More than 1,200 Scots lost their lives in drug-related cases last year, new figures reveal, the highest number since records began, and over three-and-a-half times that of the UK as a whole.
Scotland's substance mortality rate is now 15 times that of the European average.
Drug consumption rooms (DCRs) are facilities where users can legally shoot up under medical supervision, DCRs play a key role in keeping rates of overdose and blood-borne disease down.
Professor Heino Stöver, a drug expert in Frankfurt, has been at the forefront of the safe-consumption movement since its inception.
Germany now has 25 DCRs, all to be found in the country's north. This geographic divide reveals the effectiveness of safe-consumption schemes, Stöver says, with cities in the DCR-equipped north suffering a far lower death rate.
"Frankfurt has four drug consumption rooms, and there are approximately 10,000 opiate users in the city, but only 22 drug-related deaths every year. Munich has some 6,000 opiate users and more than 160 drug-related deaths every year, and they have no DCR. That shows you a little bit the survival power of drug consumption rooms in Frankfurt and other cities."
The Scottish government would tend to agree. For years, ministers in Edinburgh have been pushing for a safe-consumption approach to tackle overdose deaths and fight the rising tide of HIV transmission. But this demand — as well as calls to declare a public health emergency — have been roundly rejected by government officials in London, who have oversight of Scotland's substance abuse laws.
In October last year, this legislative conflict came to a boil. Peter Krykant — a Glaswegian drugs activist who's garnered global headlines — was charged under Westminster's 50-year-old Misuse of Drugs Act. His crime: operating a mobile consumption room.
Scotland has just 22 rehab spaces available to its most vulnerable addicts, Annemarie Ward, chief executive of the Faces & Voices of Recovery group says, indicative of a system that has given up on recovery, focusing instead on the bare minimum: "keeping people alive."