These factors make the difference in people’s life chances, establish positive opportunities and create hope.

A public health approach would do this – one that puts the person and their life right at the heart of prevention – reducing harm, removing underlying causes and improving circumstances in order to set people on the road to recovery.

Sometimes that approach might include helping people live with drugs whilst we address the more enduring problems that led to their drug misuse in the first place.  

Addressing wider social inequalities, and reducing poverty, will play an important role in the prevention of drug misuse and a reduction in associated harms. Drug-related deaths are preventable. The outcome we want is fewer people dying at an early age, and we need to do whatever that takes.”

NHS National Services Scotland’s director of public health & intelligence, Phil Couser, added:

A combination of socio-economic and political decisions created the context for the current problems with drug misuse in Scotland, and therefore immediate and simultaneous action at a similar level is required to mitigate the risks of drug-related harm.

Our joint submission to the inquiry calls on the Committee to recognise the unique aspects of Scotland’s experience of the negative impacts of poverty, deprivation and inequality, and to work closely with the Scottish Government and Public Health Scotland (when it comes into being), in order that an effective whole-system response to drug misuse in Scotland can be found.