Sixty-three per cent of people who died a drug-related death in Scotland lived alone ‘all of the time’, according to new analysis by Public Health Scotland (PHS). The agency has published a review of the circumstances of everyone who experienced a drug-related death in the country in 2019 and 2020.
Just under half of the people who died had previously had a near-fatal overdose, the document states, while a third had been discharged from a general acute hospital in the six months before death. Two thirds had been in contact with treatment or harm reduction services in the six months before death, rising to more than 70 per cent of people whose death was opioid-related. More than a third were on an OST prescription, predominantly methadone.
Just over half of the people who died had been living in the country’s 20 per cent most deprived neighbourhoods, with the average age of death 43, and more than 600 children were reported to have lost a parent or parental figure to drugs in 2020.
In the six months before death, 52 per cent of people had a medical condition – primarily respiratory illness, BBVs or epilepsy – recorded, while 46 per cent had a recent psychiatric condition recorded.
Scotland has long had the highest rate of drug-related deaths in Europe, with the total for 2023 standing at 1,172 – a year in which the country also recorded its highest number of alcohol-related deaths since 2008.
‘This report is hugely important for improving our understanding of the individual people who have sadly lost their lives to a preventable drug overdose in Scotland,’ said PHS consultant Dr Tara Shivaji. ‘The scale of the issue is often represented as a statistic, but we know each person represents much more than this. They are mothers, fathers, sons, daughters, siblings, friends and colleagues. Through this report, we can paint a picture of the circumstances that are potentially driving the ongoing drug-related death crisis and recognise high-risk scenarios and trends when people are particularly vulnerable – for example, when a person is discharged from hospital. With this information, we can identify if there is more we can do to intervene and prevent these deaths from occurring.’
Meanwhile, an open letter to the prime minister and chancellor from the Association of Directors of Public Health ahead of this month’s budget – and signed by almost 50 organisations – is calling for more funding to tackle health inequalities, tied to a ‘coherent, cross-government approach’.
While praising the decision to re-introduce the tobacco and vapes bill the document points out that the public health grant has been reduced by more than a quarter in a decade, with too many people ending up in hospital ‘because too little is spent in the community’ according to Faculty of Public Health president Kevin Fenton.
‘The staff on the ground in our drug and alcohol treatment services work exceptionally hard and do a fantastic job to provide a safe, non-judgemental environment for people to get help and support,’ said Newcastle’s director of public health, Alice Wiseman. ‘However, they are working at maximum capacity. Take into account that we are currently supporting just 40 per cent of Newcastle’s opiate and crack cocaine users, and only 26 per cent of the people who would benefit from support for alcohol use, and you can see just how difficult the situation is. We simply can’t meet the city’s needs without increased – and longer-term – funding.’
National drug related death database (Scotland): analysis of deaths registered in 2019 and 2020 available here
Open letter available here