Drug deaths: Compassionate rebellion

By 6th September 2018 May 16th, 2019 Blogs, PDI

Scotland has the highest rates of drug related deaths in Europe, 934 people died in 2017.  To put that in perspective, that’s the equivalent to the number of passengers that two jumbo jets hold.  Can you imagine what would happen if two planes fell out of the sky every year in Scotland?  There would be days of national mourning, public inquires or criminal prosecutions.  The media would be camped outside the crash site for days.  Politicians would speak soft, sad words of grief and there would be overhauls of aviation safety to prevent these hypothetical disasters ever happening again.

Yet here, in our wee country of around five million people, we really do lose almost 1000 people every year, because of predictable, preventable deaths.  Fathers, mothers, sons and daughters, best friends, old school pals, cousins, gone.  These tragic deaths leave grief, pain and irreplaceable loss across families and communities.  Don’t even start me on the overwhelming loss when we include alcohol, which is another national scandal.

The notion that these deaths are somehow inevitable, or the result of making poor choices in life is perhaps the most dangerous, judgmental misconception held across our society.  Of course using drugs comes with certain risks.  But the fact of the matter is that we know how to minimise these risks, and how to prevent deaths.

The Scottish Government introduced the first National Naloxone Programme in the world in 2012.  This was a brave, if tentative, step in the right direction, and meant equipping drug users and their friends and family with Naloxone, a medicine which can temporarily reverse opiate overdose.  The National Naloxone Programme has huge potential, literally providing a lifesaving intervention to the people who are at most risk, yet still, the numbers of drug related deaths climb each year.

Collectively, it seems we are only tinkering at the edges.

As we begin to fully understand the significant impact childhood trauma has on our health and wellbeing as adults, we must also accept that the reason people use drugs and alcohol is, most often, to anaesthetize pain.  People are suffering and quite understandably, use drugs to mask that suffering, whether it is a result of trauma, physical or emotional pain, or chronic mental ill-health.  As a wise woman once said to me when I was still green and had just started working in alcohol and drug services, ‘when you understand what life is like for some people, it’s not surprising they take drugs.  It’s surprising when people are able to deal with life without drugs’.

If we are too cautious when it comes to radical approaches we only waste time attempting to make small changes to our practice, rather than the sweeping changes Scotland needs to prevent hundreds of people dying needlessly.  Recently, colleagues in Glasgow, alongside organisational leaders and politicians from across the political spectrum, raised their heads above the parapet and took steps towards opening supervised drug consumption facilities and heroin assisted treatment.  These type of interventions are evidence based, have been shown to have a significant role in reducing death and harm and consequently are viewed as critical to properly supporting people who use drugs.

Going back to my analogy of those hypothetical planes, why then, do drug deaths in Scotland not elicit the same outcry and response as a mass aviation disaster would?  The answer is simple, and undeniable; stigma.  People who use drugs are amongst the most disenfranchised, stigmatised, excluded and ignored people in our society.  And for those reasons, their deaths are often written off as inevitable – an accepted consequence of using drugs, rather than a tragic manifestation of societal suffering; a failure to respond to people who desperately need help.

Let me be very clear.  This is not a political criticism.  Drug deaths must be understood through the prism of a deeply complex sociological system; of which generational poverty, punitive welfare systems and the influence of both decades old and current social policy play a role.  It would be disingenuous and exceptionally ignorant to blame this epidemic on one issue, institution, or government alone.  In fact, it would be dangerous to blame anyone or any one system, because that implies that attributing responsibility for our death rates is simple, which is not realistic – or helpful – in responding to this most complex of sociological nightmares.  Instead, let us think about the collective responsibility we have, as citizens, as Scots, as human beings in addressing this loss of life.

The Scottish Recovery Consortium have called for the declaration of a public health emergency – a radical but effective approach used to address serious threats to health.  When faced with similar rates of drug deaths, the Government of Canada declared a public health emergency, allowing them to use every law and resource at their disposal to address epidemic levels of death.  Declaring a public health emergency allows governments, both local and national, to take extraordinary measures, superseding laws or practice that usually constrain or determine protocol or interventions.  Implementing significant change to practice and policy is challenging, but at this point, declaring a public health emergency might just be the only option we have to properly address drug related deaths in Scotland if we want to prevent the hundreds of needless deaths that, in truth, we are already preparing to mourn next year.

I am backing the Scottish Recovery Consortium’s call for ‘compassionate rebellion’ because there are lives at stake.  We need to declare a public health emergency immediately if we are to protect the lives of people at risk of drug deaths.

I want to back our policy makers and elected officials too.  Implementing radical or innovative approaches can be nerve wracking.  As we now call for the declaration of a public health emergency, our officials need to know that they have the support of experts in the field, recovery communities, families, friends and the many members of public. From talking with my colleagues, friends and peers, I feel confident in saying, they have it in full.

I ask for your support.  Please get behind us and the campaign for a public health emergency.  Drug deaths are preventable, and enough is enough.  Collectively we can take action and save lives.  Please sign the petition here: https://bit.ly/2Mb3dxC

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