DEDICATED needle exchange clinics must be reinstated across Scotland to combat record numbers of drug users overdosing and dying, a charity boss has said.

Under the current system, addicts trade used syringes for new ones at high street pharmacies rather than static needle exchange centres as in the past.

But Andrew Horne, director of Addaction Scotland, said the switch to pharmacies has had diluted the opportunity for specialists to intervene and help steer users towards rehabilitation services.

It comes as new figures reveal that a record number of people were admitted to hospital in 2016 after overdosing on opioids – including heroin, opium and methadone.

The category can also include prescription painkillers such as oxycodone, hydrocodone, codeine and morphine.

A total of 2507 people were hospitalised in 2016, the highest number since current records began in 1999.

Of those admitted to hospital following an opioid overdose, 24 died.

It comes in the wake of figures in August which showed that total drug deaths in Scotland had also surged 23 per cent year-on-year in 2016, to 867.

Opioids such as heroin were a factor in 88 per cent of the deaths.

Mr Horne said: “From our own perspective, we would like to see the return across Scotland of static needle exchanges. They’ve been largely taken up by pharmacy but in the past, in the 1990s, there were a lot of static needle exchanges. If someone goes into a chemist they give ten needles in and get ten needles back, but there’s no interaction.

“We see static needle exchanges as an optimum place for engaging people about treatment, but they’ve largely disappeared across the country – they’re few and far between.

"We think they would be very useful.”

He added that heroin use was most prevalent among older drug addicts – those aged 35 and over – whose physical health was already compromised by years of abuse, leaving them with heart problems and respiratory problems which left them more vulnerable to fatal overdoses.

Mr Horne said there was also an issue with how much methadone – the heroin substitute – was being prescribed.

He said: “In some parts of the country we may in fact be under-prescribing. The tension happens where you have a doctor or specialist wanting to prescribe to optimum levels – 100ml – but the service user is resistant to that.

“So you have a GP who knows that everything they’ve read tells them to prescribe the optimum dose, but they have patients with aspirations and desires to cut down, maybe to 60ml. But that does become high-risk, because then you have someone thinking ‘I’m just going to have a wee lapse over the weekend’.

"Then the likelihood of overdose are greatly increased. We see that quite a lot.”

The overdose statistics emerged following a Parliamentary Question by shadow health secretary Miles Briggs.

The Scottish Conservatives have urged the Scottish Government to get tougher on dealers and suppliers, and find alternatives to methadone for those addicts who want to give up drugs completely.

Mr Briggs said: “This is the latest set of figures which show the severity of Scotland’s drug problem, which is now the worst in Europe. The sheer scale of heroin and methadone use is ruining lives left, right and centre.

"We need a new strategy urgently to help these vulnerable people beat this lethal habit for good.”

Public Health Minister Aileen Campbell said: “Scotland was the first country in the world to introduce a national naloxone programme to reduce the effects of overdoses and drug use among the general population continues to fall, while drug taking levels among young people remain low. Evidence supports that methadone remains a potential component of the treatment for opiate dependency and is just one part of a package of care, treatment and recovery that can be offered to individuals to help them recover from drug addiction.”


COMMENT by David Liddell, CEO of the Scottish Drugs Forum

THESE figures are of course closely linked to the fatal drug overdose figures released last month.

They highlight what we already know - that the number of non-fatal overdoses is very high in Scotland. This is mainly because Scotland has one of the highest rates in Europe, per head of population, of people with a drug problem: 61,500.

The Conservatives are right; we need to rethink our policy and practice.

For a new approach to succeed we must reach out far more effectively than we have and develop long-term meaningful relationships with people who have been stigmatised and marginalised through their own circumstances and as a consequence of policy.

Let’s be clear, the evidence shows that drug problems are closely linked to trauma - probably half of the 61,500 have been in care at some point.

This is a group of people massively over-represented in statistics for adverse childhood experiences - including bereavement, violence, neglect or abuse; and for poverty and for mental health problems in early adulthood.

Systems and society failed to adequately protect or help these children or their families and sadly this continues. Now, service systems stigmatise individuals and take punitive approaches to those who ‘fail to engage’ or ‘conform’ to a regime. Would this happen to other patients?

Of course people want help, but given the multiplicity of problems - mental health, homelessness, benefit sanctions for example - engagement is not easy.

And then there is the issue of the quality and suitability of treatment and what other supports are available.

The answer? Well, firstly we need to be honest and clear that for the vast majority of people with a drug problem, drug use is a crutch which makes an intolerable life bearable – a means of coping.

Take that away without meaningful support, and people fall.

We need to follow the evidence and invest in what works – services designed to meet the needs of individuals rather than the individuals, with the multiplicity of problems, having to fit the services.

We need to stop fixating on the drug (as users do) and see the whole person and help them address their issues – mental and physical health, housing, relationships and having something to do. They are not different from anyone else’s needs.

Earlier this week the Scottish Drugs Forum had a conference to explore how the Scottish Government drug strategy may be refreshed.

Evidence from countries that improved their responses to people with a drug problem and significantly reduced fatal overdoses, particularly Norway, shows more accessible services and ensuring people are retained longer in the help and support they want and need is key.

Looking over the entire course of people’s lives, it is the least that we should offer and they should expect.