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Some of the most interesting things about alcohol and other drugs in 2017
Andrew Brown
andrewbrown365
Prevalence
Estimated prevalence of dependence in England
257000
183000
595000
0
100000
200000
300000
400000
500000
600000
700000
Opiate Crack Alcohol
Estimated number of opiate andor crack cocaine users by age in England in 201112 and 201415
32628
109124
152127
30190
91808
178785
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
15 to 24 years 25 to 34 years 35 to 64 years
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Estimated number of opiate and crack users in England in 201112 and 201415 by region
169
35
46
337
36270
24
08
5
3432
9
219
52
549
85
329
35 26
051 17675
48
814
366
62
25057
34822
25910
524
87
32734
26
622
-
10000
20000
30000
40000
50000
60000
North East NorthWest
Yorkshireand theHumber
EastMidlands
WestMidlands
East ofEngland
London South East SouthWest
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Nationally there was a 2 increase in
the estimated number of OCUs but this
change was not statistically significant
The number of OCUs in the East of
England increased by 18 from 21952
in 201112 to 25910 in 201415 and this
increase of 3958 was statistically
significant (95 CI 270 to 7606) There
was an increase in the point estimate in
the North West of 2477 ndash an increase of
5 - but this was not statistically
significant All other regions saw
increases in the point estimate apart
from a small fall in the South East and a
larger (but still not statistically
significant) fall in London
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Prevalence
Estimated prevalence of dependence in England
257000
183000
595000
0
100000
200000
300000
400000
500000
600000
700000
Opiate Crack Alcohol
Estimated number of opiate andor crack cocaine users by age in England in 201112 and 201415
32628
109124
152127
30190
91808
178785
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
15 to 24 years 25 to 34 years 35 to 64 years
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Estimated number of opiate and crack users in England in 201112 and 201415 by region
169
35
46
337
36270
24
08
5
3432
9
219
52
549
85
329
35 26
051 17675
48
814
366
62
25057
34822
25910
524
87
32734
26
622
-
10000
20000
30000
40000
50000
60000
North East NorthWest
Yorkshireand theHumber
EastMidlands
WestMidlands
East ofEngland
London South East SouthWest
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Nationally there was a 2 increase in
the estimated number of OCUs but this
change was not statistically significant
The number of OCUs in the East of
England increased by 18 from 21952
in 201112 to 25910 in 201415 and this
increase of 3958 was statistically
significant (95 CI 270 to 7606) There
was an increase in the point estimate in
the North West of 2477 ndash an increase of
5 - but this was not statistically
significant All other regions saw
increases in the point estimate apart
from a small fall in the South East and a
larger (but still not statistically
significant) fall in London
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated prevalence of dependence in England
257000
183000
595000
0
100000
200000
300000
400000
500000
600000
700000
Opiate Crack Alcohol
Estimated number of opiate andor crack cocaine users by age in England in 201112 and 201415
32628
109124
152127
30190
91808
178785
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
15 to 24 years 25 to 34 years 35 to 64 years
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Estimated number of opiate and crack users in England in 201112 and 201415 by region
169
35
46
337
36270
24
08
5
3432
9
219
52
549
85
329
35 26
051 17675
48
814
366
62
25057
34822
25910
524
87
32734
26
622
-
10000
20000
30000
40000
50000
60000
North East NorthWest
Yorkshireand theHumber
EastMidlands
WestMidlands
East ofEngland
London South East SouthWest
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Nationally there was a 2 increase in
the estimated number of OCUs but this
change was not statistically significant
The number of OCUs in the East of
England increased by 18 from 21952
in 201112 to 25910 in 201415 and this
increase of 3958 was statistically
significant (95 CI 270 to 7606) There
was an increase in the point estimate in
the North West of 2477 ndash an increase of
5 - but this was not statistically
significant All other regions saw
increases in the point estimate apart
from a small fall in the South East and a
larger (but still not statistically
significant) fall in London
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated number of opiate andor crack cocaine users by age in England in 201112 and 201415
32628
109124
152127
30190
91808
178785
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
15 to 24 years 25 to 34 years 35 to 64 years
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Estimated number of opiate and crack users in England in 201112 and 201415 by region
169
35
46
337
36270
24
08
5
3432
9
219
52
549
85
329
35 26
051 17675
48
814
366
62
25057
34822
25910
524
87
32734
26
622
-
10000
20000
30000
40000
50000
60000
North East NorthWest
Yorkshireand theHumber
EastMidlands
WestMidlands
East ofEngland
London South East SouthWest
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Nationally there was a 2 increase in
the estimated number of OCUs but this
change was not statistically significant
The number of OCUs in the East of
England increased by 18 from 21952
in 201112 to 25910 in 201415 and this
increase of 3958 was statistically
significant (95 CI 270 to 7606) There
was an increase in the point estimate in
the North West of 2477 ndash an increase of
5 - but this was not statistically
significant All other regions saw
increases in the point estimate apart
from a small fall in the South East and a
larger (but still not statistically
significant) fall in London
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated number of opiate and crack users in England in 201112 and 201415 by region
169
35
46
337
36270
24
08
5
3432
9
219
52
549
85
329
35 26
051 17675
48
814
366
62
25057
34822
25910
524
87
32734
26
622
-
10000
