Statistics published on 30 July 2021 by National Records of Scotland show that the number of deaths related to drug use is continuing to rise:

  • There were 1,339 drug-related deaths in Scotland in 2020; a 5% increase from 2019 and the largest number since records began in 1996.
  • Almost all (93%) were classified as “accidental poisonings”.
  • In 93% of drug-related deaths, more than one drug was present in the body; opioids were involved in 89% of cases, benzodiazepines in 73%, gabapentin or pregabalin in 37%, and cocaine in 34%.
  • The number of drug-related deaths has increased substantially over the last 20 years; there were 4.5 times as many deaths in 2020 compared with 2000.
  • Men were 2.7 times more likely to die of a drug-related death than women.
  • People in the most deprived parts of the country were 18 times as likely to die of a drug-related death as those in the least deprived.
  • Greater Glasgow and Clyde had the highest drug-related death rate of all health board areas, followed by Ayrshire and Arran and Tayside.

Responding to the figures, Chair of the Scottish Drug Deaths Taskforce Professor Catriona Matheson said:

“Every drug related death in Scotland is an avoidable tragedy, and these figures serve to remind us of the importance and urgency of our mission to identify the areas of action that can make a sustainable impact against the challenge. We believe the approach of putting evidence into action has saved lives, and we will analyse the detail behind the headlines and look to build upon those areas showing progress and to address those areas requiring more attention.”

“Both the causes of, and the solutions to, the challenge we all face are complex, at its heart are real people at real risk, and we continue to be determined to make difference for them.”

The challenge is ‘unique and complex’

Scotland’s drug-related death rate stands at over 3.5 times that for the UK as a whole (figures available for Northern Ireland, England and Wales), and is higher than that of any European country (see European Drug Report). High risk patterns of drug use, a high risk cohort of people, and concentrated social deprivation make the challenge of preventing drug-related deaths in Scotland both unique and complex.

In December 2020, a dedicated Minister for Drug Policy was appointed to reduce the number of deaths from drugs, reduce the harms of drug use, and support the rehabilitation and recovery of those living with drug addiction.

Addressing the latest news about drug deaths, Minister Angela Constance said:

“It is a national disgrace, and the scale of the loss of life is unacceptable as it is heart-breaking, and I want to offer my condolences to everyone who has lost a loved one but also to restate my commitment, my continued commitment, to do everything that is absolutely possible in our national mission to save and improve lives by getting more of our people into treatment.”

“The First Minister made a very honest acknowledgement that we have not done enough in the past that is either big enough or quick enough to tackle the scale of the challenge we face. But we are now determined going forward to invest more in life-saving services and evidence-based interventions that will both save and improve lives.”

In January 2021, the new Minister and First Minister Nicola Sturgeon met with the Drug Deaths Taskforce, who presented 16 ways for the government to support their work to prevent drug-related deaths:

  1. Naloxone is a lifesaving drug, which the Taskforce have made significant progress in increasing its distribution through channels where its use can save lives. There is still capacity to increase this further, and this should be developed with urgency.
  2. Non-fatal overdose pathways are vital to catching the most at-risk people early and providing them with the support needed to avoid a fatal overdose. We would recommend that these should be expanded nationally, learning from the tests of change ongoing through the Taskforce.
  3. The Taskforce outlined to the First Minister some of the challenges faced with data sharing which the Government must work urgently to resolve, if this is to progress.
  4. Addressing the availability of benzodiazepines should be a key priority of this Government and we would expect them to work with Police Scotland to reduce the availability of these, as well as supporting harm reduction initiatives.
  5. More needs to be done to engage with those who do not currently access services. We therefore recommend that a network of people with living experience is established in the next 6 months.
  6. The implementation of [new rights-based standards for delivering medication-assisted treatment] must be scaled up at pace. To enable this we would recommend formal standards and indicators are developed by Health Improvement Scotland by the end of 2021. Scottish Government will have a vital role in supporting this roll out by ensuring that Chief Officers take accountability for delivery of the standards at local level.
  7. Access to treatment at the weekend continues to be a considerable gap in delivering a whole systems model of care. We therefore recommend that Scottish Government pursue increased weekend access to treatment and support.
  8. There is a need for a managed clinical care network, as was established in response to the Hepatitis C emergency. This network should include health boards and relevant professional networks.
  9. Building a skilled and motivated workforce is essential, but there has been little central investment is professional development. We therefore believe that a workforce review is required. This would enable clear career development pathways to be defined including core skills and competencies.
  10. The Taskforce called for First Minister support for the Stigma Strategy and outlined that the stigma charter (in development) should be adopted by all public bodies and services.
  11. The Taskforce clearly outlined in our meeting with the Minister and First Minister that additional funding should be made available for grass roots organisations and community-based projects alongside services to support vulnerable people.
  12. Peer support and advocacy are instrumental in accessing appropriate services, and we would recommend that the Government support the development of a national peer support programme that can be put in place without delay.
  13. The Taskforce recommended that government extend the renewed leadership and call for action to include local leadership and organisation leads.
  14. The Taskforce outlined the challenges faced in relation to delays in toxicology and asked for Government to act now to resolve this. We will work closely with Government to develop real time monitoring to enable effective decision making.
  15. Accountability was raised by many Taskforce members, and there was a clear request for Government to hold the leadership of statutory services and local delivery leaders to account. This was highlighted in the Dundee Commission but also has been a recurring theme when communicating with ADPs.
  16. A costing exercise should be undertaken, reflecting that a push to increase the number of people in services must recognise the increase pressure this will put on these services and the needs that may flow from it. This would enable costing of a long-term sustainable system of care. This includes workforce modelling options.

Read more about the work of the Drug Deaths Taskforce, which was established by the Scottish Government in 2019.

by Natalie Davies

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