There’s this vague idea – which has been going around for the past few centuries – that statistics is difficult. But in reality the maths is often the least of your problems: the tricky bit comes way before the number crunching, when you are deciding what to measure, how to measure it, and what those measurements mean.
The government’s new drugs strategy has been published, with outcomes that will be measured to see if it works or not. However you cut the cake, we should be clear: measuring drug-related death is difficult. You could look at death certificates to see what’s listed, but they’re often filled out by junior doctors, and aren’t very informative or reliable. You also need to decide where to draw the causal cut-off. Does HIV count as a drug-related death, if you got it from a needle full of heroin? Or from sex work to fund the drugs?
How about if it kills you ten years after you become abstinent, or you die from chronic, grumbling hepatitis C from a needle? Or chronic, seeping, pus-ridden abscesses bulging deep in your groin from years of injecting your femoral veins?
And that’s before we get to crack-frenzy violence and drug driving. What if there was no toxicology done? What if there was, but they didn’t test for the drug the person took? What if the coroner finds some drugs in the blood, but doesn’t think they were related to the death? Are they consistent in making that call?
The new government drugs strategy solves this tricky problem by simply not measuring drug-related deaths as an outcome any more. It was a key indicator in our major strategy document ten years ago, but you won’t see death mentioned once in ‘Drugs: Protecting Families and Communities Action Plan 2008–2011.
You also won’t see death in ‘Public Service Agreement Delivery Agreement 25’, which includes measured outcomes such as the number of users in treatment and the rate of drug-related offending. A lot of drug users die. Death, even if you don’t like drug users, is important.
But beyond the disputes over how you collect these figures, there is the interpretation and analysis; and the greatest irony is that the government may have dropped drug-related deaths two weeks ago, simply because it misunderstood that the figures are actually looking quite good.
Overall, drug-related deaths show no great improvement over the years. But what if older people – over thirty-five, say, users from the great injecting epidemic of the 1980s – were dying at a greater rate, while young people, the target of great effort, are dying at a slower rate? That’s what a recent analysis from the biostatistics unit in Cambridge shows: they presented their findings just two weeks ago, in the same week, by odd coincidence, that the government announced its deathless drug strategy.
Sometimes people can be so stupid that they don’t even know when they’ve done well.