United Kingdom (England, Wales, Scotland, and Northern Ireland)
Page last updated March 29, 2023 by Doug McVay, Edtor.
1. UK National Drug Strategies "The UK 2017 Drug Strategy addresses illicit drug problems with two overarching aims: to reduce illicit and other harmful drug use and to increase the rates of people recovering from dependency. These aims are supported by four key themes: (i) reducing demand; (ii) restricting supply; (iii) building recovery; and (iv) global action. Within the strategy, policies concerning health, education, housing and social care apply to England, those concerning policing and the criminal justice system cover both England and Wales, while the tasks of the Department for Work and Pensions relate to England, Scotland and Wales. A number of powers are devolved to Northern Ireland, Scotland and Wales, and each of these countries has its own strategy and action plans. Both the current Welsh strategy, Working Together to Reduce Harm: The Substance Misuse Strategy for Wales 2008-18, and Scotland’s strategy, The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem, were adopted in 2008. In 2018, Scotland launched a new drug and alcohol strategy. Northern Ireland’s policy, New Strategic Direction for Alcohol and Drugs Phase 2: 2011-16, was launched in 2011, and had a final review in 2018. The strategies in Scotland, Northern Ireland and Wales address both illicit drugs and alcohol. "All European countries evaluate their drug policies and strategies through ongoing indicator monitoring and specific research projects. In 2017, the Home Office published an evaluation of the actions in the Drug Strategy 2010, a multi-criterion assessment looking at the effectiveness of the responses, their costs and value for money; the evaluation focused on England. In 2018, the Welsh Assembly published an evaluation of the Substance Misuse Strategy for Wales 2008-18 as part of the process of developing a new strategy." European Monitoring Centre for Drugs and Drug Addiction (2019), United Kingdom Country Drug Report 2019, Publications Office of the European Union, Luxembourg. |
2. UK Drug Laws "The Misuse of Drugs Act 1971, with amendments, is the main law regulating drug control in the United Kingdom. It divides controlled substances into three classes (A, B and C), which provide a basis for attributing penalties for offences. Maximum penalties vary according to whether the conviction is made at a magistrates’ court for a summary offence or made on indictment following a trial at a Crown Court, with mitigating and aggravating factors determining which type of court is the most appropriate for a given case. Detailed guidance for sentencing in each case is published by the Sentencing Council. A distinction is made between possession of controlled drugs and possession with intent to supply; the latter effectively refers to drug trafficking offences. "Drug use per se is not an offence under the Misuse of Drugs Act 1971; it is the possession of the drug that constitutes an offence. Summary convictions for the unlawful possession of Class A drugs, such as heroin or cocaine, involve penalties of up to 6 months’ imprisonment and/or a fine; on indictment, penalties may reach 7 years’ imprisonment. Possession of Class B drugs, such as cannabis and amphetamines, incurs a penalty of up to 3 months’ imprisonment and/or a fine at a magistrates’ court; on indictment, the penalty is up to 5 years’ imprisonment and/or an unlimited fine. Possession of most Class C drugs, such as benzodiazepines, attracts a penalty of up to 3 months’ imprisonment and/or a fine by a magistrate, or up to 2 years’ imprisonment and/or an unlimited fine on indictment. There are also a number of alternative responses, such as cannabis warnings and cautions from the police, who have some powers of discretion. "The Drug Trafficking Act 1994 defines drug trafficking as transporting or storing, importing or exporting, manufacturing or supplying drugs covered by the Misuse of Drugs Act 1971. For trafficking in Class A drugs, the maximum penalty on indictment is ‘life’ imprisonment (which is 25 years in the United Kingdom), while trafficking in Class B or Class C drugs can incur a penalty of up to 14 years in prison. Under Section 110 of the Powers of Criminal Courts (Sentencing) Act 2000, a minimum sentence of 7 years was introduced for a third conviction for trafficking in Class A drugs. "Temporary class drug orders were introduced through the Police Reform and Social Responsibility Act 2011 to allow a faster legislative response to new psychoactive substances (NPS) supply offences. In 2016, the Psychoactive Substances Act criminalised the production, supply or possession with intent to supply of any psychoactive substance (with some exemptions) if it is known that it is to be used for its psychoactive effects. Supply offences are aggravated by proximity to a school, using a minor as a courier or being carried out in a custodial institution. Simple possession of NPS does not constitute an offence unless it takes place within a custodial institution. Maximum penalties are 7 years’ imprisonment on indictment or 1 year’s imprisonment on summary conviction." European Monitoring Centre for Drugs and Drug Addiction (2019), United Kingdom Country Drug Report 2019, Publications Office of the European Union, Luxembourg. |
3. Prevalence and Trends in Substance Use In the UK "Overall prevalence of drug use reported in general population surveys in England and Wales is similar to a decade ago, with almost 1 out of 10 adults aged 16-59 years reporting illicit drug use in the last year. In Scotland, there was a decline in last year illicit drug use between 2008/09 and 2014/15. "In the early 2000s, prevalence of last year cannabis use reported by the Crime Survey for England and Wales was among the highest reported by European countries; however, this is now at a level that is fairly typical to that seen elsewhere in Europe. Following a decrease in prevalence between 2003/04 and 2009/10, the trend in cannabis use in the general population has since been relatively stable. The prevalence rate in 2017/18 was the highest reported since 2008/09; however, the increase from 2016/17 was not statistically significant. "Prevalence of new psychoactive substances (NPS) use in general population surveys is generally low in comparison with the main traditional drugs. Mephedrone was the only stimulant NPS to show signs of becoming established alongside traditional substances among recreational drug users in these surveys. However, prevalence of use of this drug has fallen since the 2010/11 Crime Survey for England and Wales, when questions were first asked about its use. "There was a steady decline in lifetime prevalence of drug use among school children (11- to 15-year-olds) in England between 2004 and 2014; however, an increase was reported in 2016. Drug use prevalence among young people in Scotland has declined since 2004 but remained stable between 2013 and 2015. Cannabis is the most commonly used drug among school children, and there has been a long-term downward trend in reported use with a more recent levelling off that is similar to the trend for the general population. A similar trend is also seen for other illicit drug use, as well as for alcohol and tobacco use. "London and Bristol participate in the Europe-wide annual wastewater campaigns undertaken by the Sewage Analysis Core Group Europe (SCORE). This study provides data on drug use at a municipal level, based on the levels of illicit drugs and their metabolites found in sources of wastewater. For 2018, only data for Bristol were available. The results pointed to a possible increase in cocaine use in Bristol since the initiation of the study (2014). Furthermore, higher levels of cocaine metabolites were detected at the weekends." European Monitoring Centre for Drugs and Drug Addiction (2019), United Kingdom Country Drug Report 2019, Publications Office of the European Union, Luxembourg. |
4. Last Year Prevalence of Illegal Drug Use in England and Wales Among People Aged 16 to 59 "The 2018/19 CSEW shows that around 1 in 11 (9.4%) adults aged 16 to 59 had taken a drug in the last year, which equates to around 3.2 million people. The trend in the proportion of 16 to 59 year olds taking a drug in the last year was relatively flat between 1996 and 2003/04, followed by small year-onyear decreases until 2007/08. Since the 2009/10 survey, the proportion taking a drug in the last year has remained relatively flat, with the prevalence estimate remaining between 8.2 and 9.4 per cent. The 2018/19 estimate is similar to a decade ago in the 2008/09 CSEW (9.9%) and the 2007/08 CSEW (9.4%), but it is lower than all survey years before 2007/08. For further details see Appendix Tables 1.02 and 1.04. "Figure 1.2 below shows the trend in Class A drug use in the last year among 16 to 59 year olds. According to the 2018/19 CSEW, 3.7 per cent of adults aged 16 to 59 had taken a Class A drug in the last year, equating to around 1.3 million people. There was a general upward trend in Class A drug use from 1996 (when the series began) until the 2008/09 survey which was then followed by a general downward trend until the 2011/12 survey (2.9%). Since 2011/12, the trend has reversed and has generally been upward, although the 2018/19 estimate was at a similar level to 2017/18 (3.5%). The increase in Class A drug use has been primarily driven by increases in powder cocaine and ecstasy use among 16 to 24 year olds. Trends in this broader age group tend to be driven by the 16 to 24 year old population where levels of drug use were substantially higher than among older adults (see Chapter 3)." Drug Misuse: Findings from the 2018/19 Crime Survey for England and Wales. Statistical Bulletin 21/19. National Statistics. Home Office. 19 September 2019. |
5. Prevalence of Last-Year Cannabis Use in England and Wales Among People Aged 16 to 59 "Similarly to previous surveys, cannabis was the most commonly used drug by respondents in the 2018/19 CSEW, with 7.6 per cent of adults aged 16 to 59 having used it in the last year, equating to around 2.6 million people. As shown in Figure 1.4 below, there was a long-term decline in the proportion of adults who used cannabis in the last year, decreasing from a high of 10.7 per cent in 2002/03 to 6.5 per cent in 2009/10. The trend was then relatively flat until 2016/17 but has since shown a one percentage point increase in last year use of cannabis, to 7.6 per cent in 2018/19. "Cannabis was also the most commonly used drug by young adults aged 16 to 24, with 17.3 per cent having used it in the last year according to the 2018/19 CSEW (around 1.1 million young adults). The long-term decline in prevalence of cannabis use in the last year was more apparent in this age group, falling from 28.2 per cent in 1998 down to 15.1 per cent in the 2013/14 survey. Since then there has been a general upward trend although the latest estimate is similar to the previous year (2017/18 CSEW, 16.7%)." Drug Misuse: Findings from the 2018/19 Crime Survey for England and Wales. Statistical Bulletin 21/19. National Statistics. Home Office. 19 September 2019. |
