Will we ever see real action on chronic pain and drug deaths?

The Herald Scotland

02-05-2025

When Scotland declared a "national emergency" on drug deaths in 2019, the public was promised urgent action. Instead, what we received was an empire of taskforces, consultative collaboratives, stakeholder networks and endless glossy reports and strategy documents. The response to a human catastrophe was to create a self-replicating bureaucracy.
In chronic pain, real patients were locked out of decision-making for two years, while officials congratulated themselves on "participation".
In addiction recovery, real lived-experience voices were excluded in favour of state-funded charities and compliant partners who echoed official policy while deaths soared to record levels.
In both cases, participation was a stage-managed performance – a theatre of inclusion designed to give the illusion of action while obstructing real change.
The Drug Death Taskforce, the MAT Standards Collaborative, the "National Mission", the countless "action plans" and "frameworks" – all absorbed years of time and tens of millions of pounds. But frontline detox beds remained closed. Residential rehabs were starved of funding. Choice in treatment was narrowed, not expanded. And the Right to Recovery (Scotland) Bill – which would have guaranteed people legal access to treatment options – was met with bureaucratic hostility and delay.
Exactly as with chronic pain, those who challenged the system – whether patients, advocates or independent charities – were either silenced, excluded, or had their funding threatened. This is not accidental. It is structural.
It is the deliberate management of public outrage through consultation fatigue, policy jargon and bureaucratic complexity, while shielding officials and ministers from accountability.
In both cases, the Scottish Government's own guidelines on transparency, participation and human rights are being openly breached.
In both cases, ministers speak the language of rights and inclusion while presiding over systems that actively exclude the very people they claim to represent.
How many more must die before Scotland confronts the uncomfortable truth? That we have built a public sector culture more skilled at managing public relations than at saving lives. That we have spent vast sums funding consultative industries while starving direct services.
Scotland urgently needs a reckoning: a rebalancing of power in favour of patients, families, and front-line practitioners.
Real independent oversight. Real accountability. Real choice in treatment.
For those of us who have lived through these failures, it is already too late for many we loved. But it is not too late to light a fire under the culture of bureaucratic complacency that allowed it.
Chronic pain patients. Addiction recovery advocates. Bereaved families. We are not separate battles. We are one fight: the fight for a Scotland that values life over bureaucracy.
Annemarie Ward, CEO, Faces & Voices of Recovery UK, Glasgow.
• The Scottish Government is under increasing pressure to address a crisis that is affecting many communities ("Organisations demand urgent action over rising alcohol deaths", The Herald, May 1). More than 70 organisations are imploring John Swinney to take significant action, and rightfully so.
The Government must accept responsibility for failing to tackle alcohol misuse, which has reached alarming levels under its watch. It is time for a comprehensive strategy that goes beyond mere rhetoric.
Immediate investment in public health initiatives, combined with effective community support, could make a transformative difference.
Our society must not allow another generation to suffer the consequences of inaction. Action is needed now, because every life matters.
Alastair Majury, Dunblane.
A sonnet on the sexes
At last some common sense on the ongoing, perverse focus on this issue from Eric Begbie ("Why all the fuss about sex and gender?", Letters, May 1).
Brother and Sister, a sonnet by George Eliot, puts it in a lovely descriptive nutshell.
In the first two lines, indistinguishable as infants: "I cannot choose but think upon the time/When our two lives grew like two buds that kiss."
But soon, "He was the elder and a little man/Of forty inches, bound to show no dread.
"And I the girl that puppy-like now ran,/Now lagged behind my brother's larger tread."
The poet was, of course, Mary Ann Evans.
Murdo Grant, Rosemarkie.
The VAR killjoys
As a football fan for 60-plus years I thought that VAR would enhance the game. Sadly no.
During Wednesday night's excellent Inter v Barcelona Champions League match VAR intervened to chalk off an Inter match-winning goal for offside. By three inches!
These ridiculous offside decisions are ruining the beautiful game.
Football is all about goals and entertainment. However I'm sure that there are those who agree with the reported remark by Bobby Williamson: "If you want entertainment go to the cinema."
Roy Gardiner, Kilmarnock.
Is VAR in football detracting from the entertainment? (Image: PA)
A lack of Scottish TV
Homes Under The Hammer is credited as a BBC Scotland production, yet each month only about one property in Scotland is featured. The presenters are all very interesting but only one is a Scot.
I note that there is concern over the cost of costume dramas. To my recollection there haven't been any Scottish ones for many years.
River City, which gives pleasure to many people, must cost a fraction of what EastEnders does, and should be spared.
Margaret Pennycook, Glasgow.
Pint to ponder
Donald M Manson's letter (May 1) regarding those of hard of hearing, reminds me of my late mother who would often ask me to get her some semi-skilled milk.
Malcolm Parkin, Kinross.