Our partner in United Kingdom
UK focal point on drugs, Public Health England
6th Floor, Skipton House
80 London Road
UK - SE1 6LH London
Tel. +44 2079723036
Fax +44 2079724665
Head of focal point: Mr Craig Wright
Health Observatory based at the Centre for Public Health, Liverpool John Moores University. 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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Drug use among the general population and young people
In the United Kingdom the primary sources of information about the prevalence of illicit drugs among the adult population are representative household surveys. In England and Wales, the Crime Survey for England and Wales (CSEW; previously the British Crime Survey) has been a continuous survey since 2001/02. Surveys comparable to the British Crime Survey have been carried out in Scotland (the Scottish Crime and Justice Survey, SCJS), which last reported in 2012/13, and in Northern Ireland (the Northern Ireland Crime Survey), which last reported on drug use in 2010/11 (the drug use module has now been discontinued). In Northern Ireland, a Drug Prevalence Survey (NIDPS), based on the 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.
In England and Wales the 2013/14 CSEW, conducted among people aged 16–59, showed that 35.6 % of respondents had tried any illicit drug at least once in their lives. Prevalence of last year use of any illicit drug had been fairly stable at around 12 % between 1998 and 2003/04, then decreased steadily to 9.4 % in 2007/08 and fell to 8.5 % in 2009/10. Since then it has fluctuated between 8–9 %. 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, with statistically significant increases in the use of several individual substances. It is not clear whether the increase observed in 2013/14 signals a reversal or stabilisation of the long-term downward trend or merely a fluctuation within it. Lifetime prevalence of cannabis use was 29.9 %, amphetamines 11.1 %, cocaine 9.5 % and ecstasy 9.3 %. In 2013/14 last year prevalence of cannabis use was 6.6 %, indicating a stabilisation in cannabis use in the most recent years. The prevalence was higher among 16- to 34-year-olds, of whom 35.2 % reported ever having used cannabis, while 11.2 % had used it in the last 12 months. Current cannabis use was not measured by the study. It is notable that last year drug use amongst males was twice as high as amongst females. From 1996 there was an increase in lifetime prevalence of cocaine use until the 2008/2009 survey, and although it subsequently decreased it is still the second most frequently used drug among 16- to 34-year-olds (at 12.6 %). Recent cocaine use in 16- to 34-year-olds fell slightly in 2012 but in 2013 returned to the value of 4.2 %, as previously seen in 2010 and 2011. A decrease in amphetamine use has been observed since 1996. In the 2013/14 CSEW 0.6 % of respondents reported use of mephedrone in the last 12 months, similar to the level reported in 2012/13 (0.5 %) and a decrease from 1.1 % in 2011/12 and 1.4 % in 2010/11.
In 2012/13, in Scotland, the SCJS shows that 28.4 % of people aged 16–64 had tried any illicit drug at least once in their lives, and about 7.8 % had used any illicit substance within the last year. The most recent survey indicates that lifetime, recent and current drug use has fallen successively in each survey conducted since 2008/09. Lifetime prevalence of cannabis use was 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 are documented between 2008/09 and 2012/13. Among 15- to 24-year-olds, for whom recent and current use of illicit drugs is more common, about 13.8 % had tried cannabis in the last 12 months and 6.4 % in the last month.
In Northern Ireland the prevalence of any illicit drug use was 27.3 %, according to the 2010/11 NIDPS among 15- to 64-year-olds, with cannabis reported as the most commonly ever used drug at 24 %, while among those aged 15–34 some 32.2 % had ever used cannabis, 9.4 % had used it in the last 12 months, and 2.7 % in the last month.
The Smoking, Drinking and Drug Use Amongst Young People in England survey conducted on students aged 11–15 has been undertaken annually in England since 1998. The latest available data is from 2013. In Northern Ireland the Young Person’s Behaviour and Attitude Survey was undertaken in 2000 for the first time among students aged 11–16, and the latest available data is from 2013. In Scotland the Scottish Schools Adolescent Lifestyle and Substance Use Survey (SALSUS) among students aged 13 and 15 was last carried out in 2010. In England, Scotland and Wales, the Health Behaviour in School-aged Children (HBSC) survey was last conducted in 2009/10. In addition, the European School Survey Project on Alcohol and Other Drugs (ESPAD) provides data for students aged 15–16 every four years, and the latest study was completed in 2010/11.
