Drug-related Deaths

Charlotte Nichols Excerpts

Wednesday 5th November 2025 Commons Chamber

[Charlotte Nichols (Warrington North) (Lab)]

I extend my thanks to Mr Speaker for providing the opportunity to discuss the crucial matter of drug-related deaths. I declare an interest as the unremunerated chair of the Centre for Evidence Based Drug Policy, a think-tank in this policy space. The Office for National Statistics reported last month that deaths related to drug poisonings have increased for the 12th consecutive year, and have consequently reached an all-time high once again. The ONS reports that in 2024, there were 5,565 deaths related to drug poisoning in England and Wales, with just under half of those confirmed to involve an opiate. Continuity is therefore not a strategy; it is a guarantee of further avoidable loss. Every single one of those lives mattered, and every single one of those deaths was preventable.

Eight months ago, a similar debate was held in Westminster Hall on the topic of preventing drug-related deaths, to which the Minister responded. Though it was a well-attended debate, during which Members from across the House called for the expansion of harm reduction and evidence-based measures, I am afraid to say that, since then, limited progress has been made in advancing drugs policy to limit the unspeakable further loss of life in our constituencies.

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

Stoke-on-Trent has the highest number of drug-related deaths in north Staffordshire. Synthetic cathinones, colloquially known as monkey dust, are used in Stoke-on-Trent to an extent not seen elsewhere in the country. Does my hon. Friend agree that more needs to be done to battle the scourge of monkey dust in Stoke-on-Trent?

[Charlotte Nichols]

I absolutely agree. There are huge regional disparities in drug deaths across the country, and a regional approach need to be taken to tackling them.

While I appreciate that drugs policy and legislation do not fall under the Minister’s departmental remit, I am happy to see her here, as the drugs-related deaths crisis is primarily a public health issue, and must be treated as such if we are to avoid repeating the same mistakes of the last 50 years.

[Jacob Collier (Burton and Uttoxeter) (Lab)]

I am proud to be a patron of Burton addiction centre, a residential rehab centre in my constituency. It is calling for a 2% target across the nation. Does my hon. Friend agree with that target for residential rehab? Perhaps the Minister would like to visit some time, when she is able to.

[Charlotte Nichols]

I completely agree about the role that rehab facilities can play in supporting people into recovery, and about the need for proper, consistent funding from the Government.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for bringing forward the debate. I congratulate her on the campaign, and on her words to the House on the issue. We all greatly admire what she does, and thank her for it. In Northern Ireland, there were 169 drug-related deaths in 2023. That was an increase of 47% on the decade before, and it proves her point that the issue is not specific to her constituency; unfortunately, this happens everywhere. Does she agree that the tactics we have in place are not addressing the growing prevalence of drug abuse, and that not only this Government but the devolved Governments must work to save the precious souls who are passing away?

[Charlotte Nichols]

I thank the hon. Gentleman for his intervention; without it, it would not be an Adjournment debate. I completely agree. The deaths that I am talking about today are drug poisonings in England and Wales only, but if we look at drug deaths in Scotland and Northern Ireland, and at deaths related to alcohol and despair, we see that drug poisonings in England and Wales are a very small part of a huge issue in every part of our United Kingdom.

[Kirsteen Sullivan (Bathgate and Linlithgow) (Lab/Co-op)]

I thank my hon. Friend for securing this important debate. Scotland has had the highest number of drug deaths in Europe for seven years in a row; there were 1,017 in 2024. Does she agree that cuts to funding for rehabilitation facilities and drug and alcohol support services undermine the holistic, comprehensive approach needed if we are to bring down the number of drug deaths, and to give hope to those living with addiction, and to their families?

[Charlotte Nichols]

The number of drug deaths in Scotland is stark, and it underlines the fact that the issue affects every part of the UK. We know what we need to do to start addressing it. I welcome the recent Scottish Affairs Committee report, which I will mention later.

