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Interesting things about alcohol and other drugs - November 2017

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One in a regular series of slide sets on interesting data about alcohol and other drugs (and the wider issues to do with multiple needs) from a UK perspective.

Published in: Government & Nonprofit
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Interesting things about alcohol and other drugs - November 2017

  1. 1. Interesting things about alcohol and other drugs November 2017 Andrew Brown @andrewbrown365
  2. 2. Number of adults in community drug and alcohol treatment in England, 2013-14 to 2016-17 155,852 25,570 28,871 91,651 152,964 25,025 28,128 89,107 149,807 25,814 28,187 85,035 146,536 24,561 28,242 80,454 - 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 180,000 Opiate Non-opiate only Alcohol and non-opiate Alcohol only 2013-14 2014-15 2015-16 2016-17  There has been a fall in the number of adults in treatment in the community (3% down on last year).  This has been particularly steep in those in treatment for alcohol alone (5% down from 2015-16), and prevalence estimates suggest 4 in 5 people who are alcohol dependent aren’t having their treatment needs met.  The number of individuals presenting with crack cocaine problems (not being used alongside opiates) increased by 23% (2,980 to 3,657). Source: Substance misuse and treatment in adults: statistics 2016 to 2017 (PHE, 2017)
  3. 3. Change in acute housing problems between start of drug or alcohol treatment and six month review 19% 10% 12% 7% 14% 6% 8% 4% 0% 5% 10% 15% 20% 25% Opiate Non-opiate Non-opiate and alcohol Alcohol only Baseline Review Source: Substance misuse and treatment in adults: statistics 2016 to 2017 (PHE, 2017) Nineteen per cent of opiate clients reported an acute housing problem at the start of treatment, which fell to 14% by the time of the six-month review. Improvements were also seen in individuals presenting with other substances, ranging from a 4% drop for non-opiate only clients and non-opiate and alcohol clients to 3% for alcohol only clients.
  4. 4. Non-fatal overdoses amongst people who inject drugs 15% 17% 18% 19% 0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20% 2013 2014 2015 2016 Among the participants who took part in the main Unlinked Anonymous Monitoring Survey across England in 2016 who had injecting during the preceding 12 months (recent injectors), 19% reported overdosing in the preceding year, which has increased significantly from 15% in 2013. Self-reported overdose in 2016 was lowest among those who were currently in treatment for their drug use (i.e. those being prescribed a detox or maintenance drug regime; 16%). Self-reported overdose was 21% among PWID who had never been in treatment in 2016, and was especially high among those who had previously been in treatment but were not currently (31%). Source: Non-fatal overdose among people who inject drugs in England: 2017 report (PHE, 2017)
  5. 5. Reduction in re-offending in the two-years following the start of treatment, by substance group -31% -59% -44% -44% -44% -21% -49% -36% -35% -33% -70% -60% -50% -40% -30% -20% -10% 0% Opiates Alcohol only Alcohol & non- opiates Non-opiates only Total Offenders Offences 44% of clients did not reoffend in this period [two years following the start of treatment], and this resulted in the number of recorded offences decreasing by 33%. Opiate clients had the lowest percentage change in recorded offenders and offences (31% and 21%, respectively), while the alcohol only client group experienced the greatest reduction in both offenders and offences (59% and 49%, respectively). There was a 55% reduction in clients with one offence recorded against them, a 45% reduction in clients with two offences recorded against them, and this decreasing trend generally continues.There was a reduction of only 0.3% in the number of clients with 15 or more offences recorded against them. Source: The impact of community-based drug and alcohol treatment on re-offending (MoJ and PHE, 2017)
  6. 6. Number of offenders recalled to prison in England and Wales for a reason reported as drugs and/or alcohol, by sex 530 585 665 604 438 482 429 342 277 31 50 54 58 40 35 33 32 24 0 100 200 300 400 500 600 700 800 Jan-Mar 2015 Apr-Jun 2015 Jul-Sep 2015 Oct-Dec 2015 Jan-Mar 2016 Apr-Jun 2016 Jul-Sep 2016 Oct-Dec 2016 Jan-Mar 2017 Male Female Source: Offender Management Statistics Quarterly (MoJ, 2016 and 2017) There are various reasons why offenders are recalled to custody for breaching their licence conditions. For example, an offender may be recalled if there is any deterioration in his behaviour which leads the Probation Service to conclude that there is an increased risk of the offender committing further offences. If an offender is no longer in touch with his Offender Manager or if he has resumed a drug habit or alcohol abuse or has been spotted entering an exclusion zone – all such breaches are likely to lead to the offender being recalled to custody.
