The UK Focal Point on Drugs (the national focal point) is based in Public Health England. It works closely with the Home Office, other government departments and the devolved administrations (Northern Ireland, Scotland and Wales) in providing information to the EMCDDA.
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Last updated: Thursday, May 26, 2016
The primary sources of information about the prevalence of illicit drugs among the adult population in the United Kingdom are representative household surveys such as the Crime Survey for England and Wales (CSEW; previously the British Crime Survey), which has run since 2001/02. Equivalent information for Scotland comes from the Scottish Crime and Justice Survey (SCJS), which last reported results for 2012/13. The Northern Ireland Drug Prevalence Survey (NIDPS), based on European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) methodology, was first conducted in 2002/03, with further surveys in 2006/07 and 2010/11.
The above surveys all indicate that cannabis is the most commonly used illicit drug in the United Kingdom, and has been in each year that relevant surveys have been conducted. Cocaine is the next most commonly used drug, followed by ecstasy (MDMA). Overall, drug use in the United Kingdom has declined over the last ten years; however, due to its relatively high prevalence, cannabis is a substantial driver of overall drug trends. Cocaine prevalence reported through surveys reached a peak in 2007/08, and although it has since declined an increase has been noted in the most recent surveys.
In England and Wales the 2014/15 CSEW, conducted among people aged 16–59, showed that 34.7 % of respondents had tried any illicit drug at least once in their lives. Prevalence of last year use of any illicit drug had remained stable at around 12 % between 1998 and 2003/04, and subsequently decreased steadily to 8.5 % in 2009/10. Since then it has fluctuated between 8 % and 9 %. In 2012/13 drug use prevalence was at its lowest level since the survey started (8.1 %), but rose to 8.8 % in 2013/14 and 8.6 % in 2014/15. In 2014/15 last year prevalence of cannabis use was 6.7 %, indicating a stabilisation in cannabis use in the most recent years. Prevalence was higher among younger respondents, and the long-term downward trend is also more apparent among this group, with last year prevalence for 16- to 24-year-olds decreasing from a high of 28.2 % in 1998 to 16.3 % in 2014/15. However, the declining trend appears to have levelled out since 2009/10. Current cannabis use was reported by 3.7 % of 16- to 59-year-olds in 2014/15, but was higher in younger age groups, with 8.4 % of those aged 16–24 reporting use of cannabis in the last month. Cannabis use among males is significantly higher than among females, and the gender difference is sustained across all ages.
Data from the CSEW for 2014/15 show that use of powder cocaine was reported by 2.4 % of 16- to 59-year-olds, and 4.8 % of 16- to 24-year-olds. Ecstasy is the third most frequently used substance, and, while these surveys indicate a gradual decline in its use among the general population, in 2014/15 there was an insignificant increase in reported last year ecstasy use. This increase is explained by a sharp, significant rise in reported ecstasy use among 16- to 24-year-old males, among whom ecstasy use has risen from 3.7 % in 2012/13 to 7.8 % in 2014/15. Last year ecstasy use also increased among 16- to 24-year-old females over the past two years, from 2.0 % to 3.0 %, while use among 25- to 59-year-olds has remained stable. There has been a decrease in last year amphetamine use since 1996, falling from 3.2 % to 0.6 % of 16- to 59-year-olds in 2014/15. A total of 0.5 % of respondents reported last year use of mephedrone in 2014/15, similar to the level reported in 2012/13 (0.5 %) and a decrease from 1.0 % in 2011/12 and 1.3 % in 2010/11.
In 2012/13 the SCJS shows that 28.4 % of people aged 16–64 in Scotland had tried any illicit drug at least once in their lives, and 7.8 % had used any illicit substance within the last year. Lifetime, recent and current drug use has fallen continuously since 2008/09. Of the individual drugs, lifetime prevalence of cannabis use was highest at 26.0 %, followed by amphetamines and ecstasy, both at 9.8 %, and cocaine at 9.1 %. Statistically significant reductions in last year use of cocaine, cannabis and ecstasy were reported between 2008/09 and 2012/13. Among 16- to 24-year-olds, for whom recent and current use of illicit drugs is more common, 13.8 % had tried cannabis in the last 12 months and 6.4 % in the last month
According to the NIDPS, the prevalence of any illicit drug use in Northern Ireland in 2010/11 was 27.3 % among 15- to 64-year-olds, with cannabis reported as the most commonly ever used drug at 24 %. Among those aged 15–24 some 26.8 % had ever used cannabis, 10.8 % had used it in the last 12 months, and 5.2 % in the last month.
The Smoking, Drinking and Drug Use Amongst Young People in England Survey (SDD), looking at students aged 11–15, has been undertaken annually in England since 1998. The latest available data is from 2014. In Scotland the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) among students aged 13 and 15 was last reported for 2013. Both studies showed that cannabis continues to be the most prevalent drug among school-age respondents, with 18.7 % of SDD 2014 respondents (15 years old) and 16.6 % of SALSUS 2013 respondents (15 years old) reporting ever having used cannabis. Both surveys also indicate a long-term decline in cannabis use among schoolchildren since 2004.