In England, based on the Smoking, Drinking and Drug Use Among Young People in England survey, lifetime prevalence of any drug among students aged 11–15 was 16.1 % in 2013, last year prevalence was 11.3 % and last month prevalence was 6.1 %, with cannabis being the most prevalent illicit substance used.
ESPAD data showed that lifetime prevalence of cannabis use decreased from 41 % in 1995 to 35 % in 1999, increased again to 38 % in 2003 and decreased to 25 % in 2011. Last year prevalence of cannabis use was reported by 21 % of the students in 2011, compared to 31 % in 2003 and 35 % in 1995. Despite a slight increase in the last month prevalence of cannabis use in 2011 (13 %) when compared to 2007 (11 %), the overall trend in last month cannabis use is declining (20 % in 2003; 24 % in 1995).
The School Age Population Study in England confirms a long-term declining trend in lifetime prevalence of cannabis use among 15-year-olds from 37 % in 2003 to 22 % in 2013. This is further validated by data from the HBSC study in 2010, which reported that 22 % of respondents had ever used cannabis. The 2010 HBSC results also indicated a decline in lifetime cannabis prevalence rates among 15-year-olds from 36 % in 1998 to 22 % in 2010 in Wales, and from 37 % in 2002 to 19 % in 2010 in Scotland.
Data from the online Global Drug Survey (2013) provides insight into drug use patterns among clubbers, many of whom use illicit substance. Three-quarters of regular clubbers reported using cannabis in the last year, while ecstasy is the second most common illicit substance of use reported by two-thirds of this population. A number of other studies exploring substance abuse patterns in recreational settings have been implemented to assess the prevalence and role of new psychoactive substances in initiation of drug use, and to test new research methods.
Look for Prevalence of drug use in the 'Statistical bulletin' for more information
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. In the United Kingdom, the focus of prevention activities has shifted from programmes focusing specifically on drugs 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. However, an evaluation by Ofsted in 2013 found that the PHSE curriculum required improvement in 40 % of schools. Following the evaluation by Ofsted, the Alcohol and Drug Education and Prevention Information Service introduced quality standards for school covering the delivery of effective alcohol and drug education within the classroom. The Good Behaviour Game, an evidence-based programme for elementary schoolchildren has been adapted and implemented in England. In 2013 an Alcohol and Drug Education and Prevention Information Service (ADEPIS) was launched to further develop advisory services on best practice and an evaluation database in prevention.
In Scotland prevention is integrated within broader life learning for children and young people through the Curriculum of Excellence, where traditional education is integrated with wider life learning for 3- to 18-year-olds. A diversionary and educational initiative delivered by Police Scotland, Choices for Life, is used 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 Welsh School Liaison Core Programme, which targets pupils aged 5–16.
The government has prioritised the early identification of at-risk children and families and the provision of suitable interventions through their 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 is being expanded further from 2015 to include working with children under the age of 5 and will have an increased health focus. 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, youth in deprived neighbourhoods, and youth 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 [http://riseabove.org.uk/], 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 which 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.
See the Prevention profile for United Kingdom for more information.
High-risk drug use
Up to 2012 the EMCDDA defined problem drug use as injecting drug use (IDU) 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.
For England, estimates of opioid and/or crack cocaine users and injecting drug users are available. For Scotland, estimates of problematic opioid use and/or illicit use of benzodiazepines and drug injecting are available. In Wales, estimates refer to long duration or regular use of opioids, cocaine powder and/or crack cocaine, while in Northern Ireland they refer to regular use of opioids and/or high-risk cocaine powder use. 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 (confidence interval: 324 048–342 569), which corresponds to a rate of 8.06 (confidence interval: 7.91–8.36) per 1 000 inhabitants aged 15–64. There were an estimated 122 894 injecting drugs users (confidence interval: 117 370–131 869), or 3.0 per 1 000 inhabitants aged 15–64 (confidence interval: 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 (confidence interval: 364 418–388 306), or 9.16 per 1 000 inhabitants aged 15–64 (confidence interval: 8.99–9.58).
