DDN looks back at a year that saw cuts continue to bite, deaths continue to rise, ‘county lines’ become headline news – and a G7 country legalise cannabis.
A predictably downbeat start to 2018 as, after years of shrinking budgets, the latest State of the sector document warns that the field’s ability to absorb cuts through efficiency savings and service redesign has been ‘exhausted’. The report uncovered ‘worrying signs that potentially serious damage’ has been done, says Adfam chief executive Vivienne Evans. Meanwhile, Release warns that levels of naloxone provision by local authorities are ‘chronically inadequate’ and PHE announces its review of the ‘growing problem’ of prescription drug dependency. On a more positive note, the NHS states that its hepatitis C strategy could see England become the first country to eliminate the virus.
Get Connected, DDN’s eleventh annual service user conference, sees another vibrant day of debate and networking in Birmingham. In a measure of how far the event – and user involvement – has come, SUIT’s Sonny Dhadley tells delegates that ‘I can remember coming to a DDN conference for the first time about a decade ago, not long out of detox – I didn’t understand that this world existed. But if you’re championing something you believe in, you’ll do anything to make it happen. There’s so much energy and potential in every one of us.’
MPs warn that ‘significantly greater’ numbers of people will need to be tested, diagnosed and treated if the NHS is to meet its hep C elimination target, and the National Crime Agency reveals that it is seeing a dramatic increase in modern slavery cases as a result of county lines activity, with referrals of minors up by two thirds between 2016 and 2017.
The government announces that its serious violence strategy will include a £3.6m county lines coordination centre, citing the drug trade as an ‘important driver’ of rising incidences of knife and gun crime. Meanwhile, in what is seen as a landmark move, the Royal College of Physicians (RCP) issues a statement backing drug decriminalisation. ‘The RCP strongly supports the view that drug addiction must be considered a health issue first and foremost’ it says, adding that it had been ‘alarmed’ by rising rates of drug-related deaths.
In what could help show the way forward in eliminating hep C, a report from the London Joint Working Group (LJWG) reveals that a four-month community testing pilot project in pharmacies with needle exchange facilities has seen 50 per cent of people testing positive. Significantly, almost 60 per cent of participants were also unaware that the virus could now be treated with oral tablets rather than interferon. Meanwhile, minimum pricing finally comes into force in Scotland after years of legal wrangles and last month’s 12-step article by Alex Boyt, ‘All or nothing’, fills the DDN letters pages with reactions ranging from ‘brilliant’ to ‘reading this has ruined my day’.
EMCDDA’s annual European drug report identifies the UK as among the biggest consumers in a ‘buoyant’ cocaine market, with purity levels at their highest for a decade, while Kevin Flemen wonders in DDN if the recent growth in crack use indicates a move towards social acceptability. ‘I’m probably more anxious about crack this time around than I have ever been working in the field,’ he writes. ‘I hope I’m wrong.’
In what is becoming a depressing annual event, Scotland again records its highest ever number of drug-related deaths. The ‘sheer toll’ of deaths represents a ‘staggering weight carried by families and communities and the wider Scottish nation’, says Scottish Drugs Forum CEO David Liddell. Drugs are also behind the ‘huge increase’ in violence across the prison estate over the last five years, says the annual report from the chief inspector of prisons. Meanwhile the government is urged to overhaul drinks marketing legislation as campaigners warn that social media is creating ‘unprecedented alcohol marketing opportunities’.
Following last month’s Scottish statistics, ONS figures again show record drug deaths for England and Wales. A cautious note of optimism is struck by the fact that, while previous increases had been ‘statistically significant’, rates since 2015 are only increasing slightly and remain ‘broadly stable’. Fentanyl-related deaths continue to rise, however, and deaths related to cocaine have now increased for six years in a row.
As a WHO report states that one in 20 global deaths are now caused by alcohol, PHE launches its ‘Drink Free Days’ campaign in collaboration with Drinkaware as a ‘clear to follow, positive and achievable’ way for middle-aged drinkers to reduce their health risk. Partnering with the industry-funded body, however, leads to concern from some in the treatment sector and the resignation of PHE’s alcohol leadership board co-chair Sir Ian Gilmore.
Canada becomes the second, and largest, country to legalise the recreational use of cannabis, with justice minister Jody Wilson-Raybould stating that this ‘progressive public policy’ would help keep cannabis ‘out of the hands of youth and profits out of the pockets of criminals’.
Scotland pledges a ‘person-centred, health approach’ in its new drug strategy, Rights, respect and recovery. Meanwhile, the impact of price increases associated with ongoing buprenorphine supply problems continues to be felt, compounded, as PHE’s Pete Burkinshaw tells DDN, by ‘the financial pressures local authorities and services are currently under. We will continue to do everything we possibly can.’
As the year comes to close preparations are well underway to bring people together for DDN’s 2019 conference, Keep on Moving. See you on 21 February!