
As Scotland's 'Trainspotting' Generation Ages, the Dead Pile Up - notathing
https://www.nytimes.com/2019/08/07/world/europe/scotland-heroin-deaths.html
======
jdietrich
Not mentioned in the article:

The Scottish heroin epidemic started in Edinburgh, the more prosperous of
Scotland's two largest cities. This was largely due to the presence of
MacFarlan Smith, which was at one point the world's largest producer of
pharmaceutical opiates. That initial cohort of heroin users in the 1980s
predominantly used drugs that were diverted from the legitimate pharmaceutical
supply rather than smuggled from abroad, which led to an unusually rapid
increase in the user population and the illicit market.

[https://en.wikipedia.org/wiki/MacFarlan_Smith](https://en.wikipedia.org/wiki/MacFarlan_Smith)

The majority of overdose deaths in Scotland involved multiple drugs; for
reasons that are not entirely clear, Scottish addicts are particularly prone
to concurrently use opiates, benzodiazepines and alcohol in an indiscriminate
manner. This vastly increases the risk of overdose due to the cumulative and
unpredictable respiratory depression induced by multiple drugs.

[http://www.sdf.org.uk/934-deaths-from-a-drug-overdose-in-
sco...](http://www.sdf.org.uk/934-deaths-from-a-drug-overdose-in-scotland-
in-2017/)

~~~
Theodores
That is rare information. Never heard of MacFarlan Smith before.

To add to the cocktail of drugs there is also glue sniffing. South of the
border you will never see anyone sniffing glue and I doubt there are many
people in England who wake up in the morning with a burning desire to sit in
the street sniffing glue. But this goes on in Glasgow. I found this shocking
to see.

There is also 'Bucky' that alcohol that is not sold south of the border.

[https://en.wikipedia.org/wiki/Buckfast_Tonic_Wine](https://en.wikipedia.org/wiki/Buckfast_Tonic_Wine)

15% alcohol in what is effectively an energy drink. Happy times.

~~~
welly
> South of the border you will never see anyone sniffing glue and I doubt
> there are many people in England who wake up in the morning with a burning
> desire to sit in the street sniffing glue

This is quite an unsubstantiated claim. Never? Of course you will, and do.

> There is also 'Bucky' that alcohol that is not sold south of the border.

This is patently false. It's made in Devon at Buckfast Abbey, so of course
it's sold south of the border. And you see it south of the border all over the
place. I know several places off the top of my head in Leeds and London where
you can buy it. You can buy it on Amazon as well.

[https://www.buckfast.com/stockists](https://www.buckfast.com/stockists)

~~~
Theodores
You are nit-picking here.

I have spent a lot of time in the scummier parts of London and yet to step
over some kid sniffing glue. In Glasgow it is an all too common sight. You can
check the health statistics and I am sure there are a few parts of North
England and Northern Ireland that are similarly blighted but glue is not a
problem south of the Watford Gap in the way that it is in Glasgow.

Sure Bucky is now stocked by Booker and therefore available in corner shops in
England, however this is a recent development. Five years ago it was near
impossible to buy the stuff in England. As for today, good luck buying bucky
in a normal supermarket - Tesco, Waitrose, Asda, Sainsbury's, Aldi, Lidl etc.
or even in a pub. It isn't marketed in England in the same way it is marketed
in Scotland.

~~~
AnotherRainyDay
> I have spent a lot of time in the scummier parts of London and yet to step
> over some kid sniffing glue. In Glasgow it is an all too common sight.

I studied in and now live and work in Glasgow. I've been here for a total of 7
years. I walk to and from work across the city. I'm out late in either the
City Center, the west end, Finnieston or the Merchant City at least once a
week. I'm maybe out twice a month for past 1am nights and I'm up early for the
gym a few mornings a week too. I have not once seen anyone sniffing glue or
doing any kind of drugs openly on the city streets.

~~~
vinceguidry
Cities are weird beasts. I live in Midtown Atlanta and walk to and from work,
I am also out and about sometimes in the evenings. It's one city at these
times. But if I'm out late at night, every now and again I'm froggy for a late
night walk, I see packs of people just hanging out. I have no idea where they
came from, where they live, Midtown is an expensive place, or why they feel
like Midtown is a great place to bring your private outdoors party, but I
don't encounter it unless I'm off my routine.

It's possible that open drug use might be happening right under your nose and
you're never around to see it.

------
arethuza
Scotland is a tiny country but it never ceases to horrify me at the depth of
the social and health divisions between different parts of the country,
Scotland is often described as the "sick man of Europe" and Glasgow in
particular has a remarkably bad life expectancy - the "Glasgow Effect":

[https://en.wikipedia.org/wiki/Glasgow_effect](https://en.wikipedia.org/wiki/Glasgow_effect)

I can strongly recommend Darren McGarvey's _Poverty Safari_ a personal account
of a deprived childhood on the outskirts of Glasgow.

Edit: Something I find grimly fascinating is the Scottish Index of Multiple
Deprivation (SIMD) and its interactive map visualisation:

[https://simd.scot](https://simd.scot)

