Record drug deaths need radical response, says Scottish collegeBMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n593 (Published 02 March 2021) Cite this as: BMJ 2021;372:n593
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I have long been convinced of the argument for a harm reduction approach to drug policy since reading Johann Hari's compelling book 'Chasing the Scream' and see our European neighbours reap the benefits of more progressive policy. Portugal, a country of 10 million, has fewer drug deaths than Dundee, a city of 150,000. As a new doctor, I have been shocked and disturbed by the volume of patients presenting to medical receiving units in Glasgow with problems related to their drug and alcohol misuse, in particular street Valium. Street diazepam tablets are inexpensive, readily available and often contain etizolam, a benzodiazepine up to 10x more potent than diazepam, As a result we see patients present with respiratory depression, airway compromise, ECG changes and seizures. This appears to be a growing problem in Scotland and in some ways uniquely Scottish phenomenon. In data from 2019, only 11% of drug deaths in England and Wales were linked to benzodiazepines and this has been static for many years. In contrast, 64% of drug deaths in Scotland involved the drug, with a dramatic rise in the proportion they account for since 2015. Anecdotally, we have seen bored, lonely and anxious patients present following binges triggered by the restrictions of lockdown. A survey performed by Crew, a Scottish addiction charity, reports that 58% of their 300 respondents reported taking more drugs during the pandemic period.
Our Community Addiction Nurses work hard to support our patients and offer expert advice to medics on how to manage withdrawal symptoms and detoxification. However, frontline staff can clearly see this developing public health emergency in Scotland, and the potential for this to further worsen as the socio-economic effects of the Covid pandemic become more startling. Surely now is the time for more radical, evidence-based drug policy in Scotland, whether this comes from Holyrood or Westminster, to save lives and take pressure off our acute hospitals.
Dr Bethany Butcher
FY2 - Glasgow Royal Infirmary
Competing interests: No competing interests