Last year, SPICe published a blog reporting the latest drug-related deaths statistics released by National Records Scotland. At the time of writing, 2017 had been a record-breaking year with a total of 934 deaths, an 8% increase on the previous year.
Sadly, 2018 was no different. The latest figures show a 27% increase in deaths, a total of 1,187 which is more than double the figure for 2008 (574).
NRS acknowledge there are some differences in the way that data is recorded and classified in the rest of the UK, so there should be caution in making comparisons.
However, it also states that these differences are unlikely to account for the majority of differences between rates, and that the Scottish rate ‘could well be at least 2½ times that of the UK as a whole if there were no methodological differences.’
Deaths are increasing among women and older age groups
When comparing the annual average of deaths for 2014-2018 with that for 2004-2008, NRS found that the percentage increase in deaths among women was almost three times that of men (214% for women and 75% for men).
Recent years have also seen large percentage increases in deaths in the 45-54 age-group. This age-group has seen more deaths than 25-34 year olds and in 2018 accounted for 29% of all drug-related deaths.
Regional patterns in drug-related death rates show a strong link to levels of deprivation. The chart below shows a clear relationship between average rates of drug-related deaths and deprivation indicators. Generally speaking, local authorities with high rates of deprivation have high rates of drug-related deaths per 1,000 population.
One local authority area which stands out is that of Dundee, which overtook Glasgow in having the worst death rate in Scotland in 2017. It’s average death rate from 2014 to 2018 (0.31 per 1,000 population) was almost double that of the average rate of Scotland (0.16).
The stark reality of that death rate is that 66 people in Dundee lost their lives to drugs in 2018.
Aberdeen, Inverclyde and Renfrewshire also have seen large increases in average death rates in recent years.
Urban areas also tend to have higher death rates. However, some urban areas close to Glasgow such as East Renfrewshire, with more prosperous suburban communities, have low rates of drug-related deaths. The reverse is seen in rural areas close to cities, for example East Ayrshire and Clackmannanshire which have higher deprivation and higher rates of drug-related death rates compared to other rural regions.
What has been the response?
Since last year, the Scottish Government has established a Drug Deaths Taskforce. The main aim of the Taskforce is to identify measures to improve health by preventing and reducing drug use, harm and related deaths. Professor Catriona Matheson from the University of Stirling was recently announced as the Chair of the Taskforce. In November 2018, the Scottish Government published its revised alcohol and drug strategy.
Around the time the new strategy was launched in November 2018, an additional £20 million per year, for the next three years, was announced for drug and alcohol services on top of the £53.8 million allocated for 2018/19. The majority, £17 million was allocated to NHS Boards for onward delegation to integration authorities.
In its 2019-20 Programme for Government, the Scottish Government has committed to invest £20 million over two years to support local services and provide targeted support to address drug-related deaths. In a recent statement to the Scottish Parliament, Joe Fitzpatrick, the Minister for Public Health, Sport and Wellbeing said the following.
“That new money will go towards initiatives that will change and improve the lives of those who are affected by problem substance use. The money will allow our new task force to support pathfinder projects, test new approaches and drive forward specific work, which is based on evidence, to improve the quality of services. It will also allow us to establish joint-working protocols between alcohol and drug services and mental health services, with the aim of improving access, assessment and outcomes for individuals, and to develop and test integrated services for mental health and alcohol and drug use. Further, the money will aid us in developing a new national pathway for opiate replacement therapy, which will increase its effectiveness across the country. Crucially, that work will help us to reduce the stigma that is associated with the use of such therapy.”
In May 2018, the Dundee Drugs Commission was formed to investigate the causes and consequences of drug deaths in Dundee and come up with recommendations on practical and achievable actions to reduce drug use and fatalities locally – and nationally. The Commission consists of 20 independent experts. In August 2019, the Commission published its report – ‘Responding to Drug Use with Kindness, Compassion and Hope’.
Proposals for establishing a supervised injection facility in Glasgow were approved by council officials and supported by a motion in the Scottish Parliament in 2018. However, introduction of these facilities would require changes to the Misuse of Drugs Act 1971 which is reserved to Westminster. The Home Office has stated it has no plans to back the introduction of supervised consumption facilities.
Responding to the latest statistics, The Scottish Government’s Public Health Minister Joe FitzPatrick urged the UK Government to provide help in providing solutions, particularly with regards to establishing supervised drug consumption facilities.
“Last week, I gave evidence to the Scottish Affairs Committee and I asked for help in persuading the UK Government to either act now to enable us to implement a range of public health focused responses – including the introduction of supervised drug consumption facilities – or devolve the power to the Scottish Parliament so that we can act.
I want to ensure that the work of the new taskforce which I have established is driven by strong evidence and the voices of those with experience of using drugs, and their families, are heard. I am determined to shape our services in every walk of life to prevent harm and reduce the appalling number of deaths.”
The Scottish Conservatives have called for a cross-party summit to tackle the problem and the Scottish Greens have emphasised the need for a public health approach. Both Scottish Labour and the Scottish Liberal Democrats have criticised the Scottish Government for reductions in funding for Alcohol and Drugs Partnerships in recent years.
Funding for Alcohol and Drugs Partnerships
Treatment and support services for drugs and alcohol is devolved to Scottish Ministers. This work is undertaken by Scotland’s 30 Alcohol and Drugs Partnerships (ADPs).
ADP funding was transferred from the Scottish Government’s justice directorate to health in 2015. This led to a 22.25% reduction in the combined drug and alcohol funding from £69.2 million in 2015/16 to £53.8 million in 2016/17. The shortfall was expected to be covered from allocated health budgets. This change has made it more difficult to scrutinise changes in funding levels available to ADPs.
Damon Davies, Researcher and Andrew Aiton, Data Visualisation Manager, SPICe Research
Blog image by Jair Lázaro on Unsplash