Winning the war on drug-related deaths in Glasgow
As drug deaths continue to rise, new proposals could see radical reform of national drug policy
Angela Wilson used to visit charities like Street Connect, but since going clean she now works with the drug addicts who seek help in this Glasgow clinic.
In the city which boasts one of Europe’s worst drug crises, charity workers like Wilson are on the front lines of a war which local politicians are desperately trying to win.
“I work all over Glasgow, in different areas,” she said, “and as much as people are wanting help, there’s not enough help out there to give.”
Scotland’s drug problem, made famous by the cult film Trainspotting, is now the target for Glasgow’s city council, who recently proposed a unique, if controversial, solution: drug consumption rooms.
Drug-related deaths have increased by over 100% in the last 10 years, and almost all of these involve opiates such as heroin and morphine, according to statistics published by the National Records of Scotland. Drug consumption rooms allow addicts to legally inject opiates under medical supervision, and evidence from around the world shows they can dramatically reduce overdose deaths and the transmission of HIV and blood-borne viruses.
Last year in Glasgow, the rate of drug-related deaths was two and a half times higher than in the rest of the UK, and with fears that these figures are set to rise, policy makers are being forced into action.
Not everyone is happy with the city council’s proposals, and in the old church where Wilson’s charity is based, she explained her initial reluctance to the idea of a safe space for legal injection. Despite her personal experience of drug addiction, it was only after she came face to face with Glasgow’s grim, new reality that she changed her mind.
“We were walking along past Central Station and there was a lane” she said. “In that lane there was a 20-year old boy, lying deceased, who had injected and overdosed. He had lay there for hours without anybody even caring.”
What Wilson saw that morning in Glasgow’s city centre is becoming a frequent occurrence, with opiate-related deaths more than doubling in the last five years. Yet official policy for drug addiction has not changed in over a decade.
The current policy, “The Road to Recovery”, promotes abstinence-based treatment. It was published in 2008. But faced with the reality that, in Scotland, the rate of death from drugs is over 30% higher than in the next European country, Estonia, local politicians are coming around to the idea of harm reduction measures such as consumption rooms.
“For some people, the possibility of recovery or abstinence is a long way off,” said Aileen Campbell, then Scottish Government Minister for Public Health, earlier this year. “In the meantime, it is important that we focus on keeping them alive and in touch with services that may provide them with the support that they require.”
Despite agreement between Glasgow City Council and the Scottish Government on the proposals for a consumption room, this facility would require one or more adjustments to the laws regulating the possession of drugs in the UK. Neither the Scottish Parliament nor the city council have the power to do this.
A legal exception requires the consent of the UK Government, and the Prime Minister has repeatedly blocked the establishment of a drug consumption room in Glasgow. Wilson believes that policy makers in Westminster are asking the wrong people.
“[Politicians] who make these decisions don’t know,” she said. “Ask the people who have been in that life, the people who are in that life, and the people who are fighting to get out.”
In the latest public statement to rule out a facility in Glasgow, Prime Minster Theresa May said that “a range of offences is likely to be committed in the operation of drug consumption rooms.” However, experts argue that the barriers to establishing a consumption room are not legal.
According to analysis produced by Rudi Fortson QC, a specialist in drug law, the UK Government can change the law to create an exception for drug consumption rooms, provided there is political will to do so.
“The objection at central government is not evidence, it’s not legal,” said Steve Rolles, a senior policy analyst for Transform. “It’s political. Pure and simple.”
Transform is a charity which advocates harm reduction drug policies. Rolles placed the blame for Glasgow’s blocked proposals on politicians unwilling to test new ideas.
“They just don’t want to have to deal with it,” he said. “They are fearful of a backlash.”
Despite evidence from consumption rooms across the world showing that they can deliver both public health and economic benefits, for some people the idea of legally injecting hard drugs is a troubling prospect.
Seamus Petrie has been sober for almost four decades and now runs an addiction recovery service near Glasgow. He advocates a strictly abstinence-based treatment and is unsure of the proposals for drug consumption rooms, comparing them to bars and his own experience as an addict.
“They’ve already got safe places where alcoholics can go and drink,” he said. “An alcoholic can go into a bar and it’s a totally safe environment.”
His concern is that harm reduction measures such as consumption rooms do not address the underlying addictions, and that they may even make the problem worse. Yet evidence from sites across the world shows that since they force contact between hard to reach, vulnerable individuals and medical professionals, consumption rooms can connect addicts with other social services.
One of the most widely researched consumption rooms in the world was opened in Vancouver in 2003, in response to a city-wide drug crisis. In the following 2 years, overdose rates fell by 35% in the area.
Dr Mark Lysyshyn is a medical health officer at the facility. After 15 years operating in Vancouver, he explained that the benefits of the consumption room go beyond preventing death and public drug use.
“[The facility] helps the health system, it helps the individuals,” he told me over the phone. “It keeps them alive until they can take action to get their health back on track.”
Petrie did agree, despite his concerns over the long-term consequences of a consumption room in Glasgow, that something needs to be done for individuals who are not ready for abstinence. “The effects still have to be treated,” he said.
The experience of the consumption room in Canada has troubling parallels for Glasgow. In 2008, the facility in Vancouver was forced into a legal battle after the Canadian Government refused to renew its licence.
The consumption room eventually won the right to continue operating in the Supreme Court. Since then, the number of facilities across the country has increased dramatically. However, according to Dr Lysyshyn, the years lost in the court battle have had a serious effect on public health in Canada.
The legal challenge “made it very hard to open other facilities, even though there was a clear need,” he explained. “These facilities should have been open decades ago, and had they been open we would be in a much better situation that we currently are.”
Vancouver is now facing a new drug crisis, in part due to the slow process of setting up consumption rooms, but also because of the introduction of high strength opiates such as fentanyl, which has been implicated in a large number of deaths across North America. Dr Lysyshyn warned that Glasgow should seriously consider harm reduction measures such as consumption rooms before it sees the arrival of newer, more dangerous drugs.
What Wilson saw that winter morning in Glasgow is a symptom of a growing crisis. This dead man changed her views on drug consumption rooms. She now advocates for a change in policy to save lives and allow these facilities.
“The guy I was talking about had a two-year old daughter,” she said, “whose mother had passed away to drugs. Now her dad has passed away to drugs.”
“They might inject but they are still alive,” she continued, “there is still a heartbeat in there and it’s still the same blood as ours.”