NHS CHIEF SAYS LATEST DRUGS STUDY 'CHALLENGES' WHOLE REGION

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 analysis

The 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.

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."