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The latest drug & alcohol treatment trends
Drug & alcohol treatment data for 2021/22 show an increase in the number of people using powder cocaine.

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Treatment trends

Yesterday (19 January 2023), the Office for Health Improvement & Disparities published the adult substance misuse treatment statistics for 2021/22. In this blog post, I summarise the main trends in treatment numbers.

There were 289,215 adults in contact with drug and alcohol services between April 2021 and March 2022. This is a rise compared to the previous year (275,896).

However, the number of adults entering treatment in 2021 to 2022 was 133,704, which is similar to the previous 2 years’ figures (130,490 and 132,124). The numbers of people entering treatment continues to be relatively stable after falling steadily since 2013 to 2014.

 Substance of choice

The number of people in treatment for opiate use was very similar to last year (going down slightly from 140,863 to 140,558). Nearly half (49%) the adults in treatment were there for problems with opiates, and this remains the largest substance group. 

People in treatment for alcohol alone make up the next largest group (29%) of all adults in treatment. The number of those rose by 10% from the previous year (from 76,740 to 84,697) but this 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 7% increase in the non-opiate group and 12% in the non-opiate and alcohol group). This follows a similar small rise last year.

Following the pattern of last year, there has been a fall in the overall number of adults entering treatment for crack cocaine. This fall only includes people who are using crack with opiates (21,308 to 18,832). Those who are using crack without opiates saw a small increase (4,545 to 4,711).

The number of people entering treatment for crack is now at the lowest level since 2015 to 2016.

People starting treatment in 2021 to 2022 with powder cocaine problems increased by 11% (from 19,209 to 21,298). This is close to the peak number of 21,396 in 2019 to 2020.

New entrants to treatment for cannabis problems increased again this year, which saw a 4% rise (from 27,304 in 2020 to 2021 to 28,263 this year). New entrants with benzodiazepine problems fell 11% (from 4,321 in 2020 to 2021 to 3,848 this year), after increasing every year since 2018 to 2019.

Although the numbers are relatively low, there was an increase in adults entering treatment in 2021 to 2022 with ketamine problems (from 1,444 in 2020 to 2021 to 1,551 this year). This is part of a trend in rising numbers entering treatment over the last 8 years. The total is now 3.5 times higher than it was in 2014 to 2015.

You can see these figures summarised in the infographic reproduced below.

Housing and mental ill-health

One-sixth (16%, or 20,812) of adults entering treatment last year said they had a housing problem. This proportion varied by substance group, ranging from 9% (5,031) of those starting treatment for alcohol problems alone to almost a third (29%, or 9,435) 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 (42%).

Over two-thirds (70%, or 93,380) of adults starting treatment said they had a mental health treatment need. This is part of a trend of rising numbers over the previous 3 years (from 53% in 2018 to 2019). Two-thirds of new starters in all substance groups needed mental health treatment. This need ranged from 66% in the opiate group to over three-quarters (76%) of the non-opiates and alcohol group.

Treatment exits

There were 126,118 people who exited the drug and alcohol treatment system in 2021 to 2022. Nearly half (49%) of those left having successfully completed their treatment, free from dependence. This is similar to the proportion of people who successfully completed treatment in the previous year (from 50% to 49%).

This data set also includes an interesting analysis of the 1,104,927 people who have been in contact with drug and alcohol treatment services between 2005/7 and 2021/22. As of 31 March 2022:

  • 153,306 (14%) of this cohort were still engaged in treatment
  • 435,840 (39%) had left before they completed their treatment and had not returned
  • 515,781 (47%) had completed their treatment and not returned

Deaths in treatment

The total number of people who died while in contact with treatment services in 2021 to 2022 was 3,742 (1.3% of all adults in treatment). This represents a 0.4% increase of deaths in treatment compared to last year (3,726, or 1.4% of all adults in treatment).

Last year, all substance groups saw an increase in deaths in treatment compared to the previous year. By contrast, the proportion of people dying in treatment this year increased only in the non-opiate only group (17%) and the opiate group (1%).

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