Interesting things about alcohol and other drugsNovember 2017Andrew Brown
@andrewbrown365
Number of adults in community drug and alcohol treatment in England, 2013-14 to 2016-17
155,852
25,570
28
,871
91,6
51
152,9
64
25,025
28
,128
89
,107
149
,80
7
25,814
28
,187
85,035
146
,536
24
,561
28
,24
2
80
,454
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
Opiate Non-opiate only Alcohol and non-opiate Alcohol only
2013-14 2014-15 2015-16 2016-17
There has been a fall in the
number of adults in treatment
in the community (3% down
on last year).
This has been particularly steep
in those in treatment for
alcohol alone (5% down from
2015-16), and prevalence
estimates suggest 4 in 5 people
who are alcohol dependent
aren’t having their treatment
needs met.
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23% (2,980 to 3,657).
Source: Substance misuse and treatment in adults: statistics 2016 to 2017 (PHE, 2017)
Change in acute housing problems between start of drug or alcohol treatment and six month review
19%
10%
12%
7%
14%
6%
8%
4%
0%
5%
10%
15%
20%
25%
Opiate Non-opiate Non-opiate and alcohol Alcohol only
Baseline Review
Source: Substance misuse and treatment in adults: statistics 2016 to 2017 (PHE, 2017)
Nineteen per cent of opiate clients reported an acute housing problem at the start of treatment, which fell to 14% by the time of the six-month review. Improvements were also seen in individuals presenting with other substances, ranging from a 4% drop for non-opiate only clients and non-opiate and alcohol clients to 3% for alcohol only clients.
Non-fatal overdoses amongst people who inject drugs
15%
17%18%
19%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
2013 2014 2015 2016
Among the participants who took part in the main Unlinked Anonymous Monitoring Survey across England in 2016 who had injecting during the preceding 12 months (recent injectors), 19% reported overdosing in the preceding year, which has increased significantly from 15% in 2013.
Self-reported overdose in 2016 was lowest among those who were currently in treatment for their drug use (i.e. those being prescribed a detox or maintenance drug regime; 16%). Self-reported overdose was 21% among PWID who had never been in treatment in 2016, and was especially high among those who had previously been in treatment but were not currently (31%).
Source: Non-fatal overdose among people who inject drugs in England: 2017 report (PHE, 2017)
Reduction in re-offending in the two-years following the start of treatment, by substance group
-31%
-59%
-44% -44% -44%
-21%
-49%
-36% -35%-33%
-70%
-60%
-50%
-40%
-30%
-20%
-10%
0%
Opiates Alcohol onlyAlcohol & non-
opiates Non-opiates only Total
Offenders Offences
44% of clients did not reoffend in this period [two years following the start of treatment], and this resulted in the number of recorded offences decreasing by 33%. Opiate clients had the lowest percentage change in recorded offenders and offences (31% and 21%, respectively), while the alcohol only client group experienced the greatest reduction in both offenders and offences (59% and 49%, respectively).
There was a 55% reduction in clients with one offence recorded against them, a 45% reduction in clients with two offences recorded against them, and this decreasing trend generally continues. There was a reduction of only 0.3% in the number of clients with 15 or more offences recorded against them.
Source: The impact of community-based drug and alcohol treatment on re-offending (MoJ and PHE, 2017)
Number of offenders recalled to prison in England and Wales for a reason reported as drugs and/or alcohol, by sex
530
585
665
604
438482
429
342
277
31
50
54
58
4035
33
32
24
0
100
200
300
400
500
600
700
800
Jan-Mar2015
Apr-Jun2015
Jul-Sep 2015 Oct-Dec2015
Jan-Mar2016
Apr-Jun2016
Jul-Sep 2016 Oct-Dec2016
Jan-Mar2017
Male Female
Source: Offender Management Statistics Quarterly (MoJ, 2016 and 2017)
There are various reasons why offenders are recalled to custody for breaching their licence conditions. For example, an offender may be recalled if there is any deterioration in his behaviour which leads the Probation Service to conclude that there is an increased risk of the offender committing further offences. If an offender is no longer in touch with his Offender Manager or if he has resumed a drug habit or alcohol abuse or has been spotted entering an exclusion zone – all such breaches are likely to lead to the offender being recalled to custody.
Number of arrest occasions pre- and post-positive drug test for for Class A drugs in Merseyside between April and September 2015
29
8
156
102
65
32 27
14 6
15 15
235
144
82
43
40
22 14 15
5 7
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8 9 10+
Nu
mb
er o
f in
div
idu
als
Number of arrest occasions
Pre-positive drug test Post-positive drug testOverall, both the volume of offending and the number of individuals offending reduced post-positive drug test when compared to pre-test. Individuals were arrested a total of 1,951 times during the 12 months prior to their positive drug test, compared to 1,626 arrest occasions during the 12 months following the drug test. This represents a 16.7% reduction in the number of offences following the positive drug test.
