Sober N Clean

Drug-users tend to die young, but we know surprisingly little about those who survive the dangers of overdose or violence to which their lifestyle makes them susceptible. A study of a group of injecting heroin-users in Edinburgh reveals that even those who stop the most dangerous forms of behaviour remain at risk.

Drug-related deaths in Scotland reached a record high in 2006 and a recent report by the UN showed that Scotland has almost twice as many drug-related deaths (at 8.2 per 100,000) as the rest of the UK and comparable European countries. The Edinburgh research, carried out over 10 years from the mid-1980s to the mid-1990s, found that more than half the users were HIV positive and that Aids-related illness was replacing overdose as the main cause of death. That is largely due to a switch from injecting heroin to oral drugs, both prescribed (including methadone) and illegally-obtained ones. Despite this, however, the overall mortality rate among drug-users and former users will remain high owing to Aids. There are other worries attached to their behaviour, including a high number of sexual partners, with HIV now more likely to be acquired by sexual transmission than by sharing needles.

The study confirms the other bleak long-term effects of drug use. Two-thirds of the group had at least one child, but the majority of the men and 16% of the women did not live with their children, resulting in those who could not be cared for by the other parent going to grandparents, being adopted, fostered or in residential care.

This research (carried out among patients in Muirhouse, an area with a high concentration of deprivation) is published as Audit Scotland is investigating the effectiveness of drugs policy in Scotland, in particular the £12m a year spent on the methadone programme. According to the Edinburgh researchers, however, the decrease in injecting predated the policy of prescribing methadone and they suggest an increase in sentences both for dealers and people found in possession of heroin, which "disrupted an active drug-using community" was an important factor.

Their conclusion, that drug-users require long-term support for a multiplicity of problems, follows a green paper from the Westminster government which suggests that drug addicts on long-term benefits should be required to attend treatment and rehabilitation programmes. That is easier said than done: only 18% of the group abstained completely from drugs during the course of the study, while 21% had periods of abstinence and relapse. At a time when 50,000 people in Scotland have a problem with heroin or other opiates, and proposals on how to reduce associated problems include drug consumption rooms, or "shooting galleries" where intravenous users can inject in a safe environment, a coherent, effective drugs policy is urgently required. This study stands as a warning that there are no short-term solutions.
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source: The Herald, http://www.theherald.co.uk