Intended for healthcare professionals

Views And Reviews

Illicit drug use should be decriminalised and regarded as part of the spectrum of mental health disorders

BMJ 2018; 363 doi: (Published 10 October 2018) Cite this as: BMJ 2018;363:k4206
  1. Alison Bedford Russell, former medical director
  1. Birmingham Women’s Hospital, UK
  1. dollywb{at}

The disconnect between mental health and addiction services puts patients’ lives at risk

I celebrate the stands taken to decriminalise illicit drug use. There is nothing like personal experience to focus the mind on such a complex and challenging matter. My son was one of the 2593 people recorded as having died from drug misuse in England and Wales in 2016. At the time, I was the medical director of an acute NHS trust. Mental health problems, including substance misuse, can happen within any family. I have now stopped working for the NHS.

His remains a tragic, unnecessary loss. He was an intelligent and articulate young man who was a talented musician and poet, graduating with a good honours degree in English, and intending to undertake his masters. Like many substance misusers, he was plagued by depression and anxiety, in his case since he was 14 years old.

He became a heroin addict while at university, approximately two years before he died, when access to psychology and psychiatric services was difficult. He was persuaded to seek help, and engaged well with substance misuse services. He was a casualty of the fact that these services, which are commissioned by local authorities, are disconnected from NHS services. His mental health problems were not tackled within substance misuse services. This situation was highlighted by Colin Drummond in The BMJ, where he argued that cuts to addiction services are a false economy and increase pressure elsewhere in the NHS.

The response to my son’s eventual application …

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