AS PREVIOUSLY REPORTED
in
DDN
(October, page 4),
according to data from the Office for National
Statistics (ONS), a total of 2,248 deaths from drug
misuse were registered in England and Wales in 2014
– a rise of 14.9 per cent on 2013. Building on the near
20 per cent increase in drug misuse deaths from the
previous year, a notable change in the pattern of drug
deaths seemed to be emerging.
However, this paints an inaccurate picture. While
drug misuse deaths in England have risen dramatically
over the last two years, drug deaths in Wales have
fallen year-on-year since 2010, with a 30 per cent
decrease in the last five years to a total of 113 deaths
– a rate of 3.90 per 100,000 population.
With drug misuse deaths in England now at their
highest level over the 22 years for which the ONS
publishes figures, the need for credible explanations
for the rise became urgent.
One set of explanations has focused on changes to
drugs and those who use them. The ONS, in the
statistical bulletin
)
accompanying the release of the 2014 figures, points
to changes in the purity of street heroin (as reported
by SOCA, the UK’s Serious Organised Crime Agency) as
a possible influence on variations in drug deaths over
recent years. Sustained rises in reported purity
coincided with increases in deaths involving
heroin/morphine in England. The ONS also suggests
that, with increasing numbers of deaths among older
drug users, the generation who began injecting in the
1980s and 1990s are aging and therefore at higher risk
of dying from drug-related causes as other health
problems take their toll.
However, the same ONS report provides another
key piece of information that challenges the focus on
changes to drugs and this demographic of drug users
as key reasons for rising drug deaths. It comes on page
19: ‘…whilst drug-related deaths in England have now
reached an all time high, those in Wales have fallen
over the same period, down 16.3 per cent in 2014 to
113. Indeed, the rate of drug misuse deaths across the
Welsh population, at 39 per million, is now less than
England for the first time since 2004.’
With no reason to believe that either heroin markets
or drug-using careers inWales are substantially different
to England, how can we explain the difference?
The second narrative to emerge following the
release of the figures is that the difference is down to
policy and philosophy. With health policy devolved
within the UK, it is the Welsh Government that decides
the priorities for substance misuse in Wales. In contrast
to England, where – as reported in last month’s article
on the National Needle Exchange Forum meeting
(
DDN
, October, page 16) – many users, frontline staff
and managers are finding reduced funding and
support for well-evidenced harm reduction approaches
in favour of abstinence based ‘recovery’ models, Wales
has maintained focus and funding for harm reduction.
In response to the release of the 2014 figures,
deputy minister for health Vaughan Gething said,
‘These figures represent lives lost to families and
communities across Wales and while I welcome the
news of a further decrease, any death attributable to
drugs is one too many.
‘Tackling drug misuse is a complex issue, which the
Welsh Government has been working hard to address.
The fact that drug-related deaths are falling at such a
rate in Wales is testament to the significant work
which we and our partners are undertaking.
‘We are investing almost £50m a year in
programmes including a bilingual substance misuse
helpline, a take-home naloxone programme which
reverses opiate overdose and the WEDINOS harm
reduction project which tests substances. These figures
show that this money is delivering tangible benefits.’
Also commenting on the figures, Josie Smith said,
‘It is a testament to the National Substance Misuse
Strategy in Wales,
Working together to reduce harm
,
ongoing support for harm reduction services and a
willingness to innovate new approaches to reduce risk,
that have resulted in fewer drug deaths in Wales.
Problematic drug use in Wales remains but the most
severe of consequences, that of premature death, is
declining through better engagement, appropriate
and evidence-informed interventions and
collaborative working.’
Josie Smith is head of substance misuse programme
and Chris Emmerson is information analyst specialist at
Public Health Wales
With drug misuse deaths in
England now at their highest
level over the 22 years for
which the ONS publishes
figures, the need for credible
explanations for the rise has
become urgent.
drug deaths
More on harm reduction at:
Unlike in England, drug deaths in Wales have been
falling since 2010 – a result that can be traced to
Welsh public health policy and harm reduction practice,
say
Josie Smith
and
Chris Emmerson
8 |
drinkanddrugsnews
| December 2015
Bucking the trend
