Jo Kimber and colleagues1 are right to call for the government to announce a public health crisis in response to a record number of drug-related poisonings in the UK. Recognising and responding to public health emergencies is a core responsibility of government. The UK's drug-related death crisis is most acute in Scotland, which has already had the highest drug-related death rate in Europe (at 17 per 100โ000 population, equating to 934 deaths) in 2017, before the released figures that showed a further 27% rise (to 1187 deaths) in 2018.2 This figure will put yet more pressure on the UK and Scottish Governments to act. When the Canadian province of British Columbia (which has a population similar to Scotland) saw its drug-related death rate reach 11ยท1 per 100โ000 people in 2015, it declared a public health emergency, encouraging the mobilisation of provincial and federal resources and a more public health-led strategy.3 Rates continued to rise, driven by the synthetic opioid fentanyl (another threat which could yet effect the UK), but the British Columbia Centre for Disease Control stated that without the resulting introduction of emergency harm reduction and treatment responses, overdose-related deaths would have been at least twice as high. Measures that they credit with averting increased mortality included improved access to opioid substitution therapy, availability of naloxone, and supervised drug consumption rooms. Such rooms alone averted 230 (range 160โ350) fatal overdoses over a 20-month period in the province.4 The use of drug consumption rooms has expanded rapidly across Canada, from two in 2016 to over 50 in 2019. Every person at risk of a drug-related death should be valued as highly as someone at risk from cancer, someone who has had a road traffic accident, or from any other threat. An effective response will require the UK Government and devolved authorities to work together ...
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", language="en", issn="2215-0374", doi="10.1016/S2215-0366(19)30301-3", url="http://dx.doi.org/10.1016/S2215-0366(19)30301-3" }