20000
30000
40000
50000
60000
North East NorthWest
Yorkshireand theHumber
EastMidlands
WestMidlands
East ofEngland
London South East SouthWest
201112 201415
Source Estimates of the Prevalence of Opiate Use andor Crack Cocaine Use 201415 Sweep 11 report (LJMU 2017)
Nationally there was a 2 increase in
the estimated number of OCUs but this
change was not statistically significant
The number of OCUs in the East of
England increased by 18 from 21952
in 201112 to 25910 in 201415 and this
increase of 3958 was statistically
significant (95 CI 270 to 7606) There
was an increase in the point estimate in
the North West of 2477 ndash an increase of
5 - but this was not statistically
significant All other regions saw
increases in the point estimate apart
from a small fall in the South East and a
larger (but still not statistically
significant) fall in London
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated number of children who live with opiate users by region
-
5000
10000
15000
20000
25000
30000
East of England East Midlands London North East North West South East South West West Midlands Yorkshire andthe Humber
Female Opiate Users
Male Opiate Users
Source Estimates of the number of children who live with opiate users England 201112 (PHE 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated proportion of the population who are alcohol dependent by upper tier local authority
000
200
400
600
800
1000
1200
Wo
kin
gh
am
Su
rrey
Wes
thellip
Ham
psh
ire
Lei
cest
ershellip
Wilt
shir
e
Bro
mle
y
Eas
thellip
Ess
ex
So
lihu
ll
Bex
ley
Her
efo
rdshellip
Dev
on
Sh
rop
shir
e
Bat
h a
nd
hellip
En
fiel
d
Ken
t
Sta
ffo
rdsh
hellip
Ho
un
slo
w
No
rfo
lk
Su
tto
n
Ch
esh
irehellip
Eal
ing
Der
bys
hir
e
Cal
der
dal
e
Gre
en
wic
h
Wal
tham
hellip
Bu
ry
Co
rnw
allhellip
So
uth
end
-hellip
Bar
kin
ghellip
To
rbay
Du
dle
y
No
rth
hellip
So
uth
hellip
Der
by
Dar
ling
ton
Co
un
tyhellip
Red
carhellip
Bo
lto
n
Old
ham
Hac
kne
y
Po
rtsm
ou
th
Bar
nsl
ey
Wir
ral
San
dw
ell
Islin
gto
n
Tam
esid
e
Kin
gst
on
hellip
Sal
ford
Bla
ckp
oo
l
D
ep
en
de
nce
ra
te
Source Estimates of alcohol dependence in England including estimates of children living in a household with an adult with alcohol dependence supplementary tables (PHE 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Health and drug and alcohol treatment services
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Types of identified substance misuse support for women in England and Wales
337
337
120
108
96
00 100 200 300 400
Womenrsquos group in generic service
Substance misuse midwife
Women-only residentialrehabilitation facility
Other type of substance usesupport
Women-only non-residentialsubstance misuse service
N = 83Data from the National Drug Treatment
Monitoring System (NDTMS) indicates that
currently around a third of people
accessing drug treatment services are
women with the figure rising to almost
40 in alcohol only support services
As such finding that only around half of all
local authority areas in England (n=74
490) and five unitary authorities in Wales
(227 of all authorities in Wales) are home
to localised support specifically for women
experiencing substance use problems is
disappointing
Source Holly J (2017) Mapping the Maze Services for women experiencing multiple disadvantage in England and Wales London Agenda amp AVA
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of adults in community drug and alcohol treatment in England 2013-14 to 2016-17
155852
25570
28
871
916
51
1529
64
25025
28
128
89
107
149
80
7
25814
28
187
85035
146
536
24
561
28
24
2
80
454
-
20000
40000
60000
80000
100000
120000
140000
160000
180000
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
arenrsquot having their treatment
needs met
The number of individuals
presenting with crack cocaine
problems (not being used
alongside opiates) increased
by 23 (2980 to 3657)
Source Substance misuse and treatment in adults statistics 2016 to 2017 (PHE 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
NHS hospital finished admission episodes with a primary or secondary diagnosis of drug related mental health and behavioural disorders in England
819
0474
80
1
68
5976114
2
57852
5135344
585
42
170
40
42
1
38170
380
05
0
10000
20000
30000
40000
50000
60000
70000
80000
90000 There were 81904 hospital admissions with
a primary or secondary diagnosis of drug-
related mental and behavioural disorders
This is 9 more than 201415 and over
double the level in 200506 ndash though the
increase from 200506 will be partly due to
improvements in recording of secondary
diagnoses
The North West had the highest rate of
admissions per 100000 population for both
males and females at 326 and 141
respectively The South East had the lowest
rates at 139 for males and 61 for females
Source Statistics on Drugs Misuse England 2017 (NHS Digital 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Numbers of people admitted to hospital in England recorded as having a diagnosis of withdrawing from alcohol (broad measure)
10730
12620
14430
1634017960
19800
21590 2203022970 22900
2427025040
26810
1270 1290 1390 1400 1210 1220 1230 1130 1220 1230 1100 1210 1300
0
5000
10000
15000
20000
25000
30000
200304 200405 200506 200607 200708 200809 200910 201011 201112 201213 201314 201415 201516
Withdrawal state
Withdrawal state with delirium
Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Admission episode rates for alcohol related conditions and healthy life expectancy at birth for males in Englandrsquos Upper Tier local Authorities
50
55
60
65
70
75
450 650 850 1050 1250 1450 1650
Ma
le h
ea
lth
y li
fe e
xp
ect
an
cy a
t b
irth
Admission episode rates for alcohol related conditions
ldquoA proxy measure for the harmful effects of drinking is the number of occasions where acute healthcare is required as a result which can be measured through Hospital Episode Statistics The national rate of alcohol-related admissions in England for males and females combined during the financial year ending (FYE) 2015 was 6347 per 100000 but there were large differences in the rate of admission for alcohol-related conditions across the countryhellip
