"In 2020 drug related deaths in the United Kingdom (UK) reached the highest rate in over 25 years (ONS, 2021). Data between 2001-2018 evidences a substantial increase in drug poisonings over time for people who use opioids, with risk increasing particularly between the years of 2010-2018, an effect which was not entirely explained by the ageing of this cohort (Lewer et al., 2022). The concentration of drug related deaths are geographically varied in the UK. Areas of high economic deprivation, such as North-East England have more than three times the rate of drug related deaths than London (ONS, 2021). In the North East town of Middlesbrough citizens are statistically more likely to die from a drug related deaths than a car accident (Middlesbrough Council, 2020). Poverty, homelessness, an aging population of opioid users, unemployment, polydrug use and significant funding reductions for drug treatment services have been posited as contributing factors (ACMD, 2017; Lewer et al., 2022; ONS, 2019a, 2019b; Public Health England, 2018). The largest proportion of drug related deaths in the North-East of England are reported among men who are dependent on illicit opioids, such as heroin (ONS, 2022). The high prevalence of opioid usage in Middlesbrough combined with an unregulated and toxic illicit street tablet market (substances such as z-drugs, benzodiazepine and gabapentinoids) provides a potentially fatal risk environment due to interactions between these depressant drugs, which can significantly increase risk of drug related deaths (Akhgari, Sardari-Iravani, & Ghadipasha, 2021; Ford & Law, 2014; ONS, 2021, 2022)."


Poulter, H. L., Walker, T., Ahmed, D., Moore, H. J., Riley, F., Towl, G., & Harris, M. (2023). More than just 'free heroin': Caring whilst navigating constraint in the delivery of diamorphine assisted treatment. The International journal on drug policy, 116, 104025. doi.org/10.1016/j.drugpo.2023.104025