  7. 7. Number of arrest occasions pre- and post-positive drug test for for Class A drugs in Merseyside between April and September 2015 298 156 102 65 32 27 14 6 15 15 235 144 82 43 40 22 14 15 5 7 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 9 10+ Numberofindividuals Number of arrest occasions Pre-positive drug test Post-positive drug test Overall, both the volume of offending and the number of individuals offending reduced post-positive drug test when compared to pre-test. Individuals were arrested a total of 1,951 times during the 12 months prior to their positive drug test, compared to 1,626 arrest occasions during the 12 months following the drug test.This represents a 16.7% reduction in the number of offences following the positive drug test. Almost three in five of the positive drug test cohort who reoffended following the drug test were not tested at subsequent arrests.This shows us that a substantial proportion of Class A drug using offenders are not being drug tested under the targeted testing process, thus highlighting missed opportunities to identify and engage them in treatment to reduce their drug use and offending behaviour. The value of drug testing by Merseyside Police should not be underestimated as it is a key stage in the process of identifying drug using offenders and helping them to engage with local drug treatment services. Source: Drug Interventions Programme – Re-offending of clients testing positive for class A drugs across Merseyside (LJMU 2017)
  8. 8. Percentage of suspected drug driving saliva tests collected by police giving positive results, by age group 57% 60% 58% 55% 55% 47% 33% 0% 10% 20% 30% 40% 50% 60% 70% 16-19 20-24 25-29 30-34 35-39 40-49 50+ Data on saliva tests presented here is from primary data collected by the 24 police...The data is based on the results from 4,292 preliminary drug screening tests… 93% of preliminary drug screening (saliva) tests were carried out at the roadside, after a driver had been stopped, with only 7% of the tests being undertaken at a station. …the percentage of saliva tests giving positive results varies by age group, with the peak percentage for those aged 20 to 24.Those stopped are also predominantly male, with approximately 94% of those stopped and saliva tested being men. For men, 61% of tests were positive (base 3,200) while for women, 51% of tests were positive (base 200). Of these positive tests, 75% were positive for cannabis only, 14% for cocaine only, while 11% indicated the presence of both cannabis and cocaine. Source: Evaluation of the new drug driving legislation, one year after its introduction (Risksol Consulting Ltd 2017)
  9. 9. Number and rate (per 100,000 registered patients) of emergency admissions to hospitals in England for alcohol related liver disease in adults aged 19 years and older 10,361 10,644 10,879 10,696 11,794 12,402 12,50823.6 24.3 24.9 24.4 26.7 27.7 27.7 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 0.0 5.0 10.0 15.0 20.0 25.0 30.0 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 (provisional) Rateper100,000patients Numberofemergencyadmissions Number Rate Source: Clinical Commissioning Group Outcomes Indicator Set (NHS Digital, 2017)
  10. 10. Provisional rate (per 100,000 registered patients) of emergency admissions to hospitals for alcohol related liver disease in 2016-17, by CCG NHSTower HamletsCCG, 4.2 All registered patients in England, 27.7 NHS South Sefton CCG, 93.3 0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 NHSTowerHamletsCCG NHSPortsmouthCCG NHSSouthGloucestershire… NHSBathandNorthEast… NHSWestHampshireCCG NHSBarnetCCG NHSChilternCCG NHSIpswichandEastSuffolk… NHSNorthHampshireCCG NHSEastRidingOfYorkshire… NHSHighWealdLewes… NHSEastandNorth… NHSCroydonCCG NHSNewburyandDistrictCCG NHSKingstonCCG NHSOxfordshireCCG NHSHounslowCCG NHSDartford,Gravesham… NHSNottinghamCityCCG NHSEalingCCG NHSShropshireCCG NHSHorshamandMid… NHSSouthLincolnshireCCG NHSCoventryandRugbyCCG NHSBristolCCG NHSLeedsNorthCCG NHSWindsor,Ascotand… NHSHerefordshireCCG NHSSouthEastStaffordshire… NHSNorwichCCG NHSBarkingandDagenham… NHSCentralManchesterCCG NHSNeneCCG NHSWyreForestCCG NHSEastStaffordshireCCG NHSDurhamDales,… NHSBradfordDistrictsCCG NHSOldhamCCG NHSNorthWestSurreyCCG NHSScarboroughand… NHSValeRoyalCCG NHSWalsallCCG NHSHardwickCCG NHSSwaleCCG NHSHartlepooland… NHSNewcastleGatesheadCCG NHSSouthCheshireCCG NHSBlackburnWithDarwen… NHSGreaterPrestonCCG NHSKnowsleyCCG NHSRedditchand… NHSSunderlandCCG Source: Clinical Commissioning Group Outcomes Indicator Set (NHS Digital, 2017)
