Soraya Din worked on a radical and liberal approach to combat Scotland’s drugs crisis ... but when she went back to the front line it was ‘like returning to the dark ages’.

A DEADLY health emergency befalls a nation – not for the first time. The nation mobilises, as it has done before. There is an international outcry. But it all seems so far away from most of our everyday experience. Some immediate commitments seem to stem the crisis, the panic subsides. Life carries on ... until the next time.

You’d be forgiven for thinking this is a description of the latest Ebola crisis in the DRC. You’d be wrong. This recurring nightmare is on our doorstep, still around, like the unwelcome guest at an otherwise thriving national party, 30 years after it first appeared. And the nightmare’s getting worse.

Rightly dubbed a ‘‘national emergency” by Scottish Government Public Health Minister Joe Fitzpatrick, last week’s announcement of Scotland’s annual drug deaths figures – a horrific 1187 daughters, sons, parents, uncles, nieces, children – have led to the now mandatory round of hand wringing, outrage, call for solutions and parading of “experts”, very few of whom have “lived experience” of the issue.

READ MORE: Scottish minister in plea to Home Office to stop drug deaths

Some brave souls think they may have “the answer”. I’ve just retired after 33 years in the drugs field, and it is a battlefield, with many casualties – most of them working class, the majority of them male, and all with one thing in common: we, as a society, failed them.

In the vast majority of cases, and by our sins of omission, and very often commission, we let them die.

Who am I to say? I introduced the idea of ‘‘recovery” into the Scottish Government Drugs Policy Unit in 2008 as a professional advisor and co-wrote the national policy, The Road to Recovery, with civil servants.

We took it to the country, to people who had experienced drug and alcohol problems, and with it, I believe, changed the public discourse around drug use in Scotland, away from ‘‘junkies are all criminals inflicting self harm’’, to ‘‘people with a drug problem can recover and be contributing members of society, who deserve treatment like any other member of society for the problem they have’’.

This approach, along with a mandatory three-week date set for people being assessed for treatment and receiving it, helped to improve the lot of individuals and families fighting for themselves or their friends and family members to recover.

There was less stigma, less unnecessary criminalisation and acceptance – with the introduction of Naloxone – that people shouldn’t just be allowed to die.

So why didn’t it work? Why didn’t a policy, deemed so radical by my civil service colleagues that they reeled back in their chairs at my first presentation and which went on to influence drug policy in the rest of the UK, solve the problem?

Why have we continued to lose more of our population to drug-related death, proportionately more than any other country in the world?

Because we aren’t prepared to try hard enough.

Tireless, diligent, humane, creative, and comprehensive implementation is the key to eradicating this shame.

I returned to work in a large local authority after my five-year stint at the seat of policy making to a middle management operational role, working jointly as a social work manager with health colleagues in a “substance misuse” team.

As a recovery advocate, the morality against using drugs inherent in the name rankled, but pleas to senior managers to change the name of the service fell on deaf ears.

I felt as if I’d returned to the dark ages. Thirty years after embracing the use of methadone as a solution to the destruction being wrought on the young people of the Gorbals and Possil by heroin, temazepam and alcohol, I was shocked to see that there were still hundreds of people on methadone scripts three decades in and counting.

The National:

People offered five-minute reviews once a week, with no effective recovery programmes. Long-term methadone users still walking and talking in the same way they did when bouncing around Glasgow city centre hustling for a “tenner bag”, arguing with hardened addiction nurses about whether or not they’d turned up 10 minutes late for their script and whether or not they’d forfeited the “right” to receive it.

It was like stepping into a time warp, and it got worse. People with severe drug problems have a range of issues, from severe trauma and PTSD, to personality disorder, isolation, multiple bereavements and homelessness.

Not every person suffers these problems – many people can and do recover with minimal intervention, and many recover without any professional intervention at all.

But we dealt mostly with those who could not. Day in and day out our requests to mental health services to treat people were met with refusal. “There’s nothing we can do until they’re abstinent”. Bundles of GP referrals posted to community mental health services would be sent on to my service with no covering letter. Nobody wanted to work with “our people”. “They” were too difficult. And so “they” continued to die.

READ MORE: Pete Wishart: Scotland should look to Portugal to tackle drug deaths

I DIDN’T see this mentioned anywhere in the thousands of words written this week about our second “National Emergency”.

In 2016, it was estimated that more than 34,500 people in Scotland had Hepatitis C, a life-threatening liver disease made worse by alcohol consumption and poor diet.

The cost of treating this disease has fallen by 12.5% in recent years, and the side effects of treatment for the individual have become less harsh. Yet attempts to treat people, particularly those with unsettled lives, are still falling woefully short of stated Scottish Government targets.

Oh and there’s that other “National Emergency”... homelessness.

Glasgow City Council has been in “statutory failure” over their homeless provision for 10 years. This means that they are deemed as having broken the law, by Scotland’s Housing Regulator. Failure.

In order to be able to contemplate recovery from serious drug and alco-hol problems, you need a stable base. What chance to people have to recover from abuse, violence, the ravages of perhaps 30 years of drug use, if they don’t have a home?

The suggested drug consumption rooms alone won’t solve this problem. The much vaunted “Housing First” programme won’t solve it. Joint health and social care boards have only re-medicalised the issues and eroded the provision of essential interventions which motivate people to change harmful behaviours.

The latest gathering of the great and the good of the professional drugs world won’t come up with anything new.

There is no magic wand. Here’s my view of what might give us a chance of eradicating this national shame.

1. From the figures the Scottish Government currently gather, estimate the number of people thought to be at risk from drug-related death.

2. Mandate every health and social care partnership board to offer every aspect of physical and mental health care and every local authority to offer housing and financial support/income maximisation to people deemed at risk of a drug-related death.

3. Make “services” fit the person and configure them to be flexible enough to follow the vulnerable person around until they can benefit from what treatment has to offer. No judgement, no refusal. Just do it.

4. Punish refusals to treat the vulnerable by hitting authorities where it hurts, no matter how politically unpopular this might be. Stop rewarding failure. While the great and the good pick up their MBEs and knighthoods, people at the bottom of society’s pile continue to die.