I’ve been waiting for today with a degree of anxiety throughout the whole of July. Even with the Mediterranean temperatures we’ve basked in this month, my thoughts have regularly turned in dark anticipation to today. Now it is here. Today the new drug-related death statistics for Scotland have been published. 

1339 deaths. Up 5% on last year’s already awful numbers. Four and half times higher than in 2000. We are a country with a population of just over five million people. The figures are like vapour, impossible to catch and hold in my hands or in my head. So many lost lives. A few of those who died were known to me – people I met on their journey – often at hopeful points on their road. They are people who were loved by their partners, mothers, fathers, siblings, friends and children. People whose lost years of life, whose lost potential impacts us all.

And that’s not all. This week I read that more people with substance use disorders die from poor physical health, than from drugs directly. Their lives are cut short by pathologies often related to health inequalities, lifestyle, smoking etc. These numbers for drug deaths are likely a gross underestimate.

And let’s not forget the other drug death epidemic. That caused by alcohol. We have peculiar divides when it comes to comparing our illicit drugs with our legal, regulated drugs. Ignoring the connections, the similarities feels like a kind of denial. My patients no longer sort themselves conveniently into categories. Poly-drug use is the norm. It’s definitely harder now to separate out a single problem drug in individuals who come to treatment. Alcohol deaths are so clearly also part of Scotland’s shame, though it seems to me that the subject gets far less attention.

I am contemplating the issue of those of us in long term recovery today who did not die – those of us who survived, and I wonder what was different about us? What protective factors, what treatments, what supports made the difference? There’s an edge of guilt to those thoughts. If everyone got the same standard of treatment that I as a middle class doctor got, would there be fewer deaths? You are 18 times more likely to die if you come from a deprived area than an affluent one. Clearly these risk factors are hugely important,, but do we also get offered different quality and types of treatment based on our backgrounds? Is the outcome expectation different?

There will be a lot of blame in written and spoken word over the next few days, not all of it helpful. There are many people trying earnestly and in good faith to make things better. But, the truth is that the responsibility lies with us all. I wrote a couple of blogs when last year’s deaths were published which I’ll put up again over the next day or two, but I’m really not in the mood today for writing any more about the problem or approaches to tackle it.  

Today I am just letting those numbers sink in. I’m remembering the faces of those I have known over time who have died from addiction – not all of them patients. I’m thinking of the ones left behind who loved them – the devastation for families. I’m thinking of our nation’s loss and grief. And of my own..