I have said before that putting drugs within the Home Office’s ministerial purview is putting the issue in the wrong place, so I am very happy that a Health Minister is here to respond. The current approach is rooted in the belief that we can simply arrest and imprison our way out of this. Despite the death toll rising every year in the six years that I have been doing this job, the Home Office seems to show not just a lack of curiosity but hostility towards harm reduction measures. My overarching question today is: will the Government finally take an evidence-based stance on drugs policy to reduce the immense harm that the status quo causes in our constituencies? Will the Minister work across Government to bring forward necessary changes to the Misuse of Drugs Act 1971 and deliver a fit-for-purpose, public-health-led approach to drugs across the UK, saving thousands of lives?

[Anna Dixon (Shipley) (Lab)]

I thank my hon. Friend for securing the debate. In the Bradford district, there were 70 drug-related deaths in 2023. I agree with her that we need to take a different approach to tackling the problem, and it must be a public health approach. The UK could learn much from countries like Portugal, which has gone a long way towards adopting such an approach to drugs and drug-related deaths.

[Charlotte Nichols]

I absolutely agree. Later, I will try to develop my argument for that kind of approach, which we could take here but do not.

As a Parliament and as a society, we may have inadvertently come to accept the yearly statistics, and have perhaps not given them the necessary thought, but I stress that there are cost-effective solutions that could save the taxpayer money and save the lives of our constituents, while taking money out of the pockets of exploitative, organised criminal gangs.

I am afraid to say that the problem may be far worse than is recognised. A recent report by King’s College London indicates that there has been a severe under-reporting of drug-related deaths over the past 15 years. The researchers found that drug-related deaths have been under-reported by 30%, and opioid-related deaths between 2011 and 2022 were found to be 55% higher than recorded, putting the estimated number of opioid-related deaths in that period north of 39,000.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

I am grateful to my hon. Friend for securing this debate. She will be aware that many of those who have died from complications and overdoses related to opioids died on their own. That reflects the social isolation that so many experience when they become addicted to drugs. Does she agree that it is incredibly important that the social isolation of those seeking to move beyond addiction is broken through, and will she join me in thanking organisations like Jungle in my constituency, which seek to provide companionship and support for those who are trying to move beyond addiction?

[Charlotte Nichols]

My right hon. Friend is exactly right. The clearest way to recovery is with companionship and support—there is no path to recovery without that—and I of course give credit to the organisation she mentioned that is doing such fantastic work in this space, as we were discussing earlier today.

The implications of the under-reporting of drug-related deaths are that the problem is far worse than previously thought and the decision to cut funding to services under the previous Government was based on flawed figures. The National Audit Office reported that between 2014 and 2022 there was a 40% reduction in real-terms spending on adult drug and alcohol services, so I do not think it is a coincidence that the Office for National Statistics has reported a near doubling in drug-related deaths since 2014, and that the number of deaths only rises every year.

It is clear that the problem has been made substantively worse by under-investment by the previous Government. We can all acknowledge that, but acknowledgment without reform is meaningless. Persisting with failed, punitive policies will only deepen a crisis that already ranks among Europe’s worst. Now is the time to show the difference a Labour Government can make by putting in place harm-reduction policies that will start to undo this extensive damage.

As I mentioned previously, and I will repeat again because it is important, near half of all drug-related deaths registered in 2024 were confirmed to involve an opioid. In addition, this year’s ONS report found that the number of deaths involving nitazenes—a group of highly potent synthetic opioids—almost quadrupled from the year before. This marks the beginning of a new stage in the drug-related deaths crisis. As we have seen across the Atlantic, once those synthetic opioids take hold, it becomes all the more difficult to limit their devastation.

I welcome this Government’s changes to the human medicines regulation that further expanded access to naloxone, the lifesaving opioid antidote administered in the event of an overdose. Indeed, naloxone plays a vital role in the fight against drug-related deaths. However, further change is necessary and naloxone should be available rapidly and reliably in every community pharmacy in the UK, so that it can be quickly accessed in the event of an overdose.

It is important to note that naloxone cannot be administered by the person overdosing and must instead be administered by someone else. That necessitates further education on the existence of naloxone, and how and when to use it, with people who may come into contact with people who use opioids, including frontline service workers, such as police officers and transport workers, and the loved ones of those struggling with addiction.