For example by comparing the extremes the rate of admission episodes among males was more than three times greater in Blackpool (15440 per 100000) compared to Wokingham (4936 per 100000) These areas are starkly contrasting in terms of male HLE at birth men in Wokingham were expected to live 142 more years in good health compared to men in Blackpool in 2013 to 2015rdquo
Source An overview of lifestyles and wider characteristics linked to Healthy Life Expectancy in England June 2017 (ONS 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of admissions and bed days for those diagnosed with alcohol related mental and behavioural disorders associated with dependence and withdrawal in hospitals in England in 2015-16
1300
26810
320
52970
1970
0 20000 40000 60000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Admissions (broad measure)
6579
74921
4731
55581
19275
- 20000 40000 60000 80000
Withdrawal state with delirium
Withdrawal state
Psychotic disorder
Dependence syndrome
Amnesic syndrome
Number of finished consultant episodes bed days
Source Hospital Admitted Patient Care Activity 2015-16 (NHS Digital 2016)Source Alcohol-related hospital admissions ndash Statistical tables for England (PHE 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number and proportion of patients who have an emergency alcohol-specific readmission to any hospital within 30 days of discharge following an alcohol-specific admission
2116122016
2334124036
1112
1213
0
2
4
6
8
10
12
14
0
5000
10000
15000
20000
25000
30000
April 2011 - March 2014 April 2012 - March 2015 April 2013 - March 2016 April 2014 - March 2017 (Provisional)
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Provisional rate (per 100000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17 by CCG
NHS Tower Hamlets CCG 42
All registered patients in England 277
NHS South Sefton CCG 933
00
100
200
300
400
500
600
700
800
900
1000
NH
S T
ow
er H
amle
ts C
CG
NH
S P
ort
smo
uth
CC
GN
HS
So
uth
Glo
uce
ster
shir
ehellipN
HS
Bat
h a
nd
No
rth
Eas
thellipN
HS
Wes
t H
amp
shir
e C
CG
NH
S B
arn
et
CC
GN
HS
Ch
ilte
rn C
CG
NH
S Ip
swic
h a
nd
Eas
t S
uff
olk
hellipN
HS
No
rth
Ham
psh
ire
CC
GN
HS
Eas
t R
idin
g O
f Y
ork
shir
ehellip
NH
S H
igh
Wea
ld L
ewes
hellipN
HS
Eas
t an
d N
ort
hhellip
NH
S C
royd
on
CC
GN
HS
New
bu
ry a
nd
Dis
tric
t C
CG
NH
S K
ing
sto
n C
CG
NH
S O
xfo
rdsh
ire
CC
GN
HS
Ho
un
slo
w C
CG
NH
S D
artf
ord
Gra
vesh
amhellip
NH
S N
ott
ing
ham
Cit
y C
CG
NH
S E
alin
g C
CG
NH
S S
hro
psh
ire
CC
GN
HS
Ho
rsh
am a
nd
Mid
hellipN
HS
So
uth
Lin
coln
shir
e C
CG
NH
S C
ove
ntr
y an
d R
ug
by
CC
GN
HS
Bri
sto
l CC
GN
HS
Lee
ds
No
rth
CC
GN
HS
Win
dso
r A
sco
t an
dhellip
NH
S H
eref
ord
shir
e C
CG
NH
S S
ou
th E
ast
Sta
ffo
rdsh
irehellip
NH
S N
orw
ich
CC
GN
HS
Bar
kin
g a
nd
Dag
enh
amhellip
NH
S C
entr
al M
anch
este
r C
CG
NH
S N
ene
CC
GN
HS
Wyr
e F
ore
st C
CG
NH
S E
ast
Sta
ffo
rdsh
ire
CC
GN
HS
Du
rham
Dal
eshellip
NH
S B
rad
ford
Dis
tric
ts C
CG
NH
S O
ldh
am C
CG
NH
S N
ort
h W
est
Su
rrey
CC
GN
HS
Sca
rbo
rou
gh
an
dhellip
NH
S V
ale
Ro
yal C
CG
NH
S W
alsa
ll C
CG
NH
S H
ard
wic
k C
CG
NH
S S
wal
e C
CG
NH
S H
artl
epo
ol a
nd
hellipN
HS
New
cast
le G
ates
hea
d C
CG
NH
S S
ou
th C
hes
hir
e C
CG
NH
S B
lack
bu
rn W
ith
Dar
wen
hellipN
HS
Gre
ater
Pre
sto
n C
CG
NH
S K
no
wsl
ey C
CG
NH
S R
edd
itch
an
dhellip
NH
S S
un
der
lan
d C
CG
Source Clinical Commissioning Group Outcomes Indicator Set (NHS Digital 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of attendances at AampE in England recorded as having social problems (including chronic alcoholism and homelessness)
3950740867
4399346197
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2013-14 2014-15 2015-16 2016-17
Source Accident and Emergency Attendances in England for 2014-15 2015-16 and 2016-17 NHS Digital
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
It is estimated that the following proportion of a GPrsquos practice (with 2000 patients) will havehellip
176
04
60 60
30
88
0
2
4
6
8
10
12
14
16
18
20
Common mental healthproblems
Psychosis Below diagnositicthreshold for psychosis
Alcohol dependency Drug dependency Personality disorder
Source Mental health in the West Midlands Combined Authority (Centre for Mental Health and University of Birmingham 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
LGA survey of local authorities about providing naloxone in the community
99
25 2521
1812
6 5
25
0
10
20
30
40
50
60
70
80
90
100
Drugtreatment
service
Hostels Outreachworkers
Pharmacyneedle and
syringeprogramme
Peers (otherpeople whouse drugs)
Primarycare
Communitypharmacies
AampE Other
Which services or organisations provide take-home naloxone Nine in ten respondent local authorities (90 per cent) currently made available take-home naloxone Six of the fourteen respondents which did not currently make naloxone available subsequently commented that they were either considering planning or about to make it available
ldquoAll service users accessing our local drug treatment services are offered take home Naloxone - We have piloted the distribution of take home naloxone in 3 community pharmacies providing high level of needle exchange and are looking to expand this provision across all needle exchange pharmacies over the coming year subject to ratificationrdquo (West Midlands)
ldquoNaloxone saves lives and is a very important tool in tackling DRDs in our areardquo (South East)
n = 121
Source Naloxone survey 2017 (LGA 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
High risk behaviours and multiple needs
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Characteristics people who inject drugs in 2016
70
91
68
75
13
0
10
20
30
40
50
60
70
80
90
100
Currently in treatment Ever used a needle exchange Ever been in prison Ever been homeless Ever traded sex for moneygoods or drugs
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Proportion of people who inject drugs (who had injected in preceding four weeks) who reported injecting crack powder cocaine and amphetamine
35 35 35
29 2932
36 3740
46
53
1619 18 17 18
23 22 23 24
17 17
12
12 11
8 79 9
7 810 10
