Interesting things about alcohol and other drugsDecember 2016ANDREW BROWN@ANDREWBROWN365

One in five referrals to children’s social care in England in 2015/16 included alcohol and/or drugs a factor when assessed by social workers

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000Number of referrals to children’s social care where

alcohol and/or drugs were assessed as a factorAlcohol Drugs

Source: Characteristics of children in need: 2015 to 2016 (DfE)

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%18.4%

19.3%

Proportion of assessments of Children in Need where alco-

hol and/or drugs were a factor

n =

448,

200

Alco

hol

Drug

s

Expenditure (£ thousands) and number of employees recorded against substance misuse services by local authorities in England EXPENDITURE

Drugs Alcohol Young people

0

100,000

200,000

300,000

400,000

500,000

600,0002013-142014-152015-16

EMPLOYEES

Drugs Alcohol Yount people

05,000

10,00015,00020,00025,00030,000

2013-142014-152015-16

Source: Local authority revenue expenditure and financing (DCLG)

Proportion of rough sleepers seen in London during July – September 2016 assessed as having drug, alcohol, and / or mental health needs

Alcohol o

nly

Drugs o

nly

Mental h

ealth

only

Alcohol a

nd drugs

Alcohol a

nd mental h

ealth

Drugs a

nd mental

health

Alcohol, d

rugs and m

ental healt

h0%

2%

4%

6%

8%

10%

12%

Source: Chain Quarterly Report | Greater London | Jul-sept 16 (GLA)

n = 2,638

Smoking prevalence in adults with serious mental illness (SMI) in 2014/15 by region

South East

London

East o

f Engla

nd

West Midlands

East

Midlands

South W

est

North East

Yorks

hire & th

e Humber

North W

est05

101520253035404550

Source: Local Tobacco Control Profiles (PHE)

In England as a whole, 40.5% of adults with a serious mental illness are smokers which is more than twice the rate of the general population (16.9%). Rates vary across the country and in some local authorities smoking rates among people with serious mental illness are over 50%. These include: Kingston-upon-Hull (52.3%), Southampton (51.3%) and Manchester (51.1%). Some of the lowest rates can be found in Harrow (27.2%), Redbridge (30.4%) and Barnet (30.8%) although even here the rates are nearly twice as high as the average adult population.

Source: High rates of smoking among people with serious mental health conditions (ASH)

Local authorities undertaking targeted work to address smoking prevalence amongst people with mental health conditions

Comprehensive programme of work Some work undertaken No work undertaken0%

10%

20%

30%

40%

50%

60%

Source: Cutting Down, the reality of budget cuts to local tobacco control (ASH & Cancer Research UK)

Number and proportion of football related alcohol arrests

2011 to 2012 2012 to 2013 2013 to 2014 2014 to 2015 2015 to 20160

100

200

300

400

500

600

700

800

900

0%

5%

10%

15%

20%

25%

30%

35%

40%Number

Proportion

Source: Football-related arrests and banning orders, England and Wales: season 2015 to 2016 (Home Office)

Proportion of those at first assessed episode of self-harm also assessed as misusing alcohol, by age

18–24 25–34 35–54 55+0%

10%

20%

30%

40%

50%

60%

Men Women

Total

Ness, Jennifer, et al. "Alcohol use and misuse, self-harm and subsequent mortality: an epidemiological and longitudinal study from the multicentre study of self-harm in England." Emergency medicine journal 32.10 (2015): 793-799.

Odds ratio of death amongst those assessed as misusing alcohol in comparison to the general population, by cause of death and sexMEN

All exte

rnal c

auses

Suicid

es and undete

rmined

Accidental

Natural causes

12345678

WOMEN

All exte

rnal c

auses

Suicid

es and undete

rmined

Accidental

Natural causes

12345678

Ness, Jennifer, et al. "Alcohol use and misuse, self-harm and subsequent mortality: an epidemiological and longitudinal study from the multicentre study of self-harm in England." Emergency medicine journal 32.10 (2015): 793-799.

The number of drug seizures in England and Wales

2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 -00

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000 Class AClass BClass C

In 2015/16, there were 148,553 seizures of drugs in England and Wales, an 11 per cent decrease since 2014/15, when there were 167,059 seizures. The number of drug seizures peaked in 2008/09, at 241,473 seizures, and has since declined by 38 per cent (Figure 2.1). As in previous years, the majority of seizures were for Class B drugs, and, in particular, cannabis. Around three quarters of all seizures involved cannabis (either herbal, resin or plant).

