10 - Responses to the Drug Deaths Crisis: Explaining Differences at UK and Scottish Levels

Summary

Ever since the end of the heroin drought of 2010– 2012 and the simultaneous onset of fiscal austerity, drug-related deaths have been rising across the UK. This also coincided with a new emphasis on abstinence instead of harm reduction in drug treatment policies in both England and Scotland. Despite many recommendations to use evidence-informed interventions to reduce these deaths, it took until 2018 for the Scottish government to take action. The UK government was even slower to respond. It largely ignored these deaths in its 2017 drug strategy (HM Government, 2017), although they were a focus of the 2021 version (HM Government, 2021).

This chapter and the next will explore the policy constellations which surround the same issues in these two different polities: the UK level centred around Westminster and the Scottish level at Edinburgh. In both countries, there are long-standing debates between supporters of harm reduction and abstinence-based services. Both governments have faced calls to do more and have resisted doing so until recently. We will explore the different ethico-political bases of these two different national debates. This will help explain the different responses to the drug-related death crisis north and south of the Anglo-Scottish border. This explanation will rely not just on looking at the preferences of policy actors and political parties. It will incorporate the deeper cultural structures – the ethico-political bases of drug policy making – which are different in England and Scotland.

I have written elsewhere about the reasons and mechanisms for the inaction on drug-related deaths in England (Stevens, 2019). Chapter 11 examines more recent developments at UK level. So I will concentrate more in this chapter on Scottish policy constellations. Comparing these two nations shows how we can use the concepts of the policy constellations approach to explain different processes and outcomes in different settings.

In Scotland, we have the case of how a minimal and belated response to rising deaths was transformed into a substantial increase in funded and rhetorical support for saving lives.