DDN Magazine November 2020 | Page 6


Igor Dutina | Dreamstime . com
Simply blaming an ageing cohort or pre-devolution economic policies for Scotland ’ s shameful levels of drug-related deaths won ’ t cut it anymore , say Barry Sheridan and Iain McPhee

For more than a decade drug-related deaths ( DRDs ) in Scotland have increased , with the available evidence indicating poor alcohol and drug service outcomes in comparison to the UK and the rest of Europe . Between 2007 and 2019 the Scottish Government cut budgets for alcohol and drug services from £ 114m to £ 53.8m per year .

In this article we explain how Scottish Government funding and policy decisions , centralising service provision , and closing third sector service providers – while relying on unpaid volunteers in recovery – has contributed to increased risk of DRD among marginalised communities .
In assessing evidence that challenged the Scottish


Government narrative that DRD increases were attributable to a legacy of UK government economic policies before Scottish devolution in 1999 , or that increased DRDs could be explained by an ageing cohort , we reviewed the 2009 Audit Scotland report on drug and alcohol service provision . This report was published after the Scottish Government published the Road to recovery strategy in 2008 – this strategy concentrated on drugfree recovery , with a clear focus on the concept of recovery capital . The adoption of a narrow individualised conceptual approach to measuring recovery has clearly failed to reduce DRDs . The strategy largely ignored structural and environmental risk factors for problematic drug use , and increased risk of DRDs .
The analysis in our paper published in Drugs and Alcohol Today uses the 2009 Audit Scotland report Drugs and alcohol services to make comparisons with the 2019 update report ( see box opposite ). The 2009 report made six recommendations on treatment effectiveness – setting clear national minimum standards for a range of services , clear accountability of service governance , assessment of local need , service specifications on quality requirements , clear criterion on demonstrating treatment effectiveness , and , finally and most importantly , to use the Audit Scotland 2009 checklist to help improve delivery and impact of drug and alcohol services using a joined up consistent approach .
The 2019 report did not follow up on the recommendations in the 2009 report but chose to focus on naloxone provision , needle provision , and framing increases in DRDs as linked to an ageing cohort . The 2019 report indicates a 71 per cent increase in DRDs since 2009 and suggests that the average annual funding for services by the Scottish Government was £ 73.8m for 2018- 19 . These statements require deeper analysis and explanation .
NALOXONE Naloxone has an impact on people who experience an overdose of opiates . However , a large number of DRDs are – from autopsy and toxicology reports – poly-drug users , which reduces the effectiveness of naloxone in preventing overdose .