Source: Seizures of drugs in England and Wales, year ending 31 March 2016 (Home Office)

Quantity (kg) of heroin and cocaine seized in England and Wales

2006/07

2007/08

2008/09 2009/10

2010/11

2011/12

2012/13

2013/14 2014/15 2015/16 -00

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

Co-caineHeroin

In 2015/16, 4,228 kilograms of cocaine were seized by the police and Border Force, a 25 per cent increase on the previous year (3,387 kg), and the largest quantity since 2004. This large increase was driven by a 31 per cent increase in the quantity of cocaine seized by Border Force, from 2,691 kilograms in 2014/15 to 3,530 kilograms in 2015/16.In 2015/16, 806 kilograms of heroin were seized, a 28 per cent decrease on 2014/15 when 1,113 kilograms were seized. Similar to cocaine and crack, 63 per cent of all seizures of heroin weighed less than one gram each.

Source: Seizures of drugs in England and Wales, year ending 31 March 2016 (Home Office)

Quantities of cannabis seized in England and Wales

2006/07

2007/08

2008/09

2009/10

2010/11

2011/12

2012/13

2013/14

2014/15

2015/16

-00

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

-00

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000 Herbal cannabis Cannabis resin Cannabis plants

Qua

ntity

of s

eizu

res

(Kg)

Qua

ntity

of s

eizu

res

(pla

nts)

In 2015/16, 30,493 kilograms of herbal cannabis were seized, just over twice as much as in 2014/15 (an increase of 102%). This large increase was down to the quantity of seizures by Border Force increasing from 10,458 kilograms in 2014/15 to 27,132 kilograms in 2015/16 (up 159%).

Over the same time period, the quantity of cannabis resin seized decreased from 7,405 kilograms in 2014/15 to 7,035 kilograms in 2015/16 (down by 5%).

In 2015/16, there were 393,702 cannabis plants seized, an increase of seven per cent since 2014/15 when 366,841 plants were seized. Up until this year there had been a continuing downward trend in the number of cannabis plants seized since the peak in 2009/10 (758,943 plants seized).

Source: Seizures of drugs in England and Wales, year ending 31 March 2016 (Home Office)

Almost half (47%) of seizures of cannabis plants were of quantities of five plants or fewer.

One plant 2-5 plants 6-10 plants 11-100 plants

Over 100 plants

-00

500

1,000

1,500

2,000

2,500

3,000

3,500 What defines the commercial cultivation of cannabis? 1

• Twenty- five or more cannabis plants, at any stage of growth (germination), are being or have been grown OR…

• There is evidence of a cannabis farm.

The definition of a cannabis farm is:

• The premises, or part therein, has been adapted to such an extent that normal usage would be inhibited and usually present within the premises, or part therein, are items solely concerned for the production of cannabis.

1 UK National Profile for the Commercial Cultivation of Cannabis, NPCC (2014)

Source: Seizures of drugs in England and Wales, year ending 31 March 2016 (Home Office)

Number of cannabis plants seized by region in England and Wales

North East

Region

North W

est Region

Yorkshire

and The Humber Region

East Midlands R

egion

West Midlands R

egion

Eastern Region

London Region

South East

Region

South W

est Region

Wales -00

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

Source: Seizures of drugs in England and Wales, year ending 31 March 2016 (Home Office)

Two in three organised crime groups in Scotland are involved in drug crime

67%

A total of 196 serious organised crime groups (SOCGs) are recorded as operating in Scotland.

SOCGs diversify into different crime types as a means of maintaining income. Just under half (48%) of SOCGs are involved in multiple crime types.

67% of SOCGs are involved in drug crime; cocaine is the most popular commodity, followed by heroin, cannabis, tranquilisers and amphetamine.

Other crime types include violence; various forms of fraud including cigarette smuggling and tax fraud; money laundering; organised immigration crime; human trafficking; organised theft; bogus workmen; counterfeit goods and cybercrime.

66% of SOCGs are involved in seemingly legitimate businesses. The most common business types are licensed premises, restaurants, building/construction companies, shops, garage repairs and vehicle maintenance, taxis and nail bars. Over 720 such businesses have been identified.

Source: Scotland’s Serious Organised Crime Strategy (Scottish Government)

What proportion of crimes in Manchester and Lancashire are recorded as alcohol-related by type of offence

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%Manchester Lancashire

Source: Local Alcohol Profiles for England (LAPE); methodological review of the crime indicators (PHE)

Proportion of tuberculosis cases associated with social risk factors

Drug misuse Alcohol misuse Homelessness Prison At least 1 social risk factor

2 or more social risk factors

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%Female Male

Source: Tuberculosis in England 2016 report (PHE)

TB cases with social risk factors are more likely to have pulmonary disease and drug resistance, and have worse TB outcomes; cases notified in 2014 with at least one social risk factor were more than twice as likely to have died or be lost to follow-up at 12 months compared with cases with no social risk factors.