About 0.5 % 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.
Look for High risk drug-use in the Statistical bulletin for more information.
In the United Kingdom, treatment demand data are reported in aggregated form at national level from four systems: the National Drug Treatment Monitoring System in England; the Scottish Drug Misuse Database; the Welsh National Database for Substance Misuse and the Northern Ireland Drug Misuse Database. Treatment demand data for the United Kingdom are collected from outpatient and inpatient treatment units, low-threshold agencies, treatment units in prisons and general practitioners. In 2013 a total of 101 753 clients entered treatment, of which 35 229 were new clients entering treatment for the first time.
In 2013 opioids were the most reported primary drug among all treatment clients at 50 %, followed by cannabis at 27 % and cocaine at 13 %. Among new treatment clients the primary substance of use was cannabis at 49 %, followed by opioids at 20 % and cocaine at 17 % (1). About 26 % of all and 12 % of new treatment clients who reported use of opioids, cocaine or stimulants injected their primary substance of abuse.
In 2013, the mean age of all treatment clients was 32 years, while new treatment clients tend to be younger, on average 28 years old. With regard to gender distribution, 76 % of all and 73 % of new treatment clients were male.
Look for Treatment demand indicator in the Statistical bulletin for more information.
Drug-related infectious diseases
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 2013 there were 112 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 2013 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 2013 was 1.1 % (1.2 % England, 0.5 % in Wales and 0.6 % in Northern Ireland). In Scotland only 0.3 % of those attending needle and syringe programmes during 2011/12 were found to be HIV antibody positive. In 2013 some 1 829 HIV-infected PWID were seen for HIV-related treatment or care in the United Kingdom. In 2013, some 80 % 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 2013, 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. The prevalence varied markedly among the regions of England, and among PWID in Wales was lower than in many of the English regions. In Northern Ireland prevalence was 31.7 %, while 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 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 6–18 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 in 2013 has remained relatively stable in recent years, but it is lower than the level seen 10 years ago where it was 30 %. The prevalence rate varied by country between 6.8 % and 17.0 %, the lowest being for Northern Ireland and the highest for England. The decline is partly attributed to increased uptake of the HBV vaccine among injecting drug users in England, Wales and Northern Ireland from 50 % in 2003 to 72 % in 2013.
The level of needle/syringe sharing reported by PWID in the UAM survey in England, Wales and Northern Ireland decreased from 34 % in 2002 to 16 % in 2013. These declines have occurred during a period when needle and syringe provision in the United Kingdom has been expanding.
With regard to other drug-related infectious disease, a number of outbreaks and sporadic cases of anthrax, tetanus and wound botulism (in particular in Scotland) were reported in 2013–14. The epidemiological analysis indicates that environmental contamination of heroin was the likely cause of these infections.
Look for Drug-related infectious diseases in the Statistical bulletin for more information.
Drug-induced deaths and mortality among drug users
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 death cases 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 drugs.
Based on the EMCDDA definition, the number of drug-induced deaths in the United Kingdom rose steadily from 1996–2001, fell from 2001–2003, increased to the highest level of 2 231 in 2008, then decreased year by year to 1 666 in 2012. In 2013, a total of 1 946 drug-induced deaths were reported, a steep increase from 2012, mainly accounted for by England and Wales (+27 % compared to 2012). In 2013 three-quarters of victims were males. The mean age of the victims was 41.6 years. Based on the Drug Misuse Definition, the number of drug-induced deaths in the United Kingdom had the same pattern, but the total number of cases was higher. In 2013, in a total of 2 561 Drug Misuse Definition cases were recorded. Opioids (chiefly heroin/morphine and methadone) were mentioned on the death certificate in most of these cases. In absolute numbers there was a drop in heroin-related deaths in 2011, and the level remained stable in 2012 but increased in 2013. With regard to methadone, 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 44.6 deaths per million in 2013, more than twice the European average of 17.2 deaths per million.
Look for Drug-related deaths in the Statistical bulletin for more information.
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. Delivery of drug treatment is through local 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 have been 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, in England, prescribed injectable methadone and diamorphine are also available, although this is rare.
