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4% rise in numbers starting treatment for substance misuse in England

Deaths of those in treatment also rose, mainly among those with opiate or alcohol dependencies

Caroline White

Friday, 08 November 2019

The number of adults starting treatment for substance misuse in England rose by 4% in 2018-19 (127,307 to 132,210), the latest annual figures* issued by Public Health England (PHE) show.

This is the first increase recorded since 2013-14, possibly reflecting recent increases in the prevalence of illicit drug use, suggests PHE. And it is mirrored by an increase in deaths among those in treatment.

The total number of adults in contact with drug and alcohol services last year changed little over the previous year’s figures: 268,251 vs 268,390.

The number of people in contact with treatment for opiates remained stable, falling by 1% (141,189 to 139,845). This group still makes up the largest proportion of those in treatment (52%).

Those in treatment for alcohol alone also remained stable (75,787 to 75,555), the figures show. But this follows large year-on-year declines from a peak of 91,651 in 2013-14.

Numbers in the other two substance misuse groups also rose (2% increase in the non-opiate group and 3% in the non-opiate and alcohol group).

Continuing a trend over the past two years, the number of adults starting treatment in with crack cocaine problems rose. The number of people starting treatment with crack problems has risen by 32% since 2013-14.

The number of adults entering treatment in 2018-19 for problems with new psychoactive substances (NPS) rose by 11% from 1223 to 1363, an increase largely driven by those taking NPS combined with opiates.

Those starting treatment for NPS problems had the highest proportion of housing need of any substance misuse group (44%).

Over half (53%) of all adults starting treatment said they had a mental health issue, ranging from 49% of those with opiate dependency to 59% of those with non-opiate and alcohol problems.

Deaths among those in treatment across all types of substance misuse groups rose, but was largely driven by those in treatment for opiate dependency.

The number of deaths from drug misuse registered in 2018 increased by 16% to 2670, the highest level ever recorded, with deaths among middle-aged heroin users one of the main causes of the increase in drug poisonings.

The age of people in treatment has continued to increase in older age groups. More than half were over 40 (54%), with less than one in 10 of those in treatment for opiate problems or alcohol only problem under 30 (8% for opiates and 9% for alcohol only).

The average age of people in treatment varied significantly according to substance: the average age of the alcohol only group was16 years older (46) than that of non-opiates only (30). People in treatment for opiates had an average age of 41.

The figures show that substance misuse is strongly linked to deprivation. Some 58% of people in treatment for crack and 57% of those in treatment for opiates live in areas ranked in the 30% most deprived areas of England.

It’s a similar picture for those with alcohol only problems, nearly half of whom (47%) live in areas ranked in the 30% most deprived areas.

The highest prevalence rates for opiate, crack, and alcohol only problems are in the north of England.

The number of deaths in treatment has continued to rise, with a large increase since 2017-18, from 2660 to 2889 people this year, representing 1.1% of all those in treatment. This trend has increased rapidly since 2005-06 when 712 people in treatment died.

The largest increases were among those with opiate and alcohol only problems. Since 2011-12, the total number of deaths in these groups has risen from 1816 to 2696.

“More people are entering treatment which is encouraging, but the increase in drug-related deaths is still a serious cause for concern, particularly in relation to rising numbers of those seeking help with heroin, crack and powder cocaine,” commented chairman of the Local Government Association’s Community Wellbeing Board, Councillor Ian Hudspeth.

“The next government must provide sustainable, long-term funding for councils’ public health services to help relieve pressures on the NHS and criminal justice system further down the line,” he added.

Adult substance misuse treatment statistics 2018 to 2019: report. A report prepared by Public Health England, 7 November 2019.

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