The period immediately after release from prison or discharge from hospital is when risk peaks. Opt-out pathways for naloxone distribution should be the norm. Take-home naloxone on release or discharge, same-day linkage to community treatment and a clear pathway for handover care are essential for people struggling with substance use disorders.

As of December 2021, the Government estimated the annual cost of illegal drug use in England to be £20 billion. Around 48% of that was attributed to drug-related crime, while harms linked to drug-related deaths and homicide accounted for a further 33%. Notably, the majority of those costs are associated with the estimated 300,000 people who use opiates and crack cocaine in England.

Dame Carol Black’s landmark 2021 review of UK drug policy found that for every for every £1 spent on treatment, £4 are saved through reduced demand on the health and justice systems. In the face of rising fatalities and a cost of living crisis, failing to scale treatment and harm-reduction measures is both morally indefensible and financially illiterate. If we want to realise that four-to-one return, we must provide long-term funding for organisations delivering services. Drug treatment services can only deliver if they are able to retain staff, train consistently and scale according to demand.

[John Slinger (Rugby) (Lab)]

I commend my hon. Friend for bringing this important debate to the House. Does she agree that organisations such as Change Grow Live, which I have visited in Rugby, are doing superb work with people as they recover after the problems that they have been facing, and that it is incumbent upon all of us to do everything we can to encourage the Government to ensure that those organisations get the funding and support they need to do that important work?

[Charlotte Nichols]

My hon. Friend is exactly right: Change Grow Live is a fantastic organisation. Multi-year funding schemes with clear outcome metrics, such as faster time for treatment, improved retention and improved naloxone coverage, will make a difference in bringing down the figures I have talked about. That is the path out of this crisis.

I recently received a letter from my hon. Friend the Minister for Policing and Crime stating she could not support overdose prevention centres because of concerns about organised crime supplying the drugs there. Overdose prevention centres are a frontline, evidence-based intervention that save lives and public money, reducing ambulance call-outs and A&E attendances, cutting public injecting and needlestick injuries, and creating a bridge into treatment. I recognise and share the Minister’s concerns about supply but, with or without such centres, people will use the same drugs, either in alleyways and stairwells or in safe hygienic settings where sharps are disposed of, and where staff can intervene and build relationships that can be the foundation for recovery from addiction.

The Scottish Affairs Committee recently published a report into problem drug use in Scotland and Glasgow’s safer drug consumption facility, and it is interesting to note the call for legislative action from the UK Government and Parliament and the fact that they seem to share my frustration with the Home Office’s ideological rather than evidence-based approach on safer drug consumption facilities.

In written correspondence to me, my hon. Friend the Minister for Policing and Crime also maintains that supplying essential safer inhalation equipment would contravene current legislation, and that the Government are unable to support such a provision or to provide a legal pathway to address this. Encouraging drug users to change their method of consuming drugs from injecting to inhaling can be an important harm reduction step, yet while supplying clean hypodermic needles is exempt under section 9A of the Misuse of Drugs Act 1971, the Government continue to support a policy of criminalisation of potential providers and users of safer inhalation equipment.

[Patricia Ferguson (Glasgow West) (Lab)]

I am grateful to my hon. Friend for taking an intervention, and indeed for bringing forward this debate. As she has referenced, the Scottish Affairs Committee has done some work on this issue and has visited the safer drug consumption room in Glasgow, but it has also looked at facilities in Norway and Lisbon. The disappointment we have is that at the moment the Thistle operates under the prosecutorial discretion of the Lord Advocate in Scotland and that could continue indefinitely—she has made that clear—as could her permission for other centres to open. We need a change in the legislation that would allow such centres to be set up across the country if necessary. There is going to be a three-year assessment of the Thistle, and if that assessment comes up with the results that we think it might, then surely that evidence should be used to inform Government policy. Our particular disappointment is that the Government seem not to think that is relevant.

[Charlotte Nichols]

I absolutely agree and I took a note from that report:

“However, it was clear from the Minister’s evidence that the Home Office will not make legislative changes, even if the evaluation finds that the facility has been effective in meeting its aims.”

That is ideological, not evidence-based, which is why I believe the Home Office is fundamentally incapable of dealing with drug deaths and drug harm in our communities.

