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NHS chief says latest drugs study ‘challenges’ whole region

Dr Paul O'Reilly, doctor at the Dr Hickey surgery, London.  Dr O'Reilly is also a priest.
Dr Paul O'Reilly, doctor at the Dr Hickey surgery, London. Dr O'Reilly is also a priest.

A shocking report highlighting the extent of Fife’s drugs problem should “challenge” everyone living and working in the region, it has been suggested.

NHS Fife chief executive George Brechin made the comment after the Fife Alcohol and Drug Partnership (ADP) published new figures which revealed a slight fall in the number of drug deaths over the past three years, yet flagged up the severity of the situation addiction services are faced with on a day-to-day basis.

The report confirmed that the number of deaths resulting from a cocktail of illicit drugs dropped from 31 in 2008 to 26 in 2009 and then again to 24 last year-perhaps reflecting the efforts of the ADP and other agencies in trying to tackle the issue.

Nevertheless, the findings yet again paint a worrying picture of drug misuse in Fife and highlights the real risk that substance abuse poses to people’s lives.

In light of the report, agencies have pledged to work more closely with the ambulance service to provide improved follow-up support to people who have non-fatal overdoses, while steps to ensure the “safe and effective” prescribing of methadone will be pursued.

Relatives and friends of drug users are also likely to receive better training to recognise the signs of an overdose, which could see them learn proper CPR procedures and even in high-risk population areas told how to administer injections of Naloxone, the drug used to counter the effects of an overdose.

Following on from the report, Mr Brechin said, “While it is individuals who determine their own behaviour, it is all of us who set the context for their decisions.

“The people whose deaths are described in this report cannot be named, but they are sons and daughters, brothers and sisters, mothers and fathers, relatives and friends.

“Each death has left mourners behind, and has thrown away the potential of a unique human being. Reading the description of a ‘typical’ casualty reminds us what we need to do to prevent further tragedies.Information analysisThe ADP report analysed information under a number of headings, such as drug use, physical and emotional well-being, and contact with services prior to death.

The mean age of the victims, who were mostly male, is just 32, and most were also said to be physically and mentally unwell.

The majority of drug deaths occurred in the presence of others, who were in all cases known to the victim, and most involved a lethal cocktail of substances the four most common of which were benzodiazepines, heroin/morphine, methadone and alcohol.

All except one victim were known to at least one service in the five years prior to their deaths and more than 90% of victims had been arrested in the past, while more than half had been arrested at least once in the six months prior to their passing.

The need for relatives and friends to be better trained on what to do should their loved one overdose is stark though, after the report found that in many cases the victim was simply believed to be sleeping at the time of their death, thus delaying any possible intervention.

Bystanders in almost two-thirds of the cases attempted CPR, although this was often partial and had to be instructed by ambulance crew over a phone.

Although there were 81 drug deaths in Fife between 2008 and 2010, last year’s figure represented a 7.7% decrease on the previous year and also put Fife’s average drug death rate below the Scottish average.

Since the last three-year report, which looked at the period between 2005 and 2007, Fife ADP invested in several initiatives aimed at cutting the number of overdoses-both fatal and non-fatal – across the region.

Continued…

An overdose prevention co-ordinator was recruited in 2008 who led the way to improve overdose training to service users, their families and service providers, while improved communication between relevant agencies has prompted a weekly exchange of information between the Scottish Ambulance Service and the Fife Addiction Service.

A review of methadone prescribing was also carried out to ensure “optimal” rather than high dosing for the treatment of opiod dependence was practiced Fife-wide.

However, the study also found that prescribed painkillers such as oxycodone, morphine and tramadol are being diverted into the illicit market.

Mr Brechin’s comments were echoed by Chief Superintendent Alistair McKeen, from Fife Constabulary, who hailed the reduction in deaths but stressed there is no room for complacency.

He added, “The emergence of new drug trends is picked up on by the police and drugs agencies pretty quickly, and the report confirms that these drugs are proving to be a feature in some drugs deaths.

“Drug services work hard to warn users of the dangers and modify their drug-taking behaviours in order to stay safe and save lives.”

Alistair Gaw, head of service at Fife Council for children and families and criminal justice, said all of the partners involved in cutting drug deaths had agreed an action plan aimed at further reducing the risk of drug death in the future.

“All deaths from drug misuse are a tragedy for the families concerned,” he said.

“Every day the social work service works with our partner agencies to minimise the harm caused by substance misuse to the individuals themselves and their families.

“While we welcome the reduction in these tragic incidents we will continue to strive to reduce substance misuse and support recovery.”