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Improving health
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The Scottish Affairs Committee will this week begin hearing oral evidence as part of its inquiry into the use and misuse of drugs in Scotland. Together with NHS Health Scotland, Health Protection Scotland and Information Services Division (both part of NHS National Services Scotland), submitted a joint response to the call for evidence from the committee. The three organisations will soon join to form a new national public health agency for Scotland – Public Health Scotland. Public Health Scotland’s remit will include providing national leadership around tackling the harms associated with drugs in Scotland.

Misuse of drugs is a significant issue in Scotland and it leads to a variety of social and health problems. Drug use disorders are the sixth leading cause of early death in Scotland, and drug-related death rates in Scotland are 2.5 times higher than in England, Wales and Northern Ireland. There is a significant body of evidence showing that poverty and deprivation are the main structural drivers contributing to problematic drug use in Scotland, with drug-related harm a common symptom of wide levels of inequality.

Our submission, available on the UK Parliament website, supports the Scottish Government’s public health approach to drugs policy. We recommend that this requires new and alternative regulatory and treatment responses be considered for Scotland, as part of a whole-system approach to tackling the health and social harms associated with drug use. In the short term, changes to the Misuse of Drugs Act 1971 are necessary, to enable more devolved powers to address health harms (including the piloting of a safer consumption facility in Glasgow City centre).

Dr Diane Stockton, Acting Director of Public Health Science at NHS Health Scotland, said:

“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.

“The numbers of people living with, or dying early from, ill health caused by drug use is 17 times higher in our poorest areas. Described as deaths of despair, these figures are tragic and they tell us something about the nature of drug use. We need to look beyond the substances themselves to solve this problem. We have to address the factors that cause drug use and dependency in the first place. This means a focus on tackling poverty, reducing childhood adversity, improving housing, creating positive employment prospects and addressing mental ill health. These factors make the difference in people’s life chances, establish positive opportunities and create hope.

“A public health approach would do this – one that puts the person and their life right at the heart of prevention – reducing harm, removing underlying causes and improving circumstances in order to set people on the road to recovery. Sometimes that approach might include helping people live with drugs whilst we address the more enduring problems that led to their drug misuse in the first place.   

“Addressing wider social inequalities, and reducing poverty, will play an important role in the prevention of drug misuse and a reduction in associated harms. Drug-related deaths are preventable. The outcome we want is fewer people dying at an early age, and we need to do whatever that takes.”

Phil Couser, Director of Public Health and Intelligence at NHS National Services Scotland, said:

“A combination of socio-economic and political decisions created the context for the current problems with drug misuse in Scotland, and therefore immediate and simultaneous action at a similar level is required to mitigate the risks of drug-related harm.

“Our joint submission to the inquiry calls on the Committee to recognise the unique aspects of Scotland’s experience of the negative impacts of poverty, deprivation and inequality, and to work closely with the Scottish Government and Public Health Scotland (when it comes into being), in order that an effective whole-system response to drug misuse in Scotland can be found.”

To read our full submission to the Scottish Affairs Committee on the use and misuse of drugs, visit the UK Parliament website.

To find out more about drug use and health inequalities, see the Drugs section of our website.