News Focus
8 |
drinkanddrugsnews
| September 2015
For the stories behind the news
L
ast year there was cautious
optimismwhen figures showed
that the number of drug-related
deaths in Scotland fell by just under
10 per cent in 2013. Admittedly,
this followed 2011’s record high of 584, a figure
almost unchanged in 2012, but many still
hoped that the tide had finally turned.
Those hopes were dashed last month
when the 2014 statistics from National
Records of Scotland were released, recording
the highest death toll ever, at 613. Once again,
the vast majority were older drug users, with
67 per cent of deaths in the over-35s. ‘I think
within the whole sector there was a feeling of
depression that the figures were going up
again, and a realisation that it’s likely the
trend is still upwards,’ Scottish Drugs Forum
director David Liddell tells
DDN
.
As well as being older, the majority of
those dying appear not to have been engaged
with services at the time, raising questions
not only around access, but also about what
should be done ‘for those falling out’, he says.
‘Should we be doing more in terms of
assertive outreach and looking at other
models to chase people up?’
With services already under intense press-
ure, changing approach to become even more
proactive is going to be a challenge, he acknow-
ledges. ‘But I think it’s definitely something we
need to do. The other thing that links into that,
knowing what we know about the protective
factors of treatment, is that in Scotland we’ve
probably got half the population of 60,000
[problem drug users] in treatment. In countries
like Switzerland and Holland it’s much higher,
and that’s what we should be aiming at.’
On the subject of pressures, some have
commented that government cuts and
austerity measures will have played a role in
the increased number of deaths. Is that
something he’d go along with?
‘I’m only cautious in the sense that it’s very
difficult to prove that,’ he says. ‘But certainly
what we have with the older group is a group
that came out of the 1980s and mass
unemployment and austerity, so what we’re
seeing is that same group being hit by a second
wave of austerity now. Clearly that’s having an
impact. Whether it’s adding to people’s
ambivalence as to whether they live or die, and
those whole feelings of despair – I’m sure that’s
the case, but it’s very hard to quantify.
‘More generally, in terms of service cuts,
we’ve been very fortunate in Scotland in that
core funding for specialist health services has
been ring-fenced for many years,’ he
continues. ‘It hasn’t kept pace with inflation,
but it’s largely been untouched. But some of
the wider services, particularly within local
authorities, have obviously been hit. I’m sure
it’s had some impact.’
It’s been pointed out that older drug users
perhaps haven’t been as much of a priority,
because they don’t tend to be as involved in
acquisitive crime. Is that focus starting to
change? ‘It has to, just because of the profile
of the population in services,’ he states. ‘There
has been that sense that you’ve had a group
who maybe weren’t creating significant
demands, but I think services do need to pay
more attention.’
However, it’s important not to lose sight of
the fact that deaths in under-35s have actually
remained fairly constant over the last couple of
decades. ‘It was interesting in that the narrative
was that the deaths had continued to fall in the
younger age group as a percentage, but
certainly when we looked at the actual figures
they were up,’ he says. ‘In the 15-24 group they
were up by 14 on the previous year, and for 25-
34 they were up by 19.’
Here lies the challenge around the aging
cohort narrative, he stresses. ‘It’s true in
overall terms, but there are still younger
people developing drug problems and of
course you still have a large group of
vulnerable young people. So sadly it shouldn’t
really come as any surprise.’
It also highlights the importance of
continuing to pay attention to the emerging
population, he says. ‘It’s not an easy balance,
but certainly it’s a wake-up call. We can’t just
adapt our services to an aging cohort then
realise that there’s a younger group that have
opted out of services because we’re not
meeting their needs.’
As he’s pointed out, little has changed for
that older cohort over the last three decades.
Is it becoming more accepted that problem
drug use is largely the result of poverty, or is
the dominant message still the opposite?
‘I don’t think it’s largely recognised, beyond
people who work in the area or are more
widely involved in health policy,’ he says. ‘I just
did an article in the
Edinburgh Evening News
and got a particularly vicious email response,
basically saying these people should be left to
die. I was talking about underlying problems
such as trauma, on the basis that a lot of the
public narrative is around lifestyle choices and
so on. It’s about trying to get people to
understand that the folk who are dying are
actually victims of society, by and large –
they’ve had a raw deal, their drug use is
largely a way of coping with the hand they’ve
been dealt, and they deserve a bit more public
sympathy. But clearly that’s an uphill struggle.
‘Our government has been hugely
supportive in trying to reduce drug-related
deaths, but you do have to think that if there
were 600 deaths in any other area, there’d be
a public outcry. It’s a sad state of affairs, but
it’s the reality.’
STARK STATISTICS
Scotland has recorded its highest ever number of drug-related deaths.
DDN
looks at what’s behind this bleak trend, and what could be done to reverse it
‘It’s about trying to get people
to understand that the folk who
are dying are actually victims
of society, by and large –
they’ve had a raw deal, their
drug use is largely a way of
coping with the hand they’ve
been dealt, and they deserve a
bit more public sympathy.’
DAVID LIDDELL
