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FPH President calls for urgent government action on drug deaths in BMJ article

Professor John Middleton, President of the Faculty of Public Health (FPH), has warned that the national drugs policy is failing and has called for new approaches to the commissioning and delivery of drug treatment services as drug-related deaths in England and Wales continue to rise.

Drug-related deaths increased by 65.7%, and opioid related deaths by 107%, in England and Wales between 2012 and 2015, according to the Office for National Statistics.

In an article co-written with independent health policy specialist Sara McGrail and independent consultant in substance misuse Ken Stringer in the British Medical Journal (BMJ), Professor Middleton says systemic and policy issues must be urgently addressed. These include the massive changes in national policy, commissioning and treatment systems since 2010, such as the government's change of focus from harm reduction to abstinence.

They also point out that the Public Health Outcomes Framework introduced the key measure of success as the number of people successfully discharged from drug treatment programmes who were abstinent from all substances.

This is despite research showing that drug users who receive pharmacological and psychosocial interventions have a 50% lower risk of death compared with those following abstinence regimens.

While acknowledging “some welcome suggestions” in a recent Public Health England report on the rise in deaths, the authors say that more needs to be done.

They recommend expanding options for people seeking help and ensuring treatment is personalised and effective, as well as substantial take up of naloxone for opiate users. They say that investment in safer injecting advice, access to clean injecting equipment and immunisation programmes should be prioritised.

Drug consumption rooms should be developed, and new guidelines on opiate substitution therapies should be followed, they explain. A forensic early warning system informing drug users and services of changes in the quality and type of street drugs must be established.

The NHS and local authorities need to commission and plan services jointly and work together to ensure that hospital specialists are teamed up with primary care and specialised treatment services.

Efforts to provide drug users with access to better housing, jobs and incomes that support recovery - an important aim of any drugs strategy - are not helped by austerity policies, they add.

"The lessons of a failing national policy need to be learnt," they conclude.

Read the article in the BMJ here.

Written: 18/10/2016 , last modified: 27/10/2016