Proportion of adults with substance misuse treatment need who successfully engage in community-based structured treatment following release from prison, by region

East Midlands East of England London North East North West South East South West West Midlands Yorkshire and the Humber

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Source: Public Health Outcomes Framework (PHE)

Association between a recent attempt to quit smoking and attempts to cut down drinking amongst high-risk drinkers

No quit attempt in last week Quit attempt in last week0

5

10

15

20

25

30

35

40

45

50

Among those with higher risk alcohol consumption, smokers who reported attempting to stop smoking within the last week compared with those who reported no attempt were more likely to report also currently trying to restrict their alcohol consumption.

Source: Brown, Jamie, et al. "Are recent attempts to quit smoking associated with reduced drinking in England? A cross-sectional population survey." BMC public health 16.1 (2016): 535.

Adult substance treatment activity in England 2015-16ADULT SUBSTANCE MISUSE STATISTICS FROM THE NDTMS: 1 APRIL 2015 TO 31 MARCH 2016

Key messages about adult drug and alcohol treatment in England in 2015-16

There has been a fall in the number of people in treatment – overall down by 2%, with a bigger fall amongst alcohol only clients (-4.6%)

The number of people who died while in contact with treatment services increased by 14%, but is still less than 1% of all of those in treatment

Most referrals were recorded as coming from self, families or friends (51%), but nearly 22 thousand (16%) were from the criminal justice system, of whom over half (53%) were opiate users.

7% of new cases were rough sleeping, further 11% were in housing need (sofa-surfing, temporary accommodation etc.), with particularly high rates of housing need (50%) were reported by clients citing both opiates and NPS

Only a minority of new entrants into treatment were in employment either at the start of treatment (24%) or at the six month review (25%)

About two thirds (69%) of adults in treatment (154,471) at the end of 2015-16 were on at least their second course of treatment, a third (31%) had been in treatment more than three times

Source: Adult substance treatment activity in England 2015-16 (PHE)

Trends in the number of people in treatment for drugs and/or alcohol in England

2005-06

2006-07

2007-08

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

2014-15

2015-16

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

Opiate Alcohol onlyNon-opiate and alcohol Non-opiate only

Alcohol only OpiateNon-opiate and alcohol

Non-opiate only

-5.00%

-4.00%

-3.00%

-2.00%

-1.00%

0.00%

1.00%

2.00%

3.00%

4.00%

-4.5

6%

-2.0

6% 0.20

%

3.15

%

Proportion change in number of adults in treatment between

2014-15 and 2015-16

Source: Adult substance treatment activity in England 2015-16 (PHE)

Number of deaths for adults in treatment in England in 2014-15 and 2015-16

Opiate Other drugs Alcohol only0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2014-15 2015-16 The number of people who died while in contact with treatment services in 2015-16 was 2,689 (0.9% of all individuals in treatment), this is an increase from 2014-15 when there were 2,360 deaths in treatment (0.8% of all individuals). While not all deaths in treatment will be attributable to an individual’s substance use, the use of drugs is a significant cause of premature mortality in the UK.

Source: Adult substance treatment activity in England 2015-16 (PHE)

Proportion of new referrals to treatment and a breakdown of criminal justice referrals

0%

10%

20%

30%

40%

50%

60%

Opiate Non-opiate only

Non-opiate and alcohol

Alcohol only0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Arrest referral/DIPPrisonProbationATR

Source: Adult substance treatment activity in England 2015-16 (PHE)

Number of new entrants to treatment with housing needs

Opiate Non-opiate only Non-opiate and alcohol

Alcohol only0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Housing problem Urgent housing problem (NFA) Particularly high rates of housing need (50%) were reported by clients citing both opiates and NPS at the start of treatment, compared to 29% for opiate clients overall.Nineteen per cent of opiate clients reported an acute housing problem at the start of treatment, which fell to 13% by the time of the six-month review. Improvements were also seen in individuals presenting with other substances, ranging from a 5% drop for non-opiate and alcohol to 3% for alcohol only clients.

