The ‘Levelling up’ Agenda Must ‘Level Down’ Drug Deaths

by Jay Jackson


If the Government is serious about addressing regional inequalities, there can be few higher priorities than ending the drug death epidemic plaguing our ‘left behind towns’.

“Levelling up is about much more than just addressing economic inequality” wrote Levelling Up Secretary Michael Gove, previewing the release of his much anticipated ‘levelling up’ white paper published this week. “It’s also about health outcomes… life expectancy…and investing in communities that have been overlooked”. 

 Tragically, drug policy reform continues to be overlooked in discussions about the problems blighting our ‘left behind’ communities, and how to solve them. 

Despite coming to a considerable 332 pages, including a list of all the largest cities in the world since 7000 BC, if you search for ‘drugs’ in the white paper there is not a single mention to be found. For a document that’s taken over two years to produce, and coming so soon after the publication of a ten-year drugs strategy, the total lack of recognition of the role drug use and abuse plays as both cause and symptom of regional inequality is extremely careless. 

 Research has shown that the more unequal a society, the higher the level of illicit drug use. The UK has been labelled the ‘most unequal society in Europe’, with world beating levels of income inequality, as well as health, jobs, disposable income, and productivity inequality amongst the worst in the developed world.

 It should therefore come as no surprise that we also have the highest levels of both drug use and drug deaths in Europe. Drug overdose deaths are at record highs, with 4,561 registered in England and Wales alone during 2020. However, these deaths (and the associated use of the most harmful drugs such as opiates and crack cocaine) are disproportionately occurring in ‘left behind’ areas. 

The North East is home to the most ‘left behind’ areas of any English region; unsurprisingly, it’s also the region with the highest rate of drug misuse – a title its held for the past eight years running – and the highest rates of drug deaths, over three times that of London per million people, according to the ONS.

The North West and Yorkshire and the Humber, home to the next largest numbers of ‘left behind’ neighbourhoods also suffered from the second and third highest death rates respectively. London, the South East, and the East of England all had significantly lower rates proportionally. 

The 10 local authority areas with the most drug overdose deaths between 2018-2020 contain 24 ‘left behind’ neighbourhoods – over 10% of the nationwide total. 

Symptomatic of what’s been termed a “geography of discontent” these figures starkly illustrate the extent to which our approach to drug policy has failed, and how the impacts of this failure have been felt asymmetrically – hitting the most deprived places hardest. 

If ‘levelling up’ means anything, then it must address these geographic disparities in drug consumption and overdose. Luckily, there are a number of existing and easy-to-implement policy measures that would take significant strides to redressing these imbalances. By including drug policy in the ‘levelling up’ agenda, we can level down both the human and financial cost of drug use in our ‘left behind’ communities.

Utilising the Office for Health Improvement and Disparities to tackle the inequalities in drug deaths by focusing on areas with high levels of opiate use would be a good start. Alongside this, reversing the cuts to Local Authority funding for community treatment and prevention services (cut by up to 40% since 2010) would be a particularly effective measure, given that every £1 spent on treatment services prevents £4 worth of spending on health, enforcement and emergency services. 

 Encouraging and facilitating the rollout of pilot ‘diversion’ schemes, similar to that being considered by London Mayor Sadiq Khan, would further redress these imbalances. These schemes aim to avoid criminalising young people caught with small amounts of illegal drugs by dealing with them in an educational or treatment setting as opposed to pursuing criminal conviction through the courts.

 The logic behind diversion schemes chimes deeply with that of the ‘levelling up’ agenda. By avoiding criminalising young people, we protect them from the toxic shadow of a criminal record following them for the rest of their lives, constantly making it harder to engage as a fully-fledged member of society, as you struggle to gain employment, secure housing and the respect of your fellow citizens.

Finally, fully implementing all 32 recommendations made by Dame Carol Black in her independent review of drug policy published last year, including ring-fencing funding for treatment services and establishing a Local Outcomes Framework to increase transparency and accountability in service delivery, would bring an end to the postcode lottery approach to drug treatment. 

Implementing these sensible, evidence-led policy changes to tackle long-standing inequalities in our ‘left behind’ communities could add an extra £29.8bn to the country’s economy each year, as well as saving thousands of lives and improving those of many more alongside.

 By ‘levelling up’ the respect with which we treat people who use drugs, and the communities they inhabit, we can engender prosperity in our ‘left behind’ towns, bring down rates of problematic drug use and the crime it fuels, and prevent people from developing problematic relationships with drugs in the first place.  

This piece was written by Jay Jackson, Head of Public Affairs at Volteface. Tweets @wordsbyjayj

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