HOW did Scotland come to have the highest death rate from drug overdoses of any European country?

Our annual death rate from drug overdoses is three and a half times that of the UK as a whole – and even higher in comparison to other European countries.

Our relative drug death numbers exceed that of the United States.

In 2007, 455 people died from drug overdoses in Scotland. In 2019 the number of deaths was 1,264 – a rise of 6% from the year before. The mortality figures for 2018 represented a 27% rise from 2017.

The trajectory was plain to see for those in power.

Every statistic was a human being that someone knew and loved; a family member or friend. Lost for ever from a preventable death.

How did life for drug users become so bleak in Scotland compared to everywhere else? A public emergency ignored by too many for too long.

In July 2019, the Drug Deaths Taskforce (DDT) was established by the then Scottish Government Minister for Public Health, Joe Fitzpatrick MSP.

Its stated purpose was “to co-ordinate and drive action to improve the health outcomes for people who use drugs, reducing the risk of harm and death”.

A year and a half after the DDT launched, a 6% increase in drug-related deaths was recorded in December 2020. Joe Fitzpatrick resigned and a new ministerial post for Drugs Policy was created, held by Angela Constance MSP.

The First Minister said her government’s record on drugs deaths was “indefensible”. She said sorry. Six months on, and how much progress have we made?

As regards access to rehabilitation services, I can’t discern any material change.

Glasgow has an estimated 13,000 problem drug users and 69,000 problem drinkers. The actual figures could be much higher.

Yet at best we still only have 17 or 18 residential rehab beds potentially open to drug users via statutory services. I say potentially, because the experience of many drug users is the impossibility of accessing rehab.

For those who have survived addiction, harm reduction, detox and rehab all go hand in hand for recovery.

In January, the Scottish Government announced an additional £50 million each year to increase services for people affected by drug addiction; an extra £5m was allocated for the last quarter of 2020/21.

Extra funding is vital, but we need to remember: this crisis was created in no small part due to the real term cuts to local government funding. Rehab isn’t cheap and when cuts are imposed from Holyrood expensive services get slashed.

As COSLA – the voice of Scottish councils – said earlier this year, “Since 2013/14, the Scottish Government has seen a 3.1% increase in its revenue funding (real terms) – this is in contrast to a 2.4% reduction for local government over the same period”.

As far as I can fathom, we still have an infrastructure of bureaucracies that don’t really work.

Integrated joint boards were hailed as massive improvements in the strategic planning of health and social care services. The reality is they are opaque bumbling structures that justify cuts.

The DDT launched its “Medication Assisted Treatment Standards for Scotland” (MAT) last month. The MAT standards are admirable and sensible, but they don’t give drug users any enforceable rights.

One only has to think of the 12-week patient treatment guarantee introduced in 2012. Despite being enshrined in legislation it’s unenforceable and has been broken over 300,000 times since its inception.

For Annmarie Ward, CEO of Faces and Voices of Recovery UK, there are two immediate things we need to do to prevent deaths: “The first thing we need to do is make sure that people who are currently addicted and using street Valium have access to a safe supply. That will help stop deaths.

“The second thing we need to do is be aware that people cannot fall into the horrendous pattern of those addicted to opiates over the last 20 or 30 years by only being given a substitute prescription. It’s not enough to just keep us alive; it’s not enough to just prescribe substitute drugs”.

“People must have the opportunity and choice if they want to let go and be weaned off their dependence. That will mean access to residential rehab, in other cases it will mean access to community detox and everyone will need some form of psycho-social support.

“Only to prescribe a substitute prescription is not enough. We must provide a choice and opportunity for people to get off drugs to get well again.

“To return to themselves and return to their communities and help them rebuild their lives.”

Ultimately for Annmarie we need to change the culture of our addiction services in Scotland – the system often serves itself and nobody gets well. We need a culture of recovery with enforceable rights for individuals.