If Scotland’s drugs death are a “legacy issue”, why do we have more problem users than ever?

OLYMPUS DIGITAL CAMERAYOU can see them any day in Glasgow city centre – the shambling drug users with decades of despair etched on their faces. The junkies, the dregs of society, the people you cross the street to avoid. The ones who inspire pity, yes, but also fear, anger and embarrassment.

“People Make Glasgow”, someone mutters, as a woman with no teeth and a limp shuffles to the tune of a busker on Buchanan Street. Others clap or jeer, or film the scene on their phones to post online. It’s cruel and it’s dehumanising, but if you didn’t laugh you’d cry.

For every drug user whose addiction proves fatal there are dozens more still living, or at least existing, in our communities. It is shocking and shameful that drugs were a factor in more than 700 deaths last year, but for every one of those deaths there are more than 80 further “problem drug users” in Scotland, defined as those who misuse opiates (mostly heroin) or tranquilisers (mostly benzodiazepines) or very often both. And for each of those individuals there’s a whole circle of others – neighbours, parents, siblings, partners, children – whose lives are also blighted by the addiction.

It is shocking and shameful that drugs were a factor in more than 700 deaths last year

Many of this week’s headlines have focused on demographic changes: the median age of those dying from their drug habit has been steadily rising as the chickens come home to roost for the so-called Trainspotting generation. The SNP are keen to describe this as a “legacy problem” and imply that with fewer young people now taking drugs, and shorter waiting times for addictions treatment, over time it will resolve itself. But a closer look at the figures suggest this simply isn’t realistic.

When in 2008 the Scottish Government published its national drugs strategy, The Road to Recovery, the problem-drug-user population appeared to be shrinking: official figures showed a drop from 56,000 to 52,000 in the space of eight years. Unfortunately this progress was swiftly wiped out, with the figure rising to more than 59,000 in 2009/10 and more than 61,000 in 2012/13. The average age of these users may have shifted upwards, but that doesn’t mean the country is getting clean.

The average age of users may have shifted upwards, but that doesn’t mean the country is getting clean

The heroin problem in the west of Scotland is not unlike the gun problem in the United States, in the sense that if you were asked to come up with a robust, evidence-based policy to prevent deaths, you wouldn’t start from here. Catching and jailing drug dealers is like a never-ending game of whack-a-mole – market forces mean the trade is displaced, not eradicated, and those desperately seeking a fix will find a way to get one. But even if you could wave a magic wand and put every Glasgow drug dealer behind bars, you would have temporarily addressed only the supply side of the drug trade. The even trickier part is addressing demand.

Even if you could wave a magic wand and put every Glasgow drug dealer behind bars, you would have temporarily addressed only the supply side of the drug trade

The tabloids seem confident in their assertions that the rise in deaths is a criminal justice issue – the Daily Mail blamed a “soft touch” approach by the Scottish Government, and The Sun sought to link the death toll to overtime cutbacks in Police Scotland. But outrage is worthless if it isn’t supported by evidence. The Road to Recovery noted that “significant seizures by the police … have no long-term impact on the quantity or price of drugs on the street, or on the levels of dealing”. In 2013/14, almost three-quarters of drug seizures were of cannabis, with just eight per cent involving heroin. Unless you subscribe to the view that every cannabis user is a heroin user waiting to happen, this might not seem like the best use of police time and resources.

Even if the police were to increase their heroin seizure rates, it is naïve to believe short-term price rises will result in fewer people buying drugs. These transactions are simply not comparable to other types of consumer behaviour, which involve rational choice. If Greggs were to run a half-price offer I’d be tempted to indulge, but if I had a life-dominating addiction to donuts it would not matter if they were £10 each as long as I could somehow lay my hands on that sum, legally or otherwise.

In recent years there has been a welcome shift away from regarding problem drug use as a purely criminal justice issue, with improved understanding of addictions helping to reframe drug-taking as a health problem rather than a character defect. But the significant tensions between these two perspectives may be impossible to resolve – for example, NHS Greater Glasgow and Clyde wants to pilot safer injecting facilities in the city centre to mitigate the harm of drug use, in direct opposition to the law-and-order brigade who seek a zero-tolerance response.

The government should resist knee-jerk tabloid pressure and remain focused on its primary prevention strategy: reducing inequality

The government should resist knee-jerk tabloid pressure and remain focused on its primary prevention strategy: reducing inequality. We know that growing up in Scotland’s most deprived communities is strongly correlated with problem drug use, and those who believe this is due to the availability of heroin in such areas may be looking through the wrong end of the telescope. Cracking down on dealers doesn’t address the question of why they found so many customers to begin with; why so many people feel hopeless, alienated and disenfranchised. If we’re serious about reducing deaths, the first step must be to make sure the most vulnerable have something to live for.

A version of this article first appeared in The National.

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