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Earlier this month, I was saddened to see the Scottish Government’s latest statistics on drug-related deaths. The report stated there were 1,187 drug-related deaths last year. That’s a 27 per cent increase on the year before – the highest rate in the EU.
Despite these numbers, the UK Government continues to pursue an approach to drug use that is centred on punishment of people who use drugs.
As a member of the Global Commission on Drug Policy, I have long supported the implementation of evidence-backed drug policy reforms. After all, the evidence is clear – only proven harm reduction-based policies will lead to real drops in the number of hospitalisations and deaths.
Here are some examples of policies that have been shown to really work:
Around 30 countries in the world have decriminalised the possession of small quantities of cannabis or all drugs. While many still impose fines or other sanctions, the aim is to divert individuals from the criminal justice system towards support and treatment.
Many worry that decriminalisation would lead to increased drug use, but the evidence is clear – it does not. In fact, decriminalisation, when coupled with harm reduction and broader health interventions, is shown to help move people from unhygienic and dangerous environments. These typically involve needle-sharing and risky injections that fuel overdose deaths and epidemics of HIV and hepatitis.
In the UK, Avon & Somerset Police divert people caught in possession of drugs to a drug education course. In Durham, individuals enter a four-month drug programme with a dedicated key worker. Both schemes have recorded reduced reoffending rates, as well as positive health and social outcomes for those diverted.
Other countries, like Portugal in 2001, decriminalised all drugs for personal use. As a result, injecting drug use, drug-related crime, drug related deaths, HIV transmission and the prison population all fell. The drug-related death rate in Portugal is now four per million, compared to 74 in the UK as a whole, and 219 in Scotland.
2. Overdose Prevention Sites
Overdose Prevention Sites (also sometimes called drug consumption rooms, or supervised injection facilities) are legal sanctioned facilities where people who use drugs can inject their own pre-obtained drugs under medical supervision.
There are more than 100 overdose prevention sites around the world operating in 66 cities in 12 countries. They provide people with sterile injecting equipment, sometimes smoking equipment, a hygienic space, as well as access to counselling services, primary medical care and emergency care in the event of an overdose.
To date, no one has ever died of an overdose in a drug consumption room, anywhere in the world. In addition to saving lives, they are also shown to reduce the transmission of blood-borne viruses, local drug-related crime, and street drug litter. While some argue they might increase drug use, the European Monitoring Centre for Drugs and Drug Action (EMCDDA) has stated there is no evidence to suggest this is the case.
I was pleased to see a group of 13 cross-party UK MPs and peers, plus seven police and crime commissioners, send a letter to the UK Home Secretary last week. They called for a review of the evidence and an end of the policy of blocking the implementation of drug consumption rooms.
3. Drug safety testing
The high and variable strength of drugs, often unknown by the person taking them, combined with adulteration and mis-selling is a key cause of accidental drug poisonings and overdoses. One simple way of reducing that risk is by allowing people to test their drugs. Drug safety testing is happening in a growing number of countries including Canada, Mexico, Austria, the Netherlands, Switzerland and – on a smaller scale – the UK, although not yet in Scotland. And while some have expressed concern that the testing of illegal drugs could encourage use, there is no evidence to support this.
Last year, I wrote about The Loop, a brilliant UK charity that offers hassle-free and anonymous drug safety testing at music festivals, concert venues and, recently, city centres. ‘Multi Agency Safety Testing’ (MAST), as it is formally known, allows members of the public to bring substances they have purchased to The Loop’s pop-up labs for analysis. Their chemists analyse each sample and deliver the test results back to users providing them with harm reduction advice and information.
The scheme has been so successful that Secret Garden Party festival credited The Loop with reducing drug-related hospital admissions by 95 per cent.
4. Improving access to naloxone
Naloxone is the emergency antidote for overdoses caused by heroin and other opioids. Increasing the availability of naloxone is a straightforward way of reducing overdoses. Last year, US Surgeon General Jerome Adams encouraged more people to routinely carry naloxone, urging people to treat it like an EpiPen for allergies, or CPR. Like in many countries, over half of the overdoses occurring in the US are taking place inside people’s homes, so increasing the provision of naloxone improves everyone’s ability to respond, wherever they are.
It’s heartbreaking to see the statistics of increasing and needless drug-related deaths. The good news is that we know what policies work. If governments can invest in harm reduction services like the ones above and ensure equal and fair access, then we will start to make progress.