Every drug death is a personal and family tragedy. The record number of drug overdose deaths in Scotland is also devastating and depressing news for those who work to reduce this appalling loss of life. It should also be a matter of national concern.
However, too often, we find these statistics met with confusion at best and at worst indifference.
I have to state again that not one of these overdose deaths is inevitable. Sadly, as a society, we do far less than we should to act in ways that would protect people and save lives. We could make a huge impact on Scotland’s health and death statistics.
If we look at the backgrounds and lives of those who have died we find, in many cases, people who have be dealt a raw deal in life, sometimes since early childhood.
For them, using drugs is not, as some would have us believe, a ‘lifestyle choice’.
Scottish Drugs Forum recently undertook research into the life histories of people with a history of problematic drug use and identified trauma as a key factor.
This was often trauma in childhood which was the compounded by trauma in adulthood.
These traumas range from child abuse (physical or sexual) to bereavement within the immediate family and then, into adulthood, from being the victim of violent crime to witnessing death. The mental health consequences are clear and need to be addressed if people are to address their drug use. Obsessing with drug use as a sole and primary concern is an error.
Scotland has 60,000 people with drug problems and it is evident that the most vulnerable are often the ones who are dying. Their vulnerability is often rooted in not being in services. The evidence shows that being in a specialist service has protective factor in reducing the likelihood of drug-related death. Sadly it is often this group who find it most difficult to access and stay in services.
Clearly, this is a key area to be explored with the aim of improving access and retention in services. Also we must address the quality of services and deliver a holistic, person-centred approach.
This is no easy task and requires a skilled, committed and well-supported workforce and creative service planning, design and commissioning. Progress is possible. Already, for example, progress has been made in delivering faster access to services.
David Liddell is director, of the Scottish Drugs Forum