Comprehensive Summary of Drug and Alcohol Treatment Trends in England (April 2023 – March 2024)

Comprehensive Summary of Drug and Alcohol Treatment Trends in England (April 2023 - March 2024)

Drug and alcohol dependency continues to present significant challenges in England, impacting individuals, families, and communities alike. An analysis of the period between April 2023 and March 2024 offers valuable insights into treatment trends, the profiles of individuals seeking help, and the key issues they face.

Rising Numbers in Treatment

The latest figures highlight a significant increase in demand for treatment:

  • 310,863 adults accessed services—a 7% increase compared to 2022 to 2023, marking the largest rise since 2008-2009.
  • Of these, 158,991 were new entrants, up from 133,704 the previous year.

This growth demonstrates either improved awareness and accessibility of services or increasing severity of substance use issues.

Substance Use Patterns

Treatment services group individuals based on the primary substances they use:

  • Opiates: Represent 44% of people in treatment, making this the largest group.
  • Alcohol only: Accounts for 30%, with numbers rising from 86,257 to 94,173.
  • Non-opiates (e.g., cannabis, crack, ecstasy): 12%, with a slight growth.
  • Non-opiates with alcohol: 14%, continuing steady increases.

Notable Substance Trends

  • Alcohol was the most commonly reported issue (63%), followed by opiates (23%) and cannabis (21%).
  • Powder cocaine use reached its highest recorded level at 19%, a 2% rise.
  • Ketamine use surged, rising eightfold since 2014-2015.

These trends reflect shifting drug usage patterns and the growing influence of stimulants and emerging substances like ketamine.

Long-term Dependency:

Among opiate users, 63% first tried heroin more than 20 years ago, underscoring the entrenched nature of addiction within this group.

Housing Instability

Stable housing remains a crucial yet unmet recovery need for many:

  • 21% of new entrants had no fixed address, including:
    • 9% sofa surfing,
    • 4% in temporary accommodation, and
    • 3% living on the streets.
  • Housing instability was most prevalent among opiate users, 39% of whom were homeless.
  • Alarmingly, 9% of all individuals were at immediate risk of homelessness, rising to 23% for psychoactive substance users.

Secure housing must be prioritised as part of effective recovery strategies.

Mental Health and Dual Needs

The interplay between substance use and mental health is evident:

  • 72% of individuals reported a need for mental health support, with the non-opiates and alcohol group having the highest proportion (78%) and the opiate group the lowest (69%).
  • However, 22% lacked access to appropriate mental health services.
  • Of those receiving support:
    • 64% were treated in primary care,
    • 21% engaged with community mental health services.

These figures highlight a critical shortfall in integrated, comprehensive care.

Drug-Injecting Behaviour

Injecting drug use remains a significant health concern:

  • Among new entrants, 16% had injected drugs, rising to:
    • 18% actively injecting and
    • 32% previously injecting in the opiate group.

Injecting drug use increases risks of infection and mortality, indicating a need for robust harm reduction measures.

Families and Safeguarding

Addiction affects not only individuals but also families:

  • 20% of individuals in treatment live with children under 18, impacting 57,121 children overall.
  • 13% of individuals are parents who live apart from their children.
  • 37% of these children receive early help services, while 15% are on child protection plans.

This underscores the urgent need for safeguarding interventions for children in environments affected by substance misuse.

Smoking Habits

Smoking continues to be highly prevalent among individuals in treatment:

  • 47% were smokers, compared to national averages of 13.4% for men and 9.9% for women.
  • Shockingly, only 4% were referred to smoking cessation support despite the obvious health implications.

Enhanced integration of smoking cessation programmes is essential.

Treatment Interventions and Outcomes

Structured Treatment:

  • Over 99% of individuals received structured treatments, mostly in community settings (98%).
  • Residential rehabilitation and inpatient treatment saw modest growth, with 5,438 and 12,100 users, respectively.
  • Most individuals (99%) started treatment within three weeks of referral.

Programme Interventions:

  • Individual Placement and Support (IPS): Enabled 6,240 people to access employment support.
  • Rough Sleeping Drug and Alcohol Treatment Grant (RSDATG): Assisted 12,811 people.

Success Rates:

  • Of the 137,477 people who left treatment:
    • 47% completed treatment successfully, including 58% of alcohol-only users compared to just 23% in the opiate group.
    • 37% dropped out prematurely, while 3% died in treatment.

Time in Treatment:

  • Successful completions took 3.3 years for opiate users versus 6 months for other groups.

Deaths in Treatment:

  • 4,022 individuals (1.3%) died, a 3% decrease from the year before.
  • Opiate users accounted for 63% of these deaths, highlighting the severe risks associated with this group.

Self-Reported Outcomes:

  • Substance use decreased significantly, with average days of use halving within six months:
    • Opiates dropped from 23.0 to 9.4 days per month.
    • Alcohol decreased from 21.1 to 12.0 days per month.
  • Injecting drug use among opiate users fell from 20.4 days per month to 8.3.

Modest improvements were also seen in employment outcomes, with days worked increasing slightly.

The Path Ahead

This report lays bare the complex challenges of addressing substance abuse in England, from housing and mental health needs to entrenched dependency and high mortality rates. It highlights the need for:

  • Better mental health support integrated with treatment.
  • Expanded housing stability programmes for vulnerable individuals.
  • Enhanced focus on harm reduction and smoking cessation.
  • Support frameworks for families and children affected by addiction.

Substance abuse interventions must adopt a holistic approach, targeting the root causes and societal impacts of dependency. Together, we can enable better recovery outcomes and build stronger, healthier communities.

Source: GOV.UK

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