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Crack Amphetamine CocaineldquoInjection of crack increased in recent years with 53 (95 CI 50-55) of those who had injected in the preceding four weeks reporting crack injection as compared to 35 (95CI 33-37) in 2006rdquo
ldquoCrack injection also increased among the recent initiates with 50 (95CI 40-59) of those who had injected in the preceding four weeks reporting crack injection in 2016 vs 28 (95CI 22-33) in 2006rdquo
ldquoThere was no significant change in the injection of cocaine (10 95CI 9-12 in 2016 vs 12 95CI 10-13 in 2006) or amphetamine (1795CI 15-19 in 2016 vs 16 95CI 14-18 in 2006) among those who had injected in the preceding four weeksrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Prevalence of blood borne viruses amongst people who inject drugs in England Wales and Northern Ireland
44 43 43
47 47
43 43
4749 50
53
28
2018 17 16 16 17 16
14 13 14
13 11 16 15 11 12 13 11 10 10 09
0
10
20
30
40
50
60
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Hepatitis C Hepatitis B HIV ldquohellipdata from the main Unlinked Anonymous Monitoring Survey of PWID which is targeted at people who inject psychoactive drugs indicate that the proportion ever infected with hepatitis B has declined and that the prevalence of HIV remains stable and low Hepatitis C remains the commonest infection among this group and overall prevalence is currently stablehellip Whilst the vast majority of those with HIV were aware of their status half of PWID with antibodies to hepatitis C remain unaware of their infection even though four-fifths reported having been tested for hepatitis C infection After increasing during the previous decade the uptake of testing for hepatitis C infection has changed little over the last few years Services should aim to have testing for blood-borne viruses available for patients at first assessment Repeat testing of people who inject drugs is recommended and when risk is assessed as high testing may be carried out up to once or twice a yearrdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Symptoms of an injection site infection (swelling containing pus (abscess) sore or open wound at an injection site) among those who injected during the preceding year
15
20
25
30
35
40
45
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Sh
ort
ened
axi
s
Under 25 25 to 34 35 and over Symptoms of a possible injection site infection are common among PWID across England Wales and Northern Ireland In 2016 36 (95 CI 34-38) of PWID who had injected during the preceding year reported that they had experienced an abscess sore or open wound at an injection site ndash all possible symptoms of an injection site infection - during the preceding year This is a similar level to 35 (95 CI 33-37) in 2006 but an increase from 28-29 reported in 2011-2013 The levels of possible injection site infection were particularly high among the under-25 year age group at 43 (95CI 30-58) which is higher than the 27 reported in 2006 (95CI 22-32)
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Proportion of participants in the Unlinked Anonymous Monitoring Survey (who had injected in preceding four weeks) who reported injecting in their groin
35
32 32
35
34
35 35
38 38 38
40
25
27
29
31
33
35
37
39
41
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
ldquoInjecting into the groin has been associated with a number of health problems including damage to the femoral vein and artery infections and circulatory problems The proportion of current PWID who reported injecting into their groin during the preceding four weeks varied across England Wales and Northern Ireland By country the proportion injecting into the groin in 2016 was as follows England 40 (95 CI 38-43) Wales 39 (95 CI 31-48) and Northern Ireland 60 (95 CI 39- 79) Across England there are differences in the proportion reporting injecting into their groin ranging from 47 (95 CI 40-54) in the South West to 33 in the East of England (95 CI 25-42)rdquo
Source People who inject drugs HIV and viral hepatitis monitoring (PHE 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Non-fatal overdoses amongst people who inject drugs
15
1718
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 (ie 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)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Annual public spending for those with three severe and multiple disadvantage profiles per person 2016-17 prices
pound1916
pound6047
pound1957
pound1235
pound5075
pound3108
pound325
pound3108
pound-
pound1000
pound2000
pound3000
pound4000
pound5000
pound6000
pound7000
Physical health Criminal justice Mental health Prison Rough sleeping Hostels Benefits Substance usetreatment
Source Faulty by design The state of public-service commissioning (Reform 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 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)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Mental health
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Proportion of patients treated in general hospitals with serious mental illness identified as having coexisting drug and alcohol misuse problems
15
12
8
26
17
11 11
30
0
5
10
15
20
25
30
35
Schizophrenia Otherpsychosis
Bipolaraffectivedisorder
Personalitydisorder
Drug misuse Alcohol misuse
n = 204 n = 57 n = 142 n = 43
Source Mental Health in General Hospitals Treat as One (NCEPOD 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
There were 27428 appointments made with drug and alcohol treatment for people who used adult secondary mental health and learning disabilities services between April and November 2015
781
156
37 26
00
100
200
300
400
500
600
700
800
900
Attended Did not attend Appointment cancelledpostponed byprovider
Invalidmissing data
n = 27428
Source Mental Health Bulletin 2015-16 Annual Report (NHS Digital 2016)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimated excess deaths per year below age 70 in England for people with diagnosed mental health disorder by diagnosed disorder
-
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
Substance usedisorder
Alcohol usedisorder
Schizophrenia Depressivedisorder
