Last week (25 November 2021), the Office of Health Improvement and Disparities (!) published its report on the adult substance misuse treatment statistics for 2020/21. There were 275,896 adults in contact with drug and alcohol services between April 2020 and March 2021. This is a small rise compared to the previous year (270,705). The number of adults entering treatment in 2020 to 2021 was 130,490, which is similar to the previous year’s figure (132,124). The number of people entering treatment continues to be relatively stable after falling steadily since 2013 to 2014.

Key trends

• Over half (51%) of the adults in treatment were there for problems with opiates, and this remains the largest substance group. Section 2 (People in treatment) has more information about what the different substance groups are.
• People in treatment for alcohol alone make up the next largest group (28%) of all adults in treatment. The number of those rose by 3% from the previous year (from 74,618 to 76,740) but this small increase comes after a decline from a peak of 91,651 in 2013 to 2014.
• There were increases in the other 2 substance groups (a 9% increase in the non-opiate group and 1% in the non-opiate and alcohol group). This follows a similar small rise last year.
• In contrast to previous years, there has been a fall in the number of adults entering treatment for crack cocaine. This includes people who are using crack with opiates (25,043 to 21,308) and those who are using crack without opiates (4,651 to 4,545).
• The number of people entering treatment for crack is now at the lowest level since 2016 to 2017.
• People starting treatment in 2020 to 2021 with powder cocaine problems decreased by 10% (from 21,396 to 19,209). This ends a rising trend over the last 9 years, which began in 2011 to 2012.
• New entrants with cannabis and benzodiazepine problems increased again this year, with a 5% increase in cannabis (from 25,944 in 2019 to 2020 to 27,304 this year) and a 6% increase in benzodiazepines (from 4,083 in 2019 to 2020 to 4,321 this year).
• Although the numbers are relatively low, there was an increase in adults entering treatment in 2020 to 2021 with ketamine problems (from 1,140 in 2019 to 2020 to 1,444 this year). This is a 27% rise in one year and is part of a trend in rising numbers entering treatment over the last 7 years. The total is now nearly 3.5 times higher than it was in 2014 to 2015.

Housing & mental health

Over one-sixth (17%, or 22,493) of adults entering treatment last year said they had a housing problem. This proportion varied by substance group, ranging from 1 in 10 (10%, or 4,941) of those starting treatment for alcohol problems alone, to almost a third (30%, or 11,286) of those starting treatment for problems with opiate use. As in previous years, people starting treatment for problems with new psychoactive substances (NPS) had the highest proportion of housing need of any substance group (45%).

Nearly two-thirds (63%, or 82,613) of adults starting treatment said they had a mental health treatment need. This is part of a trend of rising numbers over the previous 2 years (from 53% in 2018 to 2019). Over half of new starters in all substance groups needed mental health treatment. This need ranged from 57% in the opiate group to nearly three-quarters (71%) of the non-opiates and alcohol group.

You can see the substance use, sex and age of people in treatment in the graphic below.