6. Prevalence of Last-Year Powder Cocaine Use in England and Wales Among People Aged 16 to 59 "As in recent years, the second most commonly used drug in the last year among adults aged 16 to 59 was powder cocaine (2.9% in the 2018/19 survey, equating to around 976,000 people). Among young adults aged 16 to 24 it was the third most commonly used drug (6.2%, around 395,000 young adults), behind cannabis (17.3%) and nitrous oxide (8.7%). Trends in last year cocaine use are prone to fluctuation from year to year, as can be seen in Figure 1.5, making it difficult to interpret short-term trends in cocaine use. "Powder cocaine use among 16 to 59 year olds increased between the 1996 and 2000 survey years (0.6% to 2.0%), driven by a sharp increase among the 16 to 24 age group (1.4% to 5.2%). These increases were followed by slower rises to reach a peak in the 2008/09 survey for both 16 to 59 and 16 to 24 year olds (3.0% and 6.5% respectively). "From 2008/09, last year use of powder cocaine fell before starting to rise again in 2011/12 for both age groups (see Figure 1.5 below) and there has been a general upward trend since. Although there were no statistically significant changes between the 2017/18 and 2018/19 surveys, there has been a statistically significant increase in powder cocaine use for both age groups compared with the 2011/12 CSEW. Last year use of cocaine increased among adults aged 16 to 59 from 2.1 per cent in the 2011/12 CSEW to 2.9 per cent in 2018/19. The comparable figures for those aged 16 to 24 were 4.1 per cent and 6.2 per cent." Drug Misuse: Findings from the 2018/19 Crime Survey for England and Wales. Statistical Bulletin 21/19. National Statistics. Home Office. 19 September 2019. |
7. Prevalence of Use of Ecstasy, Amphetamine, Ketamine, and Nitrous Oxide in England and Wales Among People Aged 16 to 59 "Ecstasy "The trend in the proportion of 16 to 59 year olds using ecstasy in the last year has been relatively flat throughout the lifetime of the survey, fluctuating between one and two per cent (Figure 1.6). The proportion of last year ecstasy users aged 16 to 59 in the 2018/19 survey (1.6%) was similar to the 2017/18 CSEW (1.7%). "Among 16 to 24 year olds, the trend shows greater fluctuation between years. Following a generally downward trend from the start of the times series, there was an increase in last year use among this age group between the 2011/12 (3.3%) and 2018/19 (4.7%) surveys. Whilst estimated levels of use have fluctuated between 4.3 and 5.4 per cent in recent years, prevalence of ecstasy use among 16-24 year olds remain below its peak of 6.8 per cent estimated from the 2001/02 survey. "Other drugs "The information below presents findings on some of the less commonly used drugs. These can be found in Appendix Table 1.02. Due to the lower number of people using these drugs, even small changes in prevalence can be statistically significant. Changes from one year to the next should be interpreted with caution and greater attention paid to the medium and longer-term trends in these drugs. "• Use of amphetamines decreased among both 16 to 59 and 16 to 24 year olds. For those aged 16 to 59, prevalence of amphetamine use has followed a general downward trend since a high of 3.3 per cent in 1996 to 0.6 per cent in 2018/19. Use of amphetamines followed a similar trend for those aged 16 to 24, falling from a high of 11.7 per cent in 1996 to 1.0 per cent in 2018/19. "• Ketamine use has increased from a decade ago across both age groups. For adults aged 16 to 59, use of ketamine has fluctuated in the last decade, with the latest estimate at 0.8 per cent, an increase compared with 2008/09 (0.5%). Use among adults aged 16 to 24 also showed a lot of variation in the last decade, although there was a general increase from 1.9 per cent in 2008/09 to 2.9 per cent in 2018/19, with a particularly large rise between 2016/17 and 2017/18 (1.3% to 3.1% respectively). "• Nitrous oxide continued to be the second most used drug among 16 to 24 year olds, with 8.7% having used it, a similar proportion (8.8%) to last year’s survey. This equates to around 552,000 young adults who used nitrous oxide in the last year. Use of new psychoactive substances among 16 to 24 year olds in the 2018/19 survey was also at a similar proportion to last year’s survey (1.4% and 1.2% respectively)." Drug Misuse: Findings from the 2018/19 Crime Survey for England and Wales. Statistical Bulletin 21/19. National Statistics. Home Office. 19 September 2019. |
8. Estimated Prevalence of Last-Year Drug Use Among Young Adults in England and Wales Table: Estimated Prevalence of Last-Year Drug Use Among Young Adults in England and Wales Drug Misuse: Findings from the 2014/15 Crime Survey for England and Wales. London, England: Home Office Statistics Unit. July 2015. |
9. Estimated Prevalence of "High-Risk" Drug Use In the UK "Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment centres, when considered alongside other indicators, can inform an understanding of the nature of and trends in high-risk drug use. "Opioids, particularly heroin, remain associated with the greatest health and social harms caused by illicit drugs in the United Kingdom. While there has been a decline in the prevalence of injecting among opioid users, around one third of people who seek treatment for heroin use in England report use by injection. There are concerns about changes in the patterns of drug injection in the United Kingdom, in particular the increased injection of crack cocaine and amphetamine-type stimulants, and the emergence in recent years of the injection of NPS. Data from the 2017 Unlinked Anonymous Monitoring survey of people who inject drugs indicate that the injection of crack has increased in recent years in England and Wales, with 51 % of those who had injected during the preceding 4 weeks reporting the injection of crack cocaine. "Data on the characteristics of those entering treatment in the United Kingdom indicate that heroin is the most commonly reported primary substance among those seeking treatment for drug use problems; however, there has been a long-term reduction in first-time clients seeking treatment for heroin use. Among first-time treatment clients, cannabis is the most commonly reported substance, followed by cocaine. An increase in the number and proportion of first-time treatment entrants for cocaine (both powder and crack) has been reported since 2014. Presentations to community treatment services for primary use of NPS have decreased markedly in England, and problematic NPS use is now found primarily among the adult prison population and street homeless people. Studies among vulnerable populations, such as homeless people, suggest that the use of synthetic cannabinoid receptor agonists is high among this group." European Monitoring Centre for Drugs and Drug Addiction (2019), United Kingdom Country Drug Report 2019, Publications Office of the European Union, Luxembourg. |
10. Prevalence of Drug Use Among Youth in Scotland, by Gender "Ever used drugs (includes used drugs more than a year ago, in the last year and in the last month). "Used drugs in the last year (includes used drugs in the last month). "Used drugs in the last month. "Never used drugs. Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS): Drug Use Among 13 and 15 Year Olds in Scotland 2013. NHS National Services Scotland, 2014. |
11. Prevalence of Past-Month Use of Various Drugs in England and Wales Among People Aged 16 to 59 " Around one in 25 adults (4.0%) aged 16 to 59 said they had taken a drug in the last month. This equates to around 1.3 million people. The proportion is similar to the previous year (4.3% in the 2015/16 CSEW) and is statistically significantly lower than those observed a decade ago in the 2006/07 survey (6.0%) and when CSEW measurements began in 1996 (6.7%) (Appendix Tables 1.03 and 1.04; Figure 1.5). " The proportion among young adults aged 16 to 24 followed a similar trend, although the proportion was nine per cent, more than double that of the wider age group. This equates to around 550,000 young people aged 16 to 24 having taken a drug in the month prior to interview. This represents statistically significant falls compared with 14.3 per cent in the 2006/07 survey and 19.2 per cent in the 1996 survey (Appendix Tables 1.07 and 1.08; Figure 1.5). " Last month use of Class A drugs was reported by 1.0 per cent of adults aged 16 to 59 and 2.3 per cent of young adults aged 16 to 24. Similarly to any drug use in the last month, these proportions have not changed statistically significantly compared with the previous survey year, but are statistically significantly down compared with a decade ago (Appendix Tables 1.03 and 1.07; Figure 1.5). " Among adults aged 16 to 59, the drugs most commonly taken in the last month were cannabis (3.2%, similar to the 2015/16 survey), powder cocaine (0.8%, similar to the 2015/16 survey) and ecstasy (0.3%, similar to the 2015/16 survey). " Among adults aged 16 to 24, the drugs most commonly taken in the last month were cannabis (7.6%), powder cocaine (1.6%) and ecstasy (1.1%). The use of these three drugs in the last month by 16 to 24 year olds has not changed statistically significantly compared with the previous survey year. " Mephedrone use in the last month was statistically significantly lower in the 2016/17 survey than in the 2015/16 survey among both 16 to 24 year olds and 16 to 59 year olds. For young adults it reduced from 0.4 per cent to zero respondents, and for 16 to 59 year olds it reduced to less than 0.1 per cent of respondents." Drug Misuse: Findings from the 2016/17 Crime Survey for England and Wales. Statistical Bulletin 11/17. National Statistics. Home Office. July 2017. |
12. Prevalence of Drug Use Among Students in England "There has been a decline in drug use by 11 to 15 year old pupils since 2001. In 2011, 17% of pupils had ever taken drugs, compared with 29% in 2001. There were similar falls in the proportions of pupils who reported taking drugs in the last year and the last month. The decline in the prevalence of drug use parallels the fall in the proportions of pupils who have ever been offered drugs, from 42% in 2001 to 29% in 2011. Fuller, Elizabeth (Ed.), "Smoking, drinking and drug use among young people in England in 2011" (London, England: NHS Health and Social Care Information Centre, July 26, 2012), p. 9. |
