Collective Voice’s response to the 2020/21 substance misuse treatment statistics

The 2020/21 drug and alcohol treatment data released today covers a uniquely challenging period in our field’s history. People facing drug or alcohol addiction, already a vulnerable and oftentimes isolated group, had to endure a global pandemic that radically altered how they could receive support. Some of the trends identified in today’s statistics release feel ‘familiar’ or positive. There have, for instance, been small rises in the overall numbers of people in contact with services and the percentage of people ‘successfully completing’ treatment – impressive for a system dealing with a pandemic and impoverished by years of disinvestment.

But other trends are deeply shocking. 3,726 people died while in treatment in 2020/21, a 27% compared to 2019/20. Digging into the figures reveals a particularly bleak picture for those with alcohol problems – a 44% increase against 20% for opiate users. There have also been significant – although more modest – increases in the proportion of people entering treatment with a mental health need, and in the numbers of older people needing help for alcohol use. Support need for benzodiazepine use is up, continuing a worrying trend.

The Office for Health Improvement and Disparities is right to note that it’s likely that a number of factors will have contributed to this increase. In the early phase of the pandemic the treatment system had to adapt almost overnight to new agile ways to deliver core interventions. And despite the heroic efforts of workers, managers, commissioners and peers, many services were forced to temporarily close their doors.

Meanwhile, the strain of repeated national lockdowns posed major mental health challenges to all of us, increasing isolation and preventing the normal coping strategies (social interaction and routine, family contact, exercise) from happening. The pandemic also prevented those with drug and alcohol problems from accessing the wider array of ‘safety-net’ services including primary, secondary and acute care.

But while the reasons behind this rise in deaths remain complex, the reasons behind the long-term erosion of our field’s capacity to support people with drug and alcohol problems are plain to see in Dame Carol Black’s recent review.

This recent rise in deaths makes only more important the announcement of the Cross-Government Drug Strategy in the coming weeks. The need is very clear. The skill, passion and expertise exists within the field despite a harrowing period of political disinterest and disinvestment. A carefully constructed, costed plan exists in the shape of Dame Carol Black’s excellent Review. We have as a society the means to remedy this appalling situation, and the political will appears to exist.

The perfect window of opportunity for the announcement of transformational investment exists next month with the publication of the Strategy. Our hopes as a field – and a nation – are pinned upon it.

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