  11. 11. Number of people diagnosed with HIV in the UK where probable route of exposure is injecting drug use 180 170 150 150 130 130 130 150 190 130 0 20 40 60 80 100 120 140 160 180 200 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Source: HIV: annual data tables (PHE, 2017)
  12. 12. Number of people seen for HIV care in the UK and receiving antiretroviral therapy (ART) where probable route of exposure is through injecting drug use 1,527 1,609 1,648 1,729 1,736 0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000 2012 2013 2014 2015 2016 Source: HIV: annual data tables (PHE, 2017)
  13. 13. Characteristics of patients who died by suicide and had been in touch with mental health services in the 12 months over the last 10 years 68% 22% 45% 33% 73% 27% 63% 43% 68% 25% 58% 46% 70% 25% 49% 38% 0% 10% 20% 30% 40% 50% 60% 70% 80% History of self-harm History of violence History of alcohol misuse History of drug misuse England Northern Ireland Scotland Wales n = 13,576 n = 778 n = 2,652 n = 817 Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
  14. 14. Patients in contact with mental health services in the 12 months, prior to death by suicide in England, by primary psychiatric diagnoses 6,021 2,275 1,234 1,033 765 645 576 547 - 1,000 2,000 3,000 4,000 5,000 6,000 7,000 Affective disorders Schizophrenia Personality disorder Alcohol dependence Adjustment disorder Anxiety disorders Drug dependence Other Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
  15. 15. Number of patients in contact with mental health services, in the 12 months prior to death by suicide, with a history of alcohol or drug misuse, in England 544 466 501 561 524 560 624 598 575 515 486 375 356 337 391 357 377 475 431 442 413 389 0 100 200 300 400 500 600 700 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Alcohol Drug The number of suicides in patients with a history of alcohol or drug misuse has fallen since a peak in 2011. Between 2011-2015, 375 (7%) patients who died were under drug services, 389 (7%) were under alcohol services, and 612 (11%) were under either drug or alcohol services. The most common substances misused in the 3 months prior to suicide were alcohol (59%), cannabis (21%), stimulants (15%) and heroin (13%).The number of patients misusing alcohol or heroin fell between 2011 and 2014. Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
  16. 16. Number of homicides by patients with mental ill health with a history of alcohol or drug misuse 58 52 42 47 33 35 47 35 41 37 28 58 59 49 53 36 39 42 41 47 31 34 0 10 20 30 40 50 60 70 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Alcohol Drugs 555 patients [in the last decade] (88%, excluding unknowns) had a history of either alcohol or drug misuse or both, an average of 50 homicides per year. Therefore, only 12% of patients who committed a homicide had no history of alcohol and/or drug misuse. 167 (27%) patients [who committed homicide in the last decade] had “dual diagnosis”, defined as severe mental illness (schizophrenia or affective disorders) and co-morbid alcohol or drug dependence/misuse, an average of 15 per year.The number of patient homicides with “dual diagnosis” fell after a peak in 2005 but has risen since 2010. Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
  17. 17. Behavioural characteristics of patients with mental ill health homicide offenders in England (2005-2015) 50% 53% 77% 73% 78% 71% 80% 88% 100% 89% 58% 58% 86% 91% 92% 61% 46% 75% 74% 74% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% History of self-harm History of violence Any previous convictions History of alcohol misuse History of drug misuse England Northern Ireland Scotland Wales n = 641 n = 18 n = 137 n = 39 Source: National Confidential Inquiry into Suicide and Homicide by People with Mental Illness Annual Report 2017
  18. 18. Multiple needs of people entering domestic abuse services and captured by the SafeLives database between April 2014 to March 2017 6% 12% 45% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Drug misuse Alcohol misuse Mental health problems Needs experienced within the last 12 months In the period April 2014 to March 2017, caseworkers submitted 974 intake forms for clients entering 11 health services across England and Wales which used the SafeLives Insights outcome measurement service. Where a referral route was recorded(n = 811), 1% (6 cases) were from drug and alcohol services, and 6% (47 cases) were by mental health services. Of clients accessing support (n = 515) 28% (143) engaged with mental health services, 9% (48) with drug services, and 14% (72) with alcohol services. Source: Insights National Dataset Health 2016-17 (SafeLives, 2017)
