Drug death figures show it is time for harm reduction

By Dr Iain McPhee

(Holyrood)

Tuesday’s national drug related death statistics in Scotland showed a 23 per cent rise from 2015, and while shocking, the spike is in no way surprising.

There is an abundance of evidence which shows the ‘abstinence’ strategy taken by both the Scottish and UK governments will not have the desired impact in reducing drug related deaths.

This ideological approach to drug treatment – which forces users to go completely clean – creates far too high a threshold for many of the country’s problem drug users or ‘heaviest drug users’ to adhere to, and , as a result, they drop out of the programmes and therefore fail to benefit from the recovery support that comes with them.

Alternative methods of management which focus not on abstinence as the definition of a successful treatment outcome, but take a ‘harm reduction’ approach, must be considered if we are to see any real impact on the numbers of drug related deaths in Scotland. Harm reduction focuses on the prevention of harm, rather than on the prevention of drug use itself.

Used in tandem with abstinence programmes, this strategy will help target all elements of society – particularly the heaviest drugs users, who may be unwilling to abstain.

We only have to look over to the European mainland to see this approach in action, and the positive results.

Portugal, which faced spiralling drug related deaths in the late 90s, decriminalised all illegal drug use in 2000, allowing the police to focus on crimes that directly impacted on the well-being of the public rather than arresting drug users.

This created a tolerance for drug use, in ideology, and a resulting commitment to the funding of treatment services which did not focus solely on abstinence as the definition of successful treatment outcomes. As a result, Portugal now has a drug induced death rate of three per million residents – more than five times lower than the EU average of 17.3 according to EU figures.

Had this policy been adopted in Scotland, we would not be dealing with the number of deaths we see today, which is currently two and half times higher than the rest of the UK.

Services which offer a harm reduction service to manage drug use in a controlled way, do exist in Scotland. However, without the support abstinence programmes receive, these programmes will never become the mainstream, nor fulfil their potential to help stem the drugs crisis, particularly among the heaviest drug users who largely come from the most deprived areas.

The government’s approach to drugs must change now. As a society, we must become more accepting of the harm reduction strategy. The prohibition approach alone is not the answer – as has been made abundantly clear in the most recent statistics.

Dr Iain McPhee is senior lecturer in alcohol and drug studies at University of the West of Scotland

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