Rising rates of drug-related deaths in Scotland can be explained by the impact of political decisions and social deprivation in the 1980s, according to a report from NHS Scotland and the University of Glasgow. Drug-related deaths have been increasing among those born between 1960 and 1980, which is likely the result of ‘exposure to the social, economic and political contexts of the 1980s’, the document states.
Policy decisions in the 1980s that led to high unemployment and reduced support created increased inequality and the ‘erosion of hope’, with a ‘delayed negative health impact’ on those least resilient, it says. People in the most deprived areas were affected ‘earlier and more profoundly’, and were two to three times more likely to die as a result of drugs than those in the least deprived, with men also two to three times more likely to die than women.
Drug services urgently need to adapt to the needs of an aging cohort of people at greater risk, as ‘co-morbidities from chronic conditions’ become more prevalent, stresses NHS Scotland. Figures for 2015 revealed more than 700 drug-related deaths in Scotland, the highest ever number and almost two per day (DDN, September 2016, page 4). Scottish Drugs Forum (SDF) CEO David Liddell called the statistics ‘a national tragedy’ and the ‘ultimate indicators’ of the country’s stark health inequalities.
‘The same kind of pattern we have observed and reported on previously regarding the risk of suicide in vulnerable cohorts in deprived areas in Scotland is repeated, and even more clearly visible, when looking at trends in drug-related death risk,’ said the report’s author, Dr Jon Minton. ‘For people born in the 1960s and ‘70s, the risk of drug-related deaths throughout the life course was much increased and gender and area inequalities in these risks increased even more.’ The risk factors of being male and living in a poor neighbourhood were ‘multiplicative’, he added, meaning men living in the poorest neighbourhoods ‘had up to a ten-fold greater risk of a drug-related death each year than women of the same age living in more affluent neighbourhoods. The similarity of trends in both suicide and drug-related deaths suggest a common underlying cause.’
The document’s publication comes as the Scottish Government announces a ‘refresh’ of its 2008 drug strategy, The road to recovery, along with a joint initiative with SDF on engaging with older drug users and keeping them in treatment, called ‘Seek, keep and treat’.
‘The nature of Scotland’s drug problem is changing and we need to adapt services to meet the needs of those most at risk, who we know face complex and wide ranging social and medical issues,’ said public health minister Aileen Campbell. ‘In setting out our plans to refresh the existing strategy, I’m encouraging everyone involved in treatment services to think about how they can make changes at a local level. There is also a collective need to challenge the stigma of addiction and build services based on respect and dignity, as well as clinical need. I look forward to hearing views from across the sector in the coming months as we work together to tackle the evolving and complex needs of those who suffer from problem drug misuse.’
Drug-related deaths in Scotland 1979-2013: evidence of a vulnerable cohort of young men living in deprived areas at www.healthscotland.scot