Campaigners are calling on the Scottish Government to declare a public health emergency following record levels of drug related deaths last year.
The figures, released by the National Records of Scotland, recorded more drug related deaths than ever before. They also showed a stark increase in female deaths. Last year 282 of the 934 deaths – the highest number since records began in 1996 – were women.
Drug charities and leading politicians have argued more radical solutions are needed in response, such as drug consumption rooms, where medical grade heroin could be administered, with medical support available.
However plans for a drug consumption room in Glasgow were blocked earlier this year. The Lord Advocate, Scotland’s senior law officer, stated that no exemption from the Misuse of Drugs Act 1971 could be made.
It is claimed that by declaring a public health emergency, the Scottish Government could introduce special, targeted measures, including consumption rooms.
The approach was discussed at a Scottish Government consultation event earlier this month, when drug organisations were shown a heavily edited version of its refreshed drug strategy, due to be published in coming months.
In 2016 a public health emergency was declared in Canada’s British Columbia following a rise in drug deaths. Measures introduced included increased services, public information work to reduce stigma and more social support for addicts.
Justina Murray, chief executive of Scottish Families Affected by Alcohol and Drugs, said: “It is time to declare a public health emergency which will allow additional powers and resources to be focused on addressing this issue. We need really radical measures.”
She claimed families being supported by the organisation suffered in silence due to the huge stigma around addictions, which she claimed it was essential to address, particularly for women.
Dharmacarini Kuladharini, chief executive of the Scottish Recovery Consortium, is also supporting the call, which she hopes will allow Scotland to look more holistically for cures to the underlying problems.
“What we are doing is necessary but it’s not sufficient,” she said. “There is a tendency to look for the silver bullet, the cure.”
She added: “So when we approach problems like depression, obesity, and alcohol and drug addiction we claim the problem is with the individual rather than looking at the conditions that are driving people to soothe the pain. We need to start looking at all of these together as deaths of distress.”
Mark Bitel is director of development at the River Garden residential project in Auchincruive, a radical approach to recovery in which residents will live, volunteer and later work onsite. “A number of key players in the field have been calling on the Scottish Government to declare a public health emergency which might pave the way for a range of more radical approaches,” he said.
“Here at River Garden Auchincruive we are already delivering just what the new Minister for Public Health, Joe FitzPatrick is calling for. provide long-term housing, peer support, training and upskilling people leading to real jobs in our social enterprises.”
A Scottish Government spokesman said it was “fully committed to tackling the damaging impact of drugs in Scotland” and had allocated an additional £20 million for each remaining year of the current parliament to improve alcohol and drug treatment services.
He added: “We first and foremost see this as a public health issue and are dealing with it as such. We are prepared to take forward innovative, evidence-based approaches in order to tackle this issue, even if at first they may be unpopular or controversial.
“Safe consumption areas are reserved to the UK Government and if it isn’t prepared to take action then they should devolve the powers to enable the Scottish Government to act.”
In focus: ‘authorities were looking to find a solution to a problem they never understood in the first place.’
It’s late on Friday afternoon in Glasgow and the city is starting to get into full, summer weekend swing. Here in the Gorbals, the sun still blazing down, music from the TRNSMT festival carries across the river Clyde to the Adelphi Centre.
But at Raft recovery, one of several weekly groups running under the South Community Recovery Network umbrella – and literally helping to save lives – there’s a different sort of weekend vibe on offer.
The recovery cafe, which offers a safe and substance-free social space for people in recovery from drug and alcohol addictions as well as mental ill health, is a concept imported from the US. Raft, which opened eight years ago, was the first in Glasgow and they are becoming increasingly common.
Here people are filling up their plates with pasta and salads in the cafe area, while their kids play. Charity Children 1st is due to arrive shortly, not only offering kids activities but family support. There will be group work sessions, massage and reiki, and a host of friendly faces to chat to.
SCRN network co-founder and aftercare co-ordinator Claire Muirhead gives me a tour, greeting people warmly as she goes. Like most of the staff and volunteers here she brings something important; lived experience of substance misuse. She’s been in recovery for years but knows how addiction really feels.
Last week’s drug death figures revealing the sharp rise in the number of women dying hit her hard. But they did not surprise her. “There are very specific issues that women come here with,” she says. “Here are issues around sexual abuse, trauma, domestic violence, and once they come in to problematic substance use the abuse and the exploitation will usually increase.”
