David Liddell: Change is needed to deliver a national mission as Scotland’s public health emergency continues

30th July 2021

These figures confirm that Scotland’s national public health emergency continues.  These deaths are personal tragedies.  Families and communities are left to grieve.  The trauma will be felt through generations and for years.  These deaths represent a scar on the nation’s conscience and serve as a reminder of our collective failure to support vulnerable people and their families in the moments when they most needed support.

Our collective failure to do what needs to be done to prevent people with a drug problem dying through overdose is a national disgrace.  The evidence for what should be done is clear and unequivocal.  While people’s lives are often complicated and challenging, their needs are clear.  What works, and what needs to be improved for people in Scotland,  is treatment and support.

New standards for drug treatment were published in May of this year. These should transform services – not just the processes involved but the whole culture of treatment which should empower people and give them choice and control in their lives.

These new standards need to be implemented as a national priority.  To be clear, treatment services will not transform themselves.  Change will require investment, leadership and higher expectations from the Scottish public, people who may use treatment services, their families and communities.

Only 35-40% of the 58000 people with a drug problem in Scotland are in treatment.  In the rest of the UK that figure is nearly double Scotland’s rate.  Why is that? It may be painful to admit but for many people in desperate need, treatment, in too many parts of Scotland, is neither accessible nor acceptable.  That has to change if we are to deliver on the National Mission to reduce drug deaths.

We need a full range of community treatment services which are accessible on the day people ask for help.  Some people need a choice of medication beyond just methadone and buprenorphine including heroin-assisted treatment.  We also need to consider the needs of people who have problems both with both opiates and other types of drugs – benzodiazepines and cocaine, for example.  We need a full range of residential services including stabilisation and crisis intervention services where people can step out of their present circumstances, achieve stability and be supported to address the issues they have, including issues with their medication.

As well as medical treatment people need a therapeutic relationship with their treatment provider, and wider social supports around things like housing, welfare and employability. People in Scotland’s most deprived areas are 18 times more likely to have a drug-related death than others. We need to address a whole range of issues simultaneously and not look at issues in isolation.  Treatment, recovery, decriminalisation and so on need to be seen in a wider context that includes poverty. Everybody, including people with a drug problem, need a home and something to do during their day.  They need a positive network of people around them including the professionals they encounter.  Where they have problems, they need realistic hope that there are supports so that things can change.

David Liddell, CEO, Scottish Drugs Forum

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