Scotland recorded its second-highest number of drug deaths in 2012, although the number of deaths in under-25s was down by a fifth, according to new figures from the Scottish Government.
Overall drug-related deaths stood at 581, three fewer than 2011’s record number (DDN, September 2012, page 4). More than 60 per cent of deaths were in people over the age of 35, while the number among people under 25 fell by 20 per cent to 46.
Methadone was implicated in 38 fewer deaths than 2011 – at 237 – including 12 deaths where methadone was the only drug present and 68 where it was the only drug implicated apart from alcohol. There were also 47 deaths where new psychoactive substances were present – the first time they have been included in the report – including five where they were the only drug present.
‘The Scottish Government is dealing with a legacy of drug misuse which stretches back decades and, as in previous years, the statistics published today show that many of these deaths are older drug users who have become increasingly unwell throughout the years,’ said community safety minister Roseanna Cunningham.
The high level of deaths among older opiate users re-emphasised the need for services to be ‘more targeted towards the needs of this group of people, who are likely to have a range of complex needs’, said Scottish Drugs Forum director David Liddell. ‘The Scottish Government’s programme to distribute naloxone – an emergency antidote for opiate overdoses – is one of the measures to help cut the drug deaths toll in Scotland but more needs to be done to ensure greater distribution and take up across Scotland. Our view is that at least 40 per cent of the estimated 59,600 people with very serious drugs problems in Scotland need to be provided with naloxone in order to make a substantial impact on the deaths.’
The number of deaths in 2011 involving methadone led to much debate in the Scottish media and a call for a parliamentary enquiry. However, the report of the government-commissioned Independent Expert Group Review of Opioid Replacement Therapies in Scotland has concluded that the use of opioid replacement therapies – particularly methadone – should continue as part of a range of treatment options. ‘Opioid replacement is an essential treatment with a strong evidence base,’ says the document. ‘Its use remains a central component of the treatment for opiate dependency and should be retained in Scottish services.’ The report also recommends that local information systems be improved to identify people’s progress towards recovery and more consideration be given to addressing the link between health inequalities and problem substance use.
‘Opioid replacement therapies, including methadone have had a beneficial effect in preventing the spread of viruses among drug users,’ said Scotland’s chief medical officer, Dr Harry Burns. ‘However, they often simply switch one form of drug use for another, albeit a safer one. That’s why we need to find more ways of helping people access a range of treatments and support, tailored to their needs and their aspirations for sustained recovery.’
Meanwhile, a report from NHS Health Scotland has found that while alcohol sales in Scotland fell by 3 per cent between 2011 and 2012, Scots still drink around a fifth more than the English or Welsh. Nearly 90 per cent of the difference in ‘per adult sales’ was the result of higher off-trade sales, particularly spirits, says MESAS alcohol sales update 2013. ‘Cheap vodka’ was ‘fuelling much higher levels of harm, which results in 100 alcohol-related hospital admissions a day and costs Scotland £3.6bn each year – £900 for every adult’, said public health minister Michael Matheson.
Drug-related deaths in Scotland at www.gro-scotland.gov.uk
Delivering recovery-opioid replacement therapies in Scotland – independent expert review at www.scotland.gov.uk
MESAS alcohol sales update 2013 at www.healthscotland.com