The human lives behind the numbers
On the long view, last month’s ONS report on drug-related deaths show that people continue to die in record numbers from the use of illegal drugs. It is easy to turn people into statistics, but harder to travel the other way and extract life journeys from the numbers. But this is what the ONS attempts in its accompanying ‘deep dive’ into coroners’ reports of people who died in this way.
In so doing, they reinforce the picture of the white, middle-aged man, isolated and unemployed, who dies alone after his last, lethal dose of opiates. They confirm the policy narrative of “the ageing cohort of heroin users”. Why? Because this is an accurate characterisation of many drug-related deaths.
Broadening the picture
But the report reveals others who died too. Even with the incomplete picture pieced together from the coroners’ reports, the ONS findings tell us that a quarter of the people who died were women, 10% were married, 43% were under 40 years old, 27% were living with family and a further 10% with other people, 24% were employed at the time of death, and an indeterminable number were not using opiates. (In any one year a significant proportion of deaths involving illegal drugs are not opiate-related.) This should steer us away from assuming a uniformity of those who died and encourage us to re-imagine their many and varied life journeys. What complicated set of trauma and other life problems, many originating in childhood, brought each of them to that point, while you and I remain alive?
The point is that preventing such deaths is not a unipolar problem. The death of someone who dies from cardiac or respiratory failure following an overdose of prescription drugs on which they have become dependent must be seen as preventable. The same can be said of the suicide of a young person with mental health problems which were inseparable from the drugs he used to deal with an impossibly hard family situation. And also, by the way, the slow decline and death of someone dependent on alcohol who quietly drinks themselves to death in the family home. (Alcohol deaths are outside the scope of the ONS report but significantly outnumber drug-related deaths.)
Moreover, what the ONS numbers cannot show is how many deaths were prevented through the provision of a comprehensive drug and alcohol treatment system. This ranges from early support for someone experimenting with drugs for the first time; to help dealing with a growing dependence on cocaine and alcohol use which is starting to turn a party-goer’s life upside down; to detox for the user with more entrenched drug or alcohol dependence.
Public policy, too, is about human lives
Of course the ONS findings are not designed primarily for public consumption, so much as for policy-makers. And in policy terms, we can’t design out or eliminate all risk from society. However, with drug-related deaths amongst the highest in Europe, we must treat every such death as preventable because that attitude is what has led to proper resourcing and the focus on effective, evidence-based treatment which has prevented many more deaths. We must re-double our efforts to help people dependent on drugs, whether opiates or crack, or using any other drug.
The ONS report prompts us to go behind the numbers. As well as ensure that the treatment system is fit for purpose, we must all – government, local authority commissioners and treatment agencies alike – work to ensure we better understand the varied circumstances of those we work with, not just to keep them alive but also recover and thrive.