https://publichealthmatters.blog.gov.uk/2017/03/01/health-matters-preventing-drug-misuse-deaths/

Health Matters: Preventing drug misuse deaths

Welcome to the latest edition of Health Matters, a resource for local authorities and health professionals, which focuses on preventing drug misuse deaths.

The number of drug misuse deaths registered every year have generally been on a rising trend in England for the past 20 years and, following significant increases in the last three years, have reached the highest figure on record.

There were 2,300 drug misuse deaths registered in England in 2015, an increase of 8.5% on the previous year.

Opioids are mentioned on the death certificate in the majority of drug related deaths. In fact, heroin related deaths in England and Wales have doubled since 2012.

The causes of the recent increases are multiple and complex, but two major factors have been identified as being significant.

Firstly, and in the short term, there has been an increase in the availability and purity of heroin, following a fall in 2010-11.

Heroin deaths fell sharply during the period when heroin was in short supply. But when heroin became more widely available again, the number of heroin deaths leapt back up to a more expected level.

Secondly, an ageing cohort who started using heroin in the1980s and 1990s are now experiencing cumulative physical and mental health conditions and are at higher risk of death.

For example, heroin users with chronic obstructive pulmonary disease (COPD) due to long-term smoking are at high-risk of overdose death.

For many drug users, engaging in treatment can be the catalyst for getting the medical help they need to address their physical and mental health problems.

Getting drug users into treatment is a challenge but is crucial to saving lives.

We know that the majority of drug misuse deaths in England occur among people who are not in treatment, and evidence shows that being in treatment is protective against the risk of mortality.

Modelling shows that drug treatment in England prevented an average of 880 opioid-related poisoning deaths each year between 2008 and 2011.

In addition to protecting the individual, drug treatment benefits wider society.

Drug treatment also reduces drug related offending and therefore delivers substantial crime reduction benefits.

The Home Office estimated in 2010-11 that the cost of illicit drug use in the UK is £10.7bn per year.

So how can we prevent drug misuse deaths? This latest edition of Health Matters explores the ways to achieve this including:

  • identifying drug users in the community
  • making treatment services easily accessible and attractive
  • delivering drug treatment services in line with the well-established body of evidence based guidelines
  • developing pathways that facilitate people who use drugs being screened for health conditions such as lung conditions or mental health problems

This edition also explores the underlying factors behind drug misuse and the role of naloxone in treating opiate overdoses.

Read this edition of Health Matters which brings together recommendations for action by different stakeholders to prevent drug related deaths.

This includes the rationale for continued investment in drug treatment services, and the need to integrate them more effectively into the wider healthcare system.

Download the infographics, slides and video content available with this edition of Health Matters and use them locally when commissioning or delivering services that can help prevent drug-related deaths.

Health Matters
Health Matters is a resource for professionals which brings together the latest data and evidence; makes the case for effective public health interventions and highlights tools and resources that can facilitate local or national action. Visit the Health Matters area of GOV.UK or sign up to receive the latest updates through our e-bulletin. If you found this blog helpful, please view other Health Matters blogs.

7 comments

  1. Ken Stringer

    Kevin We woud be interested in seeing the detail of the modelling that prevented 880 drug related deaths pre 2011. Also what results were revealed by this methodology post 2011 which correlate strongly with changes to service design and outcome measure?

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    • Blog editor

      Thank you for your question. The detail of the modelling that prevented an average of 880 opioid-related deaths between 2008 and 2011 can be found in the published paper ‘Fatal opioid poisoning: a counterfactual model to estimate the preventive effect of treatment for opioid use disorder in England’ by White et al (2015) – it is available here (http://onlinelibrary.wiley.com/doi/10.1111/add.12971/full). The study does not go past 2011 so we don’t have equivalent figures by that methodology.

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  2. peter mcdade

    Naloxone should be mentioned in the PHE twitter page. Why are all health authorities not mandated to administer Naloxone ?

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  3. Sarah Marshall

    Do people see a tension between achieving PHOF outcomes regarding successful completions and reducing re-presentations and trying to engage high-risk/complex users - who will be harder to move to successful outcomes?

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  4. John Divney

    Do you know how many of these deaths from opiates had ever been in treatment prior to their death? How many have been discharged from treatment, 6 months or 12 months prior to death? To say "We know that the majority of drug misuse deaths in England occur among people who are not in treatment", sort of implies that they have never been in treatment, I find this hard to believe. The PHOF outcomes encourage too many services to force or encourage or cajole early discharge for many patients who are simply not ready or able to face a future of total abstinence. What will encourage services to actively seek out 'new' high risk injectors and retain them in protective MMT programmes, as well as not discharging those already in treatment? The re-presentation part of the PHOF seems set against this.

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  5. Paul

    Legalise all drugs to reduce harm and take control of purity. Addicts can then come out of the woodwork and get help for their addiction, instead of being shut away hiding from the laws that have not worked. The billions made by organised crime would be taken away from the criminals and could used to treat people who need help. The shooting gallery and free heroin in Durham will drive crime down and prove to be a success.

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