1. Similar size, similar losses

Finland and Scotland each have around 5.5 million people. Both lose over a thousand lives every year to alcohol.

Scotland: 1,277 alcohol-specific deaths in 2023 — the highest in 15 years (National Records of Scotland, 2024).
Finland: roughly 1,700 annual alcohol deaths, including 859 working-age people in 2023.

These figures make one uncomfortable truth clear: pricing, substitution therapy and availability controls have not stemmed the tide.

2. The hidden epidemic among the working-age population

In both countries, dependency casts a devastating economic shadow.

In Finland, alcohol-related harm costs €1.7 billion annually, through lost productivity, sickness absence and premature retirement.
In Scotland, drug and alcohol deaths are concentrated among men aged 35–54, mostly in the most deprived 20% of neighbourhoods.
Every statistic represents a broken family and a hollowed-out community.

3. Policy and ideology: a questionable comfort

Both countries rely heavily on harm reduction measures.
Finland restricts sales through the state monopoly Alko; Scotland leans on minimum unit pricing, methadone prescribing and naloxone distribution.

These policies were originally introduced to save lives — and at times they did.
But over the decades they have hardened into dogma.
What began as emergency pragmatism has ossified into a political comfort zone, defended more fiercely than it is examined.

In practice, these measures now function less as stepping-stones to recovery and more as holding pens for the poor.
They have become symbols of compassion that mask a quiet indifference to outcomes: systems that sustain dependency instead of transforming it.

In Scotland, 412 drug-related deaths involved methadone in 2023, the fifth consecutive year it featured in more fatalities than heroin.
At the same time, only around 140 publicly funded and accessible residential rehabilitation beds exist across the country, despite tens of thousands receiving long-term opioid prescriptions and thousands more being alcohol dependent.

In Finland, the pattern is disturbingly similar. In 2023, 310 people died from drug-related causes — a record high — with nearly 80% of the deaths among men. Young people’s drug deaths nearly doubled, and the median age of fatal overdoses fell to 35 (Statistics Finland, 2024).

Most Finnish fatalities are polydrug poisonings — combinations of buprenorphine, benzodiazepines and amphetamine-type stimulants. EU monitoring confirms the youth surge: in 2023, under-25s accounted for 29% of all Finnish drug poisonings.
Despite this, national policy remains focused on harm reduction rather than recovery access, and rehabilitation capacity is limited.

These trends have triggered growing concern among Finnish professionals and policymakers: how should the system react to this rapid shift?
Experts highlight five urgent priorities:

1. Immediate post-overdose referral to care

2. Expansion of detox and rehab beds

3. Attention to polydrug risk (especially benzodiazepines)

4. Fast-track care for under-25s

5. Real-time national toxicology alerts

The challenge is clear — Finland must act before this wave becomes unmanageable.

4. The new drug and substance reality

In both Finland and Scotland, a new substance landscape has emerged.
Synthetic opioids, prescription drugs, benzodiazepines and stimulants have created chaotic patterns of use that outpace the treatment system.

Policies have largely stayed reactive, expanding harm reduction interventions but rarely building a pathway out.
This is where both nations falter: addiction is managed, not transformed.

5. A shared awakening, and the politics of resistance

In 2024–2025, two movements appeared independently yet simultaneously.

In Finland, the citizens’ initiative “Hoitoa, ei hylkäämistä” (“Treatment, not abandonment”) is currently gathering signatures and drawing national attention.
Its goal is to secure the right to treatment and recovery as part of Finnish law.

In Scotland, the Right to Recovery Bill, supported by 80% of public respondents, sought to give every person with addiction a statutory right to treatment within a defined time frame.

The Scottish Government’s Health Committee rejected the Bill’s general principles in September 2025, leaning instead on a non-binding Charter of Rights.
This was not a disagreement about detail; it was a refusal to make recovery a legal right.

Both events show how recovery advocacy must now confront politics head-on.
The resistance is not about evidence — it is about ideology.

6. The research that cannot be ignored

Recovery is not wishful thinking.

• Cochrane Review (Kelly, Humphreys, Ferri, 2020): 12-step and mutual-aid programmes are as effective and more cost-efficient than standard treatment.

• Recovery Research Institute (Harvard/MGH): Over 400 peer-reviewed studies demonstrate recovery capital and long-term remission.

• Humphreys & Lembke (2014): Recovery-oriented systems of care improve outcomes and reduce relapse.

• OECD (2024): Alcohol and drug deaths are among the most preventable causes of early mortality in Europe.

The science is there. The question is whether politics has the courage to act on it.

7. A moral and social choice

Both Finland and Scotland have built systems that manage addiction but rarely resolve it.
The moral cost of that is profound.

When a society normalises maintenance without hope of recovery, it concedes that the poor may live and die in managed despair.

Recovery is not a luxury — it is the social contract at its most human.

Let our two nations, sisters in both sorrow and hope, be the first to rebuild that promise.

8. A shared choice

Both Finland and Scotland now face the same question:
Will we keep managing addiction as a chronic condition to be endured — or will we finally treat recovery as the achievable norm it already is for millions?

Treatment access to recovery and healing.
Recovery pathways to help people rebuild their lives.

Recovery is the missing piece.
Without it, our systems remain reactive, not transformative.

Let’s continue building a bridge between Finland and Scotland — between research, lived experience and policy — to bring recovery into the heart of national strategies.

“Everyone can recover. Not everyone will recover. But we don’t know who will recover – so give everyone every chance to recover.”

Recovery is not guaranteed for everyone.
But everyone should be guaranteed the chance.

That principle, that hope, is what connects us.
Two nations, one awakening.
It is time to replace harm reduction alone with recovery by right.

Read this article in Finnish →

Suomi ja Skotlanti – Sama alkoholi-, huume- ja päihdetodellisuus, sama taistelu toipumisen puolesta