Drink and Drugs News DDN November 2018 - Page 12

policy Statistics on drug-related deaths should be informing our strategy. DDN reports from the Drugs, Alcohol and Criminal Justice Cross-Party Parliamentary Group More than nuMbers LATEST STATISTICS relating to drug poisoning, released by the Office for National Statistics (ONS), show no significant change in the number of deaths in England and Wales between 2016-17. There were 3,756 deaths in 2017 (DDN, September, page 4), with two-thirds of drug-related deaths relating to drug misuse. The most common cause of death was accidental poisoning. Speaking at the Drugs, Alcohol and Criminal Justice Cross-Party Parliamentary Group, Sarah Caul, ONS senior research officer, gave more detailed insight. Deaths involving cocaine and fentanyl had continued to rise – by 29 per cent in the case of fentanyl – while deaths relating to new psychoactive substances (NPS) had halved. There was now a more detailed breakdown of mortality rates available by country and region, with the North East of England showing significantly higher rates than all other English regions, and London recording a significantly lower rate. The annual statistics could be affected by different timescales for recording the deaths in different regions, she added. ‘When you show a map of areas, it almost entirely maps deprivation,’ commented Alex Boyt. ‘Then you throw in austerity, homelessness and the reduction of funding for treatment and it gives a much bigger picture.’ Sunny Dhadley added that it would be useful to know more about the background of people who had passed away, to ‘learn more about the story behind the figures’. ‘Our job is to give as much evidence as we can,’ responded Caul, citing the ONS article published in April that showed that more than half of heroin/morphine misuse death hotspots in England and Wales were seaside locations. Furthermore, an experimental ‘deep dive’ into coroners’ records relating 12 | drinkanddrugsnews | November 2018 to drug misuse, published in August, gave observations on the health and lifestyle of the deceased and the extent of their contact with health services. There was far greater scope to expand this exercise and gain much better understanding of the individual pathways of those who had died from drug-related causes. (Both articles available at www.ons.gov.uk) The second speaker was Rudi Fortson QC, an independent practising barrister known for his work on drug law. ‘Five thousand drug-related deaths a year in England, Wales and Scotland is wholly unacceptable,’ he said. So what should be our approach, he asked the group. How should we deal with two separate issues of chaotic drug use and recreational drug use? ‘We’ve seen a marked increase in homelessness and rough sleeping, a major cause of drug-related deaths,’ he said. ‘People who aren’t drug users who become homeless, become drug users. So we need to provide a safe environment.’ This could be warden-assisted housing, with a warden trained about drug use, or it could take the form of facilities for safer drug-taking. ‘I’m very enthusiastic about piloting a medically supervised drug-using facility somewhere in the UK,’ said Fortson. ‘I know they’re very contentious, but I also know they work when well managed.’ Hamburg had this down ‘to a fine art’ with a combination of ‘carrot and stick’, while Barcelona modelled its facilities on safe usage and hygiene, with medical supervision, counselling services, clean clothes, a launderette and food. It had to be ‘multi-level’ with police a key part of encouraging users to go to the drug consumption room (DCR) he said. Visiting Toronto last year, he had seen two consumption rooms and witnessed how having medical facilities allowed them to respond very quickly. There were 92 facilities around the world ‘and this country is not even piloting one – why not?’ he asked. ‘It’s a disgrace.’ As the group debated the merits of DCRs, Fortson said the evidence showed that they saved lives: ‘There have been overdoses but not deaths, as medical professionals are there to support,’ he said. He added that DCRs worked best when there were several in the same city, rather than just one. Mike Trace, chief executive of The Forward Trust cautioned against seeing DCRs as a ‘policy panacea’. They were one of several support mechanisms alongside naloxone, and would make a difference. ‘But we need to be careful about promoting them as a public health solution,’ he said. Turning to consider recreational drug use, Fortson declared himself a big fan of The Loop, for whom he was informal legal advisor. Providing a free and completely non-judgemental drug testing service as festivals and clubs, their service had highlighted that many drugs were dangerously mis-sold, such as plaster of Paris passed off as MDMA. ‘It took me by surprise to see queues at the Boomtown festival of people waiting to have drugs tested,’ he said. ‘If The Loop hadn’t been at this festival, what would the effects of these substances have been? Illness and possibly death. A high proportion of people threw their drugs away on learning the results.’ It was important that the service was well managed he said, as The Loop was by Fiona Meesham, but the multi-agency approach including police was proving highly effective. ‘We know there are ways that already work to stop drug-related deaths, so let’s provide more funding for facilities,’ he concluded. DDN www.drinkanddrugsnews.com