Opioid usedisorder
Bipolardisorder
Personalitydisorder
Schizoaffectivedisorder
Stress-relateddisorders
Anxietydisorder
Unnatural
Source On the State of the Publicrsquos Health Baby Boomers Fit for the Future (Department of Health 2016)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Use of section 136 in England 201112-201516 health and police based places of safety
14902 14053
17008
19403
22965
8667 7761
6028
3996
1764 -
5000
10000
15000
20000
25000
201112 201213 201314 201415 201516
where PoS was health-based ie a hospital
where PoS was policecell or custody suite
The use of section 136 of The Act (under which people
were brought to hospital as a lsquoplace of safetyrsquo)
increased by 18 per cent since last year to 22965
The increase in uses of Section 136 to take people to a
hospital as a place of safety should also be viewed in
the context of a fall by a similar number in the use of
section 136 where the place of safety is a police cell
Data released by the police in 2016 and previous years
shows the number of uses of section 136 where the
place of safety was a police cell in England reducing
from just under 9000 in 201112 to 1764 in 201516 a
fall in number of 6903 (80) across that four year
period
Source Inpatients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment (NHS Digital 2016)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Associations between diagnosis and being re-detained or admitted following being detained under Section 136 of the Mental Health Act
[Across the cohort the] most common primary diagnosis was F20ndash
F29 schizophrenia schizotypal and delusional disorders (n=52 21)
F60ndashF69 disorders of adult personality and behaviour (n=50 21)
and F10ndashF19 mental and behavioural disorders due to psychoactive
substance use (n=48 20) Fifty-two per cent (n=126) had either a
primary or secondary diagnosis of psychoactive substance use (F10ndash
F19)
In the year following their original S136 detention 41 individuals
(17) were detained again by the police
Patients with personality disorder were the most likely to be re-
detained under S136 and those with a primary or secondary
diagnosis of substance use were also more likely to be re-detained
multiple timeshellip in around half of the repeat detentions the
individual had been using substances Substance use should
therefore be a target for interventions to reduce crisis contacts with
health services and police
36
50
27
1713
75
6
64
2
30
0
10
20
30
40
50
60
70
80
Re-detained in follow-up period Admitted in follow-up period
Personality disorder Substance misuse Schizophrenia
Affective disorder Other diagnosis
Burgess JL White SJ OrsquoBrien A Retrospective cohort follow-up study of individuals detained under Section 136 British Journal of Psychiatry Open 2017 Nov 13(6)281-4
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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 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 = 13576 n = 778 n = 2652 n = 817
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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 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
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015)
5053
7773
7871
80
88
100
89
58 58
8691 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
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Homelessness
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Estimates of the number of households experiencing core homelessness in Great Britain by type in 2011 and 2016 (rounded)
61
00
59
00
79
00
47
100
100
00
42
90
0
91
00
89
00
121
00
42
20
0
193
00
68
30
0
-
10000
20000
30000
40000
50000
60000
70000
80000
Rough Sleepers Car tent publictransport
Squatting Hostels refugesetc
UnsuitableTemporary
Accommodation
Sofa Surfers
2011 2016
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoThe scale of core homelessness has
increased significantly across Great
Britain (33 between 2011 and 2016)rdquo
ldquoAt any one point in time core
homelessness in 2016 stood at around
1600002 households in Great Britain
(143000 in England 5100 in Wales
11800 in Scotland)rdquo
ldquoWe estimate that core homelessness
contains 57000 lsquofamilyrsquo households
(couples or lone parents) containing
82000 adults and 50000 children so
that the core homeless lsquopopulationrsquo is
236000rdquo
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Proportion of people seen rough sleeping in the year in London with alcohol drug andor mental health support needs
41
31
45
28
43
31
46
26
44
35
47
23
0
5
10
15
20
25
30
35
40
45
50
Alcohol Drugs Mental health No alcohol drugs or mental healthsupport needs
2014-15 2015-16 2016-17
Source Chain Annual Report (Greater London Authority)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Rough Sleeping Statistics Autumn 2016 England
-
500
1000
1500
2000
2500
3000
3500
4000
4500
2010 2011 2012 2013 2014 2015 2016
England London Rest of England
Rough sleeping counts and
estimates are single night snapshots
of the number of people sleeping
rough in local authority areas Local
authorities decide whether to carry
out a count or an estimate They are
encouraged to gain intelligence for
street counts and estimates from
local agencies such as outreach
workers the police the voluntary
sector and faith groups who have
contact with rough sleepers on the
street
Source Rough sleeping in England autumn 2016 (DCLG 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Proportion of local authorities reporting how the provision of specialist support andor accommodation for the groups of homeless peoplethose at risk of homelessness changed since 2010
21
11
32
2130
14
2417 16
20
10 1321 22
28 31 3338 39
44
-50
-40
-30
-20
-10
0
10
20
30
40
Migrants Women DV survivors Care leavers 16-17s Ex-prisoners 18-24s Substanceabusers
Alcohol abusers Mental illhealth sufferers
Increased Reduced n = 162
Source The homelessness monitor England 2017 (JRF and Crisis 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
The number of offences charged and reaching a first hearing at a Magistratesrsquo court in England under section 3 of the Vagrancy Act 1824
