Counting funerals is not enough: we need to measure healing

ANOTHER AUGUST, another parade of drug death statistics. The papers fill, the politicians posture, the quangos rehearse their lines. Then, as sure as night follows day, everyone moves on. Groundhog Day with bagpipes.

The headlines tell us the death toll is down a notch. Cue the government’s press officers pirouetting like North Korean cheerleaders, insisting progress has been made. Progress? Yes, the numbers are still horrendous. Yes, they’ve ticked down slightly. But if you think that’s the story, you’ve already lost the plot.

Counting slightly fewer deaths is not the same as healing the condition. And here’s the hard truth: Scotland has built an addiction system that measures survival and death, not life and recovery.

We hand out methadone by the gallon, naloxone by the kit, and call it policy. Survival matters, but it is not victory. It’s as if we’ve mistaken the recovery position for recovery itself. And every August we gather around the scoreboard, tally the dead, and call that accountability.

Meanwhile, the “expert class” coos about “complexity” and “wicked problems,” phrases designed less to enlighten than to provide an alibi for paralysis. Managed decline keeps everyone in work, the civil servants, the consultants, the academics. Only the addicts stay unemployed. Funny, that.

Of course addiction is complicated. But complexity must never be an alibi for paralysis. Families don’t need another seminar on wicked problems. They need fewer funerals.

And let’s be honest: we’ve been having the same methadone argument for thirty years. Methadone good, methadone bad, supervised or not. Meanwhile, the real scandal goes unaddressed: the lack of detox beds, rehab pathways, and recovery support. That’s why people stay stuck.

And prevention? Forget it. Scotland has no proper drug prevention programme in schools. We teach kids quadratic equations they’ll never use, but not how to say no to a line, a bag, or a toot that could kill them. Families – the first line of defence – are treated as an afterthought or worse, the problem. Recovery communities, the cheapest and most effective prevention tool we have, are left to rattle the tin for scraps. Children grow up seeing drug use normalised as part of life. That isn’t public health. That’s cultural and moral collapse. Yet it can be reversed.

Poverty explains who, not why

The article that prompted this reflection was right to link drug deaths to deprivation. Poverty does make people more vulnerable in Scotland it is overwhelmingly the poorest who die. But poverty is not destiny.

If it were, southern Europe  poorer on average than Scotland would be drowning in drug deaths. They aren’t. Italy, Spain, and Greece all record far lower mortality. Why? Because they retain cultural ballast: stronger families, stronger communities, and a refusal to normalise addiction as inevitable.

Northern Europe tells the opposite story. Scotland, Sweden, Norway, and Ireland are richer, more secular, more “liberal” in their drug policies, and all have higher overdose rates. Where liberal policies expand consumption without building exits into recovery, deaths stay high or rise. Where enforcement, treatment, and recovery are balanced, deaths fall. Portugal is often cherry-picked as the exception, but its success came not from decriminalisation alone. It came because they built more than sixty new rehabs at the same time. Legalisation activists never mention that part.

So yes, poverty explains who is at risk. But culture and policy explain why Scotland is off the charts.

What we don’t measure, we don’t fix

And where is the measure of recovery itself? How many men are back in work? How many women are raising families again? How many people once lost in chaos are now taxpayers, carers, volunteers, active citizens?

We can test for cocaethylene, yes. But if that’s where our ambition stops, then we’re not changing anything. We’re managing decline.

The consultants thrive, the quangos thrive, the academics thrive. Everyone thrives except the addicts. That’s what happens when you design a system that rewards process over outcomes. Managed decline keeps the professionals in post, while the people most in need are left behind.

What a serious Scotland would measure

• Same-week detox and guaranteed community and residential rehab pathways.
• Housing and aftercare so people don’t relapse back to the street.
• Jobs, training, and opportunities so recovery becomes contribution.
• Family support programmes that make parents and carers part of the solution.
• Prevention in every school, equipping kids with skills and hope.

That’s what would count as progress. Not another PowerPoint. Not another pilot scheme. Healing. Restoration. Futures.

We know this can change. Britain once slashed smoking rates, cut HIV deaths, and halved road fatalities. That didn’t happen because ministers stood in front of a PowerPoint saying “it’s complicated.” It happened because we decided to do it. Addiction could be tackled the same way tomorrow, if anyone at Holyrood had the courage to govern rather than manage decline.

The real poverty

So let me put it plainly: Scotland’s problem is not just pharmacology. It is politics, policy, and a deeper cultural and spiritual poverty.

For too long we have swallowed the orthodoxy that “inequality causes addiction.” It is a comfort blanket that excuses failure. Look across Europe and it collapses. Poorer countries with stronger cultural cohesion suffer fewer drug deaths. Richer countries with liberal policies and weaker families suffer more.

Poverty explains who dies. But culture and policy explain why Scotland is so lethal.

This is why Groundhog Day repeats itself every August. We pour resources into harm reduction,  important, yes,  but we don’t treat recovery with the same seriousness. Survival becomes the ceiling instead of the floor. A society that keeps people alive without helping them live is a society that has lost its moral bearings.

If Scotland began to invest in recovery with the same urgency as it invests in crisis management, the story would change. Not just fewer funerals, but more futures. Not just stabilisation, but transformation. That is what cultural renewal looks like: families restored, communities made safer, young people growing up with hope instead of despair.

Until then, we will stay stuck in Groundhog Day, managing decline, counting casualties, and mistaking it for progress.

Counting funerals is not enough. Counting futures is what matters. Until we start measuring how many people are healed, restored, and rebuilt into the life of this country, every “improvement” in the statistics is just another way of disguising failure.

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REFERENCES:

1. Scotland: Poverty & Drug Deaths

National Records of Scotland (2023, 2024)
Confirms deaths are highest in the most deprived communities.
https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/deaths/drug-related-deaths-in-scotland
Public Health Scotland (RADAR reports)
Regular surveillance reports show clustering of deaths in deprived postcodes, with polysubstance use patterns.
https://publichealthscotland.scot/radar

2. International Comparisons: EU Mortality Rates

EMCDDA (European Monitoring Centre for Drugs and Drug Addiction), European Drug Report 2023
Shows stark variation across Europe: Scotland and Northern Europe at the top, Southern Europe far lower.
https://www.emcdda.europa.eu/publications/european-drug-report/2023_en
EMCDDA Drug-Induced Deaths Statistics
Mortality rates per million (15–64 age group).
https://www.emcdda.europa.eu/data/stats2023/drd_en

3. Portugal Case Study (the “exception”)

5. Critiques of Harm Reduction Orthodoxy

Eastwood, N., Fox, E., & Rosmarin, A. (2016). A quiet revolution: Drug decriminalisation across the globe.
Useful for showing activist framing often cherry-picks positive cases, ignores failures.
https://www.release.org.uk/publications/quiet-revolution-drug-decriminalisation-policies
Substance Abuse Treatment, Prevention, and Policy (various papers)
Many studies note that liberalisation without adequate treatment provision risks rising harms.

6. The Scotland vs Europe Frame

House of Commons Library (2022). UK and international comparisons of drug deaths.
Shows Scotland as an outlier not explained by GDP alone.
https://commonslibrary.parliament.uk/research-briefings/cbp-8645/