DDN November 2022 DDN Nov_2022 - Page 16



Our approach to drug-related deaths is dangerously out of date , says the Drugs , Alcohol and Justice APPG . DDN reports

Stigma has profound public health implications ,’ said Dr Adam Holland of the Faculty of Public Health . ‘ It can be internalised and cause mental health problems , and it can also mean people don ’ t want to go back to services to seek support .’ The Greeks used the term stigma to refer to bodily signs – cuts or burns to show the person was a slave , a criminal or a traitor . ‘ In modern society we don ’ t brand people who use drugs , but we punish them by giving them a criminal record and diminishing their life chances ,’ he said .

Since decriminalisation in 2001 , Portugal had seen a reduction in problematic drug use , he said ,
‘ We need to make it safe to talk about drug policy , about creating an environment where people can put their head above the parapet without being shot down .’ and demonstrated that ‘ it ’ s not necessary to criminalise people who use drugs . There are other ways .’ Punitive measures could lead to more risky behaviours by driving drug use underground and reducing the potential for harm reduction interventions , such as clean needles .
‘ We treat drug use differently from any other public health issue and use stigma as an instrument ,’ he said . ‘ But we need to think about things that are outside people ’ s control that make them more likely to use drugs in harmful ways .’ Drug use and drug-related harm were not the same thing , he emphasised , ‘ so there is not a direct link between reducing both ’.
He called on everyone to sign an open letter calling on government to rethink the approach of the Swift , certain , tough white paper relating to drug possession offences – the letter has been supported by individuals and organisations working in drug policy , health and social care , criminal justice and human rights .
DRUG-RELATED DEATHS Paul Breen from the Office for National Statistics ( ONS ) presented detail on the latest drug-related death statistics – the 2021 registrations of deaths related to drug poisoning in England and Wales . The figures included drug poisonings and deaths related to drug dependencies ( but didn ’ t include accidents that happened while under the influence of drugs ). The 4,859 deaths related to drug poisoning represented a 6.2 per cent increase on the previous year – a rate 76.6 per cent higher than a decade ago . It represented a record high , for the tenth year in a row since 1993 .
There was a clear link between deaths and deprivation . In England the death rate for males was seven times higher in the most deprived areas and about six times higher for females . Separate data for Wales showed almost identical trends . Regional variations in England maintained the clear north-south divide , with the North East still worst and the East of England and London with the lowest rates .
The map of mortality rate age groups for 1993-2021 showed that the problem was focused on a particular generation – people who were born in the first half of the 1970s and were now in their late-40s . ‘ So for the roots of the high death rates today , the causality goes back 20 or 30 years ,’ said Breen .
DRUG TRENDS Looking at the trends in specific substances , opiates had always dominated the drug deaths data , with roughly 60 per cent of the deaths involving an opiate , but this was starting to level off . While heroin and morphine had fallen slightly , there had been ‘ quite a sharp rise in methadone , which might be related to the pandemic and cutting off people ’ s access to drug treatment services ,’ he said . ‘ They might be doing more of it unsupervised ’.
The fastest rising substances in the last five years were pregabalin and gabapentin – known as gabapentinoids and often taken alongside benzodiazepines and opiates , cocaine , mirtazapine ( an antidepressant ) and methadone . Also of interest were new psychoactive substances ( NPS ) and some benzos were categorised as NPS .
FALLING BEHIND Discussion among members of the APPG , chaired by Dan Carden MP , focused on unacceptably high statistics , a call to redouble efforts to remove barriers of stigma ,
TO SIGN THE LETTER calling for a government rethink on Swift , certain , tough , scan the barcode