Austerity linked to rise in number of opioid-related deaths in England

Our research is a stark warning against introducing austerity measures in the wake of the COVID-19 pandemic
- Rocco Friebel
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Woman with head in her hands. Pars Sahin on Unsplash

Local authorities in England that suffered the largest spending cuts under austerity also experienced the largest increases in opioid-related deaths and abuse, according to new research from the Department of Health Policy, published in the journal Social Science and Medicine.

Deaths and hospitalisations from opioid abuse were concentrated in the southeast, east and northwest of England, including in Lancashire, Cumbria, Kent, and Norfolk – all areas that have seen the most significant spending cuts between 2010 and 2017.

The researchers used economic models to demonstrate that reductions in welfare funding for social care services and housing assistance had the greatest impact, exacerbating the adverse effects of rising unemployment in a local authority area.

On average, they found that a 10 per cent increase in unemployment was associated with seven opioid-related deaths and 62 hospitalisations per 100,000 population.

In areas which experienced more drastic cuts to social care services and housing assistance under austerity, additional lives were lost and more people were hospitalised.

Overall, austerity in England was responsible for an additional 342 opioid-related deaths, and an additional 8064 hospitalisations between 2010 and 2017, beyond the effect of unemployment. 

Dr Rocco Friebel, lead author of the paper and Assistant Professor of Health Policy at the London School of Economics and Political Science (LSE), said: “This was the perfect storm of people losing their jobs or struggling financially because of the financial crisis and then, at precisely the point they needed support from the state, it wasn’t there.

“When people experience psychological pressure from not knowing how to make ends meet for long periods of time, it can begin to manifest itself as physical pain, pushing them into a cycle of medication and hopelessness. While opioids such as tramadol and fentanyl can play an important role in pain management, they are highly addictive with up to 20 per cent of those who are prescribed them becoming dependent on them.”

According to OECD data, between 2011 and 2016, opioid-related deaths have risen by more than 68 per cent to 41 deaths per million population in England. More than 40,000 patients are admitted to hospital because of an opioid overdose every year.

While previous research has linked economic downturns with increases in opioid abuse, this research is the first to explore the role that changes in government spending on welfare programmes plays in this.  

Austerity measures meant that some English local authorities experienced spending cuts of up to 50 per cent in real terms.

Dr Friebel said: “Our research is a stark warning against introducing austerity measures in the wake of the COVID-19 pandemic. A strong social safety-net is essential to protect the most vulnerable people from economic crises and prevent their lives spiraling out of control.

“It isn’t inevitable that unemployment and poverty lead to opioid abuse. We know that even in the aftermath of the financial crisis, Germany and the Netherlands - which both have strong social welfare systems - did not see large numbers of opioid-related deaths even though these drugs are widely available in both countries.”

During the period the study looked at, between April 2010 and March 2017, over 280,000 people were admitted to hospital because of an opioid overdose and 14,700 people died from opioids in England.

Behind the article

Opioid abuse and austerity: Evidence on health service use and mortality in England by Rocco Friebel, Katelyn Jison Yoo, and Laia Maynou