What I learned about Scotland's drugs crisis from 'alarming' situation in Canada

Synthetic drugs, notably potent opioids such as nitazenes, are on the rise and appearing in the drug supply in several places across the UK.

The charity I lead warned of their proliferation in a report last August. Cranstoun provided recommendations to government to mitigate the crisis. It received cross-party support from MSPs and leading experts, yet only one of our recommendations has been adopted, and we are rapidly running out of time. 

Without immediate action to get ahead of the curve, we could be facing an even bigger crisis. It is not just issues related to potent synthetics, but the need to provide better housing, treating drug dependency as a health issue, and providing more opportunity by tackling deprivation and poverty.  

The link between drug deaths and poverty is stark, with people living in the most deprived parts of Scotland 15 times more likely to die from drugs than those living in the least deprived parts. Without tackling the root causes alongside treating people, we are simply kicking the can down the road. 

In North America, synthetics are everywhere and the consequences are dire, with both the US and Canada declaring public health emergencies. The most recent data for Canada showed over 8,000 people died from opioids last year, and over four-fifths involved fentanyl – a potent synthetic hundreds of times stronger than heroin. This is a rise of 44 per cent since 2016, but the number of people dying is slowly stabilising due to measures implemented, particularly innovative work by charities and treatment providers. 

Last month, I visited Vancouver – one of the epi-centres of the drugs crisis – to understand how they deal with the challenges caused by substance use and housing issues and how they are slowly, but surely turning the tide. 

What I saw was humbling, but raised further alarm bells. Without immediate action, we could be heading towards a similar crisis.

Around 5,000 people who use drugs reside in Vancouver’s Downtown Eastside, a ten-block corridor that runs through the heart of the city. Walking the half-mile stretch is profoundly shocking. Fentanyl has fuelled the crisis and bodies lie scattered on the tree-lined streets, some barely breathing. Discarded needles are everywhere, as are makeshift encampments – tents, cardboard, and sleeping bags. 

There I saw charities providing housing, healthcare, harm reduction and health promotion for some of the most vulnerable and under-served people. Their approach is a culture of compassion - keeping people alive through a range of measures, including overdose prevention centres and getting people off the streets and into accommodation. This is helping to turn the tide, as evidenced by the stabilising number of drug deaths. 

Scotland has the opportunity to adopt this approach to prevent the situation worsening. This requires quicker action from the Scottish Government and they have been made aware of how to tackle and stem the tide of people dying each year in Scotland from overdose. 

The lesson from North America is clear - policy-makers sleep-walked into a crisis which quickly became a public health emergency. We must learn from events across the Atlantic - from the mistakes made in not addressing the crisis when it began and the positive measures taken since, but we are running out of time. 

- Charlie Mack is the chief executive of alcohol and drug harm support charity Cranstoun