Section 7.3(a) of the Misuse of Drugs Act 1971 allows for prescription and administering 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 opioid substitution treatment are: 607 in Northern Ireland in 2010/11; 22 224 received methadone treatment in Scotland in 2006/07; 147 640 received a prescribed intervention in England in 2012/13; and 2 042 in Wales in 2012/13.
See the Treatment profile for United Kingdom for additional information.
Harm reduction responses
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, referrals 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.
Sterile syringes and other injecting equipment is 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 5 242 000 for Wales in 2013; 3 997 000 for Scotland in 2012/13 (only through special outlets); and 217 750 for Northern Ireland in 2012/13.The vast majority (91 %) of the participants of the Unlinked Anonymous Monitoring (UAM) Survey among people who inject drugs across England, Wales and Northern Ireland indicated that they had used needle and syringe programmes in 2013.
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. United Kingdom administrations have developed national programmes and pilot schemes to support the availability of naloxone for the management of opiate overdoses, including after release from prison.
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 on 5 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.
See the Harm reduction overview for United Kingdom for additional information.
Drug markets and drug-law offences
The overall picture of drugs distribution appears increasingly complex and diverse. Many traffickers import and distribute more than one type of drug. London, Birmingham, Liverpool and Manchester continue to be important centres for drug distribution, but other smaller cities and towns are also involved. The main source of heroin in Scotland is from the north-west of England via the Glasgow area. Organised crime groups in Merseyside have an impact on the supply of drugs into Wales.
Cannabis continues to be imported in large quantities to the United Kingdom from Europe despite increased domestic cannabis cultivation over recent years. Throughout the United Kingdom, large numbers of commercial cannabis cultivation operations have been discovered and there is an increasing recent trend towards smaller operations in multiple locations, in living rooms, smaller houses and flats. Substantial quantities of cannabis resin continue to be imported into the United Kingdom from Afghanistan and Morocco. Herbal cannabis continues to be supplied from South Africa and the Caribbean, while the Netherlands is a source for high-quality ‘branded’ types of plant cannabis (‘skunk’). In 2010/11 a total of 7 660 cannabis farms were discovered in the United Kingdom.
Afghanistan remains the principal source country for heroin supply to the United Kingdom; the drug is sent directly via parcel post, by air courier or air passenger, and in maritime containers. Heroin is also supplied in large quantities to the United Kingdom from Afghanistan through southern Pakistan via Iran, Turkey and then onward through Europe; or by sea to eastern and southern Africa where a proportion moves on to western Europe and the United Kingdom.
Peru, Colombia and Bolivia continue to produce the vast majority of the global supply of cocaine, and they are considered significant contributors to the United Kingdom’s supply. Venezuela and Ecuador remain significant transit countries for cocaine destined for Europe and the United Kingdom. The Netherlands, Belgium and the Iberian Peninsula are key transport hubs and storage bases for cocaine smuggled into the United Kingdom. Amphetamine and ecstasy are the main synthetic drugs trafficked to the United Kingdom, with the Netherlands and Belgium as the countries of origin for the majority of these substances. Methamphetamine continues to have limited direct impact in the United Kingdom — the majority of seizures tend to involve the United Kingdom being a transit point between production (often in western Africa) and end-user markets (usually in the Far East or Australia). New psychoactive substances are mainly acquired in China via Internet orders and imported via parcel post.
In 2013, some 138 456 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), 59.9 % were cannabis-related, 15.3 % cocaine-related and 9.4 % heroin-related. In addition, there were around 79 000 formal warnings for cannabis or penalty notices for disorder issued for cannabis possession in England and Wales.
Cannabis is the most frequently seized drug in the United Kingdom, followed by cocaine. The number of seizures for cannabis products and the quantity of seized products has decreased when compared with the preceding year. In 2012 (1), some 13 432 kg of cannabis resin, 13 243 kg of herbal cannabis and 555 625 of cannabis plants were seized. In 2012, some 3 324 kg of cocaine was seized (1). In recent years the number of heroin seizures has also been declining, with the lowest number of heroin seizures reported in 2012 (1). In 2010 the quantity of heroin seized was the lowest amount since 1995 (832 kg), while in 2011 the quantity seized increased to 1 968 kg then dropped to 831 kg in 2012 (1).
