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Scotland's lethal drug problem

Blog | By Theodore Dalrymple | Jul 16, 2019


Bonnie, bonnie Scotland – you know, the land where sweetly blooms the mountain heather and love and beauty sport together – now has the highest rate of drug-related deaths in the world, beating the USA by a whisker. If I didn’t know better, I’d attribute the recent increase to the omnipresence of Nicola Sturgeon, which is enough to drive anyone to the needle: but then I recall the omnipresence of Mrs May who is hardly any better, and the English rate of drugs-related deaths are slightly less than a third of those of Scotland.

I’d like to blame it all on the Scots Nats, of course, but that would not be fair. If I blame anyone, it is the monstrous regiment of drug workers. It is they who dole out, and have longed doled out, the ghastly methadone that is involved in almost half the deaths.

Methadone, being a ghastly substance, is not manufactured or imported illicitly. It rots the teeth of those who take it – quite a number of the homeless in London have methadone teeth, that is to say black stumps. Therefore the methadone that kills derives from licit sources, largely the drug clinics that are supposed to steer addicts back to respectability, but rarely do.

This methadone is either diverted on to the black market, swallowed in incorrect quantities, or taken with other drugs, often obtained illicitly, which make methadone all the more dangerous and toxic.

Methadone is prescribed on the understanding that it should be taken as prescribed and not with other, unprescribed drugs. However, these conditions are a dead letter; many drug workers are degenerate, half-afraid and half-admirative of their addicts. They admire the addicts because they are so antinomian, as they would like to be, but they do not have the courage of their antinomianism. And they are also too afraid of them to enforce any rules at all. They are always prepared to rationalise on behalf of their patients when they do not comply with the conditions, for example by claiming that, drug addiction being a chronic condition, addicts cannot be expected to comply straight away with such conditions, thus avoiding a conflict with them that might turn nasty. I have known doctors in drug clinics prescribe almost anything the addicts wanted, such was their blue funk disguised in their own mind as therapeutic endeavour.

It is important to recall how the current epidemic of drug-related deaths in the USA started. It was started by inexperienced, corrupt or stupid doctors who began irresponsibly to prescribe strong opioids to a class of people who were obviously susceptible to becoming addicted: that is to say, the hopeless unemployed with chronic backache or vague aches and pains. They let the genie out of the bottle, and now no one can get it back. Alas, cheap supplies of fentanyl (and other drugs) easy to smuggle in are taking over from the bad work from doctors.

The problem in Scotland may be a self-limiting one, however. Fewer young people are taking up illicit drugs, and the decline is constant. The deaths are concentrated not among adolescents or young adults, but those who have been taking drugs for a long time. For once, the young are wiser than their (slightly) elders. There is hope after all.