Interesting things about alcohol and other drugsMay 2017ANDREW BROWN

@ANDREWBROWN365

Estimated proportion of the population who are alcohol dependent by upper tier local authority

0.00

2.00

4.00

6.00

8.00

10.00

12.00

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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)

Estimated number of children who live with opiate users, by region

-

5,000

10,000

15,000

20,000

25,000

30,000

East ofEngland

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 2011/12 (PHE, 2017)

Comparison of issues between families affected and not affected by domestic abuse in Troubled Family cohort

0% 10% 20% 30% 40% 50% 60% 70% 80%

Police call-outs

Mental-health issue

Rent arrears

Alcohol or drug dependency

Drug dependency

ASB incident with no futher investigation

Alcohol dependency

ASB incident with futher investigation

NEET

Homelessness applications

A week or more homeless

Missing from education

Evictions

Families without a domestic abuse problem

Families with a domestic abuse problem

2,499 families with a domestic abuse problem, 8,087 families without a domestic abuse problem

Source: National evaluation of the Troubled Families Programme 2015 - 2020: family outcomes – national and local datasets: part 1 (DCLG, 2017)

Proportion of alcohol consumption during pregnancy according to European country.

4%

7%

10%12%

13%14%

15%

18%

21%

27%29%

0%

5%

10%

15%

20%

25%

30% To our knowledge, this is the first study comparing alcohol consumption during pregnancy across eleven of the European countries using the same method for collecting data and taking maternal sociodemographic and smoking before pregnancy into account. We found that almost 16% of the European women consumed alcohol during pregnancy after recognized pregnancy and of these 39% consumed at least one unit per month. There were, however, large variations between the countries. Some of these differences can be explained by level of education and smoking before pregnancy. However, a large part of the differences remained unexplained.

Mårdby, Ann-Charlotte, et al. "Consumption of alcohol during pregnancy—A multinational European study." Women and Birth (2017).

Trend in anti-HCV prevalence among people injecting psychoactive drugs in England.

40%

42%

44%

46%

48%

50%

52%

54%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Source: Hepatitis C in the UK (PHE, 2017)

The proportion of the non drinking population saying that the reason they don’t drink is because they have been hurt by someone else’s drinking

3%

15% 16% 16% 16%18%

20%22%

31% 31%

35% 35% 36% 37% 38%

42%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Source: Comparative monitoring of alcohol epidemiology across the EU (PARPA, 2017)

Prevalence of getting drunk at least once a month in the UK by gender and age group

13%

7%

16%

10%

4%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female 18–34 35–49 50+

Source: Comparative monitoring of alcohol epidemiology across the EU (PARPA, 2017)

Proportion of UK population saying “yes” about…

16%17%

9%

3%

19%

21%

12%

4%

12% 12%

6%

3%

23%

27%

14%

5%

17%16%

12%

3%

7% 7%

2% 2%

0%

5%

10%

15%

20%

25%

30%

Feel guilty about drinking Ever blacked out Not done what is expected of you Drink in the morning

Total Male Female 18–34 35–49 50+

Source: Comparative monitoring of alcohol epidemiology across the EU (PARPA, 2017)

Proportion of needle and syringe programme (NSP) clients in the Cheshire and Merseyside areas who were anabolic steroid users, 1995 and 2015

17.1%

54.9%

0%

10%

20%

30%

40%

50%

60%

1995 2015

Cheshire and Merseyside, with a total population of 2,430,284 was served by 18 agency NSPs in 2015 and 17 agency NSPs in 1995.

A total of 2446 individual steroid users accessed agency needle and syringe programmes across Cheshire and Merseyside in 2015 compared with 553 in 1995, representing a 342% increase over the period.

Data indicate that anabolic steroid use is most common in the male age group of 20–29. This has been calculated for both years, indicating an increase from 1.88 per 1000 population to 5.72 per

1000 population.

McVeigh, J. and Begley, E., 2016. Anabolic steroids in the UK: an increasing issue for public health. Drugs: Education, Prevention and Policy, pp.1-8.

Statistically significant % difference in outcome for BME defendants compared to white ethnic group for drug offences in 2014

24%

-10%

-29%

15%

83%

116%

5%

41%

-40% -20% 0% 20% 40% 60% 80% 100% 120% 140%

Of charged, % proceeded against in a magistrates’ court

Of proceeded against, % convicted in a magistrates’ court

Of convicted, % receiving a custodial sentence in a magistrates’ court

Of charged, % tried in a Crown Court

Of tried in a Crown Court, % remanded in custody

Of tried in a Crown Court, % pleading not guilty

Of tried in a Crown Court, % convicted

Of convicted in a Crown Court, % receiving a custodial sentence

Source: Building Trust: How our courts can improve the criminal court experience for Black, Asian, and Minority Ethnic defendants (Centre for Justice Innovation)

The estimated number of high risk drug users in Great Britain

293,879

61,500 63,300

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

England Scotland Wales

In England, estimates are produced for opioid and/or crack cocaine users (together and separately) and injecting among users of those drugs.

