The Great Escape - Scotland’s flight from political and economic dystopia

This is a guest post from retired physician Dr. Andrew Docherty. He argues that the Minimum Unit Pricing policy for alcohol, although evidence suggests it reduces deaths at the margin, doesn’t address the underlying issues that drive so many Scots to abuse alcohol and other substances. In his landmark book, In the Realm of Hungry Ghosts: Close Encounters with Addiction, Dr. Gabor Mate wrote, “Inevitably, addictions are most prevalent and most deadly among populations who, historically, have suffered the most enduring trauma and dislocation.”

Scotland’s history over the last 300 years has been within a union that has traumatised the people of a once proud and independent nation. Scotland’s addiction issues are rooted in that trauma which leads to the inescapable conclusion that the path towards recovery is to end the failing union and restore a sense of power and agency to the Scottish People.

In a statement to the Scottish Parliament on February 8^th Deputy First Minister Shona Robison assured MSPs that her government’s much vaunted “Minimum Unit Pricing” policy, an international innovation no less, had now been proven to reduce deaths and hospital admissions attributable to alcohol since its inception in 2018. She signalled the government’s intention to increase the MUP level from 50p to 65p in September, a delay to allow an ever-procrastinating drinks industry to make the necessary adjustments to its pricing schedules. It is worth noting that the research that allowed the minister to make this enthusiastic assertion was undertaken by Public Health Scotland, a government funded agency. Their findings revealed some modest statistical evidence of benefit, but welcome nonetheless, and while we must allow for the almost inevitable statistical gymnastics which are now ”de rigueur” in government and corporate vested interests, any whiff of good news must be greeted with caution.

However, Dr Alistair MacGilchrist, writing in the Scotsman earlier this year felt that, with some caveats, the policy evaluation did suggest mortality and morbidity benefits in possibly preventing or delaying “graduation” from merely heavy drinking to the full blown “Dependence Syndrome” characterised by the spiritual, psychological and physical death march known as Alcoholism. 

Dr MacGilchrist is a retired and well-respected NHS consultant in liver diseases and as such will have had daily harrowing interface with the personal and family tragedy of addiction to our historically and culturally favoured “oblivionoid”. He will have made many agonising decisions involving desperate souls seeking a new liver or trying to recondition an old one. If the good doctor endorses the government enthusiasm and upgrade of MUP then I must subordinate my natural scepticism to the mild optimism he espouses towards this harm reduction policy.

It is clear that Scotland’s longstanding difficult relationship with “John Barleycorn” is deteriorating further and all social classes are suffering from the self-medication that excessive alcohol consumption represents. The 30-something lady lawyer or doctor with her Mega Goblet of Chardonnay after her demanding work to “chillax” and the post redundancy, zero-hour contract 60-something bloke with his plastic bottle of MUP priced super cider are both seeking the same escape from dystopia, and both are increasingly finding themselves in the queue for a new liver or at least a new raison d’etre. Both may be tempted from time to time to augment their experience with the new provider, “John Charleycorn,” as cocaine is embraced by Scots young and old.

What well meaning politicians must ask themselves if they have a real interest in the matter is what is it about our post-modern Scottish society that is driving so many of our fellow citizens into the marketplace for oblivion in the first place, with or without a 65p surcharge gratefully paid by eager alcohol consumers? What precisely is it that finds the mortuary fridges of our major cities receiving European record numbers of our doomed youth every week after self-administered intravenous oblivionoids? What amenable factors drive at least 20 per cent of adults to swallow “anti-depressants” of negligible efficacy and well known and concealed toxicity and previously unacknowledged severe withdrawal effects?

It is not genetics, chemical imbalances, lack of moral fibre or even the marketing departments of the drinks industry or Big Pharma that is the fundamental origin of the rush to blunt reality. It is not outright malnutrition or widespread lack of shelter from the elements. There are, sadly, increasing numbers of our poor compatriots who suffer such privations in our wealthy pseudo-democracy, but in present day conditions that would have been regarded as a veritable utopia by many, many of our great grand sires. So, what is this collective conscious and sub conscious pain that demands so many soul-destroying anodynes?

Could it possibly be the pernicious, pervasive and inevitable consequences of four decades of neoliberal economics and ideology? Can it be the result of trying to find true fellowship and esprit de corps in a society that celebrates “rugged individualism”? Could it be due to living with constant “evaluative threat” and the sense of worthlessness and shame when your life does not measure up to the meritocratic ideal and the cult of conspicuous consumption? Could it be carrying the perennial burden of debt and fret that your grandparents were not allowed to obtain? Is it possible that mum and dad were so stressed out climbing the greasy pole that dysfunction of all kinds were your portion as a child with all the heartache that goes with it? Could it be that your sense of cultural identity and the cohesion it engenders has been eroded through a loss of personal and national sovereignty by an exploitative union whose priorities lie with faraway trans-national elites? Is it living in an increasingly sterile materialism where Scientism and its priesthoods deny any transcendent reality? Or is it all of the above?

A new breed of “neo-politician” urgently needs to emerge from disaffected communities, not from the usual suspects in the professional managerial classes, to put forward a transformative vision for the next decade and beyond, to forge the commonweal and end the “Commonsteal” of the internationally perjured Disunited Kingdom. They need to be radical, progressive and above all patriotic in its widest sense rather than nationalistic. They need to be men and women of integrity whose vocation derives from a deeply felt imperative to address and redress the dilapidation and despondency that drives so many to quiet desperation, the syringe and the bottle.

The Scottish electorate, I hope, will now easily spot the three stigmata of useless representatives: entitlement, lack of sincerity and no proper job experience. These features are all too common in representatives in both houses of the electoral aristocracy, north and south of the border.

But real change can only come when the People, not politicians, take back control over their nation. We need to put some flesh on the bones of Popular Sovereignty so that real power reverts back to the Scottish People. A national Congress based on the old Convention of the Estates will hopefully be a college of education for us all in the coming years. The sooner it is constituted and convened the better. Hope springs eternal!

Dr Andrew Docherty MRCP DGM