  19. 19. First time entrants to the criminal justice system in England and Wales between 2003/04 and 2012/13 9.8% 0.9% 3.8% 1.6% 29.5% 1.1% 4.6% 7.2% 2.2% 10.0% 38.2% 0.9% 0% 20% 40% 60% Violence against the person Sexual offences Burglary Robbery Theft and handling stolen goods Fraud and forgery Criminal damage Drug offences Other indictable offences Indictable motoring offences Summary offences excluding… Summary motoring offences Proven first offence characteristics of first time entrants to the criminal justice system 7,344 6,151 3,654 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 Number of FTEs by proven drug offence, by year Source: An analysis of trends in first time entrants to the youth justice system (MoJ, 2017) n= 757,231
  20. 20. Kilos of cocaine (including crack) and heroin seized by the police and Boarder Force 3,249 3,468 2,949 2,702 2,437 3,495 3,079 3,463 3,419 4,282 5,555 1,003 1,041 1,552 1,516 732 1,849 752 642 1,113 806 783 -00 1,000 2,000 3,000 4,000 5,000 6,000 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17 Cocaine (including crack) Heroin Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office) In 2016/17, 5,516 kilograms of cocaine were seized by the police and Border Force, a 30% increase on the previous year (4,240 kg), and the largest quantity since 2003. There were 39 kilograms of crack seized in 2016/17, 3 kilograms less than in 2015/16. In 2016/17, 783 kilograms of heroin were seized, a 3% decrease on 2015/16 when 806 kilograms were seized.
  21. 21. Quantity of cannabis seized, 2006/07 to 2016/17, police forces and Border Force -00 100,000 200,000 300,000 400,000 500,000 600,000 700,000 800,000 -00 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 Numberofplants Kilograms Herbal cannabis Cannabis resin Cannabis plants The total quantity of herbal cannabis seized in 2016/17 fell by 61% from the previous year, from 30,493 kilograms to 11,861 kilograms. However, the quantity of herbal cannabis seized in 2015/16 was the largest since 2008/09, largely due to seizures made by Border Force.The fall in the last year should therefore be seen in the context of the longer term trend. Over the last year, the total quantity of herbal cannabis seized by Border Force decreased by 69%, from 27,132 kilograms to 8,370 kilograms. At the same time, the quantity of herbal cannabis seized by police forces increased by 4% from 3,361 kilograms in 2015/16 to 3,492 kilograms in 2016/17. Over the same time period, the quantity of cannabis resin seized decreased from 7,035 kilograms in 2015/16 to 5,838 kilograms in 2016/17 (down by 17%). Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office)
  22. 22. Proportion of drug seizure quantities by drug type and authority, 2016/17 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Police Boarder Force Source: Seizures of drugs in England and Wales, financial year ending 2017 (Home Office)
  23. 23. Proportion of cases where the outcome of the stop was linked to the reason for the stop and search, by reason for stop and ethnicity 0% 5% 10% 15% 20% 25% 30% Drugs Stolen property Firearms Offensive weapons Criminal damage Going equipped Other White BME In the year ending March 2017 around 1 in 5 stop and searches resulted in an outcome that was linked to the reason for the search, i.e. the officer found what they were searching for.This proportion varied considerably depending on the reason for the stop.While around 1 in 4 drug stops led to an outcome related to ‘Drugs’, this figure was around 1 in 10 for searches relating to ‘Criminal damage’ and ‘Going equipped’. The figures cover all searches, including those that resulted in an outcome of ‘No further action’. Given that ‘No further action’ outcomes will rarely be linked to the initial reason for the search, it is helpful to consider the picture when these cases are excluded. When this is done, 65% of outcomes were linked to the initial reason for the search.This proportion varied by outcome type. For example… 82% of cannabis/khat warnings were linked to the reason for the search… Source: Police powers and procedures England and Wales year ending 31 March 2017 second edition (Home Office)

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