former heroin addict, works as an advocate for Naloxone, a drug that reverses opiate overdoses. Photograph: Martin Godwin for the Guardian
Kevin Jaffray had been addicted to heroin for 20 years when he finally sought help in prison. “I was in prison more than out. I’d been living in a tent in Bournemouth. I’d lost everything, I was broken. I was overdosing once or twice a week. I was dicing with death every day. Prison was a relief.”
He approached a Luton-based 12-step recovery organisation for help and spent 11 weeks in residential rehabilitation. “I’d got to the point where my body couldn’t take it any more. We had groups and individual therapy. They helped me with my health and criminal charges. I was living with old friends. They had got clean and it inspired me to change.”
This was back in 2006, when drug funding was at its height under the Blair government. Jaffray was accepted for treatment after a single phone call. Now clean for 11 years, Jaffray, 49, has rebuilt his life. He was employed as a drug worker in Bedford between 2008 and 2015 and now works for the national Naloxone Action Group as an advocate for Naloxone, a drug that reverses opiate overdoses.
He says he was “very lucky” to have been trying to get clean when he was. At one time, he’d been given just three months to live by his doctors.
By 2015, Jaffray says his caseload in Bedford had gone up to 60 people a fortnight compared to 20 people three years earlier. He said access to treatment had completely changed. “Only one or two people in each area was getting awarded the funding to go into rehab and a hell of a lot more people than that were requesting it.” That year, drugs deaths in England and Wales reached their highest levels since records began in 1993.
The UK is now officially the drugs overdose capital of Europe with almost one in three of the continent’s overdose deaths, mainly related to heroin and other opioids, according to the European monitoring centre for drugs and drug addiction. Its 2016 annual report, published last week, which also aggregates data from Turkey and Norway, found the UK also had the highest proportion of heroin addicts. About eight in every 1,000 Britons are high-risk opioid users. Yet despite drug overdoses hitting record levels, an investigation by the Guardian has found that 11 local authorities in England, both those who were projected to cut most and least, have made average cuts of 17% between 2015-16 and 2016-17, more than £15m in total.
Collective Voice, an umbrella group of leading UK addiction charities, including Addaction and Turning Point, fears however that cuts to council drug treatment services funded by central government are far worse in some parts of the country. “Local authority funding has seen cuts of 25%, 30% or 40%: this has an impact on councils’ ability to fund drug and alcohol treatment,” says Paul Hayes, chief executive of Collective Voice. “At the same time, the needs of the drug-addicted population are increasing, particularly among the frail and ageing cohort of heroin addicts who started using in the 80s and 90s.”
Staffordshire county council has made cuts of 45% to its drug and alcohol treatment budget over the past twoyears. Local drug services campaigners claim 1,500 fewer addicts will receive treatment every year as a result. Alan White, Staffordshire council’s cabinet member for health, said it was left with no choice after its local clinical and commissioning group pulled an expected £15m of NHS funding for drug and alcohol services. “In 2015-16 we had to make some very difficult decisions on funding in order to protect services we have a statutory duty to provide,” he says. “We have worked with providers to help ensure a safe service can still be provided with the budget we have available.”
In Barnsley, where seven people this year have already died of drug overdoses (possibly due to contaminated heroin), the council cut its drugs and alcohol services budget by more than a third between 2015-16 and 2016-17. The authority’s own documents make it clear that some services will be “unavailable” after the cuts and that a number of drug workers will be made redundant. Jayne Hellowell, Barnsley council’s head of commissioning, healthier communities, says that services have merely been “reorganised.”
Even in Middlesbrough, which has the third highest level of drug-related deaths in England and the highest level of heroin use in England, drug misuse services haven’t been spared. The council cut the budget by £1m last year. Rachel Burns, Middlesbrough council’s health improvement specialist, says: “Our financial position has meant that we have actually reduced our overall substance misuse budget from £5.39m to £4.39m”.
“We were recommissioning our drug treatment services so we realised substantial savings by combining our youth and adult services, and housing all the substance misuse services into one building.” She added that redundancies were kept to a minimum and no frontline staff have lost their jobs.
The cuts are the legacy of ending what had been an effective ringfence on drug treatment funding in 2013 and the transfer of responsibility for funding drug and alcohol treatment from the NHS to local authorities. Deaths involving heroin and morphine more than doubled between 2012 and 2015. Government figures show that in 2015 more than twice as many people were killed by fatal drug overdoses in England, Wales and Scotland, in total 4,380 than in traffic accidents at 1,732.
Vanessa Fearn, a researcher at the Office for National Statistics, has said that age is a factor in the record level of drug deaths “as heroin users are getting older and they often have conditions such as lung disease and hepatitis that make them particularly vulnerable”. But Hayes insists that although the relationship between funding and drug-related deaths is complex, there is a connection. “The most important thing we can do to prevent further increases in drug-related deaths and to get a grip on recent increases is to continue to invest in treatment,” he says. “The more we disinvest in treatment, as we are doing at the moment, the more we will put increasing numbers of people at risk of early avoidable deaths.”
Jaffray says that because of the pressure on treatment providers to get good results, those who are most in need are being turned away. “The more desperate and chaotic you are, particularly if you have underlying mental health problems, which 75% of addicts do, the less chance you have of getting support because you’ll be a burden on their statistics and on their books for a long time. This is having an effect on the most chaotic people in the community: they are dying.”