ACMD: safeguarding treatment vital to avoid more deaths

Maintaining the ‘capacity and quality’ of treatment is essential to prevent more increases in opioid-related deaths, says a new report from the ACMD. The large cohort of people who have been using heroin since the 1980s and ‘90s are ‘increasingly vulnerable’ as they age, stresses Reducing opioid-related deaths in the UK,with fatalities increasing by almost 60 per cent in England and over 20 per cent in Scotland and Wales in the last four years.

Alongside the ‘increasingly complex’ health and social care needs of ageing users, other factors in the recent increases in death rates are likely to include commissioning changes and cuts to benefits and local services, the report states.

The document calls on central and local government to protect current levels of funding for evidence-based treatment as well as investment in ‘high quality, tailored opioid substitute therapy of optimal dosage and duration’. Data standards and research also need be improved, it says, while naloxone should be made routinely available. The government should also look at the potential to reduce deaths through ‘the provision of medically supervised drug consumption clinics in localities with a high concentration of injecting drug use’, as is currently being considered in Glasgow (DDN, November, page 4).

It is unlikely that allowing a regulated market for heroin – ‘outside the confines of medical prescription for a tightly defined group of patients’ – would reduce deaths, the report concludes, but it does recommend that government funding should be provided to ‘support heroin-assisted treatment for patients for whom other forms of OST have not been effective’.

‘We can assert with a good degree of confidence that the ageing profile of heroin users with increasingly complex health needs, social care needs and continuing multiple risk behaviours has contributed to recent increases in drug-related deaths,’ said co-chair of the ACMD’s drug-related deaths working group, Annette Dale-Perera (pictured). ‘The greater availability of heroin at street level, the deepening of socio-economic deprivation since the financial crisis of 2008, changes to drug treatment and commissioning practices, and the lack of access to mainstream mental and physical health services for this ageing cohort have also potentially had an impact.’

Report at Dale Perera