Is minimum alcohol pricing killing drug addicts?

Is minimum alcohol pricing killing drug addicts?

by Jonathan Stanley
article from Thursday 18, July, 2019

THIS WEEK saw the publication of data showing yet another dramatic increase in drug related deaths in Scotland. A 25 per cent increase in two years. The SNP did their usual sociopathic rejection of responsibility in exchange for glib tropes. The problems are historical, complex, some mutterings about Westminster and a segue to their latest Macguffin policy –  state funded injection rooms.

So far, so Nat. Cue unionists blaming the SNP in abstract without offering anything new. 

Could it be any more obvious that the main middle class centrists are not remotely concerned?

As a doctor the natural history of disease is core to proper diagnosis. Untreated, three things slowly kill over a few months to a few years: Cancer, tuberculosis and bad government policy. It is no laughing matter because 200 people a year more dying than were just two years ago is frightening. Given the huge differences in death rates across Europe, it is obvious government policy is critical to drug mortality.

There are many factors,  often interrelated,  that are driving drug deaths. One jumps out to me and it is worrying. The countries topping European league tables for alcohol affordability and drug mortality are the same. They differ in regards to the criminal nature of drugs but the high cost is inescapable.

Drug addicts often use alcohol in combination with opioids especially as they age. It has always been assumed by health economists that to some extent increasing cost reduces consumption. For this specific group it may lead instead to drug substitution. A rapid rise in heroin use was seen in Pakistan following the banning of alcohol. We may be seeing a similar form of this in Scotland.

This matters, because in truth public health policy is a clinical intervention as a trial. It is unethical to impose public health policy without the  minimum requirements set out in the Helsinki declaration of the world health association. They require trials be evidence based, consented, auditable,  adjustments made for specific groups and crucially the cessation of trials where harm is caused or may be caused.

We have dramatically changed the price of low cost alcohol in Scotland (it is now higher than the UK's shown on the table) – and just two years later we are seeing an escalating rise in drug related deaths. 

Are these two related?  Is minimum unit pricing of alcohol driving addicts to their deaths?  Given the huge political capital expended by the SNP driving their policy through the courts we cannot expect those averse to responsibility to objectively answer this. 

We need an independent public inquiry into these drug deaths,  just as was done in scandals that cost lives at Mid Staffordshire and Morecambe Bay hospitals. The policy of minimum unit pricing needs to be reviewed. Like the liverpool care pathway some years ago we must not spend too long fretting over bad deeds stemming from good intentions.

If the SNP cared for the most vulnerable in Scotland they would resist the knee jerk southern strategy of blaming Westminster and hold an independent inquiry as any credible government would. Or is that not the independence that matters?

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