Almost three in five of the positive drug test cohort who reoffended following the drug test were not tested at subsequent arrests. This shows us that a substantial proportion of Class A drug using offenders are not being drug tested under the targeted testing process, thus highlighting missed opportunities to identify and engage them in treatment to reduce their drug use and offending behaviour.
The value of drug testing by Merseyside Police should not be underestimated as it is a key stage in the process of identifying drug using offenders and helping them to engage with local drug treatment services.
Source: Drug Interventions Programme – Re-offending of clients testing positive for class A drugs across Merseyside (LJMU 2017)
Percentage of suspected drug driving saliva tests collected by police giving positive results, by age group
57%60%
58%55% 55%
47%
33%
0%
10%
20%
30%
40%
50%
60%
70%
16-19 20-24 25-29 30-34 35-39 40-49 50+
Data on saliva tests presented here is from primary data collected by the 24 police... The data is based on the results from 4,292 preliminary drug screening tests… 93% of preliminary drug screening (saliva) tests were carried out at the roadside, after a driver had been stopped, with only 7% of the tests being undertaken at a station.
…the percentage of saliva tests giving positive results varies by age group, with the peak percentage for those aged 20 to 24. Those stopped are also predominantly male, with approximately 94% of those stopped and saliva tested being men. For men, 61% of tests were positive (base 3,200) while for women, 51% of tests were positive (base 200).
Of these positive tests, 75% were positive for cannabis only, 14% for cocaine only, while 11% indicated the presence of both cannabis and cocaine.
Source: Evaluation of the new drug driving legislation, one year after its introduction (Risksol Consulting Ltd 2017)
Number and rate (per 100,000 registered patients) of emergency admissions to hospitals in England for alcohol related liver disease in adults aged 19 years and older
10,361 10,644 10,879 10,696
11,79412,402 12,50823.6
24.3 24.9 24.4
26.727.7 27.7
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
0.0
5.0
10.0
15.0
20.0
25.0
30.0
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17(provisional)
Rat
e p
er 1
00
,00
0 p
atie
nts
Nu
mb
er o
f em
erg
ency
ad
mis
sio
ns
Number Rate
Source: Clinical Commissioning Group Outcomes Indicator Set (NHS Digital, 2017)
Provisional rate (per 100,000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17, by CCG
NHS Tower Hamlets CCG, 4.2
All registered patients in England, 27.7
NHS South Sefton CCG, 93.3
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
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Source: Clinical Commissioning Group Outcomes Indicator Set (NHS Digital, 2017)
Number of people diagnosed with HIV in the UK where probable route of exposure is injecting drug use
180
170
150 150
130 130 130
150
190
130
0
20
40
60
80
100
120
140
160
180
200
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source: HIV: annual data tables (PHE, 2017)
Number of people seen for HIV care in the UK and receiving antiretroviral therapy (ART) where probable route of exposure is through injecting drug use
1,5271,609 1,648
1,729 1,736
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
2012 2013 2014 2015 2016
Source: HIV: annual data tables (PHE, 2017)
Characteristics of patients who died by suicide and had been in touch with mental health services in the 12 months over the last 10 years
68%
22%
45%
33%
73%
27%
63%
43%
68%
25%
58%
46%
70%
25%
49%
38%
0%
10%
20%
30%
40%
50%
60%
70%
80%
History of self-harm History of violence History of alcohol misuse History of drug misuse
England Northern Ireland Scotland Walesn = 13,576 n = 778 n = 2,652 n = 817
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
Patients in contact with mental health services in the 12 months, prior to death by suicide in England, by primary psychiatric diagnoses
6,021
2,275
1,234 1,033
765 645 576 547
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
Affective disorders Schizophrenia Personalitydisorder
Alcoholdependence
Adjustmentdisorder
Anxiety disorders Drug dependence Other
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
Number of patients in contact with mental health services, in the 12 months prior to death by suicide, with a history of alcohol or drug misuse, in England
544
466501
561524
560
624598
575
515486
375356
337
391357
377
475
431 442413
389
0
100
200
300
400
500
600
700
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Alcohol DrugThe number of suicides in patients with a history of alcohol or drug misuse has fallen since a peak in 2011. Between 2011-2015, 375 (7%) patients who died were under drug services, 389 (7%) were under alcohol services, and 612 (11%) were under either drug or alcohol services.
The most common substances misused in the 3 months prior to suicide were alcohol (59%), cannabis (21%), stimulants (15%) and heroin (13%). The number of patients misusing alcohol or heroin fell between 2011 and 2014.
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
Number of homicides by patients with mental ill health with a history of alcohol or drug misuse
58
52
42
47
3335
47
35
41
37
28
58 59
4953
3639
42
41
47
31
34
0
10
20
30
40
50
60
70
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Alcohol Drugs555 patients [in the last decade] (88%, excluding unknowns) had a history of either alcohol or drug misuse or both, an average of 50 homicides per year. Therefore, only 12% of patients who committed a homicide had no history of alcohol and/or drug misuse.
