Scotland’s drug-related crisis and the ongoing failure of progressive drug policy | Dr Gary F. Fisher

At the end of 2020 the office of the National Records of Scotland finally released their long-delayed statistics detailing the number of drug-related deaths for the year of 2019. They showed that 1,264 Scots had died as a result of drug-related causes, representing a 6% increase from the previous year and more than double that of 2014. Over half of deaths were related to the misuse of heroin and morphine. Scotland has firmly entrenched itself as the drug-deaths capital of Europe, boasting a per-capita death rate that is higher than anywhere else on the continent and is approximately three-and-a-half times greater than the rest of the United Kingdom. This crisis represents a devastating tragedy and an absolute failure of government.

These horrifying statistics briefly occupied the Scottish news cycle before being swiftly replaced by the ongoing crisis stemming from the feud between Alex Salmond and Nicola Sturgeon. Pleas for action and suggestions of potential solutions briefly filled Scottish airwaves and publications. One article that is representative of the type appeared in Scottish Legal News and was penned by criminal defence lawyer Iain Smith. In it, Smith argued that the time has come for Scotland to cease treating drug-related activities as a matter for the criminal justice system and instead adopt a ‘smart’ approach that ends the stigma and ‘othering’ suffered by drug-users and instead treat drug-related crime as a public health issue. This may all sound well and good. But there is a problem. The Scottish government is already pursuing such an approach, and has been for over a decade.

In 2008, one year after the Scottish National Party first emerged as the largest party in the Scottish Parliament during the 2007 Scottish Parliamentary election, the Scottish Government announced their ‘Road to Recovery’ policy, promising a ‘new approach to tackling Scotland’s drug problem’. This policy offered ‘a step change in the way that Scotland deals with its drug problem’, seeking to de-emphasise the role of the criminal justice system in drug-related matters and instead pursue a public health approach offering ‘treatment and rehabilitation’. This would form part of a wider effort to ‘avoid stigmatising’ those affected by substance misuse, reduce the number of drug-related deaths blighting the country (which, for reference, sat at just 421 in 2006, the year before the SNP took power), and ultimately put Scotland on the road to recovery.

This policy, evidently, was unsuccessful. When Nicola Sturgeon became Scotland’s First Minister in 2014 the number of deaths had risen to 613, an almost 50% rise in yearly deaths when compared to 2006. Sturgeon steered a similar course to her predecessors, supporting a progressive approach that emphasised treating drug-related activity as a public health, rather than criminal justice, issue. In 2016, when the number of drug-related deaths had reached 867, the Glasgow City Alcohol and Drug Partnership received the green-light to introduce ‘safe’ injection sites and offers of medical-grade heroin to the city’s drug addicts. During that same year, Sturgeon advocated for the gradual legalisation of certain controlled substances. 

In 2018, a year which witnessed 1,187 deaths, the Scottish Government published a new drug strategy titled ‘Rights, Respect and Recovery’. As with the 2008 ‘Road to Recovery’ policy, this ‘new strategy’ sought to challenge the ‘negative attitudes and stigma’ surrounding the use of illegal drugs. Warning against the ‘further challenges’ that addicts may face through the criminalisation of their activities, this 2018 policy took ‘a human rights-based, public health approach’ that emphasised ‘treatment and recovery services’. This seemingly progressive stance towards their ongoing drugs crisis was lauded at the time, with articles in progressive publications advising policy-makers in Westminster to look ‘over the border in Scotland’ where politicians were ‘displaying genuine leadership … to improve society’. One year later Scotland would record yet another all-time high number of per-capita drug-related deaths, the sixth consecutive year in which that had been the case. After more than a decade of supposedly enlightened and progressive policies, the drug crisis in Scotland has continually and consistently worsened. Something, evidently, is not working.

It is by a strange coincidence that, just as the Scottish Government were able to limp out their almost-a-year-late records for 2019 deaths, another great bastion of supposedly progressive and enlightened drug policy was experiencing a similar phenomenon. Across the Atlantic, the Canadian province of British Columbia and its principal city of Vancouver have for many years been seen as being at the cutting-edge of progressive drugs policy. In 2001, the city responded to their yearly average of 147 drug-related deaths by introducing a bold new policy direction called ‘the four pillars’ that emphasised public health and the need to ‘destigmatize [drug] users’. 

In the subsequent decades, the city and wider province have further liberalised their drug policy by introducing safe injection sites, providing registered addicts with medical-grade heroin, and permitting the sale of crack pipes through vending machines. Philip Owen, the mayor of Vancouver who pioneered this approach, has been celebrated for his efforts with honorary degrees, professorial chairs, and inauguration into the Order of Canada. In 2020, British Columbia experienced 1,716 fatal drug overdoses. This amounts to a 74% increase from the previous year and an overall overdose rate of 33.4 deaths per 100,000 people, the highest on the continent. The responses have by now become all-too-familiar. Journalists, activists, and politicians have demanded an even more permissive approach. The government of British Columbia has submitted a formal request to the Canadian government to become exempt from federal drug laws so that they might decriminalize illicit drugs. 

There are, obviously, a plurality of factors at play in the ongoing drugs crises affecting Scotland and British Columbia. A complete dissection of why both states’ policies have failed so drastically would require far greater time and space than is available in this brief article. But, the fact that the two states from across the English-speaking world that have adopted the most progressive, liberal, and de-stigmatising approach to addiction and drug-related crimes have both witnessed such unprecedented disaster, each becoming the drug-deaths capitals of their respective continents, ought to at least occasion pause.

  Instead, as historic death records have continued to be surpassed and the body-count has continued to spiral out of control, the governments of both states have doubled down on their approach, insisting that their crises could be solved if only they went even further along their present course. British Columbia’s demands to legalise drug abuse are now being echoed in Scotland, with articles calling for the decriminalisation of heroin and other drugs appearing within mainstream publications such as The Herald newspaper.

This is folly. Having personally worked both with recovering opiate addicts in the U.S.A. and also as an educator within the British prison system, I’ve been able to see how different approaches to drug-related crime have variously helped and hindered the issues they seek to solve. In some instances, a rehabilitative public health approach may yield results. In others, the intercession of the criminal justice system is necessary. A policy of absolute permissiveness is not the answer. To suggest that it is would at best be ignorant and at worst dishonest. 

Like addiction itself, the liberalisation of drug policy is a difficult genie to place back in its bottle. Once the consumption of heroin and other illicit drugs has been completely normalised and de-stigmatised, legislators may find it very difficult to re-stigmatise it should they ever wish. The architects of Scotland’s drugs disaster may find that people have learned to stigmatise opiate abuse for a reason, and that by continuing to rush headlong towards permissiveness they are dooming ever more of their countrymen to a life and death defined by addiction. 

Yet, it is easy to pass a bill when you are not the one who will pay the cost. As with many progressive policies, it is not those legislating or advocating for them who are likely to feel the long-term negative consequences. The 1,264 Scots killed by drugs in 2019 were drawn overwhelmingly from the most vulnerable sections of Scottish society. Some 75% were concentrated in just five administrative regions. The alacrity with which they have been forgotten by the Scottish news cycle ought to be shocking. For all the tragedy and deficiency of government that their deaths represent, public discourse on the matter has swiftly given way to the politics of personality surrounding Nicola Sturgeon and the accusations made against her. In his opening statement before the Holyrood Inquiry in February of 2021, Alex Salmond warned that Sturgeon’s autocratic rule was turning Scotland into a ‘failed state’. For the 1,264 dead, it already is.

If you liked this article and want to help our organisation expand, please consider donating.