The UK Government must help end Scotland's drug-related death crisis

Nicholls, James; Cramer, Shirley; Ryder, Stephen; Gold, Deborah T.; Priyadarshi, Saket; Millar, Susanne; Hunter, Carole; Hogg, Ron C.; Jones, Andrew Meirion; Measham, Fiona; Stevens, Alex; Hamilton, Ian; McPhee, Iain; Eastwood, Niamh; Powell, Martin

doi:10.1016/s2215-0366(19)30301-3

Cited by 10 publications

(11 citation statements)

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“…The study findings highlight the need for alcohol harm reduction approaches in Scotland for those experiencing homelessness. Given the current context in Scotland in which drug‐related deaths are at the highest since records began [31], and highest in Europe [37], it is not altogether surprising that approaches for those with AUDs are somewhat neglected [38], as described by our participants. Since the 1980s, the focus on substance use among those who are homeless has moved away from alcohol to both alcohol and drug use, or just illicit drug use [38].…”

Section: Discussionmentioning

confidence: 99%

Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland

Carver

Parkes

Browne

et al. 2020

Drug and Alcohol Review

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Introduction and Aims Managed alcohol programs (MAP) are a harm reduction approach for those experiencing alcohol use disorders (AUD) and homelessness. These programs were developed in Canada and have had positive results; very few exist in the UK and Ireland. The aim of this study was to scope the feasibility and acceptability of implementing MAPs in Scotland. Design and Methods Using mixed‐methods, we conducted two linked phases of work. Quantitative data were collected from the case records of 33 people accessing eight third sector services in Scotland and analysed in SPSS using descriptive and inferential statistics. Qualitative data were collected in Scotland via semi‐structured interviews with 29 individuals in a range of roles, including strategic informants (n = 12), service staff (n = 8) and potential beneficiaries (n = 9). Data were analysed using Framework Analysis in NVivo. Results The case record review revealed high levels of alcohol use, related health and social harms, illicit drug use, withdrawal symptoms, and mental and physical health problems. Most participants highlighted a lack of alcohol harm reduction services and the potential of MAPs to address this gap for this group. Discussion and Conclusions Our findings highlight the potential for MAPs in Scotland to prevent harms for those experiencing homelessness and AUDs, due to high levels of need. Future research should examine the implementation of MAPs in Scotland in a range of service contexts to understand their effectiveness in addressing harms and promoting wellbeing for those experiencing AUDs and homelessness.

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Section: Discussionmentioning

confidence: 99%

Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland

Carver

Parkes

Browne

et al. 2020

Drug and Alcohol Review

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“…While rates of young people’s substance use in Scotland have been reducing in recent years [ 6 ], they are by no means low and drug and alcohol use appear to be increasing again [ 6 ]. Additionally, drug related deaths are increasing year on year, including increases among younger age groups [ 44 ], and are the highest in Europe [ 45 ]. This could mean implementing the IM or other evidence-based primary prevention approaches would be beneficial in addressing these issues.…”

Section: Discussionmentioning

confidence: 99%

How might the ‘Icelandic model’ for preventing substance use among young people be developed and adapted for use in Scotland? Utilising the consolidated framework for implementation research in a qualitative exploratory study

2021

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Background Substance use among young people is a significant public health concern, particularly in Scotland. Primary prevention activities are essential in delaying young people’s substance use and reducing the harms associated with use. However, such prevention activities are generally lacking. The Icelandic Model (IM) has received increasing attention and has been associated with improvements in substance use in Iceland since the 1990s. There is interest in implementing the IM in Scotland but concerns regarding transferability. This research study aimed to address a gap in the evidence base by providing insight into stakeholders’ views of the IM in Dundee and more widely in Scotland. Methods Qualitative data were collected via semi-structured telephone interviews with 16 stakeholders. Data were analysed using Framework Analysis in NVivo, informed by the Consolidated Framework for Implementation Research. Results Participants were keen for more prevention activities to be delivered in Scotland and were generally supportive of the IM, given the high rates of substance use and related harm. A range of positive factors were identified, including the evidence base, the multi-component nature of the IM, and availability of current services that could be embedded into delivery. Several barriers were noted, relating to funding, the franchise model, support and buy-in and cultural differences. Conclusions Our findings provide insight into the views of a range of stakeholders regarding the potential implementation of the IM in Scotland, and perceived barriers and facilitators. There is a desire for primary prevention activities in Scotland, driven by concerns about high rates of substance use and related harms, and a general lack of effective and evidence based prevention activities across the country. Several key barriers would need to be addressed in order for implementation to be successful, and participants were clear that initial piloting is required. Future research and evaluation is required to examine its potential and the outcomes of the approach in Scotland.

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“…Furthermore, it became apparent that in Scotland, between 2009 and 2018, the number of drug-related deaths (DRDs), including ORDs, more than doubled resulting in the largest number ever recorded, whereas in England and Wales, a much smaller increase in DRDs were seen. A number of people and several agencies from the UK have urged their government to declare a public health crisis in response to the record number of drug-related poisonings in Scotland [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Explaining the Differences in Opioid Overdose Deaths between Scotland and England/Wales: Implications for European Opioid Policies

Amsterdam

Brink

Pierce³

2021

Eur Addict Res

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Backgrounds: Between 2009 and 2018, the number of opioid-related deaths (ORDs) in Scotland showed a dramatic increase, whereas in England and Wales, a much lower increase in ORD was seen. This regional difference is remarkable, and the situation in Scotland is worrisome. Therefore, it is important to identify the drivers of ORD in Scotland. Methods: A systematic literature review according to PRISMA guidelines was conducted to identify peer-reviewed studies about key drivers for the observed differences in ORDs between Scotland and England/Wales. In addition, non-peer-reviewed reports on nationwide statistical data were retrieved via Google and Google Scholar and analysed to quantify differences in ORD drivers between Scotland and England/Wales. Results: The systematic review identified some important drivers of ORD, but none of these studies provided direct or indirect comparisons of ORD drivers in Scotland and England/Wales. However, the reports with nationwide statistical data showed important differences in ORD drivers between Scotland and England/Wales, including a higher prevalence of people using opioids in a problematic way (PUOP), more polydrug use in people using drugs in a problematic way (PUDP), a higher age of PUDP, and lower treatment coverage and efficacy of PUDP in Scotland compared to England/Wales, but no regional differences in injecting drug use, incarceration/prison release without treatment, and social deprivation in PUDP. Conclusion: It is concluded that the opioid crisis in Scotland is best explained by a combination of drivers, consisting of a higher population involvement in (problematic) opioid use (notably methadone), relatively more polydrug use (notably benzodiazepines and gabapentinoids), a steeper ageing of the PUOP population in the past 2 decades, and lower treatment coverage and efficacy in Scotland compared to England/Wales. The findings have important consequences for strategies to handle the opioid crisis in Scotland.

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The UK Government must help end Scotland's drug-related death crisis

Abstract: The version in the Kent Academic Repository may differ from the final published version. Users are advised to check http://kar.kent.ac.uk for the status of the paper. Users should always cite the published version of record.

Cited by 10 publications

References 1 publication

Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland

Investigating the need for alcohol harm reduction and managed alcohol programs for people experiencing homelessness and alcohol use disorders in Scotland

How might the ‘Icelandic model’ for preventing substance use among young people be developed and adapted for use in Scotland? Utilising the consolidated framework for implementation research in a qualitative exploratory study

Explaining the Differences in Opioid Overdose Deaths between Scotland and England/Wales: Implications for European Opioid Policies

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