Root treatment for drug related harm

Many words have already been written or spoken regarding the most recent announcement that in 2019 1,264 people died as a result of problematic drug use. The ‘Drug-related deaths in Scotland in 2019’ report contains all the cold and analytical figures and it goes into great detail in the 88 page report to inform about drug types, usage and age groups. But when the range of drugs is so large and when polydrug use is so widespread I wonder just how significant the actual drugs are and if we are coming to this problem from the wrong angle.

In society we use drugs all the time. They vary in strength and in social acceptance. If you sit down at night and reach for a glass of wine or beer then you are using alcohol as your drug of choice. You probably don’t rationalise your consumption. You consume it and you enjoy it because it changes the chemistry of your brain in a way that you find acceptable. If you can consistently choose not to lift that drink then you don’t have a problem. Only 10% of drug users ( and I include alcohol as a drug ) can be defined as problem users. But there are many reasons why we use drugs and many reasons why some people form addictions. I should say now that I consume alcohol. Probably less now than I ever have and I have never considered myself a heavy drinker. And I have taken heroin. And it was amazing. I used it to address an issue I had at the time. An issue so great that I knew that taking heroin would lift me out of that situation and relieve my pain. And it did. I was passing a kidney stone and the pain was excruciating and my heroin was medical grade morphine and I accept that there are differences but none that mattered to me at that time. Of the 10% of problematic drug users, the majority are self medicating against pain. Pain experienced through physical, psychological or sexual abuse. Pain that has seeped into their consciousness from years of poverty and disappointment. Pain from a constant gnawing fear of a life unfulfilled. And that is much harder to resolve than my kidney stone because that doesn’t recur everyday and night. Whether the drug is Morphine, Heroin, Oxycodone, Hydrocodone, Fentanyl, Methadone, Buprenorphine, Cocaine or Gin and Tonic with ice and lemon the pain will return unless the causes are addressed. And I fundamentally believe that is what the Scottish government is trying to do, otherwise we will be on a never ending roller coaster of peaks and troughs. Where they can they are fighting poverty through mitigating the third bedroom tax, provided free prescriptions, free meals for school kids, expanded early learning and childcare, provided free personal care for the elderly, free concessionary travel, no fees for higher education, a fairer social security system, introduced the Scottish child payment and the baby box. They are also spending up to £95.3 million this year to tackle problem alcohol and drug use while investing £900,000 to to fund a new programme to improve the response to drug and alcohol use amongst the homeless population. And we now have Scotland’s first heroin assisted treatment service, located in Glasgow.

The First Minister made it very clear that she acknowledges changes must be made and bravely accepted criticism that many a politician would have run from. Changes have already started with the appointment of Angela Constance as the minister for drugs policy. And she has said “ I’m determined to focus on what works to save lives, to work across parliament and with those on the frontline but most of all to work with and listen to those whose lives have been been devastated by drugs.”

There are ways in which we can help those who are already in pain and the two most obvious could and should be green lighted straight away. Naloxone saves lives. It doesn’t cure addiction but it keeps people alive so they have the opportunity to seek out a better life. I know this is being looked at and pilot projects will run in Dundee, Falkirk and Glasgow East starting next February but we have been talking for a long time and I while I am impatient, people are dying. And Drug Consumption Rooms (DCR) have been tried and tested in many countries. Nobody ever died of an overdose in a DCR and they provide an environment where people can engage with housing and welfare specialists. One version of the Hippocratic oath states “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug”. I would expand that sentiment to politicians too. Because we keep talking and people keep dying.