Neil McKeganey: Scotland's relationship with drugs has to change

WHAT does a drug addict cost Scotland? Research last year by the Centre for Drugs Misuse at the University of Glasgow estimated that on average each addict costs Scotland around £60,703 a year. Over a ten-year period that's around £600,000 with no account for inflation, And there are thought to be around 55,000 addicts in Scotland. Our country is paying a massive price for its drugs problem.

For the first time in Scotland we have a national drug strategy that commits services to helping addicts become drug free. If the only thing needed to turn round Scotland's drug problem was a big vision then we have that in abundance in the Scottish Government's Road to Recovery drug strategy. Unfortunately we are going to need a great deal more than that to tackle a drugs problem that is virtually without equal anywhere in Europe.

At the moment all of the discussion about drugs problem are to do with mephedrone– the drug meant for plants that we now know is being consumed by hundreds of thousands of young people across the UK. What though should we make of a situation in Scotland where young people are prepared to consume plant food to obtain a desired high and where even something as fearful as anthrax does not halt people's drug use. What this tells us is that we are living in the midst of a culture of addiction and drug use in which pharmacology has become a commonplace feature of everyday life.

As far as one can tell it seems likely that mephedrone will be made illegal within a matter of weeks or months. But we are kidding ourselves if we think that this is the answer to our drugs problem. It probably matters little to young people which class a given drug falls within under the misuse of drugs act. That being the case we should not expect a massive reduction in the numbers of young people using mephedrone or in the number of deaths that seem to be associated with the drug use simply as a result of it being made illegal. If we are going to tackle the growing drugs problem in Scotland we are not going to find the answer in legislation but in tackling the growing social acceptance of all forms of drugs use. We need to change Scotland's relationship to pharmacology in the same way that we are now trying to changes its relationship to alcohol.

To do that will involve changing our expectations and our policies in relation to drugs misuse more broadly. At the moment we have around 22,000 addicts on methadone in Scotland. When Scottish ministers are asked about whether they have any plans for reducing that number, the typical answer is to say that prescribing methadone is the responsibility of individual doctors. Our political leaders, surrounded by those who counsel them on the benefits of methadone, find themselves passing responsibility for our national methadone programme on to the shoulders of those who are prescribing the drug in the first place. This situation is going to get worse.

In response to the increasing numbers of anthrax cases in Scotland the government has effectively given health boards an open cheque to increase their spending on methadone in the mistaken belief that prescribing one drug (methadone) is a solution to the problem of addicts turning to another drug (heroin). If methadone were seen as the answer to mephedrone then expect it to be available in clubs across the land. The lesson that ministers seem so reluctant to learn is that health protection is not to be found in another addictive drug prescribed to welcome consumers, but in reducing the amount of drugs we are consuming. In a culture where pharmacology has become commonplace it is abstinence, not drug use, that has become the radical idea. Within that context is it really such a surprise that young people are prepared to consume a drug meant for plants?

If we are going to change the culture of acceptance around drugs we need to do something that is almost beyond comprehension – we need to normalise abstinence. If we are going to normalise abstinence then prescribing can't be the heart of our drug strategy. There is something else that we need to do, which is to take collective ownership of our drugs problem. In Sweden when they shifted from a liberal drug policy to a zero tolerance drug policy, the government promoted the view that illegal drug use was everybody's responsibility. From the politician to the plumber and from the teacher to the taxi driver, everybody was seen as having a responsibility for tackling the drugs problem.

In Scotland we are steeped in the belief that the solution to our drug problem lies is in the hands of other people, whether they be politicians or doctors. There is a kind of madness in that which if it assures anything at all it is that our drugs problem will continue unabated.

For years drug prevention has been the bastard child of the government's drugs budget, lagging behind the big-spending favoured sons of drug treatment and drug enforcement. These two, however, have not served us as well as they needed to and we should now target greater resources on drug prevention. If there is one thing that we produce with frightening capacity in Scotland it is people addicted to drugs.

We should develop programmes within our schools in which addicts and their families can talk to young people about the dangers of drugs misuse and challenge the assumptions that drugs are cool. We also need to tackle the culture of middle-class drug use that has come to promote the dangerous view that drug use is not simply OK but a just reward for personal success.

• Neil McKeganey is professor of drug misuse research at the University of Glasgow.