'If You Cut Drug and Alcohol Treatment Services, People Will Die'
In their series exploring the deaths that go unnoticed, Natalie Bloomer and Samir Jeraj examine the impact of the scarce support available for those with problematic drug use.
Last summer, 22-year-old Hayley (not her real name) was found choking on her own vomit in an alley in Northampton town centre.
The former care leaver had been sleeping on the streets for around six months and was an active drug user. She was taken to hospital and later recovered but, if she hadn’t been found by a local homelessness worker early that morning, there could have been a very different outcome.
Northampton has seen a string of homeless deaths in recent years – so much so that the local homelessness service, the Hope Centre, has created a memorial garden for those it has supported who lost their lives. Small stones engraved with the names of those that have died lie amid the flowers.
“Deaths of homeless people in the town continue to be a concern, although thankfully they have been far less numerous than in the previous year,” Robin Burgess, CEO of the Hope Centre, says. “However, it is perhaps most sad that three of the seven deaths so far this year have been women under the age of 45.”
One of those women was found dead just last week. Her body was discovered on the streets of the town centre in the early hours of the morning. She was in her 30s. It is not yet known how she died but Mr Burgess says drugs have played a part in many of the deaths locally.
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“Drugs remain the most significant issue that homeless people face in regard to risk of sudden death,” he says. “Opiate use in this group is extensive and, because of the way it works, is more likely to cause sudden deaths than other substances. But perhaps less obvious is the long term attritional damage all drugs, including alcohol, cause to the health of homeless people. Whilst less headline-grabbing, these deaths are still premature and avoidable.”
Mr Burgess believes that some addiction services are unable to meet the needs of homeless people. “Whilst cuts to date may not have been so acute in Northamptonshire as in some other parts of the UK, there is growing evidence nationally and locally that specialist addiction services are just not able to manage and control the addictive behaviours of homeless people,” he says.
“As a former commissioner of addiction services nationally and locally within this community, I would argue that there is a compelling logic to funding experienced and specialist homelessness providers to offer a diversified range of addiction support services to homeless people, as the agencies with the capability, experience and contact with this client group on a daily basis.”
In 2017, the Office for National Statistics (ONS) published the first experimental statistics of the number of deaths of homeless people in England and Wales between 2013 to 2017. This followed a groundbreaking project by the Bureau of Investigative Journalism which counted the number of people who died while homeless. The ONS data showed that there were 597 deaths in 2017 – an increase of 24% over the past five years. 32% of those deaths were caused by drug poisoning.
But it’s not just the homeless who are experiencing drug-related deaths. It appears to be a crisis sweeping right across the UK. In 2018, there were 4,359 deaths from drug poisoning in England and Wales, figures show – the highest number and the highest annual increase since records began.
In Northern Ireland, male drug-related deaths soared by 98% between 2007 and 2017, with people living in the most deprived areas being four times more likely to die from a drug-related cause than in the least deprived.
The crisis is even deeper in Scotland, which now has one of the highest drug deaths rates in Europe – three times higher than England and Wales.
In the town of Kilmarnock, Chris Bermingham knows all too well the impact drugs are having on the local community. She runs the drug and alcohol recovery service Addaction in the area and her team of just five workers support 120 people across East Ayrshire. “People are devastated,” she says. “The deaths that have taken place over the last couple of years have had a ripple effect on the whole community. There’s a real feeling of helplessness among friends and family.”
In the last decade, drug-related deaths in East Ayrshire have doubled, with 29 people dying in 2018. Ms Bermingham believes that austerity has been a key factor in the growing crisis. “It’s indicative of the Government spending a lot of time cutting services through austerity,” she says. “If you cut services, people will die.”
Kilmarnock is the largest town in East Ayrshire and around half of the people that the Addaction team there support come from here or the surrounding area. Like many places, there are parts of the town that are fairly prosperous and others that are far less so. One in four people live in a deprived area and one in five children live in poverty. The rate of drug-related hospital stays in the Kilmarnock locality is higher than the rate for Scotland.
“Drugs remain the most significant issue that homeless people face in regard to risk of sudden death”Robin Burgess
“We have real areas of poverty here and, in those most deprived areas, drug use is huge,” Ms Bermingham says. “We see a lot of people who have experienced trauma in their lives and struggle with their mental health.”
A big problem in Scotland and elsewhere is the increased use of street valium. Known often as ‘street blues’, many areas have been flooded with the cheap drug. Earlier this year, the NHS, police and city council in Glasgow issued a joint warning amid fears that the drug had contributed towards an “unprecedented” number of deaths over the winter.
Saket Priyadarshi, associate medical director at NHS Greater Glasgow & Clyde Addiction Services, said at the time that people often do not know what they are getting when they buy the pills.
“When people buy street blues, they do not know what is in the pills,” he said. “The quality and dosage can be very variable. People might think they are taking diazepam but it may be other much more potent benzodiazepines such as etizolam. The use of this drug in particular is associated with severe harm – from non-fatal overdoses and presentations to emergency departments to fatalities.”
In 2017, the Advisory Council on the Misuse of Drugs, which advises the Government on the misuse and harmful effects of drugs, warned that a lack of spending on drug treatment services is “short-sighted and a catalyst for disaster.” But, its warning was not heeded.
Research by the cross-party parliamentary group for children of alcoholics found that more than half of local authorities in England cut budgets for drug and alcohol treatment last year. The charity Release is calling on the Government to declare a public health emergency to tackle the crisis of drug-related deaths.
Back in Northampton, as in other towns, the local homeless community and support services continue to mourn and remember the people they have lost. The causes of death are varied, but it is believed that addiction has played a role in a significant number of them.