In this tale of two epidemics there is a stark contrast. While coronavirus prompts a national response, unlimited financial resourcing and near universal public engagement, there is another threat to thousands of our citizens, drug-related deaths, which has seen no such response or attention.
Yet the UK and the US have all the social ingredients guaranteed to exacerbate current record-high numbers of drug-related deaths: isolation, mass unemployment, low income and stolen hope that will cut thousands of lives short.
We could almost be forgiven for looking the other way on these deaths if, like Covid-19, we were limited in our ability to halting them. But we are far from helpless, and this includes knowing how to reverse an overdose through to evidence-based recovery interventions.
Our politicians don’t miss a chance to remind us that they are guided by the science on Covid-19 yet the government has ignored its own scientific advisors, the Advisory Council on the Misuse of Drugs, on how to reduce drug-related deaths.
Labour are just as culpable by remaining silent, a passivity that essentially endorses this government’s pick and mix approach to evidence-based policy. The reaction – or lack of it – from politicians signals that, even today, moral judgement rather than evidence is shaping decisions as to which health issue deserves more attention.
We’ve all been uplifted by the weekly show of gratitude for health workers and hearing stories of individual sacrifices to protect others from coronavirus. Not only is this empathy absent for those who have problems with drugs, but people who use drugs are perceived to have self-inflicted the psychological and physical pain they experience. We see them as deviant. This lazy and widely held attitude is not discreet, and the shame and stigma do little to promote recovery from addiction.
We don’t need to look far to see where our national empathy really lies – the suffering of cats and dogs always triggers a better response than one for those trapped by addiction. There are no TV appeals, coffee mornings or sponsored marathons raising funds for drug-dependent individuals. In 2020 it is our prisons, not hospitals, that host the majority of this group.
The heroes of Covid-19 are also the villains in the overdose epidemic – the pharmaceutical industry shamelessly occupies this dual position. The rewards of supplying and expanding opiates is hugely profitable, even if tens of thousands of customers are lost along the way. Without a sense of irony, some pharmaceutical companies not only supply these addictive drugs but also provide drugs which can reverse the inevitable overdoses. The immoral practice doesn’t end there: monitoring demand for these drugs allows them to hike prices selectively and ensure profits are maximised, with no thought for those unable to afford these life-preserving drugs.
We can be quite snooty about the way Americans are exposed to these drug companies via television and online advertising. Even without such exposure in the UK, one in four of us will have been prescribed an opiate or other potentially addictive medicine.
A review prior to Covid-19 found that the highest rates of prescriptions are in the most deprived areas of the country. This demonstrates how prescribing for social rather than medical problems – for example prescribing anti-depressants for depression stemming from unemployment – drives the rise in use of these drugs. Daily announcements of thousands of redundancies is not the environment that will reverse the social pain felt by our most deprived communities.
There might be hope at the end of the story of the two epidemics, and how a spending commitment to fight one might have a positive knock-on effect for the other. Despite years of political ambivalence towards those who have problems with drugs, there is the possibility that the desire to support people who are without economic hope might be sufficiently infectious to extend to those who are at risk of a premature drug-induced death.
Ian Hamilton is associate professor of addiction at the University of York