Chief Exec Blog - A litmus test for how we are caring for the most vulnerable in our society

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6 August 2018

Phoenix Chief Exec, Karen Biggs, blogs in response to the latest Office National Staistics report on drug related deaths in England and Wales.

A litmus test for how we are caring for the most vulnerable in our society

Today the Office of National Statistics (ONS) have released their annual report on the number of deaths resulting from Drug Poisoning in England and Wales. The figures, although they seem to be stabilising, are still the highest since records began in 1993. For those of us working in the sector it won’t be a surprise. We know the sad truth of the impact of every one of those deaths on mums, dads, children, siblings and friends.

The ONS reports the number of people whose deaths have involved legal and illegal drugs. It includes death from suicide and accidental overdose and other deaths relating to the use of illegal drugs and the impact long term use has on the body.

Last year as Chair of Collective Voice I spent 6 months chairing a working group of intimidatingly bright academics, clinicians and practitioners from across NHS and Third Sector organisations. We studied the facts, reviewed our own practice, shared lessons and experiences, tested and retested assumptions and advice and arrived at a set of good practice principles to help the sector keep more people alive.

This is what I learnt;

Fact 1.

There aren’t more people using drugs but there are more very vulnerable people using drugs that have multiple and complex needs

The Home Office Crime Survey shows that drug use has remained fairly stable over the last few years and indeed is significantly lower than in the 90s. So fewer are people using drugs but more people are dying than ever before.

Why? Because there are groups of people who use drugs that are vulnerable and isolated and find it hard to get the help they need.

  • Men over 40 who have been using opiates for a long period of time - The impact of that long-term use on their bodies means they have very poor physical health.

  • Women who use drugs feel acutely the stigma society places on them - It delays them asking for help and increases the isolation they experiencecompounded often by trauma or abuse

  • The transition from prison is a risky time for people with a history of substance misuse - They find it hard to get the help they need on release that keeps them safe and motivated

  • People in parts of the country that experience higher levels of social deprivation - All health and social care agencies are stretched and people fall through the gaps

Fact 2.

We have a wealth of evidence based practice that keeps people safe.

We know treatment is a protective factor and that is because we have a wealth of evidence based practice that tells us how to deliver treatment. The Clinical Guidance (the sector manual) tells us how to deliver treatment, clinical and psychosocial, in a safe and effective way.

But there are a significant number of people dying who haven’t had any contact with treatment services.

Fact 3.

There are many national and local barriers that stop us applying our skills and knowledge to those most in need.

  • People in most need require time, they need specialist highly skilled staff to support them and they need agencies to work together to remove barriers to access to help.

  • People who experience stigma need to see stories and examples of how their lives can be better, they need advocacy to support them to get the treatment they need

  • People who have lost hope need expert tailor-made responses across clinical and psychosocial services to keep them safe and build motivation


Many will use the report today to make their own political points and pursue their own view of the world. We are a passionate driven sector.

But the very simple truth is there have been cuts in substance misuse funding of 30% over the last 5 years – similar to cuts in mental health services, criminal justice services, homelessness provision and specialist services for women.

You can’t do that without consequence and the most extreme consequences of those cuts across all of those services is that people die.

The drug poisoning statistics are the litmus test for how we as a society are caring for our most vulnerable.


Phoenix Futures is a registered charity in England and Wales (No 284880) and in Scotland (No SCO39008); Company Limited by Guarantee Number 1626869; Registered Provider of Social Housing with Homes England (H3795).