[Lewis Atkinson (Sunderland Central) (Lab)]

I commend my hon. Friend for securing this really important debate. Does she agree that even if the Home Office does not agree with changing legislation, more could be done within existing legislation, for example with drug checking facilities, of which a very small number are already licensed by the Home Office? That would allow those consuming drugs to have clarity about what they are consuming, but it would also provide important intelligence to the authorities about the drugs that are in circulation to inform the response of health and other authorities.

[Charlotte Nichols]

I absolutely agree that more can be done without the need for a change in legislation, but it is concerning that the Home Office does not look at legislation. Despite everything that was said in the Home Affairs Committee’s inquiry on drugs in the last Parliament, for example, which made very clear how outdated our current legislative framework is, there does not seem to be curiosity about fixing this. I completely agree with what my hon. Friend said about treatment and testing, particularly at large-scale events and festivals, because that can be a lifesaving intervention.

It is both bizarre and frustrating that the Home Office actively chooses not to take some of the measures it could take on safer drug consumption facilities and safer inhalation equipment. That is something that is very much within its gift. We cannot continue to hide behind a 1970s statue, periodically tightened but rarely reviewed, that has too often exacerbated harm. If the House wishes to take money out of criminal markets, I ask the Minister to work across Departments to expand diamorphine-assisted treatment, which is proven to be effective and cost-saving both here and abroad, to provide dignified, supervised care for those with the most entrenched opioid dependence. After all, it was in this country that that type of world-class treatment originated, with the publication of the Rolleston report in 1926.

I have focused much of my remarks on opioids, but in the short time remaining I will touch on some other substances. The first substance is cocaine, with 1,279 deaths involving cocaine registered in 2024, which was 14.4% higher than in the previous year and 11 times higher than in 2011. That is perhaps not surprising, given that the UK is the largest consumer of cocaine per capita in Europe and the second-largest consumer of it in the world, according to the OECD. The National Crime Agency estimates that in 2023, England, Scotland and Wales consumed 117 tonnes of the drug. It is worth mentioning that around 52% of homicides are drug-related, and there is evidence that cocaine use is fuelling domestic violence. In 2023, a pilot scheme found that 59% of domestic abuse offenders arrested in seven police force areas tested positive for cocaine and/or opiates. The status quo is not working.

The second substance is ketamine. While ketamine deaths are relatively low, with 60 deaths, the stats are again trending the wrong way, as is the prevalence of the drug in our communities. I refer Members to the rate of past-year ketamine use among 16 to 24-year-olds, which has doubled since the drug was reclassified from class C to class B in 2014. We need a fit-for-purpose national drug policy, not a platform for point scoring or performative “tough on crime” posturing while harms continue to mount.

There is much talk at the moment about the reclassification of ketamine to a class A drug, as if that is some sort of panacea, despite the fact that deaths from heroin and cocaine—both class A substances—have been increasing year on year. It is as though the Home Office thinks that making something that is already illegal more illegal is somehow worthwhile. In the light of that, I have tabled a number of questions recently on the effectiveness of the reclassification. I am genuinely concerned that no analysis of that move has been made, and the intention is clearly to ramp it up further. Other policy levers are available. In particular, an emphasis should be placed on tackling the mental health crisis among our young people, which can make the dissociative effects of ketamine an appealing proposition.

Throughout this debate, I have sought to lay out the extent of the problem and to offer realistic, cost-effective and constructive measures that could save this country billions of pounds, not to mention thousands of lives. There are solutions to these issues, and the UK has both the expertise and the capacity to lead in this area. We must simply find the political expediency and courage to take bold action and do what is right. We cannot govern as the careful custodians of a failed Conservative settlement; we must replace it.

This is a solvable problem, and it is clear what works. With clear guidance, consistent commissioning and the courage to back frontline services, we can save lives, support families and ease pressure on our NHS. We will not solve this problem overnight, but I hope to come back next year with the figures at least trending in the right direction. No amount of warm words or hand-wringing in this place will absolve us of our collective responsibility if we do not take the steps necessary to do that now. We promised the country change, and it is now time to see it.