FIONA was a grandmother, Andrew a son.
Both were long-term drug users before their deaths. Both left families with questions, so many questions, about how they spent their final hours, about why successive attempts to get and stay clean hadn’t worked, and about what could have been done differently.
The pair – both in their 40s – didn’t know each other, but are amongst the 10,663 people to die drug-related deaths since the SNP came to power in 2007. They’d each begun using before that, picking up the opiate habits that would plague them during their teenage years.
In the intervening decades, those habits damaged relationships with the family members who continue to mourn their loss. Because of the sensitivities felt by both families, we’ve agreed not to use their real names.
“It’s really hard to talk about,” says Andrew’s sister about his 2016 loss. “I’m still so angry with him, about what he’s done to my mum, but he had a sickness. Addiction is a sickness.”
“She was meant to have stopped everything a couple of years before she died but there were suspicions that had changed,” says Fiona’s brother about her death in 2018. “I spent years trying to help her. It wasn’t just me.”
Both families link their loved one’s drug use to difficult early experiences – domestic violence, parental splits, financial hardship.
But they point out that while these experiences affected all brothers and sisters, Fiona, described as pretty and bright, and Andrew, who it’d been hoped would attain stability through a steady relationship, were the only siblings in their families to develop problematic drug use.
However, they agree that social stigma and a lack of public resources hampered their attempts to overcome their problems. “Where do you go? Who do you go to?,” asks Fiona’s brother. “There’s not enough out there.”
Andrew, his sister says, “talked a good game” but would resist recovery attempts and needed a residential rehab place. Fiona, it is claimed, would have benefited from an intervention in her 20s.
Both were part of the “Generation X” cohort born from 1960-1980 described in the 2017 report by NHS Public Health Scotland and Glasgow University that cited the “social, economic and political contexts of the 1980s” as a factor behind the increase and inequality in drugs deaths from 1990 onwards.
The economic and other policy decisions taken by Thatcher’s Conservative government, they said “created rising income inequality, the erosion of hope amongst those who were least resilient and able to adjust, and resulted in a delayed negative health impact.
“Young adults in Generation X would have been exposed to high unemployment levels and diminishing support. People living in more deprived areas experienced these setbacks earlier and more profoundly”.
While that describes a time before devolution, Holyrood continues to depend on Westminster law-making on drugs, with that a reserved power. The dynamic has so far prevented the setting-up of supervised consumption rooms in Glasgow, despite cross-party support for this at the Scottish Parliament.
“The full impact of excess mortality in these cohorts with high drug-related deaths is unlikely to be known for some time,” warned Dr Andrew Fraser in the NHS Public Health Scotland report.
“It already represents the deaths of hundreds of people prematurely. As the cohort of people at greatest risk of drug-related deaths continues to age, drugs services will need to adapt to their needs as co-morbidities from chronic conditions.”
Drugs minister Angela Constance today called the latest figures “heart-breaking” and said the Scottish Government, which has been heavily criticised for previous budget cuts in this area, is “working hard to get more people into the treatment that works for them as quickly as possible”.
Any changes made now will come too late for Fiona and Andrew, but their siblings now see Scotland’s drug death problem as so acute and so widespread that only the most radical actions will have an impact.
“It’s time to decriminalise drugs like Portugal’s done,” says Andrew’s sister, citing the change that ended that country’s epidemic of drug-related deaths.