One 12p pill has single-handedly eroded years of work tackling drug abuse across Scotland.
Experts working on the front line of the country’s drugs crisis say etizolam, known as street Valium, has practically voided the efforts, and the millions of pounds in investment, put towards helping drug users tackle their addictions and cut down on drug deaths.
The small blue tablets, which are sold for 12p or less, have flooded the Scottish drugs market over the last four years and have contributed to the country’s status as the drugs death capital of Europe.
READ MORE: Drug death rate in Scotland at record high
Medics say they are fighting against a “perfect storm” of extremely severe and complex social problems affecting drug users, the impacts of austerity on the most deprived in society, as well as a “highly sophisticated” network of organised criminals bringing the deadly pills to market.
Of the 1187 people who died of drugs overdoses last year, almost half were found to have etizolam in their bodies along with other substances such as methadone and heroin.
It is the combination of etizolam and these opiate drugs which is so fatal, according to medics. They are now fighting to change their prescribing habits for drug users on methadone, and are giving out stark warnings on a daily basis about the dangers of using the drugs. Many of their warnings, however, appear to be falling on deaf ears with the draw of the cheap pills too much to resist.
Dr Saket Priyadarshi, the Associate Medical Director for Addiction Services in Glasgow, said: “Etizolam has absolutely eroded much of what we were wanting to achieve.
“The availability and supply of street drugs is as much as it has ever been, if not more so. Etizolam is particularly difficult in people using opiates. We are constantly looking at our prescribing response to minimise the harms of that combination, but it is very difficult because of the availability, low price, and the situation of people who are wanting to use them.
“Some of that has to be linked to the fact that people using drugs are getting older, feeling more distant from recovery than ever and feeling less hope about positive outcomes, and therefore falling back on drug use in an environment providing them with really large amounts of drugs.
“There are other drivers that we don’t have evidence around, like austerity and welfare reform. What is the impact on people living on the edges of society? They tend to be the ones who feel the cuts in public services and welfare reform, the most.
READ MORE: Investigation: Life on the front line of Scotland's drugs death crisis
“All those contribute to a sense of hopelessness, and ambivalence about the future. When you have the [readily available and cheap] supply of drugs, it creates a challenging environment in which to try and reverse these trends.”
According to experts working for NHS Greater Glasgow and Clyde, until four years ago the main cause of death in injecting drug users was not the drugs themselves, but the physical issues and diseases which can result from injecting.
Now, however, the scales are tipping in the other direction, mainly due to substances like etizolam.
John Campbell, injecting equipment provision lead for NHSGGC, said: “If you were to widen the scope, looking at people who have died from some other drug-related acquired condition, the numbers would be far higher.
“There are a number of very serious drug-related harms being experienced in this city on a far higher scale than anywhere else in the UK and probably Europe.
“In 2013 there were 23 deaths from clostridium novae, more recently we had 9 deaths through anthrax in Glasgow, and an outbreak of botulism with 30 people hospitalised.
“We are now living through an outbreak of HIV, with 157 people who have recently acquired it. “There are really serious harms associated with these consequences that we are struggling to get on top of.”
Experts have reiterated their calls for the implementation of a safer drug consumption room in Glasgow, which they insist will help those at the very highest risk of death from drugs.
The proposals were blocked by Sajid Javid, then Home Secretary, who said there was no scope within current legislation to allow for the facility and there were no plans to introduce it.
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