Muirhead, who helped to set up the CREW recovery group, which now meets in Govanhill, sees how much women in particular get from this non-judgemental, social support. Women’s groups have been a key part of all of the recovery cafes she’s been involved in.
Attending tonight Amy – as I agree to call her – is one of the women who has benefited. Now in her early forties and no longer using, she says fear and shame not only stopped her asking for help, but led her drug use to spiral as she attempted to cope with the cripplingly difficult feelings.
When her drug taking started it was all about music and party scenes – a bit of speed as a 14-year-old Indie Goth, ecstasy and cocaine at techno clubs of the nineties. She never thought she’d use heroin. “I was from a good family, I’d gone to university,” she says. “In my mind it was something for people who were homeless and didn’t have their own teeth.” But then she came home after a night out and the line of powered heroin she was offered seemed just like taking cocaine. “I’d only just turned 20,” she says. “From then it was a progression.”
She went travelling, appeared to be doing fine, but back in Scotland and with a job in financial services, her using stepped up to the point of getting withdrawals at work.
“I’d be sitting at my desk in my suit and court shoes and I’d jump over the road to the homeless hostel and end up using with them,” she says. “I had one foot in one world, one foot in the other.”
In the background were mental health problems – anti-depressants, medication for anxiety – but she felt unable to tell her doctor about her drug use. She got pregnant but was too ashamed to talk to her midwife so went online and did a self-detox.
Her daughter, 8lbs 9, was a picture of health when she was born. Amy started volunteering, doing breast feeding support work, daring to think drug use might be behind her.
Within six months it was clear it wasn’t. But though she was seeing doctors, counsellor and health visits she too scared they would take her baby away to ask for help.
There were failed attempts at self-detox, another pregnancy during which she was not able to stop using, after which her drug use spiralled. “I was hiding it from my partner, going out shoplifting so then the police and social work were coming into my life,” she says.
“And I just lied. I said it was all to do with my mental health. The shame and the guilt was mounting up and up, and the more that amassed the more I was having to use just to get rid of all those kind of feelings.”
When her youngest was three-years-old she had a psychotic episode that saw her sectioned and spend six months in hospital. Finally someone asked if she’d ever used drugs and out it all came. She got a diagnosis of bipolar disorder and the whole mess started to make some sense.
This is the point where you expect it all turned around. Well, it did and it didn’t. She lost custody of her daughters to their father, and had to relearn how to be a mother without taking drugs.
She had to get a methadone prescription, find a way come off that too, reject her mental health diagnosis and then realise that in fact her drug and mental health issues could co-exist (known as dual diagnosis). She did an abstinence-based recovery programme and went to meetings, like this one. As they say in recovery, you take one step at a time. She’s been clean for five years and she probably knows the days and hours and minutes too.
Aftercare development worker Thomas, who doesn’t want to use his surname because he also tells me candidly about his 30 year history of substance misuse, says drug use is self-harm – a form of self-punishment. He always wanted to come off drugs, he says, and when he first got a methadone prescription it worked at first. But as help to deal with his underlying issues was not forthcoming he started topping up.
He spent 16 years on methadone before his “crossroads” came when his son was born. He started asking for the intensive therapeutic treatment he needed to cope with deep trauma he traces back to childhood, and gradually managed to give up drugs altogether.
“What you will find when you speak to people in recovery is that we were never bad people,” he says. “When you come into recovery it’s about learning to be kinder to yourself, more accepting.”
Yet he knows not everyone is able to access the help they need. What will solve it? He pauses: “There isn’t an easy answer. I believe they were looking to find a solution to a problem they never understood in the first place.” He believes in the importance of lived experience. “And if they are going to seriously tackle this they have to begin investing in the after care set up.”
Muirhead, who like Thomas is paid for just 13 hours a week and who puts in scores more voluntarily, says with investment there is so much more even this network could do.
She’s full of plans for other groups they could be running, training and activities, that will give people the motivation to continue with their recovery. “Unless you invest in people and their quality of life, they will end up going back through the system,” she says. What she doesn’t say is that as a result of that, they could also end up dead.
A version of this story was published in the Sunday Herald on 8 July 2018.