13. Prevalence of Alcohol, Tobacco, and Other Drug Use Among Youth, England "The survey sample represents an estimated population of around 3.0 million young people aged between 11 and 15 in England. Findings from this survey indicate that in England in 2011 around 140,000 young people aged between 11 and 15 were regular smokers, around 360,000 drank alcohol in the last week, and around 180,000 had taken drugs (including glue, gas and other volatile substances) in the last month. Fuller, Elizabeth (Ed.), "Smoking, drinking and drug use among young people in England in 2011" (London, England: NHS Health and Social Care Information Centre, July 26, 2012), p. 11. |
14. Prevalence of Last-Year Illegal Drug Use in England and Wales Among People Aged 16 to 24 "As in previous years, the proportion of young adults aged 16 to 24 taking any drug in the last year was more than double the proportion in the 16 to 59 age group, at 19.2 per cent. This proportion equates to 1.2 million young people. It is this younger age group that largely drives the trend seen in the wider group of adults aged 16 to 59. "Over the last five years there has been some fluctuation in this series. However, the long-term trend is downward; the 2016/17 estimate of 19.2 per cent is statistically significantly lower compared with 10 years ago (24.2% in 2006/07) and with the start of the time series in 1996 (29.7%). The reduction compared with the 2006/07 survey year is accounted for by statistically significant falls in half of drug types. "The 2016/17 CSEW found that seven per cent of young adults aged 16 to 24 had taken a Class A drug in the last year, equating to around 429,000 young people. The change compared with the 2015/16 CSEW (6.6%) and the 2006/07 CSEW (8.1%) was not statistically significant, but this trend has fallen statistically significantly compared with 1996 (9.2%). As with the trend in any drug use, the trend in Class A drug use has been relatively stable since the 2009/10 survey year, with the exception of the 2012/13 estimate, which looks to be out of line with recent results. Drug Misuse: Findings from the 2016/17 Crime Survey for England and Wales. Statistical Bulletin 11/17. National Statistics. Home Office. July 2017. |
15. Deaths in the UK Due to a Toxic Drug Supply and Drug Overdose "In 2020 drug related deaths in the United Kingdom (UK) reached the highest rate in over 25 years (ONS, 2021). Data between 2001-2018 evidences a substantial increase in drug poisonings over time for people who use opioids, with risk increasing particularly between the years of 2010-2018, an effect which was not entirely explained by the ageing of this cohort (Lewer et al., 2022). The concentration of drug related deaths are geographically varied in the UK. Areas of high economic deprivation, such as North-East England have more than three times the rate of drug related deaths than London (ONS, 2021). In the North East town of Middlesbrough citizens are statistically more likely to die from a drug related deaths than a car accident (Middlesbrough Council, 2020). Poverty, homelessness, an aging population of opioid users, unemployment, polydrug use and significant funding reductions for drug treatment services have been posited as contributing factors (ACMD, 2017; Lewer et al., 2022; ONS, 2019a, 2019b; Public Health England, 2018). The largest proportion of drug related deaths in the North-East of England are reported among men who are dependent on illicit opioids, such as heroin (ONS, 2022). The high prevalence of opioid usage in Middlesbrough combined with an unregulated and toxic illicit street tablet market (substances such as z-drugs, benzodiazepine and gabapentinoids) provides a potentially fatal risk environment due to interactions between these depressant drugs, which can significantly increase risk of drug related deaths (Akhgari, Sardari-Iravani, & Ghadipasha, 2021; Ford & Law, 2014; ONS, 2021, 2022)." Poulter, H. L., Walker, T., Ahmed, D., Moore, H. J., Riley, F., Towl, G., & Harris, M. (2023). More than just 'free heroin': Caring whilst navigating constraint in the delivery of diamorphine assisted treatment. The International journal on drug policy, 116, 104025. doi.org/10.1016/j.drugpo.2023.104025 |
16. City Checking: Community-Based Drug Safety Testing "These pilots suggest that community-based drug safety testing can provide, first, engagement with more diverse drug–using communities than event-based testing—in terms of demographics, drugs of choice and risk taking behaviours—and therefore potentially can be more inclusive and impactful across drug–using communities including with marginalised groups. Second, there is the potential benefit of issuing proactive alerts for substances of concern in local drug markets ahead of specific leisure events, as happened with a mis-sold ketamine analogue identified in this study. Third, community testing can benefit from accessing fixed site laboratory facilities (in this case, a university chemistry department) to complement the speed and convenience of mobile laboratories with potentially greater analytical capabilities and trialling of new technological developments. "These benefits cannot be presumed, however. The community pilots highlighted that service design characteristics and operational variations such as venue, day of week, prior publicity and outreach activities all can influence outcomes. Moving to a neutral central building attracted larger numbers and a greater diversity of service users as well as building trust with new service user groups, with drugs outreach staff further enhancing engagement with more marginalised drug using communities." Measham F. (2020). City checking: Piloting the UK's first community-based drug safety testing (drug checking) service in 2 city centres. British journal of clinical pharmacology, 86(3), 420–428. doi.org/10.1111/bcp.14231 |
17. Retail Price of Heroin in the US, Canada, and the UK Prices Per Gram, 2016 United States: Canada: UK, 2016: UN Office on Drugs and Crime. Retail and Wholesale Drug Prices (In US$), accessed March 20, 2021. |
18. "Dry January," One-Month Alcohol Abstinence Campaigns and Harm Reduction "Each year, OMACs [One-Month Alcohol Abstinence Campaigns] attract an increasing number of participants. For example, even if it still represents less than one percent of the Australian adult population in 2019, 44,000 people officially registered for Dry July [28], while they were 16,787 in 2016 and 9,532 in 2010 [34]. Regarding Dry January, 4,000 people participated in the 2014 campaign while they were 3.9 millions in 2020, that is, approximately 7.5% of the UK adult population [35, 36]. However, for ensuring the continued success of such campaigns, it is important to inform participants whether these programs meet harm reduction objectives. This review thus aimed to determine the profile of participants in the different national one-month abstinence campaigns, to estimate the rates and factors of success, and to explore the associated subjective benefits in participating in or completing the challenge. "Based on the studies pertaining to Dry January, it seems that those taking part in the challenge were more likely to be heavier drinkers, more concerned about their health, and had higher levels of incomes and education. The latter aspects are consistent with those reported elsewhere: the concern for healthy behaviors is more developed among individuals with higher education and incomes [37, 38]. However, this relationship is probably mediated, at least partially, by the overall level of education received, including during school years, suggesting that sustained and universal health education programs could help to bridge this gap [39]. The finding that females were more attracted in participating in abstinence campaigns is possibly in line with the fact that females are in general more concerned about health-related behaviors [40]. However, being a male led to better chance of successfully complete the abstinence campaign, specifically for campaigns promoting restriction of alcohol use. These results may reflect cultural differences across gender, with respect to alcohol use and alcohol-related representations [41]. "Completing the one-month abstinence challenge was found to be associated with lower drinking patterns and better psychosocial functioning at baseline. Thus, it is interesting to note that those participating in the abstinence campaigns had more elevated drinking patterns compared to the non-participating alcohol users, whereas those achieving the challenge had lower drinking patterns compared to those who did not. Another important factor of success was the registration and active participation in social media communities. This is in line with the overall finding that interactive social media on the Internet can be a very effective tool to change health behaviors in the general population [42]. There may be some biases in this finding as participants who registered on social communities might be the most motivated ones, which could explain a better success in achieving the challenge. However, sharing the experience and the difficulties encountered during of a long time period of alcohol abstinence on a virtual community was designated as the most efficient strategy to successfully reach the abstinence goal during the online HSM program [7]. In this program, other strategies which were reported to be efficient to abstain from alcohol include the engagement in alcohol-free activities, the use of non-alcoholic beverages instead of alcohol, support from family and friends, and anticipation of social events [7]. On the contrary, anxiety, stress, negative emotions, social pressure to drink, loneliness, boredom, and no social support were reported as barriers to maintain alcohol abstinence [7]. Considering those dimensions as potential factors for success or failure in national one-month abstinence campaigns would be relevant in further studies. "Many participants in OMACs reported subjective improvements in health, including improved sleep, weight loss, an increased “energy”. An important finding is that Dry January participants also reported to have tried to increase their physical activity and to improve their diet, which was also reported by Dry July participants during the mid-year health check. This may suggest that these campaigns are actually not merely alcohol-focused for many participants, and might consist for them to a health-focused month, in particular when it is the first month of the year immediately after the end of year celebrations. This finding might have important implications for the evolution of the communication around these prevention campaigns. Moreover, improvement in health after one-month alcohol abstinence was objectively demonstrated for several parameters in a study with drinkers drinking above national guidelines where one-month alcohol abstinence led to a decrease in blood pressure, decrease in circulating concentrations of cancer-related growth factors, decrease in insulin resistance and weight reduction compared to the non-abstinent group [43]." de Ternay J, Leblanc P, Michel P, Benyamina A, Naassila M, Rolland B. One-month alcohol abstinence national campaigns: a scoping review of the harm reduction benefits. Harm Reduct J. 2022;19(1):24. Published 2022 Mar 4. doi:10.1186/s12954-022-00603-x |
