November saw us return to Birmingham for our second Turning Point Safer Lives Conference. A bigger event this year, with 200 delegates from across England, Scotland and Wales including colleagues from Humankind, With You, Change Grow Live, Cranstoun, BDP, Barod, Kaleidoscope and the Scottish Drugs Forum, as well as representatives from the police, NHS providers and public health.
The theme was ‘Drug deaths are all of our business’ and my hope was for us to come together and explore the role we all have to play in reducing the number of drug deaths, in a context of changing drug markets and increasing evidence of synthetic opioids entering the drug supply. It felt appropriate that we were in Birmingham, a city that saw an increase in overdose deaths across the summer.
With this year’s ONS data delayed, OHID’s Steve Taylor reviewed what we already know – drug poisoning deaths have doubled since 2012, with older age ranges increasingly affected and deaths of women rising. Recent overdose death numbers saw concentrations in certain areas and involvement of nitazenes, which is unusual. OHID’s action plan to reduce drug and alcohol deaths addresses five priority areas – within these there is a focus on improving treatment quality, expanding naloxone provision, improving toxicology, coroner reporting and information sharing, and the reduction of stigma in healthcare services.
There were presentations from the police, services that support family members, and the most moving presentation of the day from Pat Hudson. Pat told the story of her son Kevin, who tragically died of a heroin overdose in 2017. ‘Kevin was a sensible boy,’ she said. ‘If there was an overdose prevention centre in the town, I believe he would have used it and I believe he probably would be alive today’.
Jenny Scott from the University of Bristol asked us to raise our naloxone in the air, reminding us of the importance of carrying a kit. Jenny presented her work on co-designing solutions to promote naloxone carriage with people who use drugs, including the innovations that came from this project – a poster campaign to raise awareness and challenge stigma and the Carry Naloxone app that tells people where they can pick up a kit.
Chris Rintoul, head of harm reduction at Cranstoun, explored what more we can do to reduce overdose deaths. He reflected on the resistance in his native Northern Ireland towards the shift to more of an abstinence focus over the past ten years – the result of strong memories of life without harm reduction services, which were introduced much later than in England. Chris stressed the importance of making treatment more attractive, ‘a lot of those most in need of treatment often aren’t in it’.
This was echoed by Daniel Ahmed, clinical director at Cranstoun and clinical partner at Foundations. Daniel presented on the experiences of staff and service users at the pioneering Middlesborough diamorphine-assisted treatment clinic, which closed in 2022. In an area with some of the highest drug death rates in England, independent evaluation showed that in the clinic’s first year, there was a 60 per cent reduction in service users’ criminality, a significant reduction in their use of street heroin and other drugs, reduced homelessness, and improved wellbeing.
For those of us working in the substance use field, it’s a worrying time. The drugs we’re seeing in the UK are changing, and the way we work will need to change too. We need to make services that fit the people they’re aimed at, not the other way round, but the conversations I had throughout the day fill me with hope. Although we don’t know what’s ahead, we will work together to meet the challenges to come. When Pat Hudson spoke about the death of her son Kevin, we were all reminded of why we’d chosen to come together. Drug deaths are all of our business.
Turning Point would like to give special thanks to their sponsors Ethypharm, who made this event possible.
THE ROLE OF THE POLICE
Chief inspector Jason Meecham shared developments since he presented at last year’s event, including that Durham has expanded the availability of naloxone to any officer who wishes to carry it. Officers have the choice to carry injectable or nasal, and Durham is unique in that it also issues naloxone kits to people who use opiates on release from custody. This is made possible through a collaboration with local treatment providers, councils and public health teams – in the last year there were 44 uses of naloxone to reverse opiate overdose by police in Durham and Darlington, an increase of 47 per cent. Jason has also been busy promoting naloxone through appearances on local and national media, and since our conference last year has had many conversations with other police forces around the country with a goal to support them in rolling out naloxone in their area.
Inspector Tom Gent, lead for naloxone with Avon and Somerset Police, spoke about how Turning Point’s work with Somerset Police in 2021 has led the roll out of naloxone across all five areas covered by the force, with 500 officers currently trained. As well as being able to save more lives, Tom discussed the wider benefits including improved partnerships with drug treatment providers, opportunities to reduce stigma, increased referrals into treatment and the opportunity to demonstrate to other forces that this can be done with no issues. It also meant that they were better prepared when Bristol, like some other areas, saw a spike in overdoses over the summer due to synthetic opioids.
ENGAGING FAMILIES TO REDUCE DRUG- RELATED DEATHS
A number of speakers discussed the family perspective and how families can be supported. Justina Murray and Gill Harmon from Scottish Families Affected by Alcohol and Drugs (SFAD) talked about the fact that an average 11 family members are negatively affected by a person’s problematic drug or alcohol use and that it takes, on average, eight years before family members access support in their own right.
SFAD use an evidence-based approach which supports affected family members to help move their loved one towards treatment, to reduce their drug or alcohol use and simultaneously improve their own lives. They talked about the heightened responsibility that affected family members feel to keep their own family member alive and the importance of recognising this when engaging families in initiatives aimed at reducing drug-related deaths.
Jan Larkin, head of psychology at Turning Point spoke about the Family 5-Step approach. Turning Point has developed a digital version of the programme in response to the fact that often affected family members don’t know about drug and alcohol services, and if they do know about them they would still rather access support anonymously. Pat Hudson, who works with the Anyone’s Child campaign, spoke very movingly about the death of her son Kevin from opiates when he was 32 and the measures she feels could have prevented his death – namely heroin-assisted treatment and an overdose prevention centre.