Numbers entering treatment for substance abuse increase

Public Health England (PHE) has released the latest national statistics for substance misuse 2018–19, indicating that the number of adults entering treatment increased by 4% from the previous year (127,307 to 132,210). This is the first increase in the number of people coming to treatment since 2013–2014, possibly reflecting recent increases in the prevalence of illicit drug use.

However, there was no significant change in the numbers receiving treatment. In all, there were 268,251 adults in contact with drug and alcohol services between April 2018 and March 2019, which was very similar to last year (268,390).

Trends in substance use

The number of people in treatment for opiates (52%) still makes up the largest proportion in treatment overall. However, the number remained stable compared to last year, falling by 1% (141,189 to 139,845). Those in treatment for alcohol alone also remained stable (75,787 to 75,555).

There were increases in the other two substance groups (2% increase in the non-opiate group and 3% in the non-opiate and alcohol group). There were also increases in the number of people starting treatment with crack problems, which has increased by 32% since 2013–2014. For the last 2 years, there has been a continued rise in the number of adults starting treatment for crack cocaine problems. This includes people who are using crack without opiates (4535 compared to 4301) and with opiates (24,363 to 22,411).

People starting treatment in the year saying they had problems with powder cocaine also increased in 2018–2019 (17,796 to 20,084). This increase is likely to be related to a surge in global cocaine production. According to the European Drug Report 2019: Trends and Developments, seizures of cocaine in Europe are at record levels. Over 104,000 cocaine seizures were reported in the EU in 2017 (compared with 98 000 in 2016). This amounts to 140.4 tonnes, around double the quantity seized in 2016 (70.9 tonnes). Although the retail price of cocaine remained stable, its purity at street level reached its highest level in a decade in 2017. There have also been changes in distribution and supply, such as with ‘county lines’ drug dealing operations.

There was also an 11% increase in the number of adults entering treatment in 2018–2019 for problems with new psychoactive substances (NPS) (1223 to 1363). This increase was largely driven by those taking NPS alongside opiates (they increased from 584 to 751, or 29%).

Rise in drug deaths

There were increases in deaths for people in treatment across all substance groups, but the overall increase was driven by those in treatment for problems with opiates (1712 to 1897, or 1.4% of adults in treatment for opiate use).

Drug use is a significant cause of premature death in England. The number of deaths from drug misuse registered in 2018 increased by 16% to 2670. This is at the highest level ever, with deaths of middle-aged heroin users being one of the main causes of the increase in drug poisonings. There was also a large increase in deaths involving powder cocaine or crack.

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