19. Substance Use Among Unhoused People "The prevalence of homelessness globally is estimated to be roughly 150 million individuals at any given time (Busch-Geertsema et al., 2016). In the UK, recent data from the Shelter organisation estimated that 320,000 people were homeless in 2019/2020 (Bramley & Fitzpatrick, 2018). Problematic drug use among this population has been extensively documented in the scientific literature (O'Flaherty et al., 2018; Paudyal et al., 2017; Van den Bree et al., 2009; Krupski et al., 2015; Linton et al., 2013; Narendorf et al., 2017). Homelessness and drug misuse often coexist, and the recorded prevalence of drug use among homeless individuals in different countries is consistently above the national average (Doran et al., 2018; Johnson & Chamberlain, 2008; Krupski et al., 2015). Although the high prevalence of traditional drugs has been extensively documented within the homeless population, NPS have become an increasing risk to this population, with particular concern regarding the use of synthetic cannabinoid receptor agonists (SCRAs) due to their underdefined toxic effects, difficulty in treating them and lack of confidence from clinicians (Sulaiman and MP, 2019; Thornton, 2018; Williams, 2017)." Coombs, T., Ginige, T., Van Calster, P. et al. New Psychoactive Substances in the Homeless Population: A Cross-Sectional Study in the United Kingdom. Int J Ment Health Addiction (2023). doi.org/10.1007/s11469-022-00988-7 |
20. Little Evidence of Causal Gateway Effect for Soft Drugs "After applying these methods, there is very little remaining evidence of any causal gateway effect. For example, even if soft/medium drugs (cannabis, amphetamines, LSD, magic mushrooms, amyl nitrite) could somehow be abolished completely, the true causal link with hard drugs (crack, heroin, methadone) is found to be very small. For the sort of reduction in soft drug use that might be achievable in practice, the predicted causal effect on the demand for hard drugs would be negligible. Although there is stronger evidence of a gateway between soft drugs and ecstasy/cocaine, it remains small for practical purposes. My interpretation of the results of this study is that true gateway effects are probably very small and that the association between soft and hard drugs found in survey data is largely the result of our inability to observe all the personal characteristics underlying individual drug use. From this viewpoint, the decision to reclassify cannabis seems unlikely to have damaging future consequences." Pudney, Stephen. Home Office Research Study 253: The road to ruin? Sequences of initiation into drug use and offending by young people in Britain. London, England: Home Office Research, Development, and Statistics Directorate, December 2002. |
21. Opioid Substitution Treatment in the UK "Opioid substitution therapy (OST) is an evidence-based treatment for opioid dependency, with treatment engagement shown to be protective against drug related deaths (Santo et al., 2021). In England, the primary OST medications prescribed are methadone and buprenorphine, with provision ranging from daily supervised consumption at pharmacy services to take-home weekly doses. There were an estimated 261,294 people dependent on opioids in the England in 2017 (Hay, Rael de Santos, Reed, & Hope, 2017) with approximately 140,599 (or 54%) receiving OST (OHID, 2021). Barriers to ‘treatment engagement’ for the 46% of those who are not receiving OST can include concerns regarding disclosure; experiences or fears of stigmatising treatment; geographical isolation; reluctance or inability to engage with often inflexible treatment requirements; poor treatment access/availability and/or dislike of medication effects (ACMD, 2015; Harris & Rhodes, 2013; Marshall, Maina, & Sherstobitoff, 2021). People who are multiply marginalised, including women who use drugs, those who are unstably housed, living with multiple social problems, and/or cycling through the criminal justice system can face additional barriers to treatment access and be at highest risk of a drug related death (Medina-Perucha et al., 2019; Public Health England, 2018). It is crucial therefore, that treatment systems are more responsive and innovative to engage the most vulnerable, reduce health harms and risk of premature mortality." Poulter, H. L., Walker, T., Ahmed, D., Moore, H. J., Riley, F., Towl, G., & Harris, M. (2023). More than just 'free heroin': Caring whilst navigating constraint in the delivery of diamorphine assisted treatment. The International journal on drug policy, 116, 104025. doi.org/10.1016/j.drugpo.2023.104025 |
22. Heroin Treatment in the UK "Heroin Assisted Treatment (HAT) is an alternate treatment modality for people for whom more traditional forms of OST have been ineffective. HAT is currently delivered in seven countries worldwide (Switzerland, Canada, Germany, Holland, Denmark, Luxembourg and the UK) with the longest standing programme operating in Switzerland. The service usually comprises provision of synthetic medical grade heroin (diacetylmorphine) for supervised self-injection, under medical supervision in a clinical environment. Prior to 2019 in England, clinically supervised HAT had only been provided as part of the Randomised Injecting Opiate Treatment Trial (RIOTT) in 2010 (Strang et al., 2010). Despite a robust international evidence base for the social and health benefits of HAT (Haasen et al., 2007; March, Oviedo-Joekes, Perea-Milla, & Carrasco, 2006; Oviedo-Joekes et al., 2009; Perneger, Giner, del Rio, & Mino, 1998; Strang et al., 2010; van den Brink et al., 2003) and strong results from RIOTT indicating improved outcomes for ‘treatment refractory’ people (i.e. people who have not benefitted from the standard treatment offer), RIOTT did not continue beyond a trial basis. In considering possible reasons for RIOTT discontinuation, Strang et al (2015) drew on concerns about HAT noted in the international literature, such as: 1. public safety and security concerns (concentration of crime in the local area, diversion of medicinal heroin); 2. intervention expense (costs of pharmaceutical product, staff and facilities for supervised consumption); 3. diamorphophobia (anxiety around concept of heroin as medicine); and 4. patient safety (i.e. a 1 in 6000 risk of sudden onset respiratory depression) (Strang et al., 2015). "The opening of the first UK HAT service in Middlesbrough in 2019 was therefore remarkable. The service in Middlesbrough was initially implemented as a ‘whole systems approach’ i.e. compromising partners from the health and justice sectors. The development of the Middlesbrough service is a novel example of ‘bottom-up’ policy making (i.e. pushed through by the collaboration of localised systems on limited budgets with little formal intervention from the UK government (Poulter, Moore, Crow, Ahmed, & Walker, 2022). The service closed for operation in November 2022 despite client reported benefits in relation to improved social supports and having access to an innovative treatment supporting a wide range of harm-reduction and recovery-oriented goals (Riley et al., 2023)." Poulter, H. L., Walker, T., Ahmed, D., Moore, H. J., Riley, F., Towl, G., & Harris, M. (2023). More than just 'free heroin': Caring whilst navigating constraint in the delivery of diamorphine assisted treatment. The International journal on drug policy, 116, 104025. doi.org/10.1016/j.drugpo.2023.104025 |
23. Self-Medication with New Psychoactive Substances "The high prevalence of mental health issues among the homeless population has been extensively documented throughout literature, but the consumption of NPS to treat mental health symptoms is of particular concern (Gray et al., 2021; Irving et al., 2015; McLeod et al., 2016; Ralphs et al., 2021). One study demonstrated that the homeless use SCRA to escape from the realities of the streets and provide relief from physical and mental health conditions, similar to the motivations for using cannabis, heroin and crack cocaine within the population (Fountain and Howes 2002; Link, 2014; Peacock et al., 2019)." Coombs, T., Ginige, T., Van Calster, P. et al. New Psychoactive Substances in the Homeless Population: A Cross-Sectional Study in the United Kingdom. Int J Ment Health Addiction (2023). doi.org/10.1007/s11469-022-00988-7 |
24. Prevalence and Geographical Distribution of Use, Northern Ireland " In 2010/11 use of any illegal drug was highest in the BHSCT [Belfast Health and Social Care Trust]. Adults (15-64 yrs) in the BHSCT reported lifetime (41%), recent (11%) and current (6%) use of an illegal drug. National Advisory Committee on Drugs (NACD) & Public Health Information and Research Branch (PHIRB). Drug use in Ireland and Northern Ireland 2010/11 Drug Prevalence Survey: Regional Drug Task Force (Ireland) and Health and Social Care Trust (Northern Ireland) Results. Bulletin 2 (2012). p. 1. |
25. Effect of Inappropriate Use of Vivitrol (Naltrexone) "Naltrexone is a long acting opioid receptor antagonist used in drug rehabilitation programmes to maintain opioid abstinence. However, when consumed in conjunction with an opioid substance, prolonged opioid withdrawal will be precipitated resulting in unpredictable and life threatening medical consequences." Boyce SH, Armstrong PAR, Stevenson J. Effect of innappropriate naltrexone use in a heroin misuser. Emergency Medicine Journal 2003;20:381-382. |
26. Estimated Prevalence of Crack Use in England "Among the general population, use of powder cocaine is far more common than use of crack cocaine. Although crack cocaine use is relatively rare, it is associated with very problematic use and drug-related crime, predominantly among those also using opioids. Due to the often chaotic nature of users’ lives, it is likely that household surveys underestimate crack use. The last indirect estimate of problematic crack use in England puts the rate at 4.76 per 1000 population aged 15 to 64 years (Hay, Rael dos Santos, & Worsley, 2014). Cocaine (powder) is also the most seized stimulant in the UK, both in terms of number and quantity of seizures (see ST13). Having been 51% in 2003, the purity of domestic resale powder cocaine fell to 20% in 2009. However, it has risen since then and was 36% in 2014." UK Focal Point at Public Health England, United Kingdom Drug Situation: Focal Point Annual Report 2015 (2016), Annual Report to the European Monitoring Centre on Drugs and Drug Addiction, p. 52. |
27. Drug Offenses in the UK by Offense Type and Country, 2004-2005 to 2012-2013 Click here for complete data table. Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, Table 9.1, p. 154. |
28. Drug Offenses in the UK by Offense Type and Country
Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, Table 9.1, p. 154. |
