Agenda item

Opioid Dependency - Update

Representatives from Public Health will be in attendance to provide an update on progress made following the panel’s investigation into Opioid dependency.


The Chair introduced representatives from the Council’s Public Health Department and Foundations Medical Practice to provide an update on actions relating to the Panel’s report into opioid dependency.


The Panel heard there was a significantly higher death rate relating to drug misuse in the North East than in other English regions. Based on 2018-20 figures Hartlepool and Middlesbrough had two of the highest rates for drug misuse or poisoning deaths, with only Blackpool showing higher figures.  


The latest provisional data for alcohol related deaths showed there had been a significant increase in deaths from alcohol causes between 2019 and 2020. Indeed, while the data was needed validating it was possible alcohol related deaths in 2020 increased by 66% which equated to approximately 100 people. Although there were complex factors to explain this, government data showed alcohol consumption had undoubtedly increased since the covid-19 pandemic.


The Clinical Partner from Foundations Practice explained that Foundations Medical Practice was a specialist practice that supported individuals suffering from substance misuse, especially through the Heroin Assisted Treatment project (HAT). The programme was created in light of Middlesbrough’s high drug related deaths and drug related harms. While the main treatment was methadone between five and 10 percent of individuals in receipt of this failed to benefit from it. Failure to benefit from such treatment often led to individuals being trapped in a cycle of criminal activity.


It was noted that participation in programmes like HAT required significant commitment both to receive and maintain treatment. However,when individuals did so they could link in with other care coordinators to address any other complex needs they may have, including mental and physical health needs.


The Pane heard HAT had been operating for two years since October 2019 and was funded for 10 individuals and that the programme was full. The Panel was shown a walkthrough video of the clinic and how treatments were administered.


The programme had been independently evaluated by the University of Teesside and was undergoing evaluation by Durham University and the London School of Tropical Medicine to understand the programme’s impact. The results of the evaluation will be available in April 2022 however preliminary results showed a high level attendance and that regular attendance benefitted participants everyday lives.


The programme had seen full engagement by participants who had also benefited from other, non-compulsory, enhancements such as psychosocial interventions.


Overall, participants reported significant improvements in their mood, psychological health, mental health and social situations with some having been street homeless prior to engaging with the programme.


As a result of the programme there had been a 60% reduction in criminal behaviour as well as a reduction in the median crime severity score with anecdotal evidence from the Police to support this.


The Panel was shown examples of similar successful facilities in different parts of Europe and heard some had been operating for 20 years with no drug related fatalities despite the number of injections that took place within them.


The Panel heard several other projects and initiatives were linked to HAT including project ADDER (Addiction, Diversion, Disruption, Enforcement and Recovery) as well as key stakeholders such as the Strategic Homelessness lead. For all projects there was a need for a flexible system-wide approach and to continue setting up relevant governance and steering structures such as the Lived Experience Board.


It was noted that given various changes within the NHS, the role of Health Scrutiny was crucial to hold the various agencies to account.


A Member queried how easy it was for people to access the HAT programme given the level of commitment involved and what support, if any, was provided to participant’s families especially where Children were involved. It was clarified that those engaging the programme were more prepared to travel and to commit to the regularity of the treatment, with many of the individuals on the programme lived relatively close to the clinic. It was also commented that most participants in the programme had a substance misuse problem for at least 20 years and had experienced some life trauma, such as a disconnectedness to children, but that treatment helped to reconnect them. The Panel also heard that access to services was very open, with some individuals self-presenting being prescribed alternative medication within 20 minutes. 


The Panel heard that £300 million investment was being made by government toward drug enforcement and disruption and in line with Dame Carol Black’s recommendations, £780 million of investment would be made over three years towards treatment and recovery. This also meant that Project ADDER would be extended for two years to March 2025.


A Member queried if individuals could be redirected to other alcohol and drug services. It was clarified that across all drug and alcohol services, including Project ADDER and Changing Futures approximately 2,000 people received treatment in one form or another. While it was difficult to measure numbers of participants, more exact usage figures would become clearer in the following 12 months.


A Member sought clarification between assisted treatment and overdose prevention and their uses between Scotland and England respectively. It was clarified that that assisted treatment was evidence based and supported by the Home Office and classed as a pharmaceutical intervention. Overdose Prevention, however, was not supported in the same way and was, strictly, illegal. The Member suggested that lobbying be undertaken to class overdose prevention the same as assisted treatment in order to help as many individuals as possible. It was also clarified there was a misconception surrounding Overdose Prevention sites in that it was believed they encouraged increased drug use. This was not the case, however, and instead removed existing drug misuse from the street into a more controlled environment.


It was agreed that lobbying, in the form of written representations, should be undertaken by the Panel but it was acknowledged that changing the status of Overdose Prevention sites was a challenge.


It was noted that services were improving and adjusting to such a degree that more and more people were able to stabilise their lives even if complete abstinence was not possible. Switzerland was used as an example whereby both Assisted Treatment and Overdose Prevention sites operated side by side which had radically altered drug misuse in the country.


It was further clarified that as part of the additional funding from government, £300 million would be used for enforcement purposes over the first three years of a wider 10 year strategy.


The Chair thanked all involved for the presentation.




1.    Efforts be made for the Panel to visit the Overdose Prevention Ambulance

2.    Statistics presented to Members regarding drug and alcohol deaths be circulated.

3.    The Panel produce written representations in support of Overdose Prevention Sites that can complement the work of Assisted Treatment sites. 

4.    The information presented be noted.