In-depth: Why does Manchester have highest drug death rates in UK and what is going to change?

Lethal cocktails of new and exotic drugs consumed by ‘naïve’ and experimenting users is a key factor behind Manchester becoming drug-death capital of the UK, according to health experts.

While heroin remains the biggest killer, annual deaths related to opiates have continued to drop significantly, with deaths related to new drugs and legal highs remaining elevated after a huge increase during 2010.

Research from the International Centre for Drug Policy showed that during 2011, the City of Manchester coroner recorded the highest proportion of deaths caused by drugs in the country, with 15 per 100,000 people aged 16 or over.

Manchester health experts agree that there is no single discernible factor which has led to the city overtaking Brighton to top the grisly list for the first time in years – however there are emerging drug trends which must change to avoid further fatalities.

“We are seeing increases in deaths related to certain new and emerging drugs such as mephedrone (M-cat), methylone and GHB which were ‘legal highs’ but are now classified under the Misuse of Drugs Act,” says Colin Tyrie, Senior Substance Misuse Advisor at Manchester Mental Health and Social Care Trust.

He is working as part of a campaign to raise awareness of the risks of mixing different drugs and alcohol – something seemingly favoured by Manchester revellers.

The research trends seem indicative of a new type of drug-user as deaths from stimulants such as cocaine, amphetamines and ecstasy-type substances saw a small rise from 2010 while heroin deaths continued to drop significantly.

However they still count for 32% of drug-related fatalities nationally.

Mr Tyrie said: “This ‘poly-drug’ use is one of the main causes of drug-related death.

“The campaign is called ‘Bad Mix’ and is targeting young people, naïve drug users, experimenters and people who don’t see themselves as ‘drug users’ but are at high risk due to the synergic effect of combined drugs and alcohol.”

It’s not just the combination of different drugs and alcohol which seem to be causing the problem, which was documented in the National Programme on Substance Abuse Deaths 2012 report last week.

The region’s terrible drinking, smoking and eating habits are exacerbating things, according to Mike Linnell of the Lifeline Project, who has been dealing with individuals and families affected by drug misuse for more than 25 years.

He said: “It wasn’t exactly a shock as Manchester has always been up there [in the drug-related deaths table].

“In terms of the lifestyle in the North West with smoking and lack of exercise, we lead the world when it comes to unhealthy living.”

Mr Linnell believes the increase in Manchester deaths but decrease in national heroin-related fatalities could be linked, as heroin has experienced a ‘drought’ since 2010.

“There are far less people getting involved with heroin now than there was,” he said.

“The average age of a heroin user is in their 40s, not 20s, and that in itself raises the risk of death.

“The increase in Manchester may well be more to do with an aging population who were part of the rapid rise of heroin in the 80s but now its career as a drug could be petering out.

“Heroin is much more dangerous now as the purity and quality has changed but you will always get peaks and troughs.”

Mr Linnell pointed to work that has been done in the past when Manchester has experienced similarly striking drug problems.

Manchester’s rave scene, which emerged in the late 80s and continued into the 90s, prompted the Safer Dancing campaign – pioneered in the city.

This focused on harm reduction as opposed to criminalising users immediately on sight of possession of drugs.

Documented in ‘E for Ecstasy’, a book written by Nicholas Saunders at the height of the ‘Madchester’ rave scene in 1993, Dr Russell Newcombe, a former Manchester University academic specialising in research on drug use, championed the policy.

Before the Safer Dancing campaign venues were closed when the police found illicit drugs, with the result that the clientele moved on to other venues – often unlicensed premises.

People suffered from heatstroke as a result of taking ecstasy in badly ventilated venues where water to the wash basins had been cut off, forcing them to buy drinking water at exorbitant prices.

While these problems have been alleviated, Mr Linnell remarks that despite all the help, support and treatment available, it is still the most dangerous drugs which are killing people.

“If good quality heroin was available again, people would buy it,” he said.

“There will always be a market for it because people take it because of its effects and qualities.”

Now, the danger seems to be people in Manchester looking to untested drugs – often ones previously deemed ‘legal’ – to achieve the same psychological results.

It is drugs like these which can be contaminated and have contributed to the deaths of at least three people in the Greater Manchester area just this year.

John*, a Manchester drug user, told MM about the ease of tracking down new drugs despite their long-term effects being widely unknown.

He said: “Drugs are readily available in every street, in every estate, on every corner.

“Even exotic drugs like 2-CI and 2-CB (hallucinogens) are becoming common along with the normal drugs like cannabis, cocaine, amphetamines, ecstasy and pure MDMA crystal.”

In the ‘peaks and troughs’ which Mr Linnell mentions, it seems as one killer drug’s potency wanes, it gives rise to new drugs to exploit gaps in the market.

Heroin is still the biggest drug killer despite causing fewer deaths nationally than in previous years but the drugs rise in Manchester has inarguably coincided with new highs available.

And where there is a new business opportunity, there are new risks and dangers.

Unaccounted for in the International Centre for Drug Policy statistics are drug-related deaths which extend to the violence common-place in the murky underworld of drug dealing.

Something John argues is the real danger and face of the new drug scene in Manchester.

He said: “In relative terms the amount of people dying compared to the people taking [drugs] is very low.

“I’m well-versed in the drug scene. I’ve been around it for 20 years and know every trick in the book and every big mover – most of them are just normal people trying to make a few quid – some of them are evil sadistic men who like to inflict pain and suffering on people.”

Whether the North West will escape the grip of drugs remains to be seen, as for every bit of good news that comes from research into substance abuse, a fatal new danger appears to emerge.

*Name changed as source wished to remain anonymous

Picture courtesy of Valerie Everett, with thanks.

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