Country overview: United Kingdom
- Situation summary
- Drug use among the general population and young people
- High-risk drug use
- Treatment demand
- Drug-related infectious diseases
- Drug-induced deaths and mortality among drug users
- Treatment responses
- Harm reduction responses
- Drug markets and drug-law offences
- National drug laws
- National drug strategy
- Coordination mechanism in the field of drugs
- Public expenditure
- Drug-related research
|Year||EU (28 countries)||Source|
|Population||2013||63 896 071||505 665 739 ||Eurostat|
|Population by age classes||15–24||2013||12.9 %||11.5 % ||Eurostat|
|25–49||34.2 %||35.0 % |
|50–64||18.1 %||19.7 % |
|GDP per capita in PPS (Purchasing Power Standards) 1||2012||106||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2011||27.3 %||29.0 % p||Eurostat|
|Unemployment rate 3||2013||7.5 %||10.8 %||Eurostat|
|Unemployment rate of population aged under 25 years||2013||20.5 %||23.4 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2012|| |
97.6 (Northern Ireland)
152.1 (England and Wales)
|:||Council of Europe, SPACE I-2012|
|At risk of poverty rate 5||2012||16.2 % b||17.0 % e||SILC |
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).
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), 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 2012/13 CSEW, conducted among people aged 16–59, showed that 35.9 % of respondents had tried any illicit drug at least once in their lives. Lifetime prevalence of cannabis use was 30 %; amphetamines 10.6 %; cocaine 9.0 %; ecstasy 8.3 %. In 2012/13 last year prevalence of cannabis use was reported to be 6.4 %, indicating a steady decline in cannabis use since 2003/04 survey (small increases were observed prior to this point). The prevalence was higher among 16- to 34-year-olds, of whom 35 % reported ever using cannabis, while 10.5 % had used it in the last 12 months. Current cannabis use was not measured by the study. It is noticeable that last year drug use amongst males was twice as high as amongst females. From 1996 there was an increase in cocaine use until the 2008/2009 survey, and although it subsequently decreased it is still the second most frequently used drug among 15- to 34-year-olds (at 11.9 %). Recent cocaine use is more prevalent among 25- to 34-year-olds, and the trend has been stable since 2002/03, whereas among the 16–24 age group the trend has decreased over this period of time. A decrease in amphetamine use is observed since 1996. In the 2012/13 CSEW 0.5 % of respondents reported use of mephedrone in the last 12 months, a decrease from 1.1 % in 2011/12 and 1.4 % in 2010/11. Among 16- to 24-year-olds mephedrone use decreased from 4.4 % in 2010/11, to 3.3 % in 2011/12, to 1.6 % in 2012/13.
In 2010/11, in Scotland, the SCJS shows that 29.2 % of people aged 16–64 had tried any illicit drug at least once in their lives. Lifetime prevalence of cannabis use was 26.7 %, followed by amphetamines at 9.8 %, hallucinogens at 9.3 % and ecstasy at 9.0 %. Among 15- to 34-year-olds lifetime prevalence rates were higher — thus 37.1 % respondents reported ever using cannabis, while 14 % had tried cannabis in the last 12 months and 7.4 % in the last month. Lower prevalence of any illicit drug use (27.3 %) was reported in Northern Ireland, based on the 2010/11 NIDPS among 15- to 64-year-olds, with cannabis reported as the most commonly ever used drug at 24 %, while 32.2 % of those aged 15–34 had ever used cannabis, 9.4 % had used it in the past 12 months, and 2.7 % in the last month.
A school survey of drug use among students aged 11–15 has been undertaken annually in England since 1998. The latest available data is from 2012. 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 2010. In Scotland the Scottish Schools Adolescent Lifestyle and Substance Use Survey 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) study provides data for students aged 15–16 every four years, and the latest study was completed in 2010/11.
In England, based on the school survey, lifetime prevalence of any drug among students aged 11–15 was 17.1 % in 2012, last year prevalence was 11.9 % and last month prevalence was 6.5 %, 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, rose 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 22.5 % in 2012. 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 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.
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.
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 resilient young people, and most schools have a drug education policy and guidelines on dealing with drug incidents. Often, drug prevention is delivered within the wider non-statutory personal social and health education agenda and addresses both licit and illicit substances. A recent survey, however, found that education on substance abuse prevention is applied inconsistently, and in many instances the implementation is hampered by lack of time and financial resources; provision is currently being reviewed. In Scotland an online education programme, Choices for Life, is used to give young people credible information on drugs and also allows teachers and other educators to exchange prevention practices.
