Chris Marshall: Scotland's drug-death crisis is overdue an intervention
In the mid-1980s when the fear of Aids loomed large in the public consciousness, Glasgow recorded similar numbers of HIV diagnoses among both intravenous drug users and gay men.
A memorable public information film from the time depicted an oversized tombstone being hewn from granite with a chilling warning of a “danger which has become a threat to us all”.
The intervening years have brought a transformation in the way HIV is treated; antiretrovirals now allow those with the virus to live into old age.
And while the number of new cases in Glasgow among gay men (and the heterosexual population) began growing from 2000 onwards (before peaking around 2010), a series of public health interventions kept numbers relatively low among those injecting drugs.
That ended in 2015, however, when 50 new cases of HIV were recorded among intravenous drug users in the city, a five-fold increase on the annual average. The spike is thought to have been caused by the arrival in the city’s injecting population of a new HIV-positive member.
For the first time in nearly 30 years the number of new diagnoses was comparable to those which were sexually transmitted.
Since 2015, 119 new HIV contractions related to intravenous drug use have been recorded, an avoidable strain on a cash-strapped NHS board and nothing short of a public health catastrophe.
It was against this troubling backdrop that NHS Greater Glasgow and Clyde spent £100,000 researching solutions, including plans for the UK’s first drug consumption room. Variously described as a “fix room” or “shooting gallery”, the proposed facility would allow users to inject their own heroin in safe and sterile surroundings.
If that’s an idea which offends you, then you should know there are currently thought to be around 500 people injecting drugs in public within Glasgow city centre alone.
A recent Channel 4 News report showed a man playing “Russian roulette” as he searched among blood-caked syringes discarded in bushes, despite the presence of dozens of needles exchanges across the city.
Scotland’s drug-death calamity is long overdue a radical intervention, the sort of state-backed beneficence seen in the smoking ban or minimum alcohol pricing.
The 867 drug-related deaths recorded in 2016 (the most recent figures available) was not only the largest figure since records began but also the highest rate of death of any EU country.
Opiates or opioids, including heroin and methadone, were implicated in nearly 90 per cent of the deaths. And yet there are those who question why a publicly funded health board would spend money looking for a solution.
There have been attempts to include the consumption room research – paid for using charitable donations – in the current row over cash-strapped NHS boards misusing endowment funds. But unlike NHS boards which have used similar funds to replace IT systems, there should be no controversy here.
Plans for the consumption room are currently on hold after the Home Office refused to allow a relaxation of the drugs laws which would protect users and health professionals from prosecution.
The sooner that decision is reversed, the better.
Glasgow can no longer afford the cost – both human and financial – of doing nothing.