This week brought the annual publication of drug deaths in Scotland.
Again, it made for grim reading with another one thousand and fifty-one people added to the thousands before them who have died as a result of the addiction crisis the country has faced for decades.
In fact, there were 1051 people, men and women of all ages including 16 teenagers and 16 people aged over seventy.
That this was a reduction from 1330 the year before should be no cause for celebration, nor should it be taken as a success by anyone.
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More than one thousand funerals with thousands of grieving mothers, fathers, daughters and sons, left to live with their loss.
The mortality rate among people who use drugs to the extent they are considered at risk is far higher than in the general population.
In deprived communities, the situation is even more bleak with people 16 times more likely to die from drugs than in the least deprived areas.
Yet another outcome of poverty and decades of neglect in the poorest areas.
Unemployment, ill health, poor housing, crime and drug deaths, are burdens all borne disproportionately by the working-class communities of Glasgow and other towns and cities.
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The drugs policy minister Elena Whitham, in post this year, said ‘the tide is turning’ on drug deaths as a result of government interventions since deaths hit record levels year after year.
If indeed the tide is turning, and hopefully it is and fewer families are spared the heartbreak of losing someone to drugs, then it raises other questions and highlights past failings.
If, in the space of two years government policy can lead to a 20% reduction in deaths, then it makes the neglect of the previous decade, and more, even more scandalous.
Drug and alcohol budgets were cut at a time when deaths were rising. It was not a priority for the government with the former first minister admitting they took their “eye off the ball”.
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If it was as straightforward as recognising there was a major problem and investing more money in services then the fact it was ignored is unforgivable.
But is it as straightforward as government action leading to a reduction this year?
Some people, people whose eye is never off the ball when it comes to addiction and drug deaths, are questioning this assertion.
It could be that there comes a point where the older people in the cohort who have been living with addiction for so long, die, and this point is now being reached.
One academic in Glasgow, whose eye follows this particular ball very closely observed this at risk population, which is around 60,000 people has “experienced such a high mortality rate for so long it can no longer be sustained”.
Put simply, there are fewer people now at risk therefore there are fewer deaths.
If this is the case, even if partly true, then again it is an indictment of the previous years of neglect and underfunding of drug treatment services that allowed so many to die.
If this is the case then to claim that the ‘tide is turning’ because of intervention is a misrepresentation.
We need a greater understanding of what is going on with people who use drugs and those who are ‘at risk’.
We need it to ensure that, now the government has at last woken up to the problem, the investment it makes goes to the right places and is directed by the right people.
It used to be a simplistic analysis that there was an ageing cohort of problem drug users, termed by some as the “trainspotting generation’ and they were the cause of higher mortality rates.
This ignored the fact that new people, younger people were coming up after them, replacing them and becoming the at risk population of the future.
Perhaps not in such high numbers but they were there, a glance at the statistics shows this.
Among people aged 45-59 deaths increased year on year and peaked in 2000 at 253 before falling.
The 50 to 54 group also topped 100 each year from 2107 to 2021 peaking at 195 before a drop last year.
The stats also show 120 people who died last year were under 30, most of them not even born when Trainspotting was in the cinemas.
Also, changing patterns of drug use, poly drug use, and newer substances like street valium - in the last decade - and now the potential for synthetic opioids like fentanyl, present new and ever-changing challenges.
It is a hugely complex issue, and what it means is the eye can never be taken off the ball again.
Then we should be able to see an even bigger fall in deaths next year and achieve a sustained reduction accompanied by treatment that not only keeps people alive but allows them to recover from the grip of addiction.
Then the tide really will be turning
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