The fact that I am an alcoholic
Professor Julia Sinclair, chair of the Royal College of Psychiatrists’ addictions faculty, responds to soaring drug-related deaths.
George was a young graduate with longstanding anxiety and depression, who became addicted to heroin. He successfully engaged with treatment to tackle his addiction and became drug free. But when he tried to get help for his mental illness, he was turned away from services. Without mental health support, he couldn’t tackle all the root causes of his addiction and slipped back into using heroin. He died.
George is just one of the thousands of lives needlessly lost to drugs in recent years. Figures released today paint a tragic picture, with 3983 people in England loosing their lives in drug-related deaths in England in the last year - the highest since records began and a huge 46% increase in just five years. Each a tragedy, each someone who has been failed by support that should have been available.
Not only are more lives than ever before being lost to drugs, working on the frontline means I regularly see the devastating impact of addictions - the lives that are ruined, the families that are ripped apart, and the friendships that are destroyed.
National decision makers need to wake up to the fact making swingeing cuts to services, disconnecting NHS mental health services from addiction services, and shifting focus away from harm reduction to abstinence-based recovery is destroying lives and fuelling the increase in drug related deaths.
While attitudes to many mental health problems have improved unrecognisably, this cannot be said for addictions. Focus is often on criminalising drug users rather than recognising addiction as an illness with those suffering from it in need of professional support.
People living with an addiction are often made to feel ashamed, deviant, lazy, and that they could simply stop using or drinking if they wanted. This stigma can stop people admitting that there is a problem and seeking help.
Addictions are often complicated by psychological distress or mental illness. Some of the limited budget for addiction research has tried to discern whether addiction or mental ill health “comes first”, in reality it’s different for each person and deeply intertwined.
There’s almost no teaching for doctors and nurses on identifying and managing addictions. Many health professionals have ill-informed, even stigmatising attitudes about addictions.
This means that Lee’s experience is not unusual. Lee, an army Veteran referred to specialist support after finally being diagnosed with posttraumatic stress disorder (PTSD), says “They just accepted the fact that I am an ‘alcoholic’ and I am going to keep coming back…Nobody in hospital picked up on the fact, why? …had they had found out why from admission 1, 2 or 3, I might not be sat here now with 40 plus admissions on my record.”
Addiction services were moved out of the NHS into local authorities in 2013. Budgets to support people struggling with drug use in England have since been cut by £180 million (28%) and total expenditure in real terms on drug and alcohol misuse services for young people has declined by 34% (£23.2m in current prices) over the same period.
Addiction services are now often disconnected from wider health and care services, so people are bounced between addiction services and mental health services. It’s not uncommon for patients to be excluded from drug or alcohol services due to having mental health needs and vice versa. But these people are still in need.
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