This week the ONS published its drug deaths statistics for 2019, bringing into sharp focus a reality that is sadly all too familiar to organisations who support people experiencing addiction.

At Changing Lives, we help over 14,000 people in their most challenging of circumstances to change their lives for the better each year. An important part of this work is to support people to help them make the transition from addiction to long-term recovery.

In our experience, addiction is often the result of difficult life experiences such as discrimination, poverty, exploitation and abuse, sometimes manifested in experiences of homelessness, addiction and offending. We believe in the importance of therapeutic, trauma-informed recovery services focused on helping people deal with the underlying trauma at the root of their addiction and build supportive networks to sustain their recovery.

Here, we talk about our experiences of what is happening behind the headlines and set out our aspirations for helping people to achieve long-term recovery from addiction.

Deprivation

Our services support some of the most deprived communities in the north of England, so it is particularly striking that for the first time, the statistics show that rates of drug poisoning deaths have been highest in areas of greatest deprivation over the past decade. Within this context, we also learn that the North East has far higher rate of deaths relating to drug misuse than all other English regions, at 95.0 deaths per million people compared to 76.7 deaths per million nationally. Many, although not all, of these are the result of addiction.

This supports our strong belief that recovery from addiction is not simply about addressing the ‘problem’ of substance misuse, but something that must recognise and respond to the wider context of people’s lives. A person’s ability to achieve long-term recovery is based on their recovery capital – the networks of support and access to opportunities within their communities that will enable them to bring about sustainable change.

Age

The statistics also show for the first time that within the most deprived communities, drug poisoning deaths of people aged in their forties is at least 5.5 times higher than the national average. This is comparable with trends across England and Wales, in which we are seeing an ageing population of people in long-term treatment, perhaps accessing a regular prescription but not able to make progress towards recovery.

We believe that this is because recovery and addiction services have been significantly challenged in recent years by reductions in local authority funding and the loss of other public services, and increased competition among providers seeking to secure contracts of diminishing value.

At Changing Lives, we recognise the vital role of clinical interventions to help people manage their addiction in the short-term and minimise their exposure to harm, but believe that people must be supported by appropriate trauma-informed services to help them overcome their addiction and achieve their potential.

Gender

A further striking finding from the statistics is that while drug poisoning deaths are generally lower among women than men, deaths involving cocaine have increased for the eighth successive year (7.7% for male deaths and by 26.5% for female deaths). While our focus at Changing Lives is on supporting a person with their experiences of addiction, regardless of the substance, this raises important questions about the support that is currently accessible to women.

Very often, we find that women are reluctant to engage with professionals because they are fearful of the repercussions, such as the removal of their children. It is also striking that almost all women referred to our residential recovery centre have experienced domestic abuse, reflecting the complexity and trauma of their circumstances. These trends tell us that we must find new and better ways to support women who are experiencing addiction, providing services that are gender-informed and involving other professionals such as social work and health as part of this journey.

Time to change the system

The ONS statistics provides further compelling evidence that current approaches to supporting people who are experiencing addiction do not go far enough. In our recent evidence submission to Dame Carol Black’s Independent Review of Drugs, we highlighted that our concerns that budget reductions across the sector are making it more difficult to help people make changes in their lives and reach their recovery goals. But we also looked to ourselves as a sector – nationally, success rates are worryingly low for people who present with a primary opiate dependency, at around 5 per cent.

This tells us that there is a pressing need for the addiction and recovery sector, and wider stakeholders including local and national level government, to come together to deliver real change. We hope that the Black Review will be an important means of achieving this and have called for:

  • Greater investment in trauma-informed recovery services focused on helping people deal with the underlying trauma at the root of their addiction and build supportive networks to sustain their recovery.
  • More flexible, longer-term and more rounded definitions of what constitutes ‘successful completion’ of drug treatment, taking account of the whole person and the wider factors in their lives that may have contributed to their addiction or are serving as barriers to their recovery.
  • From commissioning through to delivery, integrated and flexible services that recognise and respond to the needs of the whole person. This may include co-commissioned services spanning housing, employment and addiction, and joint working for whole health improvement.
  • Shared responsibility across central government for engaging with treatment and recovery through a new Addictions Strategy, characterised by a culture of learning through innovation and taking a holistic approach to helping people achieve long-term recovery.
  • Local services that are accountable to their communities and the people they serve, through the involvement of people with lived experience as valued and equal partners in creating successful services.
  • As part of the Government’s levelling up agenda, a strong focus on inclusive growth to tackle the deprivation in towns and cities across the north that is so often a driver of addiction and other harms.

The statistics released this week are devastating, at the heart of which is huge personal loss and tragedy, both for individuals and for their families and communities who must bear the consequences of losing a loved one, a friend or a neighbour. Together, we must act now to ensure that everyone who wants to, is able to access the support they need to overcome addiction and move towards a flourishing life.

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