29. Trends in Recorded Drug Crime in the UK "The number of recorded drug crimes in the UK decreased by one per cent in 2011/12 (Table 9.1). There were variations across the UK with increases in Northern Ireland (8%) and Scotland (2%) and a decrease in England and Wales (-2%). In Scotland the increase was for possession offences with a decrease in trafficking offences while in Northern Ireland there were increases for both possession and trafficking offences. In England and Wales the decrease in possession offences was mainly for drugs other than cannabis while in Northern Ireland the increase in possession offences was mainly accounted for by an increase in cannabis offences. In England and Wales the number of possession offences for both cannabis and other drugs peaked in 2008/09. The decrease in recorded drug offences in England and Wales since 2008/09 coincides with the end of the national target regime for police (Chaplin et al. 2011). This demonstrates the impact of police priorities on recorded drug offences." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 150. |
30. Convictions for Drug Offences in the UK "There were 152,451 drug offences where the person was found guilty at court or cautioned in the United Kingdom during 2010 (Table 9.3; ST11). This represents a four per cent increase on the previous year (n=147,013) and resumes the upward trend that was evident between 2005 and 2008. Convictions for almost all drugs apart from cannabis decreased or remained stable with cocaine powder offences decreasing by 11% and ecstasy offences decreasing by 50%. The number of heroin offences remained stable. UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 153. |
31. Trends in Convictions for Cannabis Offenses in England and Wales "While the number of convictions (at court or cautions) for cannabis possession in 2010 (n=59,750) is 26% lower than in 2003 (n=80,656) before the introduction of the formal warning for cannabis271 in England and Wales, the number has increased by 24% since 2007 (n=48,299) (ST11). This suggests that more punitive sanctions are being used to deal with cannabis possession offences. Data from England and Wales show that there was a seven per cent increase in cannabis possession offences dealt with by a caution or in court between 2009 and 2010 with a corresponding seven per cent decrease in the use of non-criminal sanctions such as the formal warning for cannabis and the penalty notice for disorder272 (Figure 9.1). Although the total number of cannabis possession offences dealt with by law enforcement (either through criminal or administrative measures) decreased between 2009 and 2010 (from 154,336 to 150,765), the number remains almost twice as high as before the introduction of the formal warning for cannabis (n=77,500). This is despite a decrease in reported cannabis use over the period (see section 2.2 and Trends Analysis section)." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 153. |
32. Stop and Searches for Drugs in England and Wales "In 2010/11 there were almost 600,000 stop and searches for drugs carried out by the police in England and Wales accounting for almost half of all police stop and searches for any reason (Home Office 2012e). This is a five per cent increase on the previous year and continues a trend of increased use of this power. Almost half of the drug searches recorded were carried out in London. Overall, a stop and search for drugs resulted in an arrest in seven per cent of cases across England and Wales with the British Transport Police, South-East England, London, and East Midlands below the national average. This compares to a 12% arrest rate for searches for non-drug reasons. The number of arrests as a result of drugs stop and search was 41,961." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 152. |
33. Prison Sentences 1994 and 2005 "The use of custodial sentences for drug offenders increased substantially between 1994 and 2005. The annual number of people imprisoned rose by 111% and the average length of their sentences increased by 29%. Taking into account the rise in the average sentence length (37 months for drug dealing in 2004), the courts handed out nearly three times as much prison time in 2004 as they did 10 years earlier." Reuter, Peter and Stevens, Alex, "An Analysis of UK Drug Policy: A Monograph Prepared for the UK Drug Policy Commission," UK Drug Policy Commission (London, United Kingdom: April 2007), p. 10. |
34. Prison Inmates by Offense "On June 30th 2010 there were 85,002 people in prison custody in England and Wales, 73,305 of whom were adults.341 Of those adult prisoners in custody, 15% were on remand and 85% were sentenced. The most common offence was violence against the person (28%) followed by drug offences (16%), sexual offences (14%) and robbery (11%). Of all prisoners in custody, five per cent were female and 14% were foreign nationals (including those held in Immigration Removal Centres). Seven per cent of adult sentenced prisoners were sentenced for six months or less. UK Focal Point on Drugs, "United Kingdom drug situation: annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2011" (Lisbon, Portugal: EMCDDA, Nov. 2012), p. 163. |
35. Drug Seizures, England and Wales " There were 216,296 drug seizures by the police and the UK Border Agency (UKBA) in England and Wales in 2011/12, a two per cent increase on 2010/11. Coleman, Kathryn, "Home Office Statistical Bulletin: Seizures of drugs in England and Wales, 2011/12, Second Edition" (London, England: Home Office Statistics Unit, Government of the UK, Nov. 15, 2012), HOSB 12/12, p. 7. |
36. Commercial Cannabis Cultivation Offenses in the UK, Trends and Demographic Data "The 2010 National Profile reported 6,866 offences of commercial cultivation in 2009/10, increasing by 15 per cent over the following two years.3 Based on those forces that provided three years’ data for this profile, there was a 3.7 per cent reduction between 2011/12 and 2012/13 and a 5.6 per cent reduction between 2012/13 and 2013/14. These figures equate to an annual average of five offences recorded per 100,000 population. National Police Chiefs' Council, "UK National Problem Profile: Commercial Cultivation of Cannabis 2012" (London, England: 2015), p. 6. |
37. Price and Purity of Heroin in the UK, 2011 "Data show that there was a large decrease in the average purity of heroin in 2011 (Table 10.8). This follows reports of a reduction in the availability of heroin from late 2010 both within the international supply chain and within the UK. Indeed, the number of seizures the purity data in Table 10.8 is based on decreased by almost one-third in 2011 and seizures data also show a decrease in the quantity of heroin seized in 2010/11 (see section 10.3.2). Despite reports of a reduction in the supply of heroin and an increase in the wholesale price, the street-level price of heroin, as reported by law enforcement agencies, decreased from £45 per gram to £40 per gram. However, when adjusting for purity, the price of heroin increased significantly from £42.16 to £74.32 (Table 10.9). This suggests that dealers are more likely to adulterate their product in times of shortages than increase the price as indicated in research studies (Matrix Knowledge Group 2007). Street-level heroin is commonly adulterated with both caffeine and paracetamol." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 183. |
38. Price and Purity of Cocaine in the UK, 2011 "The mean purity of cocaine powder increased for the second year in a row after decreasing since 2005 (Table 10.8). The purity remains far below the levels seen in 2005 and almost half the level of 2003. Cocaine powder is commonly adulterated with benzocaine and levamisole. UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 184. |
39. Estimated Number of Problem Drug Users in the UK, 2011 "Latest national and regional estimates for England are for 2009/10 for opiate and/or crack cocaine use, with separate estimates available for opiate use, crack cocaine use, and injecting drug use. In Scotland, the latest national and regional estimates for problematic opiate and/or benzodiazepine use are also for 2009/10 and were published in 2011. Drug injecting estimates for Scotland are available for 2006. In Wales, local and national estimates for 2009/10 for long duration or regular use of heroin, other opioids, crack cocaine and/or cocaine powder were published in 2011. Estimates for Northern Ireland for 2004 were published in 2006 and cover problem opiate and/or problem cocaine powder use. UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 84. |
40. Estimated Number of Problem Drug Users in UK Problem Drug Use and Its Correlates "Combining the 2009/10 estimates for England, Scotland, Wales (Hay et al. 2011; ISD Scotland 2011; Welsh Government 2011a) and the most recent estimate for Northern Ireland for 2004 (Centre for Drug Misuse Research 2006) it is possible to derive an estimate for the United Kingdom of 383,534 problem drug users, a rate of 9.38 per 1,000 population aged 15 to 64 (Table 4.2)." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 85. |
41. Estimated Number of Problem Drug Users (PDUs) in England "The most recent estimates of problem drug use in England were published in 2011 (Hay et al. 2011; see UK Focal Point Report 2011) showing that there were an estimated 306,150118 opiate and/or crack cocaine users in 2009/10. New national and local estimates of the prevalence of opiate and/or crack cocaine use (OCU) are being calculated for 2010/11 with separate estimates for opiate use, crack cocaine use and injecting drug use. It is anticipated that the results will be available in 2013." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 84. |
42. Estimated Number of Problem Drug Users (PDUs) in Wales "National PDU estimates for Wales for the period 2009/10 were published by the Welsh Government in October 2011 (Welsh Government 2011a; see UK Focal Point Report 2011). Regional differences were noted in the report across Health Board areas. The rate (per 1,000 population) ranged from 3.5 (95% CI 2.4 to 9.6) in the rural Powys area to 14.3 (95% CI 11.0 to 19.0) in the Abertawe Bro Morgannwg University (ABMU)123 area." UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 85. |
43. Prevalence of HIV Among People Who Inject Drugs, UK "The overall prevalence of HIV seen amongst people who inject drugs (PWID) in 2011 was similar to that seen in recent years, and remains higher than that found in the late 1990s. The Unlinked Anonymous Monitoring (UAM)163 survey of current and former PWID in England and Wales indicated an overall HIV prevalence of 1.3% in 2011 (ST09). In 2011, the prevalence was 1.4% amongst men and 0.95% amongst women, with prevalence increasing with age from 0.89% amongst those aged under 25 years to 1.4% amongst those aged 35 years and over (ST09) UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 108. |