167 (27%) patients [who committed homicide in the last decade] had “dual diagnosis”, defined as severe mental illness (schizophrenia or affective disorders) and co-morbid alcohol or drug dependence/misuse, an average of 15 per year. The number of patient homicides with “dual diagnosis” fell after a peak in 2005 but has risen since 2010.
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
50%53%
77%73%
78%71%
80%
88%
100%
89%
58% 58%
86%91% 92%
61%
46%
75% 74% 74%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
History of self-harm History of violence Any previous convictions History of alcohol misuse History of drug misuse
England Northern Ireland Scotland Walesn = 641 n = 18 n = 137 n = 39
Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
Multiple needs of people entering domestic abuse services and captured by the SafeLives database between April 2014 to March 2017
6%
12%
45%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Drug misuse Alcohol misuse Mental health problems
Needs experienced within the last 12 months In the period April 2014 to March 2017, caseworkers submitted 974 intake forms for clients entering 11 health services across England and Wales which used the SafeLives Insights outcome measurement service.
Where a referral route was recorded(n = 811), 1% (6 cases) were from drug and alcohol services, and 6% (47 cases) were by mental health services.
Of clients accessing support (n = 515) 28% (143) engaged with mental health services, 9% (48) with drug services, and 14% (72) with alcohol services.
Source: Insights National Dataset Health 2016-17 (SafeLives, 2017)
First time entrants to the criminal justice system in England and Wales between 2003/04 and 2012/13
9.8%
0.9%
3.8%
1.6%
29.5%
1.1%
4.6%
7.2%
2.2%
10.0%
38.2%
0.9%
0% 20% 40% 60%
Violence against the person
Sexual offences
Burglary
Robbery
Theft and handling stolen goods
Fraud and forgery
Criminal damage
Drug offences
Other indictable offences
Indictable motoring offences
Summary offences excluding…
Summary motoring offences
Proven first offence characteristics of first time entrants to the criminal justice system
7,344
6,151
3,654
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
Number of FTEs by proven drug offence, by year
Source: An analysis of trends in first time entrants to the youth justice system (MoJ, 2017)
n= 757,231
Kilos of cocaine (including crack) and heroin seized by the police and Boarder Force
3,249 3,468
2,949 2,702
2,437
3,495
3,079
3,463 3,419
4,282
5,555
1,003 1,041
1,552 1,516
732
1,849
752 642
1,113 806 783
-00
1,000
2,000
3,000
4,000
5,000
6,000
2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17
Cocaine (including crack) Heroin
Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office)
In 2016/17, 5,516 kilograms of cocaine were seized by the police and Border Force, a 30% increase on the previous year (4,240 kg), and the largest quantity since 2003.
There were 39 kilograms of crack seized in 2016/17, 3 kilograms less than in 2015/16.
In 2016/17, 783 kilograms of heroin were seized, a 3% decrease on 2015/16 when 806 kilograms were seized.
Quantity of cannabis seized, 2006/07 to 2016/17, police forces and Border Force
-00
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
-00
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
Nu
mb
er o
f p
lan
ts
Kilo
gra
ms
Herbal cannabis Cannabis resin Cannabis plants The total quantity of herbal cannabis seized in 2016/17 fell by 61% from the previous year, from 30,493 kilograms to 11,861 kilograms. However, the quantity of herbal cannabis seized in 2015/16 was the largest since 2008/09, largely due to seizures made by Border Force. The fall in the last year should therefore be seen in the context of the longer term trend. Over the last year, the total quantity of herbal cannabis seized by Border Force decreased by 69%, from 27,132 kilograms to 8,370 kilograms. At the same time, the quantity of herbal cannabis seized by police forces increased by 4% from 3,361 kilograms in 2015/16 to 3,492 kilograms in 2016/17.
Over the same time period, the quantity of cannabis resin seized decreased from 7,035 kilograms in 2015/16 to 5,838 kilograms in 2016/17 (down by 17%).
Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office)
Proportion of drug seizure quantities by drug type and authority, 2016/17
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Police Boarder Force
Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office)
Proportion of cases where the outcome of the stop was linked to the reason for the stop and search, by reason for stop and ethnicity
0%
5%
10%
15%
20%
25%
30%
Drugs Stolenproperty
Firearms Offensiveweapons
Criminaldamage
Goingequipped
Other
White BMEIn the year ending March 2017 around 1 in 5 stop and searches resulted in an outcome that was linked to the reason for the search, i.e. the officer found what they were searching for. This proportion varied considerably depending on the reason for the stop. While around 1 in 4drug stops led to an outcome related to ‘Drugs’, this figure was around 1 in 10 for searches relating to ‘Criminal damage’ and ‘Going equipped’.
The figures cover all searches, including those that resulted in an outcome of ‘No furtheraction’. Given that ‘No further action’ outcomes will rarely be linked to the initial reason for the search, it is helpful to consider the picture when these cases are excluded. When this is done, 65% of outcomes were linked to the initial reason for the search. This proportion varied by outcome type. For example… 82% of cannabis/khat warnings were linked to the reason for the search…
Source: Police powers and procedures England and Wales year ending 31 March 2017 second edition (Home Office)