A medical Royal College has called for consideration of how stigma is driving drug use and action to fix social problems like poverty that are making it worse.

In a new report, the Royal College of Physicians of Edinburgh (RCPE) states that drug deaths are an “increasingly medical problem” and calls for better training and resources for staff so they are equipped to use of key urgent treatments.

The College is backing decriminalisation alongside drugs consumption rooms and heroin-assisted treatment programmes, one of which already exists in Glasgow, in all major cities.

In response, UK Government Minister Kit Malthouse said there were “no plans” to decriminalise drug possession.

Deaths linked to drugs increased by 6% in 2019, reaching the highest level in more than 20 years.

The report says all sectors of medicine should be involved in education about dealing with drug and alcohol problems.

It warns of anecdotal evidence of ‘under confidence’ among staff who are not familiar with the different names and wide range of drugs involved when managing patients.

One suggestion to improve responses is providing paramedics with relevant medicines and checklists for key rapid treatments in a tray earmarked for use in poisoning emergencies.

More widely the RCPE report calls for “urgent research” into links between poverty and drug use, and on the effects of multi-drug – or poly-drug – use.

Data from National Records of Scotland shows 94% of the 1,264 people who died due to drugs in 2019 had more than one substance in their system.

The report adds: ‘The Scottish Government and UK Government must work together, to improve the socio-economic factors associated with drug use such as employment and income, social security, education, public health, support services and housing – as well as the physical and psychological factors.

‘This is particularly vital in the midst of the covid-19 pandemic, which evidence shows is disproportionally affecting people in areas of higher deprivation.’

The College’s report has been endorsed by Professor Catriona Matheson, who is chairing a taskforce investigating how to tackle the crisis.

Professor Matheson said: “I support all their recommendations and I particularly welcome the proposals to support education initiatives across the medical profession. Tackling this through a non-stigmatising, evidence-based, public health approach is crucial and frontline clinicians are vital to that.”

Moves to create drug consumption rooms are backed by the Scottish government, experts and campaigners.

However they have so far been stymied by a lack of support from the Home Office, which is responsible for UK-wide legislation – creating a risk that professionals working in these units could be breaking the law

The UK government is also opposed to decriminalisation; Crime and Policing Minister Kit Malthouse said: “There are no UK Government plans to decriminalise drug possession.

“It would not eliminate the crime committed as a result of the illicit trade, nor would it address the harms associated with drug dependence and the misery that this can cause to families and communities.

“The Government is committed to working with the devolved administration in Scotland to tackle drug misuse and in 2020 I held a UK-wide drugs summit in Glasgow with a follow-up UK Drugs Ministerial in September, bringing together a range of experts.”

The Scottish government has pledged an additional £250m spread over the next five years to tackle drug use.

RCPE Acting President Professor Angela Thomas said: “Each death represents the life of someone who had friends, family and support networks who cared deeply about them, which is absolutely heart-breaking.

“…Our aim is to support the good work of the Drug Deaths Taskforce, put forward helpful suggestions based on our clinical expertise, encourage debate, and support medical education on this critical issue”.

Professor Roy Robertson, a GP and Professor of Addiction Medicine, said: “The excessive numbers of drug-related deaths in Scotland is a national emergency, indicating a lack of investment in drug services.

“Drug-related harms is a flawed and neglected area of public health policy which has lasted for many years.”

Read more: ‘Street benzo’ deaths surge linked to criminalisation “National tragedy”: Drug deaths highest on record UK government rejects illegal drugs policy rethink

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