If Nicola Sturgeon had a radical streak to her, this is the speech she might have made last week, as the latest figures about drug deaths in Scotland were revealed: “Earlier this year, I described the levels of drug addiction and deaths in Scotland as ‘a national disgrace.’ I stick to that comment.
“We cannot claim to be a progressive nation if we turn our backs on these shameful statistics. We have made no progress at all in tackling the problem, and I take full responsibility for that.
“When I sought to replace the previous health minister Joe FitzPatrick, it was meant to indicate a new approach, and Angela Constance’s appointment as a full-time drugs minister suggested we were serious about tackling it.
“I now realise that simply swapping jobs is not enough. The problem goes so deep, raises so many issues of social deprivation, that I have to challenge the whole nature of the policies we have adopted so far. That means confronting the difficult question of why a generation of Scots should feel driven to explore new and dangerous combinations of chemicals when they know their lives are at risk.
“Someone once said, ‘when the facts change, I change my mind,’ and that is how I feel right now. Ever since my government came to power, we have adopted the same approach — to get addicts into treatment, to find alternative medication, to offer, as it were, a safer addiction to the one they have chosen.
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“The days when we simply prescribed drugs like methadone as an alternative to heroin, have, however, been overtaken. These days people are taking a range of drugs we had scarcely heard of a few years ago, yet our treatment is no more successful than it was before.
“We have to find a new way. We have to get people off their addiction altogether; give them the support they will need in doing so; above all, offer them something their lives have lacked thus far, which is hope.
“It will be challenging, it will take time, and it will, of course, be expensive. I am open to any proposals that meet those objectives. All I would say at this stage is: the status quo is not an option.”
We may have to wait some time for that speech. But there is a way of translating it into action, one that learns from Glasgow’s Violence Reduction Unit, set up in 2005 to reduce knife crime that at one stage made the city Europe’s murder capital. It proposed seeing gang violence not just as a policing issue, but a public health one.
The motto was: “Violence is preventable, not inevitable.” Within ten years it had more than halved the incidence of knife crime in the city. By focusing on a specific area, the unit managed to involve an entire community. London is now trying to emulate it.
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Localism seems to be the key, and Dundee might be the best test case for a similar approach to addiction. It overtook Glasgow as the drugs capital of Scotland, with the country’s worst drug death rate, at an average of 0.36 per 1,000 people over the past five years. That includes an ageing population of addicts, mainly men, who have been using heroin but now also use a fearsome range of prescription drugs such as benzodiazepines, pills often dealt as “street Valium”. These can be fatal for older users, who develop serious health issues such as respiratory diseases, liver damage and viruses.
A properly funded task force in Dundee could set up a network of rehabilitation centres, to build relationships with addicts, set them on a course for recovery, and lay out how to reconnect them to society. This is about deprivation as well as desperation. Those living in the poorest parts of the city are 18 times more likely to die a drug-related death than those in the richest areas.
Sturgeon has pledged a five-year £250 million investment in the government’s current anti-drug programme. At £50 million a year, spread across Scotland, that will soon be dissipated. But targeting it at a single city, with the aim of creating a model the rest of the country could learn from, might have a more measurable effect. Many addicts, if offered the chance, want to kick the habit, but they need a support scheme, a distinct goal to aim for, and a sense of purpose.
That would require a rehabilitation programme stretching across social disciplines. One of these could be law and order. The new drugs are sold by organisations that use county lines gangs, drawing young people into a network that may set them on the path to addiction too. The Adder (addiction, diversion, disruption, enforcement and recovery) plan in England and Wales is aimed at disrupting the trade, and is beginning to have some success, but has so far been rejected in Scotland.
No one is suggesting this is easy. There are, however, two statistics that Sturgeon herself must find it hard to live with. Scotland has the worst drug-death rate in Europe, one that is three and a half times higher than anywhere else in the UK. Meanwhile, the SNP government has been in power for 14 years and has not succeeded in reversing it. Radical action seems, in the circumstances, a pretty modest idea.
