More drug-related deaths were registered in Scotland in 2011 than in any previous year, according to figures released by National Records for Scotland. There were 584 deaths, says Drug-related deaths in Scotland in 2011, an increase of 20 per cent on the previous year.
Six of the past ten years have seen increases, with an overall increase of 76 per cent since 2001. Although 73 per cent of those who died were male, the number of female deaths was the highest ever, with a 117 per cent increase in 2007-11 compared to 1997-01. The percentage increase among men over the same period was 85 per cent.
Thirty-six per cent of all deaths were among 35 to 44-year-olds and 32 per cent among 25 to 34-year-olds, with the largest percentage increases recorded for 35 to 44 and 45 to 54-year-olds. There was, however, a fall in the number of deaths among those aged under 25. More than 30 per cent of deaths were in the Greater Glasgow & Clyde NHS Board area.
Methadone was ‘implicated in, or potentially contributed to’ 275 of the deaths (47 per cent) compared to 174 in 2010, which has led to calls in some parts of the Scottish press for a parliamentary inquiry into substitute prescribing. Leader of the Scottish Conservatives, Ruth Davidson, also issued a statement that the ‘appalling loss of life illustrates the human disaster that is the methadone programme. It would appear hundreds of families are being blighted by what is little more than legalised drug-taking on an industrial scale.’
However it is unclear how many of the people who died had been prescribed methadone, as the information is not collected by the death registration process or pathologists’ questionnaires. Methadone, potentially combined with alcohol, was recorded as a ‘strong factor’ in 112 of the deaths and the sole cause of death in 14.
The report was a ‘stark reminder of individual human tragedy and the scale of wider social need in Scotland’ said Biba Brand of the Scottish Drugs Forum (SDF). ‘Wide-ranging income, health and social inequalities continue to devastate the lives of many people and the communities they live in – to the extent that services are now seeing their third generation of families seeking help for drugs problems.’
National coordinator of the SDF’s government-funded take home naloxone programme (DDN, August, page 4), Stephen Malloy, added that the statistics were ‘a reminder that the vast majority’ of deaths were opiate-related overdoses. ‘There remains a huge amount of work to be done to ensure adequate supplies of take home naloxone are available in Scotland’s communities,’ he said.
Meanwhile, figures from the Office for National Statistics show that drug poisoning deaths – involving both illegal and legal drugs – in England fell by six per cent for men and three per cent for women between 2010 and 2011. The overall number of male drug misuse deaths (involving illegal drugs) fell by 14 per cent to 1,192 in 2011 but female deaths increased by 3 per cent to 413. Deaths involving heroin/morphine decreased by 25 per cent – although these were still the substances most commonly involved in poisoning deaths – with the mortality rate among males falling by 39 per cent in two years.
The report cites the ongoing ‘heroin drought’ since late 2010 as a possible cause, with availability remaining low in some areas and consequent falls in purity. ‘Drugs workers were concerned that the heroin drought may result in more drug-related deaths, as users who had developed a reduced tolerance could overdose if they used a high quality batch of heroin,’ it says. ‘However, ONS data show the opposite trend with deaths involving heroin falling in recent years.’
There were nearly 300 drug poisoning deaths involving benzodiazepines, with mortality rates among men reaching an all-time high of eight deaths per million population in 2011, while deaths involving barbiturates and helium have increased consistently over the last five years, despite the number of prescriptions for barbiturates more than halving over the same period.
Reports at www.gro-scotland.gov.uk and www.ons.gov.uk
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Clear sighted
I was very heartened to read the interview with Alliance founder Bill Nelles (DDN, September, p10). The story of setting up The Alliance is an inspiring one of genuine user activism, and of making a huge difference and saving lives. For the past few years we have had a good system in this country with medication available, and I think it can be sometimes forgotten that this was not always the case.
There is much talk of patient choice and the oft-heard discussion of ‘an individual recovery journey’. However in the current climate individuals on a script are often left feeling stigmatised and in constant fear of having their medication removed. The situation in the UK 30 years ago, and the current lack of methadone prescribing in parts of Canada, provide a stark reminder of how many lives have been lost by the blinkered pursuit of abstinence as the sole treatment option.
Despite this, Nelles states how open he is to abstinence and how he ‘wants people to get the treatment they want’ and sees his role to protect people’s choices. Coming from him, talk of ‘individual recovery journeys’ does not sound hollow at all.
Someone with a vast knowledge of the UK treatment system gained through professional and personal experience, coupled with his current situation as someone removed, have given Nelles a unique perspective. I look forward to hearing more from him.
Colin Reed, by email.