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The needle and the damage done

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Drug paraphernalia Over half the deaths from drug poisoning are attributable to heroin or other opiates

The drugs don’t work, but they still kill very effectively. For those who grew up in the 1980s, figures on drug-related deaths just released by the ONS make for a particularly bleak kind of déjà vu. In 2018 England and Wales showed a 16% increase in drug poisoning deaths in 2018, the highest annual leap since records began in 1993. In all, there were 4359 deaths from drug poisoning, just over half of them attributable to heroin or other opiates.

Figures from Scotland are even more concerning. Drug deaths there rose by 27% to 187 people in 2018, and have doubled in the last 5 years.

Perhaps more surprising is the demographic of fatalities. These largely aren’t thrill-seeking youths, but people in early middle age. Indeed ‘accidental poisoning’ has overtaken suicide as the biggest killer of men between 35-49. Experts attribute this to an older cohort of opiate users’ bad habits finally catching up with them, as ageing breaks down their immune systems, and availability of synthetic opiates exposes them to stronger drugs.

But it’s difficult not to see these figures as yet more casualties of our decimated public health services. Councils have slashed drug treatment services by around 27% since 2015, with some areas recording a drop in funding of over 50%.

But maybe it’s also time to try something bolder. In Glasgow, MPs of all parties have expressed interest in ‘drug consumption rooms’ where opiate users can go to consume their drugs to reduce harm and be linked up with health services.

Removing the moral hazard from opiate use doesn’t seem like a road many will want to go down. But this is a war we are losing. How many deaths will it take to trigger a little more boldness in our policy makers?

What do you think? Leave a comment below or tweet your views to @IndyNurseMag

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The increase in drug related deaths amongst more mature IVDUs is a cause for concern for those involved in public health and emergency care. Drug rehabilitation services have long advocated investing in 'drug consumption rooms'. This not only gives users access to sterile needles and syringes but it importantly provides a 'safe haven' with urgent assistance in the event of accidental over dosage. Another benefit is that used needles are not casually discarded with the associated risk of needlestick injuries.

There remains a traditional hesitancy for local authorities to grasp the opportunity of introducing safe areas for users. The dramatic reduction in funding for drug services and rehabilitation means that the death rate amongst IVDUs will continue to rise. There are positive examples of countries who take a pragmatic approach to funding drug services have a lower incidence of accidental drug deaths and an associated reduction in HIV and other infections.

Mike Paynter
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