Martyn McLaughlin: Saving lives must not be confused with condoning drug use

A full business case for safe injecting facilities is being prepared, although even the best intentions is unlikely to quieten the scheme's critics. Picture: JP

It is easy to cling to the comforting notion that Scotland is a country where socially progressive policies flourish, but too often the rhetoric goes unsubstantiated. The proposals for Scotland’s first safe injecting facility for drug addicts will likely act as a litmus test of how far we think we have come.

The confirmation that a full business case for such a service is being prepared following a meeting of the Glasgow City Integration Joint Board has generated a predictable gnashing of teeth from those who regard addicts as a criminal underclass undeserving of basic human compassion, let alone state-funded treatment.

The critics are only getting warmed up, tossing out phrases such as ‘shooting galleries’ or ‘heroin hotels’, aghast at the prospect of medical-grade opiates being provided under supervision. A few have even offered a taste of the vitriol to come as the plans begin navigate uncertain legislative waters.

One right-leaning newspaper warned of a doomsday scenario where “pampered users of all ages pump themselves full of freebie drugs.” It is hard to know which addiction is more ruinous: heroin, or this kind of diet of fear, anger and misinformation.

The only valid controversy surrounding safe injecting facilities (SIFs) is the one that has too often gone unsaid. Why has it taken Scotland so long to reach this point?

For years, successive governments have artfully skirted their way around the issue, with the prospect of a public outcry drowning out an international chorus of evidence demonstrating the wisdom of introducing SIFs, or consumption rooms as they are also known.

Granted, research has shown that more than four out every ten Scots may believe that one of the main causes of drug dependence is a lack of self-discipline and willpower, but there has been abject failure to explain to the public the purpose of SIFs.

Contrary to what its opponents might infer, they are not a means of condoning illegal behaviour. Their remit is, quite simply, to save lives.

Some of the country’s most vulnerable people have paid a stark cost for this politically expedient inaction. With the number of people in Scotland dying as a result of drug abuse at an all-time high in 2015, the toll among heroin users has been especially pronounced.

While heroin and morphine were implicated in just 86 drug-related deaths in 1996, the figure now stands at an unprecedented 345. If this generation-long fourfold increase is not reason enough to introduce SIFs, consider the body of worldwide research attesting to its merits.

There have been no deaths from overdoses recorded in SIFs since their inception in the 1980s, despite tens of millions of injecting episodes. Analysis of facilities rolled out Vancouver and Sydney meanwhile, show a significant downturn in the number of city-wide fatal overdoses and ambulance call-outs, not to mention reductions in the prevalence of public injecting and discarded needles.

Frankly, there is no sound reason not to endorse SIFs in light of these findings. Yet time and again, that is precisely what has happened.

A decade ago, Scottish Labour rejected calls for a pilot study of the facilities, as proposed by an independent working group, convened by the Joseph Rowntree Foundation. It argued they would reduce the risk of overdoses, improve the health of the most problematic drug users, and lessen the damage and costs to wider society.

Two years ago, the SNP went further, dismissing the views of its own advisers on the National Forum on Drug Related Deaths who described pilot SIFs as a “national priority.” A spokesman for the Scottish Government, however, cited the “ethical and legal issues raised by such proposals.”

It was a tame and inadequate response to a complex issue, though perhaps not an unsurprising one given the government’s track record for contemptuously treating expert opinion.

Its position is unchanged, with Aileen Campbell, the public health minister, stressing that there was no central backing for the Glasgow SIF proposal. In any case, she warned, it would require legal authority from the Lord Advocate.

A key function of the law may be to set out what is acceptable or otherwise in a modern society, but so too it must exist to protect people. If ethical issues are to be taken into account, surely the unprecedented death toll and recent outbreaks of HIV, botulism and anthrax amongst Glasgow’s injecting population must be heeded?

At a time when essential service providers are seeing their budgets scythed, plunging marginalised clients further into chaos, approving such a scheme is justified not only on medical grounds, but moral ones.

There is no guarantee the Glasgow proposals will come to fruition. There is a marked degree of resistance in some quarters of the city’s community safety partnership as well as Police Scotland, while the realisation of an SIF is dependent on an exemption or amendment to the Misuse of Drugs Act 1971.

If these hurdles can be overcome, Glasgow will not be rid of its heroin problem, nor will Scotland be seen as especially radical. There was a time when such a move would have been viewed as progressive, but it has long since passed.

Scotland is still playing catch up with its approach to drug addiction. It’s not too late to do the right thing.