The Government has prioritised the early identification of at-risk children and families and the provision of suitable interventions, and aims to provide a focused approach to the needs of the family as a whole and a tailored support service, through their Troubled Families programme, which will be expanded further from 2015. A package of interventions is proposed, including: 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. 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, and youth in deprived neighbourhoods, through special programmes at the community level. The Positive Futures scheme in England and Wales engages young people at risk and provides them with employment, education and training opportunities, while the Choices programme, funded by the Home Office in 2011/12 and evaluated in 2013, aimed to enhance the ability of the voluntary and community sector to develop effective local activities for the prevention and reduction of drug use among young people. The Choices programme involved 11 national voluntary and community sector organisations working with around 190 local voluntary organisations and engaging over 10 000 young people. The interventions delivered through Choices included: mentoring and peer mentoring; intensive support; one-to-one brief interventions; motivational interviewing; the use of arts, media, work and sports based activities to enhance protective factors and build resilience; prevention interventions for young people affected by parental substance misuse and for those on the edge of statutory interventions in relation to substance misuse and related offending. Integrated Family Support Services, available across the majority of Wales, provide support for families with parental substance misuse issues.
With regard to indicated prevention, there are early interventions to target future offenders when problems such as truancy, bad behaviour in school or contact with the police first occur.
In 2013 an Alcohol and Drug Education and Prevention Information Service was launched to further develop advisory services on best practice and an evaluation database in prevention.
View ‘Prevention profile’ for additional information.
Up to 2012 the EMCDDA defined problem drug use as injecting drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis were not included in this category. 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 problem cocaine powder use. Estimates are mostly obtained through capture–recapture and/or multiple indicator methods, as is appropriate for the data concerned. The United Kingdom is currently reviewing its approach to combining problem drug use estimates.
Latest estimates for the United Kingdom (2004–11) suggest that there were 330 455 high-risk opioid users (range: 324 048 to 342 569), which corresponds to a rate of 8.06 (range: 7.91 to 8.36) per 1 000 inhabitants aged 15–64. It was estimated that there were about 122 894 injecting drugs users (range: 117 370 to 131 869), or 3.0 per 1 000 inhabitants aged 15–64 (range: 2.86 to 3.22).
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.
Treatment demand data for the United Kingdom are collected from outpatient (1 418) and inpatient (139) treatment centres, and general practitioners (148, all in England). In 2011/12 a total of 113 814 clients entered treatment, of which 43 110 were new clients admitted to treatment for the first time. It is estimated that the number entering treatment during the year represented just under half the number of those in drug treatment during 2011/12.
In 2011/12 opiates were the most reported primary drug among all treatment clients at 56 %, followed by cannabis at 22 % and cocaine at 13 %. Among new treatment clients the primary substance of use was cannabis at 37 %, followed by opiates at 33 % and cocaine at 17 % (1). About 21 % of all treatment clients and 13 % of new treatment clients reported injecting their primary substance of abuse.
In 2011/12 some 39 % of all treatment clients were over the age of 35, compared to 30 % of new treatment clients; 25 % of all treatment clients and 61 % of new treatment clients were aged 25 and under. With regard to gender distribution, 74 % of all treatment clients were male and 26 % were female. The same distribution was reported among new treatment clients.
(1) Cocaine data refers to both cocaine powder and crack cocaine users. In 2011/12 some 8.0 % of all treatment clients and 12.9 % of new treatment clients indicated their primary substance of use was cocaine powder, while 4.6 % of all treatment clients and 4.0 % 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 injectors monitors blood-borne virus prevalence among current and former PWID attending drug services in England, Wales and Northern Ireland. The Centre for Research on Drugs and Health Behaviour has conducted surveys of PWID recruited in community settings, and the Scottish Centre for Infection and Environmental Health (SCIEH) surveys the prevalence of blood-borne infections among PWID attending drug services in Glasgow. SCIEH also holds anonymised epidemiological data on everyone who has had a named human immunodeficiency virus (HIV) antibody test in Scotland since 1989. This database provides HIV prevalence data for everyone undergoing a named HIV test, including those who indicate that they had injected drugs. 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 2012 there were 111 HIV diagnoses where infection was thought to have been acquired through injecting drug use. In England and Wales, of those participating in the 2012 UAM survey, HIV prevalence was 1.3 %, while no HIV was detected among tested PWID in Wales and Northern Ireland in 2012. The latest available data from Scotland indicates HIV prevalence at 0.3 % among tested PWID in 2011. In 2012 some 1 617 HIV-infected PWID were seen for HIV-related treatment or care in the United Kingdom. In 2012 some 88 % of people who were HIV positive and had been recommended to start antiretroviral treatment received it.
