Drug fatalities highest where treatment cutbacks deepest

More heroin and crack users are dying of overdoses in the areas of England where cuts to drug treatment budgets have been among the greatest, analysis by the Observer shows.

The findings have prompted concern that addicts are at greater risk of dying due to funding cuts to the public health grant received by local councils. Over the past four years councils in 85% of areas that have an above average drug mortality rate have reduced the amount they spend on drug treatment, a comparison of drug fatalities and spending on addiction services shows.

Ten of the 30 councils that have cut spending the most since 2013 have some of the highest numbers of drug deaths, while a further 10 had higher than average drug mortality rates. The treatment budget in Blackpool, which has consistently been the worst area in England for drug deaths, will have more than halved by 2018, a cut of £2.5m.

Annette Dale-Perera, chair of the Advisory Council on the Misuse of Drugs’ (ACMD) recovery committee, told the Observer: there were “real concerns that the cuts in funding would lead to increases in drug-related deaths”.“A lack of spending on drug treatment is short-sighted and a catalyst for disaster.” She added that a “world-class” treatment system was now being “dismantled”.

The ACMD, the government’s drug advisers, is warning that cuts are the single biggest threat to drug treatment recovery outcomes.In Bristol, where there were 93 deaths between 2014 and 2016, cuts are projected to be the harshest. Spending in the city in 2013 was £12.9m and it is set to be £4.5m from next March. Other drug death hotspots with the biggest cuts are Gateshead (51%), Sefton (51%), Portsmouth (38%), and Durham (38%).

“Funding cuts are reducing the ability of drug treatment services to reduce the risk of death among people using heroin,” said Alex Stevens, criminal justice professor at the University of Kent, said: “The government is fully aware that drug-related deaths are highest in the places with the highest levels of deprivation and that they are cutting budgets the deepest in areas with deepest deprivation.”

High levels of investment helped reduce drug-related deaths in the 2000s, when services were jointly commissioned by the NHS and local authorities. Since 2012, local councils took over commissioning with a ring-fenced grant from central government.

Drug-related deaths are now at an all-time high: 3,744 last year compared with 2,640 a decade ago, and drug-related hospital admissions have also increased by 50% over the past decade.

Another factor in rising drug mortality, said Colin Drummond, from the Royal College of Psychiatrists, was the coalition government’s decision to treat heroin users with methadone less often and with lower doses, which he described as “political interference in what is essentially a clinical issue”.

He cited examples where “people disengaged from treatment, stopped taking methadone, went back to street drugs and then overdosed”.

Professor Stevens added that reducing methadone prescriptions before users were ready for the change was dangerous because they were more likely to take street heroin on top, thereby increasing the likelihood of overdose.

Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said: “Councils have long warned of the false economy of the government’s cuts to the public health grant.” There are an estimated 200,000 people getting help and a further 100,000 who are not, she said.

Councils spend more on addiction treatment than on any other area of public health, she added, with nine in 10 councils now providing take-home naloxone to try to tackle opiate-related deaths.