“To keep people safe and enable them to make the changes they want to see in their lives, every effort has to be made by all stakeholders to do all they can to change these statistics”
Drug related deaths are at the highest level since records began and have been steadily increasing since 1993. In 2021, in the UK there were 4,564 deaths related to the use of illegal drugs. Behind these numbers are individual lives cut short, denied the opportunity to realise a brighter future, and bereaved families impacted by the pain that losing a loved one causes.
To keep people safe and enable them to make the changes they want to see in their lives, every effort has to be made by all stakeholders to do all they can to change these statistics. Innovative harm reduction initiatives are needed alongside opportunities for people to realise their ambitions for recovery. The voluntary sector has been at the forefront of developing and championing both approaches for many years. For these reasons Collective Voice welcomes two key developments last week.
The government’s response to the ACMD report on naloxone implementation
In response to the recommendations from the Advisory Council on the Misuse of Drugs, the UK government has acknowledged the importance of naloxone in preventing overdose deaths. The government have published a response to the UK Naloxone Implementation Report, outlining their commitment to expanding access to naloxone across the country. Naloxone is an ‘opioid-antagonist’, a drug that can reverse the effects of opioids, and this response signifies a significant step forward in the government’s efforts to address the opioid crisis and reduce drug-related fatalities.
In particular, the government has agreed with the ACMD that a wider range of services and professionals should be able to supply take-home naloxone without a prescription and are in the process of exploring legislative change to enable this. Alongside the legislative changes, the National Police Chiefs’ Council are actively considering how to improve carriage of naloxone amongst police forces, to administer in an emergency.
The UK’s First Sanctioned Overdose Prevention Centre
Also last week, the establishment of the UK’s first sanctioned Overdose Prevention Centre (OPC) pilot in Scotland was announced.
This marks important progress towards adopting an evidence-based approach to tackling the use of opioids and the related harms. International evidence shows the effectiveness of such centres in reducing deaths and infections, particularly among people experiencing homelessness, and in increasing engagement with treatment and support services. The pilot will provide important evidence on the impact Overdose Prevention Centres can have in the UK context, and, if the anticipated benefits in terms of fatal overdose reduction and increased engagement in treatment are seen, we would hope to see rollout of OPCs nationally as one measure which can work to address our current crisis.
What else is needed?
- A well supported and diverse treatment and recovery system
Everyone in England with a substance use problem should be able to access evidence-based and person-centred support to keep them safe and enable them to make the change they want to see in their lives. Our treatment and recovery system faces persistent structural challenges arising from historical disinvestment, which limits the ability to recruit and retain staff, invest and innovate for the future, and build sector capacity. The Governments drug strategy rightly set an ambition to create a world class treatment and recovery system; to realise that ambition, long term commitment matched by sustainable funding is needed to address the systemic issues caused by long term disinvestment. A full range of services, from harm reduction to recovery support and including specialist services for underserved groups is needed. To ensure this, the eco-system of drug and alcohol treatment and recovery services needs to be rebuilt and small and specialist voluntary organisations, ‘led by and for’, nurtured.
2. A public health approach
Addiction and dependency should be treated as a chronic health condition so that stigma does not present a barrier to people accessing services. As the Home Affairs Committee recently stated in its report Drugs, the government’s Drug Strategy “signals a shift towards recognising the need for a holistic response to drugs [but] could go further by adopting a broader range of public health-based harm reduction methods”. The Committee recommended the development of a cross-departmental action plan to tackle stigma to be published by February 2024.
3. Drug testing capacity should be increased
Drug checking services, which provide test results, harm reduction advice, and referrals to relevant services, have operated internationally since the 1960s. They have demonstrated promising reductions in harm. In the UK, there were in-person drug checking services, primarily at music festivals and pilot sites in town centres, but these have faced challenges due to licensing requirements under the Misuse of Drugs Regulations 2001. Coroners should test for a broader range of emerging drugs in assumed drug-related deaths to improve intelligence around the causes of increasing drug-related death rates in the UK and police, prisons and border forces should test seizures for a broader range of emerging drugs to monitor the drugs market.
The establishment of the UK’s first sanctioned Overdose Prevention Centre, along with the government’s commitment to expanding naloxone access, are important steps towards reducing drug-related deaths. A well supported and diverse treatment and recovery system, public health approach to addiction and dependency and increased drug testing capacity are also needed.
All stakeholders have an important part to play in keeping people safe and ensuring a compassionate and evidence-based approach to drug policy. Voluntary sector drug and alcohol treatment and recovery services who have been at the forefront of innovating and championing harm reduction initiatives and recovery support for many years must continue to be supported as part of the drug alcohol treatment and recovery system.
Chief Executive Officer, Collective Voice.
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