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Hayes says the 1970s American Marxist sociologist Steven Spitzer divided the poor into two groups: "social junk" and "social dynamite": "He said that society is interested in neutralising the dynamite, so they are locked up, shot if they are in the Philippines, or in western society we invest in them. But the junk just gets ignored." Part of the reason people are dying in such increasing numbers is that the dynamite is transforming into junk because they are getting old. "Their ability to break into your house is diminishing, they are becoming less and less of a threat," said Hayes.These people are literally being left to rot, suffering not only from the physical and mental ravages of heroin addiction, but other conditions – such as lung disease and hepatitis – that further weaken already frail bodies and make them particularly vulnerable to accidental overdose.Hayes says the NHS is not equipped to deal with this population. Many don't have a GP, and when they go to A&E they find it hard to cope with the situation. They fail to keep appointments for severe heart or lung problems. "The people who need the NHS the most don't get help," he pointed out. "There is a structural and cultural barrier for these people, so we need to get together the key players, identify who these vulnerable people are and target them with interventions."READ: We Asked an ER Doctor All the Ways You Could Die of a Drug Overdose
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