Big rise in crack use

Author: Mark Gould

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There has been a 19% increase in the number of adults starting treatment for crack cocaine in England in the last three years according to a new report* which says that there is "clear evidence that crack use, production and purity is on the rise".

The latest estimates of opiate and crack use found a statistically significant increase of 8.5% in the number of crack cocaine users in England between 2011 to 2012 and 2016 to 2017 (from 166,640 to 180,748). Public Health England’s (PHE) latest data on infections and risks among people who inject drugs found an increase in crack use, from 39% in 2013 to 53% in 2017.

Crack users still account for a very small proportion of the population, at a rate of 5.1 crack users per 1,000 people in England.

The report was compiled by PHE and Home Office officials, who carried out a series of interviews and focus groups with drug treatment workers, service users and police officers.

The report’s findings can be used by local authorities and their partners to help them understand some of the factors that might lie behind any rise in crack use in their area. It can also be used by policy makers and other people involved in responding to crack and related drug problems.

Across all of the six areas of England visited by researchers there was general agreement among service users and treatment workers that crack use had increased in recent years.

All participants noted that crack was more widely available than in the past, with a ready supply from dealers and fast delivery described as “quicker than a pizza”. Dealers increasingly operate around the clock and will take orders and deliver at any time of day.

A service user remarked that he had the numbers of several dealers on his mobile phone, and, if he had to wait for more than an hour for one to deliver his drugs, he would try a different dealer next time.

The investigation has identified several factors which may have influenced the rise in crack use, including increased availability and affordability of crack and aggressive marketing of the drug by dealers. These factors are likely to be linked to the surge in global production of cocaine since 2013, as organised crime groups have potentially taken advantage of excess supply to push crack cocaine onto a captive market of entrenched heroin users and groups of new users.

The United Nations Office of Drugs and Crime reported that global opium production increased by 65% in 2017 to a record high so it will be important to monitor whether this has an impact on the availability and prevalence of heroin in England.

Other factors linked to the increase in crack cocaine use, which were not directly linked to the increased supply, were changes in the stigma about crack and a lack of police focus on targeting drug dealing. It was not clear from this enquiry whether “county lines” drug dealing operations had driven the increase in crack use, given that use had also increased in areas where “county lines” were not prevalent.

However, the findings support existing evidence, including from the National Crime Agency, about the expansion of "county lines" activity in recent years.

There was a widespread view among police officers, treatment workers and service users that “county lines” groups were much more likely than local groups to engage in serious violence and to exploit vulnerable young people and drug users.

The report concludes: "Feedback from all participants suggests that the increase in crack use has been mainly among existing heroin users, but there have also been suggestions of a new, ‘hidden’ group of crack users who are not heroin users and who have not engaged with treatment services. We would encourage research which explores the demographics of this group and its pathways into crack cocaine use.

"The inquiry has highlighted the need to explore more effective methods of getting crack users into treatment and to provide a more attractive treatment offer which is tailored to their specific needs.

"It has also identified the need for more effective links from the criminal justice system into treatment services for these individuals, for example through greater availability of arrest referral schemes and improved monitoring of drug rehabilitation requirements."


*Increase in crack cocaine use inquiry: summary of findings. A report by Public Health England and the Home Office. 25 March 2019.

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Editorial team, Wilmington Healthcare

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