More people are dying from drug-related deaths than ever in the UK - and the Government is lying about why
Today’s (15/08/17) truly appalling Scottish drug related deaths stats on top of record deaths for England and Wales demand the question - could many have been avoided with a different approach to drugs?
The answer is straightforward. Yes, they could. And many more will die unnecessarily unless the UK (and Scottish) government change direction. Because for all too many, government drug policy is a death sentence.
And the Home Office knows it, but is trying to hide its responsibility for these deaths with lies. We must stop the government blaming the poor and vulnerable. They say all these deaths, and the rise in them, are simply the inevitable result of an aging group of people taking drugs, and nothing to do with their policies. And that’s not true. How do we know?
1. Drug users are getting older across Europe - but not dying at the rates they are here
Yes, like every other group in the population, as people who use drugs have got older, they have become more susceptible to a range of chronic health problems, exacerbated for many by a history of unsupervised injecting drug use, tobacco and alcohol use, bad living conditions and poverty. And across Europe, the average age of people dying from drug-induced deaths has increased by 5.5 years between 2006-15. But if the story was really as simple as ‘these older people are all going to die of overdoses no matter what we do’, then countries with similar older user populations would have similar death rates to the UK as well. And they don’t. The UK has a drug-related death rate 3 times the EU average, and Scotland’s is the worst in Europe - by a mile. But in the past other countries have managed to reduce their death rates by taking a new approach [See box]. Because of course drug policy has a huge impact on death rates for all age groups. Which brings me onto…
Does reform reduce deaths?
Portugal had a terrible problem with injecting drug use in the late 90s, and was faced with rapidly rising drug death rates, and HIV infections. But numbers of both plummeted after it decriminalised drug users in 2001, put the money saved into treatment, shifted responsibility away from the Ministry of Justice to the Ministry of Health, and brought alcohol and illegal drug policy closer together.
As their drug using population has aged (mean age of drug-related death in Portugal is 43 vs UK at 41.6) the death rate has risen a bit, but Portugal’s death rate is still 5.8 per million vs UK 60.3 per million, and Scotland’s 160.4 per million. So back of cigarette packet calculation - if the UK reduced its death rate to that of Portugal, we would see deaths reduce to a tenth of what they are now - from 50 families bereaved each week from illegal drug use, to 5.
Switzerland introduced heroin prescribing clinics in 1994, as part of a health-oriented approach, when there were 399 drug related deaths. By 1999 deaths had fallen to 181. Dr. Thilo Beck, who runs one, says people in his clinic don’t die of drug intoxication much anymore. The most important reasons are liver disease, Hepatitis C combined with alcohol use, lung problems, cardiovascular disease and cancer. Much like the general population in other words.
2. Young drug users are dying too
Yes, their average age is rising, but it’s not just older people dying. Almost half are under 40.
3. Too many drug users have been dying for too long - not just in recent years
Drug deaths were unacceptably high, and way above European averages (let alone countries with progressive approaches) throughout the 1990s and 2000s - way before the people who started taking heroin in the 80s became ‘older users’.
4. These deaths are avoidable
When most older people have health problems, or behaviours that risk an avoidable death, we don’t just let them die, and blame them for getting old. We provide appropriate treatments, clinics, education and support - so they can avoid death. Even if they are at risk because of their lifestyles.
And the Office for National Statistics classes drug related deaths as “avoidable”. That is, all or most of them could be avoided “through good quality health care, treatment and public health interventions in the broadest sense.” given “current medical knowledge and technology,” and “our understanding of the determinants of health” at the time of these people’s deaths.
5. Life-saving measures
We know what initiatives reduce drug deaths. And so does the UK government - and not just because we’ve told them, so have their own experts the ACMD, the World Health Organisation, the Royal Society for Public Health and many others. And it’s not rocket science. It’s learning from what has worked elsewhere - a comprehensive integrated health centred approach including:
a. Decriminalising people caught with drugs for their own use. This just means stop making things worse - criminalising people who use drugs drives those in need from help, and a criminal record stops them getting jobs, and prison wrecks social support networks etc.
b. Fully funded treatments for all who need it - not cutting them, as is happening. And let’s make it more individually tailored, and based on harm reduction, and the right to health. While leading a drug-free life may be an appropriate aim for some, it is important to note that death rates began their most precipitous rise after the abstinence based ‘recovery’ approach, (often with payment by results) came in after 2010, with some providers taking a more punitive approach to users. Most people aren’t ready to stop taking drugs, and some may never be.
c. Funding (in addition to other treatments) and encouraging the implementation of Supervised Drug Consumption Rooms and Heroin Assisted Treatment. No one ever died from an overdose in either. And they can engage people who wouldn’t otherwise be reached - many of those dying have never been in treatment, or not for a long time.
And one last one from our Mission:
d. Explore models of legal regulation for other drugs - no drug is made safer by being left in the hands of criminals. With pharmacists, doctors and licensed outlets you know what you are getting and how much to take, and they won’t stab you or each other.
Drug-related deaths dramatically fell after Portugal reformed its drug laws
6. Is it just too expensive?
I regularly hear the argument that every government has a finite amount of money, and we can’t afford to give some people the treatment to stop them dying. This is wrong on two levels.
Every credible cost benefit analysis shows that treatment, drug consumption rooms, heroin prescribing, and decriminalisation save far more than they cost, by reducing crime and health costs. So the government knows that by not implementing these measures, it is both ignoring the evidence of what works, and actually reducing the resources available to spend on other priorities.
And that’s why we can be sure that when the government blames older people for dying from overdoses, and produces a new strategy that is just the same old failed one with a new cover, it is clearly about politics, not evidence, or even money.
I could write another blog on the ideological opposition to drug policy reform, internal party resistance, keeping certain media on board, showing how ‘tough’ on crime they are, and the drug war as a weapon to beat other parties with (something Labour is also guilty of). But I fear all these political reasons are only made possible because not all lives are valued equally.
The Anglo Saxons were quite explicit about this: compensation for a fatality was set at 200 shillings for a freeman, and 1200 shillings for a nobleman. Similarly, the cold, hard reality is that the UK government does not value the lives of people who use illegal drugs - who could be your children, parents, siblings and friends (see Anyone’s Child) - as highly as those of less stigmatized groups when it comes to doing what is needed to keep them safe.
But what happened in other countries when a government continued to knowingly put in place policies that would cause thousands more families to be bereaved? Well some took the approach of the people who set up Area 62 safer drug consumption facility in Vancouver, without permission.
"We just said 'screw it, we are going to have a space'.
“And anyone who says we can't, we are just going to say ‘we are saving lives, bugger off.’ "