44. Prevalence of HIV Related To Injection Drug Use in the UK, 2011 "The overall prevalence of HIV seen amongst people who inject drugs (PWID) in 2011 was similar to that seen in recent years, and remains higher than that found in the late 1990s. The Unlinked Anonymous Monitoring (UAM)138 survey of current and former PWID in England and Wales indicated an overall HIV prevalence of 1.3% in 2011 (ST09). In 2011, the prevalence was 1.4% amongst men and 0.95% amongst women, with prevalence increasing with age from 0.89% amongst those aged under 25 years to 1.4% amongst those aged 35 years and over (ST09) UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 95. |
45. Hepatitis C Prevalence and Injection Drug Use "The prevalence of hepatitis C infection amongst PWID remains high overall (HPA et al. 2012). In 2011, 44% of the (current and former) PWID participating in the UAM Survey in England and Wales had antibodies to hepatitis C169, which is similar to the level seen in recent years (ST09). However, this is higher than the level found in 2000 when prevalence was 38% (ST09). The prevalence in 2011 was 46% amongst men and 41% amongst women, and increased with age from 22% amongst those aged under 25 years to 53% amongst those aged 35 years and over (ST09). UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), pp. 109-110. |
46. Drug Misuse Deaths, England and Wales "In 2011 there were 1,605 drug misuse deaths. The number of male deaths decreased by 14 per cent from 1,382 in 2010 to 1,192 in 2011. However over the same period the number of female deaths rose by 3 per cent from 402 to 413 (Table 1). "Statistical Bulletin: Deaths Related to Drug Poisoning in England and Wales, 2011" (London, England: Office for National Statistics, Aug 29, 2012), p. 7. |
47. Drug-Related Mortality, by Gender, England and Wales "The male mortality rate from drug misuse dropped significantly from it’s peak of 55.8 deaths per million population in 2009 to 43.4 deaths per million population in 2011 – the lowest rate since 2003. "Statistical Bulletin: Deaths Related to Drug Poisoning in England and Wales, 2011" (London, England: Office for National Statistics, Aug 29, 2012), p. 7. |
48. Opiate-Related Mortality, England and Wales "Over half (57 per cent) of all deaths related to drug poisoning involved an opiate drug. In 2011, as in previous years, the most commonly mentioned opiates were heroin and/or morphine, which were involved in 596 deaths (see Background note 8). For males, heroin/morphine was involved in more deaths than any other substance. "Statistical Bulletin: Deaths Related to Drug Poisoning in England and Wales, 2011" (London, England: Office for National Statistics, Aug 29, 2012), pp. 16-17. |
49. Limitations of Drug-Related Mortality Data " In around 11 per cent of drug poisoning deaths only a general description is recorded on the coroner’s death certificate (such as drug overdose or multiple drug toxicity). Deaths where the certificate contains only non-specific information cannot contribute to the counts of deaths involving specific substances. "Statistical Bulletin: Deaths Related to Drug Poisoning in England and Wales, 2011" (London, England: Office for National Statistics, Aug 29, 2012), p. 12. |
50. Cannabis Overdose: Toxic Dosage and Mortality Risk "Tetrahydrocannabinol is a very safe drug. Laboratory animals (rats, mice, dogs, monkeys) can tolerate doses of up to 1,000 mg/kg (milligrams per kilogram). This would be equivalent to a 70 kg person swallowing 70 grams of the drug—about 5,000 times more than is required to produce a high. Despite the widespread illicit use of cannabis there are very few if any instances of people dying from an overdose. In Britain, official government statistics listed five deaths from cannabis in the period 1993-1995 but on closer examination these proved to have been deaths due to inhalation of vomit that could not be directly attributed to cannabis (House of Lords Report, 1998). By comparison with other commonly used recreational drugs these statistics are impressive." Iversen, Leslie L., PhD, FRS, "The Science of Marijuana" (London, England: Oxford University Press, 2000), p. 178, citing House of Lords, Select Committee on Science and Technology, "Cannabis — The Scientific and Medical Evidence" (London, England: The Stationery Office, Parliament, 1998). |
51. Heroin-Assisted Treatment "Uniquely in the United Kingdom, methadone ampoules can also be prescribed. Historically, they have at times been a substantial part of opiate substitution treatment in the United Kingdom (e.g. around 30 % in the 1970s and approximately 10 % in the early 1990s), but they now account for approximately 2 % of all methadone prescriptions in England and Wales (Strang et al., 2007). Injectable heroin can also be prescribed in the United Kingdom to heroin addicts as an opiate treatment and has been a treatment option for over 80 years, and this has historically been important. However, over the last 30 years, this practice has become progressively rarer and now comprises less than 1 % of all opiate substitution treatment in the United Kingdom. The established method of heroin prescription in the United Kingdom has been as a ‘take-away’ supply, which is then injected in an unsupervised context. In practice, few doctors have prescribed it and few patients have received it (Metrebian et al., 2002)." European Monitoring Centre for Drugs and Drug Addiction. EMCDDA Insights Series No 11. New heroin-assisted treatment - Recent evidence and current practices of supervised injectable heroin treatment in Europe and beyond. Luxembourg: Publications Office of the European Union, 2012. |
52. Adult Clients in Treatment and Outcomes, England
" Of the 197,110 clients aged 18 and over in treatment contact during 2011-12, 185,428 were in treatment for 12 weeks or more or completed treatment free of dependency before 12 weeks (94%) National Treatment Agency for Substance Misuse, "Statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2011– 31 March 2012, Vol. 1: The Numbers" (Manchester, England: National Drug Evidence Centre, 4th October 2012), p. 2. |
53. Treatment Clients by Primary Substance, England "81% of clients were opiates users, of which two thirds reported adjunctive crack cocaine use. The majority of remaining drug users were in treatment for powder cocaine (5%), cannabis (8%) or crack cocaine (3%) problems (excluding those also citing opiates). Among those aged 18 and over, opiates users in treatment had an average (median) age of 36, while adults in treatment for cocaine had a much lower average (median) age of 29 and those in treatment for cannabis use had an average (median) age of 26. Adults in treatment for benzodiazepines had the same median age as opiates users (36)." National Treatment Agency for Substance Misuse, "Statistics from the National Drug Treatment Monitoring System (NDTMS) 1 April 2011– 31 March 2012, Vol. 1: The Numbers" (Manchester, England: National Drug Evidence Centre, 4th October 2012), p. 8. |
54. Heroin-Assisted Treatment and Retention in Treatment "These pilot study findings showed that opiate-dependent injecting drug users with long injecting careers (most started between 1970 and 1982) and for whom opiate treatment had failed multiple times previously were attracted into and retained by therapy with injectable opiates." Metrebian, Nicky, Shanahan, William, Wells, Brian, and Stimson, Gerry, "Feasibility of prescribing injectable heroin and methadone to opiate-dependent drug users; associated health gains and harm reductions," The Medical Journal of Australia (MJA 1998; 168: 596-600). |
55. Youth Clients in Treatment by Referral Source, England " 20,688 young people accessed specialist substance misuse services in 2011-12. This is a decrease of 1,267 individuals (5.8%) since 2010-11 and a decrease of 2,840 individuals (12.1%) since 2009-10 National Treatment Agency for Substance Misuse, "Statistics from the National Drug Treatment Monitoring System (NDTMS) - Statistics relating to young people - England, 1 April 2011– 31 March 2012" (Manchester, England: National Drug Evidence Centre, 1 November 2012), p. 2. |
56. Characteristics of Youth in Treatment, England " The majority of young people accessing specialist services did so with problems for cannabis (64%) or alcohol (29%) as their primary substance National Treatment Agency for Substance Misuse, "Statistics from the National Drug Treatment Monitoring System (NDTMS) - Statistics relating to young people - England, 1 April 2011– 31 March 2012" (Manchester, England: National Drug Evidence Centre, 1 November 2012), p. 2. |
57. Treatment Availability and Use, Northern Ireland "During 2009/10: Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 4/2010, "Statistics from the Northern Ireland Substitute Prescribing Database: 31 March 2010," September 2010, p. 1. |
58. Treatment Availability and Demand, Northern Ireland "In Northern Ireland on 1st March 2012: Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 2/2012, "Census of Drug and Alcohol Treatment Services in Northern Ireland: 1st March 2012" (June 2012), p. 1. |
59. Profile of Patients in Treatment, by Substance Type, Northern Ireland "Drugs only Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 2/2012, "Census of Drug and Alcohol Treatment Services in Northern Ireland: 1st March 2012" (June 2012), p. 3. |
60. Substitution Treatment, Northern Ireland "On 31 March 2010: Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 4/2010, "Statistics from the Northern Ireland Substitute Prescribing Database: 31 March 2010," September 2010, p. 1. |
61. Treatment Effectiveness
"The overriding finding from this study is that treatment is associated with a reduction in harmful behaviours that are associated with problem drug use. The majority of treatment seekers received care-coordinated treatment, expressed satisfaction with their care, were retained in treatment beyond three months, reported significant and substantial reductions in drug use and offending, and improvements in mental well-being and social functioning." Andrew Jones, et al., "Research Report 24: The Drug Treatment Outcomes Research Study (DTORS): Final Outcomes Report" (London, England: UK Government, Home Office Ministry, Research, Development & Statistics Directorate, December 2009), p. 14. |
