Fighting Addiction

GLASGOW, Scotland — Casting a shadow over the nation’s life, Scotland has the highest number of drug deaths per capita in Europe.

Scotland has almost 60,000 people with a drug problem. That’s roughly 1% of its population.

Many locals say the number is higher.

According to Austin Smith, the Scottish Drugs Forum’s head of policy, practice and communication, the roots of the nation’s drug epidemic can be traced back to the 1980s, during a period of deindustrialization followed by economic and social impacts — the effects of which can be seen today. The Scottish Drugs Forum serves as a national resource on the epidemic, working with many groups.

In the decades after World War II, the heavy industries that drove the British Empire — shipbuilding, coal, steel, textiles and more — collapsed. Scotland was a crucial part of that network. Government support for workers dried up in the 1980s.

As unemployment rates rose, many filled the void with drinking, drugs and fighting. In 2013, Scotland’s Chief Medical Officer blamed the nation’s poor health on the deindustrialization period.

As the country grapples with the consequences of substance abuse, a complex interplay of social, economic and health care factors contribute to the problem.

A 2022 report from National Records of Scotland linked drug death rates to deprivation, noting that people who live in the most disadvantaged areas of Scotland – places facing poverty and a range of other social ills – were 16 times more likely to die from drug misuse than those living in the least deprived areas.

Smith said the stigma facing people who use drugs also plays a crucial, though less visible role.

“When people aren't looking down on you, it at least allows you to, to get your head up, to act on your own volition, to empower yourself,” Smith said. “Because when you're (being stigmatized), that's exactly what you cannot do. You need help from others.”

Over the last several years, many organizations have turned to fighting the problem with harm reduction methods, attempting to lower drug deaths and the stigmatization of people who use drugs without taking a just-say-no approach to the crisis.

That approach is not without its critics. Despite 2022’s lowest recorded number of drug deaths in five years, many still question how harm reduction will play out in the long run. Can it end the crisis, or even keep the marginalized groups it’s serving alive?

The intricacies of the crisis are magnified by the unusual political landscape that Scotland finds itself in: a country ultimately governed by the United Kingdom’s parliament in Westminster.

A small team of Penn State student journalists and faculty traveled to Glasgow last November, hosted by the University of Strathclyde. The Penn State team examined how Scottish health care professionals, advocates and activists are attacking the drug crisis here – offering women more support, introducing drug consumption rooms, pondering drug decriminalization.