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Improving health
Previously NHS Health Scotland

Figures published today show the number of drug-related deaths in Scotland is the highest number ever recorded, for the fifth year in a row. In 2018, 1,187 people lost their lives to a drug-related death. Each one of these deaths is a tragedy, and every one is preventable, not inevitable.

No-one chooses to become dependent on drugs. Deprivation and inequality create difficult conditions in which people live, and problematic drug use is commonly a sign of these complex social circumstances. We know the numbers of people living with, or dying from, drug use is 17 times higher in our poorest areas compared to the wealthiest. Described as deaths of despair, this tells us something about the nature of drug harms in Scotland. A public health approach with new regulatory and treatment responses, and which focuses on quality of life and harm reduction as a route to recovery, has the potential to reverse the current trend.

The existing approach is not working. To prevent drug-related deaths we need to ensure access to effective and sustained support. Quality treatment options and wraparound continuity of care to keep people in services, particularly at times of transition such as entering treatment, leaving hospital or custody is also essential.

We also need to take action now to address the factors that cause problematic drug use: like a lack of hope from an early age, experiences of trauma, family breakdown and poverty. We can improve people’s life chances by focusing on tackling poverty, reducing childhood adversity, improving housing, creating positive educational experiences or employment opportunities and addressing mental ill health.

The loss of life, particularly amongst those aged 35-55 years, means that drugrelated deaths are impacting on overall life expectancy trends for Scotland and are exacerbating health inequalities.

Elinor Dickie, Public Health Intelligence Advisor at NHS Health Scotland, said:

“For the first time, 2018 saw over a thousand drug-related deaths in Scotland. We should not underestimate the impact of those losses on individuals, families and communities across the country.

“Drug-related deaths are now a substantial contributor to worsening life expectancy trends. Action must be taken to address the underlying causes and improve the circumstances in which people live. Systematic changes are needed to reduce harm and save lives. The outcome we all want is fewer people dying at an early age, and we should to do whatever it takes to ensure everyone in Scotland’s right to health.

“Sometimes that might include helping people live with their drug use whilst we tackle the more enduring issues that led them to use drugs in the first place. In this way we can support them to sustain change on their road to recovery.

“Drug-related deaths are preventable. With compassion and support from joinedup services, creating hope for people in need, and laws that seek to cut harm, we can turn the rising tide around”.

Dr Andrew McAuley, Principal Scientist at Health Protection Scotland, said:

“This latest rise in drug-related deaths only underlines the need to take action now. We need to look beyond substances themselves if we are to reduce mortality and pursue a public health approach focused on quality of life and harm reduction. There is evidence of what we can do immediately to keep people safe. In particular, we have to increase capacity and retention in specialist drug treatment services to ensure rapid access to opioid substitution therapy.

“Looking further ahead, changes to legislation which would support a public health approach – for example to allow for provision of safer consumption facilities – could reduce both drug-related harms and deaths”.