I arrive in Dundee the same weekend as the opening of the V&A museum, the multi-million pound centrepiece to the city’s ambitious programme of arts-led regeneration. There’s a buzz in the air – museum fever or Fresher’s Week, it’s hard to say – but amid that buzz, there is a tragedy going on in this city.
Last year there were 934 drug-related deaths recorded in Scotland, the highest number since figures started being collated in 1996, and over double the amount recorded ten years ago. Of the many cities suffering high death tolls, it is Dundee on Scotland’s east coast that has attracted most attention, because statistically it has the highest per capita drug death rate in Europe.
In Dundee, authorities recorded 57 drug-related deaths last year – one every week, and up from 38 the previous year. Quite a toll for a city of just 148,000 people. Branded “Europe’s drug death capital”, the city has become the subject of doom-laden TV and newspaper stories about an underclass stalked by the spectres of addiction and overdose. But it’s not heroin or fentanyl worrying the city’s drug workers most; it’s the rise of a strong new tranquilliser that appears to be ruining, and cutting short, too many lives in Dundee.
Drug worker Danny Kelly apologies for the slight delay in meeting me. He’s been rushed off his feet the afternoon we meet at the Gowrie Care offices, where he works as team manager of the organisation’s drug harm reduction service. They operate an enhanced needle exchange site, largely aimed at the city’s heroin injecting population.
“When someone comes in through the door, they can expect a welcoming, non-judgmental approach,” Kelly tells me over a cup of tea. “We do more than just supplying people with a needle and telling them, ‘See you later.'” Of the 2,500 active injecting users they currently estimate for the city as a whole, around 1,200 have been through their doors.
There is another element to Dundee’s drug death problem, and it is Scotland’s problem too: not enough at-risk street drug users are actually getting treatment. Despite a reputation for outperforming England and Wales on public health, the proportion of drug users in treatment in Scotland is lower. Statistically, users in treatment are more likely to survive than those who aren’t. Worse, with austerity entrenching, there is little sign of this changing.
If you do want treatment in Dundee, there’s not much choice. Dundee remains the only city in Scotland without a single rehab centre, with NHS Tayside flat broke, having battled with parlous finances for years. And though the Scottish government has agreed to wipe its £45 million debt by 2019/20, it’s difficult to see how that crumb of good news is going to impact the average drug user in Dundee.
Heroin is still a problem in on Dundee’s streets, as it has been since the “Trainspotting Generation” – the long-term, typically male heroin users now aged 35 and above, locked into fictional immortality by Irvine Welsh. These days, purity is low in Dundee, making “street valium” an attractive top-up.
“It typically hovers at about 8 to 10 percent, though the price of a gram has dropped to around £25, whereas it was about £50 to £60 a few years ago. We’re really flooded with the stuff,” says Kelly.
The city’s drug scene doesn’t share the same cosmopolitanism as Edinburgh’s, just an hour-and-a-half away by train or car. Crack is seldom sighted, while the recent powder cocaine injecting phenomenon on the west coast also largely passed Dundee by.
After the spate of headlines about Dundee’s drug deaths this summer, it was announced that a Drugs Commission was to be set up to take a forensic look at deaths in the city, while also keeping an eye on the national context. Andy Perkins is the man in charge of facilitating their complex, labyrinthine work. “We were clear at the outset,” he tells me in his city centre office, “this is not just about Dundee, even though it gets a lot of the headlines.”
For Andy, the “drugs death capital” tag is misleading at best – a view echoed by others, including Dr McAuley – as European countries don’t keep data in the same way as the UK. “There’s different ways of presenting it,” he says. “So if you look at deaths-per-thousand of the whole population, then Dundee is in a bad state, but when you look at [the more relevant figure] of drug deaths-per-problem user, then it isn’t actually top of the pile [in the UK].”
Dundee may be skint, and the progress slow and unglamorous, but the fight to help drug users and stem the deaths continues.
Gowrie Care is at the forefront of a radical bid to eradicate Hepatitis C among its heroin-using clients by carrying out testing and providing medication. Critically, the city has increased access to naloxone, the opioid reversal drug. It might not be a panacea, or an alternative to treatment, but it saves lives, says Kelly.
Building relationships with his service users is a crucial part of keeping them alive, Danny stresses, in the absence of any formal drug treatment. And it’s trust that keeps people returning. “We work hard to get people to cut down on using drugs in the street, to cut down on drug-related litter, because we understand how that feeds into negative press portrayals of the city.”
I meet 24-year-old Jason* at a drop-in centre run by Eagles Wings Trust, a homelessness charity that runs a nightly mobile soup kitchen on the streets of Dundee, usually moored not far from Abertay University in the centre of town.
“You don’t even need to look [for drugs],” he tells me. “If you have an addictive personality, it’s so hard to keep away from it all. I was offered on Saturday, but I chose not to. For the last few days it’s been in my head.” I ask if he’d ever think about leaving Dundee. To where, exactly, he responds. His two sons are here, along with everyone he knows.
The rising number of heroin-related deaths in Scotland is already a massive concern. But it is being compounded by a lack of treatment provision and a seemingly endless supply of potent black market tranquillisers. If enforcement isn’t working – and the street drug and homeless charities helping those most at risk are working at maximum capacity – then the main aim of Dundee’s drug commission must be to ensure, at least, that life-saving treatment is there for those who need it.
This article originally appeared on VICE UK.