On 23 Jan 2023 you reported that Drug Treatment and Testing Orders (DTTOs) were standing at their lowest number (360) over the preceding eight years which had averaged 560 Orders per annum.

You reported that that Scotland had the highest rate of drug deaths in Europe, that our rate was four times the UK rate, that drug deaths were rising in Edinburgh in that particular period, and referred to adverse comments by a resident sheriff in Edinburgh to the declining resources being devoted to the problem in Edinburgh.
It has been separately reported that resources to the extent of £68M are now to be devoted to addressing this shameful record of drug deaths.

I am unaware of any research which has been devoted specifically to the efficacy of DTTOs. For that reason I sought and gained access to the personal records which I had maintained from 2005-2013 on the operation of the DTTO’s which I was dealing with at that time. I kept a dedicated “DTTO Register.”

I find that I dealt with 40 Orders and presided over 373 face to face case reviews. That appears to represent approximately one per cent of the national total DTTOs and the orders and reviews were conducted exclusively in a region containing approximately two per cent of the national population.

“Successful” outcomes can be measured by a number of metrics which to greater or lesser extents contain degrees of subjectivity but my own measure was that the order reached its conclusion with the subject being drug (and methadone) free with no repeat offending during the course of the order.

I kept subjective records of progress. At one stage during the relevant period “success” was running at 50 per cent. Over the entire period of eight years the success rate (measured by the above metric) was 25 per cent. It was my understanding from an official source that the cost of each order at that time was £13,600. If that is correct then my 40 Orders cost the public purse a total of £544,000 representing a cost of £54,400 per successful outcome.

Extrapolating “my” local success rate to the national average number of cases (560) that would represent a total cost of £8,616,000 with 140 successful outcomes each at a cost of £61,542. All of these figures are based on 2005 values.

Whether these extrapolations are statistically justified….or even substantially correct, is to some extent irrelevant. The only point which I make is that the sudden onslaught of resources being launched at a long-standing national problem must not be based on expediency or bureaucratic guesswork. Resources must be targeted at where they are most needed and where they are most capable of producing meaningful results. In addition, steps must be taken to ensure that the ‘eye does not come off the ball’ again and outcomes of the various strategies are exposed to appropriate and timely scrutiny.

Publication of quarterly drug death statistics is a step in the right direction.

TAK Drummond KC