The failure to greenlight the UK’s first drug consumption room is costing lives, writes Martyn McLaughlin.
It will take the best part of 18 months until statisticians corroborate what is already common knowledge among the ranks of social workers, addiction nurses and counsellors at the frontline of Scotland’s biggest city. By then, it will be too late for a few hundred intravenous drug users who will have escaped the desperation and chaos of an addict’s existence. By then, they will be dead.
The year is not yet a month old, but speak to those on the ground and the early indications are that an already ignominious record is on course to be broken.
There were 257 drug-related deaths in the NHS Greater Glasgow & Clyde area in 2016, the fourth successive year in which the numbers have risen. There is no reason to believe the statisticians will reveal an improvement in 2017, nor that the grim trend will be arrested in the year ahead.
The foolish decision by Network Rail to close a busy needle exchange in Glasgow Central Station last year has had predictable consequences.
Anecdotally, staff attest to fewer heroin addicts using other exchanges, while there is concern over a spike in HIV rates among injecting users. As things stand, the rate of drug-related deaths in Glasgow per million people is 283. To put that figure into context, it is 1,315 per cent higher than the EU average of 20 per million.
Such issues will frame today’s meeting of the Glasgow City Integration Joint Board (GCIJB), a body tasked with fusing the work of health providers and local authorities to better deliver social care. Through the Glasgow City Health and Social Care Partnership, it has endeavoured to establish the first drug consumption room (DCR) in the UK, a place where users can administer their own drugs under medical supervision. The purpose of such initiatives – mainstays in numerous European cities for decades – is simple: they save lives by preventing overdoses, curbing infection, and offering users a gateway to treatment.
For well over a year, it seemed common sense would prevail, and the acute crisis in Glasgow might be, if not solved, then at least tempered. The one barrier was the Misuse of Drugs Act 1971, given that anyone in possession of street-bought heroin inside such a DCR could find themselves open to prosecution.
Authorities in Glasgow sought guidance from Lord Advocate James Wolffe QC and were cautiously optimistic immunity would be won. Scotland’s most senior prosecutor, however, was unconvinced. Privately, it is understood the Crown Office and Procurator Fiscal Service took the view that making an exception would lead it down a dangerous legal avenue. The upshot was a conciliatory but dispirting note advising the pilot scheme’s proponents that were they to press ahead, they would be committing an offence under section eight of the Act.
Today’s meeting of the GCIJB will reflect on the scheme’s potted history and its myriad disappointments. But thankfully, it will not signal an end to its ultimate goal. Both behind the scenes and in full view, pressure is being brought to bear on the UK Government to amend the 1971 Act, allowing the pilot DCR to go ahead without the fear its staff and users might end up in court.
The campaign has been lent weight by Alison Thewliss, the SNP MP for Glasgow Central who has proven herself one of the most resolute and principled representatives Scotland could wish for. Yet even her considerable talents are likely to prove insufficient. Just as the conversation about how best to tackle the slew of drug-related deaths is on the verge of something approaching maturity, a stultifying ideological orthodoxy has reasserted itself.
Last week, at a Westminster Hall debate on the issue, Douglas Ross, the Conservative MP for Moray, found time in his busy refereeing schedule to posit that the “only thing that we should be encouraging” is detox and abstinence.
Let us hope Mr Ross does not rise through the ranks to become the minister of state for health, lest the NHS find itself at the forefront of cutting-edge treatments such as leech therapy, trepanation, and restorative afternoon strolls in the country air.
Yet the award for Missing the Point Entirely went not to Mr Ross, but Victoria Atkins, a former barrister turned junior minister in the Home Office, who warned that devolving the relevant powers to Holyrood risked creating an internal drug market within the UK. “I used to prosecute criminals for a living,” she said. “I prosecuted international drug gangs, so I know whereof I speak.”
Far be it from me to dismiss Ms Atkins’ record at the bar as an irrelevance, but in this case, it is just that. It says much about Home Office’s entrenched position on drug abuse and its long-standing disdain for evidence-based policy that the latest lieutenant waging its fruitless war on drugs still regards it as a criminal issue at a time when Scotland is waking up to the fact it is a public health emergency. None of this should be a surprise. Last year, the Advisory Council on the Misuse of Drugs, tasked with finding solutions to opioid-related deaths, advocated opening DCRs in areas with significant concentrations of injecting drug users.
The Home Office’s response was to bury its head in the sand. All the while, another few hundred users were allowed to die.
I’m not sure of the exact number, but you can wait for the statisticians to file their report. That seems to be the only option.