Lessons from the DRDs in Scotland 2016 Report

Lessons from the DRDs in Scotland 2016 Report

In 2016, 867 drug-related deaths were recorded in Scotland.

Similarly to the figures reported by the ONS relating to drug-related deaths in England and Wales, the National Records of Scotland report into Drug-related deaths in Scotland in 2016, show that drug related deaths in Scotland have risen substantially compared to the figures for previous years. In Scotland there has been a 23% rise between 2015 and 2016.
This suggests that addressing drug-related deaths (DRDs) is increasingly important if this trend is to be reversed.

At an average rate of 120 per million of the population for 2012-2016, Scotland's drug related death rate is over 3 times higher than the rate for England and Wales (about 39 per million for the same period). Greater Glasgow and Clyde accounted for 30% of all deaths and had the highest rate at 170 per million.
The figure of 160 DRDs per capita in 2016 puts Scotland near the top of the table for DRDs in Europe.
It is also not surprising that Glasgow may shortly open a pioneering drug consumption room in the hope of addressing this in the Glasgow area.

Male deaths accounted for 68% of the total. Although the report showed an increase of 60% for males over a ten year period, it showed a rise of 168% for females. The largest increase over the same period was in 35-44 year olds, followed by 45-54 year olds, with a reduction in deaths amongst the under 25s.
Women have previously been recognised as differing to men in their drug use and the responses that are required. These figures suggest that we are still not making enough progress in this area.

It also potentially reflects an an ageing population of problematic drug users.

Opioids including heroin and methadone were implicated in, or potentially contributed to 88% of all deaths. The figures for heroin and methadone deaths both far exceeded previous peaks (473 for heroin compared to a previous high of 345 in 2015 - 362 for methadone compared to a previous high of 275 in 2011).
Whilst the increasing death rates may be put down to an ageing population of opiate users, this problem is not going away, but is becoming more acute and needs addressing.

Most drug-related deaths involved more than one substance. In only 187 out of the 867 cases was just one substance believed to have been implicated or contibuted to the cause of death.
The focus on poly drug use and how best to respond to it must be improved.

Whilst New Psychoactive Substances (NPSs) were implicated in 286 cases, in 277 of these cases the NPS present was a benzodiazepine, usually Etizolam. Only 8 cases were related to amphetamine-type stimulants such as PMMA, PMA or MXP and all but 4 of the NPS-related deaths involved more than one substance. The rise in deaths attributed to benzodiazepines from 191 in 2015 to 426 in 2016 is primarily related to 'new' benzos such as Etizolam and diclazepam.
The real danger from NPS use appears to be related to benzos that may be increasingly easy to acquire used in a pattern of poly-drug use with other substances.

Whilst references to synthetic opiates such as Fentanyl are lacking from this year's report, it will be interesting to see what is included in subsequent years. It would be concerning if the trend follows that of Etizolam.


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