HEROIN WAS INTRODUCED INTO SCOTLAND in the early '80s. Distressed communities already struggling under the heel of Thatcherism were specifically targeted. Injecting heroin and sharing needles rapidly became commonplace.
I worked in Muirhouse as a community psychologist from the mid ‘80s to the ‘90s. The remit was to help users become abstinent. On a shoestring budget and few resources the task was insurmountable. With only two beds allocated in the Royal Edinburgh Psychiatric Hospital for a medically supervised detox it’s not surprising that only one client ever chose that route.
In 1985 a local GP discovered high levels of HIV in his heroin injecting patients.
These rates were then replicated right across Scotland. It was discovered that transmission of the virus had several pathways to infection and the fear of its spread into the heterosexual population was palpable. There was no cure at that time. Harm reduction strategies were introduced with the focus on reducing the harm caused by drug use as opposed to targeting the causes of addiction itself.
In the following years deaths from HIV matched those from overdoses. Many in that community felt the loss of family members, neighbours, friends and partners. There was much grief and fear but there was also resilience and courage shown by those both infected and affected. Already suffering from the effects of rising unemployment and grinding poverty, most people in Muirhouse met this crisis with solidarity and compassion. Families were the backbone of care in the community. Orphaned children were mainly absorbed into the extended family rather than taken into care and a host of volunteers who were locals became unwaged support workers.
Once the fear of an HIV epidemic receded there was a perceptible shift in drug policy. The Scottish government’s 2008 drug policy ‘Road to Recovery’ saw abstinence as the primary goal. The recent surge of HIV among injecting drug users, particularly in Greater Glasgow, demonstrates that interventions currently available, such as methadone maintenance and clean syringes, have proved inadequate to meet the needs of those who continue to inject. The ongoing resistance of the Scottish government to support services that include injecting facilities demonstrates a huge failure in public policy.
The National Records of Scotland recorded 867 drug related deaths in 2016. This is a rise of 23% in a year and a 106% rise in the last decade. These figures are three times higher than the rest of the UK. With the entry of fentanyl into the drug market, a powerful opioid 50 times stronger than heroin, we can expect a dramatic rise in drug related deaths. If these statistics related to any other health issue there would be a public uproar.
Given the current crisis, harm reduction strategies must be included in a Labour Party drugs policy. Such a policy should support the Glasgow Injecting Room - where registered addicts can inject in clean and managed surroundings - and extend this type of service across Scotland. It should include inhalation facilities and take-home Naloxone kits.
These services could attract injecting drug users and provide an important contact point for this hard to reach population. Depicted as ‘addicts’ and ‘junkies’ it’s not surprising that they shun services. They have been demonised, criminalised, marginalised and isolated from mainstream society.
They present with considerable mental health issues alongside other multiple and complex problems.
Services in the drug field tend to target individual vulnerability, with poverty simply acknowledged as a secondary social factor. Yet doping, at the high end in sports and at the rough end in distressed communities, has been described as one of the four pillars of neo-liberal ideology.
There is increasing recognition that the social determinants of 'addiction' are a driving force in this epidemic. Our free market society emphasises competitiveness and individualisation as important currencies for success. Yet a historical and global analysis of addiction finds that social dislocation is always present in communities that experience high levels of addiction. The personal is political and it could be argued that what presents in the individual is actually embedded within a neo-liberal programme that fractures psychosocial integration.
The Labour manifesto introduced policies that will impact on economic structures. Alongside this, drug policies, that are not ideologically driven but offer evidence-based regulatory systems, should be developed. A Labour Party drugs policy needs to be as radical as its manifesto.
Edinburgh North and Leith CLP