‘ 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 ,
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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
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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 .’
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