Prevention of Drug Deaths

Rachael Maskell Excerpts

Thursday 27th March 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered the prevention of drug deaths.

I thank all Members for being here at this well-subscribed debate. With that in mind, I will try to work to a certain timescale to ensure that everyone gets in, as I understand that there are nine speakers. Preventing drug-related deaths is an issue that touches communities across all four nations of this United Kingdom.

It is a pleasure to see the Under-Secretary of State for Health and Social Care, the hon. Member for West Lancashire (Ashley Dalton) in her place, and I look forward to her response. I said to her beforehand that there is another debate in the main Chamber, but even I cannot be in two places at the one time; it is impossible. This is the priority, and that is why I am here.

Over the last decade, drug deaths have increased by 85% in England and Wales, 122% in Scotland and 42% in Northern Ireland. It is an unacceptable situation by any measure. Northern Ireland has the second highest drug-related death rate in the UK, nearly five times the European average. Each one of those deaths represents a profound tragedy. The tragedy is not just the person who dies; it is also the families who are affected.

I stress that each and every one of those deaths is preventable, and the situation demands urgent action. Recent data from the Northern Ireland Statistics and Research Agency paints a deeply concerning picture. Drug-related deaths in Northern Ireland have risen again, albeit after a slight decrease in previous years. Behind the numbers are human beings—fathers, sons, mothers, sisters, daughters. Those are the people affected. Most alarmingly, young adults aged between 25 and 34 are dying at the highest rate. Even more stark is the fact that people in our most deprived communities are five and a half times more likely to die from drug-related causes than those in our least deprived areas.

My constituency of Strangford has not been immune to this crisis, but we have managed to stay resilient in the face of it by maintaining lower drug-related death rates compared with any other area in Northern Ireland. That is no accident; it reflects the dedication and compassion of local drug treatment service providers who, despite limited resources, tirelessly support our most vulnerable citizens. I put on the record my sincere thanks to them for their perseverance and expertise. Without their dedicated efforts, countless more lives would have been lost.

Frontline drug treatment providers in Strangford speak passionately about the daily challenges they face, and there are three key areas I wish to highlight as priorities for action. First, drug treatment service workers in Strangford stress the urgent need to integrate mental health support with drug treatment services. Drug misuse often masks deeper issues of trauma, anxiety or depression. In Northern Ireland, with our 30-year conflict, history has left a lasting impact on the current generation.

The problem is pervasive across the United Kingdom, however. Research indicates that 70% of people in community drug treatment have reoccurring and co-occurring mental health needs. An investigation into coroners’ records of people who died from drug poisoning found that a mental health condition was noted in at least two thirds of those cases, yet only 14% of the individuals were in contact with mental health services. A quarter had a history of suicide attempts, rising to 50% among those whose deaths were classified as suicide. Mental health is the No. 1 issue when it comes to drug deaths across this great United Kingdom.

The healthcare system and local authorities share a clear responsibility to provide comprehensive support. Far too many who suffer from both mental health issues and substance misuse are excluded from vital services. It is deeply concerning that mental health services often turn away individuals because of their substance use— I put it on the record that I think that is wrong—while drug and alcohol treatment services cannot accommodate those who are deemed to have mental health conditions that are considered too severe.

The cycle of exclusion disproportionately impacts people with serious mental illnesses, leaving some of the most vulnerable trapped between providers and unable to access the care they desperately need. The hon. Member for Liverpool Walton (Dan Carden) made a similar point three years ago in a Westminster Hall debate that I attended. I am pleased to see the Minister in her place, and I understand it is her third Westminster Hall debate as responding Minister. What progress has been made since that debate was held three years ago?

The other critical barrier is stigma. Stigma surrounding drug use isolates people, silences their cries for help and deters them from engaging with essential services and reintegrating into society. That compounds mental health struggles and prolongs their suffering. Let us not stigmatise drug users; let us help them—that is my big request. It is crucial that we challenge harmful attitudes in our communities, in our health services and, indeed, in the Houses of Parliament, among hon. Members and the Government, who have a responsibility. Addressing stigma means recognising that addiction is a health issue and not, as some people might think, a moral failing. I am not being disrespectful to anyone, but that is how I look at it and I hope that others will too.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for securing the debate. The last Government published a paper on this subject, “From harm to hope”, but it fell short of the vision set out by Dame Carol Black for how we get on top of the significant harm that people experience. Does he agree that alongside a public health approach to substance misuse, we need harm reduction units so that people who are drug users can access the care and support that they need to make their first contact with professional services?