~~~
smcl
Thanks for sharing that map it's fascinating. Quite eery that knife-shaped
area of orange/red in the west of Edinburgh from Sighthill into Haymarket - it
is so pronounced and so contained between the train lines. I used to take the
bus out from the city to Heriot-Watt University and both 25 and 34 routes zig-
zag through that area and it's a bit grim. Playing 5-aside in the pitches at
Sighthill was also a fun adventure.

~~~
arethuza
I worked at Riccarton for a few years and cycled from Leith - had a few late
night "adventures" including someone throwing a brick at my head, which
fortunately missed.

------
matthewmacleod
This is a particularly active political issue too – drug policy is at present
a reserved matter of the UK government, which means the devolved government of
Scotland is missing some important tools they could use to help deal with the
issue.

This something that the pro-independence Scottish government are making quite
a bit of noise about now; some of it is probably opportunism, but Scotland's
drug culture is different enough that it certainly seems to require different
tools. In particular, there is pressure among some people for the introduction
of safe drug consumption facilities, with the idea being that this keeps
people off the street, with access to medical care, in the system, and with
support to help them recover. These are currently prohibited in the UK.

We'll see what happens over the next few years, of course. The current UK
government is unlikely to be giving any concessions.

~~~
shellac
The UK used to prescribe heroin for addicts, which I understand inspired the
Swiss treatment of addicts. Rolling that back as part of the war on addiction
seems to have been counterproductive in terms of overall health.

~~~
kenneth
The Swiss experiment was a massive disaster. Wish we had never done it, and it
certainly took a few decades to clean up its effect on parts of Zürich. It
attracted junkies from all over Europe and with it brought crime and violence.
I spent a few years going to primary school near the epicenter of it in the
late 90s. The number of times I saw people shooting up in broad daylight right
in front of my school… is shocking. Even more shocking were the parks littered
in used needles. Parks kids would play in… can you imagine what can happen?
They'd be cleaned up on the regular, and staff would literally have bags full
of used needles!

It was pretty traumatic to see, not that I really understood it as a kid.

It was way worse than the streets of San Francisco today, which are an
absolute disaster too!

Good riddance, getting rid of that "treatment" was the best thing we ever did.

~~~
kgwgk
[https://www.tagesanzeiger.ch/extern/storytelling/needletraum...](https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/)

~~~
kenneth
Great story, thanks for sharing.

------
_Understated_
My late brother used to talk about an area outside Glasgow called Springburn
and how it is consistently listed as one of the poorest/deprived places in
Europe (not sure if that was the correct term but it gets the point across).

Yet each election term they voted in either the same politicians or
politicians with the same manifestos.

Nothing will change!

~~~
matthewmacleod
Well, it's more complex than that.

In a country that has for many years only had a broadly two-party system,
there was little effect to be had by voting for someone else. And given
Glasgow's historical politics, that was always going to be the lefty party.

Things have changed, though. The devolved Scottish Parliament has now been in
operation for 20 years; in Westminster, Glasgow North-East (which is the
parliamentary constituency covering Springburn) was in 2015 one of the
constituencies that saw its vote swing _massively_ behind the pro-Scottish-
independence party that was traditionally unpopular in UK-wide elections,
though they narrowly lost that seat in the unexpected 2017 election.

And this is the reason it is important – drugs policy is reserved to the UK
government, and there's a fair bit of chat about it now.

~~~
_Understated_
My issue with drug policy revolves around two key points: 1\. The war on drugs
is an utter failure (by that I mean, it hasn't halted drug use but there are
likely those in power who benefit from this) 2\. None of their policies
tackles root causes, e.g. putting ex-drug users back into their old habitats
will likely guarantee they'll just do it again.

I'm from Glasgow (Kirkintilloch), live in Ayrshire now, and I saw it first
hand: I had two friends die of OD's years ago.

I only visit Glasgow city centre on occasion and each time I do it appears to
get worse but I live near Irvine now and you can tell a mile away who's had
their methodone so it's no better down here.

~~~
daedalus_f
While I don't think it’s a cure all, Portugal seems to have had significant
improvements in drug related health problems (at least in the short term),
crime and anti-social behavior after radical decriminalization in 2001. But
sounding tough on drugs is too tempting for politicians, and most of the press
screams at any sign of decriminalization.

