SCOTLAND has the highest drug-death rate in Europe. That’s a sentence I’ve written many times in recent years. Yet it never fails to pull me up short.

How can this be that here – in this beautiful, small country that many of us are proud to be part of – we allowed the drug-related premature and preventable deaths of 1339 people in 2020?

It is likely that three more people will die today from a drug overdose. And while this year’s figures for suspected drug deaths suggest the death rate is slowing slightly, change has been far from dramatic despite the declaration of a public health ­emergency by the Scottish Government.

It’s a hard reality that everyone needs to face. The real question of course, is how do we stop this happening?

It’s the long-running quandary that the Scottish Government’s own drug deaths taskforce’s final report, published last week, most recently attempted to answer.

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Since the task force was set up three years ago there have been over 3000 suspected deaths from drug overdoses. And while many people right across Scotland will find their lives touched by addiction to either drugs or alcohol in some way, loss and grief will be felt most in deprived ­communities. Here you are 18 times more likely to die a drug related death than in the most affluent.

If that were not the case something would surely have been done long ago.

And so the task force, regarded by some as yet another talking shop when action was desperately needed – has been on the end of plenty of criticism and controversy.

In January its chair, Professor ­Catriona Matheson, and deputy chair – Turning Point Scotland’s chief executive, Neil ­Richardson, resigned claiming Drug ­Minister Angela Constance’s demand for haste would compromise its work.

David Strang, whose past roles include Her Majesty’s Chief Inspector of Prisons for Scotland, took up the mantle.

Perhaps the change of personnel is why the report took a sort of greatest hits ­approach to recommendations, many of which have been well aired.

It highlights the need for culture change, which campaigners have been screaming about for years, and an end to stigma. It ­repeats the now largely accepted wisdom that people with lived ­experience must be heard and be at the heart of change.

As former chief medical officer Harry Burns has argued, the answer to improving things is not to tell people “who ­already feel hopeless and not in control of their lives what to do”. “Ask them what they need to live better lives,” he advises.

And it calls for better resourcing, with which no-one could disagree, though ­Audit Scotland has pointed out that funding needs to be more targeted, transparent and the change achieved better measured.

The task force report also highlights the need for a multidisciplinary approach within the Scottish Government.

But there is no call to tackle Scotland’s wealth inequality, turbo charged by austerity policies of the last decade, as part of the response and little focus on trauma caused by adverse childhood experience and society’s often inadequate response.

There’s plenty about treatment though, or rather the lack of it. There’s a call for 24/7 services, which are currently not available. Parity of treatment with other health conditions must be ensured, it says and it is scathing about the failure of Alcohol and Drug Partnerships (ADPs) around Scotland to implement many of the standards of care first developed in November 2020 – known as the Medication Assisted Treatment (MAT) standards.

The first of these standards, which ­Constance had stipulated must be ­introduced across Scotland by April 1 this year, was that people looking for medication to replace street heroin – like methadone or buprenorphine – should be able to access a prescription on the same day they asked for help.

But a Public Health Scotland report found this was only “fully implemented” in 3% of alcohol and drug partnerships. In 60% of services no progress had been made. Since then Constance (below) has evoked powers under the Public Bodies Scotland Act to compel improvement plans and regular reporting direct to the minister.

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The task force report says all the ­standards – there are ten of them – must be implemented by 2024. But what if they are not? Who carries the can if people can’t access treatments – from medication to rehab and more – in years to come?

Organisations like Favor UK, who have worked with advocates in the homeless sector, have proposed the right to treatment be enshrined in law in the same way as the right to housing already is. It is used by homeless charities across Scotland to legally challenge local authorities when they fail to offer accommodation on a sometimes daily basis.

Last year Favor’s proposals for a drug and alcohol treatment bill were taken up by the Tories and introduced as the Right to Recovery Bill.

So though Constance has not ruled out a more legislative approach, it’s perhaps why the bill has become a political football. While many drug organisations have tried to kick it out of play, it has received support from leading homeless organisations, who understand its original aim.

The problem comes with the political contradictions on show. On one hand Scottish Conservatives claim we need the right to recovery for substance addiction.

But on the other their compassion runs out when it comes to criminal justice reforms, such as those introduced by Lord Advocate Dorothy Bain in September 2021, giving Police Scotland the option to issue a warning for the personal possession of class A drugs like heroin.

This effective decriminalisation of personal possession moves Scotland further from a criminal justice approach and more towards a public health one. It also keeps people who are a danger only to themselves out of already overcrowded jails.

The Tories insist this undermines the need to rid Scotland’s streets of the “scourge of drugs”. But Conservative ministers fail to explain why the current rules – which had been in place for 50 years – had not already done that.

So what better week for Home Secretary Priti Patel to enter stage right with a white paper that aims to “get tough” on drug users.

She takes a different tack, focusing not on those struggling with drug harms, but on the “so-called recreational drug users” she wants to ban from nightclubs.

The contortion skills needed for this messaging – which starts with concern for the “human tragedy”, “countless lives ruined” and “families devastated” and moves seamlessly into principally blaming “casual, non-addicted” drug users for the harms caused – would have any talented acrobat gawping.

In Scotland we have calls for enhanced de-stigmatisation campaigns. In Westminster there’s Patel’s promotional video, where “scourge” and “bad” are highlighted in big type, and police break down doors to batter the point home.

Her proposed three-tier approach starts with fines and drug testing and moves quickly to confiscating the passports and driving licences of those accused of “persistent drug use”. She is not put off by decades of evidence suggesting her “swift, certain and tough” prohibitionist consequences will not work.

The Scottish Government has ­dismissed her suggestion that tiers one and two could be rolled out in Scotland, insisting it is committed to a public health approach.

This is the last kind of political ­distraction Scotland needs when its ­leaders should be fully focused on ­finding common ground and pushing through ­urgently needed change.

But to be fair, perhaps ministers could learn something from Patel’s confidence, as wrong-footed as it might be.

“We believe that change is possible,” concludes the drug death taskforce’s report. “The evidence is clear and the time for talk is over.”

It is time, then, for swift action to make sure that people who need help to escape drug harms can access it.

It is time, too, to get tough on those authorities not willing to take that action. And if that is not through legislation, we need to be clear about how else full accountability will be achieved.

For it is only then that we can be certain that we are delivering the real and transformative justice that a significant part of the Scottish population have been denied for far too long. And that’s the ­justice Scotland needs.