The drugs death capital of Europe, with 1% of the population heroin addicts. Half the prison population on drug-related charges. Sound familiar? This isn’t Scotland in 2019, this is Portugal in the early 1990s, a nation which experienced a drugs epidemic on an even bigger scale than what we are currently observing in Scotland. In the early 90s every Portuguese family either had someone caught in heroin’s grip or knew a family affected by its scourge.
What they did about it was something remarkable.
As a nation they collectively decided that this could not go on and initiated a national debate assembling a Government led commission to address the crisis. The result was almost as bold as it was pioneering. They decided that a criminal justice approach simply didn’t work and that the response to problem drug use had to be exclusively health based.
They decriminalised all drugs for personal use. But they didn’t just leave it at that… they assembled what they now call a ‘dissuasion commission’ to address all drug users brought to the attention of the authorities. Here their drug use was to be addressed, assistance offered, or if necessary sanctions applied. Money saved in criminal justice interventions have been reinvested into drug treatments and services. Twenty eight years later Portugal has just about the lowest rates of drugs deaths and problem drug use in Europe.
I was in Portugal with members of the Scottish Affairs committee and Westminster’s Health and Social Care Committee last week and we listened in amazement to how this traditional small c Conservative nation addressed their drugs emergency. Where there was the usual resistance to embarking on such a radical approach there in now a national political consensus around this policy. Problem drug users secure support without the societal stigma that treats drug users as outcasts and criminals. Today they are discussing the next steps forward with proposals such as full legalisation of certain drugs and making the treatment of problematic drug use not just a health issue but a human right.
Before we got to Lisbon we stopped in at Frankfurt, another fascinating international example. Roughly at the same time as Portugal was experiencing its difficulties Frankfurt had an unusual and disturbing heroin emergency. The financial sector in the city centre was almost besieged with problem drug users who were shooting up in public, dealing and even dying in the streets through overdose. Hundreds of heroin users turned the Gallusanlage into the biggest collection of problem drug users in Europe. From this crisis the ‘Frankfurt Way’ was born. An approach that put harm reduction at its centre by putting in place measures exclusively against the dealing of illegal drugs.
Central to its approach was getting problem drug users better or stabilised. This involved taking the problem off the streets and into safe spaces where treatment could be offered. Drug Consumption Rooms were opened and addicts encouraged to seek help. We visited three of Frankfurt’s 4 consumption rooms and could not believe what was on offer. I know that for some these facilities are still seen as ‘shooting galleries’ but nothing could be further from the truth. One DRC offered sheltered accommodation to addicts and had workshops on site to encourage problem drug users back into the world of work. All of them had wrap around services such as counselling, medical support and treatment options. Frankfurts drugs deaths have since fallen from 147 in 1992 to 22 last year. The Galluslanage has been re-dug to get rid of the discarded needles and debris. There remains a plaque to the many who died in the park due to their addictions.
Could any or all of this work in Scotland? What we probably need more than anything else is ‘the Scottish way’. We need our own approach to address out particular issues and recognise our own cultural values and national debate. What we most definitely need to do is to asses the international examples and be exclusively evidence based. Things can not be ruled out because of a personal ideology or even a deeply held political conviction. The evidence we have received in the Scottish Affairs inquiry has been fascinating, instructive and profound. We will now factor in what we have found in Europe into our inquiry.
What seems to be happening in Scotland now is a refusal to accept our appalling current drug deaths figures. We also probably now find a public ahead of the Government in being able to consider the big levers of change and more prepared to consider the radical and creative solutions. Scotland now has the worst record in Europe for drug deaths and we must look beyond our shores and learn how other nations have dealt with their emergencies.