Presentation on some of the things that might be important for drug and alcohol policy makers in the UK

1. Issues for drug and alcohol policy
in the UK
Andrew Brown
Director of Policy Influence and Engagement

2. Trends in illicit drug use (excluding mephedrone) in the last year among
adults, by age group, 1996 to 2013 to 2014, Crime Survey for England and
Wales
Around 1 in 11 (8.8%)
adults aged 16 to 59
had taken an illicit
drug (excluding
mephedrone) in the
last year, which
equated to around
2.7 million people.
Nearly 1 in 100 people between the ages of 15-64 in Great Britain are
estimated to be high risk drug users - injecting, long term or regular use.

3. Age-standardised mortality rates for deaths related to drug poisoning and
drug misuse, by sex, deaths registered in 1993–2013
In 2013, there were 1,957
drug misuse deaths, an
increase of 20% from 1,636
deaths in 2012 following a
decrease over the last two
years.
The proportion of female drug
poisoning deaths that were
related to drug misuse was
highest in 2013 at 56%.

4. Age-standardised alcohol-related death rates in the UK, per 100,000 of
population

5. Supply issues
● The rise of the ‘dark net’ and use of the
internet as the way that people can access
legal, illegal drugs, and knock off medicines
● Organised crime and the issues of modern
day slavery, where drugs (including alcohol)
are a significant factor in the sexual
exploitation of children and women, and are
also a major part of the issue of in-country
drug production (the Vietnamese gangs
involved in cannabis factories)

6. New Psychoactive Substances
● The expert panel review and the government’s
response will lead to new legislation to ban the
sale and import of psychoactive substances (NB
no possession offences)
● New guidance to prison governors about
prisoners found with NPS will have their
sentences extended.
● An increasing focus on vulnerable people
(homeless people, young drug users, some
injecting drug users) in the responses to NPS,
moving away from the idea that these are drugs
that recreational users are attracted to.
There were about 250
recorded incidents of NPS
being thrown into prison in
2014 compared with 36 in
2013

7. Alcohol
● Integration between drug and alcohol
services, which might create better
services, or might just exclude high
risk drug takers
● Public Health England are focusing
on alcohol harms
● Local areas with the highest needs
seem to be most likely to be reducing
funding for alcohol services

8. Crime and punishment
● The evidence that drugs (including
alcohol) are a driver of crime.
o 53% of violent incidents involving
adults were alcohol-related
● The tailing off of the heroin epidemic
has accounted for about 1/3 of the fall
in property crime in recent years.
● Can policy makers interest the police in
helping to ensure that Directors of
Public Health are investing in drug and
alcohol treatment.

9. Investment in treatment
● A review of commissioning last year and
DrugScope’s State of the Sector report has
shown that resources for treatment services have
reduced in the last two years.
● The response has been to introduce a Health
Premium (£5 m) on the successful completion of
treatment, and to add a condition to the Public
Health grant which requires local authorities to
“have regard to the need to improve the take up
of, and outcomes from, their drug and alcohol
misuse treatment services”.

10. Treatment and Recovery
● How important is medication in the treatment of drug and alcohol
problems, and what dose and length of time is best for patients to be
proscribed (particularly for opioid substitution therapy)?
● A review of the clinical guidelines for treatment (which will reinforce the
clinical view that OST is an important part of the armoury)
● How should treatment systems respond to ‘use on top’ (where people in
receipt of methadone (or similar) are still using street drugs)?
● For those in recovery what is the offer? There’s a policy focus on
employability and employment opportunities.
● Is it acceptable to sanction drug and alcohol users who are in receipt of
welfare benefits who refuse drug or alcohol treatment?

11. Drug related deaths
● The unexpected (and large) rise in drug related
deaths last year is something that worries policy
makers and drug treatment services.
● The government have committed to making
Naloxone (the medicine that reverses opioid
overdose) more widely available in the
community.
● A stronger focus on the wider health issues for
an aging drug using population – for example in
identifying and treating people with hepatitis C.

12. Multiple needs
● The Making Every Adult Matters (MEAM) coalition
● Updated guidance on dual diagnosis (mental health and substance use as
co-existing conditions)
● National Institute on health and Clinical Excellence (NICE) guidance

13. Law reform
● Can policy makers continue to ignore the chorus of liberal and libertarian
calls for creating a regulated market?
● What difference will international experience with different regimes make?
● Will the government return to considerations of a Minimum Unit Pricing for
alcohol particularly if/when it is introduced in Scotland.
● Will different parts of the UK want different drug and alcohol policy and
law?

14. The elephant(s) in the room
● The precarious position of
publicly delivered or
commissioned services
and the local state – for
example that there will be
system and service
failures in adult and
children’s social care in
particular.