In Scotland, PDU refers to the problematic use of opioids and/or the illicit use of benzodiazepines and drug injecting.

Wales look at injecting drug use or long duration/regular use of opioids, cocaine and/or amphetamines.

Source: United Kingdom Drug Situation: Focal Point Annual Report 2016 (PHE, 2017)

Numbers of people presenting to drug treatment, by setting, in the UK, in 2015

80,446

28,400

1,238 1,031 6010

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

Outpatients Prison (Eng & NIonly)

Inpatients GP (Eng only) Other

A total of 1,086 treatment centres reported Treatment Demand Indicator data through national treatment monitoring systems in the UK during 2015.

Of these:

• 71% provided outpatient services (n=775)• 10% provided inpatient services (n=110)• 12% were treatment services in prison (n=131) and • 4.5% were GP services (n=49)

72% of all clients presenting to drug treatment in the UK during 2015 were treated in outpatient centres. Opioid users make up a larger proportion of clients within inpatient and GP services than within outpatient services.

Source: United Kingdom Drug Situation: Focal Point Annual Report 2016 (PHE, 2017)

Injecting status among all clients entering treatment in the United Kingdom, 2015

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

Ever injected, but not currently Currently injecting (in lastmonth)

Never injected

Previously treated clients

New treatment clients

The majority (62%) of clients presenting to treatment reported that they had never injected drugs, with 16% reporting current injecting.

Previously treated clients were three times more likely to report currently injecting than new treatment clients.

Primary opioid users accounted for 90% of current injectors, with amphetamine users accounting for 2.4%.

Heroin users were most likely to inject, with over one-third (37%) of treatment entrants citing injecting as their primary route of administration.

Source: United Kingdom Drug Situation: Focal Point Annual Report 2016 (PHE, 2017)

Proportions of the treatment population entering treatment for heroin and cannabis, 2005-2015

0

10

20

30

40

50

60

70

2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2013 2014 2015

Opioids Cannabis Figures are not directly comparable to previous years

Source: United Kingdom Drug Situation: Focal Point Annual Report 2016 (PHE, 2017)

Injecting drug use in Scotland

Housing status of users of injecting equipment provision (IEP) in Glasgow city during 2015 who reported injecting heroin and/or cocaine.

74%

23%

3%

68%

27%

5%

56%

33%

11%

41% 43%

16%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Owner or renting Homeless Roofless

All clients ‘Regular clients’ ≥5 transactions

‘High frequency clients’ ≥50 transactions Clients receiving IEP via Assertive Outreach

Source: The health needs of people who inject drugs in public places in Glasgow city centre (NHS Greater Glasgow and Clyde, 2016)

People who inject drugs in public places in Glasgow are predominantly male, aged between 30 and 50 years and of Scottish origin. Both local data and the published literature indicate that people involved in public injecting experience a combination of severe social vulnerabilities often referred to as ‘multiple exclusion’ or ‘severe and multiple disadvantage’: Homelessness and housing instability are particularly prevalent.

Time since onset of injecting of those taking part in the Needle Exchange Surveillance Initiative survey in Scotland

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

< 2yrs 2 - 5 yrs 6 - 10 yrs 11 - 15 yrs >15 yrs

2008-09 2010 2011-12 2013-14 2015-16

Source: Needle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-16 (NHS Scotland 2017)

Proportion drug users in Scotland who have injected drugs in the last six months, by drug injected

2%

3%

3%

3%

4%

4%

10%

13%

93%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Other

Crack

Temazepam/Diazepam

IPED

Heroin + cocaine

Amphetamines

Legal Highs

Cocaine

Heroin

Heroin continues to be the most prevalent drug injected with over 90% of those interviewed in 2015-16 reporting use in the past six months, similar to levels in previous NESI surveys.

Reported injecting of cocaine has increased in recent years from 9% in 2010 (n=217) to 13% (n=287) in 2015-16

Source: Needle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-16 (NHS Scotland 2017)

n = 2,207

Frequency of injecting in the last six months amongst those reporting injecting drugs in the last six months

0%

10%

20%

30%

40%

50%

60%

70%

Less than weekly Weekly not daily Daily or more

2008-09 2010 2011-12 2013-14 2015-16

Source: Needle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-16 (NHS Scotland (2017)

Prescription of naloxone and the proportion carrying it on date of survey

8%

15%

32%

5%

51%

6%

0%

10%

20%

30%

40%

50%

60%

Prescribed take-home naloxone in the past year Carrying any take-home naloxone with you today (among thoseprescribed take-home naloxone)

2011-12 2013-14 2015-16

Source: Needle Exchange Surveillance Initiative (NESI) 2008-09 to 2015-16 (NHS Scotland 2017)