Source: Adult substance treatment activity in England 2015-16 (PHE)

Proportion of people in treatment who are in employment at baseline assessment and at 6 month review

Opiate Non-opiate only Non-opiate and alcohol

Alcohol only0%

5%

10%

15%

20%

25%

30%

35%

Baseline 6 month review There was a small increase in the proportion of opiate clients in paid work by the time of the six-month review (16% to 18%), with the average days of paid work decreasing slightly (0.1%) during this time. Non-opiate only clients saw a slightly greater increase in the proportion reporting paid work, (29% to 32%), while non-opiate and alcohol and alcohol only clients demonstrated only marginal change in paid employment.

Source: Adult substance treatment activity in England 2015-16 (PHE)

Number of previous treatment journeys for those retained in treatment 31st March 2016

Continuous journey Second journey Third journey More than three journeys0%

5%

10%

15%

20%

25%

30%

35%

Source: Adult substance treatment activity in England 2015-16 (PHE)

Children in Custody 2015-16AN ANALYSIS OF 12-18-YEAR-OLDS’ PERCEPTIONS OF THEIR EXPERIENCES IN SECURE TRAINING CENTRES AND YOUNG OFFENDER INSTITUTIONS.

Perceptions of their mental health, substance use needs and availability of drugs by juvenile offenders in young offender institutions

Do you have any emotional or men-tal health problems?

Did you have any problems with alcohol when you first arrived?

Did you have any problems with drugs when you first arrived?

Is it easy/very easy to get illegal drugs here?

0%

5%

10%

15%

20%

25%

30%

35%

40%

2014-152015-16

Source: Children in Custody 2015-16 (HMI Prisons)

Sub-group analysis of juvenile male offenders mental health and substance use needs

Overall Aged under 17 BAME boys White boys Muslim boys Considered themselves

disabled

Said they had been in LA care

Said they had emotional or mental health

problems

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Do you have any emotional or mental health problems? Did you have any problems with alcohol when you first arrived?Did you have any problems with drugs when you first arrived? Is it easy/very easy to get illegal drugs here?

Source: Children in Custody 2015-16 (HMI Prisons)

Health at a glanceDATA FROM AN OECD REPORT ON THE KEY INDICATORS OF HEALTH AND HEALTH SYSTEMS IN THE EU

Source:

Proportions of the population which have used selected illegal drugs over the last 12 months among people aged 15 to 34 – UK vs EU average

Cannabis Cocaine Amphetamines Ecstasy0%

2%

4%

6%

8%

10%

12%

14%United KingdomEU26

Source: Health at a Glance: Europe 2016: State of Health in the EU Cycle, (OECD/EU 2016)

Alcohol consumption among adults - Litres per capita (15 years and over)

Sweden

Greece Italy

Netherlands

Malta

Finland

Cyprus

Spain

Denmark

United Kingdom

Romania

Portugal

EU28

Slova

k Rep.

Latvi

aPoland

Hungary

Slove

nia

Germany

Ireland

Luxe

mbourgFra

nce

Estonia

Czech Rep.

Bulgaria

Croatia

Austria

Belgium

Lithuania

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

Source: Health at a Glance: Europe 2016: State of Health in the EU Cycle, (OECD/EU 2016)

Regular binge-drinking (at least once a month), by gender and by education level, UK vs EU average

0

5

10

15

20

25

30

35 United Kingdom EU24

Source: Health at a Glance: Europe 2016: State of Health in the EU Cycle, (OECD/EU 2016)

“Alcohol-related harm is a major public health concern in the European Union, both in terms of morbidity and mortality (WHO Europe, 2012; OECD, 2015). Alcohol was the third leading risk factor for disease and mortality after tobacco and high blood pressure in Europe in 2012 and accounted for an estimated 7.6% of all men’s deaths and 4.0% of all women’s deaths, though there is evidence that women may be more vulnerable to some alcohol-related health conditions compared to men (WHO, 2014).”

Drunk at least twice in life among 15-year-olds, 2013-14

Girls Boys0

5

10

15

20

25

30

35

United Kingdom EU27 “Adolescent alcohol use is a major health concern in many European countries. Early and frequent drinking or drunkenness is associated with negative psychological, social and physical health issues, such as violence, accidents, injury and use of other substances (Inchley et al., 2016). Alcohol use has been shown to affect learning performance. Binge drinking, as well as high frequency of drinking, reduce achievement scores. Alcohol consumption also reduces attendance and increases probability of having difficulty in school or dropping out without having graduated (Balsa et al., 2011; Chatterji et al., 2005).”

Source: Health at a Glance: Europe 2016: State of Health in the EU Cycle, (OECD/EU 2016)