Revealed: The tragedy of children losing parents to drugs in Cumbria

The shocking statistic has been flagged up by the county's public health boss to highlight the extent of drug harm across Cumbria.

He also reveals that there are currently 1,400 adults receiving specialist drug treatment in the county - and 800 are in alcohol treatment.

Colin Cox, director of public health at the county council, will present his report - revealing how serious the issue of drug harm is locally - to the Cumbria Health and Wellbeing Board tomorrow. (weds)

Drug poisoning deaths, which are currently much higher in the county than they are on average nationally, can be due to legal or illegal substances, and can be accidental or suicides.

Mr Cox explains: "Deaths in Cumbria involving illegal drugs have shown a sustained increase since 2010.

"While death rates are rising at a similar rate across England as a whole, this rise started slightly earlier in Cumbria - meaning the local death rate is currently significantly higher."

Over the last five years, the Cumbrian districts with the highest death rates have been Carlisle and Barrow.

Although numbers have dropped in Carlisle, they remain on the rise in Barrow, as well as Eden, Allerdale and South Lakeland.

Copeland currently has the lowest illegal drug-related death rates.

The number of children being left without a mother or father due to fatal overdoses is one of the statistics that highlights the wider consequences of drug harm across Cumbria.

As well as parents, the children themselves are also more likely to be at risk.

Mr Cox explained: "One in five of those who use Cumbria's substance misuse services lives in a household with children.

"Cumbria's Child Death Overview Panel has recognised that a disproportionate number of the cases they receive happen in families with parental substance misuse."

The report also reveals that almost half of female suicides in Cumbria, and one in five male suicides are due to drug-poisoning.

Overdose and drug-poisoning also accounted for 4,257 ambulance call outs in Cumbria between April 2013 and March 2015 - 10 per cent of all injury-related incidents the service responded to.

Those who inject drugs are particularly at risk of drug-related deaths, and in Cumbria the numbers are much higher

Mr Cox added: "This work is particularly important as the county has a significantly higher than average rate of injecting drug use - the highest risk group for drug-related harm."

Cumbria County Council is responsible for commissioning alcohol and drug misuse services locally.

This is currently delivered by the Greater Manchester Mental Health Foundation Trust, which runs the county's Unity service.

It helps individuals affected by drugs and alcohol, providing community rehabilitation, detoxification and opiate replacement therapy.

Unity also focuses on harm reduction, offering those who use illegal drugs ways to limit the risks, for example establishing needle exchange facilities to prevent the need for injecting drug users to share.

These are often found in recovery centres, where users can also access advice on other matters such as sexual health.

Clients are also offered HIV and Hepatitis C screening.

Although the proportion of people receiving drug treatment in Cumbria is in line with national rates, those receiving support for alcohol addictions is higher than average.

Cumbria is the most successful area in the north west for treating heroin addiction, yet the figure remains low - with only 13 per cent of those receiving treatment in the county during 2015 having completed it successfully.

Success is deemed to be finishing treatment drug-free and not returning to the service within six months.

Mr Cox said that growing concerns about rising numbers of drug poisoning deaths has prompted a multi-agency response.

A review group set up in 2014 compiled an in-depth report.

It found that there was a clear link between drug poisoning deaths, deprivation and the male gender.

It also found that the majority of those who died were not in touch with either substance misuse or mental health services at the time, and about half of those who died had previously experienced a non-fatal overdose.

Alcohol was also involved in almost half of the cases.

In response, the Cumbria Multiagency Drug Harm Prevention Group was formed and a plan drawn up.

From next year, this will carry out a quarterly review of drug-poisoning deaths in Cumbria to identify any issues and learning.

The group is also overseeing the development of a Local Drug Intelligence System for Cumbria, to share information across the system, assess immediate drug risks and issue warnings where needed.

Initiatives to date include distributing more than 700 naloxone pens to those deemed to be at risk of heroin overdose.

These are similar to the "epi-pens" carried by people with severe allergies who are at risk of serious anaphylactic shock.

A pilot scheme is also being set up to respond to non-fatal drug overdoses in Carlisle, aiming to reduce recurrent overdose and death.

Agencies are also working together to improve the treatment pathway for those with alcohol addictions who are admitted to University Hospitals of Morecambe Bay NHS Foundation Trust.

Other work includes working to prevent people becoming addicted to drugs, focusing on at-risk groups, and tackling supply.

The report also issues a warning about new substances like 'spice' that produce similar effects to drugs like cocaine, cannabis and ecstasy.

Mr Cox said: "These drugs used to be referred to as 'legal highs', but the majority are no longer legal.

"They are causing small but increasing numbers of drug-related deaths nationally, and are a source of significant challenge to traditional substance misuse services which were set up before these drugs were widely available."

<hr>

Rules restricting the use of methadone to treat drug addiction across Cumbria are being relaxed.

In recent years there has been a move away from using the heroin replacement to tackle opiate abuse.

Instead, in line with a national strategy, drug services have been moving towards recovery abstinence to encourage long-term recovery.

Mr Cox said that this has been very positive, and has "undoubtedly" supported more people to come off heroin altogether.

But he said drug addiction is complicated, and there are some people who are simply just not ready for recovery - and it is often these people who are most at risk of fatal drug-poisoning.

For these, taking a strict approach may not work - which is why they are now relaxing the guidance on methadone in some circumstances.

"Fifteen or 20 years ago there were people who were essentially 'parked' on methadone and stayed on it for a long time.

"There has instead been a move towards recovery, and getting them off drugs altogether. The risk is that if people aren't ready, they can relapse and be kicked out - then they are high risk," he explained.

"They might need a bit more time on a methadone script while we support them and try to get them to a place where they are ready."

He stressed that they do not want a "lax" system where methadone is given out for long periods to a lot of people.

But he said in some situations methadone maintenance may well be the best course of short term action to help people stay away from illegal opiates.

<hr>

There is no immediate risk to funding for drug and alcohol services in Cumbria, according to the county's public health chief.

It has emerged that the amount spent on these services has fallen by a total of £1,120,000 in three years.

But Mr Cox stressed that the current contract with Unity - which provides drug and alcohol support on behalf of Cumbria County Council - does not end until October 2019 so funding is secure.

He said the drop over three years was pre-agreed as part of the current contract and has not led to a drop in recovery rates.

He praised Unity for restructuring their services, focusing resources on where they are most effective.

"They are still providing services that are the best in the north west," he added.

<hr>

Just how serious is drug use in Cumbria?

• Approximately 36 children a year lose a parent to drug-poisoning death in Cumbria
• Deaths involving illegal drugs are significantly higher than the national average
• Overdose and drug poisoning accounted for 4,257 ambulance call outs between 2013 and 2015
• Illegal drug poisoning resulted in 153 hospital admissions in 2014/15, while drug-related mental illness led to 688
• One in five male suicides and almost half of female suicides in Cumbria are due to drug-poisoning
• Cumbria Police recorded 881 drug offences in 2016/17, mainly in Barrow, Eden and Carlisle
• A disproportionate number of child deaths in Cumbria happen in families with parental substance misuse
• There are currently 1400 adults receiving specialist drug treatment and 800 receiving specialist alcohol treatment

<hr>