In Northern Ireland the Young Person’s Behaviour and Attitude Survey among students aged 11–16 was first undertaken in 2000, and the latest available data is from 2013. For Wales, the Health Behaviour in School-aged Children (HBSC) survey was last conducted in 2013/14. As seen in the SDD and SALSUS, cannabis was the most prevalent drug reported in these surveys.
Establishing a whole-life approach to drug prevention covering early years, family support, drug education and targeted specialist support is one of the main aims of the United Kingdom drug strategy. The focus of prevention activities has shifted in recent years from programmes focusing specifically on drug use towards strengthening resilience factors associated with reducing the desire to explore risky behaviours, including drug use.
Universal drug prevention initiatives are an important policy area in the field of prevention. Drug prevention is part of the national curriculum throughout most of the United Kingdom, focused on building resilience in young people, and most schools have a drug education policy and guidelines on dealing with drug incidents.
In England, universal drug prevention is a statutory part of the science curriculum for schools and can be expanded through the non-statutory personal, social and health education (PSHE) programme. In 2013 an evaluation by Ofsted (responsible for inspecting and regulating services for children and young people) found that the PHSE curriculum required improvement in 40 % of schools. Following this evaluation, the newly launched Alcohol and Drug Education and Prevention Information Service (ADEPIS) introduced quality standards for schools covering the delivery of effective alcohol and drug education within the classroom.
In Scotland, prevention is part of broader life learning for children and young people through the Curriculum of Excellence, which is integrated with traditional education for 3- to 18-year-olds. A diversionary and educational initiative delivered by Police Scotland, Choices for Life, aims to give young people credible information on drugs and also allows teachers and other educators to exchange prevention practices. For example, specific activities addressing new psychoactive substances were introduced in 2014. In Wales, drug prevention initiatives are included as part of the All Wales School Liaison Core Programme, which targets pupils aged 5–16, and in Northern Ireland the school curriculum puts a specific focus on the development of relevant ‘life skills’ for keeping children safe and healthy.
The United Kingdom Government has prioritised the early identification of at-risk children and families and the provision of suitable interventions through the Troubled Families programme, which aims to provide a focused approach to the needs of the family as a whole and a tailored support service. Interventions within the programme include: parenting skills; drugs education for children; family support to help them stay together; addressing other problems; support for kinship carers; and in some cases intensive interventions. The programme was expanded in 2015 to include more families by broadening its eligibility criteria and has an increased focus on health. Another important element of selective prevention is the focus on vulnerable young people, such as young offenders, looked-after children, young homeless people, ethnic and sexual minorities, youths in deprived neighbourhoods, and youths from families with parents having substance use problems, through special programmes at the community level. Integrated Family Support Services, available across the majority of Wales, provide support for families with parental substance misuse issues.
Rise Above, an online resource and social movement for young people, was launched in November 2014 by Public Health England (PHE) with the aim of building young people’s resilience and empowering them to make positive choices for their health (including with regard to drugs, alcohol, smoking, body confidence, relationships and exam stress). Targeted at 11- to 16-year-olds, Rise Above aims to build young people’s skills by encouraging them to engage with a range of situational resources rather than simply providing them with information. This approach is in line with the evidence base, and PHE is working with key academics to assess the effectiveness of the programme and to ensure it has maximum impact.
The Manchester Warehouse Project in collaboration with Durham University has introduced a monthly drug testing pilot scheme that involves testing drugs posted in the amnesty box or confiscated by security in and around the venue. Communication programmes such as Talk to FRANK in England, Know the Score in Scotland and DAN 24/7 in Wales provide information and advice to young people and their families.
Up to 2012 the EMCDDA defined problem drug use as injecting drug use or long duration/regular use of opiates, cocaine and/or amphetamines. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
In England, estimates are available of the number of opioid and/or crack cocaine users and injecting drug users. For Scotland, estimates are available of the number of problematic opioid use and/or illicit use of benzodiazepines and drug injecting. In Wales, the most recent estimates refer to users of ‘opioids only’, ‘stimulants only’ and ‘both’. Stimulants include cocaine/crack and amphetamine-type substances. In Northern Ireland the last available estimates (for 2004) refer to high-risk opioid and/or high-risk cocaine powder users. Estimates are mostly obtained through capture–recapture and/or multiple indicator methods, as is appropriate for the data concerned. In 2014 the United Kingdom reviewed its approach to combining high-risk drug use estimates excluding Northern Ireland.
Latest estimates for the United Kingdom (2004–11) (1) suggest that there were 330 455 high-risk opioid users (95 % confidence interval (CI): 324 048–342 569), which corresponds to a rate of 8.06 (95 % CI: 7.91–8.36) per 1 000 inhabitants aged 15–64. There were an estimated 122 894 injecting drugs users (95 % CI: 117 370–131 869), or 3.0 per 1 000 inhabitants aged 15–64 (95 % CI: 2.87–3.22). According to a new approach for a combined high-risk drug use estimate, there were an estimated 371 279 (2) high-risk drug users in the United Kingdom (95 % CI: 364 418–388 306), or 9.16 per 1 000 inhabitants aged 15–64 (95 % CI: 8.99–9.58).
About 0.6 % of the United Kingdom’s population aged 15–64 use cannabis daily or almost daily, based on the estimate derived from the most recent studies on drug use among the general population.
(1) The figure refers to an annual estimate. It is based on the 2010/11 English estimate, the 2009/10 Scottish and Welsh estimates and the 2004 Northern Irish estimate.
(2) Based on the 2011/12 English estimate and the 2009/10 Scottish and Welsh estimates.
In the United Kingdom, treatment demand data are reported in aggregated form at the national level from four systems: the National Drug Treatment Monitoring System in England (NDTMS); the Scottish Drug Misuse Database; the Welsh National Database for Substance Misuse; and the Northern Ireland Drug Misuse Database. Data from the four systems are combined into United Kingdom totals for reporting to the EMCDDA. The national focal point, the UK Focal Point on Drugs, is located within Public Health England, which also houses the NDTMS. It receives aggregated data from the four systems from the National Drug Evidence Centre at the University of Manchester. The treatment demand indicator (TDI) protocol version 3.0 was implemented in England and Wales in 2013. In 2014 treatment demand data for the United Kingdom were collected from 894 outpatient and 116 inpatient treatment units, 20 low-threshold agencies, four treatment units in prisons (just Northern Ireland) and 70 general practitioners. In 2014 a total of 100 456 clients entered treatment, of which 35 007 were new clients entering treatment for the first time.
As in previous years, opioids were the most reported primary drug among all treatment clients at 52.1 % in 2014, followed by cannabis at 26.0 % and cocaine at 12.6 %. Among clients who had never been previously treated, the primary substance of use was cannabis at 46.6 %, followed by opioids at 23.2 % and cocaine at 16.9 % (1). About 33 % of all and 21 % of new treatment clients who reported use of opioids injected the drug.
In 2014 the mean age of all treatment clients was 32, while new treatment clients tend to be younger with an average age of 28. With regard to gender distribution, 75 % of all and 72 % of new treatment clients were male.
(1) Cocaine data refers to both cocaine powder and crack cocaine users. In 2014 some 8.9 % of all and 13.7 % of new treatment clients indicated their primary substance of use was cocaine powder, while 3.2 % of all and 2.1 % of new treatment clients indicated crack cocaine as their primary substance.
Data on the prevalence of blood-borne infectious diseases among people who inject drugs (PWID) are available from a number of sources in the United Kingdom. The Unlinked Anonymous Monitoring (UAM) survey of people who inject drugs monitors blood-borne virus prevalence among current and former PWID attending drug services in England, Wales and Northern Ireland. There are also regular sero-behavioural surveys of people who inject drugs attending needle and syringe programmes in Scotland. Another source of information on blood-borne infections is laboratory reports, which are collected separately for England, Wales, Scotland and Northern Ireland.
The latest data show that in 2014 there were 131 human immunodeficiency virus (HIV) diagnoses where infection was thought to have been acquired through injecting drug use. The overall prevalence of HIV amongst PWID in 2014 was similar to that seen in recent years, and remains higher than that found in the late 1990s. The prevalence of HIV amongst the current and former PWID taking part in the UAM survey across England, Wales and Northern Ireland in 2014 was 1.0 % (1.0 % England, 1.1 % in Wales and 0.65 % in Northern Ireland). In the same survey, HIV prevalence among those who had injected drugs for fewer than three years was 0.41%, which indicates that the virus is continuing to be transmitted in the community, albeit at a low level. In Scotland only 0.8 % of those attending needle and syringe programmes during 2013/14 were found to be HIV antibody positive.
In 2014 some 1 654 HIV-infected PWID were seen for HIV-related treatment or care in the United Kingdom. In the same year, some 87 % of the people with HIV acquired through injecting drug use who had been recommended to start antiretroviral treatment received it.
It is estimated that around 90 % of all hepatitis C virus (HCV) infections in the United Kingdom have been acquired through injecting drug use, and the prevalence of HCV infection amongst PWID remains relatively high. In 2014, the prevalence of antibodies to HCV among PWID participating in the UAM survey in England and Wales was 50 %; this proportion has remained relatively stable over the last decade. In Northern Ireland prevalence was lower, at 32 %. While in Northern Ireland and England the prevalence has been relatively stable, in Wales there has been an increase in HCV prevalence in recent years. HCV prevalence also varies markedly among the regions of England. In Scotland, the estimated prevalence among clients of the Scottish Needle Exchange Surveillance Initiative (NESI) in 2013/14 was 57 %. The prevalence varies according not only to region, but also to other risk factors such as age and duration of injecting. However, the overall level of HCV transmission amongst PWID in the United Kingdom appears to have changed little in recent years. The prevalence of antibodies to HCV amongst recent initiates has also been fairly stable, and incidence is currently estimated to be 5–16 infections per 100 person years of exposure in England, Wales and Northern Ireland, and around 10 infections per 100 person years of exposure in Scotland.
The prevalence of hepatitis B virus (HBV) antibodies among PWID who took part in the UAM Survey in England, Wales and Northern Ireland has remained relatively stable in recent years. In the latest survey in 2014 the prevalence rate varied by country, with rates between 7.1 % (Northern Ireland) and 14.8 % (England and Wales). The decline is partly attributed to the increased uptake of the HBV vaccine among injecting drug users in England, Wales and Northern Ireland from 50 % in 2003 to 72 % in 2014.
The level of direct needle/syringe sharing reported by PWID in the UAM survey in England, Wales and Northern Ireland decreased from 34 % in 2002 to 17 % in 2014. This decline has occurred during a period when needle and syringe provision in the United Kingdom has been expanding. However, there are regional and also gender variations in needle/syringe sharing behaviour, thus in 2014 around 22 % of PWID in Wales reported sharing needles or syringes in the past year, and 21 % of females reported direct needle or syringe sharing, compared to 15 % of males.
With regard to other drug-related infectious disease, sporadic cases of anthrax, tetanus and wound botulism were reported in 2013–15 among people who inject drugs, as well as one large outbreak of botulism among this group in Scotland. The epidemiological analysis indicates that environmental contamination of heroin was the likely cause of these infections. An outbreak of soft tissue infections was also reported in Scotland in 2015.
Information on acute deaths in the United Kingdom is provided by three General Mortality Registers (England/Wales, Scotland and Northern Ireland) and one Special Mortality Register. The data are reported based on three different definitions. The EMCDDA definition refers to death caused directly by the consumption of at least one illicit drug, while the Drug Misuse Definition, developed for the United Kingdom’s former Drug Strategy, measures cases of death where the underlying cause is drug abuse, drug dependence or poisoning where any substances scheduled under the Misuse of Drugs Act 1971 are involved. The third definition, used by the Office for National Statistics, is much wider than other definitions and also includes death as a result of legal prescription and over-the-counter drugs.
Based on the EMCDDA definition, the number of drug-induced deaths in the United Kingdom rose steadily from 1996 to 2001, fell from 2001 to 2003, but then increased to a peak of 2 432 in 2009. Deaths recorded in each of the three years following this peak were notably lower (averaging 2 144 per year). However, in 2013 a total of 2 449 drug-induced deaths were reported, a steep increase from 2012 and slightly above the peak reported in 2009, making it the highest number reported to date. Due to delays in the registration of deaths, the number of deaths occurring in 2014 is not yet known but statistics published on the number of deaths registered in 2014 according to the Drug Misuse Definition suggest a further increase is likely. In 2013 three-quarters of victims were male, with a mean age of 41.6 at the time of death. The presence of opioids was toxicologically confirmed in 2 160 cases.
Based on the Drug Misuse Definition, the number of drug-induced deaths registered in the United Kingdom has followed a similar pattern, but the total number of cases was higher. In 2014 a total of 2 936 Drug Misuse Definition cases were recorded (with 2 551 recorded in 2013). Opioids (chiefly heroin/morphine and methadone) were mentioned on the death certificate in most (2 400) of these cases. There was a drop in heroin-related deaths in 2011, and the level remained stable in 2012 but increased in 2013. After an increase in the number of deaths mentioning methadone in 2011, the following years indicated a drop in the absolute number.
The drug-induced mortality rate among adults in the United Kingdom (aged 15–64) was 55.9 deaths per million in 2013, almost three time more than the most recent European average of 19.2 deaths per million.
All United Kingdom drug strategies give priority to the provision of better access to effective and comprehensive treatment, particularly for vulnerable or excluded groups, and to encouraging client retention, recovery and reintegration. Local authorities are responsible for the delivery of drug treatment through multi-agency partnerships representing health, criminal justice agencies and social care services. Increased attention has been given in recent years to measuring the health and social outcomes associated with treatment. In England, for example, the Government’s main indicator for measuring the treatment systems’ performance is the treatment outcome measure — the number leaving treatment free from their drug(s) of dependency and not re-presenting to treatment for six months.
Drug treatment in the United Kingdom encompasses a range of available treatments and services including community- and primary care-based prescribing, community one-to-one and group-based psychosocial interventions to support recovery, inpatient treatment, day programmes, and quasi- and full residential drug treatment and rehabilitation supports. Prescribing (mainly of methadone) is provided for stabilisation, detoxification, maintenance and relapse prevention. Local areas across the United Kingdom are expected to provide a wide range of services, including information and advice, screening, care planning, psychosocial interventions, community prescribing, inpatient drug treatment and residential rehabilitation. In addition, drug misusers should be offered aftercare and relapse-prevention programmes, HBV vaccinations, testing for HBV, HCV and HIV, and access to hepatitis and HIV treatment. In England, guidance by an expert group on recovery-orientated treatment was published in 2012. Alongside the development of a suite of recovery resources, this provided a new national framework for best practice for practitioners and effectively updated and replaced the Models of Care document and the previous four-tiered treatment framework in England. In addition, a manual for practitioners and a diagnostic tool for partnerships were published to support effective recovery-focused intervention and to optimise treatment. A guidance document on recovery-oriented integrated systems of care was also published by the Welsh Government in 2013. In 2014 a number of care quality standards were published in Scotland, England and Northern Ireland. The Drug Interventions Programme in England and Wales targeted drug users in the criminal justice system, offering them a range of treatment and social reintegration responses through criminal justice intervention teams based in the community and in the prison system. From April 2013 this programme was no longer centrally funded and local areas must decide which mechanism to use to route offenders into treatment. The Drug Rehabilitation Requirement in England and Wales is a court mandated community sentence with a drug treatment condition attached. In Scotland, Drug Treatment and Testing Orders serve the same purpose.
Opioid substitution treatment (OST) remains the most common treatment in the United Kingdom for opiate users, and is mostly offered through specialist outpatient drug services, commonly in shared care arrangements with general practitioners. Oral methadone is the most commonly prescribed drug for substitution treatment but buprenorphine has also been available since 1999. Furthermore, prescribed injectable methadone and diamorphine are also available in England, although this is rare.
Section 7.3(a) of the Misuse of Drugs Act 1971 allows for the prescription and administration of controlled drugs by medical practitioners, and Section 10.2(g)–(i) allows for the development of regulations on the control and monitoring of prescriptions of controlled drugs. The enabling legislation for substitution treatment is the Misuse of Drugs Regulations 2001, and treatment can be initiated and provided by general practitioners, specialised medical doctors and treatment centres. The latest available estimates on the total number of clients in OST are: 607 in Northern Ireland in 2010/11; 22 224 received methadone treatment in Scotland in 2006/07; 146 875 received a prescribed intervention in England in 2014; and 1 993 in Wales in 2014.
The reduction of drug-induced deaths, infectious diseases, co-morbidity and other health consequences are key policy issues within the United Kingdom’s drug strategies. Interventions include information campaigns on the risks associated with drug use, information on safer injecting and safer sex, provision of free needles and syringes, promotion of safe disposal of used equipment, infection counselling, support and testing, vaccinations against HBV, referral to drug treatment, antiretroviral treatment for HIV and HCV, and the provision of take-home naloxone and training of drug users and their family members on its application.
In April 2014 an updated public health guidance on needle and syringe programmes was issued by the National Institute for Health and Care Excellence. Sterile syringes and other injecting equipment are provided by a wide range of facilities, principally pharmacies and specialist treatment agencies, but also through detached street outreach and mobile van units. In Wales, a vending machine is available in a community-based homeless centre. Services are available across all regions of the United Kingdom, but data on syringes distributed in England are not available. Latest available estimates are 3 141 000 for Wales in 2014; 3 816 000 for Scotland in 2014 (only through special outlets); and 242 000 for Northern Ireland in 2013. The vast majority (89 %) of the participants of the UAM survey among people who inject drugs across England, Wales and Northern Ireland indicated that they had used needle and syringe programmes in 2014.
In 2003 the Misuse of Drugs Act 1971 (see section on national drug laws) was amended to allow doctors, pharmacists and drug workers to legally supply swabs, sterile water, certain mixing utensils and citric acid to drug users who obtained controlled drugs without a prescription. There are national naloxone programmes in Scotland, Wales and Northern Ireland allowing the use of naloxone in non-clinical settings such as hostels as well as facilitating the distribution of naloxone kits to those at risk of overdose or to their families and carers. In October 2015 legislative changes came into force to increase the availability of naloxone. These changes make naloxone exempt from prescription-only medicine requirements when it is supplied by a drug service commissioned by a local authority or the National Health Service.
Following a careful review of evidence in 2010, the Advisory Council on the Misuse of Drugs recommended the exemption of foil provision as an offence under the Act in order to allow its distribution as a harm reduction intervention. In July 2013 the government announced its decision to enable the lawful provision of foil in drug services, subject to its provision as part of structured efforts to engage drug users in recovery-oriented treatment, with monitoring arrangements put in place. The required amendment to the Misuse of Drugs Regulation 2001 for the provision of foil came into effect in September 2014.
In response to anthrax outbreaks among heroin users in 2009–12, guidance for professionals (clinicians, drug workers, etc.) and advice for drug users were developed, and are regularly updated. Additionally, following a recent cluster of cases of botulism among PWID in Scotland, a pragmatic risk reduction approach was taken, advising users on how best to reduce their risk of infection.
Most of the identified drug supply chains to the United Kingdom follow well-established trafficking routes. Heroin originates from Afghanistan and is transited through either Pakistan or Iran. Cocaine is produced in Colombia, Peru and Bolivia, with Spain and the Netherlands being the main transit hubs within Europe for cocaine on the way to the United Kingdom. The Netherlands is the most significant source for traditional synthetic drugs such as ecstasy and amphetamine, while China is where most new psychoactive substances (NPS) bought online originate. Domestic production of high-potency cannabis does occur, although most cannabis comes from abroad, with Africa and the Caribbean being the main sources for herbal cannabis, while resin mainly originates from Morocco and Afghanistan. Branded ‘skunk’ is imported from the Netherlands. Within the United Kingdom, supply chains take many forms with varying numbers of transactions between the importer and the user.
Arrests for drug offences, having risen between 2006/07 and 2010/11, have decreased in recent years but remain more numerous than before the increase. In 2014 some 128 260 convictions or cautions for drug offences were reported in England, Wales, Scotland and Northern Ireland. For the offences where a drug was known (England, Wales and Scotland), 50.8 % were cannabis-related, 14.5 % cocaine-related and 8.9 % heroin-related.
Cannabis is the most frequently seized drug in the United Kingdom, followed by cocaine. Apart from herbal cannabis, the number of seizures for cannabis products and the quantity of all seized products has decreased when compared with the preceding year. Seizures reported in 2013 (1) were 1 133.6 kg of cannabis resin, 18 705 kg of herbal cannabis and 484 645 of cannabis plants. In 2013 some 3 561.5 kg of cocaine was seized (1). The number of heroin seizures has been declining in recent years, with the lowest number of heroin seizures reported in 2012 (1). Although the number of seizures slightly increased in 2013/14 (1), the quantity of heroin seized was a record low (784.9 kg).
Following a huge decline in the number of ecstasy-type tablets seized since 2006, from more than 6 million down to 171 000 tablets in 2009, the figure increased to 700 800 in 2011, but reduced again in 2012 and 2013 (1). In recent years there has been a steady increase in the quantity of amphetamine seized, from 983 kg in 2010 to 1 730.1 kg in 2013 (1).
(1) Data for Scotland were available in 2010 for the first time since 2006. Since 2006, seizures data have been published on a financial year basis (data reported as 2006 is for 2006/2007, data reported as 2007 is for 2007/2008, etc.).
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, C) that provide a basis for attributing penalties for offences.
Maximum penalties vary not only according to the class of substance but also 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.
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 six months’ imprisonment or a fine; on indictment, penalties may reach seven years’ imprisonment. Class B drugs such as cannabis and amphetamines attract penalties at magistrate level of up to three months’ imprisonment and/or a fine; on indictment it may be up to five years’ imprisonment and/or an unlimited fine. Possession of most Class C drugs, such as barbiturates, attracts penalties of up to three months’ imprisonment and/or a fine at magistrate level; or up to two 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 considerable powers of discretion. In addition, temporary class drug orders (TCDOs) have been introduced through the Police Reform and Social Responsibility Act 2011 to give a faster legislative response to NPS.
Under the Misuse of Drugs Act 1971 a distinction is made between the possession of controlled drugs and possession with intent to supply to another; this latter is effectively for drug trafficking offences. 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. The penalties applied depend again on the classification of the drug and on the penal procedure (magistrate level or Crown Court level). For trafficking in Class A drugs, the maximum penalty on indictment is life imprisonment, while trafficking of Class B and C drugs can attract a penalty of up to 14 years in prison. Under the Drug Trafficking — Section 110 Power of Criminal Courts (Sentencing) Act 2000 a minimum sentence of seven years was introduced for a third conviction for trafficking in Class A drugs.
From 2016 the Psychoactive Substances Act criminalises production, supply or possession with intent to supply of any psychoactive substance knowing that it is to be used for its psychoactive effects. Simple possession of such substances does not constitute an offence; however, possession within a custodial institution does. Supply offences are aggravated by proximity to school, using a minor as a courier, or being carried out in a custodial institution. Maximum penalties are seven years’ imprisonment on indictment or one year on summary conviction.
Launched in December 2010, the Drug Strategy 2010: Reducing Demand, Restricting Supply, Building Recovery is primarily concerned with illicit drugs, but also includes alcohol use. The strategy has two overarching aims: (i) to reduce illicit and other harmful drug use; and (ii) to increase the numbers recovering from their dependence. This document replaced the 2008 strategy published by the previous government and has a greater emphasis on recovery, with more responsibility placed on individuals to seek help and overcome dependency. Increased weight is given to providing a more holistic approach by addressing other issues in addition to treatment. This is designed to support people who are dependent on drugs or alcohol by addressing issues such as offending, employment and housing. The strategy aims to reduce demand and takes an uncompromising approach to targeting those involved in supplying drugs in the United Kingdom and internationally. In addition, it places more power and accountability in the hands of local communities to tackle drugs and the harms they cause. The strategy’s aims are addressed though three thematic areas: (i) reducing demand; (ii) restricting supply; and (iii) building recovery in communities.
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. Within the strategy, policies concerning health, education, housing and social care are confined to England, while those for policing and the criminal justice system cover both England and Wales.
As part of its annual review of the Drug Strategy, the United Kingdom Government published an Action Plan on New Psychoactive Substances in May 2012. In the area of demand reduction it seeks to highlight the potential risks and harms from these substances, improve the quality of drug education and work with partners to enhance knowledge and evidence on these drugs. Actions in the area of supply reduction include increasing the understanding of the threat posed by these substances, making full use of the legislative framework, strengthening the enforcement response and bolstering the global response.
A number of powers are devolved to Northern Ireland, Scotland and Wales, and each of these countries has its own strategy. 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. The current Northern Irish policy, New Strategic Direction for Alcohol and Drugs Phase 2: 2011–16, was launched in 2011. Strategies in Northern Ireland and Wales address both illicit drugs and alcohol. All of the devolved administrations’ drug strategies are accompanied by action plans and are subject to annual implementation progress reviews.
The United Kingdom Government is responsible for setting the overall strategy and for its delivery in the devolved administrations only in areas where it has reserved power. In the Drug Strategy 2010, policies concerning health, education, housing and social care are confined to England; those for policing and the criminal justice system cover England and Wales. The Drug Strategy 2010 is a cross-government strategy, although secretariat and programme management responsibilities fall to the Home Office. The Drug Strategy has been designed to align policy development and planning across government departments and agencies and to support a cohesive, interrelated approach to delivery at the local level.
The Scottish Government has devolved responsibility for health and education and much of the justice agenda in Scotland. In 2008 it launched its own drug strategy, The Road to Recovery. This strategy focuses on person-centred care, treatment and recovery, prevention, enforcement and children affected by parental drug misuse. Implementation is led locally by 30 Alcohol and Drug Partnerships (ADPs), accountable within local arrangements for community planning. ADPs are responsible for directing the funding allocated to them in alignment with outcome-focused local alcohol and drug strategies, based on an assessment of needs in their area. The Scottish Drug Strategy Delivery Commission, consisting of experts with a wide range of expertise, provides independent expert advice and challenges to Scottish Ministers on the delivery of Scotland’s national drug strategy.
In Wales the National Substance Misuse Strategy Implementation Board oversees the implementation of the 10-year Welsh substance misuse strategy, Working Together to Reduce Harm, and its associated implementation plan. Seven Substance Misuse Area Planning Boards have been established to support the planning, commissioning and performance management of substance misuse services in Wales. These are coterminous with Local Health Boards and bring existing members of Community Safety Partnerships together with probation services, the Drug Interventions Programme, Public Health Wales and the voluntary services.
In Northern Ireland the Drugs and Alcohol Implementation Steering Group coordinates implementation of the Northern Ireland Substance Misuse Strategy at the governmental level. In addition, several working groups have been established to support the development of action in specific areas.
No budgets are allocated under the United Kingdom’s drug strategies. Budget allocations are provided annually to local commissioners responsible for providing relevant services. In 2013 the financing of drug interventions underwent considerable change. For instance, central funding for drug testing on arrest with the aim of referring offenders to treatment services (Drug Interventions Programme) was discontinued in England and Wales. These funds are now subsumed into the Police Main Grant with the decision as to whether to continue such initiatives taken locally. Decentralisation was also implemented with regard to the financing of drug treatment services and other health programmes. Local authorities have become responsible for allocating public health grants in England between services, including drug treatment.
The government commissioned studies on economic and social costs in 2002, 2006 and 2013 (1, 2, 3). Furthermore, between 2005 and 2010 labelled expenditure was estimated every year through administrative records, but unlabelled expenditure was rarely available (4).
In 2010 total drug-related expenditure, including expenditure on some indirect consequences of drug use, represented 0.49 % of gross domestic product (GDP), with 64.9 % financing public order and safety, 22.5 % for social protection and 11.7 % for health (5). This distribution was identical for both the total and the unlabelled expenditures. For labelled expenditure, 64.5 % was allocated to health, 28.4 % to public order and safety, 6.0 % to general public services, 1.0 % to social protection and 0.1 % to education.
Trend analysis shows that between 2005 and 2010 labelled expenditures remained broadly stable in terms of the percentage of GDP (varying between 0.07 % and 0.08 % of GDP). In the years leading up to 2010 some labelled expenditures have declined. Comprehensive estimates of both labelled and unlabelled expenditure were provided for 2005 and 2010 but they are not comparable. They used different methods and estimated different elements of expenditure.
Following the decentralisation of public health spending, implemented in 2013, it is now more difficult to estimate drug-related expenditure in the United Kingdom. Drug treatment budget allocations were consolidated within wider public health grants, over which local areas have greater autonomy to allocate funds according to their assessment of their area’s public health needs.
In England, following public consultation, the Health Premium Incentive Scheme was launched. It offers financial incentives to local authorities when progress is made in improving the health of the local populations and in particular substance misuse. The scheme for 2015/16 is supported by a modest incentive budget of GBP 5m and local authorities will receive a share of this money if they are able to show an improvement of around 2 % in the number of people who recover from drug dependency (measured by an increase in the proportion who successfully complete treatment with no return within six months).
Table 1: Total drug-related public expenditure, 2010
Labelled expenditure (thousand EUR)
% of total
Unlabelled expenditure (thousand EUR)
% of total
Total expenditure(thousand EUR)
% of total
|(a) According to the United Nations Classification of the Functions of Government (COFOG) Eurostat data sources: http://epp.eurostat.ec.europa.eu/ (general) and http://unstats.un.org/unsd/cr/registry/regcst.asp?Cl=4.
(b) Adjusted to 2005/06 prices.
(b) EMCDDA estimations.
Source: National Annual report of the United Kingdom (2013).
|Public order and safety||321 389||28.4||5 157 721||70.6||5 479 110||64.9|
|Social protection||11 657||1.0||1 887 182||25.8||1 898 839||22.5|
|Health||730 206||64.5||258 791||3.5||988 997||11.7|
|Education||1 049||0.1||N/A||0.0||1 049||0.1|
|General public services||68 194||6.0||-||0.0||68 194||0.8|
|Total||1 132 495||7 303 694||8 436 189|
|% of total expenditure||13.4||86.6||100|
|% of GDP||0.49||0.42||0.49|
In the United Kingdom, funding for research comes mainly from governmental sources. The main organisations involved in conducting drug-related research are university departments, although non-governmental and governmental organisations are also relevant partners. Several channels for disseminating drug-related research findings are available, ranging from scientific journals to dedicated websites, reports, guidance and conferences. Recent drug-related studies mentioned in the 2014 United Kingdom National report, include all areas of research, but mainly focus on aspects related to responses to the drug situation, consequences of drug use and drug use prevalence. Research on the mechanisms of drug use and effects, methodological issues and supply and markets is also widely available.
|Problem opioid use (rate/1 000)||2010-11||8.06||0.2||10.7|
|All clients entering treatment (%)||2014||52.1%||4%||90%|
|New clients entering treatment (%)||2014||23.2%||2%||89%|
|Purity — heroin brown (%)||2014||1||36.0%||7%||52%|
|Price per gram — heroin brown (EUR)||2010||EUR 47||EUR 23||EUR 140|
|Prevalence of drug use — schools (%)||2011||5.0%||1%||5%|
|Prevalence of drug use — young adults (%)||2014||4.2%||0%||4%|
|Prevalence of drug use — all adults (%)||2014||2.4%||0%||2%|
|All clients entering treatment (%)||2014||12.6%||0%||38%|
|New clients entering treatment (%)||2014||16.9%||0%||40%|
|Price per gram (EUR)||2010||EUR 47||EUR 47||EUR 107|
|Prevalence of drug use — schools (%)||2011||4.0%||1%||7%|
|Prevalence of drug use — young adults (%)||2014||1.1%||0%||3%|
|Prevalence of drug use — all adults (%)||2014||0.6%||0%||1%|
|All clients entering treatment (%)||2014||2.9%||0%||70%|
|New clients entering treatment (%)||2014||3.7%||0%||75%|
|Price per gram (EUR)||2010||EUR 12||EUR 3||EUR 63|
|Prevalence of drug use — schools (%)||2011||4.0%||1%||4%|
|Prevalence of drug use — young adults (%)||2014||3.5%||0%||6%|
|Prevalence of drug use — all adults (%)||2014||1.7%||0%||2%|
|All clients entering treatment (%)||2014||0.3%||0%||2%|
|New clients entering treatment (%)||2014||0.6%||0%||2%|
|Purity (mg of MDMA base per unit)||2014||90 mg||27 mg||131 mg|
|Price per tablet (EUR)||2010||EUR 4||EUR 4||EUR 16|
|Prevalence of drug use — schools (%)||2011||25.0%||5%||42%|
|Prevalence of drug use — young adults (%)||2014||11.7%||0%||24%|
|Prevalence of drug use — all adults (%)||2014||6.7%||0%||11%|
|All clients entering treatment (%)||2014||26.0%||3%||63%|
|New clients entering treatment (%)||2014||46.6%||7%||77%|
|Potency — herbal (%)||:||:||3%||15%|
|Potency — resin (%)||:||:||3%||29%|
|Price per gram — herbal (EUR)||2010||EUR 3||EUR 3||EUR 23|
|Price per gram — resin (EUR)||2010||EUR 3||EUR 3||EUR 22|
|Prevalence of problem drug use|
|Problem drug use (rate/1 000)||2009-12||9.16||2.7||10.0|
|Injecting drug use (rate/1 000)||2004-11||3.0||0.2||9.2|
|Drug-related infectious diseases/deaths|
|HIV infections newly diagnosed (cases / million)||2014||2.0||0.0||50.9|
|HIV prevalence (%)||:||:||0%||31%|
|HCV prevalence (%)||:||:||15%||84%|
|Drug-related deaths (rate/million)||2014||55.9||2.4||113.2|
|Health and social responses|
|Syringes distributed||2013-14||7 199 660||382||7 199 660|
|Clients in substitution treatment||2014||148 868||178||161 388|
|All clients||2014||100 456||271||100 456|
|New clients||2014||35 007||28||35 007|
|All clients with known primary drug||2014||97 068||271||97 068|
|New clients with known primary drug||2014||34 088||28||34 088|
|Drug law offences|
|Number of reports of offences||2013||138 456||537||282 177|
|Offences for use/possession||2013||89 291||13||398 422|
b Break in series.
p Eurostat provisional value.
: Not available.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2014.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
|Year||EU (28 countries)||Source|
|Population||2014||64 351 155||506 944 075 bep||Eurostat|
|Population by age classes||15–24||2014||12.7 % ep||11.3 % bep||Eurostat|
|25–49||33.9 % ep||34.7 % bep|
|50–64||18.2 % ep||19.9 % bep|
|GDP per capita in PPS (Purchasing Power Standards) 1||2014||109||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2013||28.1 % p||:||Eurostat|
|Unemployment rate 3||2015||5.3 %||9.4 %||Eurostat|
|Unemployment rate of population aged under 25 years||2015||14.6 %||20.2 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2014||
101.3 (Northern Ireland)
149.7 (England and Wales)
|:||Council of Europe, SPACE I-2014.1|
|At risk of poverty rate 5||2014||16.8 %||17.2 %||SILC|
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