Emergency measures

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Although Wales has largely escaped significant treatment budget cuts, drug deaths are still rising to alarming levels. Access, and evidence-based treatment, are key to tackling this public health emergency, says Martin Blakebrough.

Martin Blakebrough CEO of Kaleidoscope Project and ARCH Initiatives
Martin Blakebrough is CEO of Kaleidoscope Project and ARCH Initiatives

In 2017 Donald Trump labelled US drug addiction a national emergency, following a fourfold increase in drug-related deaths over just two decades. In Scotland, the rate of drug deaths relative to population and resources now mirrors the US crisis, and in England and Wales – while the situation may not be as alarming – the number of drug deaths are now at their highest level ever.

In Wales we have some of the worst affected areas in the UK for drug deaths. The number of people who have died in Wales as a result of drug misuse has increased by 84 per cent over the last decade. This is particularly distressing when we consider that in Wales, unlike England, drug treatment budgets have remained largely the same. In fact on many initiatives, such as the roll-out of naloxone, Wales has led the way.

Significant progress has also been made thanks to the Welsh Government’s support of a collaborative and recovery-focused approach to housing and drug treatment packages, explored through initiatives such the Housing First scheme which has attempted to meet the specific and complex support needs of rough sleepers. The number of drug deaths among Wales’ rough sleepers, in spite of these efforts, is frightening. Data published by the Office for National Statistics (ONS) estimated the number of deaths of homeless people in England and Wales in 2018 at 726. Of these, two in five were related to drug poisoning – a 55 per cent increase since 2017 (DDN, October 2019, page 4). The mean age of death for men was 45, and for women 43. In Wales, the ONS data estimates 34 people died.

Tents used by homeless people outside an empty retail unit in Cardiff,
Tents used by homeless people outside an empty retail unit in Cardiff, city centre. Credit: Matthew Horwood/Alamy

Kaleidoscope believes this crisis should be seen as a national state of emergency. As the sixth-largest national economy in the world it is unacceptable that the UK continues to fail its most vulnerable people. And while it is heartening to see some progress being made, there is still plenty more that can and should be done to meet the needs of service users.

Increasingly, research into addiction intervention is providing evidence of access to treatment’s critical importance, and the effectiveness of well-delivered, evidence-based treatment for drug misuse is now well established. Matt Jukes, chief constable of South Wales Police, has highlighted the issue in recent weeks and recognised the need to explore alternative intervention methods such as safe consumption rooms and heroin-assisted treatment. I echo this sentiment and am in no doubt that radical action is needed across Wales. People must have access to basic treatment options quickly and with ease, such as substitute prescribing within 24 hours.

To achieve this, I believe the Welsh Government must work either with area planning boards to fully understand the barriers that prevent this approach, or take bolder action and create a national prescribing service, with a clear charter of providing rapid access to services in a collaborative NHS and third sector initiative.

In Wales we need to look at safe places for people who will not engage with traditional treatment to inject their drugs. The current model, in which services knowingly provide clean needles and syringes to the homeless – who are certain therefore to consume their drugs in a public space and in a dangerous way – is nonsensical. As the updated 2017 guidelines advice considers, options of heroin prescribing may also need to be invested in.

However we navigate this crisis it is certain that bold steps are needed, as failing to provide rapid access to treatment services is costing lives. This is not acceptable, and the need for a proper focus on reducing drug deaths with a radical approach is now more urgent than ever.

Kaleidoscope are a charity who provide help and support to people with issues around drugs and alcohol.