1510 1465
1763 1825 1889
1573 1626
2771
3071
2365
-
500
1000
1500
2000
2500
3000
3500
Source Rough Sleepers and Anti-Social Behaviour (England) (House of Commons Library 2016)
ldquoBegging is an offence under section 3 of
the Vagrancy Act 1824 (as amended) It is a
recordable offence The maximum
sentence is a fine at level 3 on the
standard scale (currently pound1000) Other
provisions also criminalise begging
behaviour wilfully blocking free passage
along a highway is an offence contrary to
section 137 of the Highways Act 1980 (as
amended) punishable by a level 3 fine
Using threatening or abusive words or
behaviour is an offence under section 5 of
the Public Order Act 1986 which also
carries a level 3 finerdquo
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Projections for the number of people sleeping rough in England Wales and Scotland
-
5000
10000
15000
20000
25000
30000
35000
40000
45000
2011 2016 2021 2026 2031 2036 2041
England Wales Scotland
Source Homelessness projections Core homelessness in Great Britain (CrisisHerriot Watt University 2017)
ldquoA sub-regional housing market model has been
adapted to forecast future levels of homelessness
which has modelled 15 additional variables The
model depends on many assumptions but for the
purpose of this analysis it has been fixed on a
relatively neutral benign scenario for the economy
and labour market and current policy settings
including planned welfare reformsrdquo
The 15 variables used are rough sleeping hostel residents
unsuitable temporary accommodation sofa surfers total
core homelessness homeless acceptances total homeless
applications total in temporary accommodation people
asked to leave household evictions wider homelessness
relative low income poverty after housing costs crime rates
welfare reform cuts impact (from Beatty amp Fothergill)
households in financial difficulty
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Criminal justice system
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Numbers of adults receiving treatment for drug and alcohol use disorders in prisons and other secure settings in England in 2015-16
29146
10259
12298
8551
0
5000
10000
15000
20000
25000
30000
35000
Opiate Non-opiate only Non-opiate andalcohol
Alcohol only
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
In all 60254 adults were in contact with
drug and alcohol treatment services within
secure settings during 2015-16 and most
(56803) of these were within a prison
setting with 3124 within YOIs and 327
within IRCs [Immigration Removal
Centres] Just under half (48) of those in
contact with treatment in adult settings
presented with problematic use of opiates
a further 37 presented with problems with
other drugs (non-opiates) and 14
presented with alcohol as their only
problem substance
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Numbers of adults in secure settings (prisons Youth Offending Institutions and Immigration Removal Centres) in England being treated for use of NPS by type
2163
1156
296
83
80
41
0 500 1000 1500 2000 2500
Predominantly cannabinoid
Other
Predominantly stimulant
Predominantly hallucinogenic
Predominantly sedativeopioid
Predominantly dissociative6 of all adults in treatment cited New Psychoactive
Substances (NPS) as one of their problem substances
or their only problem substance This figure represents
the number of adults presenting for treatment with
problem NPS use and not necessarily a reflection of
overall NPS prevalence in adult secure settings
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Prisoner survey responses on drugs alcohol medicines and mental health
65
31
7
76
4247
23
53
0
10
20
30
40
50
60
70
80
Do you feel you have anyemotional well beingmental
health issues
Is it easyvery easy to getillegal drugs in this prison
Is it easyvery easy to getalcohol in this prison
Are you currently takingmedication
Women MenldquoThe proportion of new
[male adult] prisoners with
a drug andor alcohol
problem remained very
high most noticeably
among those reporting a
mental health problemrdquo
ldquoOur survey showed an
increase in the proportion
of women arriving in
prison with drug and or
alcohol problemsrdquo
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Responses by adult male prisoners in England and Wales about drugs and alcohol by ethnicity
21
12
40
20
96
32
21
49
24
139
0
10
20
30
40
50
60
Did you have aproblem with
drugs when youcame into this
prison
Did you have aproblem with
alcohol when youcame into this
prison
Is it easyvery easyto get illegal drugs
in this prison
Is it easyvery easyto get alcohol in
this prison
Have youdeveloped a
problem withdrugs since you
have been in thisprison
Have youdeveloped a
problem withdiverted
medication sinceyou have been in
this prison
BAME prisoners
White prisoners
Source HM Chief Inspector of Prisons for England and Wales Annual Report 2016ndash17
ldquoDuring the course of the past year I
have seen many prisons and other
institutions operating under
extreme pressure The challenges
thrown up by the prevalence of
illegal drugs and other contraband
increasing violence too many
prisoners suffering from mental
health issues an ageing prison
population and a prison estate that
in many places is not fit for any
purpose let alone the decent
detention of human beings are
stretching hard-working and well-
intentioned staff to their limits
Reform is overduerdquo
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of community and suspended sentence orders requiring drug or alcohol treatment by year
Drug Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Drug treatment
Community Orders - Drug treatment
Alcohol Treatment
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Suspended Sentence - Alcohol treatment
Community Orders - Alcohol treatment
Source Offender Management Statistics quarterly October to December 2016 (MoJ 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Average custodial sentence (months) in England for drug offences(shortened axis)
326 325 323
315
306
299296
316
335 337
353
26
27
28
29
30
31
32
33
34
35
36
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Ave
rag
e c
ust
od