[Jim Shannon]

I suspect that the hon. Lady and I agree on many things, and on this point we are also on the same page. I will come to Carol Black’s report and some of its recommendations. The hon. Lady has pre-empted me, but I thank her for setting the scene.

A 2022 YouGov poll found that two thirds of Britons believe that Government do too little to address addiction in our society. I respectfully believe that the Minister and the Government have an obligation to do something about this, because 66% of the nation want something to happen. Perhaps more tellingly, 49% of Britons—almost half—see addiction as a mental health issue that calls for compassionate, health-centred responses. That is very clear. In contrast, only 19% think that addiction should be treated as a criminal matter. That is something to think about. Without addressing the stigma underlying mental health conditions, we cannot hope to tackle drug dependency and its harms effectively. We must end harmful practices; we must ensure that integrated support is available to everyone who requires it; and we must ensure that our mental health care and drug treatment service systems are properly equipped and working with a joined-up approach.

That brings me to my second point, which will be quick, because I am conscious of time. Current practice is ineffective. It prevents services from planning ahead, denies them the security necessary to retain their staff and undermines the long-term progress of their clients. I am not being disrespectful to anyone—that is never my way of doing things—but before this Government came into power, the previous Government took an approach that involved short-term stop-gap budgets. We need something long term, with the continuity necessary to recruit and plan strategically. That is what we should focus on.

An National Audit Office report notes that short-term funding causes

“delays in commissioning services and recruiting new staff”,

leading to service gaps and workforce instability. Those workforces are on the frontline—on the coal quay, as we call it back home—the first person you meet, the first person you see and the first person you need help from. This instability, described by the NAO as a

“de-professionalisation of the treatment workforce”,

damages the quality of care. The NAO identified under- spending of £22 million, with 15% across the treatment and recovery stream. We really have to fix that.

Dame Carol Black’s review called for improved funding and rebuilding of the decimated drug treatment workforce, following the 40% real-terms reduction in funding that we witnessed from 2012 to 2020. She referred to disjointed approaches, struggling staff, increasing costs and decreased funding. Given those challenges, it is no wonder that services are unable to provide the quality that is needed. We must shift to a model in which people feel welcomed and cared for in drug treatment services; in which interventions foster engagement and trust between clients and key workers; and in which we uphold promises to reduce harm, lessen pressure on the health and justice system and ultimately strengthen our communities, helping those whom we represent.

Harm reduction is an essential lifeline for individuals and communities across Northern Ireland, and indeed across this whole great United Kingdom. In Northern Ireland, it is evidence-based and compassionate, and it places people at its very heart, meeting them exactly where they are by providing accessible, low-barrier support services. Harm reduction saves lives by preventing overdoses, reduces the spread of infectious diseases—that happens with those who use needles—and significantly improves both physical and mental health outcomes. Harm reduction does not enable drug use; it enables the saving of lives, the restoration of dignity and the reconnection of people to their communities. That has to be our goal, through the Minister.

The harrowing statistics that I have laid out demand that we revisit the Misuse of Drugs Act 1971, which is now more than 50 years old and has never been formally reviewed. It is time we had a long, hard look at where we are and where we need to be, and moved forward with professional and compassionate methods. The Act restricts many harm reduction interventions that international evidence has shown to be effective, but that we cannot fully implement here. We must ask, in the face of an ongoing and real rise in drug deaths and the undeniable potential for more, whether this legislation remains fit for purpose.

Before the election—I say this respectfully for the record, because hon. Members will know it is not my form to attack anyone—the Prime Minister indicated on the campaign trail that he would not make changes to the drug policy. The point I want to make is that I think it is time we did. I have the utmost respect for the Prime Minister, but I think it is time we had more flexibility and meaningful change to adapt to a changing drug market.

