Older generation blamed as drug deaths soar
THE human cost of long-term drug use was laid bare yesterday, as figures show Scotland's drug death toll has risen to record levels, with a sharp increase in deaths among older users.
And last night government ministers warned that drug deaths could continue to rise in the future, as the next generation of addicts faced the consequences of experimenting with drugs in their youth.
Health experts are blaming the "Trainspotting generation" – those who began injecting heroin in the 1980s and 1990s – for the increased deaths.
A new report shows drug deaths have increased by more than a quarter in the past year, with the number of fatalities rising significantly among older people.
Drug-related deaths in Scotland have rocketed by more than 131 per cent over the past ten years, leading to calls for urgent action.
Figures show the 35-44 age bracket made up 30 per cent of drug-related fatalities and 37 per cent were aged between 25 and 34 years old.
Last night, community safety minister Fergus Ewing said: "As a legacy of long-term drug misuse over recent decades, drug-related deaths may continue to rise over the next few years, especially among older men.
"It's a long-term problem with no single solution. That is why we must continue to take action to tackle this issue now and for the long term."
It is the rise in the number of deaths in the older age categories that is causing the greatest alarm for doctors of the National Drug Related Deaths Forum. Deaths rose faster for 35-44-year-olds and for people aged 45 and over. Last year, deaths of those aged 35-44 increased 17 per cent to 174 on the previous year. Even more worrying, the number for those 45 and over rose 54 per cent last year to 97.
Experts said Scotland was dealing with a legacy reaching as far back as the late 1970s and 1980s, when many people began experimenting with drugs for the first time. Those injecting drugs such as heroin 20 years ago are now inheriting a range of serious health problems, including heart and respiratory illnesses, which, in some cases, are leading to premature death.
Drug charities said "social isolation" could be behind the deaths of older addicts.
Biba Brand, of Scottish Drugs Forum, said: "It is difficult to tell exactly why older drug-users are increasingly featuring among the drug death statistics.
"However, many will have been using drugs – primarily heroin – for a long time.
"As a result, their physical health will have deteriorated and many will have become increasingly socially isolated over the years. This could make them more vulnerable to accidental or deliberate overdose."
The report, from the General Register Office for Scotland, revealed drugs killed 574 people in 2008, up from 455 the year before, and the number of deaths has more than doubled in a decade.
Heroin and morphine were responsible for the bulk of the deaths, with 80 per cent of the deaths among men.
Heroin remains a threat to public health, with figures showing heroin and morphine present in the body in 336 cases – 59 per cent of deaths. Methadone was present in 181 cases – 32 per cent, while cocaine, amphetamines and ecstasy were present in the body in 79, 12 and seven cases respectively.
The General Register Office for Scotland report said the long-term trend of drug deaths "appears to be steadily upwards". Throughout Scotland, there were wide variations, with the Greater Glasgow and Clyde NHS Board area accounting for 34 per cent of the deaths, Lothian 16 per cent and Tayside 9 per cent.
Mr Ewing insisted yesterday that the Scottish Government was trying to tackle the problem, citing a database launched this year to look at the circumstances behind each death. He said: "These figures demonstrate the real impact of drug misuse, which extends far beyond the individual drug user – it destroys lives.
Marnie Hodge, development manager for social care agency Turning Point Scotland (TPS), said the increase in deaths might be the result of long-term drug misuse and it was crucial that addicts got the help they needed.
"TPS is working to ensure we provide a programme of interventions particularly designed for people who do not engage with support services and are therefore more exposed to the serious health risks, including the risk of overdose by the prolonged and persistent drug use."
Last year's figures mark the third successive rise in drug-related deaths. Heroin or morphine was found in 336 bodies, with alcohol detected in 273 cases. Controversially, heroin substitute methadone was found in one-third of cases – calling into question the efficacy of the government's drug treatment policy.
Dr Roy Robertson, chairman of the National Drug Related Death Forum, described the methadone figure as "alarming", but defended the use of the drug for those addicted to heroin.
He said: "Every country that has drug-use problems debates this constantly and incessantly, about the relative value of methadone against the risks. We know that methadone, by and large, is a successful treatment."
Labour claimed the SNP were losing the battle against drugs, accusing them of failing to deliver. Justice spokeswoman Cathy Jamieson said: "The rise in the number of drug-related deaths is extremely worrying, and we need action from ministers to reverse the trend."
She said: "The SNP promised a 20 per cent increase in funding for drugs treatment in their manifesto, but, like so many other promises, they have failed to deliver it. Ministers have also cut budgets to local agencies supporting drug addicts."
Conservative leader Annabel Goldie said the figures reflected "a wasted decade".
Addicts will die on waiting list
HEROIN addicts and other drug users are waiting up to two years for treatment due to the lack of services in Scotland, it emerged yesterday.
Doctors warned it was almost inevitable some addicts would die before they had an opportunity to access services.
Dr Roy Robertson, chairman of the National Drug Related Deaths Forum, said there were about 200 drug treatment centres in Scotland, including residential facilities, but many addicts remained on lengthy waiting lists.
"There are waiting lists for almost every part of Scotland," he said. "That is one of the big issues… that is being taken seriously. Every centre has got waiting lists. It will require resources and extra help. I don't think there is an excuse for long waiting lists."
The Scottish Government announced a new drugs strategy last year, which promised a change in treatment methods, but it failed to set targets for cutting methadone use.
The debate on drug treatment has raged in recent years, with experts deeply divided over the use of methadone, the heroin substitute.
The cost of prescribing methadone has almost doubled in the past five years to nearly 17 million, according to recent figures published by the NHS in Scotland.
Last month it was reported that the total bill for dispensing the heroin substitute rose by 84 per cent from 9,049,792 in 2003-4 to 16,637,636 this year, with many drugs experts claiming methadone does not work.
Critics say Scotland's heroin dependency has simply been replaced by a methadone dependency.
Some drug misuse experts believe addicts should have a maximum of two years on methadone, which is prescribed to an estimated 22,000 people.
Wide variety of potentially fatal health consequences lie in wait for recreational users
YOUNG people who dabble in recreational drugs such as cocaine are storing up long-term health problems which can lead to premature death, medical experts warned yesterday.
The risk of a heart attack is increased 24-fold for the first hour after using cocaine, scientists believe, but there are also long-term effects which could take years to manifest.
Carol Hunter, the lead pharmacist with Glasgow Addiction Services, said users were not only at risk from a deadly overdose of cocaine or heroin, but there were serious risks to the body from needle-sharing and blood-borne infections.
"There are a lot of blood-borne viruses, like Hepatitis C and HIV, from needle-sharing. Needle reuse, in particular, causes wounds and abscesses to build up, because the needle is not sterile. Blunt needles can also damage the veins."
Pulmonary complications, such as blood clots, are also a killer. She added: "Blood clots are quite common because the circulation is affected… the veins are closed off."
Heroin use can lead to a range of chronic problems, which can kill an addict over time. Heroin use affects the brain chemistry significantly, creating the risk of seizures, strokes and even death.
Doctors say that repetitive use of the drug leads not only to physiological addiction, but physical addiction as well.
The user's body begins to need heroin in order to feel "normal" following the effects of withdrawal, with the addict searching for a greater 'hit'.
Ms Hunter said the fact that heroin was often adulterated with other substances could lead to serious problems.
"It's not so much the drug itself, but the contaminants – if they are mixing impure heroin. Heroin is diamorphine, which is used for pain relief. But the impurities can cause damage to the heart with cardiomyopathy – an infection in the heart muscle."
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