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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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