Pubdate: Fri, 31 Aug 2007 Source: Herald, The (UK) Copyright: 2007 The Herald Contact: http://www.theherald.co.uk/ Details: http://www.mapinc.org/media/189 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. - --- MAP posted-by: Derek