Debate contribution: Addiction and Drug-related Deaths

Debate contribution by Mr Robin Swann on 23 April 2024.

MLA

Mr Robin Swann

Party at the time

Ulster Unionist Party

Date

23 April 2024

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Addiction and Drug-related Deaths

Assembly identifier

Official Report component 4485543

Read the official Assembly record

Text

Thank you very much, Mr Deputy Speaker. I welcome the opportunity to speak to the motion and the amendment. I will support both, because the amendment adds to and strengthens the motion; it does not take away from it or its intent. I want to address some of the extremely important issues that have been highlighted by Members. However, I begin, as others have done, by offering my heartfelt sympathy to all of the families who have lost someone dear to them in similar circumstances, because, as has been said around the Chamber, too many people across Northern Ireland have suffered the devastating loss of a loved one because of substance use issues. I thank Members for the tone of today's discussion and for the way in which the issue has been taken forward. It was summed up in two words from Ms Ní Chuilín in her contribution when she said that we are doing this because "We care". I believe that that is why we as Members, parties and individuals are in the Chamber. I thank Ms Órlaithí Flynn for moving the motion. I have worked with her extensively on this. I thank her for the acknowledgement that she gave to my officials for the work that has been done on this. The co-working and partnership approach that she brings and that her colleagues and other MLAs have brought as we try jointly to tackle this serious issue shows how we can best work together. The previous work that we have done collectively is a prime example of what we can do when we set our minds to it. In that regard, the Member noted that I am meeting families later this week — again, with her, at her invitation — because of how she is respected in a community that wants to tackle this serious issue. Today's motion asks us to note:

"with concern NISRA's 2024 report on 'Drug-related and drug misuse deaths'".

The most recent drug death statistics, which have been quoted and were published on 31 January 2024, are a reminder of the tragic impact that drug-related harm has on individuals, families and communities across Northern Ireland.

Mr Robinson noted the positive reduction in drug-related deaths across Northern Ireland, from 213 in 2021 to 153 in 2022. Like him, I hope that that is not a blip but rather an indication that society is going in the right direction as we use our strategies and the resources that we have available to keep concentrating on the matter.

Although many Members have referred to the statistics, and I thank them for noting them, it has been realised in the Chamber today that behind every one of those statistics and each of the numbers is a person: a son, a daughter, a brother, a sister, a father or a mother. That is why the tone of the debate today has been particularly welcome. I will say, however, that we cannot be complacent. We must continue to make the issue a priority. It is important to recognise that the trend over the past decade has been an upward one. Today's motion focuses on the harms from drug use, but it is vital, and Ms Ní Chuilín raised this, that we also consider the impact of alcohol. The most recent alcohol-specific death statistics, which were published on 14 February, show that 356 such deaths were recorded in 2022. That is a stark reminder of the tragic and potentially lethal impact that alcohol can still have. As has been mentioned, the harm related to substance use is driven by a range of multifaceted issues that exist across the whole of our society. Those include poverty and deprivation, homelessness, unemployment, lack of economic development, mental health and trauma, paramilitarism, community relations and justice issues, education attainment inequalities and the legacy of the past. As has been mentioned many times, tackling those societal issues requires the whole Executive to operate collectively. The families whom I have met know only too well the pain and sorrow that sits behind each and every death recorded as a result of substance use, as well as the complex factors that drive people to substance use. It is my view that every single one of these deaths is preventable, and we must continue to work to address all the issues. The Members who tabled the motion are asking us to acknowledge the worrying statistic that the rate of drug-related deaths in the 25- to 34-year-old age group was the highest of any age group in 2022. In addition, the figures confirm once again that drug-related and drug-misuse deaths continue to be higher in areas of highest deprivation. Rightly, the motion also notes the intrinsic connection, as I mentioned, between social deprivation, poverty, isolation, mental health and addiction issues. As we are all aware, those are not issues that Health and Social Care can solve on its own. To be truly effective, our response must therefore be a collective one. I will continue to work with colleagues in the House and in the Health Committee and across all areas, and especially with my ministerial colleagues in other Departments, to address the challenging societal issues. For example, my Department works closely with colleagues in the Department for Communities to look at the needs of those who are suffering homelessness. That includes doing work through the Complex Lives initiative in Belfast, which takes an inter-agency, multidisciplinary approach to those who are most vulnerable and wraps support around them in order to meet their basic needs. We also work closely with the Department of Justice on enforcement, community safety and the healthcare needs of those who are in the justice system. Furthermore, the motion rightly calls on me, as Minister of Health, to:

"implement the provisions aimed at harm prevention, harm reduction and tackling addiction within the substance use strategy".

