NHS professionals believe there has been a “collective failure” in addressing Scotland’s drug deaths crisis.
A report issued by the Mental Welfare Commission reveals that 77% of those providing care for drug and alcohol addiction believe services are inadequate. The scathing verdict comes despite a Scottish Government vow to improve services for addicts - following a Daily Record campaign to highlight Scotland’s drug death crisis.
Dr Arun Chopra, medical director of the Mental Welfare Commission, said: “As a next, urgent step, rather than create new strategies, we call on services to deliver the strategies already in place, and on government to monitor this and report on progress in 12 months. Our collective failure in dealing with this crisis is not for want of a lack of evidence or guidance on how to tackle it.
"There are abundant policies, guides and standards at a national level. But we found a failure to implement them at local level. There is also a lack of recognition of the need to address substance use and mental illness concurrently.”
Recovering heroin addict Leeh Howell, who turned his life around after detox, rehab and long term throughcare, said the Scottish system is so overloaded that it’s impossible to deliver the right treatment. Leeh, who now works for SISCO, which helps battle addiction in Scottish prisons, said some local authority care managers are juggling up 70 cases a week, meaning a deficient and low quality service is inevitable.
He said: “It seems hard to believe but the managers are stretched beyond breaking point and it’s just not possible to see 70 people properly engage with their needs in a week. These people are stressed out and they just don’t have time to give proper quality or establish proper care programmes.”
Leeh said that, despite far more funding, very little seems to have changed in the past three years.
He said: “There are funding contracts still in place that lead to a very frustrating postcode lottery, where you might report to your local authority and be told there are no more places in rehab or detox to offer. The next door authority might have capacity but even if a person is dying they won’t be able to take up that place. It’s frustrating and immoral and it needs to be addressed.”
Scottish Labour’s health spokesperson Claire Baker said: “Since the public health emergency was declared three years ago there have been numerous policy announcements but it’s clear that these haven’t translated into a reality for those on the ground.”
She added: “Dr Arun Chopra is right. We don’t need more strategies. We know what needs to be done. What we need is action.”
Annemarie Ward, of the FAVOR UK charity said: “Dr Arun Chopra echoes our calls for admittance of systemic and government failure to give the people of Scotland the services they need. If the Scottish government continues to protect and invest in the same failing leadership, services and systems they always have they will continue to get the same results.
“Until real accountability measures and targets that have consequences if not met are in place we will continue to witness the growing tsunami of deaths across our poorest communities that the cost of life crisis is exacerbating.”
She added: “In many cases, the addiction itself is simply not addressed, where people are instead managed on long-term medication, without any plans to help those involved to recover.”
The report found that 77% of professionals said documented care planning did not happen despite “clear guidance” on the importance of clear care plans. Alcohol and drug misuse was a factor in between 48-56% of all suicides between 2008 and 2018 in Scotland, according to the report.
GPs also reported that referrals can be declined from community mental health services due to the person’s drug or alcohol use - meaning they can be trapped in a vicious cycle. In an embarrassment to the Scottish Government, the final report of the Scottish Drug Deaths Taskforce, in July this year, sets a new target to embed vital new service standards for drug treatment to 2024.
The flagship MAT standards are now more than two years behind the schedule set in stone by drugs minister Angela Constance last year.
A Scottish Government spokesperson said: “We recognise now more than ever the importance of individuals with co-occurring mental health and substance use difficulties being able to access to right support for their needs at the right time.
“The Drug Death Taskforce report highlighted the need for service providers in all sectors to ensure that support, including for mental health, is not conditional on people receiving treatment for their dependency, recovery or abstinence and we are working to address this.
“Indeed, there is a raft of activity underway to implement improvements which are designed to lead to more effective and joined up care for people with co-occurring mental health ill health and substance use.
“We will consider report from the Mental Welfare Commission and will work closely with local authorities, health and social care partnerships and NHS Education to carefully consider its findings in the context of wider work we are already undertaking to improve mental health and substance use services.”
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