Interesting things about alcohol and other drugs

November 2015Andrew Brown @andrewbrown365

What do people in receipt of opioid substitution therapy think about services

Source: How can opioid substitution

therapy (and drug treatment and

recovery systems) be optimised to

maximise recovery outcomes for

service users?

The probability of sustained cessation amongst injecting drug users in Edinburgh

“OST [opioid substitution therapy] was

associated with reduced time to cessation,

and there was some suggestion of

increased time to relapse too. The

likelihood of prolonged cessation is greater

for women, increases with age, and

decreases with time since last relapse.”

Source: Factors affecting repeated cessations of injecting drug use and relapses during the entire injecting career among the Edinburgh Addiction Cohort

Number of injecting drug users in Bristol

2,770This is 0.9% of the

population aged 15-64

years

Source: Problem drug use prevalence estimation revisited: heterogeneity in capture-recapture and the role of external evidence

Proportion of the incarcerated population who are injecting drug users

40% in Canada

40% in Australia

50% in the United States

80% in Europe

Source: Characterising Hepatitis C Virus Transmission Dynamics in a High-Risk Incarcerated Population

Number of TB cases with a social risk factor in England in 2014

In 2014, among cases with

known social risk factor a total

of 9.4% of cases (538/5,708)

had at least one:

● 3.4% had a current or a

history of homelessness

● 3.3% of imprisonment

● 3.3% of drug misuse and

● 3.3% of alcohol misuse.

Source: Tuberculosis in England: annual report

Numbers in treatment in Wales in 2014-15 by substance

Source: http://gov.wales/docs/dhss/publications/151029annual-reporten.pdf

Use of Community Order requirements for Drugs, Alcohol and Mental Health in England and Wales

Source: Community

sentences since 2000:

How they work – and why

they have not cut prisoner

numbers

The 10 least commonly used requirements of a youth rehabilitationorder (YRO): 2013/14

9,767 YROs were imposed in 2013/14:

One quarter contained just one

requirement, with a further 35%

containing two.

The most commonly used was

supervision which accounted for more

than a third of the total. Almost 15% -

2,635 in total - were curfews.

Source: The state of youth justice 2015: an overview of trends and developments

Call outs for Scottish Ambulance Service related to New Psychoactive Substances

2,229Call outs in 2014 were related to NPS, or 6 per day on average.

£268Average cost of a call out for the Scottish Ambulance Service

Sources: http://www.bbc.co.uk/news/uk-scotland-34405727http://www.isdscotland.org/Health-Topics/Finance/Publications/2014-12-02/Costs_R910_2014.xls

Percentage change in seizures of selected drugs in Scotland

Source: Drug Seizures by Police Scotland, 2013-14

Looked after children in England

1,680The number of Looked After Children in England identified as having a substance misuse condition.

570The number who refused treatment for their identified substance misuse condition.

10.8%The proportion of the looked after population aged 16 and 17 years old with an identified substance misuse condition.

Source: Outcomes for children looked after by local authorities

Use of naloxone (the opioid overdose medicine) in the community

9% of naloxone kits distributed are likely to be used for peer administration within

the first three months of supply for every 100 people who use drugs trained.

Source: Exploring the Life-Saving Potential of Naloxone: A Systematic Review and Descriptive Meta-Analysis of Take Home Naloxone (THN) Programmes for Opioid Users

Monthly heroin overdoses seen by the London Ambulance service

There were 410 heroin

overdoses recorded by the

London Ambulance Service

in the last 12 months.

This compares with 252 in

the same period 5 years

ago.

A rise of 63%.

Source: Monthly Ambulance Service Incidents, Borough

Monthly cocaine overdoses seen by theLondon Ambulance Service

There were 375 cocaine

overdoses recorded by the

London Ambulance Service

in the last 12 months.

This compares with 215 in

the same period 5 years

ago.

A rise of 74%.

