The Office for National Statistics has released the latest numbers of deaths related to drug poisoning in England and Wales in 2020. Together with the recent statistics on alcohol-related deaths and drinking trends during the pandemic, they reveal the true extent of the suffering happening in some our most deprived communities among some our most vulnerable citizens, their friends, families and loved ones. Yet again, the number of people dying has reached a record high, with 4,561 deaths representing a 3.8 per cent increase from the previous year. Mortality rates are rising for both men and women. In the last decade, the number of people dying has increased by over 60 per cent.
The story of who is dying remains similar. Drug harms and deaths are still concentrated in a cohort of middle-aged men using opiates, often in combination with other drugs and alcohol, in some of the poorest parts of the country, particularly the North East. Most will be experiencing a range of co-morbidities that impact both their physical and mental health. Some will be in contact with treatment services or other parts of our social net – far too many will not.
The latest statistics also show continuing trends around deaths where benzodiazepines are implicated, with a 19.3 per cent increase from 2019. Deaths involving pregabalin and gabapentin have also increased. These drugs are almost always implicated in deaths where other drugs have also been taken, most commonly opiates. Deaths involving cocaine also continue to rise at an extremely alarming rate, with deaths now over five times the level seen in 2010.
We are now experiencing a crisis that will only continue to escalate without significant intervention from the state. With an issue as complex as addiction, so dependent on social environment, the reasons behind the crisis are multitude. Substance misuse treatment has a strong evidence base for reducing mortality, so there can be little doubt that a huge reduction in funding for treatment is likely to have played a role, as well as the lack of clear government action on such a cross-cutting issue.
Thankfully, there are some encouraging signs the government has heard the calls of our field and is prepared to listen. Dame Carol Black’s independent review has revealed the inadequacy of the state’s response to drugs, which cost the UK almost £20 billion each year. Substance misuse treatment budgets have represented less than just four per cent of those costs, despite each £1 spent creating £3.50 in social returns. Dame Carol has therefore recommended investment of almost £1.8 billion into treatment over the next five years, which will create £6.5 billion in benefit and – most importantly – prevent over 3,000 people from dying from opiate overdose.
The government’s initial response has endorsed Dame Carol’s “whole-system approach” by announcing a new Joint Combatting Drugs Unit, local and national outcomes frameworks and commissioning quality standards. As a field we must be ready to do whatever it takes to support the change we all want to see. All eyes are now on the political decision-making shaping the Spending Review, which must unlock the resource to stem the tide. Without it, there is little hope on the horizon of the crisis abating.