HUNDREDS OF YOUNG LIVES LOST IN SPIRAL OF TRAGEDY

1999 Is Turning Out To Be A Very Bad Year For Drug Addicts In Glasgow.

The number of addict deaths has hit last year's total and we have four
months to go to the end of the year. What the figure will be by December is
anybody's guess, but it could reach as high as 120.

We call these deaths "addict deaths" or "drug-related deaths" as if they
represented a lesser form of loss. In reality, of course, they represent
hundreds of young lives lost.

In the passage of a few years, the young people who comprise these grim
statistics have made the transition from lively teenagers to being the
latest bodies on the mortuary slab. Each of these individuals has achieved
a unique form of Glasgow fame, they are remembered not for who they were,
but for their contribution to a growing tally of drug-related deaths.

Why is this seemingly unremitting toll of death occurring in Glasgow? One
answer has to do with the addicts themselves. Injecting and mixing
different drugs is just about the riskiest way of using illegal drugs.
Injecting and mixing drugs, though, is common among Glasgow's addict
population.

Why do addicts in Glasgow choose such a risky form of drug use? In
interviews with addicts who had survived an overdose, many of the young
people stated that when they had used the drugs that had nearly killed
them, they were not really that bothered whether they lived or died.

While part of this pessimism is about being an addict, another part is
about the wasted lives that are commonplace in many of the communities
within which drug abuse in Glasgow has flourished.

Communities such as Castlemilk, Drumchapel, Easterhouse and Possilpark have
suffered years of chronic unemployment and social neglect and have become
fertile grounds for the buying and selling of illegal drugs.

If we are going to reduce the number of addict deaths in Glasgow, we have
to tackle the massive problems of rebuilding those parts of the city. That
is the challenge facing national and local politicians in Glasgow.

The challenge facing those working within drug services in Glasgow is no
less massive. We need the very best drug services working in Glasgow. But
how effective are these services?

The answer to this question is that we don't know because hardly any of
these services have undergone any kind of rigorous assessment of their
effectiveness.

Methadone, for example, is the drug that is prescribed more widely to
addicts in Glasgow today than at any time in the past. There is a very good
way of finding out how effective methadone is in treating addicts.

This method is called the random control trial. Basically, you give
methadone to one group of randomly selected addicts; you give a fake drug,
or an alternative to another randomly selected group of addicts. You do not
tell the patients, or the doctors which group is getting which drug and you
wait to see if one group fares better than the other over a given period of
time.

There has never been such a randomised control trial evaluation of
methadone in Scotland, despite the fact that literally thousands of addicts
receive methadone on a daily basis. The lack of evidence in the drugs
field, however, goes way beyond methadone.

Within Scotland over the last few years there has been a huge growth in the
provision of counselling services to addicts. What almost all of these
forms of counselling have in common is the fact that hardly any of them
have undergone any kind of rigorous examination as to their effectiveness.

But what about education? Surely there is evidence of effectiveness in
relation to drug education. Once again the answer is a disappointing "no".
There can be little doubt that we need to educate our young people about
the risks of illegal drug use in the hope that this knowledge will lead
fewer of them to beginning to experiment with them.

But are any of the drug education packages we currently provide to young
people effective? Is it better to use a teacher to provide drugs education,
or should we be seeking to use police officers, parents, peers or reformed
addicts?

There will be many people who confidently assert, on the basis of no
evidence whatsoever, that one or other of these groups is the best placed
to provide drugs education and that the others in the list are the worst.
In the absence of any clear idea about what works in drug education,
individual schools are left to decide for themselves.

We have got to start collecting evidence on effectiveness. For far too long
in Scotland our search for effective drug services has been akin to a blind
man chasing a black cat around a dark room. Instead of simply continuing to
provide the same kinds of services year after year after year, we have got
to base our provision of services on evidence of effectiveness.

Following the drug death figures, an additional UKP1 million has been
allocated for drug services in Greater Glasgow.

However, not a single penny of that money has been earmarked for evaluation.

In the face of this staggering reluctance to look at the effectiveness of
drug misuse services is it really that surprising if we seem unable to
influence the number of addicts dying each year?

Shug