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worker and client, stressed Boyt.‘ But now it’ s in everyone’ s interest to underreport what’ s happening – it’ s this constant pressure on people to move forward. One manager said to me,“ these days we have to get them in and out before we’ ve even had a chance to get to know them”. People also talk about hard-to-reach populations, but it’ s services that should be doing more to reach them. If you take a map of the drug-related deaths in the UK and a map of the areas of deprivation, they’ re exactly the same. Caring for each other sits at the centre of what needs to change in this society.’

‘ People will present with a mental health problem at their GP, but they’ ll be told they need to deal with their drug or alcohol problem first,’ said one delegate.‘ We should create more environments for people with both drug and alcohol problems and mental health issues, and let people know that having mental health issues is absolutely OK,’ said Sampey.

One delegate agreed that‘ measure- ments and targets for successful dis- charge’ were driving drug-related deaths, while Andria Efthimiou-Mordaunt stated that‘ one of our fellow activists died recently of a, quote-unquote, accidental overdose. We really need to talk honestly about the grief we experience because we don’ t really deal with it.’

Drug-related deaths had doubled in just a few short years, Boyt told the conference.‘ If it was some other cohort of the population, that would be frontpage news. It all comes back to stigma. As the older drug users are dying, it’ s almost like the authorities are just wait- ing till they’ re all dead, while constantly saying“ we need to do more”.’ What’ s mad is that the people who are dying are not in service, while the naloxone doses are being given to those who are in service. But we’ re in a situation where the budgets are being cut so severely that people are just clinging on to what they do and not trying anything new. We need to be saturating the drug-using community with naloxone.’

‘ I’ ve worked in this sector for a long time, and seen it grow from a cottage industry into something huge and commercial,’ another delegate added.‘ I think we need to re-humanise this industry. It’ s about people who want to get well.’

On the question of aftercare, Becca, a worker at Build on Belief( BoB), told the session that, alongside increasing their investment in aftercare provision, commissioners needed to better understand what the lives of drug and alcohol users were actually like.‘ Commissioners sit in a town hall and it’ s very easy to cut things when you’ re not involved,’ she said.‘ I think it’ s crucial that they understand where the money’ s going, who it’ s for, and that they get some expert-by-experience knowledge.’

‘ One of the things I say in my darker moments is that the powers-that-be are funding less and less, and caring less and less,’ said Boyt.‘ There’ ll be some areas where there’ ll be almost nothing left, so more and more will be relying on peer support. I think their role in aftercare is essential.

‘ I have sat in too many meetings where drug related deaths are discussed, he added.‘ They always end with an

Becca acknowledge ment that the figures will continue to rise. It’ s almost as if we are resigned to a whole generation dying so we can get the numbers back on track. Brutal stigma devalues the lives of many in the service user community and allows people to look the other way. We need to restore meaning to our losses. Instead of throwing statistics about, sometimes we must simply remember the special people we have known and cared for.’

‘ This isn’ t about numbers,’ stated Sampey.‘ It’ s about people we knew, cared about and loved.’

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