Source: Monthly Ambulance Service Incidents, Borough

Monthly ‘binge drinking’ attendances for the London Ambulance Service

In the last 12 months the

London Ambulance Service

reported attending on

someone under the age of

40 suffering from an alcohol

related illness on 29,219

occasions.

This compares with 33,690

times 3 years ago - down by

13%.

Source: Monthly Ambulance Service Incidents, Borough

Polysubstance use by drug users in treatment in Northern Ireland

“There was a marked difference

between the number of drugs used by

clients in prison in comparison with

those who were not in prison. Almost

half of clients not in prison (49%) had

one drug of misuse compared with 12%

of clients in prison. The proportion of

clients in prison using five drugs (27%)

was four times that of clients not in

prison (7%).”

Source: Statistics from the Northern Ireland drug misuse database: 1 April 2014 – 31 March 2015

11% of people in treatment for drug problems in Northern Ireland have ever injected

Of those who have injected in last 4

weeks:

16.9% shared equipment,

78.7% always used new

equipment,

80.9% used a needle or

syringe exchange

Source: Statistics from the Northern Ireland drug misuse database: 1 April 2014 – 31 March 2015

First time convictions in Northern Ireland in 2013/14

“There were 11,610 first time

entrants (or disposals relating

to first offences) to the

criminal justice system in

2013/14. Of these, 10.4%

(1,205) were in the 10 – 17

year old age group and 29.0%

(3,366) in the 18 – 24 year old

age group.”

Source: First time entrants to the justice system in Northern Ireland

People with mental ill health receiving hospital treatment

“Getting appropriate support for

physical healthcare for people

with mental ill health is essential.

Those with mental ill health die

earlier and reasons for this are

often linked to physical health

needs, with many of the

contributory factors being

potentially avoidable. These

factors, coupled with mental ill

health, mean that this group have

very complex care needs.”Source: People with mental ill health and hospital use

Acquisitive offences with loss, broken down by offence type

“Research suggests that around 45 per cent of

acquisitive crime is committed by crack or

opiate (mainly heroin) users, who frequently

self-report that they require rapid access to

cash in order to buy drugs (Morgan, 2014).

Indeed, the primary motivation to commit

crime for most burglars interviewed by

Hearnden and Magill (2004) was the need to

fund regular drug use.”

NB The distribution of criminal gains from theft

is heavily skewed. In 2013/14, just 2 per cent of

all thefts accounted for 46 per cent of the total

value of goods stolen.

Source: Crime and the value of stolen goods

Estimated social and economic costs of serious and organised crime

“As of 31 December 2014, there were

around 5,800 organised crime groups

(comprising approximately 40,600

individuals) operating in the UK. The

social and economic costs of serious

and organised crime are estimated to

be £24 billion per year, mostly as a

result of drug supply (with a cost of

£10.7 of billion) and fraud (with a cost

of £8.9 billion). Less is known about

cyber and ‘hidden’ crimes such as

Modern Slavery.”

Source: UK national risk assessment of money laundering and terrorist financing

One in five of 34,472 new cases in 2014 for Europol were about drug trafficking

“About one third of all organised

crime groups (OCGs) in the EU

are involved in the production and

distribution of illicit drugs. The

value of the European opiates

market has been estimated at

approximately EUR 12 billion.”

Source: General Report on Europol Activities 2014

Number of offenders convicted for causing death or injury by a motor vehicle driver, England and Wales

Source:

http://www.parliament.u

k/business/publications/

written-questions-

answers-

statements/written-

question/Lords/2015-10-

05/HL2423/

5%

Reasons young people became homeless in 2014 and their support needs

Source: Young and homeless 2014

● 26% substance misuse (illegal drugs)

● 23% mental health● 22% offending history● 13% alcohol misuse● 8% use of ‘legal’ highs

Comparative risk assessment of alcohol, tobacco, and illicit drugs for individuals using the margin of exposure approach

Margin of Exposure (MOE) is a

novel approach to compare the

health risk of different

compounds and to prioritize

risk management actions... the

lower the MOE, the larger the

risk for humans.

Source: Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach