United-Kingdom Country Drug Report 2017

Drug harms

Drug-related infectious diseases

Data on the prevalence of blood-borne infectious diseases among people who inject drugs (PWID) are available from the Unlinked Anonymous Monitoring (UAM) survey of current and former PWID attending drug services in England, Wales and Northern Ireland. There are also regular sero-behavioural surveys of PWID attending needle and syringe programmes in Scotland. Other sources of information on blood-borne infections are laboratory reports, which are collected separately for England, Wales, Scotland and Northern Ireland.

The latest notification data show that, in 2015, there were 182 new cases of human immunodeficiency virus (HIV) infection thought to be a result of injecting drug use; this is an increase from 146 new cases in 2014.

The overall prevalence of HIV amongst PWID in 2015 was similar to that seen in recent years and remains higher than in the late 1990s.

It is estimated that around 90 % of all cases of hepatitis C virus (HCV) infection in the United Kingdom are a result of injecting drug use. The prevalence of HCV infection among PWID remains relatively high and has changed little in recent years; in 2015, 6 out of 10 PWID were HCV positive. There are marked geographical variations in HCV prevalence across the United Kingdom, and prevalence is lower in Northern Ireland than in the rest of the UK. The prevalence of antibodies to HCV among recent initiates to injecting drug use has also been fairly stable.

The prevalence of hepatitis B virus (HBV) infection among PWID in England, Wales and Northern Ireland has remained relatively stable in recent years and varies by country, but is lower than the level seen 10 years ago.

With regard to other drug-related infectious diseases, sporadic cases of anthrax, tetanus and wound botulism have been reported among PWID. In 2015, there was an outbreak of botulism among PWID in Scotland, which was part of the largest cluster of botulism seen among PWID in Europe.

Drug-related emergencies

Data on drug-related emergencies in the UK are available from hospital inpatient data.

In 2013/14, hospital inpatient data showed that 41 628 inpatient discharges recorded poisoning by drugs in the UK, which was an increase from 2012/13.The majority were due to ‘other opioids including morphine and codeine’, and this number has increased every year since 2008.

Emergency rooms from two hospitals in London and one in York participate in the European Drug Emergencies Network (Euro-DEN) project, which was established in 2013 to monitor acute drug toxicity in sentinel centres across Europe.

Newly diagnosed HIV cases attributed to injecting drug use

NBNB: Year of data 2015, or latest available year.
Source: ECDC.

Prevalence of HIV and HCV antibodies among people who inject drugs in the United Kingdom

NBYear of data 2015.
HIV range is 0.0 (Wales) to 1.9 (Scotland). Range 0.65 to 1.00 is for NI and EW. HCV range is 22.3 (Wales) to 57.5 (Scotland). Range 27.5 (NI) and 51.8 (EW).

 

Characteristics of and trends in drug-induced deaths in the United Kingdom

NBYear of data 2014.

Drug-induced deaths and mortality

Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).

Drug-induced death is the fifth most common cause of preventable death among 15- to 49-year-olds in the United Kingdom. In 2014, the United Kingdom reported a record number of drug-induced deaths. Because of delays in the registration of deaths, the number of deaths in 2015 is not yet known, but statistics published so far on the number of deaths registered in 2015 suggest that a further increase is likely. Heroin is involved in the majority of deaths, and other drugs commonly associated with deaths from illicit substance use include benzodiazepines, cocaine and amphetamines. The number of deaths linked to NPS use is relatively low, but has increased greatly since 2010. In England, there were 107 NPS-related deaths in 2015, compared with 82 in 2014. In 2014, almost three quarters of victims were male and the mean age at time of death was 41.6 years

The drug-induced mortality rate among adults in the United Kingdom (aged 15-64 years) was 60.3 deaths per million in 2014, almost three times the most recent European average of 20.3 deaths per million.

Drug-induced mortality rates among adults (15-64 years)

NBYear of data 2015, or latest available year.


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