Drink and Drugs News DDN December 2018 | Page 17

Missed a conference? Catch up: www.drinkanddrugsnews.com deaths could, however, lead to advances in care, he said. ‘It shines a light on the range of morbidities this client group is suffering from.’ The new Scottish drug strategy (see news, page 4) also had ‘some good things in it’, he added. ‘It endorses things like human rights, take-home naloxone, lived- experience advocacy and it takes a swipe at the UK stance on consumption rooms.’ However, while it was evidence-based that evidence was ‘highly selective’, he argued. ‘There’s stress on the “recovery journey” but, to my mind, at the expense of the NHS.’ While Scotland’s take-home naloxone programme was well-received and discussed internationally it was still not possible to see a ‘causal effect’ in preventing drug-related deaths, he said. ‘But it has clearly had an impact in that super-high risk period of the first few weeks after release from prison, so there is clear evidence that it can work.’ On the issue of consumption rooms, ‘we really do have to make some progress on this’, he stressed. ‘The international evidence is there, and they’re part of a whole spectrum of treatment. You wouldn’t have a hospital without an A&E or intensive care unit.’ eaths involving ‘festival and party drugs’ were increasing alongside those involving opiates, director of The Loop, Fiona Measham, told the conference, with purity levels for ecstasy at their highest ever level. Her organisation had been carrying out festival testing for the last three summers, and there was ‘an opportunistic element’ to festival drug use with people tending to take more drugs than they normally would. ‘There’s polysubstance use, and a significant group of older people who only ever take drugs at festivals and may be unaware of the higher purity levels.’ One in 20 MDMA samples from this summer were actually n- ethylpentylone, a very long-lasting cathinone, she added, with festival dealers twice as likely to be selling contaminants and substances of concern. ‘They can sell anything and get lost in the crowd. ‘We’re not encouraging or condoning drug use, but we give harm reduction D advice – 90 per cent of our service users have never spoken about drug use to a healthcare professional so we’re reaching people at the very beginning of their drug- taking careers. We can monitor trends in local drug markets and remove high risk substances from circulation.’ The Loop had also been involved in setting up testing in consumption rooms in Copenhagen and Vancouver, and would soon be operating in Bristol and Durham city centres. ‘This is something that should be available to all drug-using communities.’ The human cost behind the statistics, however, was brought home powerfully by author and journalist Poorna Bell, who told the conference how her husband Rob had taken his own life in 2015. ‘He struggled with chronic depression and addiction. They tore at him to the point where he couldn’t see anything getting any better.’ She’d known nothing about addiction, she said. ‘My mind reeled with the horror that it had been heroin. We have this incorrect hierarchy of substances, and heroin seemed the worst of the worst. I stayed with him and helped with his recovery but ironically I felt I couldn’t tell my family and friends, which shows the isolation faced by people and their loved ones. The resources for someone whose loved one is an addict are abysmal.’ DDN ‘People talk about the jewel in the crown of the UK treatment system being the very low HIV prevalence.’ Fentanyl: the opportunity to prepare is now One substance associated with worsening drug harms was fentanyl, delegates heard. ‘Early last year we had a spate of overdoses in one of our services in the North East,’ said medical director at Change, Grow, Live, Dr Prun Bijral. ‘We were really concerned and the samples turned out to contain fentanyl and its analogues.’ Fentanyl was now ‘ubiquitous’ in the US, he said. ‘People ask why would dealers and criminal gangs want to sell drugs that kill their customers. The answer is they don’t care.’ On the question of whether we could see a similar situation here, the UK now accounted for almost a tenth of all global ‘darknet’ sales of fentanyl, he said. ‘We have to consider fentanyl in terms of the current situation for people who use drugs. It’s a really difficult time, with the highest ever rates of drug- related deaths, and there’s been a small but significant increase in the number of deaths involving fentanyls. We know their impact.’ The scale of the problem was better understood here than it had been in the US, however, and the services were in place. Any response would need to be multi-agency, and optimisation of treatment was also vital. ‘In Teeside, where they had the problems, they’ve established a preventing drug-related deaths co-ordinator.’ Other essential measures were sharing police seizure results, and post-mortem testing for fentanyl as standard practice. Take-home naloxone was also critical, along with OST. ‘The opportunity to prepare is now.’ www.drinkanddrugsnews.com December/January 2019 | drinkanddrugsnews | 17