Public Health England has been accused of watering down a briefing on the life-saving merits of overdose prevention centres (OPCs) after a paper was retracted and then rereleased with a much less optimistic outlook on the facilities.
The paper by PHE’s knowledge and library service was published in March 2019 after appeals from Labour to run pilots of OPCs but it was taken down and altered by the agency’s national drugs team after it faced calls to recommend the establishment of such centres in the UK.
OPCs, found in more than 70 cities around the world, are supervised facilities where people dependent on drugs can consume with safe equipment and have access to social and health services. No overdose death has ever been recorded in the facilities, and tens of thousands of overdoses have been reversed.
Successive UK governments have been firmly opposed to OPCs, and last year the policing minister, Kit Malthouse, said they “distracted” from treatment. But experts have said new funding for treatment services is “a drop in the ocean” compared with cuts in the sector in the last 10 years.
About 10 amendments modified the thrust of the PHE report, which had initially set out the seemingly overwhelming benefits of OPCs.
One line, “[OPCs] have contributed to lower rates of fatal overdoses”, was removed but research has shown that developing a network of OPCs in British Columbia, Canada saved around 230 lives in almost two years.
Crispin Blunt, a co-chair of the all-party parliamentary group for drug policy reform, said more than a third of all European drug deaths occurred in the UK, and OPCs should be established to reduce record levels of overdose deaths.
“Policies that are based on ideology and not on evidence cost lives,” the Tory MP said. “Ignoring the evidence or, worse, altering it can only further undermine the authority of the government and faith in the justice system.”
Martin Powell, the head of partnerships at Transform, a drug charity that advocates for legal and regulated drug markets to reduce harm, said political concerns seemed to be taking precedence over evidence, and the PHE’s “independence and focus on evidence should not be negotiable”.
He said: “Why was the original report taken down, and why were its findings toned down? It is hard to see how this decision was motivated by the evidence. Rather, it looks like a response to political pressure from a government determined to stick to its view that safer consumption facilities are ‘a distraction’, rather than an evidence-based approach to saving lives.
“The revised version cites no evidence that weakens the original study, even adding new evidence that should strengthen it, and yet key conclusions – especially regarding impact on overdose deaths – have been removed entirely. At a time when drug deaths in Scotland and across the UK continue to spiral, and as medical support for safer consumption facilities becomes nearly universal, it is unacceptable for a report of this kind to be dealt with in this way.”
A guerrilla OPC in Glasgow has recently been making headlines and has reversed potentially fatal overdoses, and the government has been under pressure from police and crime commissioners, MPs and the Scottish parliament to sanction the facilities.
Rosanna O’Connor, the director of drugs, alcohol and tobacco at PHE, said there were concerns that some findings in the initial report were “stated more strongly” than previously published reviews would support.
“The authors agreed to re-issue the briefing to more precisely and accurately reflect the evidence base,” she said. “Additional changes were also made independently by the authors. The tone has been made more neutral, which was appropriate given the nature of the available evidence.”