Following a decline in the number of ecstasy tablets seized since 2006, the figure almost doubled in 2011 in comparison to 2010, but dropped again in 2012 (1). Following a reduction in the quantity of amphetamines seized in 2010 (983 kg), an increase was reported to 1 192 kg in 2011 and 1 491 kg in 2012 (2).
Look for Drug law offences in the Statistical bulletin for additional data.
National 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, C) based on harm, with Class A being the most harmful. These classes 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 have been introduced through the Police Reform and Social Responsibility Act 2011 to give a faster legislative response to new psychoactive substances.
Under the Misuse of Drugs Act, 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.
Go to the European Legal Database on Drugs (ELDD) for additional information.
National drug strategy
Launched on 8 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.
Coordination mechanism in the field of drugs
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
|COFOG classification a ||Labelled expenditure |
(thousand EUR) b
|% ||Unlabelled expenditure |
|% ||Total expenditure |
|% of total c |
|(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 |
|1 132 495 |
| ||7 303 694 |
| ||8 436 189 |
|% of total expenditure c || ||13.4 |
| ||86.6 |
| ||100 |
|% of GDP c || ||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.
See Drug-related research for more detailled information.
Key national figures and statistics
b Break in series.
p Eurostat provisional value.
b Break in series.
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, 2012.
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 ||64 308 261 ep ||506 824 509 ep |
|Population by age classes ||15–24 || 2014 ||12.7 % ep ||11.3 % bep |
|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 || 2013 ||109 ||100 ||Eurostat |
|Total expenditure on social protection (% of GDP) 2 ||2012 ||28.8 % p ||29.5 % p ||Eurostat |
|Unemployment rate 3 || 2014 ||6.1 % ||10.2 % ||Eurostat |
|Unemployment rate of population aged under 25 years || 2014 ||16.9 % ||22.2 % ||Eurostat |
|Prison population rate (per 100 000 of national population) 4 || 2013 || |
99.6 (Northern Ireland)
147.2 (England and Wales)
| : ||Council of Europe, SPACE I-2013 |
|At risk of poverty rate 5 || 2013 ||15.9 % ||16.6 % ||SILC |
Data sheet — key statistics on the drug situation
| || || || ||EU range || || || |
| ||Year || ||Country data ||Min. ||Max. ||Average ||Rank ||Reporting Countries |
|Opioids || || || || || || || || |
|Problem opioid use (rate/1 000) ||2010-11 ||1 ||8.06 ||0.2 ||10.7 || ||21 ||21 |
|All clients entering treatment (%) ||2013 || ||50.3% ||6% ||93% || || || |
|New clients entering treatment (%) ||2013 || ||19.7% ||2% ||81% || || || |
|Purity — heroin brown (%) ||2013 || ||33.0% ||6% ||42% || ||22 ||24 |
|Price per gram — heroin brown (EUR) ||2013 || ||EUR 63 ||EUR 25 ||EUR 158 || ||17 ||22 |
| || || || || || || || || |
|Cocaine || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 ||2 ||5.0% ||1% ||5% || || || |
|Prevalence of drug use — young adults (%) ||2012-13 ||3 ||4.2% ||0% ||4% ||2% || || |
|Prevalence of drug use — all adults (%) ||2012-13 ||3 ||2.4% ||0% ||2% ||1% ||26 ||26 |
|All clients entering treatment (%) ||2013 || ||12.9% ||0% ||39% || || || |
|New clients entering treatment (%) ||2013 || ||17.1% ||0% ||40% || || || |