In recent years, the UK has seen a surge in synthetic opioids, a dangerous and highly potent substance peddled by unscrupulous organisations that rob families of fathers, brothers and children. They must be stopped, and we need a drugs policy in place to do just that. It has become clear that simply classifying substances in higher categories or imposing longer sentences is not enough. If it is not enough, we must look at a different way.

Nitazenes, which are up to a thousand times more potent than morphine, have already claimed the lives of hundreds in the UK, and their presence in the illicit drug supply is rising. According to the latest drug-related death statistics, opioids were the most common drug associated with drug-related deaths in Northern Ireland, and I believe those figures are replicated on the mainland as well. If we do not act now, the statistics will only become more devastating.

Dame Carol Black’s review on drugs made some progress, so let us not be churlish. There have been advances and steps in the right direction, but have they gone far enough? I do not believe they have, and others will probably confirm that. The Government recently legislated to expand the provision of the lifesaving drug naloxone, which is used to reverse opioid overdoses. I welcome those changes and understand the need for them, but they are not enough. I am sorry to say that, but we really need to have a new look at the issue. We are falling behind our international partners in tackling the crisis, failing to safeguard our constituents and allowing criminal organisations to profit immensely from their illegal drug trade.

Harm reduction should not be controversial. It is simply about saving lives and mitigating the harms associated with drug use. Historically, the UK led the world in harm reduction, with Liverpool being the birthplace of efforts to reduce drug-related deaths and infectious disease. Every 90 minutes in the UK, someone dies a drug-related death, meaning that during this debate, at least one life will be lost. Only 10 years ago, the figure was one death every two and a half hours. The situation is becoming incredibly serious. We must act now if we are truly committed to ending the crisis, and we must go beyond the medical and behavioural solutions that some have suggested.

Another related issue is the serious concern of death by suicide. The hon. Member for Rother Valley (Jake Richards), who had an Adjournment debate on Monday night, referred to suicide in his constituency. In Northern Ireland, 70% of the suicides are by men, and the majority of them occur in deprived areas. The very thing that the hon. Gentleman talked about in his Adjournment debate is happening in my constituency and across the whole of Northern Ireland. A new standard, BS 9988, has been drafted by people with expertise in the policy area, and comprehensive guidelines will be brought forward to support organisations in developing an effective suicide prevention strategy.

Those are some of the things that I wish to say. I am coming to the end of my speech; I am conscious that nine people wish to speak, and I want to give every one of them the chance to make their contribution.

In Strangford, a local drug treatment service and prevention programme has been designed specifically for the friends and families of people who use drugs. It provides a vital space in which they can support each other, learn from each other and realise that they are not alone—it is important that people are not alone, thinking that the whole world is against them and that they have to try to get through it themselves. It also trains the loved ones in naloxone administration so that they can save a life if necessary, and discusses the risks of drug use and how to mitigate them. Most importantly, it brings the community together in a team effort so that they can put their arms around people. That shared purpose enables them to care for those they hold dear and support them through the challenging journey of addiction. I am told that the response has been overwhelmingly positive.

I tell that story because, despite the darkness of what this debate is about, we also have to see that a light can shine and take us to somewhere we can be better. That is what I want to do. As a country, we must do the same and act collectively with compassion and purpose.

Drug-related deaths are not inevitable; they result from choices made—I say this with respect—in this House. The United Kingdom has the expertise and evidence, domestic and international, to act decisively. We have a moral obligation to safeguard our communities, reduce pressure on our strained healthcare system and spend money responsibly.

I call on the Government and the Minister—the responsibility for responding to this debate is on her shoulders, but I know she will not be found wanting—to prioritise the lives of our most vulnerable citizens, protect the healthcare system, act preventatively against drug-related deaths and commit to a fully funded, evidence-based harm reduction approach. This debate can be the first step in moving us forward, and if we do that I believe we will have done an honourable job on behalf of our constituents.

We must discuss the very difficult issue of drug deaths across this great United Kingdom of Great Britain and Northern Ireland. They are too high, and they have to come down. We need a new strategy and a new way of looking at it. I have suggested some things from my constituency that we can do in Northern Ireland, and I very much look forward to hearing other hon. Members’ contributions.