Drug deaths: Scotland should press ahead with safe consumption rooms after failure of 'prohibition' – Joseph Silke

Public health has come to the fore of public consciousness over the past 18 months. We have witnessed the good that intelligent, evidence-based public health policies can do to protect the vulnerable and save lives.

Safe consumption rooms would enable addicts to get life-saving treatment if they overdose (Picture: Jeff J Mitchell/Getty Images)

This doesn’t just apply to Covid-19, it applies to the urgent drugs crisis too. The Scottish government is failing spectacularly to save lives, and the UK government is complicit. It’s time for a new approach: to start treating drug misuse as a public health matter, rather than a criminal justice one.

Drug-related deaths in Scotland have continued to skyrocket to tragic new heights, the worst in the whole of Europe by far. The scale of Scotland’s drug deaths is a stain on the moral fabric of the country.

A total of 1,339 people died in 2020, the largest number ever recorded. Each one is a lost partner, child, parent, sibling, friend. There has been a disproportionate impact on more deprived areas of the country, particularly parts of Glasgow, Ayrshire and Arran, and Tayside.

One constant of prohibition is that the poor and the vulnerable suffer the most. The rate of drug-related deaths in Scotland’s most deprived areas is now 18 times higher than the rate in the least deprived areas.

In other ways, however, the crisis is evolving. It is a picture that has moved beyond the old Trainspotting stereotype. Yes, heroin is still a major feature, but today’s loss of life typically involves a cocktail of substances, with cheap benzodiazepines now available for as little as 50p per pill.

The crisis in Scotland has been building consistently over the last 20 years, but has been particularly acute since 2013 when deaths began to spiral out of control. Despite this rise, the Scottish government cut £47 million of funding for drugs and alcohol addiction services between 2015 and 2019. Nicola Sturgeon crassly suggested that her administration had taken their “eye off the ball” and has now scrambled to commit additional funding for addiction services.

Adequate funding for such services is crucial, but a true public health approach requires a more fundamental shift in how the state treats drugs. Sturgeon has pointed out that the Home Office retains the lead responsibility for tackling the misuse of drugs in the UK. This doesn’t account for why Scotland’s drug deaths per capita are almost five times that of England and Wales, but it is true that tackling this emergency will require Westminster and Holyrood to work together.

A public health approach has been successful abroad. At the turn of the millennium, Portugal was battling an alarming rise in deaths from opioid overdoses, as well as drug-related infections like HIV and hepatitis. Their government took a radical decision to decriminalise all drugs in 2001, meaning that low-level possession became a civil misdemeanour, rather than a criminal offence. Those who need it are now referred to support services by a local commission, rather than to a judge for punishment.

The years following the change of strategy have seen dramatic falls in the number of deaths from overdoses and drugs-related infections, as well as reductions in drugs-related criminal activity and rates of incarceration.

Drug-death numbers in Portugal are now some of the lowest in Europe. In 2019, it had just six deaths per million people among those aged 15 to 64, compared to 318 per million in Scotland for the same year. This hasn’t resulted in an explosion of recreational drug use either, with drug use remaining consistently below the European average.

Decriminalisation has only been part of the story, however. These results have been made possible by a revolution in cultural attitudes towards those who have a problematic relationship with drugs.

Ending the crippling stigma associated with drugs has been absolutely critical to Portugal’s success. “The biggest effect,” the country’s drugs policy architect Dr João Goulão explained, “has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear.” Beyond funding, treatment services need to be compassionate and trusted.

The Scottish Conservatives under Douglas Ross are to put forward a Right to Recovery Bill before the Scottish Parliament. The proposals would enshrine the right to addiction treatment, and even a residential place, in law.

This would be a welcome step, but Ross and his party have rejected the wider reforms necessary to tackle the crisis, including SNP proposals for the roll-out of safe consumption rooms, which could protect users who are going to take drugs regardless, but will otherwise be at risk of overdosing far from anybody who can help.

The problem is that there has been no indication that Westminster is willing to consider a public health approach. Recent briefings to the press suggest that Boris Johnson and Priti Patel intend to begin a new prohibitionist crusade. The Prime Minister has dismissed potentially life-saving safe consumption rooms, saying that he doesn’t want to do anything that “would encourage the consumption of more drugs”. While the Home Office still rules drugs policy, change seems unlikely.

This is despite the fact that a public health approach has public support. Research published by Glasgow Caledonian University last year found that 61 per cent of Scots back the introduction of safe consumption rooms in Scotland. If the Scottish government pushes ahead with them as planned, the UK government should not get in the way.

Scotland is one of the great cradles of the Enlightenment, a movement which sought to use reason and science to challenge the faulty assumptions of authority. Fifty years since the passage of the Misuse of Drugs Act in 1971, it is demonstrably clear that prohibition has failed.

The current regime panders to outdated dogmas and defies the growing body of evidence that a public health approach works. It’s time to treat victims of drug misuse like patients, not criminals. If not now, when?

Joseph Silke is a communications officer at liberal conservative think tank Bright Blue

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