[https://www.theguardian.com/news/2017/dec/05/portugals-
radic...](https://www.theguardian.com/news/2017/dec/05/portugals-radical-
drugs-policy-is-working-why-hasnt-the-world-copied-it)

------
petepete
For the record, I love Scotland and visit at least once per year. The North
East coast is beautiful.

For people outside the UK, I'd recommend tracking down a BBC documentary
called The Scheme. It's quite old now (~2010) but still pretty relevant.

[https://en.wikipedia.org/wiki/The_Scheme](https://en.wikipedia.org/wiki/The_Scheme)

~~~
christoph
It's all available on YouTube, although the quality isn't great, it's still
watchable. It might be a struggle for people not used to Scottish accent
though.

Episode 1:
[https://www.youtube.com/watch?v=9X6KfCYJx_g](https://www.youtube.com/watch?v=9X6KfCYJx_g)

Episode 2:
[https://www.youtube.com/watch?v=ZgwELFu6Erw](https://www.youtube.com/watch?v=ZgwELFu6Erw)

Episode 3:
[https://www.youtube.com/watch?v=k9YV4aJ49SI](https://www.youtube.com/watch?v=k9YV4aJ49SI)

Episode 4:
[https://www.youtube.com/watch?v=-bK0bleFCuI](https://www.youtube.com/watch?v=-bK0bleFCuI)

Episode 5:
[https://www.youtube.com/watch?v=E90kfvhSS7E](https://www.youtube.com/watch?v=E90kfvhSS7E)

------
Teever
Does anyone know what is going on with Estonia in that first graph?

The first spike in deaths for Estonia seems to happen after the 2008 financial
crisis, but I'm surprised to see that the dfinancial crisis hit Estonia harder
than the US?

What other facts give Estonia a surprisingly high mortality rate from opiates?

~~~
fulafel
Googling some gdp graph tells you that Estonia's GDP dipped -14% in 2009 while
some other countries featured in the article's drug graphs had it a lot easier
(around -5% for Scotlan, Denmark, USA). Seems like the # of unemployed
quintupled as well. Combined with the country's rather light social safety net
and relatively low GDP to begin with it must have been pretty nasty.

~~~
ocschwar
A lot of young Estonians went west to make money to send home, and that money
counts towards GDP in France/England et cetera, not Estonia, even though it
then was sent home.

Meanwhile, they were not home to add to the public health statistics, while
those who couldn't do that stayed behind, including those who fell into opiate
addiction.

So the stats make the Estonian situation look more miserable than it was.
(Which is plenty miserable, mind.)

~~~
adventured
> A lot of young Estonians went west to make money to send home, and that
> money counts towards GDP in France/England et cetera, not Estonia, even
> though it then was sent home.

If that money was sent home to Estonia, then it is getting measured in the
impact it has on GDP. It shows up in, for one example, household consumption
data.

Jane takes remittance money, goes into a shop in Tallinn, makes a purchase.
Now that's part of GDP. Jane pays her rent with remittance money, now that's
part of GDP.

That's exactly how it should work. Further, those remittances are a small
minority share of all generated production by that person - leftover savings
(which can then be shifted) after expenses necessary for existing in
France/England.

Mexico as one famous example often leads the world in remittance figures,
money coming from the US ($20-$30 billion per year). The impact of that
remittance money shows up directly in the measured GDP figures of Mexico. It's
still only 2% of the Mexico economy each year however.

If you look at Estonia's remittance numbers, you see a modest increase after
the great recession. That increase difference would be a trivial share of
their economic results, 0.3% or so. Total annual remittances today are higher
now than they were in 2010-2013. Back then it was typically 200m-300m euro
annually, or roughly 1% of GDP (nowhere near meaningfully denting the 14%
decline figure referenced by the parent).

------
prestonbriggs
I remember the discussion here:
[https://news.ycombinator.com/item?id=18766301](https://news.ycombinator.com/item?id=18766301)
Is this what growing up in those tenements leads to?

------
billfruit
I do feel that the book had the effect of popularizing the insinuation that
trainspotting is a futile, otiose pursuit, where as for many people it is a
pleasearuble, fulfilling hobby with some of the same evocations that
birdwatching does.

~~~
chrisseaton
Do you mean heroin is a fufilling hobby? 'Trainspotting' is a euphemism for
taking heroin. The novel and the film don't have anything to do with literally
spotting trains.

~~~
billfruit
I meant the real trainspotting.

------
ensmartha
Maybe there’s just no solution to the drug problem. We’ve tried everything
already at great cost. Sometimes it’s better to admit a war is not winnable
and to pull out before wasting more resources.

~~~
sleavey
There is a solution, but it involves the rich paying more tax to rebalance
society and boost social mobility. We've not tried everything, we've just
tried most of the things that don't involve rocking the boat.