ial s
en
ten
ce (
mo
nth
s)
Source Criminal justice system statistics quarterly (MoJ 2017)
ldquoThe requirements for courts to
follow the wide overall offence
guidelines rather than the
narrower category ranges within
them mean that the Council can
report high rates of compliance
In 2014 for drug possession
offences 84 per cent of
sentences imposed fell within the
guideline offence range for Class
A drugs over 99 for class B and
89 for Class Crdquo
Source The Sentencing Council for England and Wales brake or accelerator on the use of prison(Transform Justice 2016)
New sentencing guidelines
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Prison population in England and Wales under immediate custodial sentence for drug offences by sentence length
88 139
548
3552
1399
1920
1404
877711
11
30257
0
500
1000
1500
2000
2500
3000
3500
4000
Source Hansard 2017
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Prison population under an immediate custodial sentence for drug offenses
9987
59341
55
10582
49332
450
2000
4000
6000
8000
10000
12000
Trafficking in controlled drugs Other drug offences Possession of controlled drugs(excluding cannabis)
Possession of cannabis
30-Jun-15 30-Jun-16
Source Hansard 2017
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
What did people who had a previous conviction for drug offences get reconvicted for if they reoffended during the period July 2014 to June 2015
964
87
211
6079
118
9211
767
706
2873
287
7804
3815
498
0 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000
Violence Against the Person
Sexual
Robbery
Theft
Criminal Damage and Arson
Drug
Possession of Weapons
Public Order
Miscellaneous Crimes Against Society
Fraud
Summary Non-motoring
Summary Motoring
Other
Source Proven reoffending statistics July 2014 to June 2015 (MoJ 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Positive drug tests carried out by Liverpool police on arrest by drug type (2014-15 vs 2015-16
0
500
1000
1500
2000
2500
2014-15 2015-16
Cocaine only
Opiates only
Both cocaine amp opiates
The number of attempted drug tests conducted in
Liverpoolrsquos custody suites halved between 2014-15 and
2015-16 while the number of individuals testing positive
decreased by around two-fifths (41) The rationale for
targeted testing was to reduce the number of negative
tests in order to reduce police time Although the positive
drug test rate has increased it is only by a small proportion
(6) There are substantially lower numbers of offenders
being imposed with an RA and therefore lower numbers of
drug using offenders coming into treatment This is where
there is considerable concern by treatment services
commissioners and the Police themselves This concern is
greater still for opiate drug users in Liverpool who are not
coming into the treatment system
Source Criminal Justice Project Impact of targeted drug testing on drug using offenders coming into treatment in Liverpool (PHI 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 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 amp 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 03 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)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Over a quarter (27) of all shoplifting incidents involved food and grocery items in 2016 one in seven (14) involved alcohol
0
3
3
3
4
4
6
7
14
14
16
16
27
0 5 10 15 20 25 30
Electronics toysDVDstoysgames
Toiletries
Watches belonging to the business
Personal possessions belonging to employees or customers
Money
Jewellery belonging to the business
Home accessories
Electrical or electronic equipment
Alcohol
Parts components or small equipment
Clothing
Cosmetics
Food or groceries
There were 35 million incidents of shoplifting in 2016
The 2016 CVS also included new questions for respondents who said the most commonly stolen items in shoplifting incidents were food or grocery items Respondents were asked whether the food or groceries typically stolen were high value luxury items (eg expensive cuts of meat) lower value day-to-day items (such as bread or milk) or a combination of these Responses shows that the majority of premises (71 for all incidents and 80 for the most recent incident) typically had low value goods stolen in shoplifting incidents involving food and grocery items
Source Crime against businesses findings from the 2016 Commercial Victimisation Survey (Home Office 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of offenders issued a Penalty Notice for being drunk and disorderly aged 16 and over
43556
4699644411 43570
37119 36001
32648
27907
23679
17973
13860
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source Criminal Justice System statistics quarterly December 2016 (MoJ 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Young people
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
The number of young people entering treatment with a primary problem with cannabis or alcohol in comparison with all other drugs
1278413200
13581 13659 1345412863
7054
5884
4704
37763133
2556
20211549 1495 1668 1747 1651
0
2000
4000
6000
8000
10000
12000
14000
16000
2010-11 2011-12 2012-13 2013-14 2014-15 2015-16
Cannabis Alcohol All other drugs
ldquoSince 2005-06 young people have been
increasingly likely to seek help for
problems with cannabis compared to
other substances During 2015-16 12863
presented to specialist services with
cannabis as their primary substance (75
of all those receiving help during the
year) Although there was a 7 fall in the
number of young people in treatment in
2015-16 the proportion of young people
citing primary cannabis use increased
slightly (from 73 in 2014-15 to 75 in
2015-16)rdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Substance use of all young people in treatment in secure settings in England in 2015-16
91
51
19
19
9
8
8
4
2
1
1
0 20 40 60 80 100
Cannabis
Alcohol
Nicotine
Cocaine
Amphetamines
NPS
Ecstasy
Other
Opiates
Solvents
CrackThere were 1541 young people in specialist
substance misuse treatment in a secure setting in
2015-16 The majority (69) of young people in
treatment in secure settings reside in YOIs with a
