LOSING THE DRUGS WAR

It is both frustrating and depressing that despite the expenditure of
literally hundreds of millions of pounds on tackling Scotland's
illicit drugs problems, drug-related deaths rose sharply last year.
Statistics released yesterday show 421 deaths, a 25% increase over the
previous year. Of that total, 280 fatalities were the direct result of
drug abuse, 76 more than 2005. Even breaking down the figures offers
little comfort beyond a slight dip in such deaths in Lothian and fewer
dying from the effects of cocaine and diazepam.

In both Grampian and west-central Scotland, drug deaths have risen
sharply and heroin and morphine - responsible for just 84 deaths a
decade ago - last year claimed the lives of 260.

More than anything, these sad figures reflect the growing ranks of
Scotland's long-term drug addicts, for whom serious health problems
tend to accumulate as they get older.

Some of this group, predominantly men, have been using heroin since it
first appeared in Scotland around 30 years ago. Many have been
addicted for at least a decade.

And these figures probably under-estimate the real scale of the
problem, as many eventually die from other causes, such a hepatitis C,
bacterial infections, HIV/Aids, accidents or heart attacks.

The health of many of these individuals is already so poor that no
government policy will save them from premature death, though the
Glasgow pilot scheme involving the distribution of the antidote,
Naloxone, is already saving lives.

In the longer term, how can Scotland turn the tide on
drugs?

A particularly worrying figure in yesterday's statistics was the tally
for deaths from methadone, the drug of choice used to treat addicts in
Scotland. The government currently spends an estimated UKP12m a year or
more on supplying liquid methadone to some 21,000 registered heroin
addicts.

It is intended to act as a substitute for injecting heroin and
stabilise their chaotic lives. Yet this prescription drug, taken to
keep them alive, killed 97 people last year, close to the record set
in 1996. This is an indictment of a policy that has placed too much
emphasis on harm reduction and not enough on effective treatment and
rehabilitation. It is a scandal that after three years on methadone
only 3% of addicts are drug free.

Drug courts, with their emphasis on treatment and counselling as an
alternative to custody, offer a hopeful way forward but there is still
far too much reliance on drug-based treatments. This partially
reflects the way the modern health service depends on the big
pharmaceutical companies to fund trials and the fact that it is hard
to measure scientifically the effectiveness of some non-chemical
treatments. More imagination and lateral thinking are required.

This month (Herald Society, August 7), we reported on an Italian
charity that treats 1800 recovering drug users at a time, not with
drugs but cookery, wine-making, wallpaper manufacturing and
horse-breeding. It works.

So does a practice used extensively in the Far East that includes the
use of acupuncture. Scotland could learn from such experiences.
Justice Secretary Kenny MacAskill is right to stress the importance of
prevention but the opportunities he refers to in sports and the arts
to build self-esteem should be on offer to everyone, not just the
young. Diversion is as important as prevention. Reducing deaths from
drug abuse has been a government target for 10 years but, on the
evidence of the latest figures, this problem is going to get worse
before it gets better.