|Purity (%) ||2013 || ||38.0% ||20% ||75% || ||12 ||27 |
|Price per gram (EUR) ||2013 ||4 ||EUR 50 ||EUR 47 ||EUR 103 || ||3 ||24 |
| || || || || || || || || |
|Amphetamines || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||4.0% ||1% ||7% || || || |
|Prevalence of drug use — young adults (%) ||2012-13 ||3 ||1.5% ||0% ||3% ||1% || || |
|Prevalence of drug use — all adults (%) ||2012-13 ||3 ||0.8% ||0% ||1% ||1% ||22 ||25 |
|All clients entering treatment (%) ||2013 || ||2.7% ||0% ||70% || || || |
|New clients entering treatment (%) ||2013 || ||2.8% ||0% ||22% || || || |
|Purity (%) ||2013 || ||7.0% ||5% ||71% || ||2 ||25 |
|Price per gram (EUR) ||2013 ||4 ||EUR 13 ||EUR 8 ||EUR 63 || ||10 ||21 |
| || || || || || || || || |
|Ecstasy || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||4.0% ||1% ||4% || || || |
|Prevalence of drug use — young adults (%) ||2012-13 ||3 ||3.0% ||0% ||3% ||1% || || |
|Prevalence of drug use — all adults (%) ||2012-13 ||3 ||1.6% ||0% ||2% ||1% ||25 ||25 |
|All clients entering treatment (%) ||2013 || ||0.3% ||0% ||2% || || || |
|New clients entering treatment (%) ||2013 || ||0.7% ||0% ||4% || || || |
|Purity (mg of MDMA base per unit) ||2012 || ||102 mg ||26 mg ||144 mg || ||19 ||23 |
|Price per tablet (EUR) ||2013 ||4 ||EUR 4 ||EUR 3 ||EUR 24 || ||2 ||19 |
| || || || || || || || || |
|Cannabis || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||25.0% ||5% ||42% || || || |
|Prevalence of drug use — young adults (%) ||2012-13 ||3 ||11.2% ||0% ||22% ||12% || || |
|Prevalence of drug use — all adults (%) ||2012-13 ||3 ||6.6% ||0% ||9% ||6% ||22 ||27 |
|All clients entering treatment (%) ||2013 || ||26.8% ||3% ||63% || || || |
|New clients entering treatment (%) ||2013 || ||48.6% ||5% ||80% || || || |
|Potency — herbal (%) ||: || ||: ||2% ||13% || || || |
|Potency — resin (%) ||: || ||: ||3% ||22% || || || |
|Price per gram — herbal (EUR) ||2013 ||4 ||EUR 4 ||EUR 4 ||EUR 25 || ||1 ||19 |
|Price per gram — resin (EUR) ||2013 ||4 ||EUR 4 ||EUR 3 ||EUR 21 || ||2 ||21 |
| || || || || || || || || |
|Prevalence of problem drug use || || || || || || || || |
|Problem drug use (rate/1 000) ||2009-12 ||5 ||9.16 ||2.0 ||10.0 || || || |
|Injecting drug use (rate/1 000) ||2004-11 ||6 ||3.0 ||0.2 ||9.2 || || || |
| || || || || || || || || |
|Drug-related infectious diseases/deaths || || || || || || || || |
|HIV infections newly diagnosed (rate/million) ||2013 || ||1.8 ||0.0 ||54.5 || || || |
|HIV prevalence (%) ||: ||7 ||: ||0% ||49% || || || |
|HCV prevalence (%) ||: ||7 ||: ||14% ||84% || || || |
|Drug-related deaths (rate/million) ||2013 || ||30.5 ||1.5 ||84.1 || || || |
| || || || || || || || || |
|Health and social responses || || || || || || || || |
|Syringes distributed ||2013 || ||9 457 256 ||124 406 ||9 457 256 || || || |
|Clients in substitution treatment ||2007-13 || ||172 513 ||180 ||172 513 || || || |
| || || || || || || || || |
|Treatment demand || || || || || || || || |
|All clients ||2013 || ||101 753 ||289 ||101 753 || || || |
|New clients ||2013 || ||35 229 ||19 ||35 229 || || || |
|All clients with known primary drug ||2013 || ||99 186 ||287 ||99 186 || || || |
|New clients with known primary drug ||2013 || ||34 524 ||19 ||34 524 || || || |
| || || || || || || || || |
|Drug law offences || || || || || || || || |
|Number of reports of offences ||2013 || ||138 456 ||429 ||426 707 || || || |
|Offences for use/possession ||2013 || ||89 291 ||58 ||397 713 || || || |