62. Treatment Effectiveness at Reducing Levels of Drug Use "During the course of treatment, many treatment seekers stopped using the drugs that they reported using at entry to the study. Lower rates of drug use were recorded at each follow-up. Furthermore, those that continued to use tended to use less. Most of the changes observed occurred by first follow-up. For most forms of drug use, no particular treatment modality was more associated with cessation than any other and the route into treatment (CJS or non-CJS) did not influence drug-use outcomes. "The proportion using each drug reduced significantly between baseline and follow-up (Figure 5). Most of this change occurred by first follow-up; indeed use of some drug types increased marginally, and levels of abstinence from all drugs decreased between first and second follow-up. "The proportion of treatment seekers using heroin, crack, cocaine, amphetamine or benzodiazepines decreased between baseline and follow-up by around 50 per cent; the proportion using non-prescribed methadone or other opiates such as morphine, decreased by considerably more; but the proportion using cannabis or alcohol decreased by considerably less.The proportion who reported each drug to be causing problems fell substantially for all drug types, suggesting that continued use was often, in the client’s view, non-problematic." Andrew Jones, et al., "Research Report 24: The Drug Treatment Outcomes Research Study (DTORS): Final Outcomes Report" (London, England: UK Government, Home Office Ministry, Research, Development & Statistics Directorate, December 2009), p. 10. |
63. Opioid Substitution Treatment and Risk of New HIV Infection Among IDUs "There is evidence from published and unpublished observational studies that opiate substitution treatment is associated with an average 54% reduction in the risk of new HIV infection among people who inject drugs. There is weak evidence to suggest that greater benefit might be associated with longer measured duration of exposure to opiate substitution treatment. All of the eligible studies examined the impact of methadone maintenance treatment, indicating that there are few data regarding the impact of buprenorphine or other forms of non-methadone opiate substitution treatment in relation to HIV transmission. We found no evidence that methadone detoxification is associated with a reduction in the risk of HIV transmission." MacArthur, Georgie J., et al., "Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis," BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj… (Published 4 October 2012). |
64. Treatment Effectiveness at Reducing Levels of Offending "Overall, lower levels of acquisitive offending and high-cost offending were recorded at follow-up. Among those who continued to offend, improvements in offending behaviour at follow-up, in terms of a decrease in its volume and/ or the costs associated with it, were observed. Crack users, injecting users, users with high SDS [Severity of Dependence Scores] scores, and those with previous treatment experience were more likely to offend than others at any point. However, neither referral source nor the type of treatment modalities received, were significantly associated with the level of acquisitive offending at any point (within the adjusted model)." Andrew Jones, et al. Research Report 24: The Drug Treatment Outcomes Research Study (DTORS): Final Outcomes Report. London, England: UK Government, Home Office Ministry, Research, Development & Statistics Directorate, December 2009. |
65. Substance Use Prevention Programs In The UK
"Policies have been embedded in, or complemented by, a much wider framework of social action to create the capacity of both individuals and communities to resist drugs, including policies for children and young people aimed at enabling them to reach their full potential. In England, the Children's Plan aims to facilitate this (DCSF 2007). The devolved administrations take a similar approach, in Wales through Rights of Children and Young Persons (Wales) Measure 2011(Welsh Government 2011a). The GIRFEC (Getting It Right For Every Child) programme48 provides the methodology for delivering the Scottish Government’s three social policy frameworks: the Early Years Framework; Achieving our Potential; and Equally Well (Scottish Government 2008b;c;d), which aim to develop the prevention and early intervention agenda. In Northern Ireland, Our Children and Young People – Our Pledge: A 10 year strategy for children and young people in Northern Ireland, 2006-2016 (OFMDFMNI 2006) sets a framework for addressing the needs of young people. Improved education and early interventions for young people and families (especially those most at risk) and improved public information about drugs are priority areas." Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 52. |
66. Heroin Assisted Treatment Leads to a Reduction in Heroin Use "We have shown that treatment with supervised injectable heroin leads to significantly lower use of street heroin than does supervised injectable methadone or optimised oral methadone. Furthermore, this difference was evident within the first 6 weeks of treatment." Strang, J., Metrebian, N., Lintzeris, N., Potts, L., Carnwath, T., Mayet, S., Williams, H., Zador, D., Evers, R., Groshkova, T., Charles, V., Martin, A., & Forzisi, L. (2010). Supervised injectable heroin or injectable methadone versus optimised oral methadone as treatment for chronic heroin addicts in England after persistent failure in orthodox treatment (RIOTT): a randomised trial. Lancet (London, England), 375(9729), 1885–1895. doi.org/10.1016/S0140-6736(10)60349-2 |
67. Syringe/Needle Sharing, UK
"The level of needle and syringe (direct) sharing reported by participants in the UAM Survey in England, Wales and Northern Ireland has declined from 33% in 2001 to 17% in 2011 (HPA 2012a; HPA 2012b). Direct sharing was reported by 17% of the participants in England (regional range: 11% to 23%), 11% of those in Wales, and 29% of those in Northern Ireland in 2010 (HPA 2012a; HPA 2012b). Throughout the period 2001 to 2011, direct sharing levels were consistently higher amongst those aged under 25 years than amongst older participants; in 2011, 24% of those aged under 25 years reported direct sharing compared with 17% of those aged 25 to 34 years and 16% of those aged 35 years and over (HPA 2012a; HPA 2012b). UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), p. 114. |
68. Northern Ireland Needle and Syringe Exchange Scheme Activity "In Northern Ireland during 2009/10: Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 2/2010: Statistics from the Northern Ireland Needle and Syringe Exchange Scheme, 2009/10 (June 2010), p. 1. |
69. Average Potency of Seized Cannabis in the UK, 2008 " Twenty-three Police Forces in England and Wales participated in the study. Forces were requested to submit samples confiscated from street-level users. In early 2008, they submitted 2,921 samples for analysis to either the Forensic Science Service Ltd (FSS) or LGC Forensics at Culham (LGC F). Hardwick, Sheila; King, Leslie, "Home Office Cannabis Potency Study 2008," Home Office Scientific Development Branch (Sandridge, St Albans, UK: May 2008), p. 1. |
70. Estimated Annual Public Expenditure on Drugs in the UK
"Labelled public expenditure on drugs is estimated at around £1.1 billion per annum. Data on labelled public expenditure on drugs have been provided to the UK Focal Point annually from government departments and the devolved administrations but changes to drug funding in England makes the identification of drug-specific expenditure increasingly difficult. A recent estimate of the economic and social costs of drug supply in the UK for 2010/11 put the cost at around £10.7 billion (Mills et al. 2013). Using a similar methodology to a social and economic costs study in England and Wales for 2003/04 (Gordon et al. 2006), it was estimated that the economic and social costs of illicit drug use in Scotland were £3.5 billion in 2006 (Casey et al. 2009)." Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 24. |
71. Estimated Drug Control Spending in England, 2013-2014 "On 1st April 2013, local authorities became responsible for public health in England supported by a ring-fenced public health grant of £2.66 billion in 2013/14 and £2.79 billion in 2014/15. Historically, 34% of national spend on public health has been on substance misuse. Activity and performance on drug treatment influenced how much money local areas received in 2013-14 and will continue to be recognised in the target formula for the public health grants. This funding is no longer ring-fenced for the provision of drug treatment services (see section 5.2.2). In addition, there is no longer central funding for the routing of offenders into treatment, historically called the Drug Interventions Programme (DIP), which provided funding of £32 million for England and £5.1 million for Wales in 2012/13.24 Alongside other crime, community and drugs grants, funding ended in March 2013. The Community Safety Fund is providing £90 million to Police and Crime Commissioners in 2013/14 for them to decide what to fund at a local level. Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 34. |
72. Estimated Drug Control Spending in Wales "From April 2013, the allocation of both the revenue and capital elements of the Substance Misuse Action Fund (SMAF) was made at a regional rather than local level with Area Planning Boards receiving the funding instead of Community Safety Partnerships. Substance misuse funding in Wales is shown in Table 1.1. It shows an increase in overall funding since 2006/07, with a doubling of funding for the Substance Misuse Action Fund over this period. Reductions since 2010/11 are principally due to funding decreases for the Drug Interventions Programme (DIP)." Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 34. |
73. Substance Misuse Funding In Wales, 2006-07 - 2013-14 Click here for complete datatable of Substance Misuse Funding In Wales, 2006-07 - 2013-14 Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, Table 1.1, p. 35. |
74. Estimated Drug Control Budget in Northern Ireland, 2012-2013/2013-2014 "The majority of the funding for the New Strategic Direction for Alcohol and Drugs was devolved to the Public Health Agency (PHA) in 2009. Given that the Strategy is combined, it is difficult to provide data for ‘drugs only’ expenditure. In 2012/13, the PHA allocated just under £7 million to alcohol and drug-related services. In addition, almost £8 million is allocated to the provision of alcohol and drug treatment services within the Health and Social Care Trust. The Department retains a small amount of funding (£518,000 in 2012/13) for the provision of regional functions such as research and evaluation. Total substance misuse funding in 2012/13 was therefore in the region of £15,518,000, similar to previous years. Figures for 2013/14 are not available at this stage." Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 35. |
