Today (16/07/19) National Records of Scotland released their Drug-related deaths in Scotland in 2018 report. This provides statistics on drug-related deaths (DRD) in 2018 and earlier years, with analysis of age, sex, selected drugs reported, underlying cause of death, NHS Board and Council areas. In 2018 the number of deaths was 1,187 – the largest number ever recorded and more than double the number recorded a decade ago. Of these deaths, 86% involved heroin or other opioids. Benzodiazepines were implicated in 792 (67%) and alcohol contributed to 156 (13%) deaths. The vast majority of deaths involved more than one substance.
DRNS acknowledges the tremendous human cost associated with these preventable deaths which affect individuals, families, and communities. Drugs research should inform policy and practice leading to real improvements for those most affected by problem drug use.
We are committed to helping inform policy and practice across Scotland to reverse the trend. We are currently building partnerships across the sector to link skills and experience. We are also mapping DRD research, audit and evaluation activities across Scotland. These networks and mapping exercises will help us understand what work is underway and where there are gaps in our knowledge. We need to know what works, for whom, and in what settings to develop new approaches to saving lives. This will form a substantial part of our workplan for the coming year. We also know that much work can be taken forward immediately based on the decades of research and evaluation activities, international through to local, that can and should be informing a Scottish public health approach to overdose prevention.
Scottish Government’s Public Health Minister Joe Fitzpatrick released a statement describing the DRD figures as “shocking” and the current situation as an “emergency”. He outlined the Scottish Government’s commitment to treat this “tragedy … as a public health issue” and to take “innovative and bold measures … to save the lives of those most at risk.” He repeated his call for a change in the law to enable Scotland to open Supervised Consumption Facilities.
I want to ensure that the work of the new taskforce which I have established is driven by strong evidence and the voices of those with experience of using drugs, and their families, are heard. I am determined to shape our services in every walk of life to prevent harm and reduce the appalling number of deaths. So I will give consideration to any proposals they bring forward which may help to tackle this issue and, ultimately, save lives.Joe Fitzpatrick MSP, 16/07/19
Scottish Drugs Forum (SDF) has responded publicly in a statement titled “The shame of a national scandal“. Dave Liddell, SDF Chief Executive and DRNS Steering Committee member, discussed several areas for urgent change in Scotland including treatment, stigma and service quality:
NHS patients are receiving treatment that does not meet standards laid out in national and international good practice guidance … we have stigmatised drug use and people with a drug problem and also [opiate substitution therapy (OST)] a life-saving pharmaceutical treatment … We need to address service quality. In particular we need to see improvements in access to OST. In some areas we seeing waits of 6 months to get on OST. There are also issues of retention for the most vulnerable with significant drop out rates. There is a need for assertive outreach to ensure people are not allowed to just ‘disappear from services’.Dave Liddell, SDF, 16/07/19
Scottish Directors of Public Health released a Position Statement on Drugs and Substance Misuse which identifies a need for further research to develop cost effective health improvement interventions and models of care delivery which improve health outcomes for people accessing services. They also note variance in the availability, quality and accessibility of evidence-based treatment and support services across Scotland, stating that this needs to be addressed “as a matter of urgency”. The statement ends with recommended actions for the Public Health community, UK and Scottish governments. DRNS is a member of the Public Health Drugs Special Interest Group and will work with colleagues across Scotland to help meet these needs.
Sufficient resources must be allocated to research, monitoring and evaluation of approaches at a national level. There is a particular gap in literature about the effectiveness and cost effectiveness of community based approaches to prevention, early intervention, treatment and recovery.Scottish Directors of Public Health, 16/07/19
Professor Catriona Matheson, DRNS Convenor and Chair of Scotland’s Drugs Death Taskforce, was interviewed on BBC Radio 4’s Today programme. She noted that the Taskforce is currently being established and will take a public health informed approach. They will review evidence of what has been shown to work across Scotland and internationally, including drugs policy developments. Importantly, she indicated that the Taskforce will not delay exploring developments, implementing actions, and generating evidence-based recommendations:
It is going to be an action and outcome based approach … we will be looking at evidence from the outset and putting into place actions and pilot studies across Scotland, then learning from those … and expanding those where they are shown to be successful. It will be a rolling programme of actions.Prof. Catriona Matheson, BBC Radio 4, 16/07/19