By Angelo Thomas and Roy Robertson - The Royal College of Physicians of Edinburgh,
The report recognises that Scotland’s drug deaths crisis is complex, but says much more can be done to tackle the problem, including action on harm reduction and on the social determinants of drug use.
The College believes that bold policies, such as decriminalisation of the possession of drugs, safe drug consumption facilities, and rolling out a heroin assisted treatment programme in all major centres in Scotland should be considered to help reduce drug-related harms.
Urgent research is required to examine the links between poverty and drug-related deaths, including the impact of COVID-19 on drug use. There is also an urgent requirement to study and understand complex poly-drug use (or “multi-drug use”), as National Records of Scotland data for 2019 show that the number of drug-related deaths of people who took more than one substance was 94%.
And the College is calling for more joined up care for people who use drugs, as well as support for those who have completed rehab or who have left hospital after being admitted for drug overdose.
The College’s report makes 5 key recommendations to help reduce drug-related deaths in Scotland:
- Decriminalisation: the Scottish Government and the UK Government must give evidence-based consideration to the decriminalisation of drug use.
- Constructive political debate: the College calls on politicians to work constructively together on drug-related deaths, and to listen carefully to the views of front-line clinicians and researchers.
- Cross-party consensus: continued and increasing cross-party and cross-discipline engagement is required to effectively manage drug-related deaths and deliver real and measurable change.
- Socio-economic factors: the UK Government and Scottish Government must work together to address the socio-economic factors associated with drug use such as employment and income, social security, education, public health, support services and housing – as well as the physical and psychological factors.
- The medical community: leaders of the medical professions must support educational initiatives which maximise the involvement of all sectors of medicine in managing problems related to drug and alcohol dependency.
Drug-related deaths is a complex issue caused by a wide range of factors including high levels of deprivation in the most affected communities, an ageing population of people who use or have used drugs in the past, psychological trauma, high-risk patterns of drug use, the risky behaviours of some people who use drugs and stigma by society.