75. Oral Fluid Test Evaluations for DUI Enforcement "It is disturbing that the sensitivities of the cannabis and cocaine tests were all quite low, although further testing of the cocaine tests is desirable due to the low prevalences and the low concentrations encountered in this study. There are several countries in Central and Southern Europe for which these two substance classes are of special interest. On the other hand, it seems the sensitivities of the devices are generally better for amphetamines, a frequently encountered drug class among the DUI drivers in the Nordic countries. The suitability of the device for the intended national DUI population should also be considered, for example, PCP is rarely, if ever, found in Europe, therefore at the current time utilising a PCP test is unnecessary. Since the on-site tests are relatively expensive the suitability of all the individual substance tests incorporated in the device should be considered. Driving under the Influence of Drugs, Alcohol and Medicines (DRUID Project) 6th Framework Programme, "Analytical evaluation of oral fluid screening devices and preceding selection procedures," Deliverable 3.2.2 (Finland: National Institute for Health and Welfare, March 30, 2010), p. 95. |
76. United Kingdom Drug Strategy
"The United Kingdom Government is responsible for setting the overall strategy and for its delivery in the devolved administrations only in matters where it has reserved power (SQ32). A new drug strategy was launched in December 2010 (HM Government 2010) replacing that of the previous Government, which was published in 2008 (HM Government 2008). The 2010 Strategy places a much greater emphasis on supporting those who are drug dependent to achieve recovery – and also widens the focus on dependence to prescription and over-the-counter medicines and tackling emerging new psychoactive substances (NPS). Within the strategy, policies concerning health, education, housing and social care are confined to England; those for policing and the criminal justice system cover England and Wales. Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, pp. 23-24. |
77. Basic UK Drug Laws "The United Kingdom (UK) consists of England, Wales, Scotland and Northern Ireland. England accounts for 84% of the UK population. A number of powers have been devolved from the United Kingdom Parliament to Wales, Scotland, and Northern Ireland, but each has different levels of devolved responsibilities. Reitox Focal Point at Public Health England, United Kingdom Drug Situation 2013 Edition. UK Focal Point on Drugs Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Oct. 31, 2013, p. 23. |
78. National Drug Strategies for Scotland, Wales, and Northern Ireland "The Scottish Government and Welsh Government’s national drug strategies were published in 2008, the latter combining drugs, alcohol and addiction to prescription drugs and over-the-counter medicines. All three strategies aim to make further progress on reducing harm and each focuses on recovery. The Scottish and Welsh strategy documents are also accompanied by an action or implementation plan, providing a detailed set of objectives; actions and responsibilities; expected outcomes; and a corresponding time scale (Scottish Government 2008a; WAG 2008a; WAG 2008b). Each plan reflects the devolution of responsibilities to the national government. UK Focal Point on Drugs, "United Kingdom drug situation: annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2011" (Lisbon, Portugal: EMCDDA, Nov. 2012), p. 26. |
79. Progress Toward Strategy Goals, Wales "The Substance Misuse Annual Report 2010 (WAG 2010a) sets out the progress made in implementing the Welsh Assembly’s 10-year substance misuse strategy. An annex to the report sets out progress against the Key Performance Indicators (KPIs).21 Data show a 12% decrease in reported serious acquisitive crime since the previous year and a 19% decrease since baseline. Other achievements include an increase in the proportion of clients waiting no more than 10 working days between treatment referral and assessment, from 55% at baseline to 65% in 2009/10 and the creation of 1,794 additional treatment places in 2009/10. However, drug-related deaths increased from 96 in 2008 to 132 in 2009 and there has been an increase in the proportion of clients waiting more than 10 working days between assessment and the beginning of treatment." UK Focal Point on Drugs, "United Kingdom drug situation: annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2011" (Lisbon, Portugal: EMCDDA, Nov. 2012), p. 33. |
80. Needle and Syringe Exchange Policy, Northern Ireland "1.2 In 2000 funding was made available to develop a free needle and syringe exchange scheme in community pharmacies in Northern Ireland. With input from community pharmacists and other expert advisors, and taking account of models of best practice developed elsewhere, the Northern Ireland Needle and Syringe Exchange Scheme (NSES) was introduced in April 2001. Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 2/2010: Statistics from the Northern Ireland Needle and Syringe Exchange Scheme, 2009/10 (June 2010), p. 2 |
81. Experiment With Reclassification of Cannabis "The Misuse of Drugs Act 1971 (Modification) (No. 2) Order 20035 reclassified cannabinol and cannabinol derivatives (previously Class A drugs), and cannabis and cannabis resin (previously Class B) as Class C drugs; effective from January 2004. This followed an assessment of their relative harmfulness (ACMD 2002), and should enable a more effective message to be conveyed about the graded scale of danger of different types of drugs, according to their classification. In addition, it reinforces Government’s priority to tackle those drugs that cause the most harm: Class A drugs. UK Focal Point, "United Kingdom Drug Situation. Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2004" (Lisbon, Portugal: EMCDDA, 2005), pp. 16-17. |
82. Development of Substitution Treatment Policy, Northern Ireland "1.3 The Substitute Prescribing Implementation Group was created by the DHSSPS and in February 2004 ‘Northern Ireland Guidelines on Substitution Treatment for Opiate Dependence’ were published. The new guidelines, including the arrangements for the monitoring and evaluation of Substitute Prescribing, were introduced on 1 April 2004. Northern Ireland Statistics & Research Agency, Statistical Bulletin PHIRB 4/2010, "Statistics from the Northern Ireland Substitute Prescribing Database: 31 March 2010," September 2010, p. 2. |
83. Diverting Offenders to Treatment in England "In England the Department of Health, the Ministry of Justice, HM Court Services, the National Offender Management Service and the Home Office are working together to take forward government proposals to invest in liaison and diversion services at police stations and courts to ensure that an individual’s health needs or vulnerabilities are identified and assessed early and that they are linked to appropriate treatment services. Within this wider programme, an 'Alternatives' pilot has been set up to test alternatives to custody at the point of sentencing, i.e. court based activity. The project is restricted to those offenders who have mental health problems, including personality disorder, and/or a substance misuse problem and whose index offence and risk of reoffending is of sufficient seriousness to attract a short prison sentence. UK Focal Point on Drugs, "United Kingdom Drug Situation 2012 Edition: Annual Report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)" (London, England: UK Government, Department of Health, October 31, 2012), pp. 151-152. |
84. Policing of Cannabis in England South Bank University's Criminal Policy Research Unit conducted a detailed study of the policing of cannabis in England. The study found that: "Findings: The Policing of Cannabis as a Class B Drug," (London, England: Joseph Rowntree Foundation, March 2002), p. 1. |
85. Drug Rehabilitation Requirement, England and Wales "The Drug Rehabilitation Requirement (DRR) within a community order or suspended sentence of imprisonment is an intensive vehicle for tackling the drug misuse and offending of many of the most serious and persistent drug misusing offenders in England and Wales (SQ31). DRRs involve treatment, regular testing and court reviews of progress and are subject to rigorous enforcement. UK Focal Point on Drugs, "United Kingdom drug situation: annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2011" (Lisbon, Portugal: EMCDDA, Nov. 2012), Table 9.1, pp. 147-148. |
86. Recommendation of British Advisory Council on Misuse of Drugs "Recommendation 1. Local service planners need to review local needle and syringe services (and be supported in this work) in order to take steps to increase access and availability to sterile injecting equipment and to increase the proportion of injectors who receive 100 per cent coverage of sterile injecting equipment in relation to their injecting frequency." Advisory Council on the Misuse of Drugs. The Primary Prevention of Hepatitis C Among Injecting Drug Users. London, United Kingdom: February 2009. |
87. Scientific Validity of Drug Classification System "Our findings raise questions about the validity of the current Misuse of Drugs Act classification, despite the fact that it is nominally based on an assessment of risk to users and society. The discrepancies between our findings and current classifications are especially striking in relation to psychedelic-type drugs. Our results also emphasise that the exclusion of alcohol and tobacco from the Misuse of Drugs Act is, from a scientific perspective, arbitrary. We saw no clear distinction between socially acceptable and illicit substances. The fact that the two most widely used legal drugs lie in the upper half of the ranking of harm is surely important information that should be taken into account in public debate on illegal drug use. Discussions based on a formal assessment of harm rather than on prejudice and assumptions might help society to engage in a more rational debate about the relative risks and harms of drugs." Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007). Development of a rational scale to assess the harm of drugs of potential misuse. Lancet (London, England), 369(9566), 1047–1053. doi.org/10.1016/S0140-6736(07)60464-4 |
88. Low Priority Cannabis Violations Law enforcement authorities in the UK conducted an experiment in policing in the London borough of Lambeth, wherein cannabis violations were given a low priority. Researchers for PRS Consultancy Group undertook an evaluation of the program at the request of the Borough Police Commander. The researchers found that: PRS Consultancy Group, "Evaluation of Lambeth's pilot of warnings for possession of cannabis - summary of final report," March 2002, p. 1. |
89. Strip Searches of Arrestees, England "One study on the role of closed circuit television in a London police station emphasizes the potential for abuse and discrimination when police officers have discretion to strip search detainees.174 From May 1999 to September 2000, officers in the station processed over 7000 arrests.175 The station’s policy allowed officers of the same sex to conduct strip searches only if they felt it was necessary to remove drugs or a harmful object.176 Ha, Daphne, "Blanket Policies for Strip Searching Pretrial Detainees: An Interdisciplinary Argument for Reasonableness," Fordham Law Review (New York, NY: Fordham University School of Law, May 2011) Vol. 79, No. 6, pp. 2740-2741. |