further 16 residing in Secure Childrenrsquos Homes
(SCHs) 12 in Secure Training Centres (STCs) and
3 in Welfare Only Homes (WOHs)
Cannabis was the most commonly cited problem
substance amongst young people in treatment in
secure settings (91 of all in treatment) Around half
cited problematic alcohol use (51) Other
substances reported by young people included
nicotine (19) cocaine (19) amphetamines (9)
ecstasy (8) and NPS (8) Two percent of young
people cited problematic opiate use
n = 1541
Source Adults and young people in secure settings in England data for 2015-16 (PHE 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Diagnosis of alcohol abuse or dependence by age of onset of alcohol use amongst adolescents who had consumed alcohol in the past 3 months visiting Emergency Departments in England (n=609)
247
221
94
23
0
50
100
150
200
250
300
Age of onset before age 15 Age of onset age 15+
No diagnosis Diagnosis
Among adolescents who had consumed
alcohol in the past 3 months 15
screened positive for alcohol abuse or
dependence (using MINIKID)
ldquoThe prevalence of a diagnosis of
alcohol abuse or dependence was
considerably higher among participants
who started drinking before the age of
15 years with almost 1 in 3 meeting the
criteria for alcohol abuse or
dependencerdquo
Source Donoghue Kim et al Alcohol Consumption Early-Onset Drinking and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England Journal of Adolescent Health
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Number of looked after children aged 16 to 17 years identified with substance misuse needs and the proportion refusing intervention
760 750790
450 480510
0
10
20
30
40
50
60
0
200
400
600
800
1000
1200
1400
2014 2015 2016
Pro
po
rtio
n r
efu
sin
g in
terv
enti
on
Nu
mb
er id
enti
fied
wit
h s
ub
stan
ce u
se n
eed
Male Female Refused intervention Any young person who is at increased risk of
substance misuse including those who are
leaving care should be provided with
targeted prevention support which focuses on
reducing risks and strengthening resilience
Through commissioning of public health
services local councils should ensure they
have clear referral pathways into specialist
substance misuse services for those young
people who are assessed as requiring
structured drug and alcohol interventions
Source Healthy futures Supporting and promoting the health needs of looked after children (LGA 2016)
Source Children looked after in England including adoption 2015 to 2016 (DfE 2016)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Selected individual vulnerabilities identified among all young people starting treatment in England in 2015-16
-
500
1000
1500
2000
2500
3000
Affected byothers
substancemisuse
Affected bydomestic
abuse
Mentalhealth
problem
Self-harm Sexualexploitation
Pregnantandorparent
Injecting
Female Male ldquoYoung people do not develop substance misuse
problems in isolation The 2015-16 data shows that a
significant proportion of young people who entered
specialist treatment services also had other multiple
problems or vulnerabilities that were linked to their
substance misuse
ldquoFor some young people these wider issues may be
the cause of their substance misuse problems and
for others a consequence So it is vitally important
that young peoplersquos treatment services are working
closely with a wide range of other children and young
peoplersquos health and social care services to ensure
that vulnerable young people have all their needs
supportedrdquo
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Age and gender breakdown of young people starting treatment in England in 2015-16 who reported sexual exploitation
0
20
40
60
80
100
120
140
160
180
200
Under 14 14-15 15-16 16-17 17-18
Female Male
Source Young peoplersquos statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2015 to 31 March 2016 (PHE 2017)
ldquoOverall 6 of young people (704) reported
sexual exploitation However the proportion
is much higher among females (14) than
males (just over 1) Although these figures
suggest a large difference between sexual
exploitation experienced by boys and girls
research from Barnardorsquos has highlighted
difficulties in identifying sexual exploitation
of boys and young men because they often
do not disclose abuse The median age of
young people reporting sexual exploitation
was 15 compared to 16 for all new
presentations reflecting the high proportion
who were femalerdquo
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Distal risk indicators of child sexual exploitation
50
34
26
24
23
20
16
16
16
15
14
13
11
10
5
3
0 10 20 30 40 50 60
Criminal prosecutions prior to 2013
Living in care
Truancy disruptive behaviour at school
Neglectful parents
Unrelated sexual assault
Mental health issue learning disability
Physical emotional abuse from family
Domestic violence within family
Family links to OC
Parents drug and or alcohol abuse
Links to gangs or OCGs (not family)
Sexual abuse within family
Physical emotional abuse by adult (not family)
Aggressive behaviour
Excluded from services
Has contracted STIs
Source The impact of organised crime in local communities (Police Foundation 2017)
ldquoThe victims of CSE are some of the most
vulnerable children in society With an
average age of 15 most come from highly
dysfunctional families half have a
criminal record and a third live or have
lived in care Some are repeatedly
abused by multiple perpetrators over long
periods of time The multiple risks they
are exposed to are not dissimilar to those
experienced by adult sex workers they
include physical psychological and
emotional trauma sexually transmitted
diseases educational failure and
problematic substance misuserdquo
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)
Selected Antecedents of Suicide In Under 20s And 20-24 Year Olds
22
34
43
52
57
16
119
42
51
47
41
55
108
3
0
10
20
30
40
50
60
Excessivealcohol use
Illicit drug use Academicpressures overall
Previous self-harm
Suicidal ideas Family history ofmental illness
Family history ofsubstance
misuse
Witness todomesticviolence
Under 20 (n=285)
20-24 (n=106)
Source Suicide by Children and Young People (NCISH 2017)