It is depressing that the debate over Scotland's scandalously high level of deaths from drugs has descended so rapidly into a constitutional tit-for-tat.

'Why won't the UK Government wake up and start treating this as a public health emergency?' Scottish Government ministers say: 'Change the law to give us power over drug policy and let us test our safer-injecting room idea in Glasgow'.

While the evidence certainly favours providing a place for chaotic drug users to take street drugs safely, it is a footnote in terms of what is really needed. Yes, it would mean help was on hand if people overdose. More importantly it would bring some of the most at risk people in touch with services which could give them longer term help.

READ MORE: Scotland’s drug death shame 

But an estimated 56-59,000 Scots are problem drug users. The Glasgow consumption room would help at most around 350 city centre based 'public injectors'. What about the rest?

Some people reading this won't care much. Drug use is "self-inflicted" and "addicts" are unworthy of help. Such attitudes are entrenched and are a part of the problem. The stigma attached to drug use is one reason why the mounting crisis has reached the stage it has. The reality is that this health crisis affects mainly working class, mostly older males, and they have too often been written off by services, politicians and the public.

This isn't a population which votes much, or which troubles voters when they mark their X at the ballot box. Otherwise the deaths of 1187 people last year, 23 times as many as were killed on the roads, more than died from cancers of the pancreas, prostate, cervix or breast, would merit more than a few days headlines.

The stigma applies to their treatment too. Methadone is clearly the most successful evidence-based intervention and yet it is poorly understood. The current approach hasn't worked, say people who often know little about it. But methadone does work, it is the rest of the picture which is often missing.

An unfortunate period when the Scottish Government pushed the recovery and abstinence approach didn't help.

David Liddell, director of the Scottish Drugs Forum, warns the methadone prescriptions many drug users are on are not strong enough, with around a third on doses less than the WHO recommends.

READ MORE: Letters: We all must act on this drugs emergency 

Why is this? Well one reason is that they ask for it. Years of stigma and political assaults on the very idea of giving people an opiate substitute, has led users themselves to feel they are failing if their dose is not being reduced.

Because so much judgement is attached to being on a ‘script’ they ask to be weaned off it too quickly or when it is not advisable to be off it at all. Doctors too may also feel a pressure to reduce prescriptions.

But sub-optimal doses lead people to ‘top-up’ with street drugs. They drop out of treatment programmes. They end up in the criminal justice system. Their families, sheriffs, the whole country then loses faith in methadone. It is a vicious circle.

Dr John Budd of the Edinburgh Access Project, a clinic for homeless people, says many people need to be on methadone for years, sometimes indefinitely. The opiate substitute is a treatment but more importantly it is a gateway. Once stable, freed from the anxiety of sourcing illicit drugs, with the likely criminality involved, patients can address their underlying problems.

Some 70 per cent of the practice’s 800-odd patients have a triple whammy of a drug dependency, chronic physical health issues and serious mental health problems. Until they are stable on methadone, you can’t address these, and their housing issues, let alone, for example, their poverty, relationship problems, childhood abuse or trauma.

Scotland's drug deaths are so high, we are told, because we have so many users, putting more at risk. The question has to be why? Why do so many people in Scotland feel so bad that they are self-medicating in an attempt to deal with their pain? For make no mistake, most are not taking drugs to get high. The majority of the drugs implicated in Scotland's death toll are depressants, blotting the world out rather than summoning up Lucy in the sky with diamonds.

If the answer is that people are self-medicating because of traumatic backgrounds, and mental health issues, those are problems the Scottish Government can do something about.

Swiss expert Thilo Beck aims to offer Methadone to drug users within 20 minutes at his clinics and describes waiting lists of up to six months in Scotland as a "death sentence". Those who do get a prescription may not be getting the dose they need. And once stable, it is almost impossible for vulnerable people to access mental health support.

The Scottish Government is right to back the Housing First model and models of trauma-aware support. But mental health services are inadequate. Tackling that, and vigorously defending methadone treatment, ending the punitive attitudes still faced by many of those who seek help; ensuring treatment is accessible and timely; making Naloxone - which can reverse the effects of overdose - more readily available, these are things Scottish Government ministers could do now. And in the face of intransigence from the UK Government, however regrettable that is, hand-wringing over drug consumption rooms is a deadly distraction.