Key trends in numbers in treatment and substance use
The adult substance misuse treatment statistics for 2017/18 were published last week (1 November 2018) and the headline findings are summarised below. I also include more detailed information from the report on the use of New Psychoactive Substances and the stubbornly high number of drug-related deaths underneath the graphic.
- There were 268,390 adults in contact with drug and alcohol services in 2017 to 2018, which is a 4% reduction from the previous year (279,793).
- The number of people receiving treatment for alcohol alone decreased the most since last year falling by 6%, (80,454 to 75,787) and by 17% from the peak of 91,651 in 2013 to 2014.
- There were an estimated 589,101 adults with alcohol dependency in need of specialist treatment in 2016 to 2017. These alcohol dependency estimates have remained relatively stable over the last 5 years, which suggests that the falls in the numbers of alcohol-dependent people accessing treatment does not reflect a fall in prevalence, with only 1 in 5 of those in need of treatment currently receiving it.
- People in treatment for opiate dependence made up the largest proportion of the total numbers in treatment (53% or 141,189). This is a fall of 4% since the previous year.
- The number of people entering treatment who were in the non-opiate group and the non-opiate and alcohol group (35,473) was broadly the same as the previous year (35,491). However, the number of people being treated for crack cocaine problems – people using crack but not opiates – increased by 18% since last year (3,657 to 4,301) and 44% since the year before that (2,980 to 4,301).
- The increase of numbers of people in treatment for crack but not opiates during 2017 to 2018 was seen in all age groups except 65 years and over.
- There was also a 3% increase in people entering treatment for both crack cocaine and opiate problems (21,854 to 22,411), which was seen primarily in those aged 35 and over. This represents over half (54%) of people entering treatment for opiate problems in 2017 to 2018, compared to 35% in 2005 to 2006.
- It is likely that the recent increase in the number of people entering treatment for crack problems reflects the rise in the prevalence of the drug’s use. The increase in the number of new users may be in part caused by changes in the purity and affordability of crack cocaine and patterns of distribution over the last few years. The latest report from the UK Focal Point on Drugs has information about increases in purity.
New psychoactive substances and club drugs
There were 1,223 people who had problems with new psychoactive substances (NPS) starting treatment in 2017 to 2018, which is a 16% decrease on the previous year (1,450) and a 40% decrease on the year before that (2,042). This fall was mainly driven by a 36% reduction in under 25-year-olds entering treatment for NPS problems (321 in 2016 to 2017 dropping to 206 in 2017 to 2018).
People who are in treatment for NPS problems were more likely to be homeless (25%), compared to those not using these substances at the start of treatment (8%). This has increased from 6% in 2013 to 2014.
There was a 7% fall in the number of people entering treatment for ecstasy problems in 2017 to 2018 (1,013 to 939), with a much larger decrease of 53% recorded in the number starting treatment for problematic mephedrone use.
The total number of people who died while in contact with treatment services in 2017 to 2018 was 2,660 (1% of all individuals in treatment). This is similar to the previous year when there were 2,680 deaths in treatment (1% of all individuals in treatment).
The number of people in the opiate group who died in treatment decreased very slightly since the previous year from 1,741 to 1,712. Deaths as a proportion of all opiate clients in treatment remained at 1.2%. The median age of opiate treatment clients recorded as having died in 2017 to 2018 was 45 and 77% were male.
The number of deaths for users of other drugs rose slightly from 172 in 2016/17 to 174 in 2017/18.
Drug use is a significant cause of premature mortality in the UK, as ONS statistics have shown. In England, the number of deaths from drug misuse registered in 2017 decreased by 3.2% to 2,310. This is the first decrease since 2012 and follows increases of 3.7% between 2015 and 2016, 8.5% between 2014 and 2015 and 17% between 2013 and 2014.
The number of registered heroin deaths decreased by 3.7% from 1,209, the highest number on record in 2016, to 1,164 in 2017. Treatment has been demonstrated to provide some protection against drug-related deaths, and these numbers would likely be even higher without the harm reduction safeguards it provides.
There were 774 deaths in 2017 to 2018 among people accessing treatment for alcohol problems only, which was a 1% increase on the previous year. Deaths as a proportion of all people in the alcohol only group were 1%. The median age of these deaths was 50 and 64% were male.