Purpose-The purpose of this paper is to examine the reasons and risk factors that explain the threefold increase in drug-related deaths from 267 in 1996 to 934 in 2017 in Scotland. The authors explore the known links between deprivation and problem drug use (PDU) and discuss the impact of drug policy and service provision on PDU and drug-related deaths. Design/methodology/approach-Using quantitative data sets from the National Records of Scotland (NRS) for drug-related deaths registered in 2017 and data sets from the Scottish Index of Multiple Deprivation (SIMD), we produce statistical data on mortality rates relating to areas of deprivation, gender and age. Findings-The data highlight the disproportionate number of deaths in the most deprived areas in comparison to the least deprived areas and the national average. Findings indicate that one quarter of male and female DRD in 2017 were under 35. When examining the least deprived vingtile, drugrelated deaths account for 2.84 per 100,000 population. Based on this mortality rate calculation, the amount of drug-related deaths are 23 times higher in the most deprived area than the least deprived area. Research limitations/implications-The research design uses data obtained from the NRS and data from Scottish Multiple Index of Deprivation. Due to the limitations of available data, the research design focused on SIMD population vingtiles. Practical implications-This research contributes to making unarguable links between entrenched structural inequality and increased drug-related death. Social implications-This paper contributes to knowledge on the need for drug policy advisors to recognise the importance of deprivation that plays a major part in risks of problematic drug use and harms. Originality/value-While several national data sets have published information by SIMD vingtile, no published research has sought to investigate the disproportionate number of deaths by population in the most deprived areas.

This paper investigates options available to policy makers responding to the challenges of drug use in modern society, focussing on the UK. It investigates the failings of prohibition policy that has driven historic reactions to drugs, drug use and drug users globally, nationally and locally. This policy paradigm has been largely destructive and counter-productive and has led to a whole host of health and social problems. The authors have approached their investigation from a public health perspective, free from moral biases that have driven many policy initiatives until now. Many countries and regions of the world are rejecting prohibition as they move towards public health models in opposition to criminal justice responses, and this trend is continuing. Four policy models are examined; prohibition as the status quo; extension of prohibition to include alcohol and other drugs; decriminalisation; legalisation and regulation of all drugs. Each of these policy options are contested; none have universal support. However, given careful consideration, this paper proposes that our only way out of the public health and criminal justice crises that have been driven by drug policy globally is to adopt the more contentious option of legalisation and regulation of all drugs commonly used non medically.

Cultural ecstasies: Drugs, gender and the social imaginary, by Ilana Mountian, London, Routledge, 2013, 168 pp., ISBN-13: 978-0415583831 This book reviews and interprets the discourse analyses on drugs, drug users and drug policy that focus on gender, class and race; it proposes that much of society's understandings on drug issues are based upon essentially moralistic underpinnings. The book takes a value-free approach to study the social history that informs our present knowledge and understanding of drugs in society.Drugs and drug use, therefore, are looked at in their specific historical locations, understanding the phenomena within its specific economic, political and moral backdrop. Discourses around drugs and gender formulate society's views and our generally accepted moral standpoints lie within. Mountian attempts to deconstruct some of these assumptions in order to provide the reader with another gaze -away from a comprehension of drug matters that is constructed, formed by morals and power relations.Two very interesting chapters on the history of drug discourses, and how this links to our present view of treatment and addiction, should be useful to all students of addictive behaviour. These chapters offer students a critique furthering the works of Berridge and Edwards' (1998) medicalisation process and Courtwright's (2005) good drug/bad drug dichotomy, and the subsequent effects on drug policy. The penultimate chapter on drugs and gender should be a valuable addition to students of sociology, alcohol and drug studies or behavioural psychology who have an academic interest in gender politics and bias.The final chapter focuses on how policy is influenced by these social constructions, arguing that policy is flawed, and that prohibition is central to this failure. Illegality of drugs enhances both the constructed discourse and perpetuates associated harms, and Mountian illustrates how these harms affect gender, class and race.This book is a useful and insightful contribution to our knowledge of drugs in society that adds to the body of work that challenges present political standpoints. It offers a fresh perspective on drug use and genderattempting to analyse how women are represented in the discourse, and offers the reader an objective view on historical perspectives. It should provide students in many academic disciplines an innovative view on how dominant discourses shape and affect potentially harmful outcomes.