‘ Deaths in the under-30s have been going down – that’ s good, that’ s a success story – but deaths among the over- 40s have been going up exponentially.’ anneTTe Dale-Perera
combination with poor health and with mental health issues on top. Some people have got to the point where they don’ t really care enough if they stay alive or not, and some deliberately overdose.’
Growing social deprivation was one of the key drivers, she warned, with deprived areas disproportionately suffering the effect of government cuts.‘ So it’ s a double whammy.’
The ACMD also felt‘ quite strongly’ that another factor driving the deaths was constant re-commissioning, she said.‘ It’ s creating transitions. People are being handed over from service to service, with different philosophies,
|
different key workers, and the possibility of falling between the gaps.’ More cuts would inevitably be on the way, she stressed, with funding for treatment likely to reduce by 30 per cent by 2021.‘ We’ ve lost harm reduction services. I’ m very supportive of the recovery agenda, but we need harm reduction as well.’
The ACMD had told the government that it needed to do more to reduce supply, but its recommendation was also that levels of OST coverage must not be reduced.‘ We obviously need more coverage, not less,’ she said, but it was important that this went hand-in-hand with more action to prevent overdoses, such as naloxone provision and training, supervised injection facilities, and more to improve the physical and mental health of drug users.
‘ You have a right to non-discrimi na- tory treatment and healthcare,’ she told delegates.‘ Challenge these cuts, use your organisations, challenge discrimination!’
‘Important though it is to get the messages out, it’ s more important to mobilise people who can make things happen – the people in this room can do that,’ agreed head of Collective Voice, Paul Hayes.‘ You should get your voice heard, and challenge discrimination. Particularly in a local authority-led environment, if you don’ t make your voice heard you won’ t get the results you want.’ |
There was a moral obligation on everyone to concentrate on these‘ early avoidable deaths’ he said, but stressed that it was‘ not just’ about overdoses.‘ There’ s a far larger number of hidden cases – people with compromised livers, lungs, hearts.’ In terms of practice, therefore, it was vital to‘ identify, integrate, intervene and engage’, he told the conference.
‘ You need to identify the people most at risk. Treatment providers know where they are, and we need to spend more time and resources on them. We also need to make sure there’ s much better integration between treatment services and the rest of the NHS.’ Links had become fractured through a lack of integration in commissioning, he said.‘ You can’ t take the background pressure on NHS services out of the equation, but there’ s no reason why we can’ t engage with this and challenge those fractures.’ The fractured system between commissioning for treatment in prisons and in the community was
‘ If you don’ t make your voice heard you won’ t get the results you want.’ Paul hayes
|
also putting people at risk, he said.
‘ The first thing that needs to happen is to engage with people outside the system,’ he said.‘ Our system has a penetration of 60 per cent – one of the highest in the world – but we need to engage with the other 40 per cent.’
In the summer, Collective Voice would be publishing a short document consistent with the clinical guidelines and evidence around best practice, he said.‘ We want to get this right. In too many places, what’ s being commissioned is not consistent with the evidence, the clinical guidelines, or the 2010 drug strategy.’
Clearly, all of this was in the context of‘ very, very heavy’ cuts, which were only going to get worse, he stated.‘ The most important thing to hang on to is to protect access to evidence-based treat- ment. It’ s interesting how the shiny new tends to drive out the boring old. The stuff that gets the headlines is consump- tion rooms and naloxone – they’ re both important, but one of the reasons things are being cut is that drug treatment is not a natural fit with public health.’
Public health was‘ population-based’ he said, and the fact that the death tolls for tobacco and alcohol were far higher than for drugs inevitably meant they would be a higher priority.‘ But you have voices. You’ re at risk. Your friends and family have died. These stories need to be heard – this has to be in the mix. I hope together we’ ll be able to make some impact.’
|