As Members will be aware, I launched our 10-year substance use strategy, 'Preventing Harm, Empowering Recovery', in September 2021 with the full support of the Executive. The alcohol- and drug-related statistics that we have already touched on demonstrate why we need to continue to drill down and focus on the strategy's full implementation, because it is that strategy that sets out the values and priorities that underpin all our efforts in this area. Those efforts include targeting groups for which the need is greatest and for which it is most necessary that the strategy be effective. The strategy describes three main priority groups believed to be most at risk of harm: those who are homeless; those who inject drugs; and those who are in contact with the justice system. The strategy also recognises the risks that face our young people today and set outs what more we need to do in that space. Our strategy aims to directly reduce harm through that focus, as has been said, on prevention and on harm-reduction support measures for people in those groups who use alcohol and other drugs. In recognition of the fact that it is a growing issue, work is under way to develop what will be a new, holistic, strategic plan for the delivery of substance use services. That will seek to improve the availability, accessibility and quality of the treatment and support provided right across Northern Ireland. The strategic commissioning plan was consulted on earlier this year following a co-production process that involved over 100 individuals and organisations. That strategic plan is being updated and finalised following the consultation and will be published in the near future. It will then become the new road map for effective services, not just for my Department but for any organisation looking to address substance-use-related issues. However, a plan on its own will not solve all our issues.

I do. It goes back to the point that the Member and others made about how we look at the abuse of drugs. The substance use strategy sits, rightly, in my Department. Addiction is a health issue, not a justice issue. We should not punish people who cannot step out of addiction and out of that cycle that keeps them where they are. There is a health response and a public response. There is a holistic approach to be taken across the Assembly, too. The Member mentioned the Misuse of Drugs Act 1971. We talk about overdose prevention centres and the opportunity to have one in Northern Ireland. As the Member acknowledged, that is UK-wide legislation, so it is not within my remit to be able to set one up here in Northern Ireland. However, we will monitor forthcoming evidence on the effectiveness of two different interventions: the pilot overdose prevention facilities in Glasgow and Dublin. We will give due consideration —

— to new interventions, as appropriate, within the wider legislative framework. It is not, therefore, something that I am opposed to.

The Member raises an issue on which her party leader, the Minister of Justice, and I have said that we want to work closely together. I look forward to continuing work on how we make sure that substance abuse and addiction are not treated as criminal activities; we should address them as health issues. We have to look at how we as an Executive approach that as well. Miss McAllister raised the issue of naloxone in her comments. I can confirm wider expansion of its use. Earlier today, I corresponded on the issue with Andrea Leadsom, Parliamentary Under Secretary of State for Public Health, Start for Life and Primary Care, who is looking at introducing legislation on that in Westminster, on how we develop that and bring it forward. I will continue to work with her on that. I go back to the substance use strategy. When it was published, it was estimated, at that point, that its implementation would require an additional £6·2 million in recurrent funding. In what will undoubtedly be an extremely challenging budget environment, I am pleased to confirm that, to date, I have managed to assign an extra £750,000 recurrently towards that strategy's implementation. I am conscious of time. With regard to other positives, a number of Members mentioned dual diagnosis services. Members will be aware that dual diagnosis is mentioned in both the mental health strategy and the substance use strategy, because, when we were co-designing and co-producing those two strategies in the Department, we recognised that dual diagnosis sat across both. Dual diagnosis, or co-occurring mental health and addiction problems, is a key priority in both those strategies. Therefore, it is critical that we reinforce the linkages between the two strategies, with early intervention and an action plan, development of the regional mental health crisis service and development of the regional mental health service. Again, recurrent funding has been provided to appoint a co-occurring mental health and substance use project manager who will be based in the SPPG. Recruitment to that post is under way. That should ensure improved pathways with more timely access to the treatment and support that a person with a co-occurring mental health and addiction problem needs to enable them to maximise their recovery. The problem is significant, but ongoing work and recurrent additional investment will address some of the core issues in the system, such as ensuring that there are clearer pathways, better support for dual diagnosis when an individual experiences co-occurring mental health and addiction issues, and greater consistency in inpatient treatment services. Those services range, as we have heard, from tier 1, the provision of information and education, to tier 4, inpatient treatment services. While we seek to improve the accessibility and quality of services that we provide, there are already vital life-saving services in place. If you think that you may have an issue with substance use, or you know someone who needs help, you should come forward and seek help and support. In respect of services, the motion specifically references rehabilitation; an issue that has often been raised with me. That is why one of the key early actions that we have undertaken under the strategy is the independent review of inpatient tier 4 detoxification and residential rehabilitation services across Northern Ireland. That work was commissioned in 2023. A report has now been submitted for consideration. Following the tier 4 review, that will provide an overview of current service provision and will help to set the future direction for inpatient treatment services, both statutory services and —

— services in the community and voluntary sector across Northern Ireland. I have tried to keep my comments succinct and to the point. It would be impossible to cover all the complexities of this concerning issue today. I encourage Members to support the motion and amendment.

2,114 words. Text as published by the Northern Ireland Assembly.

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