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Health-focused line on drugs misuse would save lives and money

Issue is now a public health emergency and needs similarly large-scale solutions including decriminalisation, say MPs

Louise Prime

Wednesday, 23 October 2019

The government should consult on the decriminalisation of drug possession for personal use from a criminal offence to a civil matter, and invest the money saved from the criminal justice in prevention and treatment to save lives and provide better protection for communities, MPs have recommended. They said a health-focused and harm-reduction approach would not only benefit those who are using drugs, but would also reduce harm to and the costs for their wider communities – and they called for responsibility for drugs policy to move from the Home Office to the Department of Health and Social Care.

The Commons Health and Care Select Committee this morning published its first report on drugs policy*. MPs pointed out that drug-related deaths in the UK, the vast majority of which involve opiates, have escalated to their highest ever levels, placing the UK near the top of all European countries, and more than three times the European average – in England in 2018 there were 2,670 deaths directly attributed to drug misuse (overdose), an increase of 16% since 2017; and Scotland has by far the highest rate in Europe. But even this figure, they said, underestimates the true harm caused by illicit drug use and would probably be about doubled if it took into account other causes of premature death. They commented: “This issue has now escalated to the proportions of a public health emergency, and the scale of the problem the UK faces requires similarly large-scale solutions.”

They also noted that problematic drug use is concentrated in areas that suffer from poverty and multiple deprivation, so the pressure is on areas that have the least capacity to respond to them – and although poverty and lack of opportunity do not inevitably lead to drug use, they “can drive experimental use onto a higher risk of dependency”.

The committee reported that the overall cost of illicit drug use is estimated to be about £10.7 billion per year. But although there is a considerable cost-benefit to investing in drug treatment – with every £1 spent on treatment estimated to save £4 – spending on drug treatment has fallen by nearly 30%, and they said police services and NHS trust leads had all told them of the profound effects of cuts to drug treatment systems. They noted: “We have heard that clear, evidence-based guidelines exist for drug treatment services, but that current practice does not deliver them.”

They called on government and other policy makers to:

  • implement their recommendations without delay
  • take holistic, non-judgemental harm-reduction approaches that facilitate access to services
  • make available sufficient funding to ensure that heroin-assisted treatment in a supervised clinical setting (“proven to be both clinically- and cost-effective as a treatment for a small number of people”), “life-saving” naloxone treatment, and needle and syringe exchanges are accessible to all those who could benefit from them
  • introduce on-site drug checking services at festivals and in night-time economies
  • review the commissioning of drug treatment services to consider how they should be strengthened to enable them to co-ordinate and deliver the much-needed improvements to drug treatment services as effectively as possible
  • improve existing drug treatment services, and extend and develop harm reduction initiatives
  • develop and fund a comprehensive package of education, prevention and support measures focused on prevention of drug use amongst young people
  • improve the unacceptably high rates of drug-related deaths by explicitly reframing drug use as a health rather than a criminal justice issue
  • consult on decriminalisation of drug possession for personal use, by changing it from a criminal offence to a civil matter.

They concluded: “Every drug death is avoidable…

“We recommend a radical change in UK drugs policy from a criminal justice to a health approach. A health-focused and harm-reduction approach would not only benefit those who are using drugs but reduce harm to and the costs for their wider communities. Responsibility for drugs policy should move from the Home Office to the Department of Health and Social Care…

“The first priority in developing a comprehensive response to drugs must be to invest in existing drug treatment services, and extend and develop harm reduction initiatives. The government also needs to fund a comprehensive package of education, prevention and support measures focused both on prevention of drug use amongst young people, and on improving the life chances of people who are recovering from drug use.”


*Drugs policy. A report prepared by the Commons Health and Care Select Committee, 23 Ocotber 2019.

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