Every year, on the day that the Government announces the number of drug-related deaths in the previous year, Scotland braces for devastating news. This year was no different.
In 2021, just a week after I met the then-First Minister (FM) Nicola Sturgeon, hope was high for change: the FM launched a renewed effort to reduce drug deaths, announcing a “national mission to end what is currently a national disgrace”, committing £50 million as an annual investment as well as direct funding for Heroin Assisted Treatment (HAT) to make it “widely accessible across the country.”
Today, I write this thinking of all those lost since that conversation, and all those that we may lose from today onwards.
Unfortunately, the situation has not changed. This week’s data release shows that 1,172 people lost their lives to drug harms in 2023, a 12% rise from the previous year. There is still an average of three people dying every day in Scotland, a number that has not dropped in the past three years. Three years into the “national mission”, it’s still a disgrace. We haven’t taken the right actions nor put them in place fast enough.
A performance of condolences
This year, like every other year, the media turn their eye to Scotland, focusing on these devastating numbers. The Scottish Government is by now well-rehearsed in their answers: phrases like “our heartfelt condolences” and “our thoughts are with everyone who has lost a loved one” are said year after year. In the five years I have worked in harm reduction, I have heard these statements from across the political spectrum: Nicola Sturgeon, Joe Fitzpatrick, Angela Constance, Elena Whitham and this year from Neil Gray, the current Health Secretary, have all uttered versions of it.
As someone who has lost too many family and friends to preventable drug deaths, I am personally tired, frustrated and upset with these hollow words. They ring empty when standing over the coffins of those whose lives have been cut short too soon, people who could still be among us if only this “national mission” was taken seriously, and Scotland implemented the tried and tested measures that have saved countless lives in so many countries.
So much running on one room
This performance of condolences and regrets cannot go on forever. Next year, the Scottish Government will have even more difficult questions to answer. As part of its efforts to curb drug deaths, a safer Drug Consumption Room (DCR) was accepted in 2023, after much political fanfare. Its opening was pitched as a needed measure to reduce drug-related deaths, and will be the first official facility of its kind in the United Kingdom. After many delays, its opening date was finally announced: 21 October.
And while it is a valid intervention, too much rests on just one room to change the fatal direction of Scottish drug policy. With a staggering budget of £2.3 million per year to run, this room will only operate in one location in Glasgow, Scotland’s drug death capital, meaning it will only possibly serve people using drugs in its surrounding area. While Glasgow is one of the areas with the highest number of drug deaths in Scotland, other places with high rates, like Dundee, should not continue to struggle just because they were not lucky enough to have a DCR themselves.
The advantage of spaces like DCRs is their ability to reduce health-related harms from drug use, and bring people into treatment. The idea for a DCR was first pitched to Glasgow in 2016 as a response to a significant outbreak of HIV cases among people injecting drugs. DCRs can reduce the transmission of bloodborne viruses, as well as soft skin tissue infections and ambulance callouts for drug use. It can save pain, money, and lives.
However, DCRs can take a while to reap these rewards. The site and its staff needs to build relationships and trust with local people using drugs; it needs to reach out to drug using communities and change what may be quite ingrained drug using behaviours or pre-conceived notions of what the site can offer to people. We can’t forget that this is happening within a context of economic struggle and deprivation; the most deprived areas of Scotland are often hit the hardest by drug deaths. A DCR will not be a quick fix for issues around homelessness, lack of social support, and economic hardship that people are facing all over Glasgow and Scotland.
So, while I am happy it is finally here, I am personally still frustrated with it. Having visited DCRs in Portugal, Spain and Mexico, which operate at a fraction of the costs proposed for Glasgow, there’s a way to provide safety, security and a warm welcoming environment without breaking the bank. The same £2.3 million budget for a single site could be used to operate several more facilities, run by experts and the community of people that it aims to serve. Opening just one room as a “pilot” is unnecessarily reducing the number of lives that this intervention could save. Why limit it to just one?
I am truly thankful that a DCR will finally open in Glasgow; but I am scared that it will go down the same way as many other drug-related developments here. From the heroin-assisted treatment programme to our current system of substitute prescribing, we are left with an expensive, slow and overly-medicalised model that will not fully address what people need to stop hurting, and be cared for.
When will the pain, hurt, devastation, anguish and suffering end?
For me I live with it daily, sliding into morbid thoughts of why so many of my family and friend are dead. How have we reached the point where we allow for so many lives to be lost?
We need a system change to save lives
Until people who use drugs are not treated as second-class citizens with expendable lives, then we will continue to die.
With a British Government bent on ignoring the truth of the harms of the War on Drugs – a system that oppresses, punishes and imprisons those outside of the white upper-class – condolences and thoughts do little to stop past, present and future deaths.
Until politicians are able to admit their faults in changing the system, and are willing to fund and support those from impacted communities to lead the way through this crisis, then we will continue to lose three lives each day – year, after year, after year.