The prevalence of hepatitis C virus (HCV) infection amongst PWID remains relatively high. In 2012 the prevalence of antibodies to HCV among PWID in England and Wales was 47.9 %, indicating an overall increasing trend since 2001. 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 33.9 %, while estimated prevalence among clients of the Scottish Needle Exchange Surveillance Initiative (NESI) in 2011–12 was 53.0 %. The prevalence varies not only according to region, but also to other risk factors such as age and duration of injecting. There has also been evidence of increased incidence, especially among new injectors.
Prevalence of hepatitis B virus (HBV) antibodies among PWID has steadily declined since the early 2000s, and in 2012 the rate varied by country between 5.8 % and 17.1 %, the lowest being for Northern Ireland and the highest for England and Wales. The decline is partly attributed to increased uptake of the HBV vaccine among injecting drug users in England, Wales and Northern Ireland from 43 % in 2002 to 75 % in 2012.
The level of needle/syringe sharing reported by PWID in the UAM survey in England, Wales and Northern Ireland has decreased from 34 % in 2002 to 14 % in 2012. These declines have occurred during a period when needle and syringe provision in the United Kingdom has been expanding; however, further expansion is needed.
With regard to other drug-related infectious disease, a number of outbreaks and sporadic cases of anthrax and wound botulism were reported in 2012–13. The epidemiological analysis indicates that contaminated heroin batches were a likely cause of clustered outbreaks, while the presence of spores in the drug supply or environment might be responsible for sporadic cases.
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, and the latest data are for 2011. 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 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 previous 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 to 2001, fell from 2001 to 2003, increased to the highest level of 2 231 in 2008, then decrease year by year to 1 666 in 2012. In 2012 three-quarters of victims were males. The mean age of the victims was 41.4 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 2008, in total, 2 569 cases were recorded, while in 2009 the number dropped to 2 481 and continued to fall in 2012 to 2 152. Opioids (chiefly heroin/morphine and methadone) were mentioned on the death certificate in around 83 % of these death cases. In absolute numbers there was a drop in heroin-related deaths in 2011, and the level remained stable in 2012. With regard to methadone, after an increase in the number of deaths mentioning methadone in 2011, the following year indicated a drop in the absolute number.
The drug-induced mortality rate among adults in the United Kingdom (aged 15–64 years) was 38.3 deaths per million in 2012, more than twice the European average of 17.1 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. 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 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.
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, detoxification and residential rehabilitation, and aftercare and relapse-prevention programmes. In England, a report 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.
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 main 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 drug of choice 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 substitution treatment were: 607 in Northern Ireland in 2010/11; 22 224 received methadone treatment in Scotland in 2006/07; 146 100 received a prescribing intervention in England; and 2 151 in Wales in 2011/12.
View ‘Treatment profile’ for additional information.
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.
Needle and syringe exchange is offered by a wide range of facilities, including specialist drug treatment facilities, detached street outreach and mobile van units and pharmacies. 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 5 207 100 for Wales in 2012/13; 3 946 000 for Scotland in 2011/12; and 214 550 for Northern Ireland in 2012/13.
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 that its provision is part of structured efforts to engage drug users in recovery-oriented treatment, with monitoring arrangements put in place.
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.
The overall picture of drugs distribution appears increasingly complex and diverse. Many traffickers import and distribute more than one type of drug. London, Birmingham and Liverpool 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 drug supplies into Wales.
