So much for harm reduction techniques reducing drug deaths.

An ageing population of heroin users does not fully explain the five year peak in deaths from drug poisoning in English and Welsh men. The increase is attributable to heroin, methadone, and morphine, and death rates were highest in young adults.
The UK has the highest prevalence of drug misuse in Europe.  The social laboratory of harm reduction as practised in the UK does not focus on prevention by creating and implementing drug use prevention activities and increasing drug free recovery facilities. Substitute prescribing protocols and needle exchange facilities have an important role in preventing further harm being incurred by users, but they cannot reduce the mental, physical, spiritual, and social harms caused by continued use or the severity of addiction with continued use.

Methadone maintenance, the flagship of drug treatment in the UK, needle exchange facilities, and drug consumption rooms have all failed to reduce or prevent the increasing use of addictive substances, as well as the associated deaths and bloodborne diseases.

The action plan on reducing drug related deaths referred to by the Department of Health spokesperson proposes more of the same. Abstinence is mentioned twice in the eight page plan, but there is no mention of increasing drug free recovery protocols or programmes.

Peter O’Loughlin principal, Eden Lodge Practice, Beckenham BR3 3AT peteroloughlin5@hotmail.com

Competing interests: PO’Lis an addictions counsellor and psychotherapist who is principal of a practice offering a non-residential service to those seeking to become free of alcohol, addictive psychoactive substance disorder, or addiction.
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Cite this as: BMJ 2008;337:a1671