Although Afghanistan remains the main producer of opiates in the world, almost all seizures of heroin at the United Kingdom border are made from consignments originating in Pakistan. Since 2010 supplies of heroin to the United Kingdom from Afghanistan via Iran, Turkey and the European Balkan route have reduced. The seizures indicate that the supply from Pakistan is sent via air freight, fast parcels and the postal service. There are also indicators that east Africa is developing as a key nexus point for heroin sourced from Pakistan. However the Netherlands and Belgium still remain important transit points for trafficking to the United Kingdom via large goods vehicles and ferries. Peru, Colombia and Bolivia continue to produce the vast majority of the global supply of cocaine. Shipments are trafficked to Europe via a variety of means, including by air and sea, either directly from Latin America or via the Caribbean and West Africa. Near Europe remains a major threat for cocaine importation to the United Kingdom. Substantial quantities of cannabis resin and herbal cannabis continue to be imported into the United Kingdom. Morocco, via the Iberian Peninsula, is the primary source of cannabis resin and herb for the United Kingdom market. However, there is an indication of cannabis trafficking via air freight from South Africa (mainly originating in Afghanistan) and the Caribbean (mainly from Jamaica). There has been a move away from large-scale cannabis cultivations to smaller production, especially in living rooms, smaller houses and flats. In 2010/11 a total of 7 660 cannabis farms were discovered in the United Kingdom. Amphetamine-type stimulants are the main synthetic drugs trafficked to the United Kingdom, with China and India as the countries of origin for the majority of these substances.
In 2012 some 134 241 convictions or cautions for drug offences were reported in England and Wales. Of those offences where a drug was known, 62.5 % were cannabis-related, 14.9 % cocaine-related and 8.4 % heroin-related. In addition, there were 86 830 formal warnings for cannabis or penalty notices for disorder issued for cannabis possession in England and Wales, with the most noticeable decrease in the number of formal warnings for cannabis possession.
Cannabis is the most seized drug in the United Kingdom. In 2012 (2) some 13 432 kg of cannabis resin, 13 243 kg of herbal cannabis and 555 652 cannabis plants were seized. In 2012 some 3 324 kg of cocaine was seized (2). In recent years the number of heroin seizures has been declining, with the lowest number of heroin seizures (10 624) reported in 2012 (2). 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 (2). 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 (2). Following a reduction in the quantity of amphetamines seized in 2010 (983 kg), an increase was reported to 1 192 in 2011 and 1 491 in 2012 (2).
(2) 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 in 2006 is for 2006/2007, data reported in 2007 is for 2007/2008, data reported in 2008 is for 2008/09, data reported in 2009 is for 2009/10, data reported in 2010 is for 2010/11, data reported in 2011 is for 2011/12 and data reported in 2012 is for 2012/13).
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 a summary one made at a magistrates’ court or one 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. In 2000 a minimum sentence of seven years was introduced for a third conviction for trafficking in Class A drugs.
View ‘Legal profile’ for additional information.
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 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.
View ‘National drug strategies’ for additional information.
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. Overall, the Drug Strategy is governed by the Home Affairs, Public Health and Social Justice Committees. Implementation of the Strategy is governed by three overarching groups: the Inter-Ministerial Group on Drugs; the Drug Strategy Group; and the Drug Strategy Implementation Group. 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 challenge 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.
Authorities have funded three studies on economic and social costs, in 2002, 2006 and 2013 (3,4). Between 2005 and 2010, labelled expenditure was estimated every year through administrative records, but unlabelled expenditure was rarely available (5).
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 (6). 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. This was mainly as a result of the mainstreaming of certain grants and a reduction in expenditure on counter-narcotics work in Afghanistan. Budgets for large expenditure items such as drug treatment have seen funding levels maintained in cash terms.
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.
The decentralisation of public spending, implemented in 2013, could make it more difficult to estimate drug-related expenditure in the United Kingdom as drug budgets become more integrated with wider public health budgets, local areas take more responsibility for dealing with the drug problem and interventions become more focused on early preventive policies.
(3) L. Gordon, L. Tinsley, C. Godfrey and S. Parrott (2006), ‘The economic and social costs of Class A drug use in England and Wales, 2003/04’, in N. Singleton, R. Murray and L. Tinsley (eds), Measuring different aspects of problem drug use: methodological developments, Home Office Online Report, Home Office, London.
(5) Some of the funds allocated by governments for expenditure on tasks related to drugs are identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled drug-related expenditures.
(6) Public expenditure is classified according to purpose, using the Classification of the Functions of Government (COFOG).
View ‘Public expenditure profile’ for additional information.
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 2013 United Kingdom National report include all areas of research but mainly focus on aspects related to responses to the drug situation and the consequences of drug use. Research on drug use prevalence and on supply and markets is also widely available.
View ‘Drug-related research’ for additional information.